31 October 2010

6-APB Briefing

Although you won’t know it from visiting Frank, Drug Discussion forums and on-line drug retailers have been a-buzz since the Summer, excitedly discussing and promoting the latest “legal high” – 6-APB. As with Mephedrone before it, the lack of reliable and factual information, especially analysis, is once again creating a hugely unsafe environment. This briefing attempts to summarise the current confused situation.
6-APB is short for 1-benzofuran-6-ylpropan-2-amine or 6-(2-aminopropyl)benzofuran. Unfortunately, due to the drug containing the benzofuran molecular ring, some on-line retailers decided to give it the name benzo-fury. This is confusing as 6-APB is not an benzodiazepine, and shares none of the effects of a benzodiazepine. So the slang name is deeply unhelpful. The more sensible of the drugs discussions forums have tried have some influence here by refusing to use the term ‘benzo fury,’ but despite this it is listed for sale on many sites by this name. There is no relationship between “benzo-fury” and the (currently) unrestricted benzodiazepine phenazepam which is being flogged on some sites. The latter is really a benzo and 6-APB isn't!

There is a molecularly very similar product 6-APDB or 6-(2-Aminopropyl)-2,3-dihydrobenzofuran. This product has been offered for sale by vendors aswell as or instead of 6-APB. In the absence of laboratory analysis it is not possible to say which of these products has been actually sold – or in truth it is either of these products.

Early suggestions are that retailers initially may have believed that they were selling 6-APDB but early forum discussion raised concerns about the legality of 6-APDB and the suggestion that many people experience severe nausea when coming up on 6-APDB. This may have led to the conclusion that marketing 6-APB was an easier proposition.

Routes and Effects:
The very few credible trip reports for 6-APB suggest that the drug is a relatively powerful psychedelic drug causing significant visual distortion. It has been described as more MDA-like than MDMA – so less energetic and more trippy. Users also report MDMA-type effects such as gurning and urine-retention.

It has been snorted and swallowed; some reports suggest that swallowing is more effective. Dose ranges have been at around the 100mg mark.

The available evidence suggests the drug causes elevation of serotonin levels (probably by blocking reuptake) with low levels of impact on nor-adrenaline and dopamine levels.

The early reports indicated effects from 4-6 hours with little urge to redose during or afterwards.

The early users who wrote trip reports were very positive about their experience.

Availability and Supply:
These early reports, dating back to July triggered a significant interest in 6-APB and attention turned to a number of on-line vendors who claimed that they would have the drug in stock shortly, some of whom were taking advanced orders. As has become more common with some of the on-line vendors, some distributed samples, especially to those people who were writing trip-reports or would otherwise promote the drug.

Since then a number of companies have offered to supply a range of products, under the name 6-APB. A quick trawl suggests between 10 and 20 online vendors all offering products of different appearance. It is not clear how many, if any of these contain 6-APB.

User reports of many of the products being sold range from non-active products, through those which have a low level of potency, up to reports of people being sold very long-lasting stimulants with unpleasant side effects. There is little consistency either in terms of the products sold or reported effects.

Appearance of 6-APB:
Early supplies of drugs reported to be 6-APB and used in early trip reports discussed a tan-coloured powder. However, later on this was replaced by an off-white, creamy coloured powder. None of the early reports described a crystalline white powder.

After the initial availability of powder, the products that came to market were either “pellet” form or capsule form. And at this point the supply side and the discussion side both seemed to go in to what can only be described as melt-down.

Discussions, partly it seems fed by vendors, talked about “official” 6-APB supply chain and so a distinction started to emerge between “official -6-APB” and other stuff. It should be stressed at this point that the idea of “official” or “authorized retailers” in the context of any so-called legal high is bogus. There is no quality control or monitoring body. It’s all equally unofficial.

The pellet forms of 6-APB sold in a professionally produced foil bag were orange in colour; some had a chemical, TCP-esque smell. The alleged dose range was 100mg. Pelletised drugs bring a couple of new challenges – they make it harder to take an initial “allergy test” sample to check for bad reactions. And they increase the chances that people will take several pills in a sitting, and thus increase dosing in 100mg increments, increasing the risks of overdose.

Since then a large range of capsules have been marketed and sold as 6-APB. These have included red capsules, blue capsules, translucent capsules, orange ones and so on. The early availability of red and blue capsules and fierce arguments about which were better led to some commentators referencing the Matrix. Either way, the consensus was that the capsules did not contain 6-APB and the actual contents were unknown. There is at least one trip-report of a person who, taking white capsules containing a white powder sold as 6-APB had very negative, long acting effects off it more akin to a strong stimulant than 6-APB.

The bottom line at present has to be the vast majority of compounds being sold as 6-APB do not contain this drug. There is no evidence that any of the capsules being sold contain this drug. The odds are that if you go to an on-line vendor and attempt to buy this drug you will not receive 6-APB.

What is being sold as 6-APB:
Quite simply, we don’t know. A report in August 2010 published in Drug Testing and Analysis titled “Analyses of second-generation ‘legal highs’ in the UK: Initial findings“ analysed a range of products being sold by online retailers and found that the majority contained now-banned compounds such as mephedrone or relatively low-acting stimulants such as caffeine. Unfortunately this research was conducted before the upsurge in sales of 6-APB so these were not analysed.

So we cannot be certain what is in any product being sold as 6-APB including those tested early on and described as more MDMA-esque.

Reducing Harm:
It is difficult to offer harm reduction information when we know so little about what is being sold, or the risks attached to that substance. So harm reduction information needs to be loosely couched to ensure it is relevant not just to the substance allegedly being sold, but also likely substances being sold in its place.
• If using powders swallow rather than snorting;
• If using a new substance take a small amount first. Take a very small amount (e.g. no more than 10mg) as an “allergy test” to check for unexpected adverse reactions; wait at least an hour. If there are no adverse effects use a larger dose if you are still convinced you want to.
• You should use on-line forums to assess the range of doses being sampled and start at the low end of this range. And then half this. So for example if people are using a substance at the 100-150mg range start at 50mg. Wait at least an hour. Then and only then increase dose cautiously and not exceeding the upper dose range.
•Don't use if you are prone to poor mental health, especially depression or psychosis.
• Don’t use on top of other substances including alcohol. Don’t mix with other stimulants or anti-depressants
• Seek medical help if you experience serious unpleasant symptoms.

Legal Status:At present 6-APB is not believed to be covered by the Misuse of Drugs Act 1971. Sale for human consumption would probably put it within the terms of the Medicines Act hence being sold once again labelled as "plant food" or "for technical use." As with MMCAT before this is not a plant food. Some commentators suggest that the decision to sell it in pelletised form (and to call it pellets, not pills) is to further reinforce the illusion that it is a plant food, and not for human consumption.

The situation regarding 6-APDB is more confusing with a number of sources suggesting it may fall under the Misuse of Drugs Act, but in lieu of a ruling from a court or the Home Office this is mere speculation.

It is likely that some of the compounds sold as 6-APB are, in fact, Controlled Drugs, and possession of them will be illegal.

To summarise:
• Compounds sold as 6-APB could contain a range of different chemicals. The one thing you can be reasonably certain of is that it won’t contain 6-APB;
• We do not categorically know that any 6-APB has been sold in the UK at all; early samples could have been any of a range of compounds;
• The products sold as 6-APB may contain hazardous substances which may also be controlled drugs;
• It is possible to be prosecuted for possession of a Controlled Drug even if you bought it believing it to be legal;
• A flashy website does not ensure they sell what they claim to sell; what they claim to sell may not be safe.

Sources for this article include but are not limited to:
Drugs Forum, Bluelight, Partyvibe, Legal Highs Forum
Liverpool John Moore University

Training: If you need a workshop or training on new, legal or herbal highs get in touch to discuss our course "Cats Bees and Dragonflies." Can be delivered anywhere in the UK.

To download this blog as a PDF for reproduction and distribution click here www.ixion.demon.co.uk/6apb.pdf

24 October 2010

Project Prevention: Beams and Motes

We now have such a crisis…that we ought to give active consideration to paying female drug users to take long-term contraception.”

Ah-ha! You think – another diatribe against Project Prevention.

Sections of the drugs support and treatment community have been up in arms as Barbara Harris came to the UK and used her model of cash incentives to promote long-term contraception and sterilisation for drug users.

Nowhere was this state of high dudgeon more apparent than on the pages of the Wired In community where diatribe after diatribe has appeared. Which is ironic as the quote at the top of this article is not from Project Prevention but from the UK’s own Professor Neil McKeganey in an article from the BBC  in 2004. And Professor McKeganey is also one of the Advisory Board of Wired In.
Despite the Professor’s apparent support for at least some of the measures promoted by Project Prevention, he doesn’t seem keen to step in to the current fray and defend the idea of incentivised long term contraception to Wired In members or the wider public. Conversely, despite McKeganey’s stated views on the subject, Wired In don’t seem to have any problem with him being on their Advisory Board.

There are of course significant differences between the views espoused by McKeganey and Project Prevention. McKeganey drew the line at long term contraception while Harris goes further and promotes these measures and sterilisation. And to my knowledge McKeganey only promoted measures for women, not for men.

Of course he is not the only person to make such proposals in recent times: a Greenock MSP made suggested adding oral contraceptives to methadone .

The approach and measures suggested by Barbara Harris are odious and the promotion and incentivisation of non-reversible or permanent sterilisation, to a client group ill-equipped to make such a fundamental decision, is ethically and morally repugnant. It is right that her appearance in the UK has attracted such a wide range of condemnation.

But mere condemnation of Project Prevention is not, in itself, an adequate response. We need to look at some of the failings of interventions in the UK which have created fertile ground for the sterilisation policies of Project Prevention. The wider social picture is one where drugs users are demonised and denigrated in the media. Judgemental and stigmatising language is routinely used and the type of language and attitude which is now unacceptable when discussing mental health, ethnicity or sexuality is commonplace when considering drug use.

This stigmatisation helps foster a climate where measures that would be unacceptable if
  promoted for any other social group become more acceptable when applied to drug users.

The wider social context is important, but beyond this, the issue of contraception and family planning for drug users in chaos is something that does warrant proper and detailed discussion. It is a serious and sensitive subject, and one of the tragedies of the Project Prevention backlash is that it will be harder to have this discussion now without people resorting to end-arguments like “Hitler” and “Eugenics.”

It is also a subject that has been considered before, most sensibly in the 2003 ACMD report
Hidden Harm, which advocated:

Contraceptive services should be provided through specialist drug agencies including methadone clinics and needle exchanges. Preferably these should be linked to specialist family planning services able to advise on and administer long-acting injectable contraceptives, contraceptive coils and implants.”

This is an eminently sensible proposal – and one that most right-thinking people would have little problem with. A “belts and braces” approach – temporary barrier contraception (i.e. condoms) to address the risk of STDs combined with effective long acting contraception seems like a balanced approach provided that it is undertaken with the patient’s informed consent and there is sufficient consideration for follow up and referral and support in to drug treatment.

But we haven’t really done this properly. Too much contraception is delivered in a half-hearted way – a couple of condoms given out with a bag of needles, the basket of condoms in the reception of a drugs project – rather than a proper assessment and contraception care plan.

If this were done, and were done properly then the number of unplanned and unwanted pregnancies amongst drug users in chaos could be addressed. And by doing so we can demonstrate there is no place for the bribed sterilisation of Project Prevention. Just as badly delivered needle exchange or badly executed drugs education helps create a climate which embraces “just say no” or “abstinence” models so a failure to adequately address family planning with drug users creates a climate which is ready for Project Prevention.

So instead of just sending off angry letters about how wrong Project Prevention is (and it is very wrong) it is equally important that the field engages with a sensible discussion about how to ensure that the contraception – effective and reversible – is made accessible to drug users, especially those in chaos.