A variation on the anaesthetic ketamine appears to be making its way into the party drug scene that has effects lasting eight hours or more.
“The users themselves sent it to us regarding their concerns regarding its actions. We have several people who have described its effects,” said Dr Caldicott, emergency consultant at Calvary Hospital, Canberra.
Using NMR spectroscopy, Dr Caldicott’s team at the ACT Identification of Novel Substances project has identified the new compound called des-chloro ketamine. “It’s just missing a chlorine,” he said and publication of the results is awaiting review.
“And we’ve been able to tell the users, ‘You’re absolutely right. This is something new and potentially dangerous. You should go back to your people and let them know’.”
Ketamine is usually considered a ‘safe drug’ in terms of its toxicology as it maintains airways and is hard to overdose on except in combination with other depressants. Frequent use can, however, lead to panic attacks, memory impairment, depression and cystisis of the bladder.
Dr Caldicott said that the more immediate dangers of a long-lasting variant come from the loss of coordination and awareness it induces. It can put users in a vulnerable state of submission, “where they’re unable to protect themselves from things being done to them like assault, robbery or sexual crimes.”
“If any of your readers were to find themselves to be treating a patient in a long dissociative state they should consider the possibility that their patient is intoxicated with a novel ketamine-like substance.”
Australia and NSW in particular, are lagging behind the rest of the world in their attitude towards pill-testing for party drugs.
Dr David Caldicott told the 2015 National Drug Trends on October 14.
In the emergency department he has seen plenty of incidences like the death one month ago of a 26 year old attending the Defqon1 festival. The young man crashed and was unable to be revived at Nepean Hospital. Last summer two more teenagers died at dance parties after taking what they believed to be ecstasy.
Dr David Caldicott presented findings from surveys conducted at Australian parties showing that if drug-checking were to reveal impurities in a consumer’s presumed ecstasy, “as many as two thirds would bin the drug or ask around for more information.”
This research replicated European findings that have since led to drug-checking services in Portugal, Spain, Belgium, Austria, Switzerland and the Netherlands. A decade ago the AMA called for a medically supervised research program to establish whether there was a role for this service in Australia but still there has been no support from lawmakers.
“Australians have an uncanny requirement to prove things locally,” Dr Caldicott told the Medical Republic. “They were very keen to probe whether the Ottawa ankle rules applied in Australia- as if being detached from the rest of the world for so long has had some evolutionary consequences [for the ankle bones!]”
Harvesting the data
The infrared spectrophotometers used for onsite drug-checking are portable devices like the ones they swipe you down with at the airport to test for explosives. The advantage of doing testing at the front line is that you can pick up the very latest sample and detect new batches of drugs (see box New drug on the block).
Dr Caldicott said, “You look at the big parties in Europe and they can test hundreds of pills per night. That’s in an environment that’s far likelier to have the new stuff than anywhere else.”
The data collected could also help law enforcement track batches of drugs produced by particular suppliers, he added. “You could certainly link a pill that had been responsible for the death of an individual to the manufacturer,” he says.
“The consumers get fairly tetchy if somebody has put something really bad in a pill and has portrayed it as something else. They’re more than happy to collaborate to stay safe.”
For $100,000 his research team would be able to take two of spectrophotometers machines to take to dance parties every weekend, “and in the space of two months we could generate more data than the entire drug detection dog unit has generated in the entirety of its existence.”
The sunk costs of sniffer dogs
The colorimetric assays used by police to identify drugs are limited to testing for a very specific drug reaction rather than picking up new compounds. And the sniffer dog program itself costs the state over $800 000 every year in training and staffing.
Dr David Caldicott told the National Drug Trends conference that despite evidence for its ineffectiveness, law enforcement are wedded to the drug detection operation because of the massive sunk costs . He showed that there has still been no change in approach despite the 2006 NSW ombudsman’s report showing that 73% of people identified by dogs are not carrying drugs and those drugs detected are usually small amounts of cannabis.
The sniffer dog program had been championed as a way of cutting supply and yet “In the two year period they evaluated there were only nine searches resulting in a supply conviction,” said Will Tregoning, of the law reform campaign Unharm.
Mr Tregoning also said there has been an increasing number of cases in which drug detection actually promoted risky behaviour such as preloading, secretion of drugs internally and panicked mass consumption. “And that’s something we know has directly contributed a death in NSW at a party in 2013,” he said.
“The victim’s father told the ABC at the time he was concerned about dogs at the entrance to the party and he took three pills as once. And he was dead within twelve hours.”
In response to the death in February the NSW Police Assistant Commissioner, Frank Mennilli told ABC’s 7:30 report that, “the police strategy is to try and stop drugs from getting past the gates at festivals.”
“All that we can do is to keep on running drug dog operations because drug dog operations save lives, they really do.”
A chink in the legal window
There is little reason the law could not accommodate drug-checking facilities whether at parties or at walk-in centres. A precedent for tolerance towards drug harm-minimisation is the needle syringe program (NSP) begun in 1987. In that case drug laws were amended in very state to protect operators and users of NSP centres from prosecution.
Dr David Caldicott said he understood why that program had the support for that program had such impetus at the time. “The needle syringe program was introduced at a time when the risk of blood-borne viruses and public health was far more important than [recreational drug use] will ever be.”
But this was still a valid model on which to base the tolerance of drug-checking services and so far Victoria had made some steps towards considering his proposals. “We think this is a very low hanging fruit,” he said.
“We don’t think this represents any surrender on the war on drugs because it provides law enforcement with intelligence they didn’t have, and protect young people in the broader situation.”