Legal highs - and lows

It was just hours before the gig was due to start. They’d been looking forward to seeing Massive Attack for ages and thought they’d just pop a couple of pills to try to have a more exciting time over the evening. But the night did not turn out as they hoped.

“We felt really nauseous,” says James*. “After half an hour we were feeling really exhausted, but we were completely unable to sleep. We even had to call in sick for work the next day.”

The pills were benzylpiperazine, more commonly known as BZP, a drug that at the time was legal in the UK, where James and his partner live. With effects similar to those of amphetamines and ecstasy, BZP was popular as a legal alternative on the clubbing scene before it was designated a class C drug under #link:https://www.gov.uk/penalties-drug-possession-dealing:the UK’s classification system of illegal drugs# - alongside anabolic steroids and benzodiazepines like diazepam - #link:http://news.bbc.co.uk/1/hi/8427439.stm:in 2009.#

New psychoactive substances - or so-called ‘legal highs’ - are used as alternatives to their illicit cousins, with many mimicking the effects of cocaine, cannabis and amphetamines.

In recent years, legal highs such as “Meow Meow” and “Spice” have hit the market, quickly being banned in many countries, including in Europe and the US, as authorities struggle to determine the risks posed by these unknown substances. As each product is made illegal, new legal versions, where the compound has been changed slightly, appear on the market to take its place. The number of legal highs available on the global market more than doubled from 166 in 2009 to 348 in 2013, exceeding the number of controlled substances at an international level, according to the #link:http://www.unodc.org/documents/wdr2014/World_Drug_Report_2014_web.pdf:United Nation’s World Drug Report 2014.#

Legal means safe

The relative ease in the availability of such drugs makes them particularly attractive to young people, who are unaware of, or ignore, their potential dangers.

Before BZP became illegal, James bought his in a small, colorful package from a “head shop”, a store specializing in tobacco, legal drugs and drug-related paraphernalia. “They came as capsules,” James says. “There were three or four and we were supposed to take all of them. Because they were legal we thought they were safe.”

It is a sentiment shared by many who take legal highs. And there are some who enjoy the effects and have positive experiences with the drugs. However, the consequences for others can be dire, resulting in hospitalization or #link:http://www.bbc.com/news/uk-29829172:even death.#

Uncertainties over what the drugs are made of and how they will affect those taking them surround legal highs and are what make them dangerous, according to David Caldicott, an emergency room medic at Calvary Hospital in Australia’s capital, Canberra.

“The products that are being consumed by young people are products that have never been described before, even by doctors like myself – drug nerds,” says Caldicott, who analyzes legal highs to diagnose and treat patients. “People present themselves in an emergency department in a way we’ve never seen before – the drug can’t be identified in urine.”

Delivered by your post man

Identifying the drugs and finding out where they came from has become even more difficult with the evolution of the internet. Being able to go online has made psychoactive substances easier to obtain and even created the opportunity to use new potential compounds using scientific research published on the web.

While some of the chemicals created and adapted are done so by “intelligent graduate chemists” keen to make an impression on their peers, what they come up with is exploited by individuals and firms looking to make money, says Caldicott.

“They’re made in places like southwest India and China, probably by proper chemical or pharma companies and therefore with a great deal of purity,” he said. “Then they are delivered, not by shady street corner people, but by your local post man.”

Then there are #link:http://www.theguardian.com/society/2014/jul/04/psychonauts-drugs-experiment-chemistry-legal-highs:the psychonauts#, who test new compounds, making themselves the guinea pigs before blogging about their experiences – how long the drug took to work, what the effects were, dosages – for others to find and experiment with, regardless of the outcome.

Blanket bans

Governments all over the world are continuing to struggle with regulating legal highs. Some countries have put a blanket ban on psychoactive substances, while others like New Zealand try a different approach. In 2013, the country’s parliament voted to pass the #link:http://psychoactives.health.govt.nz/psychoactive-substances-act-2013/background-act-and-regime:Psychoactive Substances Act#, which requires products to be approved by the Psychoactive Substance Regulatory Authority. Businesses must then obtain a license to sell them.

In Europe, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) assesses the risks posed by new and previously unknown legal highs as they appear on the market. However, it is the member states themselves that take action if they believe a new substance is causing harm in their jurisdiction, says Andrew Cunningham, scientific analyst at the EMCDDA.

“The EU member states have introduced a range of legal responses geared toward controlling the open sale of these substances,” he said. “These include rapid interventions that have been put in place to allow countries time to design other responses or to fill the gap before drug law can be enacted.”

Such measures include creating controls using consumer safety or medicines legislation, extending and adapting existing laws or devising new legislation, he adds.

Caldicott blames the crackdown many countries have made on illegal drugs for the evolution of legal highs.

“You have a situation where these drugs are transitioning so fast that we don’t have time to keep up with them,” he said. “This is the scenario that scares me the most because it’s very hard for me to keep up with what’s going on and therefore it’s quite hard for the consumer to know what’s going on. I hanker after the good old days of just having to treat heroin overdoses.”

*Names have been changed to protect the identity of the interviewees