06 September 2015

full circle

As anyone who has come on the KFx Novel Psychoactives course will know, early on we look at the known statistics about some of the newer compounds, and caution against the hype that suggests that we stand before an unstoppable wave of new compounds that have changed the face of drug taking.

Despite the "one new drug a week" type headlines, not all new drugs come to market in significant quantities. And of those that do, not many achieve lasting popularity. And none of the new pretenders come close to the popularity of mephedrone in its heyday.

We also talk a fair bit about Ecstasy on the course. Which of course isn't new or legal. But as the course stresses, it's tempting to chase after the shiny new Novel Psychoactives, whilst failing to recognise that traditional, time honoured substances like MDMA have never gone away and are now enjoying a renaissance.

One of the things asserted in the NPS course is:
"We need to keep abreast of NPCs. But we don’t need to lose sight of some fundamentals here:

• NPC use in part rose and peaked because the “right drug” – 4-MMC – arrived at the right time: pre-austerity, poor quality cocaine and MDMA.

•Some evidence that while a small number of people are dabbling with NPCs, the majority, given a choice, will gravitate back towards the “classics” of cocaine, MDMA, cannabis and speed."

It has been interesting therefore to see the results of the annual research on drug trends in the UK, the Drug Misuse - Findings from the 2014/15 Crime Survey for England and Wales and Smoking, Drinking and Drug Use Among Young People in England - 2014.

Smoking, Drinking and Drug Taking.... covers the age group 11-15. It shows small increases in the use in last year of cocaine, MDMA, LSD and Magic Mushrooms.The increases are very small - a fraction of a percent in each case. Cannabis, it is interesting to note, has dropped, with use in the last year at the lowest levels that the survey has ever recorded.

The Crime Survey covers the age group 16-59 but presents detailed information for 16-25 year olds too.
It shows similar increases in a number of drugs, but with more marked increases than the younger age range.
Use of the following drugs in the past year showed amongst 16-25 year olds increased in the 2014/15 survey.
  • cocaine:        4.8%, up from 4.2% the preceding year
  • Ecstasy:        5.4% up from 3.9% the preceding year
  • LSD:            1.2% up from 0.9%
  • Mushrooms: 1.5% up from 0.8%
Interestingly the Ecstasy and LSD figures means reported use of both drugs is at the highest levels for around ten years. Ecstasy use in last year was reported as 5.5% in 2003/4 and LSD last reached this level at 2001/02.

In order to try and determine if this is a statistical blip or the start of an increase in recreational drug use, we need to try and understand what is driving this modest increase.

The increase in Ecstasy use is likely, at least in part, down to improved availability and quality. Newer synthesis routes have resulted in an increase in production of high quality, strong MDMA pills. And Dark Web successors to the Silk Road, such as Dream Market, have made access to pills easier than ever.

The increase in LSD is marginal, but more of a suprise. Some of it may simply be down to improved access via the Dark Web.
Some media commentators have suggested that this is a retro trend linked to tastes in retro fashion.
It may also be some distortion where people have had used novel psychoactives such as 25i-NBoMe and or 1P-LSD and these have ended up recorded as LSD in the survey. Or if this and the increase in mushroom use are any more than a blip, it could signal a resurgence of interest in psychedelics.
The mushroom example is especially interesting. Now we don't know exactly what sort of mushrooms people are taking, based on the research. But this is one of the only drugs that isn't affected by global production issues. They grow and can be picked (illegally) in the UK. Legitimate commercial sales ended in the UK in July 2005, and resulted in a rapid drop in reported use in the UK that has persisted until this year. It may be again that supply via the Dark Web is playing a role here. But I await with interest the next set of figures to gauge whether this is a blip or something different.

Either way, and importantly, it does rather undermine the Government's repeated claims about the efficacy of drugs policy and the mantra that "drug use is down." Some drug use is clearly, according to the research, up.

My belief that MDMA use was something to focus on, and was probably more of an issue than many NPS, has been borne out by the latest research.

My other key concern has not (yet) come to pass. The levels of heroin use in the Crime Survey are lower than the preceding year, and, at less than 0.1% of 16-24 year olds reporting use in the last year, at their lowest ever levels.

These figures are probably more prone to problems with research than recreational drugs. Those who are most excluded from society, the homeless, vulnerably housed, and those incarcerated are under represented by the research. It may be that those who are most likely to be using heroin are also the most likely to be under-counted.

Other proxy indicators of heroin use, such as seizures and police activity are also affected by a number of other factors. Cuts to police funding have an impact on the policing of drugs, so changes in such indicators are not automatically indicative of reduced use.

Either way, i am not convinced that the downward trend will not sustain, and we will start to see an increase in levels of heroin use again. This is in part because historically heroin has followed a cyclical pattern of use and if the past trends hold true, it will start to increase again.

Other key factors that I fear will contribute to this upsurge are:
  • increased production in Afghanistan. According to the UNODC  production in 2014 was at its highest level ever, a situation liable to worsen with the pull out of western troops and increased instability in the country;
  • increased regional instability maximising opportunities for smuggling and distribution;
  • increasing homelessness and exclusion from wider society in the UK. In this regard, a key risk will be the ending of housing benefit to under 21s, which will increase exclusion of young people
  • increased access to all drugs via the dark web, increasing the prospects of new micro-dealing networks 
  • the banning of synthetic cannabinoids: while some people are using synthetics in place of "normal" cannabis, there is concern that some people who use them will move to (or back to) heroin when these compounds are banned. 
Once, we could have expected  street level drugs agencies to be the first place where any such increase in heroin use would show up. But even this can no longer be taken for granted. As services have been rebranded, it will be interesting to see the extent to which those at the start of their drug using careers access them. But we should watch Needle Exchange statistics very carefully as it is likely to be here that any upsurge in heroin use will show up first.

Although it is gratifying to get it "right" on the MDMA issue, i don't really want to be right about heroin. We are ill prepared for an upsurge in use so I very much hope to be wrong.


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