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Video FAQ Transcript

Below is a transcript of the Video FAQs on Legal and Illegal Highs

What are Bath Salts & Powders

The head shops now sell a range of drugs that are designed to mimic the effects of illegal drugs that have been around for a long period of time. I suppose the most notorious category of product that they have been selling are those sold as bath salts, which are generally in the cathinone category of drug. They are designed to mimic the effects of cocaine or a strong ecstasy type effect. Again, as with all of the products sold in the head shop come in packages saying not for human consumption, either with a statement saying that they are bath salts or plant food, but typically what people will do is they will snort the bath salts to get a cocaine type effect. A minority of drug users are actually choosing to dissolve the powder and inject it which is bringing a very significant problem for them linked to the hazards of injecting.


What are Herbal highs and smokable products

They were marketed as herbal highs which are products designed to mimic the effects of cannabis. What the shops weren’t telling people was that these products as well as containing herbal material such as rose hip leaves and marshmallow leaves were also sprayed with artificial, synthetic chemicals that stimulate the same brain receptor as THC does. THC being the active drug in cannabis - so when smoked they gave an effect quite like cannabis. The recent legislation in Ireland appears to have been comprehensive in banning all of these synthetic cannabis type drugs so none of those have re-appeared on the head shop shelf as yet.   


What are Party Pills?

Party pills are again designed to mimic … ecstasy or a mild sort of speed or amphetamine... BZP is a drug that people may have heard of certainly it was widely used in Ireland before it was banned in June 2009 and it was certainly widely used for a good few years in places like New Zealand. It is part of a category of drugs called the peperizines and quite a few of those have appeared in the recent products sold in the shops. Many of those though were banned in Ireland in the recent modication to the Misuse of Drugs Act but other stimulant drugs, synthetic drugs have now appeared on the shelves.


What are Hallucinogens?

These are drugs that are again designed to mimic the effect of LSD or magic mushrooms both of which are illegal but these drugs that are not listed on the Misuse of Drugs act and therefore not yet illegal. Some of which are synthetic, some of which are sorts of plant materials - exotic plants grown in various weird and wonderful parts of the world which produce a hallucinogenic experience.


What effects do the powders and bath salts have?

The bath salt category of drugs, the mephadrone type drugs, seem to have a particular ability to produce very unpleasant psychological experiences and even people who remain committed to continuing drug use who try these drugs for a while are increasingly recognising that they are a particularly nasty category of drugs. They produce … an unusually frequent amount of paranoia, confusion, irritability, deterioration in mood, with some suicidal thoughts and suicidal behaviour, people hallucinating in a way that they find very very distressing. I think these drugs are appropriately getting a bad name, I suppose across multiple sectors of our society including the drug using population within Ireland. Psychiatric hospitals have seen a significant increase in admissions of people presenting with brief psychotic episodes which seem very linked to use of these drugs, again particularly the bath salt or cathinone type drugs.  


Why do people use drugs?

Obviously people take drugs because they want a pleasant experience out of it and where the drugs are designed to produce slightly different psychological or different sorts of highs they tend to produce increased energy, a positive mood, increased sociability, … a sort of “loved up” sort of feeling. Some are more stimulant than others and … the bath salt category of drugs and the party pills fit into that broad category of desired response.


What psychological problems can they cause?

In terms of the psychological problems that people are encountering while using these drugs, many of them are confined to the intoxification phase. After three or four hours people settle down if they have become acutely paranoid and confused and irritable or acutely depressed. After a few hours those distressing psychological symptoms pass but in a good number of people they are not passing in a number of hours and are persisting for a few days and again that has resulted in people being admitted to hospital, sometimes involuntarily sectioned into psychiatric hospital because they have lost touch with reality to such a degree that they need to be hospitalised for their own safety.


Are there any particular risks for young people?

What we have also seen … is a significant number of teenagers presenting with acute anxiety states, where after consuming the drugs, they become acutely anxious, sometimes with palpitations, sort of a racing heart and acutely self-conscious, very aware of their own voice, very aware of their own movements, the world around them doesn’t seem quite real and it’s symptoms that psychiatrists would call de-personalisation or de-realisation, which are very distressing for the individual involved. Again some of those are quite time limited, just around the time the drug is used, and pass after a few hours. But certainly we have encountered cases where those particular symptoms have persisted for weeks and in one or two cases for quite a few months, making those individuals’ lives very difficult for quite a prolonged period of time.   


How serious a problem are they?

Our clinical experience, as a service that deals with teenagers with drug and alcohol problems, is that … in 2008 we weren’t seeing anyone reporting use of these drugs. By the end of 2009 and into 2010 now they’re probably part of the substance problem profile of about one quarter of the young people who access the service, they are presenting saying that they are using these drugs and it’s contributing to their substance abuse problem, but again often in combination with other substances like cannabis or alcohol or benzodiazapines or cocaine.


What are the physical side effects?

The most common sorts of physical symptoms or side effects that people are encountering are excessive sweating, headaches, nausea, upset stomach and so on, and then there are some sort of stranger side effects that might be a bit rarer again particularly with the cathinone type drugs. About 15% of the users reported cold peripheries, or cold fingers and blue fingers, suggesting poor circulation linked to use of these drugs and now there is increasing speculation that the cathinone type drugs like mephadrone … seem to damage small blood vessels, or else cause blood to clot in those blood vessels. Another side effect I haven’t mentioned so far is effect on bladder function. The bladder is obviously where urine is stored and we seem to be getting two different types of effect there, regular users of the head shop products are reporting incontinence where they just end up … peeing themselves and often times not realising it, others are reporting significant difficulty just going to the toilet, that they can’t pee when they want to.


Are there any long term side effects?

In terms of the medium and long term side effects it would seem likely that some of them (psychoactive substances) are going to be carcinogenic. We know that some of the drugs that fall into the same categories as these drugs are carcinogenic but the way cancers develop, they develop over years if not decades, it might be 2020 before we make linkages between regular users of these drugs and subsequent development of cancers.


Are they safe to use if pregnant?

… another sort of physical concern I have about these drugs relates to potentially damaging effects on the developing foetus. If a woman takes them when she’s pregnant, maybe not knowing that she’s pregnant. Again generally what we know about drugs, whether they are prescribed or illegal drugs, is that some do have a propensity to damage foetal development, either damaged limb development as say drugs like thalidomide did, but also to potentially damage the developing brain of the foetus. Again these drugs have never been tested in animals or humans so we don’t know how many of them are going to be damaging to the developing foetus but there are so many of the drugs in this particular category I suppose it would seem inevitable that some will be, but again it will be decades before we know. So, I think it would be prudent advice for young women who … are at risk of becoming pregnant to avoid use of these drugs. 


Can they damage the brain?  

As with all drugs there is the potential that these drugs will damage the brain function of the individual who takes them. It is becoming increasingly clear that drugs that are abused by humans, whether you are looking at alcohol and cannabis, or particularly at potent stimulators like cocaine and amphetamine, again drugs that many of the head shop products are designed to mimic, we know that regular use of those drugs over prolonged periods of time does have a negative impact on brain functioning. That has been demonstrated now with MRI studies of brain functioning in those individuals who are regular users of illegal drugs. What research tells us is that if people start taking the drug there seems to be a degree of recovery which may be complete in some individuals but seems to be incomplete in other individuals. And again it appears inevitable that these head shop drugs will have a similar propensity to cause brain changes in those people who use them on a regular basis.


Can they cause death?

(Since recording this video a death has been directly linked to use of illegal and legal highs in the Republic of Ireland)

There have been deaths linked to mephadrone certainly in Europe and in Britain. I would be shocked if there hadn’t actually already been overdose deaths linked to mephadrone, it’s just the coroners system in Ireland moves quite slowly so people who died of overdoses in the last six months, they won’t have come to the coroner’s court for an inquest. Now their case won’t be heard for probably another six or twelve months, and what I would confidently predict will happen is that some of the overdose deaths that have occurred in Ireland in the last number of months will involve use of head shop products. My guess though is that they will be in combination with alcohol and perhaps other illegal drugs like cocaine, so once again it would be hard to prove causality but it would seem sort of impossible based on what we know about drugs again whether prescribed by doctors or developed by pharmaceutical companies are illegal drugs but some people will just find themselves having you know strange reactions to these drugs, some people with underlying cardiac problems it will just exacerbate that and they will end up just dropping dead.


Is it dangerous to use them with other drugs such as alcohol?

Head shop products are typically consumed with alcohol it would appear. People tend to take them on a night out, maybe after having had a few drinks beforehand… I would worry about that combination. Trying to understand or figure out the impact that alcohol or other drug use in combination with the head shop products it is hard to draw conclusions, but based on what we know from other drugs it that usually when you take things in combination you are increasing the likelihood of an overdose scenario or an unpleasant, unwanted psychiatric or psychological event occurring.


Are they as dangerous as other drugs?

It would be my opinion that the bath salt type drugs like mephadrone or the cathinones are really at the extreme end of the spectrum. They are up there with cocaine and heroin in terms of their potential harm and I think it is wise, with particular urgency, that we really tackle those drugs and make sure that people don’t have ready and easy access to them in shops. I think the spice or smoke type drugs that were designed to mimic the effect of cannabis in my opinion are probably more dangerous than cannabis and .., as such, need to be tackled even more robustly than we would tackle cannabis.


What about mental health problems?

Again the drugs haven’t been around long enough to make definitive conclusions about the impact on long term mental health. We are still required to give medical advice and I think that’s got to be precautionary. What we know about other drugs and perhaps the one we know the most about is cannabis. It is the one that has been studied for the longest period of time across the largest population groups and you know people who smoke cannabis a lot during their teenage years are doubling or trebling their risk of developing schizophrenia in adulthood and that seems to happen maybe because some people with an underlying genetic vulnerability smoke a lot of cannabis during their teenage years it affects that brain development which is on-going throughout the teenage years and you know causes damage to it which means the brain doesn’t function right and it manifests itself as an illness like schizophrenia. But even though those people might have had that genetic vulnerability if they had devoted cannabis use they would never have developed schizophrenia so it’s doubling or trebling the risk from 1% to two or three percent with cannabis and to put that in perspective if you have got I suppose a thousand fifteen year olds who don’t smoke cannabis, ten will develop schizophrenia statistically over their life. If you have a thousand cannabis smoking fifteen year olds, maybe twenty or thirty will develop schizophrenia. Ten would have developed it anyway but you are getting ten or twenty people more than would naturally have occurred. It does still mean of course that 97% of those cannabis smoking teenagers will get away with it but I guess it’s a big risk to take in life. Schizophrenia is not an illness you would like to wish on anyone so again it’s a reason … to delay use of these drugs, if you are determined to use them, for as long as possible.

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The HSE and Union of Students in Ireland (USI) ask students to think about drug safety measures when using club drugs
Harm reduction messages from the #SaferStudentNights campaign.
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