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Jonas Hartelius opened the panel setting the stage for a discussion of one of the newest but growing challenges of the modern drug epidemic, the tsunami of new psychoactive substances. Currently, there are scientific and forensic problems related to monitoring the market, analyzing the substances and assessing the hazards of the substances. Once the knowledge is collected about a substance, steps can be taken to schedule it. Only 10 opiates of an estimated 4, have been scheduled in Sweden. There is a magnificent task ahead in terms of the number of new psychoactive drugs, identifying what they do and how to control them. Mike Sabin provided an overview of the problem of psychoactive substances in New Zealand and the recent legislative changes made to address this problem. Since the early s, there has been an increase in drug use and harms from that use in New Zealand, driven by cannabis and pure methamphetamine use. The drug culture is different in New Zealand than in Europe. Binge use is common. As a result of this reality, the nation is working to spearhead drug policy solutions. The country had a drug policy based on harm minimization since the mids. Sabin stressed that rather than harm reduction or minimization, harm prevention should be the goal of policy. Why is it with narcotic drugs that we wait until problem use before intervening? The direction of policy should be centered around prevention. Tobacco policy has been very successful. Tobacco use is no longer acceptable in same way that it was 20 years ago. Alcohol laws were liberalized in in New Zealand in which the purchase age from age 21 to age Alcohol was then sold in the supermarket. As a result, binge drinking increased dramatically. From , New Zealand had the highest population prevalence of methamphetamine in the world and in had the highest prevalence of marijuana use. New Zealand conducts good research on substance use. NPS first became a problem in New Zealand in NPs are referred to as legal highs because the substances are not themselves illegal. The law is silent about NPS until they are used in a manner that would constitute as harmful. But the legal status of a substance will never alter its chemical components. The country has seen an increase in methamphetamine use where getting high is normal part of growing up. Many people shifted from using new psychoactive substances to methamphetamine. Presently, the youth in New Zealand are growing up with higher potency cannabis and are using at a greater prevalence. An increase of NPS have been sold on liquor stores, among others. Between , products emerged, predominantly synthetic marijuana. A significant problem is that NPS are continually changing. Scheduling NPS is a cumbersome process of identifying a new product, determining the harms it causes, implementing temporary class status, legislation to schedule the drug and then between 6 and 12 months to pass the law. Ultimately, a drug that is acceptable should not produce a high. New Zealand established an expert advisory group and regulatory authority to asses products and regulate sales. The regime of clinical testing implemented including animal trials for the substances and sales were restricted to persons age 18 and older with other limitations on advertising, product labeling and location of sales. At the time, products were banned, and a total of 47 products were granted interim approval to remain on the market because at time there was no evidence of harm. Approximately outlets were closed for retail sales and retailers were given interim licenses. There was tremendous public backlash against the law, including protest marches related to the animal testing provisions. By December the movement gained momentum and there was concern from the public that the government was endorsing drug use. In early , a media campaign began showing lines of users waiting to buy NPS. By March there were marches and protests calling for blanket bans. In response, on May 5, the government passed urgent legislation introduced to remove 47 products removed pending approval through the clinical trial process. The criteria for animal testing were removed and thus, products go through for human clinical trials. The legislation raises the bar for manufacturers in that they must come up with cause for conducting human trials. He noted that if cannabis were subjected to the standards of NPS, it would not pass. More people are hospitalized in New Zealand for cannabis-related problems than any other drug. Sabin concluded by emphasizing that laws should set the direction of civil society and that laws are for the populous to influence the majority of people who will obey them; and to have consequences for those who will not follow. There are different classes of NPS as they typically mimic other drugs. When using an NPS a user cannot rely on what is on the packaging. These substances are sold as other products, advertised for other uses, and their contents are not known. NPS are associated with serious health risks, though many risks are unknown. Many NPS are more intense and higher potency, at lower doses, and there are few studies on the impacts of these drugs. In terms of health services, it is difficult to treat effects of drugs in emergency cases to determine the correct medical response. Adding to the complexity, laboratories may not be able to identify range of NPS available. To create an NPS, designers take the basic structure of a drug and identify areas where the compounds can be modified, replaced or otherwise changed. This is why there are so many new psychoactive substances. The number of NPS already exceeds number of controlled substances. Low frequency indicates that the NPS is less successful. National legislative responses to NPS have included banning the sale of a specific substance, instituting temporary bans and rapid procedures for NPS and generic legislation to look at groups of NPS that cause harm. Raithelhuber concluded his presentation by recognizing that the internet has played an important part of the development of NPS and their sales. The internet is an as acceptable tool to exchange information on chemistry worldwide, proving tools to allow financial transactions e. Chemists exchange their experiences on blogs, networks, etc. These elements are key factors in making the emergence of NPS a global phenomenon. This is a direct reflection of the increase in prevalence of NPS in Sweden. His organization takes 82, calls each year, though not all are about NPS. They are interested in the clinical toxicology of the NPS, specifically acute poisonings and examining the effects and risks of these substances. Presently it is rare to have data about living intoxications rather than lethal exposures to drugs which is why this data is so helpful. Internet surveillance on NPS is difficult. From to Swedish Poisons Info Centre experienced a dramatic increase in the number of calls related to NPS whereas calls related to scheduled illicit drugs have remained steady over this time. Cathinoine-derivatives are the focus of most NPS calls. There are two ways to address NPS in Sweden. Drugs are scheduled one-by-one which is a lot of work and it is difficult to keep up with the vast number of NPS. There are presently 83 substances on a waiting list for investigation on how to go about controlling these drugs. The prevalence and impact of an NPS can be monitored in different ways. While MXE, a ketamine-like substance was first confirmed in a sample in , calls about its use occurred in through early Along with those calls were more analytic confirmations. After it was scheduled, the use of MXE declined. There are no recent confirmation tests and inquiries. MDPV entered the market in after methadrone. During , there were calls and it was scheduled as a narcotic drug. In there was an increase in calls and confirmed cases about 20 per month , and Sweden still has a problem with this NPS drug, receiving about calls each year. Jonas Hartelius added that after the criminal sanctions for MDPV were lowered, police investigators saw an increase in sales. You must be logged in to post a comment. Special Session — New drugs — new legislation? New psychoactive substances are easily available on the market; they are legal in spite of their danger. What can legislation do to keep up? In order to protect the health of individuals who use NPS, New Zealand has decided to regulate the market. It is now possible to sell these drugs legally in New Zealand — if you prove that they pose no more than a low risk of harm to individuals who use it. A global overview and a Swedish perspective will also be presented. Leave a Reply Cancel Reply You must be logged in to post a comment.

Voices from the 4th World Forum Against Drugs

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