On 11 May the Irish government moved to control the sale of psychoactive substances in head shops and on line using a two-fold strategy: amendments to the list of controlled substances under the Misuse of Drugs Acts 1977 and 1984, and the newly drafted Criminal Law (Psychoactive Substances) Bill 2010 which will prevent the sale of substances created to get around existing laws. As of 11 May, synthetic cannabinoids, benzylpiperazine derivatives and six named cathinones are banned substances under the Acts, with sentences of up to seven years and/or a fine for possession and up to a maximum of life imprisonment for supply. The new Bill, when enacted, will make it a criminal offence to sell or supply, for human consumption, substances which may not be specifically prohibited under existing Acts, but which have psychoactive effects. Further amendments to existing Acts towards the end of 2010 will regulate other head shop products.

http://health.gov.ie/blog/press-release/minister-for-health-and-children-announces-immediate-criminal-ban-on-list-of-head-shop-products/ and www.justice.ie/en/JELR/Pages/Press_releases

 

The leading article in the spring issue of Drugnet Ireland (No. 33) described a range of head shop products; three additional substances are described below.

Pyrovalerone is a psychoactive drug with stimulant effects that was developed in the late 1960s for the clinical treatment of chronic fatigue and as an appetite suppressant for weight loss purposes. Because of problems with abuse and dependence, it is now less frequently prescribed, but there are reports of its continued use in France and South-East Asia. Its side effects include loss of appetite, anxiety, sleep disturbance, and tremors. The user may become depressed when use is discontinued. Its use is controlled in Ireland, Australia, Britain and the US.  Pyrovalerone is closely related in structure to a number of other stimulants, such as methylenedioxypyrovalerone (MDPV) (banned in Ireland under Order of 11 May 2010). Naphyrone (O-2482, NRG-1, Energy 1 ), also known as naphthylpyrovalerone, is a drug derived from pyrovalerone that has stimulant effects and has been reported as a novel designer drug. It is sold as a plant food on line. No safety or toxicity data are available on naphyrone.

 

2-Aminoindan is an uncommon short-acting stimulant with effects that have been compared to those of 1-benzylpiperazine or methamphetamine. Little is known about its recreational use, but aminoindans are the active ingredient in at least one head-shop product, Pink Champagne pills, which also contain cola vera and caffeine. The pills may cause an increased heart rate and short-term insomnia. Online sellers of these products indicate that they should not be consumed in combination with alcohol or other drugs, particularly anti-anxiety or anti-depressant drugs, or by people with any medical condition (in particular, heart or liver disease), with mental illness, or who are pregnant or breast feeding.

 

1,3-dimethylamylamine or DMAA, also known as methylhexaneamine, is a derivative of geranium oil and acts as a central nervous system stimulant. Methylhexaneamine is registered for use as a nasal decongestant. In combination with caffeine and other ingredients, it has been marketed as a dietary supplement under trade names such as Geranamine and Floradrene. Methylhexaneamine, at extremely low concentrations (less than 1%), is a component of geranium oil which is approved for use in foods. DMAA is emerging as an active ingredient in party pills in New Zealand, where the government has indicated its intention to schedule it as a restricted substance. Recreational drug users have reported adverse effects of DMAA, including headache, nausea, and stroke. Online user reports describe a desire to reuse the drug, episodes of profuse sweating, and feeling depressed and paranoid. Products containing DMAA are available in head shops and on line under names such as Iced Diamond, Vegas Nights and Blessed.

 

Dr Pierce Kavanagh and colleagues (at Trinity College and the Drug Treatment Centre Board) identified the active ingredients and other constituents in 41 products sold in head shops in Dublin and illustrated their results in a poster,1 reproduced on page 16-17. This poster is useful for staff working in emergency departments and drug treatment centres. Eighteen of the products analysed contained cathinone derivatives, either in isolation or in combination: mephedrone (28% of cathinone products), flephedrone (17%), methylone (22%), butylone (17%) and MDPV (22%). Dr Kavanagh and his team are analysing other psychoactive products to determine their contents and will release the results when their research is completed.

 

The authors reported that the negative effects of cathinones were: dehydration, erectile dysfunction, discolouration of the knees attributable to vascular damage (‘blue knees’), cardiac arrhythmias, and paranoia. They also said that mephedrone had been linked with at least one death in Europe and was suspected in other deaths. For further information, email id.lab.team@gmail.com
 

1. Kavanagh P, McNamara S, Angelov D, Mc Dermott S and Ryder S (2010) Head shop 'legal highs' active constituents identification chart (May 2010, pre-ban). A modified version of this poster was presented atthe All Ireland Joint Schools of Pharmacy Research Seminar (March 2010) and at the launch of the Trinity Student Medical Journal (April 2010).

Carol Murphy and colleagues presented an abstract of their survey, displayed as a poster titled ‘Head shop bath salts – not good clean fun’,1at the College of Psychiatry of Ireland’s spring meeting on 25 March 2010. This survey sought to estimate the extent, and describe the experience, of ‘bath salts’ use among problem drug users living in a hostel for homeless people in Dublin city centre.  Nurses or key workers administered a questionnaire to a random sample of 20 clients during December 2009, of whom 17 participated in the survey. The researchers found that:

1. Murphy C, McCarthy C, Harkin K and Keenan E (2010)Head shop bath salts – not good clean fun. Poster presentation at the College of Psychiatry spring meeting, Dublin, 25 March 2010.

 

The National Advisory Committee on Drugs has commissioned a review of products sold in head shops and other outlets in order to establish what the products contain, according to their labelling and on laboratory testing. The researchers will investigate availability of reference standards to facilitate the analysis of new psychoactive substances. They will update an inventory of head shops and other outlets (including internet sites) in order to assess geographical access to these substances. The users of products will be interviewed to determine products used, reason for use, expected effects, unexpected effects and preferred place or source of purchase. Problem drug users will be interviewed to identify specific risks associated with their use of these products. Data will be requested from hospital emergency departments to determine the negative health effects associated with head shop products. The research team will examine opportunities for legal and harm reduction interventions in Ireland and other countries.  For further information, contact sscally@nacd.ie

 

Ana Liffey Drug Project has developed a web page on legal highs which contains links to published harm reduction information. Peer workers at Ana Liffey have produced a booklet, Use your head, which provides some guidelines on how to minimise harm when taking drugs and how to intervene if someone experiences harm caused by drugs.