Emergency Info

Guidelines on when to call the Emergency Services 999 for unwell recreational drug users

Call 999 if ANY one of the following is present:

Unconsciousness – if the patient does not respond to vocal commands, requires painful stimulus (e.g. pressure across the fingernails) to respond or does not respond at all.

Significant agitation (e.g. pacing around the room) or aggression not settling within 15 minutes.

Seizures (e.g. a convulsion similar to an epileptic fit)

Breathing difficulties such as fast breathing rate which does not settle within 15 minutes.

Heart rate over 140 beats per minute not settling within 5 minutes.

Temperature over 38.5 not settling after about 5 minutes of rest, or if very flushed and feels very hot if no thermometer is available.

Blood pressure – Systolic (“upper pressure”) over 180mmHg, or Diastolic (“lower pressure”) over 110mmHg on two repeated blood pressure measurements.

Other concerns – if there are any other concerns (e.g. severe headache, chest pain).


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Public drug checking

The best known UK organisation in this field is The Loop, a non-profit social enterprise which provides drug safety testing, welfare and harm reduction services at festivals and which was established in 2013.

This is how it works. Festival goers can bring any substances of concern for testing and receive results as part of an individually tailored brief intervention by healthcare staff. Users put a dose – a pill or approximately 5 mg of powder – into a small plastic bag which they seal and post in a locked amnesty bin. Individuals receive a unique ID number and are asked to return about an hour later while the substance is tested on site. In that time, the Loop’s team of professional chemists conducts up to five different analyses to best identify the sample in their pop up lab.

A recent evaluation1 of The Loop’s work makes for interesting reading. Tests revealed that nearly one in five samples (19.5%) were different from what they were sold as. The most interesting part of the evaluation records what people who used the testing service said they intended to do when they were told what was actually in their drugs. About one in five people chose to use the police approved disposal service. Two thirds of those who found out their drugs were not what they thought they were handed over further substances in their possession.

The team at The Loop also provided a number of people who tested substances with onward referral to local health services.

Indeed, perhaps the main benefit of drug checking services is to engage drug using festival goers in conversations about how to reduce the harms of taking illegal drugs. People discuss not only their drug-related issues and concerns during the consultation, but often also questions about interactions between illegal drugs and medications or the contraceptive pill, managing a serious medical condition such as MS, and other health concerns that they prefer not to discuss with their own GP.


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