Health and Social Care Committee
Inquiry into new psychoactive substances (“legal highs”)
Note of informal visits in North and South Wales, 2 October 2014
1. As part of its inquiry into new psychoactive substances (“legal highs”), the Health and Social Care Committee undertook a series of informal visits in South and North Wales on 2 October 2014.[1] The aim of these visits was to learn more about the experience of those who use new psychoactive substances, or those who are in close proximity to users, either by virtue of their role as service providers or as members of a community affected by their use.
2. In order to capture experiences from across Wales, the Committee split into two groups, one travelling north and the other south. Members in North Wales visited the Life on the Streets (LOTS) project and Dan 24/7, both based in Wrexham; counterparts in South Wales visited Drugaid, Caerphilly and the Fixers initiative, Merthyr Tydfil.
3. The notes provided in this paper outline the themes discussed informally during the visits. Many of these themes were also raised by service providers who participated in the Committee’s focus group discussions, also conducted on 2 October 2014. A note of the focus group discussions has also been published on the inquiry’s webpage.
4. The Committee wishes to put on record its thanks to those who took the time to speak with Assembly Members as part of its programme of informal visits.
Life on the Streets (LOTS), Wrexham
5. Police and the voluntary sector have joined forces to create LOTS to work with people who: are homeless, or at risk of becoming homeless; are misusing substances (both legal and illegal); are aged between 16-25; or are on the local anti-social behaviour radar. This group is made up of around 15 young people who meet once a week. The Committee met with LOTS representatives for one hour at the headquarters of the Association of Voluntary Organisations in Wrexham.
6. Participants in this discussion noted that part of the attraction of new psychoactive substances (NPSs) is that they are “10 times cheaper and 10 times stronger” than substances such as cannabis. In addition to the lure of their price and strength, it was noted that the fact that many are sold legally – often via high street shops dedicated to their sale (known as “head shops”), and the internet – means that accessing them is “easier than the rigmarole of getting illicit drugs”. It was noted that the attraction of NPSs is made stronger by their alluring names and packaging, regardless of the warnings displayed on the packets that the substances are “not for human consumption”. Participants were not convinced, however, that plain packaging would deter people from taking NPSs. When asked what proportion of drug users, in their experience, are taking NPSs, participants noted that they are being used “everywhere”.
7. The impact of the presence of a local “head shop” was emphasised by the group. It was noted that the shop’s presence made it easier for people to buy NPSs, particularly those who do not have credits cards and are therefore unable to make online purchases. It was noted that use of NPSs surged in the area following its opening, although public pressure from the local community, police and trading standards officials had eventually led to its owner closing the premises. Participants noted that the shop’s impact was still visible with many users now travelling to Chester to purchase NPSs.
8. It was emphasised that the term “legal highs” is misleading and gives the wrong impression that the substances are safe to consume. Participants noted that the contents of an NPS are often unknown, and may contain illegal as well as legal substances.
9. Former users present, and those working closely with current users, noted that the effects of NPSs can be as severe as those experienced by users of class A drugs such as heroin, and that they can be equally addictive. It was noted that some class A drug users are switching to NPSs due to their lower price and relative strength. It was also noted, however, that some class A drug users “would not touch legal highs with a bargepole” as they do not know what they contain and are frightened of their potential effect. Participants were very conscious that the long-term effects of using NPSs are unknown as their consumption is a relatively new development.
10. The group noted that there is a misconception that only young people use NPSs. The group noted that many older people are using NPSs, often consuming them in the form of pills as opposed to smoking them.
11. It was noted that prisons are “awash” with NPSs. Some participants noted that they began using NPSs during their time in custody, and that the criminal justice system and police are ill-equipped to deal with their use. It was also stated that some individuals are consciously switching to NPSs instead of classified drugs in order to avoid breaching drug rehabilitation requirements and being sent/returned to prison.
12. The group emphasised that it was aware of many cases in which an individual has turned to crime in order to purchase NPSs or as a consequence of consuming them.
13. The group explained that many people take NPSs “to forget life”. In its view, the trigger to preventing their consumption is to provide adequate support services that help address the underlying causes of reliance on substances, such as mental health problems, homelessness, poverty and unemployment. It was also noted that as well as being the underlying cause of an individual choosing to take NPSs, in many cases, consumption of NPSs can also lead to mental health problems, unemployment, poverty and homelessness. The group emphasised the positive influence of The Warehouse Project, a local voluntary initiative which has provided shelter, assistance and training to substance misusers and former users in the area.
DAN 24/7, Wrexham
14. The Wales Drug & Alcohol Helpline, also known as DAN 24/7 is hosted by the Betsi Cadwaladr University Health Board with funding provided by the Welsh Government. The health board is able to afford to host the helpline due to the economies of scale provided by its role as the host of other helpline services. DAN 24/7 is a free and bilingual telephone helpline providing a single point of contact for anyone in Wales wanting further information and/or help relating to drugs and/or alcohol. The service is available 24 hours a day, 7 days a week. The helpline will assist individuals, their families, carers, and support workers within the drug and alcohol field to access appropriate local and regional services.
15. Staff explained that all calls are fielded by a mixture of volunteers and contracted staff who log calls and relevant information. It was noted that those answering calls are not experts in the field of substance misuse, but are experts in handling calls of this nature and signposting to appropriate services and/or explaining the options for self-help.
16. It was noted that the onus is on the individual calling the helpline to contact the relevant service once signposted. Members were told that this is partly to empower individuals to make the necessary commitment to seek support, but also to ensure that the capacity of relevant services is not over-stretched.
17. Although feedback is sought from services on the extent to which those signposted are taking the second step of contacting them for assistance, no formal mechanisms are in place to confirm whether advice given by the helpline is followed up by the caller. This makes evaluation of the service’s impact difficult.
18. It was noted that although DAN 24/7 advertises its service (mainly via the internet), it has struggled to raise awareness of its existence. It was noted that many partners and public service providers still refer to Talk to Frank which is now an England-only service, replaced in Wales by DAN 24/7.
19. It was noted that, of the 2100 average calls a month taken by the centre, 350-60 are calls to the Dan 24/7 helpline. Staff explained that most calls come from worried parents seeking advice, rather than users. Nevertheless, staff noted that anecdotal evidence suggests that, while users were previously naïve and assumed that NPSs legal status meant they were safe for recreational use, the impact of NPSs on users’ health is now starting to filter through.
Drugaid, Caerphilly
20. Drugaid provides support, information and advocacy to those in South Wales who are vulnerable and marginalised as the result of their own, or someone else's, drug and/or alcohol misuse. It is funded from a number of sources including health boards, local government, Welsh Government, community safety partnerships and youth offending teams.
21. The group noted that NPSs have become increasingly popular in their community. The easy availability of these substances and their low price were cited as reasons for their increasing popularity. The group also noted that these substances are often stronger than illegal drugs. It was explained that whereas illegal substances are “cut” (and therefore diluted) with other substances, so-called “legal highs” are purer, and perceived as such. Drugs cited by the group as being particularly prevalent in its local community included mephedrone, methoxetamine (a form of synthetic ketamine), and “pandora’s box”. Participants said that these substances are highly addictive and dangerous. The group also noted that users have no idea of the strength of each substance.
22. The group described the rising prevalence of steroid abuse in valley areas and increasing use of substances such as melanotan. It was suggested that body image issues could be an influencing factor for this.
23. When asked about the issue of legality, the group felt that making NPSs illegal could result in increasing levels of criminality on the part of suppliers and users. The group also suggested that legal frameworks would not be able to keep up with the constant flow of new substances entering the market.
24. The group felt there is variation in support available in different geographic areas; one ex-user argued that there is much support available in Rhondda Cynon Taff compared with Caerphilly. Another ex-user who had taken stimulant-based substances for over five years, said that his local GP had not been able to offer direct assistance, but did advise that he should contact Drugaid, which had subsequently “changed his life”.
25. Participants in the discussion suggested that much more could be done in terms of education and awareness raising, and that information and communication channels relating to NPSs need to be improved. The group praised WEDINOS and said it would be helpful if it also provided information on the effects of different NPSs. Participants suggested that ex-users, speaking from personal experience, could be used as a powerful tool in raising awareness.
Fixers, Merthyr Tydfil
26. Fixers is a UK-wide initiative funded by the Big Lottery Fund. The initiative was extended to Wales in 2013. The initiative allows young people from a diverse range of backgrounds to meet and to act on issues that are important to them. Issues range from eating disorders to drugs, offending, and cyber-bullying, amongst others. Merthyr Tydfil’s Fixers group has recently produced a video about NPSs and their dangers.
27. Group participants described their perception that the use of NPSs increased markedly around two years ago in their community. One member of staff estimated that around 80% of year 8 school pupils were taking an NPS called ‘NRG’. Participants noted that members of their peer group (aged 14-18) who they would not normally associate with drug-taking were being drawn to NPSs. The group noted that, in its experience, people around the ages of 12 to 14 were taking NPSs. However, they also knew about individuals as young as 11 who had taken a “legal high”.
28. The group explained that NPSs were “easy to get hold of” and that they used to be sold on a stall at Merthyr market. The stall has subsequently closed, allegedly due to pressure from the police. The group went on to explain that many young people from its community now travel to Cardiff and Pontypridd where NPSs are available in market places and shops at cheap prices.
29. Participants noted that ‘black mamba’ (similar to strong cannabis) is popular in prisons. It was noted that as ‘black mamba’ has no distinctive smell, wardens cannot detect when it is being smoked.
30. The importance of education and awareness-raising was emphasised by participants. The group stated that there was little information regarding the effects and implications of taking NPSs available for its peer group.
31. The group also emphasised that young people should be allowed to talk openly about their experiences of NPSs and any related concerns without fear of getting into trouble. Fear of recriminations and a lack of confidentiality were identified as barriers to people acknowledging that they have used or continue to use NPSs.
[1] Members present: North Wales – Janet Finch-Saunders, Darren Millar and David Rees; South Wales – John Griffiths, Lynne Neagle, Gwyn Price, Lindsay Whittle and Kirsty Williams