14 August 2006

The Ice Age is Coming

By 'Delia Venus Wynn'

Over the last few months, the media has become increasingly rabid about a 'new' drug arriving on our shores. As always it has been demonized as the beginnings of the worst drug epidemic in history. Methamphetamine (ice) is becoming the new drug bogey man.

Much has been written about methamphetamine, a great deal of it inaccurate, some just total fantasy but some is all too true.

So what is really going on? With access to major manufacturers, dealers and users I will try to delve below the media froth, and explore the real UK position. This in turn highlights how enforcement and Government Agencies can minimize the risks posed by this new challenge.

The United States' Experience of Meth Production:

The majority of the US market is supplied by large-scale labs, principally in Mexico, California and, to a lesser extent Texas, but a significant proportion comes from what the DEA term 'Mom & Pop' laboratories. Mom & Pop manufacturers use their garden shed, garage or kitchen to make relatively small batches (between 10 & 50 grams) on a 3-4 day cycle. They won't get rich, but to some it looks like an easier life than getting a McJob!

Methamphetamine is not primarily derived from a plant source so unlike heroin or cocaine, it doesn't necessarily require long supply routes. This has in turn made it especially popular in less accessible markets, such as New Zealand, where home grown methamphetamine production is an easier undertaking than importation of, for example cocaine.

Unlike many other forms of drug synthesis, methamphetamine is, in reality, relatively straightforward. Critically, precursor chemicals are more readily available than is the case with most street drugs. Your local pharmacist sells over-the-counter cold medication that contains a healthy amount of the precursor (a £3.50 box of tablets is enough to make about ¾ of a gram of pure methamphetamine which could be sold for £50-£80.

That isn't to say that production from plant precursors isn't also feasible. South East Asian suppliers obtain Ephedrine from Ephedra Sinica, a hardy shrub which has been used in Chinese herbal medicine for 5000 years. These traditional growers extract the ephedrine which can be easily converted to methamphetamine using very basic chemicals.

The relative ease with which precursors can be obtained has been exacerbated by the growth of the Internet, which makes both recipes and sources of precursors easy to find. Key chemicals used in common production processes are available cheaply on-line, although some of these may, in turn, be sting operations run by enforcement agencies.

As the chemicals in question are not on watch-lists for precursor chemicals, such companies will be able to act with impunity unless the licensing laws relating to these compounds is changed or it is possible to prove that they are being supplied with the intention of manufacturing a controlled drug.

UK methamphetamine is currently imported either from the Far East (Yaba, made from ephedrine extracted from the Ephedra Viridis shrub) or from former Ecstasy manufacturers (mainly based in The Netherlands or Belgium) who have switched from MDMA production to the more profitable methamphetamine.

The simple replacement of PMK (piperonyl methyl ketone) for BMK (benzyl methyl ketone) is all that the chemist has to do. The reaction is identical in all other respects, so they are ideally placed to make the switch.

It is interesting to note that within The Netherlands the black market price for BMK is now higher than that of PMK.

The effects of methamphetamine are similar to amphetamine (speed) but four times stronger weight for weight and with a significantly longer duration of action. In addition, methamphetamine can be smoked like crack and has a similar rush. The difference is that while a crack high lasts for ten minutes or so, the methamphetamine high lasts for eight hours and is qualitatively very similar.

This makes it a more economical drug for those looking for a powerful stimulant high.

Methamphetamine can be smoked, snorted, swallowed or injected. This makes it a very versatile drug. Whatever method of ingestion a user is familiar with, they can take methamphetamine in the same way. This makes it relatively easy to market. The downside is a much bigger crash, so heavy users seek to repeat dosing to avoid this event, often for days and weeks at a time. The crash from a single dose begins at the 8 hour mark and lasts for a further 8 to 16 hours. With chronic usage, the crash can last a week or more.

Meth Trends:

Recent reports from the US have shown that methamphetamine is not the national epidemic that the media suggests, but is very prevalent in certain urban areas. For example, in these areas, the proportion of males testing positive for methamphetamine on arrest, according to the DEA newsletter 'Microgram' are as follows:

Phoenix 38.3%
Los Angeles, 28.7%
Portland, Oregon 25.4%
San Diego 36.2%
San Jose, California 36.9%.

Nationally, however, just 5 percent of men who had been arrested were found to have methamphetamine in their systems. By contrast, 30 percent tested positive for cocaine and 44 percent for marijuana (although it should be noted that cannaboids will show up in modern drug tests for weeks).

These figures seem to indicate that methamphetamine is nowhere as popular as say, crack, probably because of its long duration and horrible crash. Also, as users become tolerant, users are likely to take larger and larger doses to obtain the same high so methamphetamine looks increasingly less like a "cheap" drug.

Lessons Learned and Early Interventions:

The experience of the US, Australia and elsewhere is certainly that methamphetamine can and does have a massively damaging physical and psychological effect on users, and causes huge collateral damage to users.

However, the US experience has not been that the drug became a widespread 'foundation' drug in the same way that heroin has. Instead, it springs up in concentrated, but highly damaging pockets.

Indeed, evidence suggests a significant decrease in methamphetamine use in the States with estimates that use has diminished 30% since 2001.

Some factors that may have contributed to this include:

1) Heavy ongoing use of methamphetamine is less feasible than with most other drugs due to the serious physical and mental health problems that are likely to stem from it and the increase in tolerance. So use tends to be sporadic and bingeing (similar to a crack 'mission') rather than ongoing for sustained periods of time.
2) Many areas of the US are only supplied irregularly (mom & pop producers are frequently caught) so finding a steady supply remains difficult.
3) With a longer time-frame of problematic use, education and awareness messages in the US and elsewhere are more widespread. With families and friends of users having direct experience of the effects of the drug, and in turn with these being translated in to education, there is a higher level of awareness, and in turn resistance, than in the UK. The extent to which mainstream US TV shows such as CSI and ER routinely feature methamphetamine story-lines highlights the extent to which awareness of the drug (but in turn the 'glamour' too) has been absorbed by the media.
4) Efforts to clamp down on precursor chemicals, including decongestants, have had significant impact on areas where supply was reliant on local production rather than imports.

Of course, only the heavy users come to light via law enforcement agencies and drug support agencies. There is, no doubt, a large number of users (students, truck drivers and so on) using it to allow them to keep working, rather than for recreational purposes. These users take far less and so decrease risk of detection. It is also worth pointing out that a great many US employers and educational establishments have introduced a mandatory random drug test policy which may have a deterrent effect on many potential users.



View from the UK Street:

Currently, the market in Manchester, UK, is just starting to see the drug being sold in two specific markets. Firstly, the Gay scene (centered on Canal Street) has a small but expanding market of recreational users who love the energy giving, inhibition losing effects which also boost sexual drive (initially at least). It allows people to make use of the whole weekend from Friday evening until Sunday morning. As with heavy use of other stimulants, afternoons and evenings are for comedowns, typically aided with alcohol or increasingly anxiolytics such as un-prescribed benzodiazepines. The main risk to these users is unprotected sex due to the lack of inhibitions and increased sex drive. If the U.S. experience is any kind of indicator, the rate of STDs amongst these users will increase quite drastically.

The second group of users is likely to form the bulk of drug workers' caseload. We are beginning to see a marketing campaign strongly reminiscent of the introduction of crack. Dealers are offering 2 points of brown and 1 of methamphetamine for £20. Now crack is established, with some crack users not using much, if any heroin, the dealers are hoping to use methamphetamine for several reasons.

· Methamphetamine is highly addictive, requiring increasingly larger doses to get the same high, resulting in larger sales.
· The over stimulation caused by methamphetamine over long periods mean that instead of needing 1 point of heroin to balance 1 point of crack, a user is likely to find that they need two or three points of brown to balance 1 point of methamphetamine.
· Users who have not taken heroin may also be tempted to indulge to offset the comedown.
· Dealers are also likely to sell increasingly large amounts of tranquillizers. With Valium & Xanax available on the internet for pence rather pounds per pill and currently being imported from Eastern Europe in large quantities, the dealers are able to sell them at increasingly high prices to 'tweaked' users desperate for something to help them unwind.

On a personal note, having tried the drug, it does seem like only hardened drug users would contemplate imbibing this compound regularly. Its extreme physical and mental effects mean that only people who find extremely potent stimulant use pleasurable would enjoy the effects. It is also interesting that within the US, there are still clandestine laboratories producing plain amphetamine, so it seems reasonable to assume that some people, at least, prefer the weaker (safer) compound.

The next steps:

Uniquely, the UK is in a good position to respond proactively to methamphetamine as we have had fair warning that the drug is likely to start entering the UK in significant quantities or start to be produced here.

The decision to move the methamphetamine from Class B to Class A should provide the required impetus to develop effective responses. Given the rapidity that crack cocaine achieved massive market penetration, it seems likely that methamphetamine would follow the same route and achieve a wide market distribution quickly, following the same supply lines and getting in via the heroin market and sex-worker markets. So developing effective responses now is essential.

This will require responses from law-enforcement and drugs agencies and would ideally include the following:

· Prevention of UK-based production: this will require reformulation and greater control of OTC medicines containing precursor chemicals, and more robust licensing to prevent the sale of additional chemicals used in the production cycle.
· Effective monitoring of importation routes.
· Targeted education messages to high risk populations, especially clubbers, the gay scene, and heroin or crack users being targeted by suppliers.
· Effective training of drugs workers to be aware of methamphetamine and the role of therapies such as CBT in working with methamphetamine users
· Local monitoring of methamphetamine trends to provide early warning of increased use.
· Closer examination of the experience of other countries' models of control and treatment, especially those with extensive experience of responding to methamphetamine.

Conclusions:

Methamphetamine does represent a new and significant risk to drug users and the communities in which they live. Drugs agencies, mental health services and the criminal justice system are likely to see users presenting with a collection of drug and health related needs.

However, if the experience of other countries, especially the U.S. holds true, methamphetamine is unlikely to become as uniformly widespread as heroin or crack due to the deeply unpleasant side-effects. In the short term, the levels of use are likely to expand rapidly. This expansion could be reduced through effective control and education strategies.

Without wishing to be complacent, it may well be that, after reaching a peak within the next five years or so, levels of use will drop off as older users move away from the drug and the next generation reject a drug which perhaps offers too much of a high and too much of a crash.

Last edited 28/6/06

Delia Venus Wynn is a pseudonym; the author is a former manufacturer and user of a large range of compounds. Delia is now working towards a professional career in the other side of the drugs field.

Edited, and additional material added by Kevin Flemen/KFx

A shorter version of this article was published in Drink and Drug News.

Right of Reply/Comment:

KFx was contacted by a senior professional in the Manchester area following publication of the above article. They made the following comment which we wanted to post here as it challenges the content of the above article and we are always keen to maintain balance and debate.:

>>>>"I've been asking around with our sources (very reliable) and as yet there appears to be virtually no methamphetamine available in Greater Manchester. This would apply to both the scene around Canal St. and amongst users at our needle exchanges. There was one arrest earlier this year but as far as we are aware of no evidence of an organised market.." [comment received 28.9.06]