Changing face of drug use - Equinox Brook Drive article

Posted by Phil Watterson on 5 February 2014 | 0 Comments

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Equinox Brook Drive is a 27 bed detoxification unit in South London, providing medically assisted detoxification for people with alcohol and/or drug dependence. In this article, Equinox Brook Drive team leader, nurse Phil Watterson, describes the changes he has seen amongst the service user group at Equinox Brook Drive and he writes about some of the effects of using ketamine, GHB and mephedrone.

At Equinox Brook Drive, we typically provide detoxification for alcohol, opiates, benzodiazepines and stimulants.

Research from the National Treatment Agency in 2011 suggested there are 25,000 fewer heroin and stimulant addicts in the population; Britain has 103,185 injecting drug users (a fall of 12% from the previous count).

There is a suggestion, however, that people may be changing the drugs that they use rather than an overall reduction in drug use.

Amongst Equinox Brook Drive service users, what drugs are people seeking help to stop using?

Over the last 20 years there have been noticeable changes in the service user group at Equinox Brook Drive.

Where once we saw resistance from service users with alcohol dependence to sharing a unit with drug dependent people, we are now increasingly seeing poly-drug use – combined with alcohol dependence in many cases.

We are also seeing more dependence on prescribed medications such as benzodiazepines.

Equinox Brook Drive are also starting to see a small subset of service users identifying ketamine as their primary drug of choice – there have been 3 in the last 2 years, with 2 further service users stating regular usage.

Referrals for service users using GHB and mephedrone are also coming in – in the last 3 months, 2 service users have stated they use mephedrone as part of their initial assessment, for example.

What is ketamine?

Ketamine is a dissociative analgesia commonly used in veterinary surgery and paediatrics. The effect on the user in small doses is that it can cause euphoria, though in larger doses ketamine can cause paralysis and hallucinations, including a separation from reality and distortions in time and place.

Ketamine users can build tolerance quite quickly and long term use causes the growth of cysts in the bladder; some ketamine users are referred on to drug services after seeing a urologist due to problems urinating.

What is GHB?

GHB (or GBL which is a similar compound)   was originally developed as an anaesthetic and has been used in sleep disorders. It is more commonly found in solvent cleaning products and usually comes in liquid form. GBL has very subjective effects including euphoria and sexual disinhibition; larger doses can cause sedation. GHB tends to have a more short-term effect so users have a tendency to top-up their use, which also increases the risk of overdose; this can lead to a rapid onset of respiratory depression and profound unconsciousness. The use of this substance with alcohol can increase the risk of overdose.

Certain clubs in London now have medical staff on-call for such emergencies as this drug has become so commonplace. We also understand that some establishments are having so many issues with people overdosing that they are requesting the ambulance crew take patients further afield than the nearest hospital so as to not attract police attention.

What is mephedrone?

Mephedrone is a stimulant usually found in powder form and snorted by users; the effects being close to that of amphetamine or cocaine. It is cathinone and contains the same chemical found in the plant Khat which is more often chewed and is mainly used by people from the Horn of Africa. Mephedrone (more commonly know as miaow miaow or bubbles) is now classified as a Class B drug under the Misuse of Drugs Act but prior to this was being sold as ‘plant feed’ or ‘bath salts’. Mephedrone can cause irritation to the nasal passages and the effects on the heart are still be researched at present. It has been implicated in a number of deaths but as these have been usually among people taking more than one substance, it is difficult to assess how many may be due to mephedrone.

To speak to someone in confidence about alcohol and drug detoxification, contact Michael Twamley at Equinox Brook Drive on 020 7820 9924.

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