Are legal highs safe?

If a drug is legal, then surely it's safe? Not necessarily. In fact, law-dodging legal high manufacturers change the formulas so regularly that users could be putting themselves at risk.

Close-up of boy taking pills

Do you know what you're taking?

Legal highs are substances that replicate the effect of illegal drugs. They can be herbal blends like salvia which gives users a quick LSD-type experience. Or they can be synthetic chemical-based drugs made to mimic stimulants like MDMA, amphetamines or cocaine.

Even though they are, in some ways, legal doesn’t mean their effects are less strong than other street drugs. Not only can effects be potent and cause users to hallucinate, rush, or give them the energy to dance for 10 hours straight, but legal highs have also been linked to several deaths by the media.

What’s the law?

The laws about drugs in Britain are a tad complex. The Misuse of Drugs Act determines what’s legal and what isn’t. A Home Office spokeswoman told us the act can only ban specific substances and chemical compounds, so anything it doesn’t cover is therefore legal.

Many previously legal highs now come under the Misuse of Drugs Act. This includes GBL, BZP, naphyrone and mephedrone, which was linked to several deaths in 2010.

In April 2015, the Home Office introduced new legislation to ban five legal highs for up to a year. This will give the Advisory Council on the Misuse of Drugs (ACMD) time to work out whether these drugs should be permanently controlled.

This new legislation would allow police to confiscate suspected substances. The penalty for supplying a temporarily banned drug is a maximum of 14 years in prison and an unlimited fine. Possession would not be considered a criminal offence.

Some substances or compounds aren’t illegal to possess, but can’t be sold for human consumption. Therefore drugs manufacturers cover themselves by simply writing “not for human consumption” on the label. Or they advertise them as something other than drugs – for example, mephedrone was sold as “plant food” when it was legal, and ivory wave is often disguised as bath salts.

In May 2016, the Psychoactive Substances Act came into force. The act is a blanket ban on legals highs and criminalises the production, sale, supply and distribution of legal highs. This won’t replace the Misuse of Drugs Act, but it will make it an offence to produce or supply legal highs (not including nicotine, alcohol and caffeine). Offenders who break the law could face up to seven years in prison under the new Psychoactive Substances Act. It won’t be an offence to possess them.

No. Sorry. These drugs often haven’t been tested for human consumption so users are effectively human guinea pigs. Just like illegal drugs, legal highs are not regulated. You don’t know what you’re buying, how much you should be taking or what the side effects might be.

Dr Phil Yates, a government forensic scientist, said: “If something’s advertised as a legal high, people might think somehow the government have sanctioned that and so it’s safe to take. Really, all it means is that nobody’s tested it, nobody knows if it’s safe. These are completely unknown quantities.”

Because the chemical compositions of these drugs are continually changing, you never know what you’re getting. So your last trip on a synthetic legal high might have been fine, but that ‘version’ of the drug might have since been banned. Your next trip may be completely different and not as plain-sailing as you’re experimenting with a brand new substance.

Plus, let’s not forget, that anything that gets you off your face is likely to lead you to do things you wouldn’t do sober.

Harry Shapiro, director of communications at Drugscope, said: “The truth of the matter is that you don’t know what you are buying. It’s not got any consumer quality control, there’s not a reliable ingredients label.So people can be using a mephedrone substitute and think it’s legal. But police could find it, test it, and say ‘actually that is illegal’, which would land you in trouble.”

How long is a line of cocaine? These synthetic substances are so new, and so untested, that it’s impossible to say exactly what the health implications are. But there are some common patterns.

“It’s the impact these chemicals have on people’s psychological health that I find worrying,” says Dr David Caldicott, who works as an emergency doctor at Nevill Hall hospital in Wales and specialises in illicit drug use.

“I’ve seen lots of people who have tried to kill themselves while on legal highs. They change your mood so you don’t see sense anymore. Quite often we need to restrain patients.”

Other potential concerns are changes in blood pressure and problems breathing.

Dr Caldicott says that if you are going to take legal highs, you should follow this advice:

  • Don’t mix your drugs – especially with alcohol.
  • Ideally don’t use a drug you haven’t tried before.
  • Don’t take legal highs if you have mental illness.
  • If you take a legal high and you end up in hospital, try and bring a sample of what you’ve taken to give to medical staff.

“Caring for a patient who’s taken an unknown legal high is the medical and toxicology equivalent of winging it,” says Dr Caldicott. Even though Dr Caldicott is a specialist, he admits treating patients who have taken an unknown substance is tricky.

Legal highs are often brand new and untested on humans. So, medical types don’t have the knowledge and experience that they have with well-known illegal drugs such as heroin or ecstasy.

“We can make an educated guess,” Dr Caldicott says. “But, from our perspective, it’s a whole different kettle of fish.

“Heroin is a very dangerous drug and potentially lethal, but every emergency medic knows how to deal with it. With legal highs, we have no idea what you’re on. So while there may be a decreased hazard in strength, there’s an increased hazard due to lack of familiarity.”

What’s more, these drugs keep changing. The chemical make-up of synthetic legal highs is in constant flux to keep on the right side of the law, so medical experts are always playing catch up. Dr Caldicott says it takes months to even get an idea of the effect of a new drug. Doctors can try and work out what type of drug you’ve taken (is it a stimulant or a downer?) and treat you according to your symptoms. But there’s no way of knowing exactly what to do when they have no idea what you’re on.

So why have they been legal?

Synthetic legal highs have a very similar chemical makeup to illegal drugs. But brainiac chemists tweak the compounds and make tiny variations so they’re not covered by the drugs act. And no sooner has the government caught up with one particular compound, the chemists get to work on creating a new one that is similar enough to create the same sort of effect, but chemically different enough to be legal.

James Brokenshire, minister for crime prevention, says: “The legal highs market is changing. Unscrupulous drug dealers constantly try to get around the law by peddling chemicals, which are often harmful, to young people.”

The government tries to keep up with all these new ‘brands’ of legal highs, and from April 2010 made a lot of them illegal. But suppliers are speedy at inventing these different, but similar, chemicals to replace them, always staying one step ahead of the law.

Next Steps

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Updated on 29-Sep-2015