Misuse of Drugs (Jersey) Law 1978: Proposed Classification of Substances as Controlled Drugs

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A decision made 4 July 2012:

Decision Reference: MD-HSS-2012-0023
Decision Summary Title :	Misuse of Drugs (Jersey) Law 1978 – Proposed Classification of Substances as Controlled Drugs		Date of Decision Summary:	14th June 2012
Decision Summary Author:	Chief Pharmacist		Decision Summary: Public or Exempt? (State clauses from Code of Practice booklet)	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:
Written Report Title :	Misuse of Drugs (Jersey) Law 1978 – Proposed Classification of Substances as Controlled Drugs		Date of Written Report:	14th June 2012
Written Report Author:	Chief Pharmacist		Written Report : Public or Exempt? (State clauses from Code of Practice booklet)
Subject: Misuse of Drugs (Jersey) Law 1978 – Proposed Classification of Substances as Controlled Drugs
Decision(s): The Minister endorsed the recommendation of the Misuse of Drugs Advisory Council and accordingly determined that an amendment to the Misuse of Drugs (Jersey) Law 1978, as amended, should be prepared that would classify a number of substances as controlled drugs.
Reason(s) for Decision: The Misuse of Drugs Advisory Council has recommended that a number of substances be classified as controlled drugs under the provisions of the Misuse of Drugs (Jersey) Law 1978
Resource Implications: None
Action required: The Law Draftsman to be requested to prepare the necessary amendment on the basis of a drafting brief to be provided by the Chief Pharmacist.
Signature:		Position: Minister for Health and Social Services
Date Signed:		Date of Decision (If different from Date Signed):

Misuse of Drugs (Jersey) Law 1978: Proposed Classification of Substances as Controlled Drugs

STATES OF JERSEY

HEALTH AND SOCIAL SERVICES DEPARTMENT

Misuse of Drugs (Jersey) Law 1978

Proposed Classification of Substances as Controlled Drugs

Issue

The Minister is requested to consider bring a range of substances under the control of the Misuse of Drugs (Jersey) Law 1978.

Introduction

The Misuse of Drugs Advisory Council (MDAC) is established in accordance with Article 2 of the Misuse of Drugs (Jersey) Law 1978 and has a duty to advise the Minister on measures, which in its opinion, should be taken to prevent the misuse of drugs and/or to deal with the social problems connected with drug abuse.

Substances recommended for control under the Misuse of Drugs (Jersey) Law 1978

The MDAC has given consideration to proposals to bring a range of substances under the control of the misuse of drugs legislation due to their potential to cause harm. The specific substances are as follows:

3.1. Phenazepam [7-bromo-5-(2-chlorophenyl)-1,3-dihydro-2H-1,4-benzodiazepin-2-one]

Phenazepam is a benzodiazepine drug with a potency around five times that of diazepam. It has recently been made subject to the Misuse of Drugs Act in the UK.

The MDAC recommends that phenazepam be controlled under the Misuse of Drugs (Jersey) Law 1978 as a Class C substance and scheduled as a Schedule 3 substance under the Misuse of Drugs (General Provisions) (Jersey) Order 2009.

3.2. Desoxypipradol (2-DPMP) and other pipradol related compounds

This compound is related to pipradol, a previously licensed medicine for the treatment of Attention Deficit Hyperactivity Disorder (ADHD), obesity and narcolepsy. Pipradol is classified under the Misuse of Drugs (Jersey) Law as a Class C substance. Pipradol is still used in some countries, but its use is limited due to its abuse potential.

Desoxypipradol has been identified in a product known as “Ivory Wave” which has been sold on the internet as a so called “legal high”. Use of desoxypipradol has been associated with symptoms that are similar to amphetamine toxicity but with predominant neuropsychiatric features including hallucinations, paranoia and severe agitation. In some cases these effects persisted for several days after ingestion.

The MDAC recommends that desoxypipradol and structurally related compounds are controlled under the Misuse of Drugs (Jersey) Law 1978 as Class B substances and scheduled as Schedule 1 substances under the Misuse of Drugs (General Provisions) (Jersey) Order 2009. In addition, as these compounds do not have an identified therapeutic use they should also be controlled under Part 1 of the Schedule to the Misuse of Drugs (Designation) (Jersey) Order 1989.

3.3. Methoxetamine [2-(ethylamino)-2-(3-methoxyphenyl)cyclohexanone]

The pattern of adverse events reported following acute use of Methoxetamine is similar to that seen with acute ketamine toxicity – including hallucinations, catatonia and dissociative effects. Methoxetamine appears to also present significant additional toxicity, the effects of which include agitation, cardiovascular effects including tachycardia and hypertension and cerebellar features such as ataxia. Ketamine is controlled as a Class C substance.

The MDAC recommends that methoxetamine (and its simple derivatives) be controlled under the Misuse of Drugs (Jersey) Law 1978 as Class C substances and scheduled as Schedule 1 substances under the Misuse of Drugs (General Provisions) (Jersey) Order 2009.

3.4. Tapentadol

Tapentadol is a recently developed centrally acting analgesic with effects and risks similar to opioids like morphine which is controlled as a Class A drug. Tapentadol presents a risk of misuse, diversion from legitimate sources, addiction, and potential medicinal misuse. The risks associated with an overdose of tapentadol are constriction of the pupils, vomiting, loss of consciousness, seizures, difficulty in breathing and a risk of serious complications likely to lead to death.

The MDAC recommends that tapentadol be controlled under the Misuse of Drugs (Jersey) Law 1978 as a Class A substance and scheduled as a Schedule 2 substance under the Misuse of Drugs (General Provisions) (Jersey) Order 2009.

3.5. Amineptine

Amineptine is a powerful and fast acting antidepressant, misuse of which has been reported mainly in Asia and Europe. The Commission on Narcotic Drugs, on the recommendation of the World Health Organisation, has included amineptine in Schedule II of the Convention on Psychotropic Substances of 1971. Amineptine has the potential for both dependence and misuse, predominantly in patients with a previous history of substance misuse. The withdrawal symptoms include anxiety, psychomotor agitation and insomnia.

The MDAC recommends that amineptine be controlled under the Misuse of Drugs (Jersey) Law 1978 as a Class C substance and scheduled as a Schedule 2 substance under the Misuse of Drugs (General Provisions) (Jersey) Order 2009.

3.6. Gamma-butyrolactone (GBL) and 1,4-butanediol (1,4-BD)

GBL and 1,4-BD are chemicals that have widespread legitimate uses (for example, in nail polish, paints and as industrial solvents) but are also misused. They are pro-drugs of the Class C drug gamma-hydroxybutyrate (GHB), meaning that when either substance is ingested it is rapidly converted to GHB. The effects and risks associated with their misuse are unconsciousness, a risk of death by intoxication and a dependence syndrome if used regularly. The risks are increased if combined with alcohol or other depressant substances.

The MDAC recommends that GBL and 1,4-BD are controlled under the Misuse of Drugs (Jersey) Law 1978 as a Class C substances. The MDAC also recommends that amendments to the Misuse of Drugs (General Provisions) (Jersey) Order 2009 are made to ensure that legitimate use of these substances is not prevented. In addition, as these compounds do not have an identified therapeutic use they should also be controlled under Part 1 of the Schedule to the Misuse of Drugs (Designation) (Jersey) Order 1989.

3.7. Oripavine

Oripavine is found in poppy straw or the opium poppy which can be converted to thebaine (controlled under the Medicines (Jersey) Law 1978 as a Class A drug) and used in the production of semi-synthetic opioids such as hydrocodone and oxycodone. The view of the UK Advisory Council on the Misuse of Drugs is that oripavine’s potential harm is commensurate with drugs in Class C such as the opioid buprenorphine.

The MDAC recommends that oripavine be controlled under the Misuse of Drugs (Jersey) Law 1978 as a Class C substance and scheduled as a Schedule 2 substance under the Misuse of Drugs (General Provisions) (Jersey) Order 2009.

3.8. Nabilone

Nabilone is a synthetic cannabinoid with therapeutic use as an antiemetic and as an adjunct analgesic for neuropathic pain. It is a synthetic cannabinoid, which mimics the main chemical compound of cannabis (THC).

The MDAC recommends that nabilone be controlled under the Misuse of Drugs (Jersey) Law 1978 as a Class B substance and scheduled as a Schedule 2 substance under the Misuse of Drugs (General Provisions) (Jersey) Order 2009.

3.9. 15 anabolic steroids and 2 non-steroidal agents (growth promoters)

A number of anabolic steroids and growth factors are already controlled as Class C drugs under the provisions of the Misuse of Drugs (Jersey) Law 1978. The control of a further 15 anabolic steroids and 2 non-steroidal agents (growth promoters) will update the list of those substances currently controlled.

When misused steroids have a range of physical and psychological harms. The original group of in excess of 50 anabolic steroids (as well as 5 growth hormones) which came under the control of the 1978 Law as Class C drugs were identified by reference to the International Olympic Commission Prohibited List. It is appropriate to update the control of such drugs by reference to its successor, the World Anti-Doping Agency Prohibited List.

The MDAC recommends that the following anabolic steroids are controlled as Class C drugs: 5α-Androstane-3,17-diol, Androst-4-ene-3,17-diol, 1-Androstenediol, 1-Androstenedione, 5-Androstenedione, Boldione, Danazol, Desoxymethyltestosterone, Gestrinone, 3-Hydroxy-5α-androstan-17-one, 19-Norandrostenedione, 19-Norandrosterone, 19-Noretiocholanolone, Prostanozol and Tetrahydrogestrinone, along with the growth promoters Zeranol and Zilpaterol. These substances should also be scheduled as Schedule 4 substances under the Misuse of Drugs (General Provisions) (Jersey) Order 2009.

3.10. 6-(2-aminopropyl)benzofuran and 5-(2-aminopropyl)benzofuran (6-APB and 5-APB or Benzo Fury)

6-APB and 5-APB are stimulant drugs chemically related to the phenethylamine and substituted amphetamine classes. Based on this chemical similarity to other amphetamines it is likely that they will have similar pharmacological activity although this has not been validated.

The MDAC recommends that 6-APB and 5-APB be controlled under the Misuse of Drugs (Jersey) Law 1978 as a Class B substances and scheduled as a Schedule 1 substances under the Misuse of Drugs (General Provisions) (Jersey) Order 2009.

Recommendation

The Minister is requested to approve the recommendations of the Misuse of Drugs Advisory Council to bring the substances described above under the control of the Misuse of Drugs (Jersey) Law 1978 in the manner described and to direct the Chief Pharmacist to prepare a brief for consideration by the Law Draftsman.