Advice on “Legal Highs” For Homelessness Services
It seems like hardly a day goes by without the news media broadcasting a lurid tale of young people taking so-called ‘legal highs’ at some festival or other. But does this deter use or simply increase anxiety amongst parents? By all accounts it is the latter.
But these Novel Psychoactive Substances (or NPS, to give them their official title) can have life-threatening consequences and appear to be having a far greater impact amongst the homeless and prison populations. So what can support services for these groups do to ensure clients remain safe?
Homeless Link has produced a new briefing on NPS that provides some useful Good Practice tips. It states that the acute symptoms from an overdose of NPS include seizures, vomiting, unconsciousness and psychosis. Where acute symptoms occur, the following will help to minimise harm:
- Maintain direct visual observation at all times.
- Treat as medical emergency rather than a public order offence or mental health episode.
- Call an ambulance rather than escorting in a police vehicle or a psychiatric unit.
Early identification and admission to A&E will give access to treatment, which may include rapid sedation and cooling followed by emergency anaesthetic.
Where NPS results in aggressive behaviour, there should be a local policy clear to all staff and clients on how this will be dealt with, following any medical intervention.
Of particular concern is the rise of synthetic cannabinoids (chemicals that activate cannabis receptors in the brain) because they are so potent that they can over-stimulate the brain leading to a seizure and, in some cases death. This is unheard of, as there has not been one recorded fatality caused by natural cannabis in the 10,000 years or so that humans have been using the plant.
So what is going on and how have we ended up here? Alan Matthews, Chair of Trustees at Bosco House, is a researcher and trainer with over 30 years experience in the drugs field. We asked him to explain the situation.
“I first heard about synthetic cannabis in Jersey, the Channel Islands, in 2002. Youth workers there told me that young people on the island were into this product called Spice, which you could buy legally in Head Shops. I was sceptical at the time because I reckoned that if it got you high it must be illegal. But at that time it was legal and from then on it just took off all over the country.”
The potency is the problem
“The reason why things like Spice are so potent, and so dangerous, is that this stuff really is not meant for human consumption. These chemicals, known in scientific circles as Synthetic Cannabis Receptor Agonists, or SCRAs for short, were invented to study the human cannabis receptor system – yes, we’re wired for cannabis!”
“When some entrepreneurs realised that these turned on our cannabis receptors they sprayed them on to some herbs and marketed it as Spice. The trouble is, these chemicals are designed to be used in the laboratory at tiny doses, millionths of a gram, but a bag of Spice may contain a couple of grams of highly potent material. Users have no way of knowing the correct dose so they often put as much in a joint as they would normally using real cannabis, and that’s how problems occur.”
“And then there’s the “baggy-bottom” problem. Because this stuff is sprayed onto the herbs it has a tendency to fall off and gather as dust in the bottom of the bag. When the user comes to the end of the bag they just pour all this highly potent dust into a joint. That’s an overdose, right there.”
“The government recently brought out a catch-all law, The Psychoactive Substances Act, which bans selling anything that has a psychoactive effect. But,” Alan adds, with a wry smile, “Alcohol and tobacco are exempt from this law, of course.”
Homeless Link recommend that client assessments should include questions about drug use, particularly NPS, and this should be discussed in key-work sessions. Building good rapport will help the client to feel comfortable and share personal information.
Staff should also be able to talk about their service’s drugs policy and be aware of their responsibilities under the Misuse of Drugs Act. To ensure this, staff should have sufficient training in these issues to gain the knowledge and confidence to engage clients in an effective conversation about their drug use.
If you would like to find out more about this topic or discuss learning needs for your group, email alan@alanmatthews.org.uk
The Homeless Link NPS Briefing for Homelessness Services can be downloaded here http://www.homeless.org.uk/sites/default/files/site-attachments/New%20Psychoactive%20Substances%20briefing%20July%202016.pdf
