Neil McKeganey: ‘Legal’ highs a low point

'Legal high' drugs are now being openly sold in 'headshops' on local high streets, and via the internet across the UK. Picture: Ian Rutherford

NOVEL Psychoactive Substances, the dry scientific terminology for what are more commonly known as “legal high” drugs may represent the biggest threat to drug enforcement, drug treatment and drug prevention that the UK has faced for decades.

Over the last 50 years UK government drugs policy has concerned itself, for the most part, with heroin, cocaine, LSD, amphetamines, cannabis and, more recently, ecstasy. Now, with the production and distribution of legal highs at the rate of one a week, often from laboratories in China, that list is looking increasingly out of date and the government’s response increasingly out of touch.

It is ironic that China should be the source of so many of the legal high drugs that are now being openly sold in “headshops” and via the internet across the UK. In the face of vehement opposition from the Chinese government, Britain enforced its right to export opium to China in the 1800s through gunboat diplomacy and the two Opium Wars. Now, 150 year later, China is returning the favour – exporting a growing number of legal high drugs and in the process delivering a massive headache to governments around the world.

The list of novel psychoactive substances currently being sold in the UK is as bewildering as it is vague in cloaking what the drugs themselves actually contain: Anhiliation, Toxic Waste, High Beams, Lime Fantastic, Sectioned, Dr Death, Fanny Powder.

What is being traded here is not pharmacology but experiential exotica and it is the appeal of those promised new, risky experiences that draws in a market of young people who might not otherwise consider themselves to be drug users. One may well wonder though what consumer need is being met by a drug which in its labelling seems to promise some form of personal annihilation.

What’s in a name, you might ask? An awful lot, it turns out.

When MDMA was first marketed as a recreational drug it was going to be called Empathy. Ecstasy was felt to be a name that would appeal to a wider market and hey presto, within months a largely unknown appetite suppressant had become the must-have drug in clubs and raves across Europe. Get the name right and your market expands beyond even your wildest dreams.

The willingness of young people to consume drugs without actually knowing what they are taking was evident in the 2012 Global Drug Survey in which 15 per cent of 15,000 people questioned said they had consumed a powder without knowing what it was.

The legal high drugs have taken that willingness to an entirely new level with literally hundreds of substances now being consumed by people who neither know nor care what the drugs contain. The age of brand loyalty, and a single preferred drug, may now be dead in a world that has moved on to a plethora of exotically-named substances that are limited only by the imagination of those involved in their marketing.

In 2013 the United Nations Office on Drugs and Crime identified the UK as having the largest market in novel psychoactive substance use anywhere in Europe, with an estimated 670,000 young people having consumed a legal high.

In the last five years there have been 154 deaths in England and Wales linked to legal highs, with the number of deaths leaping some 80 per cent from 29 in 2011 to 52 in 2012. In Scotland there were 12 deaths linked to the novel psychoactive substances in 2010, with that figure more than trebling to 47 in 2012.

According to the 2012 Global Drug Survey, a quarter of those who had consumed the now banned legal high mephedrone reported feelings of agitation, one in ten reported feeling chest pains, just under half reported feeling depressed and a quarter reported having experienced memory loss.

Despite those worrying statistics the UK government recently announced that it had no intention of banning the headshops that are now sprouting up in high streets across the country selling legal highs. Instead the government favours a policy of imposing a temporary ban on specific legal highs where there is prima facie evidence of harm and a full ban where there is clear evidence of harm.

The trouble with a policy that looks at each drug in turn is that it is simply overwhelmed by the sheer scale of production of the legal highs. No less worrying, though, the UK government response effectively leaves young people as the guinea pigs in their own national experiment; only when the hospital admission statistics start to mount up will the government take action. That is a shocking abrogation of responsibility.

Increasingly in Europe other governments are taking a much tougher line on the headshops selling legal highs. In Ireland and Poland headshops were banned in 2010. In Portugal, where all drugs were decriminalised for personal use in 2002, the government has decided that no such liberal stance can be taken on the headshops, with the shops selling these drugs banned in 2013.

Other countries outside of Europe are exploring the possible use of trading standards legislation to control the availability legal high drugs. The government in New Zealand, for example, has passed legislation licensing the sale of legal highs where the manufacturers of these drugs can prove that they are of only low harm.

On the face of it that may sound like a smart move, making the producers of the legal high drugs responsible for the safety of their products in the same way as occurs with the wider pharmaceutical industry. However, nobody in New Zealand believes that the legal high producers have either the will or the capacity to mount an equivalent drug-testing programme to that carried out by the pharmaceutical industry.

There is, though, a big difference between assessing the harm of a drug in the short term and understanding its possible impact in the long term. In New Zealand researchers recently reported that over time cannabis use was associated with a marked reduction in measured intelligence. The research was based on testing the intelligence of cannabis smokers over a 38 year period.

In the absence of such long-term research, the New Zealand government may find itself on the wrong end of legal action initiated by consumers who had taken a licenced product believing that its approval ensured its safety, only to find that the drug has caused serious long-term harm.

Handing the responsibility for assessing the harm of legal high drugs to those who have a financial interest in their rapid and widespread consumption may turn out to be a costly move on the part of the New Zealand government.

Banning headshops may turn out to be the easiest option for a government trying to stem the sales of these drugs. Legal highs are now only an internet-click away; ordered in seconds and delivered to an address near you.

To stem that trade it will be necessary to bring substantial diplomatic pressure to bear on the producer countries, encouraging their drug enforcement agencies to follow the internet trade back to its source, identify the laboratories producing the drugs and seize the assets of those involved in the legal highs business.

The fact that China is one of the market leaders in the legal highs business may make the prospect of effective diplomatic action that much harder, but no less necessary. In the absence of such effective action, expect the numbers of legal highs on sale to grow and the statistics on drug-related deaths to rise.  

• Neil McKeganey BA, MSc, PhD is a sociologist by training and has carried out research in a wide range of topics related to drugs misuse