Walking the "legal high" wire…
Once thought to be a largely Western problem, a report due to be released shortly by the UN Office on Drugs and Crime (UNODC) shows that new psychoactive substances, so called "legal highs," are now a global issue being fuelled by the Internet.
The world's drug culture is constantly evolving, but it is not becoming any safer. Those taking drugs today are just as likely to be unwittingly supplied a new psychoactive substance (NPS) as they are ecstasy in clubs and bars. In this new environment, the seemingly legal is competing with the outright illegal; but the health risks remain.
Today, we are staring at a new drug horizon where those willing to take these substances have become the participants in a lottery where the ticket comes at the risk of lives. Users of NPS are potentially one tweaked molecule away from living or dying.
Sold with names such as "Spice" and "K2", these drugs, or drugs similar to them, have killed and injured young people across the world. Wrongly described as "legal highs", these substances simply exploit existing legal loopholes.
Such drugs also exist in a wide variety. For example, there are over 60 different types of Spice, which mimics cannabis.
Based on statistics from Coroner's courts, more than 40 deaths in the United Kingdom in 2010 have been linked to a class of NPS known as cathinones, including the controlled substance mephedrone. These drugs have rightly been controlled in a number of countries, but they also highlight a fundamental problem when dealing with these drugs.
A new report by UNODC, titled, New Psychoactive Substances - The New Challenge, examined the situation in 80 countries and received information from 142 national drug test laboratories in 54 countries.
The report found there are now around 250 new psychoactive substances, which are not under international control and for which we know very little about. For the very first time, this figure is greater than the 234 substances scheduled under the international drug conventions. The gap continues to widen.
By simply changing a part of a molecule it is possible for chemical researchers to stay ahead of those attempting to regulate the drugs. For this reason, the number of NPS is potentially limitless. Health care professionals are facing a situation where outbreaks of new groups of 'legal highs' can cause death and injury before they fully understand their impact.
Our study also shows that where this was once a Western problem, NPS are now being sold across the world. What was once a regional problem has become a global threat. This creates daunting challenges for health services in fragile countries without the resources to respond to these types of specialised health issues.
While avoiding moral panic, we need to respond decisively. Most importantly we need to ensure that political understanding and commitment is locked into a coordinated health and law enforcement response. Decision-makers, community leaders, police and health officials all need to speak with a single voice and based on a sound understanding of the situation.
Research and analysis is also pivotal. Many countries are carrying out isolated, studies, but the real situation is largely uncharted territory. We need a wider understanding of the spread of these substances and more information on their composition and potentially harmful effects. Countries also need to strengthen their forensic science capabilities. Expertise and experiences should be shared globally for the benefit of the international community as a whole.
Treatment of the effects of new psychoactive substances also remains in its infancy. Although more people are presenting themselves to hospitals and clinics a gap in knowledge remains. We do not know if present use is creating future addiction. To help, further study, more analysis, and greater information sharing is needed among health professionals.
We must also build a bridge to young people through greater awareness raising. This means engaging young people in a dialogue, not talking down to them. We cannot risk losing them to ignorance and to misunderstanding.
Innovative approaches should be applied by law enforcement officers. New Zealand, for example, has enacted creative legislation that places the onus of proving the substance is safe on the seller.
There is also a need to come up with fresh strategies to deal with the Internet. In all 80 countries studied, the Internet was named as a source for new psychoactive drugs. Studies by the European Monitoring Centre on Drugs and Drug Addiction have also shown that online shops steadily increased from 170 in 2010 to 690 shops in 2012.
At the international level, we need greater cooperation and coordination across the globe. Information and knowledge are power but it needs to be shared as widely as possible.
By March UNODC will publish a complete list of substances to make everyone aware of the size of the challenge we face. Identifying and monitoring the emergence of these substances at the global level is the first step to finding an effective response to this emerging global issue.
When governments look down from the "legal high" wire to make carefully balanced choices about how to deal with NPS, they need to acknowledge that the safety net of health care professionals is largely operating in the dark.
To improve this situation, we need to start working closely together at the international level and we need to do so now.
Executive Director, United Nations Office on Drugs and Crime.
This opinion piece originally appeared in German in the Neue Zuercher Zeitung on 22 February 2013.