Welfare Briefing. Key drug trends

Transcription

1 1 Welfare Briefing This is a briefing intended to inform on site festival staff of possible drug trends and other welfare issues at 2016 events. It includes anecdotal and user reported information in addition to some intelligence from drug agencies and enforcement. It is not intended for forwarding or circulation as a drug alert or indeed to be disseminated to the media. Individual alerts where there has been evidence, have already been released by relevant bodies. As with any anecdotal reporting, information should be treated with sensitivity and staff should be aware of the unintended consequences of releasing information to the public about strong or dangerous drugs especially where this information has not been confirmed by analysis. It is useful to remember the main factors in overdose are poly substance use, large doses and re- dosing. Key drug trends Similarly to festival trends last year the main drugs of choice requiring people to visit welfare appear to be alcohol, MDMA, Ecstasy and Ketamine. The main novel psychoactive substance (NPS) reported to Chill is mephedrone but there is some evidence to suggest NPS may be sold as other substances, such as crystal MDMA or cocaine. Poly substance use remains high with the majority of people using substances with alcohol or often multiple substances. Negative reactions are much more likely where people have used with other drugs (including alcohol) or have taken large doses. Active doses of some drugs can be as small as a matchstick head. Some substances can take up to three hours to take full effect, which means re- dosing too quickly can result in overdose. The key message to get across is there is no visual way to tell the contents of powders or pills, drugs can contain other substances than what they claim to, therefore, people should treat all drugs as unknown. The strength of powders and pills can also vary even with tablets that look the same. MDMA Crystal/powder MDMA appears to be more prevalent at some events than ecstasy tablets and is preferred by some users as they may believe it is less likely to be adulterated than ecstasy. In 2015 at some events substances such as alpha- PVP were discovered in amnesty bin testing, in some cases where samples had been handed in which were believed to be MDMA. There is little recreational demand for alpha- PVP and therefore it is likely the majority of this substance in circulation at events is sold as something else. Dosage range to MDMA for example is much lower

2 Welfare Findings so people can experience very unpleasant effects including anxiety and paranoia if dosing as MDMA. MDMA MDMA Since 2015, The Loop and Chill Welfare have run a campaign about dosing crystal MDMA. This advice can be applied to any powder. MDMA capsule Ecstasy Over the last few years, there have been various issues with ecstasy tablets in circulation. The main issue currently in UK is high purity MDMA tablets but equally to a lesser extent, adulterated batches containing substances such PMA/PMMA remain a concern. In the midlands and surrounding area, tablets being reported on the user database pill reports include purple ninja turtles, blue Louis Vuitton s minions teslas. The Loop issued information about red or pink mastercards, which contained 250mg MDMA and yellow Mickey Mouse pills, which contained 200mg MDMA. Three other Join us online:

3 Welfare Briefing 3 batches at Parklife event orange Warner Bros, blue Instagrams and grey Darth Vaders approx. 150mg. Some examples of their recoveries from their amnesty bin collections are below: Various tablets Mastercards Some other popular tablets in circulation in 2016 are below. Tablets similar in appearance to the yellow monkey tablets below and orange versions of the teslas below were analysed in Zurich and found to contain approximately 240 mg of MDMA. Warner Brothers Ninja Turtles Instagrams Dice All seeing eye Walter Whites Join us online:

4 4 Welfare Findings 2015 Three Wise Monkeys Teslas Lego bricks Punishers Teslas PMA/PMMA PMA/PMMA can be sold as Ecstasy and has a lower threshold for toxicity than MDMA. Even small amounts can cause blood pressure and temperature to rise steeply and often does not give the same pleasurable intoxicating effects of MDMA and takes longer to take effect, leading users to take more, believing it is not working. Police Scotland issued a warning about green rolex tablets after T in the Park, which were implicated in incidents previously. These tablets contained PMA but it is unclear at this time if the batch recovered at TITP were an isolated recovery. An unconfirmed warning on user forums was issued about chupa- chup ecstasy tables believed to contain PMA in March. Rolex Chupa- Chups

5 5 Welfare Briefing Signs of a stimulant overdose include: Overheating Dehydration Rapid heart rate Extreme agitation or disorientated and experiencing vivid hallucinations Weird body sensations e.g. pins and needles Muscle tension and uncontrollable reflexes- this may present as being very rigid or jerking Seizures If in doubt, get checked out! If people choose to use, they should be aware of this harm reduction advice: Always start with a low dose e.g. quarter of a pill Wait at least 2 hours before taking any more Avoid using with other substances- this includes alcohol and prescribed medication If your powders or pills don t take effect as quickly as you d expect, don t assume they are poor quality- they may contain another substance that takes longer to kick in If in a hot environment, take breaks to cool down If dancing, rehydrate with water or isotonic drinks regularly - don t go over one pint in one hour as drinking too much can also be dangerous If you or someone you are with becomes unwell, get medical help immediately! All festivals have medical and welfare points on site that will be able to help. Ketamine Ketamine remains a popular festival drug of choice. There have been anecdotal reports of increased availability in some areas and various welfare providers have seen an increase in presentations at events in Chill has seen people combining with MDMA as a relatively common occurrence with welfare presentations involving ketamine.

6 6 Welfare Findings 2015 NPS As highlighted earlier, NPS can be sold as other traditional drugs. The Loop has recently reported methylone potentially being sold as MDMA and methoxetamine sold as ketamine. Alpha- PVP was found at an event in 2016 sold as cocaine. Alpha- PVP Psychedelics Psychedelics vary in popularity between different events. Availability of blotters appears to have increased in some areas. Again NPS can be sold as LSD including substances such 25i- NBOMe, DOx compounds and 1p- LSD. Dosage and duration with some psychedelic NPS differs from LSD and therefore people may have unexpected effects and therefore become anxious due to this. Blotters containing NBOMe have been found with the markings below in Scotland. Hoffman Bicycles Rolling Stones Dalai Lamas Set and setting are extremely important with managing negative psychedelic reactions so often supporting people to be managed within welfare is a more appropriate intervention unless there is a medical need which requires people to go straight to medical. Psychedelics are commonly used with other substances including nitrous oxide, ketamine, cannabis and sometime MDMA which all enhance the hallucinatory effects. There were incidents in Ireland in January involving 25i- NBOMe with some anecdotal suggestion that people believed they were taking 2CB. There has been 25i- NBOMe

7 7 Welfare Briefing sold as 2CB in Zurich, which came in powder form. Dosage range for 2CB is entirely different to 25i- NBOMe, which is dose in micro grams so therefore misidentification of 25i- NBOMe is a concern. Mental health Mental health presentations are a growing issue at festivals. Some of these presentations are connected to drug use although it is often difficult to establish whether this is an existing underlying health issue, vulnerability to mental health issues or a one off reaction to the drug taken. Where drugs are involved it is often dose related and most common where multiple substances have been used. It is important to recognise the difference between an acute mental health presentation (drug related or not) and what can be described as excited delirium caused by stimulant overdose. In such cases particular attention should be given to other signs they may present with: High body temperature Muscle tension and uncontrollable reflexes Jerking or fitting Use of restraint in stimulant overdose can be potentially life threatening as fighting against restraint and serotonin toxicity from stimulants can both individually trigger a condition rhabdomylosis that causes muscle tissue breakdown and can lead to organ failure. The cumulative effects of both toxicity and restraint make this especially high risk and medical sedation is recommended in combination with other treatment such as cooling. Equally there are been various incidences of restraint causing fatalities even where drugs are not involved. Where someone is experiencing such extreme agitation where they cannot be calmed using verbal techniques and require restraint or is in a state such as excited delirium, clinical advice from medical should be sought and should not be managed solely by security or other onsite staff. Multi- agency working for responding to acute mental health is the safest response to ensure welfare of both patients and staff alike. Welfare teams such as Chill have specialist mental health experience with dedicated staff trained in mental health, suicide intervention and counselling. In conjunction with medical services and police, Chill Welfare can support in regards to mental health assessment. Sexual assault Sadly, there have been incidences of sexual assault reported again in 2016 at festivals. There has also been coverage in the media about survivor s experiences of

8 8 Welfare Findings 2015 seeking support due to sexual assault at events, which has been less than desirable. In addition to crime reporting support, it is crucial for on the ground staff to understand how to respond to survivors whether they do or don t wish to make a crime report. The most important thing is to establish safety for the individual, this may be supporting them an onsite support area e.g. welfare or medical and/or contacting a friend or family member to be present with them. It may be that the survivor would prefer to speak with someone of a specific gender and this should be facilitated if at all possible. The person may have physical injuries and may require medical assistance, they may also be experiencing shock so staff should be aware of outdoor temperatures and facilitate access to warm clothing, blanket and hot drinks if required. It is very important that staff listen to what the survivor wants and not coerce them in to any actions or decisions they do not want as this can further traumatise them. Many welfare services such as Chill have trained staff to support people with issues such as this. There are also specialist services Sexual Assault Referral Centres often called SARC which provides services to survivors of rape or sexual assault regardless of whether the survivor chooses to reports the offence to the police or not. Sexual Assault Referral Centres are designed to be comfortable and multi- functional, providing private space for interviews and examinations, and some may also offer counselling services. SARC s have specialist staff that are trained to help people to make informed decisions about what they want to do next. More info can be found here Acknowledgements This briefing would not be possible without the kind contributions of: Kenny Simpson Police Scotland Fiona Measham The Loop Mike Kent Sussex Police Safer Party Zurich Scottish Drugs Forum Serotonin toxicity protocol developed by Dr Richard Stevenson (NHS GGC) Pill Reports Erowid For more information, contact: Katy MacLeod Operations and Communications Director Chill Welfare katy@chillwelfare.org.uk