Getting ahead of new drug trends

In the mid-2000s, an alarming new drug started to emerge in Europe and the United States. Underground labs began using potent industrial chemicals to make a new class of psychoactive drug that mimics the effects of cannabis.

In some cases, these new synthetic substances were hundreds of times more powerful than cannabis itself.

In the decade or so that followed, international authorities faced surging use of synthetic cannabinoids, which more commonly known by their street name ‘Spice’.

They became increasingly popular as recreational drugs or ‘legal highs’ from about 2008 because they were legal and relatively cheap compared with other recreational drugs such as cannabis.

Usually smoked with tobacco in a joint, or on their own in a pipe, the effects of ‘Spice’ can be more intense and last for hours. Many new users report quickly wanting to take more and more of the drug. Mental health problems can get much worse. At the extreme, psychotic episodes lasting for weeks can be triggered, usually in those who are already susceptible.

Unsurprisingly, Spice caught the attention of the press and social media, with alarming images and stories being shared, often of vulnerable homeless and street-based users.

Governments around the world have acted. In the UK, many of the synthetic cannabinoids were made illegal to sell by the Psychoactive Substances Act 2016. They are now categorised as a Class B drug under the Misuse of Drugs Act 1971. There are stiff penalties for possessing and supplying ‘Spice’, including up to 14 years in jail.

But being illegal doesn’t prevent a drug from being used. Synthetic cannabinoids remain a significant part of the UK drug scene, particularly in our prison and homeless communities. Understanding what’s happening and being able to educate people about the risks is a vital part of being able to reduce the harm they cause.

‘We didn’t really know what people were using’

Robert Ralphs is Professor of Criminology and Social Policy at Manchester Met. He has been investigating substance use and drug markets since the 1990s.

A lot of his work has involved studying gang-related drug dealing and drug use in prisons. One of the ways he was alerted to the prevalence and impact of Spice was through mentoring young people in jail. They would tell him about the disturbing behavioural problems they were seeing in other inmates who were using Spice and of the money people were making selling it.

Outside the criminal justice system, Rob also heard about other so-called ‘legal highs’ from DJs and promoters: “In the past people would have been on ecstasy, maybe a bit of cocaine, or ketamine but with the emergence of synthetic cathinones, we didn’t really know what people were using in club settings anymore.”

With frantic stories about ‘Spice zombies’ hitting the headlines, and concerns about the content of ecstasy pills and powders, there was an urgent need to understand the use of legal highs. Who was taking them? How? What effects were they having?

The 2016 research into New Psychoactive Substances in Manchester laid the groundwork for the establishment of the Greater Manchester Local Drugs Information System. This network of over 800 service providers and subject experts keeps an eye out for at-risk groups, and identifies opportunities for service development, training, awareness raising and harm reduction.

Subsequently, Manchester Met’s Substance Use and Associated Behaviours (SUAB) research group, which Rob leads, made history in 2018 by publishing the first study and survey of the emergence of synthetic cannabinoids.

Since then, they have been at the forefront of research on new psychoactive substance use and the response through the development of an annual survey, initially in Manchester but now covering the wider Greater Manchester region.

Piecing together the picture

There are many different ways of understanding a new drug. A chemist can run tests and identify what the novel substance is made of, the properties it has and its likely effects. A social scientist can track and document the way it’s being used, which can have significant implications for its effects.

In a first for the UK, Greater Manchester Combined Authority has now commissioned Manchester Met to monitor new substance use trends and drug market changes.

The Greater Manchester Trends Research on Emergent and New Drugs Survey (GM Trends) combines Rob and his criminology colleagues expertise with the forensic chemistry provided by Dr Oliver Sutcliffe’s research team, MANDRAKE.

Put them both together, and there is a powerful new perspective to be had. As Professor Ralphs puts it: “Our approach uniquely combines the testing of substances – the chemistry of it – with the social science. It’s interdisciplinary and revelatory.”

Rob and his colleagues in SUAB were able to get a clearer understanding of how the new psychoactive substances were being used by a wide range of groups - people in prison or being released on licence, homeless people, clubbers, and those using the drugs during sex.

Crucially the insights their interdisciplinary research provides are used to train health and social care practitioners, and to help a wide range of services plan better responses to emerging trends, including substance use treatment providers and the police.

Through a combination of data analysis, focus groups, observations and interviews, they recommended improvements to partner agencies, including the introduction of a drug alert and drug information system. Other measures included modelling good practice and suggestions for how to improve treatment for people suffering from the effects of Spice.

The work also helped assess whether existing services were able to meet users’ needs, and identify gaps in the knowledge or training for staff. They provide awareness raising and professional development training for frontline staff including health care, criminal justice and housing sectors on new drug trends and how to reduce harm. 

This need for staff upskilling in drugs services was also highlighted Black Report, commissioned by the Home Office and the Department of Health and Social Care. The report made recommendations to improve drug use treatment and prevention, and SUAB’s research complements this by keeping drugs services informed about emerging trends.

Protecting the vulnerable

A focus of the GM Trends 2022 survey was on young people’s use of nitrous oxide, which is intended for use in food production. Also known as laughing gas and NOS, it can be inhaled to give a feeling of being relaxed and giggly. But it may make users anxious and cause powerful headaches, and in some circumstances lead to suffocation.

Recent data pointed to an increased use of larger catering-sized cannisters of nitrous oxide, with users going to hospital with third degree burns or neurological damage as a result.

Following a similar approach to Spice, researchers interviewed young people to understand how the nitrous oxide is being used, the risks it can present and how services may need to respond.