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NPS Novel Psychoactive Substances Tony D’Agostino Start Outline • Current UK Snapshot • What are they? • Service User Consultation • Recommendations Current UK Snapshot • Cocaine • Ecstasy MDMA crystals • Cannabis • Ketamine – Methoxetamine • Methamphetamine starting to appear? • BZP • Mephedrone Internet trends • “…it is likely that the future drugs of abuse will be synthetics rather than plant products. They will be synthesized from readily available chemicals, will be very potent, and often very selective in their action. In addition, they will be marketed very cleverly.” Gary Henderson, Journal of Forensic Science 1988 Changing Markets • Main manufacturers – China & India • Sold from sites in those countries and shipped internationally (customs disrupts some trade) • OR • Imported in bulk to UK vendor • Then sold to people on UK based websites Online Vendor Purities reality • (SOCA) has shown that around 19% of batches contain illegal substances • Some retailers don’t even tell people what chemicals are in the product • Words like ‘blend’ are used • Very high caffeine or all caffeine content Khat Salvia divinorum Nitrous Oxide Fly agaric (muscimol) Ketamine (K, Special K) • Dissociative anesthetic Methoxetamine Mephedrone • Meow • M-cat • Bath Salts • Drone • Fert • Etc Skunk and Haze Original Concentrates Spice Gold Black Mamba Annihilation 5F-AKB48 and 5F-PB22. Cherry Bomb Service user consultation • Commissioned by Bucks Drug and Alcohol Action Team (DAAT) • Conducted between September and December 2014 • 84 (problematic) non-opiate users interviewed from drug service providers in Aylesbury, High Wycombe, Buckingham, Chesham and Burnham Routes of use 57% Snorted 44% Smoked 42% Orally 29% Injected Injecting mephedrone • Injected 20 to 50 times a day over a period of 3 days or more • 12 to 20 grams in a 24 hour period. • Re-using needles and admitted to sharing • Hepatitis C was identified / vein damage • Un-hygienic environments (tents) • Picking needles up from pharmacies • Adulterated mephedrone Debt & Housing • Rent arrears, court fines, debt to family and friends, dealers and debts to other users • Clear difference between users in services (who tended to have some form of housing) and those who were outside services • Off the Concrete & Homelessness Project Costs The total, low estimated cost to the local authority, NHS and DWP • 61 individuals is approximately £2.2 million per year. • This equates to an annual estimated bill of nearly £37,000 per person. Recommendations Key strategic • Partnership approach • Coherent non-opiate strategy • Steering group - non-opiate leads nominated Key operational • Targeted outreach team - could work alongside the Thames Valley Police, community engagement team, A&E • Private Landlord Scheme • BBV’s, infection control, needle exchange and disposal - Further screening and medical support is necessary, among users injecting mephedrone QUESTIONS