PSYCHOACTIVE DRUGS
AT THE RECENT ROYAL PHARMACEUTICAL SOCIETY IN BIRMINGHAM, DR CAROLE HUNTER, LEAD PHARMACIST, ADDICTION SERVICES, NHS GREATER GLASGOW AND CLYDE, SPOKE ABOUT WHAT PHARMACISTS NEED TO KNOW ABOUT THE NEW PSYCHOACTIVE SUBSTANCES....
A NEW THREAT... A NEW CHALLENGE P
sychotropic drugs, as pharmacists will know, is a technical term for psychiatric medicines that alter chemical levels in the brain which impact mood and behaviour. Antipsychotics, antidepressants, ADHD drugs, anti-anxiety medications and mood stabilisers are some of the more commonly-used psychotropic drugs in this country.
What is not so well known is information about the new psychoactive substances: narcotic or psychotropic drugs, in pure form or in preparation, that are not controlled by the 1961 United Nations Single Convention on Narcotic Drugs, nor the 1971 United Nations Convention on Psychotropic Substances, but which may pose a public health threat comparable to that posed by substances listed in these conventions.
These drugs were developed to improve clinical practice in the management of harms resulting from the use of ‘club drugs’ and novel psychoactive substances, and are primarily aimed at clinicians working in drug treatment, emergency departments, sexual health services, primary care and mental health services.
CLINICAL RESOURCES
Project NEPTUNE is an independent clinical expert group that has developed guidelines on treating acute NPS problems. NEPTUNE’s guidelines, which were published last year, provide both easy-to-use online training and a document, which provides guidance on the clinical management of harms resulting from acute intoxication and from the harmful and dependent
38 - SCOTTISH PHARMACIST use of club drugs and NPS.
NEPTUNE’s guidance is aimed in particular at clinicians in a range of settings and includes:
‘technical’ knowledge (what the drugs are and how they work)
‘cultural’ knowledge (who is using them, and how)
‘clinical’ knowledge (how to clinical manage both acute and chronic presentations)
THE ‘AT RISK’ SECTOR
The ‘cultural’ knowledge focuses on clubbers and night-time economy, primarily because there is evidence that people who use the night- time economy, and dance clubs or nightclubs in particular, are more likely to use club drugs than the general
There is UK and international evidence that levels of club drug use among lesbian, gay, bisexual and transgender (LGBT) people, and men who have sex with men (MSM), in particular, is higher than in the general population. Associations between club drug use and high-risk sexual behaviours among a minority of MSM have also been recognised. This includes concern over ‘chemsex’, a term used to describe sex between men that occurs under the infl uence of drugs immediately preceding and/or during the sexual session, with methamphetamine, GHB/GBL and mephedrone the drugs most often used.
‘Psychonauts’ is the term given to a group of people who explore their own psyche, especially by taking psychedelic or hallucinogenic substances. The emphasis of use is on seeking novelty and
extremes of experience.
Amphetamine-type substances (ATS) are used for their stimulant, euphoric, anorectic and, in the case of some substances, empathogenic, entactogenic and hallucinogenic properties. They produce feelings of euphoria and relief from fatigue; they may improve performance on simple tasks and increase activity. Unwanted subjective effects of amphetamines include increased anxiety, insomnia, irritability, aggression, restlessness and paranoia, and in some cases violent behaviour. Psychotic symptoms can occur when
PSYCHOACTIVE SUBSTANCES ACT
The Psychoactive Substances Act, which came into force on 26 May 2016, makes it illegal to produce, supply, import or export any psychoactive substance that is likely to be used to get high.
The Act aims to stop the sale and importation of psychoactive substances by making supply and
using amphetamines and can last for days or weeks. Serotonin syndrome or toxicity is also a potential risk.
Just as drug services need to understand and meet the needs of NPS users and their different social and cultural groups, pharmacists and other frontline healthcare staff also need to have accurate information about working with NPS users.
For further reading visit:
http://neptune-clinical-guidance.co.uk www.crew2000.org.uk www.thedrugswheel.com
importation illegal - including website sales. If someone buys a psychoactive substance from a website abroad, they could be prosecuted for importation.
Under the Act it is not illegal to possess a psychoactive substance (not covered by the Misuse of Drugs Act) unless a person intends to supply it to others or is in a custodial institution.
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