1960 fentanyl -methylfentanyl, alfa-methylfentanyl phenethylamines DOM,.
MDMA (PiHKAL compounds). ➢ 1980 tryptamines DiPT, Foxy (TiHKAL
compounds).
Drugs on the Internet: a phenomenon out-ofcontrol?
Ornella Corazza, MA, Ph.D Principal Lecturer in Mental Health Academic Lead ReDNet Project EU Manager Postgraduate Medicine University of the Hertfordshire, UK & King’s College, Institute of Psychiatry, UK
[email protected]
Internet monitoring and new psychoactive substances: Identifying opportunities for collaboration and knowledge exchange
Canadian Centre on Substance Abuse (CCSA) May 15, 2013
Background
Hundreds of websites and videos are dedicated to the dissemination of new drugs and provide detailed ‘recipes’ for synthesizing, growing, and consuming a variety of novel compounds
Lack of scientific knowledge
Might well have short and long-term on users
Can remain unregulated for a long period of time
Perceived as legal and thus “safe”
Often sold as ‘something’ else (e.g. “Bath salts”, mystical incenses)
Attractive messages, accessible
Young people seem to be targeted
2010: 41 NPS 2011: 60 NPS 2012: 57 NPS
SITUATION OUT OF CONTROL?
2011 report the UN International Narcotic Control Board (INCB) declared that NPS production and distribution was ‘out of control’
The EMCDDA, since 1997, has been officially reported more than 160 synthetic compounds
650 novel psychoactive compounds/combinations were identified by the Psychonaut/ReDNet Projects
Record number of online shops selling “Legal Highs” – up to 693 selling psychoactive products in 2012 (up to 170 in January 2010)
ONLINE BUYERS
• Contact sellers directly • Get alerts about new products advertised by the seller via text messages, or instant messages • Email product to a friend
These products are often called with different names Designer Drugs Novel Psychoactive Substances (NPS) “Legal Highs” “Bath Salts” “Smart Drugs” Others according to the country
A CENTURY OF NOVEL PSYCHOACTIVE SUBSTANCES (NPS)
1925 morphine // 3-benzoyl-morphine, 6-acetyl-3-propionyl-morphine 1960 fentanyl -methylfentanyl, alfa-methylfentanyl phenethylamines DOM, MDMA (PiHKAL compounds) 1980 tryptamines DiPT, Foxy (TiHKAL compounds) 2000 Piperazines (BZP, mCPP, TFMPP, 2C-B-BZP) –’fake ecstasy’ Synth. cannabinoids (JWH-018,-073,-200, etc.) - cannabis Cathinones (mephedrone, MDPV, naphyrone) - mimic effects of cocaine, amphetamine/MDMA
“LEGAL HIGHS” A MISLEADING TERM? ‘LEGAL’: Labelling these substances as ‘legal’ could be misleading especially for young and vulnerable people, who are not always well aware of new drug legislation and associate the legal with “safe”
‘HIGHS’: it emphasizes the pleasurable and enjoyable effects of these substances Corazza, O., Demetrovics, Z., van den Brink, W., Schifano, F. (2012) ‘Legal highs’ an inappropriate term for ‘Novel Psychoactive Drugs’ in drug prevention and scientific debate, Letter, International Journal of Drug Policy
SURVEY ON THE USE OF NEW PSYCHOACTIVE COMPOUNDS AMONG STUDENTS IN THE UK Corazza, O. Simonato, P., Corkery, M. J., Trincas, G., & Schifano, F. (2013) Rivista di Psichiatria, in press
From 9th November to 6th December 2010
446 students aged between 14-30 from the UK were surveyed
Online survey on the Study Room website
1/3 students made used of NPS
“WHAT DO YOU THINK A ‘LEGAL HIGH’ IS?”
EXPERTISE ABOUT NPS AMONG HEALTH PROFESSIONALS ACROSS THE EU
18 YR OLD WAS BUYING
LIST OF THE PSYCHOACTIVE SUBSTANCES AN ONLINE (ALPHABETICAL ORDER) (CASE REPORT PROVIDED BY PROF.SCHIFANO) 1 2
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
Amisulpride Bupropion Caffeine tablets/Minikikke Cannabis seeds Codeine D,L-phenylalanine Ephedrine hydrochloride Gabapentin GBL and GHB Ginseng Isopropyl nitrate Kava-kava Ketamine Methylphenidate Niacinamide Nitrous oxide Phenelzine Phenylalanine Pregabalin Rhodiola rosea Salvia divinorum Selegiline Sildenafil/Viagr Tryptophan Various antihistamine drugs Various benzodiazepines
More in particular, he was giving his preference to the following combinations:
Methylphenidate plus clonazepam Selegiline plus benzodiazepines plus cannabis plus SSRIs Cannabis plus benzodiazepines GHB plus benzodiazepines
REDNET RESEARCH PROJECT First prevention programme designed for novel compounds across Europe based on the efficacy on ICT tools (www.rednetproject.eu) Funded by the EC Executive Agency for Health and Consumers in the Framework of the Public Health Programme [2009 12 26]
Corazza, O., Assi, S., and the ReDNet Research Group (2011) Novel Drugs, Novel Solutions: Exploring the Potentials of Telemedicine for Prevention of Drug Abuse, Italian Journal on Addiction, Vol 1, Numero 1-2, 2011, pp 24-31. Corazza, O., Davey, Z., Deluca, P., Demetrovics, Z., Drummond, C., Enea, A., Moskalewicz, J, Di Melchiorre G., Di Furia, L., Farre', M., Flesland, L., Scherbaum, N., Siemann, H, Skutle, A, Torrens, M., Pasinetti, M., Pezzolesi, C., Shapiro, H., Sferrazza, E., van der Kreeft, P., and Schifano, F. Le nuove potenzialità della prevenzione digitale in materia di nuove droghe: il ruolo del Recreational Drugs European Network. Dipendenze Patologiche, 43-46, 2010.
OUR PARTNERS
Bergen Clinics Foundation
University of Hertforshire DrugScope Institute of Psychiatry, King’s College London
De Sleutel
University of Szczecin, Law Department LVR, University of DuisbergEssen
Consorci Mar Parc de Salut
Institute of Psychiatry and Neurology
Servizio Salute Regione Marche
National Institute for Drug Prevention
COLLABORATING PARTNERS • EMCDDA-EU • UNODC-UN • UNESCO – chair of information and computer ethics • Antidrug Departments • ACMD-UK • National Focal Points • ELISAD-UK • Drug Treatment Centres (also in Eastern Europe – Poland, Hungary, Russia) • Eotvos Lorand University-H
WORKING HYPOTHESIS Traditional forms of intervention appear to be negatively appraised by those ‘at risk’: • Fear based and moralistic • Theoretical and didactic • Focused on traditional drugs Thus the need to pilot INNOVATIVE solutions
TARGET GROUPS • Young people (16-24) who don’t have access to appropriate drug information and/or treatment services (the online community, high school students, university students, etc.) • Health and other professionals working directly with the above group who are often not up-to-date with information, or have completely inaccurate information
REDNET RESEARCH PROJECT: METHODOLOGY
Research
Dissemination
Drug testing
1. RESEARCH/WEB-MONITORING
PSYCHONAUT/REDNET MONITORING ACTIVITIES
• Google search engine • 8 EU languages in the UK, Germany, Poland, Spain, Italy, Norway, Belgium and Hungary and Iran • More then 650 novel compounds/combinations were identified
NEW DRUGS ON THE WEB
WEB MONITORING IN IRAN
MEPHEDRONE (O MIAOW)
MEPHEDRONE • •
• • •
•
4-methylmethcathinone (4-MMC) aka: Miaow, Meow Meow, Meph, Bubbles, Plant feeder, Drone, 4-MCC, MMCat Novel compound: research chemical Derived from the khat plant Online market: 2007 Banned in the UK in April 2010
MEPHEDRONE
PUBMED: 100 ARTICLES SINCE OCT-2009
MEPHEDRONE = A CAUSE FOR CONCERN? 70 CONFIRMED MEPHEDRONE-RELATED FATALITIES IN THE UK
(SCHIFANO ET AL, PSYCHOPHARMACOLOGY –BERLIN, 2011; CORKERY, SCHIFANO AND GHODSE, 2011)
METHOXETAMINE
Ketamine (RS)-2-(2-Chlorophenyl)-2 (methylamino)cyclohexanone
Methoxetamine 2-(3-methoxyphenyl)-2(ethylamino)cyclohexanone (under temporary class drug control since April 2012 in the UK)
ONLINE PHARMACIES (OPS)
PERFORMANCE AND IMAGE ENHANCING DRUGS (PIED) PIEDs are similar to recreational drugs, especially NPS, but also attract the attention of people who DO NOT consider themselves ‘drug user’ and are generally vulnerable to cultural pressure to optimise their self-image
2. DRUG TESTING
OPTIONS FOR ANALYSIS
Identity What’s the active chemical? Is there more than one active component or a mixture?
Purity Are batches consistent? What about different supply sources?
Biological Analysis (plasma, urine or hair)
Pharmacokinetics
NRG-1
Figure 1 NMR spectrum of NRG-1
NRG-2
Figure 2 NMR spectrum of NRG-2
TECHNICAL REPORTS
3. DISSEMINATION VIA ICT TOOLS
INTERNET AND NEW TECHNOLOGIES
WEB 2.0
VIRTUAL SEMINARS FOR PROFESSIONALS
VIRTUAL DRUGS EXHIBITION
SMS/SMART PHONE APPLICATIONS FOR PROFESSIONALS FROM APRIL 2012
FILM PRODUCTION AND INTERACTIVE EDUCATIONAL GAMES FOR YOUNG PEOPLE
KEY ELEMENTS OF OUR SUCCESS: -
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Use of ICT; Involvement of young people; Good use of our multidisciplinary and cultural resources; International networks;
WAYS TO ADDRESS THE CHALLENGE -
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Monitoring is essential (EWS, Internet monitoring, Grey literature, Personal communications, etc) Testing/Laboratory analysis (handheld instruments for the identification of NPS) Dissemination of information using technological tools (Internet, social networking, etc) to inform, policy, practice and the general public New legislation and sanctions to combat the diffusion of NPS/illegal material on the Internet/collaboration with Policy Makers More socio-cultural studies on life-styles Promotion of positive and healthy attitudes toward life and associated activities (mindful behaviour; engaging activities
2 INTERNATIONAL CONFERENCE ON NPS IN SWANSEA 12-13 September 2013 www.novelpsychoactivesubstances.eu
Email:
[email protected]
EMAIL:
[email protected] Thank YOU for your attention.
