HSE and NVDAS Survey

HSE and National Voluntary Drug and Alcohol Sector Emerging Drug Trend Monitoring Pilot Project

Cannabinoid Market Survey, Quarter 1 2022

(Image source: Forensic Science Ireland 2022)

Background

Information provided by frontline services is important and can help to quickly identify trends of concern that may require monitoring at a national level. To improve information gathering in this area, the HSE National Social Inclusion Office and National Voluntary Drug and Alcohol Sector (NVDAS) will collaborate to improve drug monitoring and emerging drug trend responses in Ireland on an on-going basis.

In Quarter 1 of 2022, a survey was shared with services within the NVDAS network through Merchants Quay Ireland to capture drug market trends relating specifically to cannabinoid products (Hash, weed, edibles, vape, synthetic cannabinoids etc).

Aim

The aim of the ‘Cannabinoid Drug Market Survey’ was to identify if services currently have concerns regarding cannabinoid products available on the Irish market based on reports from their service user populations.When reading the below findings, it is important to remember that this feedback is from service providers in relation to their experiences and it may not represent all trends or other user groups nationally. These findings are also not supported by analytical drug confirmation.

Overview of Questions

A series of questions were asked in relation to:

The type of service provider and profile of clients (under 18 or over the age of 18)
The types of cannabinoid products reported by service users in the last 3 months
Possible drug market changes reported by service users in the last 3 months and if they suspected that synthetic cannabinoids may be appearing
Reports of negative health effects from service users

Findings

23 services completed the survey with the majority being Dublin based (69.57%)

Types of cannabinoids reported by services

Of 22 services who responded to the question on the types of products used by service users, all reported the use of herbal products (hash and weed), 12 services (55%) reported the use of edibles, 10 (45%) reported the use of CBD from high street shops, 9 (41%) reported the use of THC vape and 6 services (27%) reported on the use of oils (not obtained from high street shops).

Negative health outcomes after using cannabinoid products in the last 3 months

15 (71%) services stated that their service users experienced negative health outcomes after using cannabinoid products within a 3 month period whereas 6 (29%) services have had no concerns.

Of those reporting that service users became unwell following cannabinoid use:

15 (100%) stated that service users have become mentally unwell (anxiety, paranoia, hallucinations, psychosis like symptoms)
8 (58%) services reported that people experienced behavioural concerns (violence)
7 (47%) reported acts of self-harm or suicide ideation and 6 (40%) reported that people had become physically unwell
2 (13%) services documented that service users required hospital admission

When asked what products led to service users having a negative reaction, 8 services stated 'weed', 3 reported 'edibles', 2 reported 'synthetic cannabinoids' and in 3 cases other substances were referenced as part of a polydrug pattern (nitrous oxide, cocaine and benzodiazepines).

Synthetic cannabinoids

Concerns about synthetic cannabinoids

When asked about synthetic cannabinoids and if services felt that they may appear without service users knowledge at the point of purchase, different views were expressed, some had concern about this trend whereas others felt that their service users were aware of what they were purchasing:

Some services felt that synthetic cannabinoids may be appearing in “Weed/herbal” and “edible” products
One service raised concern on the current quality of products and stated that service users don't want to buy synthetic products “if it's the real thing or a substitute in general users are mainly not interested in synthetic cannabinoids”
Others had no concerns “No, they know what they are taking”

Profile of synthetic cannabinoid users

When asked about the profile of the user group choosing to use synthetic cannabinoids, 7 services felt that use was associated with younger service user groups

“Younger service users tend to experiment with synthetic cannabinoids but only if getting a good price, once get educated about synthetic cannabinoids tend to move away from use through concerns about getting cannabis that has been sprayed with toxins, etc obviously no quality control”

Rational for using synthetic cannabinoids

Of the 18 services who responded to questions on the use of synthetic cannabinoids:

2 reported that they are not being used in their service user community which meant that 16 services reported synethtic cannabinoids as a trend locally
50% (N=9 services) felt that use was opportunistic and because of availability and 33% (N=6 services) felt that use correlated with price
33% (N=6 services) felt that service users may be unknowingly consuming synthetic cannabinoids, so use in these cases use is not by choice

Conclusion

While this survey only presents data from a small number of services, it is important for this style of information to be captured nationally from service providers on an on-going basis. This information can help identify emerging trends and the information needs of service providers. More service providers should be encouraged to become involved to increase the geographical spread of reporting.

Unknown contents and the strength of products are key issues raised in this survey by service providers which shows the need to identify the types of products being consumed and which products could lead to adverse health reactions.

Nearly three quarter of services reported significant negative health outcomes among their service user populations. Of these, all reported significant mental health issues with half reporting behaviour issues such as violence. At point of care, it is important to identify if a person presenting to hospital has been exposed to a new psychoactive substance and which one it is if this information is available.

The majority of services reported that synthetic cannabinoids were being used by younger populations which correlated with price and availability. This area requires further review among services and young people to monitor the possible re-emergence of new psychoactive substances among younger age profiles.

The findings from this survey show emerging concern in some areas and the need for analytical drug monitoring to identify the presence of synthetic cannabinoids. Further, the area of new psychoactive substances and young people requires further consideration and research in Ireland.

Information about cannabinoids

A number of new trends have been identified both nationally and within the EU, such as new varieties of edible products as well as the emergence of synthetic cannabinoids in a range of products which is a cause for concern. A number of alerts have been issued throughout Europe relating to synthetic cannabinoids appearing in products without people knowing.