Legal highs have entered and reshaped recreational drug markets throughout Europe, confusing policy makers, law enforcers and users alike. In one Eastern-European country, injecting drug users have radically changed their habits.
When Constantin R. first injected Insomnia, it literally felt like “walking on air”. An experienced heroin user – he started doing the drug in his teenage years – he was a bit sceptical when his girlfriend started to use some new substances that had themselves appeared from thin air. Powders called Special Gold, Magic, Flower Magic Powder, Euphoria, Charge, Generation 2012, and many more, had became available all of sudden and even with a receipt. Usually wrapped in small vividly coloured paper or plastic packages that indicated how the content was to be used as bath salt or plant fertilizer. The 28-year-old Constantin, a Roma ethnic who lives in one of Bucharest’s poorest neighbourhoods, soon replaced his drug of choice with these mysterious products that were being sold freely in the many ‘head-shops’ that had appeared in the city. He liked the energy they gave him. “There were times when I simply couldn’t sleep for seven or eight days in a row. Day and night, I would keep on taking it. Sometimes I would just wander the streets for hours on end,” he tells me outside the ARENA methadone substitution treatment centre in Romania’s capital, where he now seeks help to fight his addictions.
The personal stories of many heroin addicts who are being treated here, are similar to his. Some of them apparently thought that the new drugs, labelled by the shops and by the media ‘ethno-botanical plants’, would be a sort of natural remedy that could help them quit heroin altogether. Others were simply fed up of being harassed by the police, and hoped that by getting their supply from what looked like certified shops they would be safe. Some others simply wanted a cheaper alternative to the illegal trade and to the ever-doubtful quality and unpredictability of the underground heroin market. And it all looked like a good deal, at least in the beginning.
Paranoia creeps in
“It started to give me a very bizarre type of panic”, says another former heroin user in his early thirties. He refers to a drug sold under the label Pure by Magic, that appeared in 2010 after the Romanian government banned a total of around 40 substances, ingredients of products sold in what the local media there now calls ‘dream shops’. He recalls how under their influence, he experienced bizarre hallucinations. Once, he saw one of his addict friends staring at him with a wolf’s head. He then started to feel a compulsive need to scrounge for things in litter bins and garbage containers. “I am a normal human being. It was becoming absurd. I was going home each evening stained with rubbish up to my neck. I took things out of a pile of junk, looked at them, put them back and pulled them out again in case I had missed something. I was curious to see what was inside, and I could do this over and over again,” he confesses. Others tell me the new drugs brought about paranoia. It made them look over their shoulder with every step they took, worried that the police or strangers who wanted to hurt them were on their trail. Others found themselves hiding behind cars in plain daylight or locking themselves inside their houses in fits of panic, not even allowing members of their own families to approach them. Constantin himself was picked up by the police from a park where he was found, naked and confused, after he had ditched all his clothes, obsessed with the thought that someone had slipped a heroin ball in his pocket in order to have him thrown in jail.
|A new drug each week|
Close to 60 new legal highs have been identified in Europe last year alone, as a report compiled and released by the European Monitoring Centre for Drugs and Drug Addiction in November revealed. More than one new psychoactive drug thus reached the market, on average, every week of the year.
According to a study coordinated by the Romanian Harm Reduction Network (RHRN), a network of NGOs in Bucharest which advocates for more relaxed drug policies focussed on education and treatment for users, there were two main categories of drugs sold in street and online ‘dream shops’: blends of plants and chemicals destined for smoking; and blends of energizing chemical powders (amphetamine type stimulants) destined to be snorted or injected. It looks as if the first category, mainly represented by synthetic cannabinoids that mimic the effects of marihuana, was most appealing to young users, who may or may not have had a previous habit of smoking cannabis as well. The 2012 National Report on Drugs recently released by the Romanian National Anti-Drug Agency revealed that the ‘new psychoactive substances’ (NPS) are still the most popular drugs with 16-year-old high-school students. The second type (which includes substances like mephedrone and MDPV) caught the attention of more experienced users who either completely substituted them for, or mixed them with, the illicit drugs that they were already familiar with.
The same report cited above also shows that NPS are now the main type of drugs affecting drug users’ health in the country. Apparently, the come-down is also considerably faster than in the case of other narcotics – one year after starting use, in the case of legal highs, as opposed to eight years for opiates (heroin), before users find themselves knocking at doctors’ doors or attending emergency rooms. Dr. Adrian Abagiu from the ARENA medical centre, who has been observing injecting drug users over the years, has also noticed that the number of addicts suffering from heart infections is surging. NSP are largely stimulants, he explains, and make users lose appetite almost completely. They experience massive weight loss and their soon weakened, anaemic organisms gradually lose the capacity to protect themselves from pathogenic bacteria in the environment. Add to that, the strain that these heavy energizers put on the cardiac system, and it becomes a serious health issue. “In 2011 we had seven patients dying from endocarditis. And this did not happen before,” he adds.
“We actually told users to go back to heroin”
One other problem for the drug services was that with legal highs, injecting users didn’t just change the drug. They also changed patterns of use. Consumers who use the new drugs feel an almost instant urge to re-dose and this makes them lower their guard precisely when they shouldn’t. Another user whom I interviewed details the possible consequences: “I didn’t have my own syringe with me that day or a new one and I used this guy’s… I had done it before so I trusted him. And then his girlfriend started saying that she had HIV. I think it’s from them that I got it myself.” Official medical data is now starting to show that such stories are not isolated occurrences. According to another RHRN report, over 110 drug users were diagnosed with AIDS in 2011, a more-than-tenfold increase from the previous year. Dr. Abagiu says that a heroin user would normally inject no more than three to five times a day: “He or she would inject again in three hours’ time and if the syringe is not used for that long the HIV in that blood will eventually die. With these new substances, they can shoot up as often as ten times in a day, and the virus survives from one dose to the next one.”
“We actually told consumers to go back to heroin. My friend and dear consumer, go back to heroin! If you can afford it, stop using this,” Dan Popescu from the ARAS Romanian Association Against Aids tells me. Working in the streets with users and having no research data to rely on except for the very visible damage to the consumers whom they had contact with, he explains, his outreach team had no other option but to evaluate possible harms and to suggest the potentially less toxic one. Oddly enough, it was just at the time that the new drugs were growing in popularity, that the country also lost its financing from the United Nations Office on Drugs and Crime (UNODC) and the Global Fund to Fight AIDS, Tuberculosis and Malaria – funds which had literally kept harm-reduction services like syringe exchange programs alive. In 2009, outreach workers like Dan, and treatment centres, distributed 1.7 million sterile syringes to drug users. Two years later, that number fell to 0.9 million.
A structural problem?
|Mephedrone, still the star of the British underground night-time economy|
Legal highs have also had their ‘moment of fame’ on the other side of the continent. In April 2010, the most popular one in the UK – mephedrone – was banned, after a wave of tabloid media reports categorised it as a ‘killer-drug’, and associated it with violent antisocial behaviour. Data released last summer by Lancaster University, Kings College London and Guys and St Thomas' NHS Foundation Trust and Kings Health Partners showed mephedrone to be the only novel psychoactive substance that has entered clubbers’ drug repertoires, even though it has now been illegal for more than two years and numerous new uncontrolled substances have tried to replace it. One in two users reported taking it in the month before being interviewed. Druglink magazine also revealed that despite the ban, more users are contacting drug services, reporting mental and physical harm caused by their use of the drug.
The new drug market took the former communist Eastern-European country by surprise. In February 2010, Romanian authorities placed a first set of 36 new substances under control. Four months later, the list was supplemented with another eight. But somehow ‘dream shops’ always seemed to be one step ahead of the authorities in this game. They kept diversifying their offer, always coming up with new ‘ghost’ products. If the police raided them, they would concentrate more on online sales. At the peak of their trade, they had created complex distribution networks, with mobile units assigned to different areas of the major cities where markets had developed. One phone or online order placed with the shop, and the drugs would reach consumers in a matter of minutes. In 2007, when business kicked off, only 1.9 per cent of the population had tried legal highs (in any form) at least once in their lifetime. Four years later, that same prevalence rate had risen to 9.5 per cent.
It is only now, that more coherent measures and legislation are starting to produce effects. A new law forces any commercial operator interested in distributing potentially psychoactive substances to register through a complicated, time-consuming and costly procedure, and empowers state institutions to shut down shops. While it will most likely choke the legal highs trade – the number of distributors is declining rapidly – some voices claim that this is only a partial solution, and that the challenge is not case-specific but structural. “We are expecting the demand for the new substances to remain stable, which will only make them attractive for organised crime, a possible consequence being that the market won’t disappear but will just contract while the quality of the products will decrease and the price will rise,” writes Valentin Simionov, director of the Romanian Harm-Reduction Network for a local website. Policies, he says, should not be founded on the criminalization and repression of drug use. That only encourages drug mafias to proliferate and illicit research to become more and more innovative, while law enforcement mechanisms end up abusing the most vulnerable link in the chain – the consumer.
Ironically, the legal highs phenomenon has reminded this predominantly Christian Orthodox and very traditionalist Eastern European state, that drug users exist and that their problems can’t be hidden under the rug anymore. For the young post-communist democracy, which since its birth a little more than two decades ago has never hosted a properly informed debate about drugs, adopting a more humane and compassionate view of addicts would be a giant leap of faith. Before any talk of decriminalization, public opinion would have to let the state know that everyone knows they are out there and they need help. And that could be the first part of their treatment. “They see us as animals. Even worse than animals, I think,” Constantin tells me when I ask him how regular people in the street treat ‘legalists’, as NPS consumers are sometimes referred to. “Whoever introduced these drugs, definitely wanted to kill us bums,” another user cuts in.
The author is a freelance journalist and a PhD student in sociology at Lancaster University, UK. He is currently also involved in research on legal highs.