MCat testing

Thursday, November 7th, 2013

I have good news for the hundreds of people who have visited this site looking for information on mephedrone testing.

As I thought, instant, onsite MCat testing kits are not yet available. They are being developed, and I will let everyone know as soon as they come onto the market, but for now at least, if your employer uses the instant urine testing method, any MCat in your system will not show up on a drugs test.

(Your employer may use oral swabs, or send urine samples off to a laboratory – and MCat may be detectable using these methods. But if your employer takes a urine sample and gives an immediate result, you shouldn’t be providing a positive test – for now at least.)

However, this information is only useful if you are sure that it is actually MCat you have been taking – if it was different drug such as amphetamine, you would still give a positive result for this drug. And so I think I have managed to source some kits which test the drug itself, and tell you whether you have bought mephedrone, methylene, MDPV – or something else entirely. Whilst these won’t be able to tell you if you are clear of the drug before going back to work, they will be able to tell you if what you are taking is in fact mephedrone, or something else. So then you will know whether you will give an MCat-positive swab or lab result, or not.

Another good thing about these tests is they will allow you to test your drugs before you take them. If you have taken MCat before, you think you know how it affects you, and want the same effects, the safest way to take it again is to test a tiny sample to see if it is what you think it is. That way, you know what to expect, and you know what the potential side-effects may be and how to manage them. This also indicates that your supplier is probably trustworthy as they are selling what they claim to be selling. This makes the whole process safer, and less likely to put you into a state you weren’t expecting.

For information about the expected effects and side-effects of MCat, you can look at Frank or Know The Score. If you are in the UK, you can ring a confidential free phone number between 8am and 11pm (0800 5875879), but if you have serious concerns about the health of someone on mephedrone, you need to ring an ambulance immediately.

And bear in mind, if you are getting wasted at the weekend, not sleeping or eating, and turning up to work in such a state that you can’t do your job, you will still be subject to disciplinary procedures. There’s nothing wrong with having a good time – but it ain’t worth losing your livelihood for. And if you do have an accident at work and require a medical, any substances you have taken will still be identifiable via a blood test – so make sure you eat, sleep, rehydrate and straighten your head out before work.

The tests have been sourced from the same supplier as the Police, so I have every faith in their validity, but once I have set up an online check-out I will post again. In the meantime, if you are interested in purchasing the tests, or you want to know about testing kits for other drugs, email me at drugsworkertowriter@gmail.com. I promise to treat your information with the upmost respect and confidentiality, and will answer any queries you have as best I can.

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What’s worse than being a woman with a drug problem?

Thursday, October 31st, 2013

Something which the Government failed to mention in its recent, polished figures is that female unemployment is at its highest for twenty five years. Women’s organisations are pointing out that austerity measures unfairly target women, by making cuts to child benefits at a time when childcare and household bills are rapidly increasing, whilst those that do have jobs still get paid less than men (in 2010, in the public sector – which one may imagine to be the least discriminatory employer – the pay gap between men and women was still an incredible 21%).

An interesting article in Drink and Drug News this month considers the impact of austerity on female drug users. I touched on the stigma faced by women who use substances in Baby wants a double vodka, but this article looks at the effects of the cuts to service provision, given the complexities that often come hand-in-hand with being a woman with a drug problem.

As Caroline Lucas MP points out, women’s substance misuse is often more complicated than men’s, regularly associated with parental and sexual stigmatisation and shame, childcare issues, domestic abuse and prostitution. Yet these specific needs were omitted entirely from the 2010 Drug Strategy, and the ‘bulk-buying” approach to commissioning has meant that gender nuances are now ignored.

The women’s drug service in our area has vanished during the cuts, and their work absorbed by generic drug workers who have less capacity for home visits and parenting work. Many of their clients, who have experienced issues such as sexual abuse, may now need to be seen by male workers, unless they have the confidence to make demands (confidence not being a trait often associated with this group – neither the balance of power when your script depends on it). And whereas having a family may be seen as increasing someone’s ‘recovery capital’, is this necessarily the same when, for women, this may include single parenthood and domestic abuse?

Attempts to maintain and develop best practice are further stretched as fewer staff mean workloads increase – and research into joint-working models has exposed that workers who attempt a multi-agency approach to supporting women often report having to hide this from their managers, as the extra work they do cannot be directly evidenced statistically and so is considered ‘out-of-remit’.

And then there’s what social worker Gretchen Precey has tagged ‘start again syndrome’ – the desire to see every woman’s pregnancy or birth as a fresh start. The dilemma working with this client group is balancing the constant need for motivation and positivity, the belief in the possibility of change, with prioritising the needs of helpless foetuses and babies. As workers, when we see chaos, we often understand vulnerability – and we desperately focus on the glint of positive in the shit pile of someone’s life. But to ignore a woman’s past experiences of motherhood is dangerous, warns Precey – and in a culture where professionals are blamed for any harm that comes to a child (as though, I always feel, they are the perpetrators), workers are left to balance hope against risk. It creates a moral clash. These are the cases that keep you awake at night.

Almost ten years ago, I was involved in a consultation on the Government’s white paper, Paying the Price, which looked at how best to manage prostitution. It seems sad that, years later, the comments I made then ring truer than ever. My point was – the links between child abuse and sex work are well-documented, and yet Social Care are increasingly under-funded and over-stretched. What was once a support service now exists almost exclusively for the purpose of risk management. And so, whether we consider female sex workers, female drug misusers, or women who struggle with motherhood, the common themes remain the same – and as long as we fail to address the root causes of these issues, we are producing the next generation exhibiting these behaviours. The chain continues.

And some of you will know how it feels to see the kids you tried to protect all those years ago arriving at your door with baby bumps, track marks and utter disgust at the world.

Lord Coca Leaf vs Baron Cocaine

Thursday, October 10th, 2013

Those cheeky peers have been at it again. Following their revelationary recommendations back in January, which suggested we dropped the moral stance on drug use and took a more pragmatic approach, this week the All Party Parliamentary Group For Drug Policy Reform have come up with an idea so good and so politically-unaligned that it has blown my socks off.

Using the same level-headed, true harm-reduction manner as Towards a Safer Drugs Policy, Baroness Meacher and Co. have this week published Coca Leaf: A Political Dilemma?. This new document, commissioned and published by the peers but written by a specialist in The Americas’ human rights, tracks the damage done in Latin America by the War On Drugs, and then looks at the ancient benefits found in the coca leaf in its unprocessed form.

The report provides a historical context to the current UN Drug Conventions, which, since 1961, have prohibited not only the production of cocaine but also the coca leaf. This has resulted in mass fumigation programmes, leaving huge areas of South America desolate. The poverty has left populations open to exploitation by drugs barons, and massive territories have fallen under criminal control. This has, in turn, undermined democratic systems, and destroyed large areas of jungle and wildlife.

Attempts to counter this movement have met strong opposition. Publication of evidence from the World Health Organisation, which stated that coca leaf had “no negative health effects”, was blocked, and when Bolivia made its case to exclude coca production from the UN Convention for traditional use, the USA and fourteen other countries objected. Despite this, Bolivia won, and legal coca leaf production is now underway. The report released this week appears to be in response to this change, and to President Santos’ recent call for a more pragmatic approach to the impact that drugs are having in the region. It looks towards the 2016 United Nations General Assembly Special Session on Drugs, where, it seem, it is hoped that the international sanctions on coca leaf production will be lifted.

In terms of the benefits offered by the coca leaf, it has long been used to enable working at high altitudes. However, it is now thought that this may not be, as originally thought, related to oxygen saturation or blood pressure – instead, it appears to moderate blood sugar levels. This indicates its possible uses in diabetes treatment. Because of the UN restrictions, it has been impossible for any research to be carried out in the modern era, but the high iron and calcium content, along with its richness of vitamins and minerals and a variety of other health-giving properties, mean that there may potential in the future to use it in the treatment of asthma, anaemia, gastrointestinal illnesses, low immunity and colds, and as an analgesic and antibacterial.

Its potential use in the food and nutrition industries, too, is possible. Containing seven times more iron and seventy-four times more calcium that the average plants we eat, it is thought to be useful for those with broken bones or osteoporosis, and its high protein content also has dietary implications. (It contains more calcium than milk or eggs, and more protein than meat.) It could also be used as an appetite suppressant for treating obesity, or taken like caffeine to increase energy levels and enhance performance. Given that it can be processed into flour, its use in the modern diet has great potential.

And finally, it is also thought to be usable in the treatment of cocaine addiction. Research is needed to test claims that the coca leaf could be used as methadone is in the treatment of opiate dependence, or whether it can also be used like buprenorphine by limiting the neural rewards available from taking the drug.

For any of these hypotheses to be rigorously tested, legal access to the coca leaf needs to be improved. Unsurprisingly, the report calls for restrictions on coca leaf production to be lifted, work to be done with the local governments to ensure that production be channelled for legal purposes instead of being made available to the drugs trade, and for farming communities to be supported in freeing themselves from black-market slavery.

These are big asks, and not requests to be implemented half-heatedly or quickly. However, with international political unity, and humanitarian aid from the countries that caused the damage in the first place (for example, maybe the four thousand US troops currently based in South America fighting the War On Drugs could be redeployed to protect the farmers?), maybe there is a glimmer of hope on the horizon for millions of South Americans.

Well done, peers. You continue to surprise and educate me.

The end of the Road

Thursday, October 3rd, 2013

Some interesting updates on previous articles have appeared in the news this week.

Silk Road has finally been taken offline, and the alleged administrator, the pseudonymed Dread Pirate Roberts, has been arrested. The website appears to have been a one-man operation based in San Fransisco. The suspect, Ross William Ulbricht, kept his operations so secretive that his housemates knew him only as Josh, the guy who spent all his time in his room on his computer, and the FBI had to scour years of data to find very rare glitches in his online personas in order to identify him. It was only when a package containing fake IDs were seized at the Canadian border with Ulbricht’s picture on them, that investigators linked this to online activity – Dread Pirate Roberts had asked for advice on gaining fake identities to set up more servers. Given that Silk Road had a estimated $1.2 million worth of trading each month, and the FBI have seized $3.6 million worth of Bitcoin during the operation, it is astounding that Ulbricht has evaded identification and capture for so long. I wonder whether the US authorities will now power on with their War On Drugs and hunt down his suppliers and customers..

It will also be interesting to see whether previous Silk Road customers see a decline in the quality of their purchases now they have lost access to the Ebay-style seller rating system.. If there are any ex-customers out there, I would love for you to get in touch and let me know how you are buying your drugs now and what impact this has had on you.

Following on from last week’s blog about the normalisation of alcohol, a couple of interesting articles have been suggested to me by staff at Sheffield University. The first informed me of the alcohol industry-driven marketing concept that is Arthur’s Day. The producers of Guinness launched this national event in Ireland four years ago to ‘celebrate Arthur Guinness’, and then refused to accept any responsibility when alcohol-related ambulance call-outs increased by thirty percent. This somewhat sinister celebration, cleverly timed six months after St Patrick’s Day and on the busiest drinking night of the month (Thursday – student night, 26th – payday), has been described by some as exploitation of Irish culture for capitalist gain – and the way it has been embraced by the public suggests that alcohol marketing is even more powerful and socially influential than anyone could have predicted. (Apart from the Dr Evil-style masterminds at Guiness, obviously.)

This seems somewhat in conflict with the Irish health minister’s claim today that he wants to ‘denormalise’ tobacco use, and achieve a ‘tobacco-free state’ by 2025. Yet another example of policy-makers’ bizarre lack of parity between substances. Given that the Irish Government are encouraring Arthur’s Day as a tourist opportunity, I’m guessing from this that they would take a different approach to smoking were Marlborough produced in Galway…

The second article recommended looked at the normalisation of women’s alcohol use in the UK. It presents some scary facts about women’s health, and considers how the pressures of being a working mum are influencing alcohol intake. Again, it is pointed out that wine is sociably acceptable whilst cooking, and suggests we really need to question what has become ‘normal’ behaviour. It does make me wonder whether our kids think we drink that like all the time, been as that’s all they see of us. And with our young women drinking more than any others in the western world, maybe we need to look at ourselves and the patterns our children emulate.

And finally – I know you will all have seen this, so I will be brief – in a brave move which may mean he does himself out of a job, Chief of Police Mike Barton has stated that decriminalisation is the way forward. Drawing a clear division between drug dealers and drug users, Mike is making a bigger statement than many of us realise, given that many Police targets focus on homogenising and prosecuting anyone associated with drugs because ‘drugs are bad’. Mike draws the same comparisons that have been previously drawn here between the War On Drugs and alcohol prohibition in 1920s America – instead of stopping the trade, it routes the profits directly to criminals. It’s a relief to know that the frontline last bastion of the moral crusade, the Police, are willing to make their voices heard – instead of, as with the Police in 20s America, seeing the battle as a way of either lining their own pockets or buying their way into heaven. I think it is an honest and altruistic move by Mike, one which may well both damage his career and sit him outside his peer group, but I for one am heartened by his stance.

Alcohol – it’s not a drug, it’s a drink

Wednesday, September 25th, 2013

I have had somewhat of an epiphany recently. In light of my self-questioning around the application of morality to the laws of the land – specifically with reference to drug use – I have started to perceive alcohol differently. Anyone who knows me knows that I am a drinker. I always have been, and so has everyone around me. This is despite losing people to alcohol. And yet we all still drink drink drink like it was going out of fashion.

I still told my clients the dangers of drinking, indeed I knew them myself, and to be fair in recent years I have generally drunk within ‘safe’ limits. But that is far as I ever thought about going – after all, it was safe, so why would I question it any further?

Recently, I have pretty much stopped drinking – because after a spell of drinking very little, I realised that, when I do drink, I feel anxious the next day. Not only on the night itself, but the day after, I misjudge things, and my perception of the world and of myself is altered. This has nothing to do with ‘safety’ – but it definitely has a lot to do with health. If, as I am starting to wonder, alcohol can significantly affect mood the day after use – and bearing in mind that many people drink every night – does this not have huge implications for the mental state of the nation?

Then I saw a news report last week about the proposed ‘drunk tanks’. The idea was that people who were incapable of being responsible for their own welfare because of excessive alcohol consumption would be put into a unit overnight and then charged for the care they received – both to protect people and to reclaim some of the money in revenue spent on policing costs. It seemed like quite a good idea for me. But the man representing the alcohol industry gave me an insight into how much they care about the damage done by alcohol consumption and what they want to do to tackle it – which was, in summary, fuck all. The well-groomed young man in expensive glasses had a seemingly endless list about why no national mandates should be passed – why this was about local services making local decisions. Which, as anyone who works in the public sector knows, means doing nothing. Because everyone is too busy, are all praying to keep their heads above water and their jobs, and are not about to stump up the cash and time to commission and implement something so huge without imperative direction from the very top.

And as I sat there, watching this nicely-spoken young gent, something happened. Before my eyes, he morphed into every heroin and crack dealer I had ever met. His shirt was ironed, his face was clean – but his justifications for the continued sale of his product, his reasonings for why the deaths and the violence and the illnesses were not his fault, made him seem to me no different from the many dealers I have challenged about their choice of product and its impacts. The truth was – he didn’t give a shit about the number of young women getting sexually assaulted. He wasn’t the least bit interested in how much use of his product cost the taxpayer each weekend in policing and health interventions. And he certainly wasn’t willing to do anything about it.

Now, fear not – I am not about to go all evangelical about alcohol use and start praying to a higher power for strength to repel the demon drink. I am still going to have a drink when I feel like it and, likely as not, will drink too much on occasions. I suppose I am just realising, for myself, another layer to my indoctrination on the matter of legal and illegal drugs. Alcohol is not ‘bad’ – just like any other drug – and of course alcohol companies are only interested in taking your money, as per the capitalist mantra, or just like any other drug dealer. But where is the logic that most drugs should be illegal while just one remains legal – and what impact does this have on perceived safety and social acceptability?

My brother recently came back to the UK, and commented after a night out, “God, I’d forgotten how the English drink”. Recent reports indicate that, in fact, much like the truth-dodging representative for the licensing industry, we as a nation also forget how we drink. A report published by Alcohol Concern found that, in 2007-8, for Brits to drink within advised limits, alcohol consumption (excluding that brought into the country duty-free and home-brewed) would need to reduce by a third. The report found that if the alcohol bought in shops was divided between every adult, we would all be consuming twenty-six units a week.

However, an even scarier report published this year in the European Journal of Public Health , found that half the alcohol consumed in England was unaccounted for. (Again, this does not include imported of home-brewed alcohol, so the actual consumption is even higher.) The report exposed the discrepancy between self-reports of alcohol consumption, and alcohol sales. So at least three quarters of the population are estimated to drink above recommended limits – and no-one is admitting to it.

Now the alcohol industry clearly know this. If this wasn’t happening, they wouldn’t be eating caviar on their yachts. And yet, despite the serious health problems associated with drinking at these levels, they continue to push the drug. They continue to fight legislation to minimise the harm it causes. And they continue to put their hands up in objection when anyone suggests maybe they could be partly responsible for this problem and, as such, should maybe put their hands in their ever-deepening pockets and contribute towards reducing some of the damage done by their product. No less ruthless that the dealers who keep selling heroin they know contains congealants, or market their stash of PMA as ecstacy.

It also makes me wonder how much sway the alcohol firms have in the Tories’ drug policies. They bring in billions in revenue – and I am sure they are none-to-happy at the idea of someone muscling in on their market share by selling cannabis or other alternative products. Yet again, I am left questioning how much of our legislation is about the welfare of the population, and how much is about rich people scratching each other’s backs..

What’s morality got to do with drugs?

Friday, September 13th, 2013

My beliefs about the criminalisation of drug use have changed over the last few months of researching and writing this blog. Although I always supported a health agenda, I spent years working alongside criminal justice agencies and, in essence, being part of the machine that maintained the War On Drugs. Drugs caused harm – that was for sure – and whilst I insisted on working for health services and within a harm reduction agenda, I still had to contribute drug tests and pre-sentence statements to criminal justice organisations on behalf of people I didn’t really think were doing anything wrong. Besides, most of the criminal justice drugs services were part of the NHS. The whole agenda was blurred – and the lines between health and justice disappeared under the weight of morality. As we all know, drugs are bad, kids.

But let’s face it – they’re not. They’re just drugs. If it’s a moral compass we’re using, some of them, such as anaesthetic, are definitely good. But this isn’t the issue I want to discuss here – I want to showcase a couple of the best resources I have found which outline the damage caused by unquestioningly taking this legal and moral standpoint on drug use.

Count The Costs has published an Alternative World Drug Report to coincide with the UN’s Global Commission On Drugs Policy (which I wrote about in The War On Drugs versus livers, and focuses on the public health implications of socially excluding drug users). Instead of relying on self-reporting by international governments, the Alternative Report collates its own data, looking at the unintended negative consequences of the War On Drugs.

It is organised into seven main areas of damage that is caused by the continuing approach taken by drugs policies across the world:

undermining development and security, fuelling conflict
threatening public health, spreading disease and death
undermining human rights
promoting stigma and discrimination
creating crime, enriching criminals
deforestation and pollution
wasting billions on drug law enforcement

For those of you who haven’t considered some of these arguments before, or if there is a particular issue that catches your attention, do have a look at this website. It really is the best, most comprehensive single resource I have seen, and isn’t so arrogant as to presume it has the answers – it merely forces the question.

A more capsule summary of the War On Drugs is available from Peter Watt of Sheffield University, whose recent piece on the upcoming legalisation of cannabis in Uruguay identifies the main motivations behind the problems in South America, the continent most damaged by the US-driven criminalisation agenda. Uruguay is an experiment worth watching – and it seems that the countries most crippled but the War On Drugs are starting to take matters into their own hands and make some interesting moves when it comes to drug policy (as previously discussed in Santos speaks out).

A specialist in the South American drug wars, Peter also identifies the value to the US economy of perpetuating the War On Drugs, by generating the private prison industry. Quoting journalist Chris Hedges, “Poor people, especially those of colour, are worth nothing to corporations and private contractors if they are on the street. In jails and prisons, however, they each can generate corporate revenues of $30,000 to $40,000 a year”.

This sentiment is shared in Eugene Jarecki’s excellent documentary, The House I Live In, which looks at the impact of the War On Drugs on the USA’s poorest, predominantly black, communities and asks who this system is benefitting. Despite drug use being proportional across racial groups in the US, almost all those incarcerated for drug offences are black – one in three young black men spend time in prison in the US.

I hope some of you will look at these links, and that, if you find them interesting, you will share them. This is not a small problem – areas of Asia, South America and Africa are being destroyed by this nonsensical battle, where poverty is exploited by organised criminals using fear and violence – and the continents providing the target markets, North America, Australasia and Europe, are also seeing their poorest and most excluded communities injured by the trade. Drug use isn’t bad – whether it is smoking crack or having a quiet pint on a Friday, we all do it to some degree, and until the moral and criminal precursors are removed from the debate, a practical, just solution will remain evasive.

Does MCat show up on a drugs test?

Tuesday, September 3rd, 2013

The main question that brings strangers to my blog is – does MCat show up on drug tests? I’m going to address this to the best of knowledge now, and if anyone has anything to add or knows any different, please leave a comment to inform others. There are some resources at the bottom for people wanting more information.

MCat, or mephedrone, is so called because of its chemical compound, 4-methylmethcathinone. It is just a happy coincidence that it smells like cat urine, hence sometimes being know as meow meow. Also known as mephedrone, it was originally marketed as plant food or bath salts so people could buy it without being detected, although it was never intended to be used as such. It seems to be able to be used as safely as other illicit drugs such as ecstacy. However, long-term effects are unknown, risks dramatically increased when used with other drugs, and I can say from my experience as a drugs worker that it can also be significantly, rapidly harmful to users’ mental health. It has also been described to me by more than one seasoned drug user as “more addictive than crack”. There have been various deaths linked to the drug.

In terms of drug testing, it IS now possible to test for mephedrone. It does, of course, depend on what you have actually taken – if you have bought it from a street dealer, it could be anything, and even substances bought via the Internet are not being monitored by Trading Standards and so might not be what you think you were buying. I have had loads of people tell me they have taken MCat, with widely-varying reports of the effects, and then test positive for amphetamine or methamphetamine, which have different chemical structures. I have even found a website which claims it can test for mephedrone using its methamphetamine testing kit (although I seriously doubt the validity of this). So be aware that, whatever you think you have taken, you could still flunk a drugs test.

In short, if you are being tested by your employer, it is possible that you could fail a drugs test after taking MCat. Basic testing windows for other stimulants (cocaine, amphetamine) are around two days in the bloodstream and five days in urine, so if you haven’t used any for a week you should be clear.

However, most standard workplace drug tests still do not test for MCat. It is, of course, possible that your employer is clued-up and has bought separate MCat testing kits, or has the samples sent off to the lab for detailed testing – and an article in the Welsh press this morning highlights that employers are becoming more aware of their staff using MCat – but the testing options are expensive, and my guess is your employer is just following their drugs and alcohol policy and covering their own backsides. Some drug services do now test for mephedrone, but some don’t.

If the test is via an oral swab (where a stick with cotton wool on is pressed against your gum or cheek for two minutes) then it is possible but unlikely to test for mephedrone, as, as far as I can gather, this test is only available via confirmation test (which costs about £30 per substance). Even if the lab did look for mephedrone, only the specific and original chemical compound would be detected. So in the case that the substance being used was some derivative of the original compound (such as any of those which flooded the market when mephedrone was made illegal to skirt legislation), then even if the sample was tested for MCat, it would still give a negative result. It is also possible to test for cathinone (khat), and given that mephedrone is a synthetic cathinone I thought this might also give a positive result for MCat, but on speaking to the lab this seems unlikely, as again the test only detects the specific chemical compound.

So if your employer or drugs worker is using oral fluid testing, it is unlikely but not impossible that you will give a positive result, unless they are willing to spend the money (for example, if they are testing as part of a court order). I’m not totally sure on testing windows for MCat, but given its short action and its similarity to amphetamine and other stimulants, I would hazard a guess that it only remains in the bloodstream (and so would be detectable through oral fluid testing) for a couple of days.

In terms of urine testing, again it is possible but not likely that employers will test for mephedrone. The mainstream-marketed dip-test strips or urine pots available for bulk-buying via the Internet do not test for MCat. Again, your employer could be on-the-ball, so there’s no way of ruling it out. Drugs will show up much longer in your urine than in your bloodstream, so if you have used MCat at the weekend it will probably still be present in your urine throughout your working week.

A good idea might be to get hold of your employer’s drugs and alcohol policy, and to look at your contract to see whether testing is mandatory. If possible, also find out what method of testing is used, and possibly even the company that provide the testing. (Oral swabs or urine pots will have the name of the company displayed on the side.) You can then look on the company’s website, or ring them, and ask whether they test for mephedrone and synthetic cathinones.

And if you interested in purchasing MCat drug tests, follow this link to my more recent post, MCat Testing.

For more information about MCat, it might be worth having a look at these resources:

– An excellent documentary called Legally High looks at new psychoactive substances, where they come from, the problems with legislating them, and the spectrum of drug use per se.

– Really interesting Wiki page about MCat, which charts its history, its researched neurochemical effects, and seems to me to under-report the negative effects and risks.

Frank’s generic drugs advice that slants to the negative, but also has links to help and support.

European Monitoring Centre For Drugs’ drug profile for synthetic cathinones, including mephedrone.

– My somewhat hopeless rant about my own experiences working with MCat users as a drugs worker – lets call it an industry insight.

America, Land of the Brown

Wednesday, August 21st, 2013

I warned about a resurgence of heroin use, following this year’s bumper opium crop in Afghanistan, in Smacktastic Britain, and unfortunately this may be already starting to come true, with reports of presentations of new heroin users at services (too young to remember the stigma of the last wave) and increased purity levels of the drug. But, given that there has been an international drought for the last three years, I guess this could just be business getting back to normal. And it will be another few months, possibly into early next year, before that crop reaches our shores and heroin use becomes a tempting prospect again – and people like the drug so much they start dying all over the place.

There has, however, been somewhat more of a significant increase in America. Fox News report that heroin use is “on the rise: cheap, available and out of control”, and the Wall Street Journal state that “heroin use in the U.S. is soaring, especially in rural areas”.

Fox’s Dr Manny Alvarez makes the claim that this increase is due to the last decade of prescription drug abuse, as painkillers such as Vicodin and oxycodone have been dished out like sweets and created large numbers of opiate addicts. The report also spells heroin with an ‘e’ on the end, claims that it causes miscarriage, and demands that America starts another War On Drugs – so I’m guessing we can take its contents with a pinch of salt – but it remains however an interesting suggestion that America’s increase is heroin use may be self-created. This claim is supported by other reports, which claim that OxyContin (the market name for oxycodone) has been refomulated to make it less abusable (by making it harder to crush and pastey, so that snorting or injecting is more difficult), and that, compared to the price of buying prescription meds, heroin is by far the cheaper option for those who find themselves dependent.

The Wall Street Journal, who also support the idea of a vast shift from prescribed opiates to painkillers, give some insightful and scary facts on the country’s growing heroin problem – seizures from the Mexico border have quadrupled between 2008 and 2012, and overdoses are going through the roof. Some of the rural communities are heroin-naive, most of them have no service provision, and heroin purity is at its highest in years, making overdose an inevitable consequence. Even more headline-grabbing – these medicated kids are white and middle-class.

So maybe we haven’t got as much to worry about in the UK as we first thought. The US market is prepped, desperate, and think that heroin is a bargain. If I was a drugs baron, I know where I’d be taking my bumper crop. Something tells me that the horrendous US drug overdose death rate of someone every nineteen minutes might be about to get a lot, lot worse…

Texas fights the War On Drugs (no, really)

Wednesday, August 14th, 2013

A bizarrely sensible change to US drug policy appears to have been made this week – based on a model trialled in Texas. In what seems to me to be a primarily fiscal move spun into a moral one by the Obama administration, the ideas from the conservative Bible Belt state are being rolled out to the rest of the country. Described as ‘a major shift in criminal justice policy’ by The New York Times, the changes are being implemented without the agreement of Congress, in order to bypass Republican opposition. Instead of changing legislation, alterations are being made to criminal justice directives, or the guidelines which inform federal prosecutors. The changes will stop the amount of the drug possessed from being declared in court, to avoid minimum sentencing requirements being triggered, and instead allow shorter sentencing or community orders where there is no violence, no sales to minors, no significant criminal history, and no links to organised crime and gangs.

This, in principle, seems like a positive move. However, when we consider the model originated in Texas, where millions of dollars were saved by avoiding building new prisons, and potential inmates were diverted into treatment and work programmes, we can be fairly confident the reasoning is financial rather than compassionate. It remains open to prosecutors’ discretion, which may well not reduce the race gap in prison populations (80% of those incarcerated for drug-related crime are black, which equates to one in three, yes that’s ONE IN THREE, young black males), and could in fact increase the racial discrepancy should prosecutors use their discretion biasedly. As the decriminalisation movement in America point out, this “tepid new directive.. smacks of… good spin and no spine”.

But Attorney General, Eric Holder, who unveiled the new plans this week to The Washington Post, offered some reassurance of the administration’s good intentions and understanding, saying “A vicious cycle of poverty, criminality and incarceration traps too many Americans and weakens too many communities… many aspects of our criminal justice system may actually exacerbate these problems rather than alleviate them”.

Only time will tell whether this will have the intended impact. But whatever the motive for the changes, the outcome will be fewer non-violent drug users incarcerated, the release of older inmates who were imprisoned for what would now be considered more minor drug offences, and hopefully a social shift in the perceived criminality and dangerousness of drug users in the US. A vast reduction the criminal justice budget is another good outcome – especially for a country which apparently now houses 25% of the world’s prisoners – and if the move is supported with an increased access to work and housing for these people, they should soon be contributing positively to tax figures instead of eating away at the other end.

Drugs policy fails – again: Postscript

Monday, August 5th, 2013

This one’s for the geeks and academics. I consider myself the former.

A mystery donor has sent me the full article for the research I wrote about recently (thanks, mystery donor), and it seems my theory about MCat was incorrect. What I didn’t deduce from the abstract was that the inverted correlation between the legal classification of cannabis and the number of people admitted to hospital with cannabis-related psychosis straddled not only the regrading from Class C to Class B, but also the earlier move from Class B to Class C. This method, known as a reversal design, references both the introduction and removal of the intervention – in this case, down-grading cannabis. The article states:

“There was a significantly increasing trend in cannabis psychosis admissions from 1999 to 2004. However, following the reclassification of cannabis from B to C in 2004, there was a significant change in the trend such that cannabis psychosis admissions declined to 2009. Following the second reclassification of cannabis back to class B in 2009, there was a significant change to increasing admissions… This study shows a statistical association between the reclassification of cannabis and hospital admissions for cannabis psychosis in the opposite direction to that predicted by the presumed relationship between the two.”

So my theory about unidentified MCat use causing an increase in psychosis admissions after cannabis was re-upgraded in 2009 doesn’t explain the previous decrease in admissions after it was downgraded in 2004. However, what became clear from reading the whole article is that the study relies entirely on participants being admitted under the criteria of ‘cannabis-related psychosis’. I query the validity of this data. In my experience, psychiatrists wang down any old shit on admission. As the article acknowledges, “This research has highlighted the need for research that explores the way that diagnoses of cannabis psychosis are made and the influences that operate on these decisions”. I would love to be the person to undertake that research, as from what I have witnessed, the pre-admission assessment usually goes something like is..

Psych: So you’ve been hearing voices?
Patient: Yes.
Psych: Have you ever used cannabis?
Patient: Yes.
Psych (writes): “Patient X is a drug user with a long history of cannabis use. Conclusion: cannabis-related psychosis.”

This diagnosis not only provides an excuse for a quick in/out treatment pathway and passing-of-the-book to substance misuse or dual diagnosis teams, it also puts the responsibility for the illness on the person being admitted. I will not mince my words – psychiatrists hate drug users. They perceive them with the same level of moral integrity that Conservative politicians do – drugs are bad. Those who use them are bad, and we need to police and punish all who use them. Certainly not treat them. Certainly not block up our hospital wards with them for more than a day or two. Get them in, give the Valium for a couple of days until they’re symptom-free, chuck them back out.

Drug users are perceived and accordingly treated by mental health services, and especially by those that rule and dominate these services, as time-wasters – impossible to assess, impossible to treat. I mean, how can I tell whether it is the condition or the substance causing the symptoms? And when I want to know the answer these questions, why won’t they just stop using drugs like I tell them to? Why aren’t they compliant?! And how am I suppose to use my tool of choice – dangerous, numbing drugs – to these liabilities when they have nowhere to live, no family member willing to supervise, and haven’t even got a lockable bathroom cabinet?!

Going back to the research, my original thought that maybe cannabis-related psychoses were in fact unmonitored MCat psychoses has been blown out the water, as overall inpatient psychotic admissions actually went down over time – not up as mephedrone and other new synthetic drugs became more commonly used. Again, this might be due to something completely different – such as psychiatric wards closing and so less space being available to admit people, or community teams such as Early Intervention or Assertive Outreach Home Treatment becoming more effective at keeping people out of hospital – but based on admission data alone, there is no trend here to suggest that psychotic incidences have increased since these new drugs became widely available.

If you consider my point above, you might feel, as I do, that this is less about the mental health of drug users and more about how mental health systems treat people who use drugs – but having spent twelve years banging this drug I am going to leave this point before I start bursting blood vessels.

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