Urgent synthetics response underway

No sooner do synthetic cannabinoids (sometimes called synnies) drop out of the headlines when a new spate of hospitalisations or deaths somewhere in New Zealand throws them back in the spotlight. The New Zealand Drug Foundation has teamed up with over a dozen organisations to support a Government multi-agency response.

Canterbury is the latest region to report a spate of Emergency Department admissions for synthetic cannabinoid overdose – some minor, others serious or fatal.

Paul Gee, Canterbury DHB Emergency Medicine Specialist, said toxicology analysis identified the substance taken was either AB-FUBINACA or AMB-FUBINACA which was linked to numerous other deaths in the past year. With little known about these drugs, many support services have felt unsure how to respond.

Community Responses Did You Know - Synthetics Overdose Emergency Info

What's being done

We have set-up a Synthetics Crisis page, and established partnerships with Police, Ministry of Health, ESR, and front line social service providers to undertake urgent  survey-based insight gathering with people who use synthetics. The responses should provide valuable information to inform a wider, co-ordinated response.

Initial discussions with these organisations confirm that people in precarious living situations are most at risk. Young people may not be more affected than other age groups, but they could heavily comprise two user sub-groups – people avoiding a positive workplace drug test, and people not in either work or education.

What we know so far

Some examples of insights from initial conversations with organisations:

• Synthetic cannabinoid-based substances are cheap and, where use is established, easy to get.
• The substances currently available are more harmful than the ‘legal highs’ sold in shops before 2014.
• People who use synthetics daily, often use it multiple times a day (perhaps up to ten times). The effects are strong and short (up to four hours), with withdrawal symptoms coming on very fast after use (about one hour after the high). This creates a strong urge to use again, to avoid the highly unpleasant feelings.
• Withdrawal following prolonged use can take up to 10 days. This means detox is a longer process and someone needs to not use for a long time before they start feeling better.
• Secondary alcohol and drug services are not seeing many people using synthetics. The reasons for this are unclear, and we are continuing to gather insights.
• Losing consciousness can be perceived as a normal part of the experience, making a fatal overdose harder to detect. A person may have stopped breathing for many minutes before being noticed.

Combining initial insights with a harm reduction approach points us to interconnected responses such as an early warning system, widespread free drug-checking, guidelines for workplace drug testing, funding new treatment options, user outreach and one to one social assistance. Some of these responses will be explored in detail as we analyse the data gathered.

Updated harm reduction information

• There is no safe way to use synnies.
• Sit down before you smoke a synnie.
• Mix with tobacco instead of smoking neat.
• Only use small amounts, and wait for the effects to wear off before using more.
• Use with someone who is not using. If someone is unconscious and unrousable, call an ambulance. If you choose not to call an ambulance, monitor breathing continuously even if their reaction appears typical. Place them on their side if possible, and be ready to call 1-1-1 if breathing becomes labored or stops.