As
those who have participated in the KFx NPS training course over the past
couple of years will know, the course spends some time looking at
responses to Synthetic Cannabinoid Receptor Agonists (SCRAs, Spice,
Mamba.)
For several months before the Psychoactive Substance Act
came in to force there was an urgent need to plan for what could happen
once the PSA was enacted.
The course stressed that there would
be dumping of residual stocks, as on-line suppliers and head-shops got
rid of prohibited stock and, as had happened with ever NPS before it, it
ended up sold via the street market.
The course also stressed that
agencies needed to prepare for what could happen yet. There was an
urgent need to get treatment protocols and pathways in place so that
those who had become dependent on SCRAs could access treatment. Agencies
needed to start this process before SCRAs were banned. The development
of care pathways and proactively engaging with dependent SCRA users was
an essential measure and given the looming enactment of the PSA, a
time-limited one.
The risk of not acting ahead of the
prohibition was that dependent users, unable to access appropriate
treatment, would self-medicate using other substances. All too
predictably, this has started to happen in a number of areas. Numerous
participants on training courses across the UK have recounted cases of
dependent SCRA users drifting to heroin or other opiates to stave off
their opiate-esque withdrawal symptoms. The same trend was picked up by
Max Daly writing for Vice.
Concerned about the lack of tools and
resources for working with SCRA dependency, the existing Cannabis Dependency Toolkit on the KFx website was adapted to reflect SCRA
dependency. The SCRA Dependency Toolkit has proved popular with a number
of workers to prompt discussion about SCRAs and start the process of
addressing dependency and promoting change.
The area that still
needed to be addressed was how to respond effectively to physical
dependency, specially where pharmacological interventions were
indicated.
The only significant report on the management and
treatment of SCRAs was produced by Project Neptune and the section on SCRAs republished separately in 2016.
The report has very little concrete information on treatment of withdrawal symptoms, saying only:
“No
specific medications are indicated for SCRA harmful use or
dependence and no substitute prescribing is currently available.
Symptomatic management of withdrawal symptoms may be indicated in some
cases.”
In the absence of clear direction, piecemeal resources
have emerged but haven’t been evaluated, reviewed or been shared with
wider audiences. Medical responses have included Buscopan or
phenothiazine for nausea. However misuse of Buscopan in custodial
settings has increased wariness of using antihistamines in such settings
and measures such as peppermint oil have been trialed.
At least
one prison treatment prescriber used their initiative and used
Pregabalin with some success, until told by senior management not to
continue as the medicine was not licensed for this purpose. In other
settings, benzodiazepines (such as chlordiazepoxide) have been used.
In
a contemporary drugs field where centralized agencies work slowly to
national protocols and “evidence-based treatments” can take an age to
emerge, we have been left with too little concrete on offer.
When
resources like the BMJ's infograph on NPS don’t even make mention of
physical withdrawal symptoms, it can hardly be a surprise that GPs and
treatment workers may miss the link between presenting symptoms to SCRA
withdrawal and prescribe accordingly.
This ongoing void is
increasingly dangerous. Some drugs agencies have stated (both publicly
and to dependent users) that it would be easier to work with them if
they were using heroin as there would then be a clear treatment
protocol. Given such messages from helping agencies, it can hardly be
surprising that dependent, unsupported users have done just that.
Following
numerous courses in Kent and elsewhere, and after discussion with a
number of agencies, there was a clear need for an additional resource to
complement the SCRA Dependency Toolkit. The initial idea was for a
Severity of Withdrawal index. This would follow on from the dependency
toolkit: for those identified as having a physical or psychological
dependency, a more detailed exploration of their symptoms could take
place. The second stage of this would be a tiered collection of
interventions ranging from holistic to inpatient treatment, with
potential pharmacological interventions for different presenting
symptoms.
On the back of one such discussion, as the tool was
being discussed, participants on courses were discussing potential
treatments. One we kept coming back to was Mirtazapine. It seemed that
it had the potential to address several key issues including craving,
sleep disruption, nausea, appetite loss, anxiety and neural pain. It
also had an advantage of being less prone to and risky from a misuse
point of view, especially when compared to Pregabalin which also could
be useful in managing several of the symptoms of SCRA withdrawal.
The
Index and Treatment suggestions are very much at a draft stage. What is
urgently required is that clinicians stop waiting for some
authoritative national guidance on SCRA treatment. Using the guidance
from Neptune, the only clinical guidance is “symptomatic management of
withdrawal symptoms may be indicated in some cases.” This should be used
as the rationale and argument for trialing appropriate pharmacological
interventions.
In turn where measures have been successful (or
not) they need to be written up, even if it is only as a brief letter to
medical journals. Then and only then will the published evidence base
start to emerge. It requires agencies to take the lead and there should
be no need to wait any longer.
The draft SCRA Withdrawal Screening Tool and potential interventions can be downloaded here.
It is in draft form and all feedback and suggestions are gratefully received.
Showing posts with label "Drug Strategy" UK. Show all posts
Showing posts with label "Drug Strategy" UK. Show all posts
13 February 2017
31 May 2015
The Psychoactive Substances Bill – a fundamental shift in drugs legislation and state control.
Part 1: Commentary
Every now and then, a piece of legislation emerges which
fundamentally changes the way that the State seeks to regulate how people
choose to get intoxicated. The Misuse of Drugs Act was one such piece of
legislation. If it becomes law, the Psychoactive Substances Bill will represent
another such seismic shift.
It is essential to recognise that, whilst the Bill emerges
against a backdrop of concern about Novel Psychoactive Substances (NPS), its
breadth and reach far exceeds newly emergent drugs. It represents a step change
in how substances are and will be regulated.
Up until now, substances were lawful to produce and supply
provided that they were not currently regulated either by the MDA or the
Medicines Act. The Psychoactive Substances Bill reverses this position and says
that all psychoactive substances will be illegal to produce or supply unless
specifically exempted.
This fundamentally changes the way that the State manages
the risk of substances. Until now the onus has been on the State (via the ACMD)
to demonstrate that any specific substance was so dangerous that it needed to
be “controlled” under the MDA. Now any substance, old or new, will be
automatically prohibited for production, importation or supply unless
specifically exempted. It’s all too dangerous for us to access unless the state
determines otherwise.
The Act to a large extent nullifies the role of the Advisory
Council on the Misuse of Drugs (ACMD) as any new emergent Psychoactive
Compounds are automatically covered by this Act. Their only role in relation to
new drugs would be (presumably) to determine if they should also be controlled
under the MDA, and if so in which Class.
The Act contains provision to exempt specific psychoactive
substances and the Secretary of State has the power to add to this list via
Statutory Instrument. There is no formal or independent mechanism for such
reviews to take place beyond a loose requirement that the “Secretary
of State must consult such persons as
the Secretary of State considers appropriate.”
The list of exemptions includes:
- · Controlled Drugs and Medicines,
- · Alcohol,
- · Tobacco and Nicotine,
- · Caffeine,
- · Food.
Aside from the obvious inherent contradiction in
restricting some very low-risk compounds (e.g. Nitrous Oxide) while not acting
on others (e.g. alcohol, tobacco) the legislation in its current form makes
prohibits supply of a number of lawful substances, such as Areca Nut (betel,
paan).
This is however not the key issue. It will be
relatively easy for such substances to be exempted prior to the Act coming in
to force. It’s the idea that from this point on the relative risk or safety of
a substance is irrelevant. If it’s psychoactive and not exempt, it is
forbidden.
Because the legislation is coming at a time of
ill-informed moral panic about NPS, the odds are that the legislation will be
passed without significant changes to it. It’s a bad time for the sector to
lose voices such as Drugscope, however muted they had become over time. The
voices that have got the Government’s ear are more likely to be those who will
endorse such a blanket ban.
But, ideological objections aside, will this
legislation work? That in part depends on how one measures success. If the
experience of the Irish Republic is anything to go by, then it will have a
significant impact on so-called Head-Shops. The vast majority of Irish
Head-shops closed down when similar legislation was introduced. The trade and
use of NPS has not, however ceased. It’s still goes on, but more underground,
akin to more traditional drug markets.
The other potential development will be the
relocation of key suppliers outside of the UK. The legislation creates offences
around importation, and includes requirements that can be imposed on internet
service companies. However it seems likely that suppliers with websites and
storage outside of the UK, and especially outside of the EU will be able to
supply NPS with a low level of risk to purchasers in the UK.
In the longer term, as successors to the Silk Road
emerge and stabilise, on-line sale of both old and new psychoactive substances
will continue and grow via virtual markets. Ultimately, a future Government
will have to recognise and accept that prohibitive responses are and will
become increasingly obsolete. Sadly this Government is intellectually too
myopic and ideologically opposed to any such insight and instead will leave us
a terrible legacy: a piece of legislation that views all possible psychoactive
substances as equally dangerous and a single response to them – ban them all.
Part 2: The legislation.
The main provisions of the proposed legislation restrict
production, supply and importation of Psychoactive Substances.
A Psychoactive
Substance is defined as “is
capable of producing a psychoactive effect in a person who consumes it, and is
not an exempted substance.” A psychoactive effect is “a substance produces a
psychoactive effect in a person if, by stimulating or depressing the person’s
central nervous system, it affects the
person’s mental functioning or emotional state.”
In its current form
the Bill creates key offences of production, supply, importation and
exportation. It doesn’t make possession for personal use an offence BUT
the Bill creates the power for the Police to stop and search for suspected
offences under the Act, to seize substances and to destroy them.
There is also provision for the searching of vehicles,
buildings etc.
The offences are:
The offences are:
Producing a psychoactive substance
(1) A person
commits an offence if—
(a) the person intentionally produces a psychoactive substance,
(b) the person knows or suspects that the substance is a psychoactive substance, and
(c) the person— (i) intends to consume the psychoactive substance for its psychoactive effects, or (ii) knows, or is reckless as to whether, the psychoactive substance is likely to be consumed by some other person for its psychoactive effects.
(a) the person intentionally produces a psychoactive substance,
(b) the person knows or suspects that the substance is a psychoactive substance, and
(c) the person— (i) intends to consume the psychoactive substance for its psychoactive effects, or (ii) knows, or is reckless as to whether, the psychoactive substance is likely to be consumed by some other person for its psychoactive effects.
Production
here means “producing it by manufacture, cultivation or any
other method.”
Supply, a psychoactive substance
(1) A person
commits an offence if—
(a) the person intentionally supplies a substance to another person,
(b) the substance is a psychoactive substance,
(c) the person knows or suspects, or ought to know or suspect, that the substance is a psychoactive substance, and (d) the person knows, or is reckless as to whether, the psychoactive substance is likely to be consumed by the person to whom it is supplied, or by some other person, for its psychoactive effect.
(a) the person intentionally supplies a substance to another person,
(b) the substance is a psychoactive substance,
(c) the person knows or suspects, or ought to know or suspect, that the substance is a psychoactive substance, and (d) the person knows, or is reckless as to whether, the psychoactive substance is likely to be consumed by the person to whom it is supplied, or by some other person, for its psychoactive effect.
Additional
clauses cover Possession with Intent to Supply and Offer to Supply.
Importing or exporting a psychoactive substance
(1) A
person commits an offence if—(a) the person intentionally imports a substance,
(b) the substance is a psychoactive substance,
(c) the person knows or suspects, or ought to know or suspect, that the substance is a psychoactive substance, and (d) the person—(i) intends to consume the psychoactive substance for its psychoactive effects, or (ii) knows, or is reckless as to whether, the psychoactive substance is likely to be consumed by some other person for its psychoactive effects.
(b) the substance is a psychoactive substance,
(c) the person knows or suspects, or ought to know or suspect, that the substance is a psychoactive substance, and (d) the person—(i) intends to consume the psychoactive substance for its psychoactive effects, or (ii) knows, or is reckless as to whether, the psychoactive substance is likely to be consumed by some other person for its psychoactive effects.
(2) A
person commits an offence if—
(a) the
person intentionally exports a substance,
(b) the substance is a psychoactive substance,
(c) the person knows or suspects, or ought to know or suspect, that the substance is a psychoactive substance, and (d) the person— (i) intends to consume the psychoactive substance for its psychoactive effects, or (ii) knows, or is reckless as to whether, the psychoactive substance is likely to be consumed by some other person for its psychoactive effects.
(b) the substance is a psychoactive substance,
(c) the person knows or suspects, or ought to know or suspect, that the substance is a psychoactive substance, and (d) the person— (i) intends to consume the psychoactive substance for its psychoactive effects, or (ii) knows, or is reckless as to whether, the psychoactive substance is likely to be consumed by some other person for its psychoactive effects.
Commentary:
One of the key challenges in
drafting this legislation will have been to ensure that labelling products as “plant
food” or “not for Human Consumption.”
The key
wording in the proposed legislation to address this is “knows, or is reckless as to
whether, the psychoactive substance is likely to be consumed”
The
expectation is that a court could determine that a person was acting in a
reckless way by the production or supply of compounds which a reasonable person
could assume were for the purposes of intoxication, irrespective of how they
were packaged.
Enforcement Powers:
In
addition to the criminal sanctions of fines, imprisonment or action under the
Proceeds of Crime Act, the Bill introduces new powers to prohibit activity or
close premises.
Prohibition Notices could be served against
individuals who are believed to be carrying out prohibited activities such as production
or supply of prohibited activities, requiring them to stop any such activity.
Premises notices can be issued to people who own,
manage or lease premises where there is a belief that prohibited activities in
relation to Psychoactive Substances are taking place, requiring that any such
activity ceases.
In
situations where such notices have been breached or in other circumstances,
Prohibition or Premises Orders can be issues by a court. The standard of proof
for these is on balance of probability, though they could be issued as part of
a sentence for an offence under the Act.
Commentary:
If the experience of Eire is anything
to go by, the Prohibition and Premises orders will be a key tool to act against
shops and other retail outlets. As there is no requirement to prove to criminal
standards that the any criminal breach has taken place, it will be relatively
easy to enforce and effectively stop sale via shops.
The
full text of the bill can be viewed and downloaded here:
http://www.publications.parliament.uk/pa/bills/lbill/2015-2016/0002/16002.pdf
http://www.publications.parliament.uk/pa/bills/lbill/2015-2016/0002/16002.pdf
26 November 2013
Head-shops: Regulation or Prohibition
This is our chance to have a radical shift in drugs policy. But we're going to end up with more prohibition...again.
Recent
legislative proposals and media coverage have pushed the subject of
“head-shops” to the top of the drugs agenda. It has also been a recurring theme
for me in recent workshops, hence this article, to explore head-shops more
closely, especially in relation to the retail and regulation of Novel
Psychoactive Compounds (NPCs).
Though no statutory
figures exist, anecdotally there has been a significant increase in the number
of head-shops in the UK. The Angelus Foundation[1],
says that there are in excess of 250 in the UK, based on on-line research and
liaison with trading standards. As they acknowledge, this may not be an
accurate figure. Part of the problem in counting head-shops is that (a) there
is no clear definition of what would constitute a “head-shop” and (b) there is
no licensing or regulatory framework that would enable local authorities to
keep track of such shops.
For the
purpose of this article, I am going to consider a head-shop to be any retail
outlet where a significant proportion of its sales includes NPCs or other
psychoactive substances.
Head-shops
have proliferated in step with a growing market for NPCs. The growing
availability of un-regulated psychoactive compounds has coincided with cheap
empty retail units in town-centre locations. There are a number of independent
traders, and a smaller number of chains. The ambience, product range and
willingness of outlets to ‘self-police’ vary massively.
Workshop observations: The issue of head-shops has cropped
up repeatedly during recent workshops. In a number of different areas,
participants have noted the sudden and significant impact that the arrival of a
new head-shop has had on local drug patterns. This has included changes within
night-time economy, impact on door-staff, presentations in custody and A+E, and
demands on drug services.
Sadly, much
of the reporting is anecdotal. There is no routine recording of NPC usage and
its links to Hospital admission, drug service usage, or offending behaviour. As
such, reports from agencies of local shifts in use and behaviour are hard to
evidence. But the consistency and regularity of these reports in workshops
makes them compelling and hard for me to ignore.
Head-shops v. On-line retailing: A key concern is that head-shops,
rather than on-line retailers that provide the more ready access point to
people under 18s. Most of the websites require some form of credit or
debit-card payment and this, combined with the requirement to have things
delivered to the home, acts to some extent as a barrier to younger purchasers.
Head-shops on the other hand are much more accessible and accept cash payments. They also remove any lingering misgivings about home deliveries or using cards online.
Head-shops on the other hand are much more accessible and accept cash payments. They also remove any lingering misgivings about home deliveries or using cards online.
Head-shops
also allow for more impulsive, less considered use. The process of ordering
online, the selection process and the delayed delivery mitigate against
impulsive use (to an extent.) Whilst a punter may purchase impulsively, they
may be more considered than when buying in a shop. So the presence of a
town-centre head-shop may provide a readily accessible point for the impulsive
purchase of NPCs by younger people.
Conversely,
a counter argument can be made FOR head-shops. Their products may be risky, but
the same can be said for wholly unregulated street drugs. Does the presence of
a head-shop undermine street drug markets, providing a less risky alternative?
This argument has certainly been made by colleagues noting that in areas with
easy access to unregulated NPCs they have seen less injection of mephedrone.
But conversely some areas with easy access to legal white powder stimulants from
head-shops have seen injecting of these compounds in place of street drugs.
At the very
least some head-shops will at least try to ensure that they don’t sell to
under-18s, through measures like checking ID. This at least provides a modicum
of control which doesn’t exist in street settings.
The pressure for change: At present the media are building up
a fine head of steam in relation to head-shops and politicians are not far
behind. The odds are the present situation will not be allowed to continue.
There are two courses of potential action – to regulate the industry or to
clamp down on it.
The Angelus
Foundation is pushing for such an approach, supporting an amendment to the
Antisocial Behaviour, Crime and Policing Bill, [i]
which says:
It is an
offence for a person to supply, or offer to supply, a psychoactive substance,
including but not restricted to-
(a) a powder;
(b) a pill;
(c) a liquid; or
(d) a herbal substance with the appearance of cannabis,
(a) a powder;
(b) a pill;
(c) a liquid; or
(d) a herbal substance with the appearance of cannabis,
which he knows, or has reasonable cause to believe,
to be so acting, that the substance is likely to be consumed by a person for
the purpose of causing intoxication.
This clause would require significant revision in
order to be viable. At present it would probably make it illegal to sell tea
and coffee, and the simple measure of dying a product like “Exodus Damnation”
pink would get round the strictures of clause (d) in the proposal. As it stands
it wouldn’t criminalise end users and doesn’t result in the closure of shops.
The
response in Ireland has been subtly different and creates a system of Closure
Notices and Closure Orders for head-shops selling intoxicated substances.[2]
This piece of legislation importantly includes a “reverse burden of proof,”
requiring retailers to prove to the court that a product was NOT sold for human
consumption, irrespective of any wording on packaging.
Further, importantly, the legislation doesn’t criminalise end-users but does provide scope to close down retailers. The Mirror[3] claims that this legislation reduced the number of head-shops from “from 100 to six in three months.”
Further, importantly, the legislation doesn’t criminalise end-users but does provide scope to close down retailers. The Mirror[3] claims that this legislation reduced the number of head-shops from “from 100 to six in three months.”
In lieu of
regulatory or prohibitive legislation, a variety of piece-meal responses have
emerged. The use of the Intoxicating Substances (Supply) Act 1985 was
successfully used in Leeds.[4]
Attempts to use Trading Standards legislation failed in Chester due to a
botched case.[5]
Police enforcement action against head-shops in Wales used more conventional
approaches, including charges for drugs offences related to cannabis and
charges for money-laundering.[6]
Elsewhere
Police and Trading Standards have been more and more inventive, exploring other
branches of legislation relating to cosmetics, chemical storage and fire safety
to apply pressure to head-shops. There are many such avenues that could be
explored. For example, synthetic cannabinoids, sold as “herbal incense” would
need to be safe to use as instructed – when placed on a incense burner. As they
would release toxic, intoxicating fumes if heated they would be an easy target
for Trading Standards in their current form – they are not safe or fit for
purpose as “incense” or “pot-pourri.” But this is a temporary measure – it
would be easy to relabel the product to side-step this issue.
Another potential issue is the insurance of head-shops. It will be interesting to see how many shops are covered for building insurance if they cover significant amounts of chemicals on site, and if they have valid employer’s liability insurance given the chemicals on site.
Another potential issue is the insurance of head-shops. It will be interesting to see how many shops are covered for building insurance if they cover significant amounts of chemicals on site, and if they have valid employer’s liability insurance given the chemicals on site.
All the interventions so far have been prohibitory and
restrictive rather than regulatory. However, they haven’t resolved the issue of NPCs and prohibitive
responses may have their own unintended consequences.
Sale of
NPCs is not restricted just to head-shops. There is a thriving market in less
typical retail outlets ranging from newsagents through to fast-food shops. This
is an issue that has recently been highlighted by Max Daly in Drugscope.[7] So restriction or banning of head-shops runs
the risk of driving the products in to a range of other outlets which could be
still harder to regulate.
We have already seen that as an existing product is prohibited they are firstly discounted massively on websites and post-prohibition sold via other outlets including car-boot sales, pubs and under the counter in head-shops. With no mechanism for regulating shops or reimbursing retailers post-prohibition, it is inevitable that prohibition will see residual products dumped on to the market.
We have already seen that as an existing product is prohibited they are firstly discounted massively on websites and post-prohibition sold via other outlets including car-boot sales, pubs and under the counter in head-shops. With no mechanism for regulating shops or reimbursing retailers post-prohibition, it is inevitable that prohibition will see residual products dumped on to the market.
Clamping
down on head-shops does nothing to address on-line side of distribution which
would persist even if head-shops were closed down. It’s worth noting that the
primary distribution channel for mephedrone prior to it becoming a controlled
drug were on-line suppliers, rather than head-shops.
And it’s also worth stressing that it easier to hold a shop-based retailer to account than a virtual one.
And it’s also worth stressing that it easier to hold a shop-based retailer to account than a virtual one.
Regulation would require a significant step change in
terms of drug strategy. It must be said that some of the current head-shops see
themselves as having some moral and social values and endeavour not to supply
to younger people. But the lack of a regulatory framework and the moral
‘flexibility’ of some outlets means that head-shops are certainly not
“off-limits” to younger purchasers. One participant on training recently
described how her existing older clients were up in arms about the behaviour of
the local head-shop, as they saw children in school uniform queuing for NPCs.
The current
legislative and regulatory framework is confusing and widely misunderstood. And
in truth the current options for agreeing a regulatory framework are distinctly
limited.
A key
option would be to require “head-shops” to be licensed by a Local Authority.
This could open up a range of control options including:
- Vetting and training of staff
- Requirements to check ID in relation to age
- Control over where shops can open and when they can trade
- Capacity to remove licences in response to emergent problems.
Regulation requires licensed substances: At present there are some limited
legal barriers to the sale of products that are NOT controlled drugs or
medicines.
Whilst many of the NPCs currently sold carry “adults only” or “not for under 18s” badges there is limited legal basis for this. The rationale for such voluntary age-restriction is more politic than legal. By attempting to legal sales to “informed adults” retailers are slightly better protected from litigation. It may also have been intended to reduce political and media ire but is clearly becoming less effective in this regard.
Whilst many of the NPCs currently sold carry “adults only” or “not for under 18s” badges there is limited legal basis for this. The rationale for such voluntary age-restriction is more politic than legal. By attempting to legal sales to “informed adults” retailers are slightly better protected from litigation. It may also have been intended to reduce political and media ire but is clearly becoming less effective in this regard.
It is also intended to protect
retailers from falling foul of the Intoxicating Substances Supply Act (1985)
which makes it an offence to supply an inhalable product to a person under 18
where it is known that it will be used for intoxication. Originally intended to
deter the sale of solvents, it has also been applied to the sale of some NPCs.
The key obstacle to regulation is the legislation
relating to the sale of medicines. At present products are sold “not for human
consumption,” and variously sold as “research chemicals” or other flags of
convenience, so that they do not fall foul of the Medicines Act.
The greater the extent to which retailers acknowledge
that their products are sold for the purpose of intoxication, the more the
products are likely to fall within the scope of the Medicines Act. In itself,
this doesn’t happen just because a retailer gives a customer advice about a
substance. So when for example the Daily
Mirror says “Legal highs:
Store worker flouts drug laws to dish out drug advice to customers[8]” this isn’t strictly accurate. The provision of advice on its own
doesn’t put the retailer on the wrong side of legislation. But it DOES make it
easier for the Borderline Products Team at the MHRA to conclude that the
product in question is being sold for the purpose of ingestion and as such
should be considered a medicine. However, to reach this stage, the MHRA would
have to consider and reach such a decision and, until such a decision was
reached, the substance in question would still not be subject to the strictures
of the Medicines Act.
So whilst the provision of verbal advice about doses
and choice of compound nudges retailers closer to restriction under the
Medicines Act, it’s a long way from having a product or family of products
labelled “medicines” by the MHRA.
Where the provision of advice about choices or usage
does leave retailers more exposed is in the event of someone suing for damages
– citing breach of Duty of Care.
At present retailers shelter behind the “Not for Human
Consumption” claim which is often backed up by assertions that the product
should not be ingested and medical help sought if taken. This wording is in
part a defence against products being brought under the Medicines Act. But it
is just as important as a defence against civil litigation.
If a product were sold as a “legal high,” and the user
were harmed as a result of taking it, it should be possible to sue the
supplier, or possibly the manufacturer. The retailer would have to demonstrate
that they had taken “reasonable care” to avoid “actions or omissions” that they
could “reasonably foresee” could cause harm to (for example) a purchaser.
In most legitimate retail settings, this “reasonable
care” would involve ensuring that the products were as safe as possible, fit
for purpose and packaged appropriately with information on how to use the
product safely.
At present, with NPCs retailers attempt to side-step
the risk of being sued by the wording on packaging. It may well be that anyone
attempting to sue a retailer for harm arising from use would fail, because the
retailer could reasonably argue that the products were not intended for
consumption and were clearly labelled as such.
This defence could however be undermined if the
retailer also gave advice about consumption. It would then be easier to
demonstrate that the retailer was aware of the use to which the product was
probably going to be put, irrespective of the wording on the package.
Ultimately such a decision would need to be made by a
court. But herein lies our stumbling block.
If head-shops were somehow licensed or brought within
the ‘harm-reduction’ fold, then they would no longer be able to shelter behind
the “not for human consumption” dodge. The very act of describing how to use
specific products more safely would hole the defence against negligent claims
below the waterline.
So while on the one hand it may be desirable to
encourage NPC retailers to work collaboratively with drug services to develop
safer retail models, they would in turn need to ensure that their products were
safe to consume – probably an insurmountable barrier for most retailers. It
would also mean that the substances would likely fall under the purview of the
Medicines Act.
In order to achieve licensed, regulated head-shops,
we would also need products which could be licensed and regulated too,
requiring changes to the Medicines Act, Misuse of Drugs Act, and a slew of
other pieces of legislation. We would probably need to adopt an approach more
like New Zealand, which allows for the sale of products whose safety has been
adequately demonstrated.
Over the next few months, it seems more likely that the indirect methods of policing head-shops mentioned earlier will be replaced by prohibitive legislation. It would be really desirable if instead we could have a sensible discussion. Are we safer with regulated head-shops which can be licensed and vetted? Possibly. Can we achieve this unless we also licence some of the products that they sell? Probably not. And is the Government going to explore this as an option as part of their exploration of responses to NPCs? Well, never say never but there will be few people more astounded than me if they do.
[1]
http://www.prnewswire.co.uk/news-releases/over-250-headshops-in-uk-are-selling-legal-highs-says-angelus-foundation-232476221.html
[2] http://www.attorneygeneral.ie/eAct/2010/a2210.pdf
[3] http://www.mirror.co.uk/news/uk-news/legal-highs-labour-looking-clamp-2715685
[4] http://www.westyorkshire.police.uk/news/men-charged-landmark-legal-highs-case
[5] http://www.chesterfirst.co.uk/news/122737/case-against-chester-legal-high-shop-owner-dismissed.aspx
[6] http://www.southwalesargus.co.uk/news/10765334.Five_released_on_bail_following_raids_in_Newport_and_Cwmbran/
[7] https://pressfolios-production.s3.amazonaws.com/uploads/story/story_pdf/50357/503571385371333l7hrMWTLRGE8jGSPOYMw.pdf
[8] http://www.mirror.co.uk/news/uk-news/legal-highs-uk-skunkworks-worker-2644152
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