Muddying the waters – should we ban naphyrone?

July 22, 2010

The ACMD recently recommended banning naphyrone. Relatively unheard of until the banning of mephedrone, it is now being sold as the new legal alternative, though one small survey of products found that most of what is sold as naphyrone – or as NRG-1/energy  – is in fact mephedrone or similar substances [Brandt et al 2010]. The ACMD itself supports these findings:  “Limited samples of test purchasing would suggest that the prevalence of the compound naphyrone is currently relatively low and makes up a relatively small percentage of the total compounds found in marketed ‘legal highs’”.

If there is little use of naphyrone by the public, why do the ACMD wish to ban it?  Is there evidence of harm?  Judging by the ACMD report, the answer is no – they could find little if any evidence of human harm from naphyrone and they present no evidence of toxicity in animals either. The ACMD decision was made on the grounds that it has a (weak) chemical similarity to mephedrone and other cathinones and is 10 more potent than some of these. “The ACMD believe that naphyrone is likely to exhibit a similar spectrum of harmful effects as the other previously controlled cathinones. The data that are available for naphyrone suggest that its high potency, in comparison with the other cathinones, is likely to be associated with a higher risk of accidental overdose” [my emphasis].

An interesting choice of words and one which bears comparison with Brown’s public pronouncements as Prime Minister demanding cannabis upgrading three years ago: “the greater damage it appears to be doing…is that there is a stronger case for sending out a signal that cannabis use is … unacceptable…new lethal forms of cannabis such as skunk” [my emphasis].

The ACMD disagreed with this analysis that the potency of cannabis warranted Class B status [Rawlins et al 2008] as greater potency only results in more toxicity if drugs are taken in equal doses. Suppliers of naphyrone understand this and the unit dose sold is proportionately lower than that for mephedrone for this reason.

To reduce accidental harms, users need to be provided both with education on drugs and their harms and the option to know what they are taking. Whilst I was chair of the ACMD last year, we recommended to government that we should gather evidence about the efficacy and value of testing schemes for drugs that have been tried in the Netherlands and Australia. The suggestion was dismissed without justification by the then Home Secretary. Hopefully, the ACMD can present the suggestion again to the new government which may be more receptive.

A major problem with the ACMD report is its lack of critical appraisal of the science behind naphyrone. The pharmacology on which the ban is recommended is that it blocks brain reuptake sites for the neurotransmitters noradrenaline, 5HT (serotonin) and dopamine. Such actions are a feature of antidepressant rather than stimulant actions. Based on the ACMD’s logic then, potential new antidepressants such as NS2359 [Wilens et al 2008] as well as established ones such as bupropion, venlafaxine and even imipramine could be the next to be banned by the ACMD!  Needless to say, these drugs do not have abuse liability.

Another important consideration is that the development of naphyrone was driven by a desire to find new treatments for addiction [Meltzer et al 2006].  Such research will inevitably suffer once the compounds are outlawed – another perverse consequence that must always be taken into account [see my post Precaution or perversion: eight harms of the precautionary principle]. MDMA (ecstasy) was originally developed as adjunctive treatment in psychiatric therapy. This research stopped when it was made illegal in the 1970s and has only just been resumed – with major benefits emerging [Mithofer et al].

The case for banning naphyrone is weakened by the fact that that most products sold as naphyrone are in fact mephedrone or related substances [Brandt et al 2010], which are already illegal. Indeed, this legislative approach may increase awareness of naphyrone as an alternative to mephedrone and we may see an increase in use in the weeks before it is made illegal as happened with mephedrone [Measham et al 2010, Drug and Alcohol Today]. This is, of course, assuming that  the government goes with the ACMD recommendations, which seems certain as no UK government has ever resisted a request to impose more legal constraints on drugs.

The emergence of naphyrone as a potentially more dangerous variant of mephedrone raises further questions about the value of banning mephedrone in the first place when it was already widely used without causing a great deal of harm [see my post Hysteria and hubris: lessons on drug control from the Scunthorpe Two]. As predicted by me and many others, making it illegal has only displaced interest to other compounds about which less is known and which are potentially more dangerous.  I discussed these perverse consequences of prohibition in an earlier blog [Precaution or perversion: eight harms of the precautionary principle].

Once naphyrone is banned, what will be the next ‘legal high’? I don’t know but I can guarantee many chemists and manufacturers already do. Will these new compounds be banned without any testing of pharmacology or any knowledge of harms?  What is an appropriate threshold of harm that should lead to a drug being considered for banning? These are important scientific and social issues that the ACMD need to develop guidelines to address; I hope that they are doing so.

Brandt, S. D., Sumnall, H. R., Measham, F., Cole, J. (2010). The confusing case of NRG-1. British Medical Journal. 341:c3564.

Wilens TE, Klint T, Adler L, West S, Wesnes K, Graff O, Mikkelsen B. A randomized controlled trial of a novel mixed monoamine reuptake inhibitor in adults with ADHD. Behav Brain Funct. 2008 Jun 13;4:24.

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16 Responses to “Muddying the waters – should we ban naphyrone?”

  1. Ken Walker Says:

    While the Government continues to judge the issue of drugs on moral, historical and cultural grounds this ridiculous situation will continue. You are right to describe the current situation as perverse. Perhaps if MDMA was allowed to be sold as part of a regulated scheme, along with other less harmful drugs than tobacco and alcohol, there would be no need to continually produce new designer drugs. I truly despair. The war on drugs – it was lost years ago. I hope you continue to highlight the nonsense that is the Governments current stance and hope the ACMD takes stock and decides to follow its remit under the Misuse of Drugs Act 1971 and doesn’t just ask ‘how high’ when the Govt says jump!

  2. Sam Adcock Says:

    I agree with you there Ken, I think it MDMA was legal and regulated the majority of people would stick with that rather than try untested chemicals. For a start it’s far more enjoyable than these legal highs.

    Keep fighting the good fight Professor Nutt, I admire you greatly for your actions.

  3. andy Says:

    The Governments who have supported prohibition should be made to face responsibility for the Crime and death their laws have caused. It is stating the obvious to say that new legal highs are manufactured to beat the current ridiculous drug laws. Interesting blog Prof. Nutt.

  4. Home Grown Outlaw Says:

    Another great article.

    The admittance that the ACMD has no way ahead with the new legal market is surely a sign that prohibition is a complete lost cause. Not only are we left in the dark with no controls on the illicit market of known drugs, we now have no idea on the new crop and the many more to come. Once more, thank you Professor Nutt for your continued work. It is of some comfort and irony that with each passing day now, you are receiving public vindication on every level… not that you needed it of course, but with the headline scanning public still blinkered, it is becoming an unavoidable and inconvenient truth for those who believe that total law and drugs are still appropriate bedfellows.

    The Your Freedom website has proudly utilised Professor Nutt’s work and that of the ISCD. Thank you once more!

  5. John Ellis Says:

    All this new software for people to run.

    I remember blogging a few years ago about synthetic cocaine and other substances being the way forward.. now its here… time to dig out Canute and his throne.

    Sooner we move towards adaptive user policies the better for everyone involved. I wonder how many deaths will be attributed to this new drug before relevant information is to hand only to find to the ACMD with egg on its face again for bowing to media and political scaremongering.

    next on the list will be little buddha statues that don’t become a viable drug until you dissolve them in a drink etc so the customer actually makes the drug in a reaction in a cup… would that be hard to do? I don’t suppose it would be to hard to add an extra chain that was destroyed in say coca cola or fresh orange. a whole new range of wetware..

    right back in the box 😀

  6. Mafficker Says:

    Dr Nutt, I thank you for being a voice of reason in a wilderness of irrationallity.

    But i am still amiss why you want to talk about ‘legal constraints on drugs’ and not the fact that it is legal constraints on what PEOPLE can do with drugs. Hence, that old chestnut, illegal drugs do not exist in fact or law.

    This simple fact reminds us that the Misuse of Drugs Act 1971 controls people not drugs.

    Fiat lux! Mx

  7. Szwagier Says:

    While the Government continues to judge the issue of drugs on moral, historical and cultural grounds this ridiculous situation will continue.

    Shouldn’t that be hysterical grounds?

  8. John Ellis Says:

    Dave you’ve appeared on Facebook?
    Just that someone recommended you as a friend and with all the dubious people out there claiming to be one person or another I thought I would check.

    I wonder how the relationship with the police will change on sink estates if drugs are decriminalised as the case seems to be growing for such a move, as we look out on the problems drugs cause will this line of angst that occurs within society bring about a new balance in social thinking as people will no longer have the thuggery of a blind law hanging over them.

    Dave on another not with unregulated highs I presume that your own drug that mimics alcohol falls within this remit and there for may fall foul of this instant ban until tested and approved, if so how will the law effect the development of less harmful drugs.

  9. Mafficker Says:

    John, and all!

    No drug causes ‘problems’ without human action. So as a matter of personal responsibility it is humans that need to be regulated so that over time our relationships with drugs create minimal harm. Hence if and when we have a grown up conversation that pins the responsibility firmly on the user, with access to pure drugs, safe places of consumption and supply, and accurate, unbiased information on the drugs and their effects when consumed, we will have gone a long way toward solving the ‘drugs problem’ on sink estates, 10 Downing St, and in the Houses of Parliament. Mx

  10. John Ellis Says:

    Mafficker when i say drug problems in talking about the failure of a supposed social cohesion policy, I used sink estates as a base line example, currently everyone that uses drugs is seen as problematic by the police and the laws they unwittingly enforce on a whole cross section of society. Once this is removed how will the social attitude change? will we see an end to the US and THEM attitude that currently divides our youth and young adults from the institutions of law and order.

    I almost had our local area commander pop in for a cuppa on Friday, they are really keen to work with us and the groups we setup, Im really dubious over this as its our 3rd one in the last few years. We have built a strong community based on equality and the right to a private life. I have to explain this to Him when I eventually get around to this cup of tea… Last time I tried the area commander just said I want to stamp out all the people that use cannabis… our relationship ended there.. I do hope this one can see that its got nothing to do with people using drugs, that these people are making deep changes in the community for the better through cohesion of people and not subdivisions based on supposed harms that equate to nothing more than fairy tales…

  11. Mafficker Says:

    John! The kids the Old Bill want to stamp out have been lied to from day one. I have lived every day, drawn every breath inside a War on some people who use some Drugs. My earliest interactions with the Bill, and i assume most born since the 60s, were about drugs, be it underage drinking, smoking, and then controlled drugs. The problem started when i realised that they, yes THEM, were lying about the drug effects and the possible harms. If they are so willing to lie to us, yes US, about this, what else are they lying about? War, Oil, Terrorism, etc.

    Now, i would suggest that most people who grew up in this mess would, if asked to the table for a genuine honest and open debate, begin to trust again; hell, they might even start to participate in the democratic process and transform those other lies and shortcomings of Government.

    Imagine that, no longer the targets of a scapegoat strategy, no longer denomised for their (re)creationally prefered mindstate, no longer harassed, invaded, shot at, trampled on, or what not for their activities with drugs known to be safer either in chronic or acute use than alcohol and tobacco, they would feel they belonged to the community. And that would go a long way to resolving the US and THEM.

    To quote a friend: Ashes and Diamonds, Foes and Friends, We are all Equal in the End.

    Thank you for being of service! Mx

  12. zumbum Says:

    I’m terribly sorry that you lost your job. I’m even more sorry that the fuckers never listened to you. Apparently a coherent approach is not what the government were looking for, and it seems their new ACMD is fulfilling their role quite to the standards the government expects.

    A lot of people in this country have a tremendous amount of respect for you, keep on writing my friend; the era of the tabloid is coming to a close.

  13. John Ellis Says:

    Pioneer Productions commissioned to produce three-part series for National Geographical channel and BBC Three investigating the science behing drug use

    http://www.pioneertv.com/news.php

    should be interesting

  14. John Ellis Says:

    seems there is a lot of problems with these so called bathsalts…. lots of places reporting admissions to AnE for white ivory etc.

  15. Neuroskeptic Says:

    Triple monoamine reuptake inhibitors show promise as antidepressants, antiobesity and antiParkinsonian drugs. I wonder how the banning of naphyrone will affect prospects for research into these drugs.

    I wrote about an ultra-long-acting triple reuptake inhibitor on my blog a while back.

  16. Garry Says:

    I like reading your reasoning but on the subject of Naphyrone, from somebody who has tried it from several different sources, it was a terrible, horrible, destructive experience. If anything ever needed banning, it was this. I used it after they banned Mephydrone. I suspect naphyrone is still being sold but as Mephydrone. My local paper is running a campaign against the ‘deadly menace of mephedrone’ but after reading the experiences of the users, it is clearly not mephydrone they are taking!


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