Poisons hotline

After that, the key to safety will be surveillance. If a drug starts to cause more harm than expected, Medsafe will be able to further restrict its sale or ban it completely. An interim version of this system has already been introduced. Any negative effect reported to a hospital or poisons hotline  is ranked in one of three categories. Mild reactions such as restlessness, mild pain  or vomiting are given a score of 1. Cramp, unconsciousness or hallucinations score 2; coma, paralysis or deafness score 3. Any product that accumulates a score of more than 2 per 20,000 units sold is taken off the market. By building science into drug laws in this way, Jessamine says the risks can be studied, controlled and communicated to users.  There will be no need for manufacturers to constantly dream up new drugs. Consumers who want to stay on the right side of the law won’t be forced to give up a legal high they know works for them and try a new, possibly more dangerous one. Not everybody sees this approach as  a panacea. Forensic toxicologist Keith  Bedford, who sat on the committee that classified drugs under New Zealand’s old system, points out that it fails to take into account people’s tendency to mix drugs with alcohol or other recreational substances. That’s something New Zealand has seen before. Many of the people who had serious reactions to BZP had also taken something else – often several drugs, says Bedford.  He works for ESR, the company that does  all the New Zealand government’s forensic toxicology work, and has seen a lot of the toxicology data. Published studies back up Bedford’s claim. A 2010 study by Chris Wilkins from Massey University in Auckland, New Zealand, found that 86 per cent of BZP users combined the pills with other drugs – usually alcohol, but also cannabis and ecstasy. “I think unfortunately they’ll get some nasty surprises that their  low-risk product is used in combinations. That’s something that’s hard to model in advance,” Wilkins says. Similar adverse drug reactions have been spotted elsewhere. In 2012, for example, the European Monitoring Centre for Drugs and Addiction reported that 21 people had died after taking an amphetamine called 4-MA. But if you look at the reports, in each case 4-MA was combined with other drugs. Bedford suggests the safety testing ought to include combinations, at least with alcohol. But Jessamine says that’s not likely to happen: “It’s much more likely that they’ll be required to include advice about not engaging in those behaviours on the packet.” Dr Z supports the new law but he also worries about people mixing drugs. On behalf of a group of legal high manufacturers, he is coordinating studies of an MDMA analogue called 5-MAPB. “It’s a good drug, it’s fun,” he says. “So people will start drinking on it.” But he warns that the structure of the chemical suggests that mixing it with alcohol would be very risky. “People could start dropping like flies. What’s the next thing that happens? The newspapers will react. The whole thing will be called a ‘terrible flop’ and ‘dangerous’ and it will never be heard of again.” As these issues are dealt with, international experts are watching, with some hoping the results will demonstrate that an alternative to prohibition can work.