A chemical analysis examining the pharmacology of novel psychoactive substances freely available over the internet and their impact on public (ill)health. Legal highs or illegal highs?

摘要

Objectives Public Health England aims to improve the nation's health and acknowledges that unhealthy lifestyles, which include drug use, undermine society's health and well-being. Recreational drug use has changed to include a range of substances sold as ‘research chemicals’ but known by users as ‘legal highs’ (legal alternatives to the most popular illicit recreational drugs), which are of an unknown toxicity to humans and often include prohibited substances controlled under the Misuse of Drugs Act (1971). Consequently, the long-term effects on users' health and inconsistent, often illegal ingredients, mean that this group of drugs presents a serious risk to public health both now and in the future. Therefore, the aim of this study was to ascertain what is in legal highs, their legality and safety, while considering the potential impact, these synthetic substances might be having on public health. Design A total of 22 products were purchased from five different internet sites, 18?months after the UK ban on substituted cathinones, like mephedrone, was introduced in April 2010. Each substance was screened to determine its active ingredients using accepted analytical techniques. Setting The research was conducted in Leicestershire but has implications for the provision of primary and secondary healthcare throughout the UK. Results Two products, both sold as NRG-2 from different internet suppliers, were found to contain the banned substituted cathinones 4-methylethcathinone (4-MEC) and 4-methylmethcathinone (4-MMC), the latter being present in much smaller quantities. Although sold as research chemicals and labelled ‘not for human consumption’, they are thinly disguised ‘legal highs’, available online in quantities that vary from 1?g to 1?kg. Conclusions Despite amendments to legislation, prohibited class B substances are still readily available in large quantities over the internet. The findings suggest that these prohibited substances are being manufactured or imported into the UK on a large scale, which has serious implications for public health and clinicians who are ill equipped to deal with this newly emerging problem. Article focus To analyse the chemical composition of substances bought over the internet, including the legality of the active ingredients and if products differ between retailers. To consider the medical implications and adverse health risks associated with legal highs bought over the internet. Key messages The most recent examination of the composition of ‘legal highs’, conducted 6?months after the introduction of the ban, found no presence of banned cathinones. Our study shows that, 18?months after the introduction of the ban, illegal cathinone substitutes are readily available for purchase in the UK in large (1?kg) quantities with little known about their clinical effects. Strengths and limitations of this study The small number of products tested (22 products) and the limited number of retailers sampled are limitations of this study. However, this study does show that despite being banned, illegal cathinones remain readily available over the internet, despite their potential harmfulness.