Rapid Action Drug Alerts and Response (RADAR) quarterly report
July 2023
A Management Information Statistics publication for Scotland
- Published
- 25 July 2023
- Type
- Statistical report
- Author
- Public Health Scotland
Trends
Police drug trends bulletin
This bulletin contains photos of drugs.
This update provides information on street benzodiazepines and synthetic cannabinoids.
This information has been provided by Police Scotland’s Statement of Opinion (STOP) Unit to raise awareness of drug appearance and to demonstrate some of the substances present in Scotland’s drugs market.
Street benzos
'Street benzos' is a term used to describe benzodiazepines that are unlicensed or illicitly produced.
Police Scotland continues to see a rise in the recoveries of bromazolam in various forms. Bromazolam is a class C controlled drug within the provisions of the Misuse of Drugs Act 1971. It is a depressant drug classed as a benzodiazepine.
Bromazolam tablets
The most commonly encountered street benzo is white and stamped '10', with a half score on the reverse. This tablet is now more commonly recovered containing bromazolam, than the previous etizolam.
Bromazolam powder
Although most commonly recovered in tablet form, recent intelligence shows bromazolam is being smuggled into prisons throughout Scotland, predominantly in white, pink or tan powder form.
In a recent incident in the west of Scotland, multiple prisoners suffered a suspected overdose after consuming bromazolam powder. Less than five were hospitalised and admitted to intensive care. The symptoms included excessive vomiting, unresponsive, loss of verbal communication, memory loss and difficulty breathing.
Toxicology results from NHS services were positive for benzodiazepines. A recovery of powder was rapidly assessed by the Scottish Police Authority Forensic Services (SPA FS) laboratory and found to contain bromazolam.
It is assessed that bromazolam has a similar potency to other benzodiazepine-type drugs, such as clonazolam, but it is unclear how its potency compares to that of etizolam.
Synthetic cannabinoids
Most synthetic cannabinoids are deemed Class B drugs under the Misuse of Drugs Act 1971. Newer ones are covered by the Psychoactive Substances Act 2016. They have various official chemical names, but they are known and marketed by names such as 'spice' and 'black mamba'.
ADB-BUTINACA
ADB-BUTINACA, a new synthetic cannabinoid, has been detected in recent overdoses.
ADB-BUTINACA first appeared in drugs markets in 2019. Online forum posts by people who self-report use suggest that its primary route of administration is inhalation by smoking after the chemical has been sprayed onto herbal material or impregnated onto paper destined for the prison environment. Oral use has also been reported. ADB-BUTINACA has previously been found in a small number of recoveries of 'street Valium' in Scotland.
In a recent incident in the east, two people suffered a suspected overdose and were hospitalised after having consumed an unknown cream or brown-coloured powder. One person was found unresponsive and the other person’s condition deteriorated rapidly upon police and ambulance service arrival.
A number of small deals of the substance were recovered and urgent analysis carried out by the SPA FS laboratory confirmed the substance to be ADB-BUTINACA. The substance was packaged in a similar manner to street deals of diamorphine (heroin) and also has the visual appearance of diamorphine. It is further assessed that people may inadvertently consume this substance on the pretence of it being diamorphine.
RADAR intelligence and reports
24 reports were validated by RADAR between 5 April and 4 July 2023.
A summary of validated reports is shown below for informational purposes.
Emerging concerns
Over 50% of submissions report polydrug use – the use of more than one substance at a time. Mixing drugs increases the risk of drug harms and death, this includes mixing alcohol with other drugs.
30% of reports relate to drugs being contaminated, 'laced' or stronger than expected. Although not all these reports are confirmed by toxicology, it highlights there are concerns about the unexpected effects of drugs in the market.
RADAR is assessing the harms related to cocaine and has current alerts for nitazene-type opioids and new benzos - bromazolam.
Drug harm reports to RADAR
Since July 2022, RADAR has validated over 90 reports of drug-related information and harms received through the reporting form and mailbox.
Shown below are 24 reports validated between 5 April and 4 July 2023.
Please note, many of these reports have not been confirmed by toxicology and should be considered anecdotal.
Reports validated prior to 5 April, are shown in previous quarterly reports.
Report 2
Local authority: National
Reason for report: Adverse effects
Drug: Cocaine
Appearance: White powder
Summary: Increase in cocaine use and harms (nasal problems, soft tissue damage, increase in PR3 antibodies). Concern that harms are increased by cutting agents, such as levamisole.
Report 7
Local authority: National
Reason for report: New drug
Drug: Bromazolam
Appearance: Various
Summary: Ongoing prevalence of bromazolam in prisons in pill, powder and paper form.
Report 17
Local authority: National
Reason for report: New drug
Drug: Xylazine
Appearance: Unknown
Summary: RADAR has received multiple enquiries related to the emergence of xylazine, a new depressant drug. There have been two known detections of xylazine in Scotland by WEDINOS:
- January 2020, East Ayrshire, white crystalline powder, sold as ketamine
- June 2022, Fife, colourless liquid, sold as THC vape liquid
RADAR will continue to monitor and assess the threat of new substances such as xylazine.
Report 1
Local authority: Fife
Reason for report: New drug
Drug: Bromazepam
Appearance: Tablets
Summary: 3 mg tablets sold as diazepam but contain bromazepam.
Report 3
Local authority: Dundee city
Reason for report: Trend
Drug: Ketamine
Appearance: Unknown
Summary: Use of ketamine in young people.
Report 5
Local authority: Fife
Reason for report: New drug
Drug: Tapentadol
Appearance: Unknown
Summary: First time seeing tapentadol [opioid] associated with death. Polydrug use with several other substances detected.
Report 8
Local authority: Fife
Reason for report: Adverse effects, overdose
Drug: Valium
Appearance: Unknown
Summary: Concern that Valium is contaminated after people overdosed, even after taking small amounts. Increase in patients presenting very sedated and other adverse effects including itchy skin, psychosis and hallucinations.
Report 9
Local authority: City of Edinburgh
Reason for report: Adverse effects
Drug: Heroin
Appearance: Yellow crystal that turns to 'tar-like' substance when heated
Summary: Heroin marketed as 'scab’ and sold as being double the strength of normal heroin.
Report 10
Local authority: Scottish Borders
Reason for report: Adverse effects, overdose
Drug: Heroin
Appearance: Unknown
Summary: Nausea and vomiting, memory loss and overdose after injecting 0.3 grams of heroin. Felt unwell, felt themselves 'going over', and woke up in hospital. Another person stated that they had smoked around 0.2 g and said it was strong and that they had not had heroin like this for a long time.
Report 12
Local authority: Falkirk
Reason for report: Trend
Drug: Cocaine
Appearance: Liquid
Summary: Cocaine administered using a liquid nasal spray.
Report 13
Local authority: Falkirk
Reason for report: Adverse effects, overdose
Drug: Spice
Appearance: Orange powder
Summary: Adverse effects from spice smoked in a pipe: difficulty breathing, memory loss, loss of consciousness and cardiac arrest.
Report 14
Local authority: City of Edinburgh
Reason for report: Concern
Drug: Cocaine
Appearance: Unknown
Summary: Poor quality crack cocaine thought to be due to people buying prop [high purity cocaine powder] and making crack themselves with ammonia and bicarbonate [baking soda].
Report 15
Local authority: Fife
Reason for report: Photo
Drug: Street benzo
Appearance: White pill, half score on one side and a 10 on the other side
Summary: Effects: increased energy. Pill was tested by WEDINOS and returned as etizolam.
Report 16
Local authority: Scottish Borders
Reason for report: Photo
Drug: Street benzo
Appearance: Bright blue pill, score line on one side
Summary: Adverse effects: confusion, really sleepy, could not keep eyes open and could not remember what had happened days later. Pill was tested by WEDINOS and returned as bromazolam.
Report 18
Local authority: City of Edinburgh
Reason for report: Adverse effects
Drug: Cocaine
Appearance: Unknown
Summary: Cocaine powder being mixed with legal high, magic [mephedrone]. Adverse effects: hallucinations and headaches.
Report 19
Local authority: City of Edinburgh
Reason for report: Concern
Drug: Valium
Appearance: Blue circle pill
Summary: Valium pill stamped with KB10, adverse effects were consistent for benzodiazepines but more intense.
Report 21
Local authority: Scottish Borders
Reason for report: Adverse effects
Drug: Tapentadol
Appearance: Red or orange round pill, no markings
Summary: Tablets known as red apples, confirmed by WEDINOS to contain tapentadol [opioid]. Adverse effects of swallowing one pill include: confusion, auditory and visual hallucinations and paranoia. Sold loose for £4 per pill.
Report 23
Local authority: City of Edinburgh
Reason for report: Adverse effects
Drug: Cocaine
Appearance: Bright yellow crystal
Summary: Crack cocaine mixed with legal high, magic [mephedrone].
Report 24
Local authority: City of Edinburgh
Reason for report: Adverse effects, trend
Drug: Valium
Appearance: Unknown
Summary: Valium described as stronger. Reduced response to naloxone in overdoses in situations of polydrug use.
Report 4
Local authority: Renfrewshire
Reason for report: Anti-social behaviour, littering
Drug: Nitrous oxide
Appearance: Unknown
Summary: Variety of large (600–650 g) branded nitrous oxide canisters left behind after use by young people.
Report 6
Local authority: East Ayrshire
Reason for report: New drug, adverse effects, overdose
Drug: Bromazolam
Appearance: Tan or pink powder
Summary: Adverse effects after consuming 'grains' of powder: overdose and hospitalisation. Confirmed by toxicology to be bromazolam.
Report 20
Local authority: Renfrewshire
Reason for report: Adverse effects, trend
Drug: Cannabis
Appearance: Sweets: disguised as Chewits and Squashies
Summary: Use of cannabis (THC) edibles. Adverse effects after swallowing sweets: aggression, confusion, decreased energy, loose jaw, sedation, unusual behaviour and verbally hostile. Presented as a normal sweet and once the wrapper was removed there was a strong potent smell.
Report 22
Local authority: Glasgow City
Reason for report: Trend
Drug: Street benzo
Appearance: White paper in 7x5cm (approximate) sections, with a square grid pattern
Summary: Tabs of paper seized that looked similar to LSD but thought to contain etizolam.
Report 11
Local authority: Aberdeen City
Reason for report: Adverse effects
Drug: Street benzos
Appearance: Unknown
Summary: Depressed breathing, unresponsiveness and overdose after swallowing benzos bought from a dealer. Concern about the drugs being contaminated after reports of overdoses and deaths in the area.
Reporting drug harms
The information in the regional breakdown can be used by local areas for their own drug trend surveillance. Please encourage people and services in your area to share information on trends, incidents and harms related to drugs, such as:
- adverse effects including overdose
- routes of administration
- new substances or patterns of use
- testing data.
Anyone can make a report by using our reporting form or by emailing phs.drugsradar@phs.scot