Legal Highs and New Psychoactive Substances

What are Legal Highs?

Legal Highs is an informal term for new psychoactive substances, synthetic drugs, that were discovered through experimentation upon the chemical structure of existing drugs, legal or illegal. They are created in concealed locations and homemade labs and sold online or in ‘head shops’.

The number of legal highs available is constantly changing and growing which makes it difficult for law enforcement to control them. Once one is banned, the chemical structure can be tweaked so it is technically a different molecule, and therefore a new ‘legal’ drug.

Legal Highs are also commonly referred to as “designer drugs”.

Types of Legal Highs

Because these drugs are labelled as “not for human consumption” they are often not subject to any of the legal regulations that apply to drugs – despite the fact that they are often significantly stronger and less well understood than their illicit counterparts. Even when Legal Highs are sold as specific substances (such as Mephedrone), it is impossible to know which chemicals are actually contained in the substance.

Mephedrone, Miaow Miaow, M-Cat, Bubble, Flakka (synthetic stimulants), Spice, Black Mamba, Annihilation (synthetic cannabinoids), Benzo Fury, 25I-NBOMe, N-Bomb, foxy methoxy (synthetic hallucinogens) are examples of new psychoactive drugs, some of which have now been made illegal. Legal Highs are sold as innocent-sounding products, most commonly labeled as potpourri or incense, synthetic marijuana, bath salts, plant food or jewellery cleaner.

In the UK, to avoid being controlled by the Misuse of Drugs Act, Legal Highs such as mephedrone have been described as “bath salts” or “plant food”, despite the compounds having no history of being used for these purposes.

Legal Highs are also known as club drugs, because they tend to be abused by teens and young adults at bars, nightclubs, concerts, and parties.

The three major categories of these drugs are:

  • Synthetic cannabinoids
  • Synthetic stimulants (often marketed as “bath salts” but mimicking cocaine, methamphetamines and Ecstasy) and:
  • Synthetic hallucinogens (mimicking LSD and Ecstasy).

The Effects of Legal Highs

Depending upon the drug taken, a user may experience feelings of exhilaration, prolonged periods of wakefulness, decreased appetite, extreme relaxation, amnesia and feelings of detachment. Unwanted effects might include hallucinations, panic attacks, aggressive behaviour or feelings of paranoia. In addition, there may be physical effects like nausea, significant changes in blood pressure, seizures, slurred speech and blackouts. These drugs can even cause coma and death.

Signs of Abuse of Legal Highs

Many of the signs of new psychoactive drug abuse are similar to the signs of addiction to alcohol or street drugs:

  • Discarded packets that look like sweet packets;
  • Changes in behaviour: isolation from family; defensive about drug use;
  • Unexplained weight loss or gain;
  • Changes in hygiene or personal appearance;
  • Confused or disoriented behaviour;
  • Paranoid or delusional behavior;
  • Visual disturbances or hallucinations;
  • Problems with sleeping: insomnia, restlessness, nightmares;
  • Stealing money from family members;
  • Decline in performance at school or work;
  • Trouble maintaining relationships;
  • Loss of interest in former friends and activities;
  • Hidden pipes, inhalers or syringes;
  • Legal high drugs can even be disguised in electronic ‘vaping’ cigarettes.

As legal highs can be bought online, a check of the user’s internet history may reveal what they have been taking.

Legal Highs Health Risks

Often packaged in shiny, colourful bags to look like packets of sweets, there are a large number of health risks associated with taking Legal Highs. Uncertainties about the sources, levels and types of chemicals, and possible contaminants used to manufacture many Legal Highs make it extremely difficult to determine toxicity and associated medical consequences. Additionally, the unpredictable inconsistencies may create a false sense of safety for users. A substance may not have severe consequences for an individual the first time they use it, creating the sense that that particular “brand” or “type” is “safe.” But the “same” substance may not actually be the same as one taken previously, and the individual remains vulnerable to all of the health and safety risks such as decreased inhibitions and increased risk-taking behavior. Additionally, many Legal Highs can’t be detected through urinalysis or other screening methods, making it difficult to measure intoxication levels.

Legal Highs can produce some dangerous side effects:

  • Physical and psychological addiction
  • Mood changes
  • Sleep disturbances
  • Psychotic behaviour
  • Hyperthermia (overheating)
  • Seizures
  • Heart failure
  • High blood pressure
  • Fatal respiratory problems
  • Coma and even death

Legal Highs Withdrawal Symptoms

Since Legal Highs are created in illegal labs, their ingredients and potency vary a lot, making it nearly impossible to know what is actually in them or what they can do to you. Some identified withdrawal symptoms are: insomnia, anxiety, tremors, and sweating, physical dependence and addiction.

A user who is withdrawing from Legal Highs may experience depression, agitation, nausea and vomiting, tremors or cold sweats and other symptoms such as a rapid heart rate and high blood pressure.

Treatment at Castle Craig for Legal Highs Addiction

There is very little information available in scientific/medical literature about treatment for people who abuse or are dependent upon Legal Highs and new drugs and very little is known about their chemical formulas and metabolism within the body. Most new psychoactive substances cannot be detected with urine or blood tests alone.

On admission a patient receives a urine and blood test to determine their overall well being, the extent of kidney function/damage and evidence of muscle breakdown which can be caused by new psychoactive drugs (e.g. Spice). We then take a clinical history from the patient which aims to find out what drugs they have been taking. Our doctors medically assess the patient’s vital physical signs: heart rate, blood pressure, alertness, pupillary size; all of these things can help to form an assessment of the type of substance they may have taken.

Once the patient is stable we monitor them for signs of withdrawal and treat these symptoms accordingly. We have an experienced medical and nursing team who help patients through the detoxification process at Castle Craig Hospital, and they are given 24/7 medical coverage and all the support they need.

As well as detox, 12 Step therapy and other psychotherapies including cognitive behavioural therapy (CBT) and EMDR are used to help change negative thoughts, attitudes and behaviours that block recovery, and treat the root cause of the addiction. Patients are taught relapse prevention and family members also receive therapy sessions. Visit our treatment section to find out more information about drug rehabilitation at Castle Craig.