| Date post: | 22-Apr-2015 |
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Jean-Paul Grund, PhD
CVO – Addiction Research Centre, Utrecht
Department of Addictology, Charles University, Prague
Harm Reduction & NPS
Who’s up to the Challenge?
New drugs,
new &
challenges,
new harm reduction? EUROHRN @ Amsterdam
Thursday 2nd October 16.30 – 17.30
New Psychoactive Substances
Homemade drugs
The Internet
The future • New Harms?
• Harm Reduction 2.0
Presentation Outline
But it did get easier,
way easier..
First, a lesson from history
Lifetime use of 'legal highs' in the EU
15–24 year olds, percentage by country, n > 12000
“In certain countries some new substances
that imitate the effects of illicit drugs are being
sold as legal substances in the form of - for
example - powders, tablets/pills or herbs. Have
you ever used such substances?”
The Rise of a New Dawn: New Psychoactive Substances (NPS)
Huge growth in number, type and
availability 303 new drugs notified 2005–2013, 67 notified in 2013 so far…
More than 200 have been
notified since 2010
New NPS in the EU
2012: 73
2013: 81
Timeline of NPS
Desomorphine (Permonid™)
opiate analogue
Analgesic effect: 10 x morphine
Toxicity: 3x morphine
short half-life,
need for frequent administration
2/10/14
Homemade Drugs
Cheornaya, Vint, Jeff, Krokodil
This is not Breaking Bad!
Breaking Worse: Bad Chemistry
Breaking Worse: Bad Chemistry hurts
WARNING!
GRAPHIC
CONTENT!!
2/10/14 strana 12
Diffusion of drug trends: Heroin in the Netherlands 1972~
2/10/14 strana 13
Cultural Capital
Major Port City
Homemade Drugs – an Act of Defiance in Eastern Europe
Tor network Bitcoin
1874 1980 1989 1990 1999 2002 2003 2008 2011 2014
What happens under the Surface
Krokodil RU, UK USSR ╪
Cheornaya Vint, Jeff
PIHKAL
Heroin
Krokodil GA
Krokodil Panic US
Silk Road
Silk road shut down by the DEA (10-2013)
Silk Road 2
Evolution
Pandora
Blue Sky
Cloud Nine
Hydra
Andromeda
Agora
Twitter, Instagram 18
A glimpse of the future of drug markets?
”There are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns -- the ones we don't know we don't know.”
Donald Rumsfeld
New Harms: What do we know?
• Substance related • Unknown drugs
• Unknown Potency – some extremely
potent (µg) – Overdose!
• Set related • … … “Legal Highs” & the Unprepared
• Setting related • BBVs?
• Who is your dealer?
• Absence of regulation
New Harms: What do we know?
Where there used to be Grass, Acid, Speed, Brown & Blow…
Where you used to buy from a dealer (a real person), you now buy online or you cook your own…
Harm Reduction 2.0
A disconnect between drug use 2.0 and
harm reduction movement
A growing gap between “official” harm
reduction and spontaneous, peer
driven harm redux
P2P HR went online
• User forums, blogs
• bluelight.ru; drugs-forum.com;
legalhighsforum.com.”
(1) uncovering the substance facts, (2) dosage and administration, (3) subjectively experienced effects, (4) support and safety
“The main characteristics of the discussions
in general were a concern for safety and harm reduction.”
Tor network Bitcoin
1874 1980 1989 1990 1999 2002 2003 2008 2011 2014
PIHKAL
Silkroad
Molecular 3D Printer
2/10/14 strana 25 strana 25
The Future: Homemade Meets NPS?
Tor network Bitcoin
1874 1980 1989 1990 1999 2002 2003 2008 2011 2014
PIHKAL
Silkroad
Molecular 3D Printer
2/10/14 strana 26 strana 26
The Future: Homemade Meets NPS?
LC: “In 5-10 years we will be ordering our
medications online, prescription software,
personalized to our genetic make up, will be
streamed to our 3D printer at home.”
Tor network Bitcoin
1874 1980 1989 1990 1999 2002 2003 2008 2011 2014
PIHKAL
Silkroad
Molecular 3D Printer
2/10/14 strana 27 strana 27
The Future: Homemade Meets NPS?
JPG: “Before that, we will be printing our recreational
drugs at home. We’ll pay for the software or develop
these in online ‘connoisseurs’ clubs.”
Thank you for your attention!
T: @HeisenbergXL
W3: drugresearch.nl
–
(Most images: Internet. Thanks2Authors!)
