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Many working in substance misuse will no doubt be relieved that the government is pushing ahead with the Psychoactive Substances Bill, which will introduce a blanket ban on the production, distribution, sale and supply of so-called ‘legal highs’. 

Whilst the proposed Bill is making its passage through parliament, there are still many head shops and online stores brandishing the highly controversial concoctions reported to have killed over 60 people during 2014 alone.  

The availability and prevalence of ‘legal highs’ is particularly troublesome in London and other inner-city areas, where substance misuse professionals are having to respond to the growing number of people recreationally using them. 

Essentially, ‘legal highs’ replicate the effects of many illegal drugs and so the risk profiles are very much the same. Many have reported to be just a small slight of chemistry away from class A drugs. 

A challenge for those working in substance misuse


What’s particularly challenging is that the changes in drug chemistry have been so rapid that not even the government has been able to know what’s really being sold effectively over the counter. With Greater London alone reportedly having 16 head shops, there’s likely to be a significant number of people addicted to these somewhat ‘unknown’ psychoactive substances. This itself presents those working in substance misuse jobs with a challenge that is somewhat unique to the ‘legal highs’ scene.

From an addiction point of view, the onslaught and availability of synthetic cannabis has been somewhat of a game-changer in drug addiction in recent years. The substance replicates the active chemicals of the cannabis plant, including tetrahydrocannabinol (THC).

With cannabis there is both THC and cannabidiol (CBD), the active substance that calms down the person that takes it. With the synthetic versions of cannabis CBD is often missing altogether, making the ‘drug’ up to 50 times stronger. 

Central and North West London NHS Trust research


Given the potency of legal highs, commonly referred to as Novel Psychoactive Drugs (NPD), substance misuse professionals in London have been busy formulating treatment options over the last couple of years. Formed by the Central and North West London NHS Foundation Trust, the Novel Psychoactive Treatment UK network (NEPTUNE) takes a closer look at the options available to the NHS in helping people that are taking NPDs. In its initial report on 27th March 2015, NEPTUNE acknowledged that there was little clinical experience of treating problems resulting from the use of psychoactive club drugs. Now entering into Phase II of its recommendations it aims to provide learning resources and tools across a range of health settings, in ways that are straightforward to implement. In light, of the imminent change in law, the recommended changes and approaches will no doubt be welcome by those working in substance misuse throughout the UK. 

Potential impact on youth offending 


It is hoped that the NEPTUNE recommendations will take a look at what can be done to respond to the growing number of young people taking the substances. 

With London-based legal highs charity Angelus reporting that 13.6% of 14-18 year old school students and 19% of University Freshers had tried a ‘legal high’, it’s alarming how many young people have experimented with the substances. 

Unsurprisingly, the number of police incidents involving ‘legal highs’ also rose by 169% in 2014 compared to 2013, The Centre for Social Justice found. 

UK global hub for the legal highs

 
Furthermore, the Centre for Social Justice claims that the UK is effectively a ‘global hub’ for the legal highs trade. Instead of cartels, the substances are not just purchased through head shops but on over 115 websites registered to the UK. 

Some have gone remarkably quiet on twitter since the Queen’s speech, maintaining a somewhat muted profile, whilst others still remain quite blatant in their promise of next day delivery. 

Until the ban goes ahead though, Police are still pretty much reliant on issuing health warnings, especially in cities across the UK. Only last Friday Police in Manchester issued an urgent health warning on a psychoactive substance known as Vertex as thousands visited the city for a big music festival. 

Warnings came after authorities were alerted to several people being taken to hospital after having taken the substance. Alarmingly, Vertex is reported to contain a particularly lethal chemical known as AB-CHMINACA, which has been responsible for a number of seizures, deaths and psychotic behaviours. 

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