While the forensic information has yet to be made public, the tragic death of Nick Bonnie at the Warehouse Project in Manchester (28 September) appears to be the latest in a series of deaths linked either to strong ecstasy or the PMA-ecstasy combination. Up until 2011, PMA had only been implicated in two deaths in the previous 18 years. That figure leapt to 20 in 2012, while the BBC File on Four programme (29 October, listen here) claimed that figure had already been exceeded for 2013.
From a public health perspective, why this is happening now is almost beside the point; the question is ‘what more can be done to warn club goers of the dangers of using ecstasy?’ And then you have to throw into the mix the numerous anecdotal reports of serious outcomes for users of some of the new compounds, especially synthetic cannabinoids. There are no official statistics on the prevalence of use of substances like Black Mamba, Annihilation and Exodus Damnation – and nobody should be helping the more scurrilous end of the media, by unduly ramping up concerns. But even if the names are just a marketing ploy to encourage sales, the percussive effects of these drugs are all too real.
We could do worse than reinvigorate some of the harm reduction initiatives from the 1990s, when rave culture was at its height. Not that this was exactly free from controversy. The first materials on safer dancing appeared in Liverpool in 1992 published by the Merseyside Regional Drug Training Unit (now HIT). After hearing about the rising tide of MDMA-related A&E admissions to local hospitals, they produced the ‘Chill Out’ leaflet, setting out what has now become standard information about not getting overheated, staying hydrated and so on.
The tabloid response was swift and brutal, with one paper going so far as to suggest that parents go round to the unit’s offices and chuck the director Pat O’Hare in the River Mersey. It didn’t take too long for that information to appear in medical articles, in materials from organisations like DrugScope (then ISDD) and Release and, significantly, in government literature. The government also backed the London Safer Dancing Campaign; ISDD launched the London Study Safely Campaign aimed at students and there were other similar initiatives around the country. The more responsible venues began supplying free water, chill out areas and allowing drugs workers onto the premises to offer advice and support. Did people still die from taking drugs? Sadly they did, but few club goers could have said that they had no idea about the possible ways they could reduce potential risks.
It is true that for a decade now, most drug use, be it problematic or recreational has been in decline. And we don’t know how much of a health problem we really have with the new drugs – except there seems to be a lot of them about. But there is sufficient anecdotal evidence coupled with the jump in MDMA-related deaths to warrant a step change in thinking about information provision – not least because, as well as traditional indoor venues, the last decade has seen an explosion in outdoor festivals where drug-related fatalities and casualties have also occurred.
Unfortunately, proactive information underlining risk reduction is looking pretty scarce right now. The government would point to the FRANK website as a reliable source of information – which it is. But, as reported in this issue, a survey of school students in Nottingham showed that while FRANK has high brand recognition, virtually none of the students would use it a source of information. This will sound quite Luddite, but whatever new technology can deliver, I would argue there is still a significant role for shoving a leaflet in somebody’s hand, putting up posters and providing other tangible objects of social marketing.
DrugScope continues to get regular calls from a whole range of professionals looking for just this – and we can’t help, because there are no funds for free print distribution these days. And due to financial cutbacks, government funds for similar communications activities have also dried up.
It is impossible to say if more readily available information would have saved those who have recently died; but it has to be worth making sure people are properly informed. After all, when Leah Betts died in 1995, one of the most widely publicised drug deaths of all time, few of the current casualties would even have been born.