A new method to monitor drugs at dance venuesBMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7313.603 (Published 15 September 2001) Cite this as: BMJ 2001;323:603
- John D Ramsey, head, toxicology unita,
- Marcus A Butcher, toxicology service managera,
- Martin F Murphy, studentb,
- Terry Lee, senior clinical scientista,
- Atholl Johnston, head, laboratory servicesc,
- David W Holt, director, analytical unit ()a
- a St George's Hospital Medical School, London SW17 0RE
- b King's College, London SE1 8WA
- c St Bartholomew's and the Royal London School of Medicine and Dentistry, London EC1M 6BQ
- Correspondence to: D W Holt
- Accepted 11 July 2001
Information on the use of illicit drugs depends heavily on users' recall—what they remember, or think, that they have purchased—and on seizures by law enforcement agencies. Neither method may be able to give accurate information on what is currently available.1 We have developed a new method designed to gain information on current drug consumption in a London dance venue.
Methods and results
We analysed solid dose formulations retrieved from an amnesty bin at a London dance venue, into which visitors were required to discard illicit drugs and into which security staff place substances found during searches. We obtained a Home Office licence to analyse the contents of the bin, which were removed in the presence of a police officer and sealed in evidence bags. The data reported are for one year up to February 1999.
The 299 items, which ranged from single tablets to bags containing several, comprised 156 tablets and 90 powders; 26 cannabis items (joints, herbal material, or blocks of resin); 11 capsules; 10 knives; 5 “snorters” (often, but not exclusively, used to take cocaine or amphetamine); and 1 CS gas canister.
Initially, we tried to identify solid dose formulations using the TICTAC database (an identification CD Rom for tablets and capsules).2 We confirmed or established identification using a simple chemical test, the Marquis reagent3 and gas chromatography with mass-spectrometry detection. The Marquis reagent reacts with many of the drugs used in dance venues, including 3, 4-methylenedioxymethylamphetamine (MDMA, known as ecstasy) and several related compounds, producing various colour reactions.
The table shows the drugs detected in the 105 (67%) tablets and the 79 (88%) powder items that could be identified. A high proportion of the tablets contained MDMA, whereas the powders were predominantly amphetamine. Two formulations of MDMA were not known to the Forensic Science Service, and 16 formulations were not noted in TICTAC. Of concern clinically was the presence of 4-methylthioamphetamine (4-MTA, known as flatliners) in nine tablets. This drug is known to be highly toxic, having been implicated in four deaths in Britain and one in the Netherlands (see http://www.londontox.org.uk/) and does not give a colour reaction with the Marquis reagent. Although there were 17 seizures of 4-MTA in England during 1997-8, the drug was not thought to have been on the streets after late 1998. Our data show, however, that it was still in circulation during 1999.
The table also shows that several “prescription only” and “over the counter” medicines were also found, together with some items of confectionery, such as Smints. Some of these substances could have been used fraudulently to mimic illicit drugs, a distinct possibility in the case of paracetamol, which was found powdered and in wraps. It is likely that many of the capsules were food supplements, usually a cocktail of amino acids and vitamins, taken before ingesting ecstasy (a practice known as preloading).
In the era of evidence based medicine this method of monitoring drugs in dance venues does not rely on what the user thinks he or she has bought. If the contents of the bins were analysed regularly the results would reflect what is currently available on the streets. This would allow timely information to be disseminated on the appearance of new drugs or formulations, through the TICTAC database and its associated secure website. Accurate information on drug use would allow healthcare professionals to formulate better advice on avoiding injury through drug use and to design the most appropriate campaigns against drug use.4
Other clubs are willing to participate in a study of this nature, and our approach also has the benefit of encouraging a healthy cooperation between the police, clubs, researchers, and drug users.
We gratefully acknowledge the collaboration of the Metropolitan Police (Southwark) in London.
Contributors: JDR conceived and designed the study and contributed to the final manuscript. MAB helped in the analysis and prepared the first draft of the manuscript. MFM helped in the identification of the solid dose formulations and contributed to the final documentation of the results. TL developed the mass-spectrometry methodology, helped in the interpretation of data, and contributed to the manuscript. AJ helped in the data analysis and contributed to the manuscript. DWH was involved in the development of the study, the logistics of organising the analyses, and wrote the final manuscript.
Competing interests None declared.