Tuesday 29 November 2011

Clubbers should be able to test their ecstasy

Media reports of two deaths at the weekend in the same party venue have once again been accompanied by police suggestions that the drug responsible is ecstasy that may be from a "contaminated" batch. Speculation as to the cause of these tragic deaths is unhelpful, and recent experience with mephedrone has shown such preliminary comments are often quite wrong, we will know the truth only when toxicology results are reported.
Users of club drugs are exhorted to attend hospital casualty departments if they feel ill; this is good general advice for anyone that is feeling ill after taking drugs, whether legal or controlled. While deaths from MDMA are now quite uncommon following the instigation of health-promotion regulations such as free water and chill-out rooms in dance clubs, they are still very regrettable and hugely distressing to family and friends. So is there anything that could be done to reduce risks to the users of this and other recreational drugs?
This is a topic the Independent Scientific Committee on Drugs (ISCD) has considered at some length over the past years, and on which we have taken evidence of good practice elsewhere. We need to abandon the current government approach that relies on fear of harms underpinned by ignorance of what drugs users are taking as the prime approach. This has failed, and will continue to do so, for young people are relatively uninterested in possible threats to health. It may even make things worse as often young drugs users are fearful of seeking medical help for themselves or their friends because of the real threat of police prosecution.
We should replace it with a knowledge-based approach to their keeping safe. This should be based on the Dutch Drugs Information and Monitoring System (Dims), a nationwide network of hospital-based labs that will analyse substances with no questions asked. Users – or those considering use – can have their purchases analysed free from any risk of prosecution. The turnaround time is in the order of days and when they collect the information on their purchase they are told about its nature and given advice on its dosing, adverse effects and safety. This then reduces the risk to the user (provided they take the advice) and, vitally, also provides the government with information on what drugs are being used. In this way, trends in purity can be quickly established and new entrants to the market detected very early.
Sadly in the UK, we do not apply anything so sophisticated and logical. Instead, we rely on a few test purchases and some amnesty bin surveys to gather information – and no clear personalised guidance can be given. The UK coroners system is slow, often taking months after the death for the analysis of drugs in the body to be completed and usually it's months before the final coroner's assessment of the contribution that these made to the death is reported. The current proposed reorganisation of coroners and the disbanding of the Forensic Science Service that provided much of the analytical tools for drug detection will make the situation even worse. The new early warning system announced as part of the new drugs bill has not since been formulated and, without investment in a structured approach, is unlikely to be useful except in retrospect.
When I was chair of the Advisory Council on Misuse of Drugs I wrote to the then home secretary, Jacqui Smith, suggesting that the UK might benefit from a conversation with the Dutch experts about their system and the evidence base that has emerged from it over the past decade, I received a very clear message that the government had no interest in this approach.
Perhaps the coalition might like to rethink?
David Nutt @'The Guardian'

1 comment:

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    MDMA

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