Hard News by Russell Brown

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Hard News: The perilous birth of the Psychoactive Substances Act

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  • Russell Brown, in reply to debunk,

    The point is that “A large number of synthetic cannabinoids have been designated class B drugs” (UK) “As with all legal highs, it is unfortunately not clear for users” (that) “many brands vary enormously in the compounds they contain” ie they are not THC – the main active compound in cannabis

    No. By definition they’re not. That’s also covered in the original post.

    What's been happening until now is that consumers not only don’t know what a given cannabinoid does, they haven’t even known what they’re consuming. In the case of prohibited drugs, it's even worse. See my comments on the NBOMe class.

    As a post-grad psychopharmacologist I am appalled at the state of ignorance in New Zealand about psychoactive drugs and their dangers – and this includes anti-depressants, “mood” changers etc – all of which are poorly researched. No-one is going to “research” these legal highs if they can’t even do proper assessments of main stream drugs!

    I’m hopefully going to be able to ask some questions about the trial and approval process of the authority soon. But the idea that even drugs formally approved for prescription by doctors can’t necessarily be trusted is kind of a different issue.

    Auckland • Since Nov 2006 • 22754 posts Report Reply

  • debunk, in reply to Russell Brown,

    Robert Whitaker's two books "Mad in America" and "Anatomy of an Epidemic" are instructive for anyone interested in how much research has gone into mainstream psychiatric drugs ..not a lot. The only useful test for the effects of these assorted "legal highs" will be hospital attendances, symptoms, deaths and disabilities, that one hopes will be recorded against the product type (assuming that the hospital can find this out). What would you measure otherwise? And how will the governments who allow this account for the social and health costs? These are the questions this blog should address, in my view. Despite the rugby terminology of prescription "pills" there's no difference in the basic issues. Richard Bentall's "Doctoring the Mind" is also useful; times and attitudes are changing. What will happen is that "legal high" users will end up in the psychiatric wards and be treated with the even more noxious anti-psychotics, "antidepressants" and various offlabel drugs meant for epileptics but now favoured for "seizures"..that's where this Act and these sales are heading. British Psychiatry lecturer Joanna Moncrieff's "The Myth of the Chemical Cure"and "The Bitterest Pills" are also timely and informative.

    New Zealand • Since Aug 2012 • 105 posts Report Reply

  • Rich of Observationz, in reply to debunk,

    No-one is going to "research" these legal highs if they can't even do proper assessments of main stream drugs!

    It's not an easy thing to do, right?

    An antibiotic, you can measure primary outcomes in terms of the progression of the infection. With something like a hypertension drug, you measure blood pressure, which is a surrogate outcome. (I owe Ben Goldacre for this insight)

    Any kind of psychoactive substance, you can pretty much only talk to the subject and see how it makes them feel - it's highly subjective. So if one gets told that something causes kidney failure, brain damage and excessive flatulence, there's a good chance of presenting with appropriate symptoms even if it does none of those things.

    The experiment I would really like to see done would be to introduce an inert placebo into the market and see how many users present at casualty or report unwanted effects.

    Back in Wellington • Since Nov 2006 • 5550 posts Report Reply

  • Ian Dalziel, in reply to debunk,

    ...the social and health costs

    from The Press today

    A 28-year-old Avonhead man has been granted a discharge without conviction after his first venture into using a type of synthetic cannabis led to him doing $5271 damage around the neighbourhood....
    ...She said at his sentencing today: "Unfortunately, you are like a lot of young men we see before the courts because of the use of legal highs."
    Using a synthetic high he had never used before had made him "quite psychotic".

    Christchurch • Since Dec 2006 • 7889 posts Report Reply

  • debunk, in reply to Ian Dalziel,

    Concluding sentences in "The Bitterest Pills" by psychiatrist academic Joanna Moncrieff palgrave macmillan 2013:

    "The increasingly indiscriminate prescribing/_availability_ of these noxious substances represents a substantial public health problem waiting to happen. The vision of a population incapacitated by prolonged chemical toxicity may be be realised if we don't wake up to the real nature of antipsychotic/_"legal high"_ drugs."

    I have substituted "availability" for "prescribing" and "legal high" for "antipsychotic" ..this is what is happening and it will only get worse. Hon Peter Dunne has sealed his political legacy and it will not be a proud one!

    New Zealand • Since Aug 2012 • 105 posts Report Reply

  • debunk, in reply to Rich of Observationz,

    There can be a socially-mediated placebo effect with ordinary garden strength cannabis (same with laughing, or yawning response) but I doubt whether you will see it with these "legal high" concoctions ..which are selected for their desired effect as per chemistryworld article I quote earlier..so much to choose from why would they market weak product, and why would consumers buy it?

    New Zealand • Since Aug 2012 • 105 posts Report Reply

  • Virginia Brooks, in reply to Rebecca Williams,

    There is a thriving black market where old stock is being sold on. But new (illegal) product is also for sale in the NZ black market.
    A key problem with many of the synthetics is they are made at mass volume to sell cheap. This is achieved by using inexpensive compounds chemically unfit for human consumption / and in cocktail combinations that are toxic. Fit for human use isn't the point. Making money is. Its business, pure and simple (uh no, not ethical). The manufacturing is part of the same counterfeit industry known for bringing us cheap bags, clothes, parallel imports of all shapes and descriptions including food and legal medicines.
    The Psychoactive Substances Act may be forward thinking legislation. Prohibition doesn't work. Hopefully the Act will drive demand for 'safer' products and educate as it goes. But much like the official economy, it will only ever control part of the market.

    Since Jun 2008 • 43 posts Report Reply

  • Russell Brown, in reply to debunk,

    Robert Whitaker’s two books “Mad in America” and “Anatomy of an Epidemic” are instructive for anyone interested in how much research has gone into mainstream psychiatric drugs ..not a lot. The only useful test for the effects of these assorted “legal highs” will be hospital attendances, symptoms, deaths and disabilities, that one hopes will be recorded against the product type (assuming that the hospital can find this out).

    Any approvals will apply to individual products, rather than active ingredients, and the same is true for the monitoring of adverse reactions. That's covered here. Reports are collated by the Centre for Adverse Reactions Monitoring (CARM) at Otago University.

    The Authority's paper on reporting includes this passage:

    "As with all post-market safety monitoring systems, including medicines monitoring systems, the data sources available tend to underestimate the risk posed by a product. In order to ensure that products pose no more than a low risk of harm, the Authority has taken a precautionary approach by setting the risk score for acceptable products at a very low level.

    The effect of this decision is that a single report of a severe adverse effect, such as an epileptic seizure, is sufficient to identify the product as posing more than a low risk of harm. Details of the risk framework and the products which have been assessed and approved are available on the Ministry of Health website."

    And how will the governments who allow this account for the social and health costs? These are the questions this blog should address, in my view.

    It might help if you could address any of the reasons that this Act exists. You've repeatedly quoted the Chemistry World article. Why do you think that article describes New Zealand as "leading the way" with this legislation?

    Auckland • Since Nov 2006 • 22754 posts Report Reply

  • Russell Brown, in reply to debunk,

    There can be a socially-mediated placebo effect with ordinary garden strength cannabis (same with laughing, or yawning response) but I doubt whether you will see it with these “legal high” concoctions ..which are selected for their desired effect as per chemistryworld article I quote earlier.

    The adverse reactions to the most risky synthetic cannabinoids definitely aren't placebo. There's plenty to attest to that in the relevant Erowid experience vault. It's troubling that most of the adverse reactions involve JWH 018, which was the ingredient in Kronic and other pre-regulation products. It should never have been on sale to the public, but it was because until last year there was no regulation.

    so much to choose from why would they market weak product, and why would consumers buy it?

    Consumers didn't choose JWH 018 -- it simply happened to be in products made available for sale. Users had no way of knowing what was in the products they bought. It's not as straightforward as it being 'weak" or "strong".

    Auckland • Since Nov 2006 • 22754 posts Report Reply

  • Russell Brown, in reply to Virginia Brooks,

    The Psychoactive Substances Act may be forward thinking legislation. Prohibition doesn’t work. Hopefully the Act will drive demand for ‘safer’ products and educate as it goes. But much like the official economy, it will only ever control part of the market.

    Yeah, I think that's true and everyone knows it. But the alternative was an uncontrolled market.

    I do hope that eventually this kind of approach will cover currently illicit drugs. The situation with Chinese-made NBOMe drugs taking the place of LSD in the market is bad. A young guy in Christchurch was put in intensive care with kidney and cardiac complications last month. Whatever LSD's flaws, it doesn't do that.

    Auckland • Since Nov 2006 • 22754 posts Report Reply

  • Ian Dalziel,

    covalence ambivalence...
    I'm thinking this discussion may have to head over to the Feed masthead - addressing as it does, the fine NZ traditions of home 'bake and shake' at a molecular level...

    ;- )

    Christchurch • Since Dec 2006 • 7889 posts Report Reply

  • debunk, in reply to Russell Brown,

    The aspect of the article that I hoped would attract attention from those who already think NZ is best at all things and always ready to re-invent the wheel - was the way that manufacturers are choosing product to copy. LSD, and heavy cannabis consumption, does have nasty effects too, such as hastening psychosis which will nowadays be "treated" with atypical antipsychotics which shorten life by 15-20 years due to metabolic effects (weight gain, diabetes etc and worse in younger people - just what NZ needs) and one can perhaps speculate how much of our current problems with body weight and diabetes etc are a consequence of prescribed "antidepressant" drug side effects. End of my comments. Just do some reading - and not just the bits of articles that reinforce your existing prejudices.

    New Zealand • Since Aug 2012 • 105 posts Report Reply

  • George Darroch,

    I was at a local body committee meeting this morning. It's fair to say that the councillors were disappointed that the responsibility for making the decision on the location of outlets had been put in their hands. They did not know the harm caused by these substances, and were waiting for guidance from the Ministry of Health. But they felt compelled to make decisions on the basis of community response and a desire to minimise harm.

    WLG • Since Nov 2006 • 2264 posts Report Reply

  • Josh Petyt, in reply to debunk,

    Just do some reading – and not just the bits of articles that reinforce your existing prejudices.

    If that’s your philosophy, and it’s an admirable one, I’ll assume that you haven’t read David Nutt’s Drugs Without the Hot Air. Please do. It is an excellent and easy to read examination of the issue of harm in relation to drugs.

    Why do you persist in implying that the Act is more permissive when in fact it seems that the opposite is true, as Russell has patiently pointed out more than once ?

    Japan • Since Apr 2014 • 44 posts Report Reply

  • Russell Brown, in reply to debunk,

    Just do some reading – and not just the bits of articles that reinforce your existing prejudices.

    That's a bit rich.

    Auckland • Since Nov 2006 • 22754 posts Report Reply

  • debunk,

    Yes, sorry Russell. You are doing a good job here. Re David Nutt (and Les King) article in Guardian ..a better comment by TerribleLyricist 14March 9.38am

    "Here in the US, the drug-policy landscape is shifting decisively. It really feels like a sea change. Cannabis has never been so available, or cheap, or such high quality. Nearby, Mexico is reforming its drug laws. Jamaica too. Uruguay too.

    No one - not even the banners and floggers - believes the old myths about drugs any more. Banned drugs can cause misery, just as alcohol can, but we all know a functional user and we have learned to separate the bullshit from the reality."

    "British politicians risk looking very silly if they cling to the policy of prohibition much longer."

    My own view is that the costs of cannabis prohibition in NZ, which are huge (search, collection, prisons etc) - should be estimated in an academic quality economic cost benefit analysis - clarifying the financial and social costs of this novel, dingbat, government legislation.
    ________________________________________________
    Article: Figures for UK deaths from legal highs cannot be trusted.

    I have been looking through Guardian articles on the topic of Legal Highs etc and there is some good information on this site.

    New Zealand • Since Aug 2012 • 105 posts Report Reply

  • debunk,

    This week's New Zealand Listener has an interesting, though sometimes equivocal, editorial "Unfortunate experiment 11" worth serious consideration: to quote

    "There is mounting evidence that these substances are causing tremendous physical and mental damage."

    @Rob Stowell This is the way that the hospitals will "bring some data to the party" and it will be entirely legal; and costly to both communities and the health system.

    New Zealand • Since Aug 2012 • 105 posts Report Reply

  • Ian Dalziel,

    legal sighs...
    Duncan 'Donuttin' Garner thinks all councils should individually reinvent the wheel, irrespective of their ability to process technical information - look at the fluoride 'debate' and how unified councils are on that, not...
    It is a nationwide governance issue, not something to be left to the piecemeal random factors of elected officials...

    Christchurch • Since Dec 2006 • 7889 posts Report Reply

  • debunk,

    And having spent a term on a rural council with not much brain amongst the elected ones (who have since unilaterally doubled their pay) it is an even worse approach. Research online shows that the "Legal High" businesses are obviously trading well so the "legal" requirement for shops is even more bizarre- make the elected people pay for the damage perhaps ..both centrally and locally. Or orthodox welfare economics would ask what they are Willing to Pay for this monstrous policy, and thereby indicate the "value" of this risky product. Of course, in reality, we will all pay for the consequences.

    New Zealand • Since Aug 2012 • 105 posts Report Reply

  • Ross Bell,

    Wellington, NZ • Since Nov 2006 • 168 posts Report Reply

  • Russell Brown,

    Well, The Listener has weighed in on the issue with an editorial that could hardly be more wrong or less logical.

    Edit: Oops, snap!

    Auckland • Since Nov 2006 • 22754 posts Report Reply

  • Ian Dalziel,

    I thought safety was the issue
    not psychoactivity...?

    and then there is this...

    An invisible swath of middle-class New Zealanders are drinking heavily and indulging in drugs, a new survey has found

    ...who knew?
    Doh!

    Christchurch • Since Dec 2006 • 7889 posts Report Reply

  • debunk,

    And an unimpressive contribution from the NZ Drug Foundation on the STUFF site! Who are these people? Coffee and tea are "psychoactive" but considered safe. Now methamphetamine (and by association the related "Legal Highs") ..on which I have published several research papers in the distant past ..is another matter...definitively unsafe and lethally enhanced by social context (MRA Chance, 1946). Behavioural research of psychoactive drugs goes back quite a long time, tho folk seem to think it's all new. Sorry Russell, again, but I think the Listener editorial is quite useful.

    New Zealand • Since Aug 2012 • 105 posts Report Reply

  • Rich of Observationz, in reply to debunk,

    1946? Was it a case study on Hitler?

    Kids, don't inject meth - it may lead you to attempt genocide, start a global war and kill 60 million people

    Back in Wellington • Since Nov 2006 • 5550 posts Report Reply

  • Russell Brown, in reply to debunk,

    And an unimpressive contribution from the NZ Drug Foundation on the STUFF site!

    Why don't you look it up on their website? The NZ Drug Foundation is an internationally-respected, publicly-funded charitable organisation focused on reducing the harms from drug use.

    Behavioural research of psychoactive drugs goes back quite a long time, tho folk seem to think it’s all new. Sorry Russell, again, but I think the Listener editorial is quite useful.

    No, it's not, it's nonsense. It's a mess of demonstrably false claims (starting with the first sentence) and weird leaps of logic. Whoever wrote it doesn't seem to have a clue about what the Act actually does.

    Auckland • Since Nov 2006 • 22754 posts Report Reply

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