Street Drugs In The Northern Powerhouse Conference – An Overview

For those of you who didn’t have the opportunity to attend this unforgettable conference, here is a brief overview of all of the talks by the influential speakers…

Professor Fiona Measham

Professor of Criminology, Fiona Measham, works at Durham University conducting research in the fields of criminology and social policy in relation to illicit substances. Measham is an advocate for the use of education as a means to safe drug-use. Although stating that the safest way to use drugs is to not use them at all, she acknowledges that individuals will still use drugs. Therefore, by teaching people the effects of specific drugs and possible side effects there should be less hospitalisations as a result of drug-use. During her talk, she explored the ideas of what a drug policy reform may bring to society.

Prof. Measham is also the cofounder of The Loop, a non-profit community interest company that educates individuals on both drug use and sexual health at festivals and nightclubs across Europe. The Loop offer to test samples of drugs using their state-of-the-art equipment. This is especially important as a lot of drugs sold at these events are not what they claim to be with varied strengths and many having additional substances. There are then many benefits from this analysis, including: informing the individuals who bought the drugs about the contents of the drug and the likely effects, allows this information to be spread amongst others attending the event, and it informs paramedics on site so that they can treat individuals more effectively if they have adverse reactions to the drugs. The Loop ensure that people are informed so that can enjoy the event and a “safe sesh”.

Mr Neil Woods

Mr Woods is an ex-policeman who worked undercover as a heroin addict for fourteen years and is now a member of Leap UK (Law Enforcement Against Prohibition). His talk was about his experiences of uncovering and breaking down drug dealing gangs, ending with a clear message that we need to reform drug policies in the UK. Throughout his time undercover Woods was exposed to some of the most notorious criminal gangs and the violence that accompanied them. You can read his story here.

Woods described that there is currently an “urban Darwinian soup” manifesting in society when it comes to the illegal drug market (an estimated £10.7 billion per year). He elaborated this point, explaining that when police tactics for removing drugs become ‘smarter’, criminals evolve by adapting their tactics to match, usually including increased levels of organised crime (including using adolescents to carry drugs across policing districts) and more extreme violence (e.g. rape), to build their already violent reputations.

The message Mr Woods portrayed was bleak, stating that after months of being undercover (on dangerous and expensive operations) the drug market would be paused for only a few hours. He said that the drug market will always exist despite efforts to remove it and that it is only when we change government regulations and enforce drug education that we can manage the problem.

Professor Ash Soni OBE

Professor Ash Soni is both a community pharmacist and President of the Royal Pharmaceutical Society. Soni emphasises the importance of an integrated healthcare system to ensure the value of community pharmacy. Through his work, and experiences of the Needle and Syringe Exchange programme, Professor Soni delivered a talk about the reality of how illicit substances would be supplied from a health care perspective.

The talk was very important and informative, displaying the complexity of drug-reform policy changes. One factor that must be considered is the likelihood that people will in-fact purchase substances from their pharmacy. The connotations with registering as a drug-user may be off-putting and therefore we cannot ensure that people will stop purchasing from street-dealers. This being said, Soni fully supports decision making through informing. Like Measham, he vocalised the importance of informing people who are going to use drugs about hygiene and drug contents, as it is a much safer and has many benefits.

Professor Val Curran

Prof. Val Curran is the Director of the Clinical Psychopharmacology Unit at University College London, and a research lead at Camden & Islington Drug Services. In her talk, Curran discussed the benefits and risks of cannabis. She began by discussing the spiritual and medicinal use of cannabis throughout history, with examples such as Ancient Egyptians and Native Indians using it to seek enlightenment, and Queen Victoria using it to ease period pain. Prof. Curran stated that are over 100 different cannabinoids which can be isolated from cannabis, with the most notable being tetrahydrocannabinol (THC) and cannabidiol (CBD). There also many different strains of cannabis, which vary in strength and psychoactive effect (hash contains around 5% THC and 5% CBD, whereas skunk contains 15% THC and <0.1% CBD).

THC is thought to increase anxiety, psychotic experiences and the risk of dependence [1, 2]. In contrast, there is evidence to suggest that CBD reduces anxiety, psychotic experiences and even the risk of dependence [3]. There is some evidence to suggest that CBD may be a protective factor, raising the possibility of it being used as a treatment for psychosis [4]. There is an abundance of evidence showing other medicinal benefits of CBD – for treatment of muscular sclerosis, cancer pain, epilepsy, cannabis addiction, acute and chronic pain. Strains of cannabis are increasing in THC, and decreasing in CBD, as people try to create more potent strains, correlating with an increase in treatment seeking for cannabis dependence [5]. Curran highlighted the importance of legalising cannabis to utilise its medicinal benefits and regulate the potency to prevent strains containing harmful levels of THC.

Mr Andrew Costello

Andrew Costello has been a police officer for the Greater Manchester Police for 15 years. He’s currently working on the MANDRAKE project at Manchester Metropolitan University. During the conference, Andrew discussed the emergence of spice and how spice-use has evolved and entrenched itself within user groups. Spice is a synthetic cannabinoid, which was original made as a legal high in 2013, most likely due to cannabis being illegal. However, in 2016 it was also made illegal.

When spice was legal in 2013, it was sold in Head Shops, used mainly by “spice tourists”. But after the ban in 2016, the main users of spice were rough sleepers and offenders in prisons, leading to a street supply of spice. Working with Manchester Metropolitan University, the Greater Manchester Police began operation MANDRAKE, using overt and covert tactics to target the street supply of spice. This led to 8 of the main spice dealers being arrested.

Additionally, they worked together to analyse different strains of synthetic cannabinoids and examine their strengths. Using this knowledge, they were able to help several people in critical condition, who had used a strain of 99% pure spice, known as “crystallised spice”, by testing samples and transmitting the results straight to A&E. Like Curran, Costello supports the legalisation and regulation of cannabis, to prevent the further emergence of harmful strains of synthetic cannabinoids.

Dr Tim Millar

Dr Tim Millar is a Reader in Substance Use & Addiction at the University of Manchester. In his presentation, Dr Millar discussed premature and preventable mortality among illicit opioid users. Dr Millar discussed opioid use in the UK, stating that there are less opioid users than other substances in the UK, but more premature deaths in opioid users. In fact, 80% of UK drug deaths involve opioids [6]. Research conducted with the Home Office, examined any causes of premature death in a cohort of 198,247 opioid users, finding that they were nearly 6 times more likely to die prematurely than the general population. Worryingly, most deaths were not directly related to opioid use but to factors related to the marginalisation of opioid users, i.e., suicide, homicide, etc. [7].

Opioid substitute treatment, whereby substances are controlled for safer use, massively decreases mortality and reduces the risk of overdose by half, with those receiving psychological support being at a much greater risk. However, the risk of fatal overdose increases massively during the transition out of treatment and leaving the treatment “drug-free” does not appear to reduce the risk of experiencing a subsequent fatal overdose [8]. Millar vocalised that there is no obvious relationship between a country’s level of toughness on substances and level of substance use; in countries using prohibition models, the number of users may be less, but the level of harm is much greater.

Professor David Nutt

The final talk of the day was delivered by the Professor David Nutt – former chair of the UK Advisory Council on the Misuse of Drugs, and current founder and chair of Drug Science (formerly ISCD). Professor Nutt discussed the UK’s drug policies, asking the following key questions: Are illegal drugs proportionate to other harms? Do the presumed “benefits” of UK laws against drug use outweigh the costs? Do these laws reduce drug use and harms?

Nutt presented evidence that the UK’s current drug laws are majorly flawed and ineffective. He argues that they put punishment above harm reduction, which is not only immoral but penalises a marginal group of people (who usually need the most help!). He also claimed that the current drug laws are not based on scientific evidence – that there is no correlation between the proven harms of specific drugs and their classification within UK Drug Acts, or the UN conventions. For example, tobacco and alcohol are the two biggest causes of premature death and are the most harmful to society, yet they are legal.

Also, Professor Nutt showed that prohibition does not work and is more harmful as it leads to alternative versions of substances are created when people are unable to access the original substance. For example, PMA/PMMA was created as an alternative to MDMA, crack was created as an alternative to cocaine, and spice was created as an alternative to cannabis. These substances are even more harmful than the original drug.

His message was clear – the current drug laws create more harm, rather than prevent it and a policy reform is well overdue!

“It’s time to put science, not politics, at the heart of UK drug policy”

References

[1] Curran, V. H., Brignell, C., Fletcher, S., Middleton, P., & Henry, J. (2002). Cognitive and subjective dose-response effects of acute oral Δ 9-tetrahydrocannabinol (THC) in infrequent cannabis users. Psychopharmacology164(1), 61-70.

[2] Englund, A., Freeman, T. P., Murray, R. M., & McGuire, P. (2017). Can we make cannabis safer?. The Lancet Psychiatry4(8), 643-648.

[3] Leweke, F. M., Piomelli, D., Pahlisch, F., Muhl, D., Gerth, C. W., Hoyer, C., … & Koethe, D. (2012). Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia. Translational psychiatry2(3), e94.

[4] Morgan, C. J., & Curran, H. V. (2008). Effects of cannabidiol on schizophrenia-like symptoms in people who use cannabis. The British Journal of Psychiatry192(4), 306-307.

[5] Freeman, T. P., & Winstock, A. R. (2015). Examining the profile of high-potency cannabis and its association with severity of cannabis dependence. Psychological medicine45(15), 3181-3189.

[6]https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsrelatedtodrugpoisoninginenglandandwales/2016registrations

[7] Pierce, M., Bird, S. M., Hickman, M., & Millar, T. (2015). National record linkage study of mortality for a large cohort of opioid users ascertained by drug treatment or criminal justice sources in England, 2005–2009. Drug & Alcohol Dependence146, 17-23.

[8] Pierce, M., Bird, S. M., Hickman, M., Marsden, J., Dunn, G., Jones, A., & Millar, T. (2016). Impact of treatment for opioid dependence on fatal drug‐related poisoning: a national cohort study in England. Addiction111(2), 298-308.

Contribution by Patsy and Jasmine, editors at PsychLiverpool.

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