Testing Legal Highs Would Save Lives – So Why Isn't It Happening?

    The number of new drugs available is growing at an unprecedented rate. These novel compounds operate in a legal grey area and the confusion around them is causing widespread illness and death. What happens when the solution to illegal drugs is worse than the problem?

    When Jennifer Whiteley took Benzo Fury she probably didn’t expect to end up dead. The 27-year-old trainee psychologist, who had experience of working with drug users, consumed some of the formerly legal high along with alcohol and cocaine, started sweating, had a heart attack, and died the following day. As photographs of her in graduation robes began appearing in the papers, her family insisted she was a smart, knowledgeable girl who wouldn’t have taken unnecessary risks.

    Similarly, when Richard Phillips, 26, decided to take LSD imposter Nbomb, or NBOMe, which was legal at the time but has since been deemed a Class A, he wouldn’t have been banking on brain damage. As his brother Byron vehemently told reporters: “I know for a fact that with everything Rich had in his life he would not have taken this if he knew the risks.”

    The same could be said for Jason Nock from Cradley Heath, who died in 2013 at the age of 41 after overdosing on AH-7921 or doxylam, a legal morphine substitute. Or Adam Hunt from Southampton, who died in 2013 at 18 after taking AMT and etizolam. Or indeed any of the growing number of people who have been dying, or falling seriously ill, from what some are calling an epidemic.

    Whether you refer to these novel compounds as designer drugs, research chemicals, or new psychoactive substances, they’re growing in number all the time. In 2009, the European Monitoring Centre for Drugs and Drug Addiction's Early Warning System identified 24 new drugs, a figure that's increasing every year – the UN office on drugs and crime recently revealed the existence of 348 new types of synthetic drugs, over 100 of which emerged in the last year alone.

    This bounteous new array of mind-altering products brings with it potentially dire consequences. The National Programme on Substance Abuse Deaths reported 68 deaths from new psychoactive substances in 2012, up from 51 the previous year and just 10 in 2009. A recent, much-quoted report suggested (somewhat tenuously) that legal highs could contribute to more deaths than heroin by 2016.

    While these numbers need to be kept in perspective, and tabloid frenzies should be taken with a pinch of salt, there has been an abundance of cautionary tales of late. One of the most striking things about the raft of stories over the last few years is the variety of compounds involved. Almost every time it’s a different culprit, and often it’s a lack of information or understanding that’s as deadly as the substance. Ignorance isn’t bliss.

    The typical response from governments is to beef up legislation, outlaw these compounds, and confiscate as much contraband as they can. However, it’s these very drug laws that are causing chemists to innovate, tweaking molecules here and there to produce new, untested, and potentially unpredictable products that exist on the fringes of the law. Legislators are playing whack-a-mole: Clamp down on one drug, and several similar ones pop up elsewhere.

    Add in a number of other factors – global distribution networks, information and cash flows enabled by the internet, and a good old fashioned dose of media hysteria – and you have a vicious cycle that provides a fertile breeding ground for new compounds. The drug landscape is changing fast, and governments, healthcare providers, and, crucially, users can’t keep up. You could try talking to Frank but his head is spinning from it all. As journalist Mike Power put it in his book Drugs 2:0 – The Web Revolution That’s Changing How the World Gets High, “the rules of chemical engagement have changed”.

    Molecular structures for methoxetamine (left), quetiapine (centre), and alprazolam.

    “It still seems unreal five years later that my daughter’s not coming home," says Maryon Stewart, whose daughter, Hester, a 21-year-old University of Sussex student, died in 2009 after taking gamma-butyrolacton, or GBL. "It was devastating, two policemen on my doorstep telling me my daughter had died. I was more than shocked, as you can imagine."

    Stewart, who refers to the current situation as an “epidemic”, created the Angelus Foundation to raise awareness around legal highs. A former health practitioner and broadcaster, she lobbies government, tours schools, and has launched an online information service called Why Not Find Out.

    It was during a four-day hideout from the media after her daughter’s death that Stewart learned more about GBL – that it was banned in other countries, was known to cause death in conjunction with alcohol, and hadn’t been properly addressed by then home secretary Jacqui Smith – and campaigned to have it outlawed.

    “I really thought that by getting GBL banned I’d be saving other families from going through similar misery,” she tells me, “but what I didn’t realise was that there’d be an epidemic: that if you ban substances then chemists in China tweak the molecules and put them on the market.

    “Kids are playing Russian roulette with their lives. They’re not just dying, they’re ending up in psychiatric institutions, being sectioned in mental hospitals, having heart attacks, losing their bladder. … It’s ridiculous that these chemists have managed to outsmart everybody, and as a result the wellbeing and lives and longevity of our kids is in their hands.”

    One cautious step on the path towards a solution is being taken in Cardiff. The Welsh Emerging Drugs and Identification of New Substances project (Wedinos) is an online drug-testing service based on the principle of harm reduction. Anyone can anonymously send in a sample of a new compound, adding only their postcode and a mention of the expected and unexpected effects of the substance, which will then undergo rigorous tests, with the results posted online.

    Run by a small team of toxicologists and chemists and funded by the Welsh government, Wedinos was set up in response to the increasing need to find out exactly what’s in the new drugs circulating the country, and users and healthcare-givers alike are finding it invaluable.

    “We were seeing an increase in concern from clinicians within emergency departments and drugs services saying, ‘We are seeing people present with psychosis, with wounds, with symptoms that we cannot explain,'” Josie Smith, the programme's leader, tells me. “They said, ‘Definitely drugs have been consumed but we don’t know what the drugs are, and nor do they.’”

    The service “is really about identifying [the difference between] what people believe they’re taking and what they’re actually taking, and the potential consequences. Samples are sent in from users, concerned family members, youth services, schools, substance abuse practitioners, the police, prisons – the full range.”

    Four men from Llandudno went temporarily blind in January after taking a liquid amphetamine called Brain. Their pulses soared, their hearts palpitated, and their limbs went numb. They were hospitalised, and Wedinos subsequently began testing the substance so the next time it happens hospitals will be better equipped.

    Smith names a number of surprising discoveries. “Ivory Dove was sold as a legal high in head shops right across the UK,” she says, “and it contained three Class A substances”. Synthetic cannabinoid Clockwork Orange, meanwhile, had some ultraviolent side effects.

    “We had a number of young people, who were smoking fairly large amounts it must be said, who were experiencing swollen lymph nodes and bleeding from the nose and throat,” she remembers. Toxicology tests confirmed that the product did indeed cause these things, so the kids either switched product or stopped altogether. The team also discovered that the Clockwork Orange sold in Gwent was a different substance to the Clockwork Orange with the same packaging in Cardiff.

    By making this information available to all, Wedinos empowers users and doctors and exposes ruthless dealers, but Professor David Nutt, a neuropsychopharmacologist who was chairman of the Advisory Council on the Misuse of Drugs until he was sacked for suggesting that taking ecstasy was no more dangerous than horseriding, is still somewhat sceptical.

    “Drug-testing may have the potential to save lives, but you could argue that it’s a bit of a fudge, a bit of a half measure,” he says.

    Naturally, the likes of the Daily Express and the Daily Mail howled in outrage at a government-run drug-testing facility that supposedly aids and abets dealers by providing a quality-control service, while Welsh Conservative Darren Millar, the country's shadow minister for health, jumped on to Radio 4's Today show in April to declare that “the Welsh Labour government have given up the fight against drugs”.

    Smith denies the allegation, telling me: “We don’t quality control. We don’t provide information on purity. And actually what the service does is report on the unexpected and unwarranted effects that individuals are experiencing.” And the most popular comment under a MailOnline story about Wedinos headlined “Is this really a wise use of taxpayers’ money?” reads: “It’s a wiser use of taxpayers’ money than the hugely expensive, pointless war on drugs,” suggesting that the furore could fizzle out.

    That said, it doesn’t take long on the latest iteration of the Silk Road using a semi-anonymous browser to find a forum where users and dealers openly discuss collaborative ways to test products via Wedinos, linking up the supplier information with the published results. As Wedinos doesn’t publish percentages of its ingredients, the forum users discuss using a Spanish service called Energy Control for more detailed tests if needed, but essentially they’re successfully using Wedinos to locate reliable dealers.

    One forum poster’s signature is the astoundingly flagrant “the only place you need to go for your NBOMe”. On the deep – and to be honest even the shallow – web, the narcotics trade is a flourishing marketplace with all the feedback systems you’d expect from Amazon (where, incidentally, legal highs were available until Maryon Stewart campaigned against it).

    The question is, though, does it actually matter if people are looking for ways to ensure their drugs are pure, unadulterated, and not dangerous?

    In fact, in an official information vacuum in which selling highs is legal as long as they’re labelled “not for human consumption” rather than accompanied by dosage advice and other helpful information to reduce harm, forums like Bluelight and Erowid, where users share knowledge and experience, are invaluable.

    A recent thread in Bluelight was concerned with rogue and lethal batches of NBOMe – advice that might have been invaluable to Richard Phillips – while a co-owner of Erowid told Mike Power that she receives emails every week from people who say the site has saved their lives.

    Alongside untold numbers of discussions that are essentially drug users looking out for each other, there are numerous trip reports which – depending on your outlook – will either have you running to the hills or tempted to dive in. Covering a huge range of substances and scenarios, they’re often exhaustive accounts, meticulous in detail and dosage, and similar to the explicit experiments of early psychonauts like Alexander Shulgin.

    Bluelight also hosts discussions on all manner of topics, from general FAQs to drug culture, drugs in the media, support and recovery groups, healthy living, and beyond. Set against the government’s propaganda division in the war on drugs, its value can’t be underestimated.

    Nutt naturally has a thing or two to say about the situation. “The main intent of traditional drugs education and government information campaigns is to deter use,” he says, “and its effectiveness seems to be measured by how disgusted, upset, and fearful you can make people. All the evidence from drugs education shows this doesn’t really work. … Instead the main aim of drugs education should be to reduce harm."

    Stewart is also keen to distance herself from the preachy side of things. “We’re not just saying, ‘Don’t take these things because we don’t want you to experiment or have fun or whatever,’” she insists. “We’re basically saying we don’t want you to risk your wellbeing or your life inadvertently because you think it’s safe and fun."

    Britain is one of the biggest producers and consumers of new substances, and our archaic drug laws are the catalysts that fired this rapid growth in new products.

    Nutt uses cannabis as an example to explain the process. “A big chunk of the new substances are new generations of synthetic cannabinoids that have been created specifically to evade three separate failed attempts to ban these cannabis substitutes,” he says. “These ineffective laws have boosted innovation and so inflated the number of new drugs, which drives up the media hysteria, which in turns boosts the pressure on politicians to demonstrate toughness with knee-jerk bans. And so the cycle continues."

    As substances are banned, underground chemists take the discoveries and notes of early pioneers, such as Shulgin and his peer David Nichols, tweak the recipe to evade existing legislation, get their new creation synthesised in an Asian lab, and distribute it across the world to eager customers via the internet.

    These new compounds evade existing drug laws, but how they work and what effects they might have are completely unknown, and within days the drugs are being taken by eager guinea pigs worldwide.

    Shulgin, the "godfather of ecstasy", who died in June, produced two seminal books, PiHKAL (i.e. "Phenethylamines I Have Known and Loved", 1991) and TiHKAL ("Tryptamines I Have Known and Loved", 1997). Considered sacred texts by psychonauts and drug connoisseurs and “cookbooks on how to make drugs” by the US Drug Enforcement Administration, they contain detailed information on his synthesis and sampling of 200+ psychedelic compounds, most of which he discovered himself.

    Nichols was also involved with the books. He’s become a world leader in dopamine research while investigating new treatment ideas for Parkinson’s disease. His work on serotonin receptors ultimately led to the distribution of ecstasy substitute MTA, which caused several deaths in the '00s, and he spoke out in 2011 about his work being exploited by illicit chemists and causing deaths, declaring that he felt “hollow and depressed”.

    Nick Bonnie, 30, from Stroud, died last year after overdosing at Manchester’s The Warehouse Project on PMA, a drug that's often sold as ecstasy but comes on slower and thus encourages users to take too much, with sometimes fatal consequences.

    Since then, the club has been working with Fiona Measham, professor of criminology at Durham University and an expert on drug culture, on a testing and awareness project.

    Once a month she heads to the club and tests drugs seized from people entering or dropped in an amnesty box. If she discovers anything nasty, she passes the information on to the owners, who put out warnings on social media and in the venue.

    Measham is remaining tight-lipped about the details of her experiment until she publishes her results, but agrees that there’s a potentially fatal ignorance regarding drugs on the market, exacerbated by the proliferation of legal highs, and would like to see testing more widespread. She told me she’s not convinced about Wedinos though, citing “problems of delays because of postal service” as a key factor.

    Measham's project might be groundbreaking, especially for the UK, but it’s not unique. Drug tests have been running across Europe from Portugal and Spain to Belgium, Austria and Switzerland, and the Netherlands has been offering on-the-spot testing for some time. The latter is only good for established drugs, though, and results are approximate – and relatively useless when it comes to the ceaseless flow of novel substances.

    Colombia has also trialled drug-testing labs at clubs that tell users whether the substance they’re about to take contains what they think it does, and whether it contains adulterants.

    In the US, a group called the Bunk Police who hand out drug-testing kits have made some interesting discoveries. Their website says that some of the MDMA pills they have tested were “made up of an inert binder with food colouring and maybe some caffeine” but that a majority contain a variety of other products, including unusual research chemicals such as methamphetamine, BZP, TFMPP, mCPP, and 5-MeO-DIPT, the latter of which is a kind of psychedelic tryptamine.

    The Bunk Police are barred from most events as organisers think their presence gives off the wrong message, so they have to operate under the radar. On their website they lay out their covert MO: “We are now proudly responsible for smuggling tens if not hundreds of thousands of test kits into events across the US – we throw them over fences, stuff them into door panels and bribe food truck owners to let us hide them under their produce. We don’t take no for an answer and we do not fuck around.”

    Police test drugs at festivals all summer, so why won’t they pass on their knowledge to the people in the field?

    The Home Office has historically been set against any of this potentially life-saving stuff, telling one reporter who pitched the idea: “Drugs are illegal because they are dangerous.” However, it's recently had a bit of a change of heart and come to the conclusion that “banging people up and increasing sentences does not stop drug use”, in the words of former minister Norman Baker.

    One thing is clear: An outright ban won’t work. Every time something is outlawed, or even becomes controversial, its popularity rockets, and demand soars before chemists set to work tweaking a molecule here or there to create a new and untested substance. Meow meow’s seductive purrs are a recent cautionary tale. “Every time mephedrone hit the news, even when the news was anti-drug hysteria, it boosted Google searches for ‘buy mephedrone’,” Nutt recalls.

    “Mephedrone was almost unique among new drugs because users really loved it. So perhaps it woke some young people up to the idea that a legal substance could be just as powerful and fun as illicit drugs, whereas before they might have expect all legal drugs to be weak imitations of the ‘real thing’, as indeed they often are.”

    Last year the New Zealand government attempted to regulate the industry, passing a law that offered drug manufacturers the chance to get official approval for their products. If chemists could prove to the new Psychoactive Substances Regulatory Authority, via a long series of clinical trials lasting up to 18 months that could cost up to £500,000, that their products were low-risk, they’d be licensed to market them. However, that testing regime hasn’t been implemented yet, and all legal highs have since been banned.

    Back in the UK, Smith says Wedinos works closely with more “conscientious” head shop owners who want to be clear on what they’re selling, and a representative from Herbal Highs (“the people’s favourite legal highs company since ‘94”) told Vice recently “we take safety very, very seriously”, and claimed he was looking at putting together an independent body of legal-high-sellers.

    Nutt agrees that UK legal high shops often have good intentions. “Many of the biggest vendors attempt to be as responsible as they can, for example withdrawing products that cause problems and diluting the most potent chemicals,” he says, “but if major supermarkets can lose track of what animal goes into their lasagne, there is no hope at all of all NPS [new psychoactive substance] vendors keeping in control of what they sell unless a proper regulatory framework is put in place.”

    How this story pans out remains to be seen, but something will need to change. As Smith says, “This is not something that’s going to go away now that the box is open.”

    Observation is not enough, but the alternative will take some doing. Harm reduction is still too controversial among decision-makers.

    “The main obstacle to progress with instituting drug-testing is that it is helpful to people who are using drugs,” Nutt says. “Certain newspapers and politicians like to describe it as if it was collaborating with evildoers, and sending out mixed messages to the innocent. That’s a stupid argument, and one that was lost decades ago in the UK by those who didn’t want heroin users to be given access to clean injecting equipment. Drug-testing should be even less controversial, because the testers are not giving out needles, they are giving out one thing: information.”