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A primary
question should
be ‘how do you
feel?’ rather
than ‘what have
you taken?’
feel?’ rather
A
nyone trying to keep abreast of novel
psychoactive compounds (NPCs) will know
what a daunting task this can be. My inbox
is constantly refilling with bulletins inform-
ing me of new compounds, alongside
emails from frontline workers asking about substances
that their clients are experimenting with. As with any new
development, a flurry of new responses emerges. In an
echo of the period after the crack strategy was published,
some agencies are creating ‘NPC worker’ posts.
Elsewhere, commentators are using use the emergence
of NPCs as evidence for stricter laws or as proof of the
failure of prohibition, according to their ideology.
Closer to the coalface, one can spend thankless
hours reading through forum accounts of people’s
latest psychedelic experiments, while their peers, with
varying levels of knowledge, discuss the finer points of
pharmacology.
In much the same way that an incautious worker can
get drawn in to the chaotic presentation of their client,
so the researcher exploring NPCs can get so swept
along in the novelty, uncertainty and confusion that they
lose sight of some pragmatic responses. I’ve found
myself in this situation, chasing the illusory white rabbit
in numerous forum threads. Over the past few months
in training sessions, another set of responses has
started to emerge, which can offer a useful approach:
1. Acknowledge ignorance
We need to be very cautious about thinking we know
more than we do. From the lab that thinks it is making
drug X, to the end user who believes they have bought a
specific drug, there are layers of uncertainty. The lab, the
web retailer, the head shop and the end user cannot be
certain what they are making, selling or using.
Even if they could be certain, it doesn’t help us that
much because we don’t know enough about how most
NPCs will work in the short, medium and long term.
The snag for most people involved in this fast-
moving scene is that we tend to crave facts. Whether
posting to a website, writing a leaflet or offering training,
we want to proffer knowledge. We then run the risk of
creating an illusory sense of knowledge, when actually
what we largely offer is conjecture and speculation.
The primary message to everyone contemplating
use or who is already using is the extent of the
‘unknowns’. It is not a failing not to know; it is a failing
to not acknowledge that we don’t know.
2. Work symptomatically
Given the colossal uncertainty as to what an individual
has taken (or what combinations they have used) and
how little we know about specific compounds, trying to
ascertain what a person has used, or thinks they have
used, may not be that helpful. Instead, a primary
question should be ‘how do you feel?’ rather than
‘what have you taken?’
If, for example, a person presents to club outreach
workers saying that they have just used AMT, how do
they know that’s what they have had? Is this based on
what the website/head shop/dealer/mate said?
Without previous experience to compare it to, or an
objective reference point, how can they know that this
is what AMT feels like? And even if it is AMT, what else
have they had?
Alongside this uncertainty, we may struggle to gain
any objective evidence of what has been used. Newer
drugs may not show up in tests or may give misleading
positive results.
So it is much more useful – and important – to lead
with an exploration of symptoms. Management of
panic, high pulse rate, elevated temperature, delusion,
blood pressure – these will be much more important in
the short term than trying to identify exactly what the
person has used.
3. Share knowledge
Having successfully managed a presenting situation
(
eg
in a crisis) it is then wholly appropriate to try to
identify what was used. It will be useful to ascertain
the name of the substance, its appearance,
packaging, route, dose and other substances used.
But until confirmed by analysis, the identity of the
substance should be treated as uncertain.
Without toxicology we can cascade what we know –
that substance sold or bought as X, which looked like this
and was taken like this, possibly caused these effects.
If we have toxicology results and it says that the
8 |
drinkanddrugsnews
| May 2013
Cover story |
Novel psychoactive compounds
www.drinkanddrugsnews.com
Knowing enough about each novel
psychoactive compound that emerges
in time to help clients can feel like an
impossible task.
Kevin Flemen
gives a
pragmatic approach to staying ahead
Psychoactive ch