Psychoactive Substance Abuse – The Lowdown on Legal Highs
“Legal high” sounds harmless. Individuals can alter their state of mind in many ways without breaking the law – drinking alcohol, for example. The mind-altering properties of certain naturally occurring plants and mushrooms are well known. Some individuals enjoy cheap thrills from inhaling volatile substances like gases, glues and aerosols. The most harmful narcotics, however, are thought to be stashed safely out of reach behind drugs legislation.
Legal highs branded with innocent sounding names or chemical labels are easily bought in specialist shops and on the Internet. Unfortunately, these New Psychoactive Substances (NPS) are designed to mimic the effect of drugs that fall under international controls, yet the structural and pharmacological profile of an NPS is different enough from the parent compound to avoid classification as an illicit drug, and a government ban on one substance can be neatly sidestepped by making molecular changes to create a new one.
Suppliers often bypass drug laws by marking their products as “not for human consumption.” Many users assume no consequences simply because access to these substances seems to be legal and relatively uncontrolled. In addition, possession of many NPS remains legal despite some harbouring ingredients that are actually illegal.
While pharmaceutical drugs are the result of controlled manufacture and involve rigorous testing, ingredients of NPS are not listed but include plant and herb extracts, synthetic cannabinoids or synthetic cathinones, other chemicals and binding agents. Some compounds are adulterated with other drugs.
Synthetic cannabinoids are related to chemicals found in marijuana; as NPS, they are sprayed on dried plant material and then smoked or vaporized and inhaled. NPS with synthetic cathinones come in powder form that users snort or inject and are chemically similar to amphetamines.
The effects are unpredictable but broadly similar. Legal highs produce pleasurable stimulant, sedative, hallucinogenic and aphrodisiac effects in users. However, heart rate and rhythm are disturbed and blood pressure is elevated. Body temperature is increased, causing severe dehydration that can lead to kidney failure and damage to skeletal muscle. Users also display psychological symptoms of widely varying intensity and some drugs exert powerful and lasting effects on mood and memory.
For users the danger lies in the differing biological effects and toxicology profiles of the drugs being imitated. It seems NPS have high abuse and addiction potential with frequent use leading to tolerance and increased consumption just like any other drug. This makes it easy for users to gloss over the very real risks of losing control or being exposed to long-term harm from their use.
One drawback to understanding the health impact is a lack of evidence. Adding to the confusion is the perception that legality implies safety – clearly untrue from the experience of alcohol and tobacco. In practice NPS are not at all harmless but a fast-growing illicit market that represents a serious public health threat.
Insurers can conclude that legal highs, and other “club drugs,” have considerable health effects. Synthetic drugs like this include amphetamine type stimulants (ATS) and ecstasy. Underwriters should take care to include questions about all drug-taking on application forms, including legal highs. While youthful clubbers and wilful adolescents who experiment with NPS or ATS may not represent an obvious target market for insurers, their grown-up selves do. It’s the lasting morbid health effects that should trouble us.
More information is available from the European Monitoring Centre for Drugs and Drug Addiction and National Institute on Drug Abuse in the U.S.