Auckland UniServices Limited Legally available, unclassified psychoactive substances and illegal drugs in New Zealand before and after the ban on BZP: a web‐ based survey of patterns of use FINAL REPORT OF FINDINGS June 2009 Janie Sheridan, PhD, BPharm, BA, FRPharmS, RegPharmNZ Rachael Butler, BA, PGDipPH Christine Y. Dong, BSc Hons, BCom Hons Joanne Barnes, PhD, BPharm, MRPharmS, RegPharmNZ, FLS The School of Pharmacy The University of Auckland New Zealand TABLE OF CONTENTS 1 Executive Summary ........................................................................................... 7 2 Introduction .................................................................................................... 11 2.1 Background .............................................................................................. 11 2.1.1 The legislative and regulatory background ................................ 11 2.1.2 The current study ........................................................................ 12 2.2 Study aims ................................................................................................ 12 2.3 Study methods ......................................................................................... 13 2.4 Ethics approval ......................................................................................... 13 2.5 Structure of this report ............................................................................ 13 3 Adverse effects associated with herbal substances used for recreational purposes: a literature review ............................................................................................. 14 3.1 Introduction ............................................................................................. 14 3.2 Aims.......................................................................................................... 14 3.3 Methods ................................................................................................... 14 3.4 Results ...................................................................................................... 16 3.4.1 Extent and context of use ........................................................... 16 3.4.2 Adverse effects ........................................................................... 17 3.5 Discussion and Conclusions ..................................................................... 31 3.6 References ............................................................................................... 32 4 Web‐based survey .......................................................................................... 39 4.1 Aims.......................................................................................................... 39 4.2 Methodology ............................................................................................ 39 4.3 Methods ................................................................................................... 40 4.3.1 Sample population ...................................................................... 40 4.3.2 Recruitment ................................................................................ 40 4.3.3 Questionnaire and website design ............................................. 41 4.3.4 Data collection ............................................................................ 42 4.3.5 Data analysis ............................................................................... 43 4.4 Results ...................................................................................................... 44 4.4.1 Full sample data .......................................................................... 44 4.4.2 Demographics ............................................................................. 44 4.4.3 Data from all participants ........................................................... 46 4.4.4 Use of BZP party pills .................................................................. 47 4.4.5 Use of BZP‐free party pills ........................................................... 50 4.4.6 Use of legally available smokeable products .............................. 52 4.4.7 Use of other legally available substances ................................... 53 4.4.8 Use of alcohol ............................................................................. 54 4.4.9 Use of cannabis ........................................................................... 55 4.4.10 Use of ecstasy ............................................................................. 56 4.4.11 Use of methamphetamine .......................................................... 56 4.4.12 Use of GHB .................................................................................. 57 4.4.13 Use of ketamine .......................................................................... 58 4.4.14 Use of LSD ................................................................................... 59 4.4.15 Use of prescription drugs (for non‐medical purposes) ............... 59 4.4.16 Use of other illegal drugs ............................................................ 61 4.4.17 Paired data analysis of change over time ................................... 61 4.4.18 Reasons for change in substance use – qualitative data ............ 71 2 4.4.19 Experiences of adverse events ................................................... 77 5 Summary and Discussion................................................................................. 85 5.1 Sample demographics .............................................................................. 85 5.2 Sample substance use .............................................................................. 85 5.3 Change in use over time .......................................................................... 86 5.3.1 Change in BZP party pill use over time ....................................... 86 5.3.2 Change in BZP‐free party pill use over time ............................... 86 5.3.3 Change in legally available smokeable substance use over time86 5.3.4 Change in alcohol use over time ................................................. 86 5.3.5 Change in cannabis use over time .............................................. 87 5.3.6 Change in ecstasy use over time ................................................. 87 5.3.7 Change in methamphetamine use over time ............................. 87 5.3.8 Change in GHB use over time ..................................................... 87 5.3.9 Change in ketamine use over time ............................................. 87 5.3.10 Change in LSD use over time ...................................................... 87 5.3.11 Change in non medical use of prescription drugs over time ...... 88 5.3.12 Qualitative data ‐ self‐reported reasons for a change in substance use ..................................................................................................... 88 5.3.13 Adverse events associated with use of unclassified substances 89 5.4 Limitations and confounders ................................................................... 91 6 Conclusion ...................................................................................................... 93 7 Appendix ........................................................................................................ 95 7.1 The website .............................................................................................. 95 7.2 Advertising material ................................................................................. 96 7.2.1 A5 Flyer ....................................................................................... 96 7.2.2 Promotional cards ....................................................................... 97 7.2.3 Radio advertisement ................................................................... 99 7.2.4 Website advertising .................................................................. 100 8 References .................................................................................................... 101 3 TABLES AND FIGURES Table 1: Plants (selected common name) included in literature searches ............................. 15 Table 2: Botanical nomenclature and other descriptive information for plants discussed in the literature review ................................................................................................................ 19 Table 3: Numbers of spontaneous reports of suspected adverse drug reactions associated with single‐ingredient preparations of herbal substances of interest held in the Vigisearch database of the World Health Organisation Uppsala Monitoring Centre (WHO‐UMC) for the period up to March 30, 2009. .................................................................................................. 30 Table 4: Demographic data 1 .................................................................................................. 45 Table 5: Demographic data 2 ................................................................................................... 46 Table 6: BZP party pills named by respondents ....................................................................... 47 Table 7: Frequency of use of BZP party pills at Waves 1 and 2 ............................................... 49 Table 8: Where BZP party pills were obtained ........................................................................ 49 Table 9: Level of use of BZP party pills....................................................................................