Archive for the ‘psychosis’ Tag

What do you like more: your drugs or your genitals?

Monday, January 13th, 2014

I know some of you probably think I was scare-mongering when I wrote Maurice the Feline, and I know there are many MCat users out there who take the drug without more than mild side-effects – but spare a thought for the poor sod who apparently came back from university for Christmas, took mephedrone, then stabbed his mother and cut off his own penis.

The story sounds bizarre, but national newspapers ran it and I can’t find anything disproving it. And I can’t say, in the time I have been working with mephedrone users, that it comes as a huge surprise to me. Despite some young MCat users responding with claims that “there’s no way MCat could do that”, I have seen the scary impact the drug can have on the mind. A serious psychotic episode, with no previous mental health history, is something I have unfortunately witnessed more than once – and that’s only from the cohort of people who come to the attention of drug services. I would imagine, behind closed doors, there are many people suffering from from paranoid and suicidal thoughts, and all the horrifying and damaging behaviours that come alongside them.

I am doing my best to set up some testing facilities – because, at the end of the day, no-one currently knows what they are taking. At least if you know something has not sent you crazy once, you have a greater chance of avoiding a negative experience thereafter. But please do not underestimate the potential this drug, or group of drugs, can have on your mental health. If you have any previous issues with your mental state, or any history of psychosis in your family, I would genuinely advise you to steer entirely clear – but, unfortunately, these factors are not strong enough indicators, in the case of this drug, that all will be well.

And as for the poor guy in the news – although I would not like having to heal the relationship with my mother after I’d tried to kill her, nor would I want to embark on a life with a mutilated, floppy todger, I would rather face either of these futures than live with paranoid psychosis. Let’s just hope he hasn’t triggered off something that lasts a lifetime.

Advertisements

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.

Drug policy fails – again

Wednesday, July 24th, 2013

Another kick in the teeth this week for Theresa May and her determined squeal that drugs policy is working. After ignoring the research-based recommendations from a group of cross-party peers concerning decriminalisation, then developing selective deafness towards her drugs advisory board by banning khat, Theresa seems fixated on perpetuating the War On Drugs, whether anyone agrees with her or not.

It will be interesting, then, to see how she reacts to the news that cannabis psychosis admissions have actually increased since the drug was reclassified as a Class B substance. Yep, you’ve got us there, Theresa, you font of knowledge for all things street – clearly drugs policy is reducing use and minimising harm just as it should. Well done for sticking to your guns, and thank god those running the country know what they’re talking about. Phew.

Tottering Tory Totty aside, I have to admit this is a pretty bizarre finding. At no point did I think that reclassifying the drug would decrease the harm caused – why would it, it’s still illegal and that didn’t put people off before – but the inverted correlation between cannabis-related psychosis hospital admissions and reclassification of the drug is difficult to explain.

I have been pondering on this. Without subscribing to the Journal of Drug Policy (which is, I have to admit, surprisingly tempting, but takes money, of which I have little), I can’t see whether participants who suffered psychotic admissions had taken solely cannabis. My hunch is that something different may be afoot here. Rates of psychosis amongst my client-group have gone through the roof since MCat has surfaced, and I have heard similar reports from prisons regarding synthetic cannabanoids. I know that, until very recently, and certainly not within the confined dates of this longitudinal study, testing facilities for these drugs had not been developed – and even if they had, the average mental health ward would not have had access to them. So, my sneaky conclusion is that the increased rates of psychosis admission may have been due to the use of other substances – which were not only impossible to detect, but were also legal at the time and so potentially not reported or classified.

That is my suspicion. Just don’t tell Theresa. I can’t wait to see what shit she spins to explain away this one. Although, to be fair, I think she’s more likely to get a bad case of tinnitus than indulge in any scientific analysis. You keep on trucking girl, we’re all behind you (with a metaphorical spade).

%d bloggers like this: