New Zealand’s novel legislative approach P:02 The Kronic chronicles P:04 Communicating the risks of unknown harms P:06 Tracking emerging drugs in Australia P:08 Emerging drug laws: a minefield of complexity P:09 Why the legal high industry is thriving P:10
Australian Drug Foundation • Alcohol & Drug information
Opinion
What can Australia learn from the UK experience? Dr Adam Winstock P:03
Your view
Could legal highs be a safer alternative to alcohol? P:10
ISSN 2201-9197
New and emerging drugs Responding to one of the biggest challenges in the alcohol and other drugs sector.
April 2013
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In this issue Zealand’s novel legislative 02 New approach. Why NZ is requiring manufacturers to prove that their products are ‘low risk’ at their own cost.
Harm reduction: 03 Opinion. only collaboration between
regulators, manufacturers and consumers will work.
Kronic chronicles. A story 04 The about the rise and ineffective legal demise of synthetic cannabis.
the risks of 06 Communicating unknown harms. An argument against warning the public of new drug harms.
emerging drugs in 08 Tracking Australia: the case of NBOMe drugs. How free online tools can be used to find out more about new drugs.
drug laws: a 09 Emerging minefield of complexity.
The shambolic efforts to criminalise new substances.
perspective. Why the 10 Industry legal high industry is thriving. view. Could legal highs 10 Your be a safer alternative to alcohol? review. Drugs without 11 Book the hot air: Minimising the harms of legal and illegal drugs.
11 Website review. Bluelight.ru
New Zealand’s novel legislative approach Like many other countries, New Zealand faces the challenges associated with the increasing prevalence of new and emerging drugs. And, like other nations, the legislative environment contains a loophole that has allowed these substances to be legally sold without any regard for the harm they may cause. But new legislation will change that by requiring manufacturers to prove that their products are ‘low risk’, at their own cost. This innovative policy response, which will be passed in August, is being watched by other countries for its effectiveness and to see if it might become a template for use elsewhere. At present, new and emerging drugs are banned in New Zealand only after they have gone to market, and generally after harm becomes apparent. There is a minimum lag time of six weeks between a product appearing on the market and a temporary ban being established. During this time, manufacturers can generate millions of dollars in profit with no financial or criminal risk. This system encourages producers to create new substances and release them to the market without knowing the effects. The new legislation changes that situation. It reverses the onus of proof onto the manufacturer to show that the psychoactive substances (as the bill terms them) are ‘low risk’ before they can go on sale. To do this, a regulatory authority will be established that will develop guidelines about pre-clinical toxicology testing and clinical trials, and then administer applications for approval to be sold.
Part of the prevention series Keep an eye out for the Prevention Research publication and the prevention seminar on new and emerging drugs. druginfo.adf.org.au
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The definition of a psychoactive substance is purposefully broad so that it includes any substances that could be used for psychoactive purposes. It excludes alcohol, tobacco and substances already banned. The bill creates basic restrictions on who can import, manufacture and sell psychoactive substances, as well as anticipating future regulation about where the products can be sold, who can sell them, packaging, marketing and health warnings - in a similar way to tobacco legislation. The regulatory authority will create a code of practice; issue licenses for importation, manufacturing and sale; conduct postmarket monitoring; and have the ability to fine people who breach the legislation. There is some concern that there is no apparent health focus in the bill, and that it does not specifically define ‘low risk’. There are also questions about whether an excise tax should be levied on the products. The New Zealand Drug Foundation’s advice to people considering tackling new and emerging drugs is to start the conversation. A wide consultation process is imperative and the proposed system must be evidence-based. Building cross-party political consensus about the problem at the outset will increase the likelihood of success.
All stakeholders must accept that the current drug laws are ineffective in dealing with the realities of new and emerging drugs. Final word: watch this space. Monitor the New Zealand experience, learn from our mistakes and build on the positives that eventuate from the new system. The legislation can be accessed at www.nzdrug.org/psychoactivesubs. Jackson Wood and Catherine McCullough are senior advisers for the New Zealand Drug Foundation
opinion
Photo: Dr Ray McCrudden
Dr Adam R Winstock is a Consultant Psychiatrist at SLAM NHS Trust in the UK, Honorary Senior Lecturer at Kings College London, Founder and Director of the Global Drug Survey, and the architect of the drugs meter (www.drugsmeter.com) and drinks meter (www.drinksmeter.com)
Harm reduction: only collaboration between
regulators, manufacturers and consumers will work
In the last five years, more new and emerging psychoactive drugs have been notified to various global monitoring agencies than over the last 50 years. Regulatory bodies are unable to keep abreast of the rapid release of new drugs, and simply monitoring their existence does nothing to curb their potential for harm. So, different approaches must be considered that heed the lessons learned from tobacco and alcohol control. Consideration must be given to a variety of strategies, including mandating manufacturers to take more responsibility for the effects of their products through risk assessments and advice to consumers, and ensuring that users of these products are informed and are supported to adopt harm minimisation strategies.
UK experience While declining purity of MDMA (or ecstasy) and cocaine has contributed to demand for new and emerging drugs, the successful commercial collaboration between basic pharmacological research, astute online promoters and thriving manufacturing capabilities in China, has led to a paradigm shift in the supply of these substances. Often purchased online, these unknown, untested and unregulated substances can simply arrive with the morning post, exposing consumers to potential harm. To avoid contravening existing non-drug control regulations (such as medicines or food legislation) manufacturers often describe their products as ‘research chemicals’ or ‘plant feeder’. While labelling these products ‘not for human consumption’ conceals their true purpose and protects vendors from prosecution in some countries, it means they arrive with no dosing or harm reduction information. In the UK, where control of new and emerging drugs falls under the Misuse of Drugs Act 1971, experience has shown that while prohibiting specific substances reduces their
widespread availability, banned drugs are swiftly replaced by newer unknown compounds. One of the first substances categorised as a new and emerging drug was mephedrone. It was banned across Europe before much was known about it, except that people liked it and it was cheap. Time and experience have changed our views and those of users. While mephedrone’s effect profile was initially rather positive, this has since given way to concerns about overdose-related toxicity, dependence potential and migration to injecting communities. Experience from the UK suggests that while control under the Misuse of Drugs Act has reduced availability, it may also have transitioned the drug to street dealing, increased its price, and heightened the risk of harm with reports that it is increasingly being injected in the UK and wider European Union. Banning mephedrone in the UK also led some of its users back to MDMA and cocaine. A recent increase in the quality of MDMA may also have been a response to the loss of business to these newer substances.
Australian experience While new and emerging drugs have made a real impact in the UK, other parts of Europe and the USA, evidence suggests that these substances are yet to make real inroads in the Australian market. Data from the recent Global Drug Survey of over 6500 Australians found that only nine per cent of the sample reported purchasing drugs promoted as bath salts, legal highs or research chemicals - common descriptors for new and emerging drugs - in the previous 12 months. Drugs such as synthetic cannabinoids, mephedrone, 2-CB, DMT and 25BNBOMe were only reported by a very small minority.
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While new and emerging drugs have made a real impact in the UK, other parts of Europe and the USA, evidence suggests that these substances are yet to make real inroads in the Australian market.
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harm reduction
...continued from page 3
So, what can be done? While coordinated global monitoring of these new drugs exists via such bodies as the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Focal Point Network and the UN SMART project, monitoring of a drug’s existence does not protect consumers without some awareness of its risk and effect profile. Legislators in Australia could consider supporting an independent risk assessment unit for new and emerging drugs, which integrates data from universal and targeted public health surveillance, subjective user effect and risk profiles, police and emergency health services data, and basic scientific information. By supporting a flexible and responsive unit, assessments could target the compounds of most concern. A useful framework for such a risk assessment strategy has already been developed by the EMCDDA in Lisbon. Alternatives to control under the current drug legislation must also be considered, and the lessons learned from alcohol and tobacco control taken into account. We know that price, age and promotion restrictions work. We could consider the integration of familiar regulations for other consumables such as consumer protection, quality control and trading standards. Mandating producers to include dosing advice, contraindications, side effects and what to do in an emergency, would be an interesting approach. For example, including a warning such as, ‘May cause paranoia, psychosis and extreme mood swings’. A reporting system for side effects could also be set up, which is independently monitored by researchers and funded by manufacturers, to observe longer term harms and emerging complications. Other approaches might include requiring producers to demonstrate that their product is ‘safe for human consumption’ or that it is fit for purpose by applying for approval through the Therapeutic Goods Administration (TGA). Evaluating the ideas of New Zealand’s legislators may also be instructive, with the Advisory Council for the Misuse of Drugs in the UK calling for a similar review of how new drugs should be assessed and controlled. Finally, we need to explore the best ways to support informed decision-making by individuals, the majority of whom are interested in their own health and wellbeing. While there is much talk about harm reduction, there has been little research into what messages are most effective, how they are best communicated, and how acceptable currently recommended approaches are to users of new and emerging drugs. In the future, harm reduction will need to explicitly incorporate the maintenance, and possibly even the enhancement, of pleasure if we really want people who use drugs to see that harm reduction advice is balanced and truly non-judgmental.
In the future, harm reduction will need to explicitly incorporate the maintenance, and possibly even the enhancement, of pleasure.
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The Kronic chronicles A case study of the emergence of Kronic as the most popular brand of synthetic cannabis demonstrates how policy, media and drug-related harm intersect. The story of its rise and ineffective legal demise involves several characters: entrepreneurial businessmen, medical experts, mining companies, policy makers, media and, of course, people interested in using synthetic cannabis. Kronic’s story began here when its owner, Matthew Wielenga, expanded his synthetic cannabis business from New Zealand to Australia in 2010. By late April 2011, the Australian media were reporting that workers on Western Australian (WA) mine sites were using Kronic to evade drug testing. Since Australian mining companies must meet strict occupational health and safety regulations, the WA mining lobby quickly persuaded the WA Government to respond. On 13 June 2011, it was announced that seven of the chemicals that Kronic was suspected to contain would be banned in WA from 17 June, prompting strong support from the Australian Medical Association. The announcement also created significant publicity for Kronic, with most media headlines referring to the brand. The manufacturers of Kronic endeavoured to sell their remaining stock ahead of the ban, using social media to engage their customers. On the evening of 16 June, a party was organised in Perth encouraging people to smoke their remaining Kronic, which was quickly shut down by police. Soon after the June 2011 bans came into effect, similar products became available that were alleged to contain new chemicals. Kronic released a Black Label blend for its WA customers. The Kronic brand was further publicised when, on 30 June, the media reported that a novel benzodiazepine had been detected in Kronic by New Zealand authorities. Wielenga asserted that this benzodiazepine was not intended to be in Kronic, and that the company importing the chemicals that he used in Kronic must have been at fault. This company, Stargate International, established the ‘legal highs’ industry in New Zealand. On 4 August 2011, a man with a pre-existing heart condition died after apparently smoking Kronic Black Label. The WA Government reacted promptly, banning another 14 chemicals from 6 August and other states quickly followed WA’s lead. New South Wales banned eight chemicals on 1 July, while Tasmania and the Northern Territory took action in early August. Later in 2011, Queensland and Victoria also scheduled several chemicals, while the federal government banned eight chemicals in July 2011 and eight broad chemical categories in May 2012. The Kronic chronicles demonstrates the piecemeal response to synthetic cannabis in Australia, which has essentially been reactive and ineffective. There is little evidence that these changes have significantly reduced the availability of synthetic cannabis. In fact, each legislative action has raised awareness of it through the media, and manufacturers have responded to legislative actions by bringing new and lesser-known chemicals onto the market. While Wielenga’s company is no longer producing Kronic in Australia, a number of others have capitalised on the Kronic brand, selling their own synthetic cannabis products as Kronic.
Policy makers should take heed of the Kronic chronicles and consider alternative legislative responses that better mitigate harm than banning specific substances. As discussed by Dr Winstock, regulating markets for new and emerging psychoactive substances is one option. Yet, if only new or emerging drugs are regulated, we may just shift trends in drug consumption towards lesser-known drugs and away from traditionally prohibited drugs. Research indicates that the legal status of new and emerging drugs is attractive to drug consumers, who wish to alter their mind or experience drug-induced pleasure without breaking the law. In the case of Kronic, mounting evidence suggests that synthetic cannabis is more harmful than cannabis itself. If the goal of policy is to reduce drug-related harms in the community, ending prohibition of cannabis may achieve this goal by breaking the cycle of new and lesser-known products entering the market, and reducing the demand for a ‘legal’ cannabis-like alternative. The question shouldn’t be whether cannabis is regulated, but what model of cannabis regulation is most suitable. Stephen Bright is Coordinator of Addiction Studies and Monica Barratt is Research Fellow at the National Drug Research Institute, both at Curtin University
The Kronic timeline 2010: Matthew Wielenga expands his business from New Zealand to Australia Late April 2011: Media reports of Kronic being used by workers on WA mine sites 13 June 2011: WA Government announces impending ban on chemicals thought to be contained in Kronic 16 June 2011: Party held for Kronic users to consume remaining product ahead of bans 17 June 2011: Bans come into effect June/July 2011: Kronic releases Black Label blend for WA customers 4 August 2011: Man dies after allegedly smoking Kronic Black Label 6 August: WA Government bans a further 14 chemicals July 2011-2012: Other state and territory governments and the federal government follow WA’s lead, banning a variety of chemicals 2012-2013: Newer versions of Kronic released into the market
Mounting evidence suggests that synthetic cannabis is more harmful than cannabis.
Kronic 05
Communicating the risks of unknown harms The use of new and emerging drugs raises many difficult issues for workers and services attempting to minimise the potential harms. Many people who use illicit substances are wary of messages from health professionals because of a lack of credibility. Official sources often highlight only the potential negative effects of substance use without any real data. Likewise, mass media campaigns have had limited impact using scare tactics. Devising credible health messages is essential to effectively communicate with people who use drugs. This becomes extremely difficult however, when we, as health workers, are unsure of what the potential harms might be. So, how then do we effectively communicate the risks of unknown harms? Historically, drug prevention campaigns have relied on, at worst, scare tactics, and sometimes at best an over-statement of potential harms. This has been coupled with a denial of the existence of positive side-effects of substance use. For example, one official government information source describes the signs or symptoms of ecstasy (MDMA) use as including, ‘increased blood pressure, nausea, confusion, panic’ amongst a raft of other negative effects. People who have never used MDMA would question why someone would pay for such a negative, if not toxic, experience. Naturally, people who use drugs such as MDMA are sceptical of information that only focuses on the negative health effects, because it doesn’t always equate with their actual experience of drug use where many people do not experience any significant negative health effects.1
Mass media campaigns also have a questionable history of effectiveness. A meta-analysis conducted in 2011 indicated that public service announcements about anti-illicit drugs may have limited impact on either intention to use or actual use of illicit drugs2. Despite knowing this, we continue to see mass media campaigns that often go unevaluated. A recent example was the United States Navy advertisements titled, ‘Bath Salts: It’s not a fad… It’s a NIGHTMARE’. This campaign was in response to issues experienced within the United States Navy, however advertisements of this nature can be problematic for several reasons. Some campaigns inadvertently instruct people in how to access substances. The US Navy ad, for example, began with the arrival of a package - presumably MDPV - inferring that it had been ordered online. Secondly, mass media campaigns can increase perceptions of the prevalence of substance use. We know from a range of research that young people are more inclined to engage in behaviour when they perceive it to be common amongst their peers3. A study published in 2009 tested the effects of anti-marijuana advertisements on various groups of young people including those considered at risk of cannabis use, compared with those considered to be less at risk of using cannabis4. The authors found that those more likely to use cannabis reacted negatively to ads with stronger arguments against use. They also found that actual depictions of cannabis use created even stronger reactions against the ads.4 These cautions need to be heeded as we consider how to effectively communicate the potential harms from new and emerging drugs. Workers who interact with individuals using these drugs should attempt to ascertain the person’s actual experience of the substance in question. Is the person concerned
It is important to communicate that while we have significant knowledge of the possible impacts of many traditional drugs, we do not yet understand the potential harms of many new and emerging drugs.
g n i t a c i n u m Com 06
Historically, drug prevention campaigns have relied on, at worst, scare tactics, and sometimes at best an over-statement of potential harms. about his or her own, or a friend’s, use of these drugs? Has he or she witnessed negative outcomes from their own or someone else’s use of these substances? It is important to communicate that while we have significant knowledge of the possible impacts of many traditional drugs, we do not yet understand the potential harms of many new and emerging drugs. Sadly, most of our current knowledge of the negative outcomes experienced by people who use these drugs comes from reports of adverse events as humans effectively test these substances on themselves. References 1 Nutt D, King L & Phillips L 2010 “Drug harms in the UK: A multicriteria decision analysis” The Lancet, vol 376, issue 9752, 6-12 Nov 2010, pp. 1558-1565. 2 Werb D, Mills EJ, DeBeck K, Kerr T, Montaner J & Wood E 2011 “The effectiveness of anti-illicit drug public service announcements: A systemic review and meta-analysis” Journal of Epidemiology & Community Health, vol 65, issue 10, pp. 834-840. 3 Perkins HW 2002 “Social norms and the prevention of alcohol misuse in collegiate contexts” Journal of Studies on Alcohol, Supplement no. 14, pp. 164-172. 4 Kang Y, Cappella J & Fishbein M 2009 “The effect of marijuana scenes in antimarijuana public service announcements on adolescents evaluation of ad effectiveness” Health Communication, vol 24, pp. 483-493.
Cameron Francis is a social worker at Dovetail
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Tracking emerging drugs in Australia: the case of NBOMe drugs
The rapid proliferation of new drugs available to Australians has necessitated the use of innovative techniques to monitor their emergence. This article will use the example of NBOMe drugs to outline four ways of monitoring drug use trends online and in real-time. These tools are freely available for use by clinicians, allied health and youth workers, and researchers who are seeking further information about new drugs presented by clients, or that are talked about in their work. NBOMe (or 25-NBOMe) drugs are a new class of hallucinogens. These drugs have structural similarity to the 2C family of hallucinogens, and blotter tabs containing NBOMe drugs have been sold as ‘legal LSD’. Other representatives of this class of drugs include 25C-NBOMe and 25D-NBOMe. According to Erowid (www.erowid.org), an educational organisation that provides information about psychoactive drugs, these compounds have almost no history of use by humans until 2010 when they first became available online. To date, there have only been two peer-reviewed articles published about the availability of these compounds in drug markets, both authored by Zuba et al. from Poland. While local Australian monitoring systems have not yet reported NBOMe use, in 2012, Adelaide Now reported one death from an overdose of 25I-NBOMe and numerous non-fatal overdoses associated with NBOMe drugs. The online methods outlined below seek to answer the question: ‘Are Australians using 25-NBOMe drugs?’
1. Google trends Interest in the NBOMe series can be tracked using Google Trends (see Figure 1). Limited to an Australian sample, Google Trends reveal that Australians began searching for NBOMe drugs in March 2012, with increasing levels of activity since then. Google Trends also shows a positive association between the publication of specific news articles and increased searching (see point A in Figure 1, which indicates the timing of the Adelaide Now article).
Figure 1: Google trends
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2. Drug user forums Drug user forums are an important source of current drug information. When searching for experiences or harms associated with specific drugs, the geographical source of the information is not as important. However, to identify local trends, the international nature of drug user forums poses a problem. A search of Australian drug discussions for the term ‘NBOMe’ on Bluelight (www.bluelight.ru) found 29 threads. Most were posted within the last 12 months, with the oldest in 2010. These discussions may be further analysed to obtain specific information about availability, purity and the drug’s appeal to Bluelight’s community of psychonauts.
3. Twitter Twitter is another valuable resource for identifying breaking trends. Using the search phrase ‘NBOMe near:adelaide within:1500mi’, which encapsulates all of Australia, no tweets were found. However, searching globally for ‘NBOMe’ drew about five tweets a day across the entire Twittersphere, including discussions about its use, links to vendors, and tweets made during people’s trips on NBOMe drugs. Access to Twitter’s ‘firehose’ (their complete archive of all tweets) comes at a high cost (e.g. through Datasift) but could possibly be used to track trends in new drug discussion similarly to the free Google Trends.
4. Silk Road marketplace Finally, an examination of the Silk Road marketplace for current listings of NBOMe drugs for sale revealed 214 listings, including 25B, 25C, 25D and 25I. Vendors shipping from Australia to Australia included 18 listings for NBOMe drugs. Given that NBOMe is usually consumed on blotter paper and is therefore easily sent by post, the ‘ship to’ column for all listings was analysed and found to include mostly worldwide shipping.
Emerging drug laws: a minefield of complexity Conclusion Using four online real-time monitoring methods, it is clearly evident that some Australians are using NBOMe drugs. This up-to-date information could be used to add questions about NBOMe drugs to regular monitoring surveys. These four sources of information could also be monitored at regular intervals over a 12 month period to detect any increases in interest, discussion, sales or use of this new category of hallucinogenic drugs. These tools may also be useful to field workers who encounter new substances described by their clients. Dr Monica Barratt is Research Fellow at the National Drug Research Institute at Curtin University
New and emerging drugs have long been a grey area for legislators with inconsistencies in laws across state, territory and federal boundaries. While governments across Australia are now legislating to criminalise these new substances, their efforts so far have been, without exaggeration, shambolic. The current strategy of banning substances as they emerge means legislators are effectively seeking to outwit manufacturers and their endless ability to innovate and stay ahead of the law. In this environment, prosecutions are difficult and key participants, including sellers and consumers, are unsure of the law. New laws to amend the Criminal Code Act 1995 from May 2013 were recently passed by the Commonwealth. Under these new drug laws, ‘analogue’ is defined as a substance such as a stereoisomer, an isomer, an alkaloid, or structural modifications to a group of chemicals. However, state and territory laws define analogues only in relation to specific substances or drugs, or not at all. In Victoria, for example, there is no reference to analogues. The law only references derivatives, which are defined as any form of a prohibited drug, ‘whether natural or synthetic, and the salts, derivatives and isomers of that drug and any salt of those derivatives and isomers’. The differing definitions of analogues and derivatives in each of Australia’s nine criminal law jurisdictions means that if ever ignorance of the law should be an excuse then this is it. Of course, ignorance is never really an excuse, however no other area of the law, whether criminal or civil, exhibits such complexity caused by differences in definitions. The current law means that a person can be charged with trafficking a prohibited synthetic analogue by the Commonwealth, but not have committed an offence against state law. The current legislative environment for new and emerging drugs is complex and largely ineffective. New drugs are emerging at such a rapid rate that legislators are constantly playing catch up as manufacturers innovate to stay ‘legal’. This is also an area of law where the definitions of words such as ‘analogues’ and ‘derivatives’ will be tested by defendants and prosecutors, and where forensic testing of substances will be disputed by both sides. Greg Barns is a barrister and former National President of the Australian Lawyers Alliance
These tools are freely available for use by clinicians, allied health and youth workers, and researchers who are seeking further information about new drugs presented by clients. 09
industry perspective
Why the legal high industry is thriving It may be coincidental, but as the internet reached a new peak in popularity some 10 to 12 years ago, a new generation of synthetic highs - known as ‘legal highs’ - was born. And, like the internet, these drugs have become game changers for regulators, governments, businesses and consumers. In terms of availability and accessibility, legal high products are, in some ways, similar to pornography. In the 1970s and 80s, users of porn often had to source their products from sleazy sex shops. Now, in the privacy of their own home they can access an infinite cornucopia of sexual material online. Similarly, in the past, a person seeking recreational drugs often sought out a backyard drug dealer. Now, that same adult can walk into a brightly lit store and discuss or request a specific type of high. The purchaser will be provided with a product that they can pay for with a credit card and on which the ‘dealer’ has paid federal tax. Ironically, it was the internet that provided the platform for both of these products to become widely available. In addition, as pornography has increasingly moved online, retail stores that previously sold adult media have now allocated space to legal highs. The two platforms are working well together. It may come as a surprise to many, but a lot of Australians like and use drugs without becoming homeless addicts or helpless no-hopers. Over the past 10 years, the Australian market for new and emerging drugs has grown quickly. According to sales figures from our distributor and manufacturer members, it is now worth an estimated $600 million per annum. This explosion has mostly been due to the prohibition of natural cannabis, although the comparatively shorter and less intense experience from synthetic cannabis has also attracted some people. Australian retailers have noted that the main demographic for purchasing legal highs is 30-50 year olds, typically purchasing a three gram pack. Retailers report that a large proportion of customers, including many in the 65+ demographic, use synthetic cannabinoids as analgesics and for the relief of insomnia. They also say that cancer patients are among those using these substances for therapeutic purposes, presumably due to their advertised similarity to cannabis. Anecdotally, adult retailers say that they have elderly people on walking frames in their shops for the first time, and have estimated that less than one per cent of their customers report having adverse reactions to the products. An industry growing this rapidly would benefit from regulation. Although the industry has begun self-regulating and has adopted a code of practice, legislation would further ensure that the industry was safe and that harm to consumers was minimised. The New Zealand approach (discussed in this publication) therefore has broad support from the industry. Fiona Patten is Executive Officer at The Eros Association - Australia’s national adult retail and entertainment association – and President of the Australian Sex Party
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Could legal highs be a safer alternative to alcohol? New medicines sometimes replace older ones. This is because newer products are often safer and more effective. Mercury, for instance, was once administered to patients with syphilis. It would now be considered crude and anachronistic. This is exactly how I feel about the ongoing use of alcohol and tobacco. It’s hard to believe we are still using them. Can we envision another millennium of recreational use of these substances? Why should we have to? There must be safer alternatives. A product less addictive and less carcinogenic would be a start. Some of the new and emerging drugs might fit the profile but are often caught in knee-jerk, anti-drug legislation. Electronic cigarettes are facing a similar fate. Apparently they send the wrong message. What message? That we should stick with alcohol and combustible tobacco products for the next 5000 years? The situation is intolerable. Substances sold for nontherapeutic use with a poor safety profile (such as alcohol and tobacco) should generally be abandoned and replaced where possible. New drugs could be engineered with superior safety profiles. Innovation in this domain is sorely lacking and drug policy should encourage rather than prohibit it. If it is possible to develop new therapeutic drugs and review the safety of older ones, then it is possible to do the same with substances designed for non-therapeutic use. Prohibition is retrogressive and has impaired our ability to formulate sensible drug policy. The emergence of novel psychoactive substances gives us the perfect opportunity to rethink it. Why has there never been a pathway to approve new substances for non-medical use? Evert Rauwendaal, social worker
Substances sold for non-therapeutic use with a poor safety profile (such as alcohol and tobacco) should generally be abandoned and replaced where possible. New drugs could be engineered with superior safety profiles.
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Drugs without the hot air:
Minimising the harms of legal and illegal drugs by David Nutt In Drugs without the hot air, Nutt provides straightforward explanations of his various theories for minimising the harms caused by legal and illegal drugs. The book also describes how drugs affect people and how drug harms can be quantified using categories such as medical, social, economic and legal. Nutt provides a range of evidence-based information about drugs, including the contexts in which they are used and the ways that society has attempted to control them. He poses some very challenging and important questions, including: • How can we reduce the harm from alcohol? • What and when should I tell my kids about drugs? • Can addiction be cured? Readers with an interest in evidence-based information about drugs and their use, and recommendations for harm minimisation will find Nutt’s book very accessible. It is suitable for parents, teachers, allied health and youth workers and policy makers. Reviewed by Ian Comben, Information Officer, Australian Drug Foundation
Bluelight is a place for people who use drugs to share and find information in a safe, anonymous and nonjudgemental environment. It is also a great place for workers to find out what is happening in the community, including insight into trends in new and emerging drugs. The site is funded by private donations, administered by volunteers from around the world and supports the belief that harms are best prevented through education and harm reduction messages rather than scare tactics. To cater for a range of audiences, Bluelight provides more than 50 moderated forums covering topics as diverse as psychedelic drugs, healthy living and electronic music. Discussion is fairly open. Contributors can ask questions, discuss their first-hand experiences or provide warnings about the dangers of particular doses or drug combinations. Comments about where drugs might be sourced are not tolerated and any contributors involved are banned. The Bluelight Wiki provides general announcements and frequently asked questions, including descriptions of particular types of drugs. It is great to see that it includes a lot of new and emerging drugs that have not yet been the subject of formal research. A sister site, www.pillreports.com, provides contributors’ reports of pills available in each continent, including images, descriptions and quality. This is a large site so it’s advisable to read through the FAQs and become familiar with the breadth of content available to identify relevant sections of interest. Reviewed by Linda Rehill, Web Content Editor, Australian Drug Foundation
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Look out for the next prevention suite on leveraging social media for health promoters.
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