(Top photo: A heroin user in the US preparing to inject. Image used for illustrative purposes. Photo: Jae C Hong AP/Press Association Images)
This post originally appeared on VICE UK
When the synthetic cannabinoid Spice first gained a following among internet drug geeks as a cheap, mellow, legal marijuana substitute in 2009, no one predicted what would happen next.
Under myriad brand names and legal bans, synthetic cannabinoid products—now generally known as Spice, after the original—became increasingly unpredictable, potent, and toxic. Instead of making people feel slightly stoned, demand for a stronger hit led to a drug with side effects more reminiscent of crystal meth than weed. It left users agitated, incapable of sleep, aggressive, and addicted, and caused havoc among young offenders, the homeless, and those in the prison system.
Now, nine months after the Psychoactive Substances Act banned all "legal highs" such as Spice, research into the latest UK drug trends has revealed that the continued use of the substance may be breeding an as yet unreported side-effect: an increase in heroin use among young people.
Published today by DrugWise, a study I co-authored—"Highways and Buyways: a snapshot of UK drug scenes"—includes interviews with drug treatment workers, police officers, researchers, and other experts representing 32 organizations and 13 police constabularies. The survey revealed that in several parts of the country, young people—a demographic not associated with heroin these days—have been reported as using the opiate to self-medicate the side effects of Spice use.
"We've seen [Spice users] using valium for withdrawal, then the valium sellers are selling heroin, and so they will try that."
Sam, in his early 20s, is one of a growing group of young homeless hostel residents in Newcastle who have started using heroin on the back of Spice. "One day in November I'd been on the rattle [withdrawing] from Spice for two days," he tells me. "I was sweating, I had the shakes, felt sick, and couldn't get to sleep. One of the older residents suggested I try heroin to calm me down. It didn't knock me out like Spice did—it made me tired—but it helped take the rattle off. Now I smoke a £10 [$12] bag of heroin a day at night after Spice. Since then I've also started using crack. So now, after starting on Spice, I'm chasing three habits instead of one."
Many of these young people are unfamiliar with the risks of taking heroin. Two weeks ago, a 19-year-old who was known to drug and homeless services in Newcastle died. A source confirmed that he had been addicted to Spice and that he had recently started using heroin. However, the results of the autopsy have not yet been released and therefore the cause of death has not been confirmed.
Kevin, 26, almost died during his first heroin hit, taken intravenously last summer. "I was cutting down on Spice because I was sick of the scene and needed something to make me sleep for the night," he says. "Someone gave me some heroin and I injected it. It felt better than valium and [I] just went onto my back. I overdosed and an ambulance came to save me." Despite this, he now regularly uses heroin as a comedown for Spice. Like others fresh to heroin from Spice, he has also started using crack.
"Spice can be a gateway to heroin and crack. Since last year I've seen a rise in young people moving from Spice to heroin," says Mick Portis, a harm reduction worker at the city's Lifeline project. Portis tells me that heroin has crept onto young people's drug menus because the Spice withdrawal is so severe.
As we walk down one of the city's smartest Georgian streets, Portis tells me of two teenage boys he knows—who've begged on this street for money to pay for Spice—who have started sex work and moved onto heroin. "We've seen people using valium for withdrawal, then the valium sellers are selling heroin, and so they will try that," he says, adding that crack—never a big drug in Newcastle, unlike 30 miles down the road in Middlesbrough—has entered the city "in a big way in the last two months."
Alongside Newcastle, Scarborough, Southampton, Stoke, east London, and Manchester, Belfast has seen a similar picture develop. One drug expert explained: "There is a new phenomenon of young people as young as 17 starting to use heroin in Belfast, mainly on the back of using Spice. Most of the hostels said these young people who were on Spice are all on heroin now."
The DrugWise research into Britain's drug market reveals a patchwork of hidden scenes—a narcotic landscape that is becoming increasingly varied and mutable, from codeine-addicted housewives in Hartlepool and West Country fishermen on speed, to Lithuanian dealers in Belfast and homeless powder cocaine injectors in Glasgow.
The survey provides the first litmus test into the impact of last year's Psychoactive Substances Act—which banned the sale of new psychoactive substances (NPS) from head shops—on the supply and use of Spice. And it reveals a divided picture: in around half of the areas surveyed, the Act has barely affected the market, with many users buying drugs under the counter from head shops, from street dealers and the internet. By contrast, in the rest of the areas surveyed the law has done what it set out to do, resulting in reduced availability and use, even in prisons. Drug services are finding, however, that some people are replacing NPS with old school drugs such as cannabis, alcohol, and opiates.
The move away from NPS use in some areas comes at a time, the report found, of "unprecedented" street purity levels in traditional substances, namely heroin, crack, and powder cocaine and ecstasy, alongside the continued rise of the black market in prescription and over-the-counter drugs. Heroin, powder cocaine, and rock cocaine have risen from sub-20 percent purities in 2010 to more common purities in 2016 of between 43 and 74 percent. The rise in purity of ecstasy pills has been well documented, with some pills containing quadruple doses: 300mg of MDMA.
Related: Watch 'High Society—The Truth About Ecstasy'
One drug expert quoted in the report says that in the face of highly pure traditional drugs and the ban on legal highs, he believes Spice and other NPS are living on borrowed time in Britain. "The USP of Spice was legal, accessible, did not come up in drug tests, cheap. But it is starting to lose all these selling points. I'm not convinced there will be a big enough market, as its users need continuity of supply, otherwise they will go onto something else. So unless it's being imported into the UK in large amounts, supply may not be maintained."
Official statistics show amphetamine use is increasingly uncommon in the UK. However, the report found it's a drug still being used, albeit under the radar. For example, as well as speed being popular among a large group of middle-age injectors in Lincolnshire and domestic abuse victims in east London, the drug is also being used by fishermen in coastal areas in the south west of England as an alertness aid in an increasingly competitive industry.
As one drug worker explained: "There is a no drinking rule at sea, but that does not stretch to taking illegal drugs, as long as it's kept under control. The need for drugs seems to be accepted within the community, but is kept behind closed doors."
At the other end of the country, in Glasgow, exists another counter-intuitive drug scene. Over the last two years, health workers have been dealing with an HIV epidemic among homeless drug injectors. One of the causes of this spike is an escalating number of city center homeless people opting to inject powder cocaine, a rarity in Britain. As with the injection of crack, a form of cocaine that is rarely sold in Glasgow, cocaine injecting often entails more frequent and risky use of needles.
Prescription and over-the-counter medications diverted onto the black market are a rising presence on the UK drug scene, according to the report. Alongside valium and tramadol, the anti-epilepsy drugs pregabalin and gabapentin have become a mainstay of diverted medications taken by heroin users.
Meanwhile, in places such as Hartlepool, Northern Ireland, and Tyneside, codeine is increasingly being used, the report says, by adults as a way of getting through the day. Some are taking up to 40 codeine-containing pills—such as Nurofen Plus and co-codamol—a day. In Hartlepool, codeine is particularly popular with housewives, as one drug service told the survey: "These housewives use codeine regularly throughout the day, to take the edge off, make them more relaxed, less stressed, so they can cope. But it's creating long-term health problems."
Codeine is also on the rise with young people as a recreational drug. In Southwark and Kent, drug workers say they are seeing more teenagers, inspired by US hip-hop culture, drinking Lean (also known as Dirty Sprites, Sizzurp, and Drank), which is codeine, in the form of cough syrup, mixed with a soft drink. Similarly, one source told the survey that the benzodiazepine Xanax, another drug linked to American celebrity culture, is becoming more popular with young adults.
Despite falls in the number of cannabis users, drug services have reported a rise in people coming in for treatment for problems with the drug. But according to a separate report published today by drug policy group Volteface, "Black Sheep: An investigation into existing support for problematic cannabis us," the help out there is largely inadequate. It says if cannabis was a regulated drug then treatment for problem users would not be so badly neglected.
In conclusion, the DrugWise report says the British drug market is slowly reconfiguring itself since being shaken up by a dive in purity levels and the arrival of NPS eight years ago.
"The history of drug use in the UK since the Second World War," says the report, "has been propelled by a series of 'tipping points' such as smokeable heroin, HIV/AIDS, rave culture, and the internet. None of the previous tipping points could have been predicted, so what comes next remains to be seen."
Some names have been changed.
Follow Max Daly on Twitter.
UPDATE 07/02/17: An earlier version of this article did not make it clear that the results of the autopsy of the 19-year-old in Newcastle had not been released, and so a cause of death had not yet been confirmed.