22 August 2018

Monkey Business

Stoke on Trent and Staffordshire have been contending with "monkey-dust" for years. The rest of the UK and the media have just caught up.

There have been numerous reports in the UK media of a "new" drug hitting the streets - "Monkey Dust." The Daily Mirror from 16th August is as representative as any of the hyperbolic media reporting: "Monkey Dust: Terrifying new drug on UK streets 'that turns users into the Hulk'"

The wall-to-wall media coverage will undoubtedly drive interest and demand for products sold as "monkey dust." And it has already generated lots of email questions. Hence this short article.

"Monkey Dust" is not slang for a single substance. Most of the media reports say that "Monkey Dust" is slang for MDPV [methylenedioxypyrovalerone.] Substances sold as "monkey dust" may indeed contain MDPV. But they have also been found to contain other related compounds such as a-PVP, MDPHP and other hallucinogenic stimulants.

Hostel workers in Stoke routinely report that the "monkey dust" has changed again as they see different emergent behaviours.

This same confusion as to what is in "monkey dust" can be found in reports and discussions dating back a number of years. 

A 2013 report notes a person in Hanley arrested for importing 40g of "Monkey Dust" from China: the drug in question was MDPV.
A 2016 report notes a similar case in Normacot, but the "monkey dust in question was a-PVP.

The BBC cites Public Health England and describes Monkey Dust as being "Methylenedioxy-α-pyrrolidinohexiophenone or MDPHP. 

A (confused) Staffs Live report in 2016 worked on the basis monkey dust was PCP and also made reference to alpha-PVP. 

 A 19 year old arrested in 2016 again in Stoke was found to have a-PVP which the media report referred to as "monkey dust."

The Stoke on Trent Community Safety Assessment from 2015 makes explicit reference to the uncertain composition of "Monkey Dust" saying:

Information provided by ‘Drugs Expert Witnesses via the Staffordshire Police Drugs Liaison/Controlled Drugs Liaison/Chemical Liaison Officer suggests that Cannabis, Cocaine, Mephedrone and ‘MonkeyDust’ (MDPV/Alpha PVP) are common amongst problematic drug users (PDUs) in Stoke-on-Trent and across North Staffordshire as a whole.
    ... In the case of Monkey Dust the uncertainty surrounding ingredients is enhanced,hence the effects may not be what the user expects. This can then cause erratic drug users to commit public order offences unwittingly.

So, rather than thinking of Monkey Dust as being MDPV, it is safer and more accurate to view "Monkey Dust" as an "unknown white powder." From batch to batch it may be strong or weak, short or long acting, more or less hallucinogenic.

"Monkey Dust" is not a new term. MDPV is not a new drug.

Monkey Dust has been used as a slang term in Stoke/Stafford for over five years. As a trainer i have delivered sessions for the Local Authority and third sector agencies in Stoke for over ten years. The term "monkey dust" started to emerge after 4-mmc (mephedrone) and related compounds were prohibited and became more widespread after the PSA came in to force.

Stoke on Trent had a very significant issue with Synthetic Cannabinoids legally sold via local smoking shops. These sources were restricted, initially by Community Protection Orders and later as a result of the Psychoactive Substances Act.

Levels of  'monkey dust' use became more common and amongst homeless and vulnerably housed clients became as widespread and subsquently more widespread than synthetic cannabinoids.

MDPV and relatives such as a-PVP are not new drugs. MDPV emerged at the same time as Mephedrone (MCAT) and was banned in 2010. However it MDPV along with a host of other cathinones were showing up being sold as "new" "legal" highs when they were neither new nor legal.

Zombies, Hulks, Cannibalism and Prawns:
The ever-reliable Max Daly wrote a scathing critique of the media's obsession with horror stories combining shocking images with vicarious gore.

The combination of media sensationalism and hyperbole makes it harder to understand what is really going on and reinforces prejudice, fear and misunderstanding.

The various drugs sold as "monkey dust" can cause convulsions, paranoia, hallucinations, delusions and possible psychosis. So can alcohol and benzodiazepine withdrawal but we don't refer to people undergoing alcohol withdrawal as "cannibals" or "zombies."

Working with "monkey dust."Whatever is in "monkey dust" is likely to be a psychostimulant. It will send up adrenalin, causing intense fear and panic responses. It may also send up dopamine, causing delusions, euphoria and possible hallucinations. It may also send up serotonin, also causing hallucinations and increasing the risk of convulsions and overheating.

Depending on what is in a batch, other drugs consumed and individual responses the drug may wear off quite quickly, but could also last for longer periods of time. MDPV can be long acting  and so unpleasant symptoms can last 12-24 hours, possibly longer.

"Monkey dust" could contain a range of different drugs, and there is no set "antidote" or protocol for responding to episodes. The guiding principal should be assessing and responding to symptoms not trying to guess what they have used. 

In mild to moderate episodes, reassurance, de-escalation approaches and keeping the person calm can resolve the situation. Where the person is experiencing significant levels of delusion and paranoia, a safety-driven approach which endeavours to keep others safe, while looking after the wellbeing of the casualty is a priority.

This could require management of convulsions, hyperthermia, and in some situations restraint to prevent significant harm in high-risk settings.

Medical interventions to manage convulsions, psychosis, blood pressure or cardiac problems may also be required.

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