Recreational Drug Toxicology with Dima Abdulrahim

Pre-Hospital Care Podcast - A podcast by Eoin Walker

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In this session we will examine the latest perspectives and insights into recreational drug toxicology with Dima Abdulrahim. I wanted to unpack some of the recreational drug toxicology with reference to drugs that seem to be in favour with youth and have pre-hospital touch points from an acute perspective. Dima Abdulrahim has been working in the field of substance use treatment for 30 years. She is currently the Quality Lead in the Addictions department of CNWL NHS Trust. Dima was the Principal Researcher and Programme Manager of the NEPTUNE Project, based in the Club Drug Clinic. She is the author of two books on novel psychoactive substances and club drugs and other publications and has developed as a series of e-learning and mobile-learning modules, with co-author Owen Bowden-Jones. Dima was a council member of the Advisory Council for the Misuse of Drugs (ACMD) for many years. Topics covered include a deep dive into: • Some of the most addictive recreational substances Dima has seen in practice  • Poly-pharmacy and the associated incremental risk profile to the user • The combined use of sildenafil with other drugs within the chem-sex context • GHB addiction and profile and the narrow therapeutic window and GABA-B stimulation/sedation (and over sedation) in overdose • The half-life of GHB  • Serotonin linked harms and syndromes, mainly within MDMA and ecstasy • The incumbent fentanyl crisis (unwarranted and unregulated cutting of drugs with fentanyl) • The false economy of safety around drugs bought online • The contemporary issue around fake ketamine distribution • The circulation of fake pregabalin and benzodiazepines and the related deaths • Take home Naloxone campaigns  • Other emergent synthetic recreational drugs seen within the clinic Resources that Dima has written include:  Books:  Abdulrahim D and Bowden-Jones O: Textbook of Clinical Management of Club Drugs and Novel Psychoactive Substances Cambridge University Press Medicine. October 2022 (book) Bowden-Jones and Abdulrahim: Club Drugs and Novel Psychoactive Substances. The Clinical Handbook. Cambridge University Press Medicine. November 2020 (book) Resources (available free of charge) NEPTUNE e-learning modules on club drugs and novel psychoactive substances http://neptune-clinical-guidance.co.uk/e-learning/ Neptune guidelines and resources http://neptune-clinical-guidance.co.uk/ ATOMIC- Addiction to Medication: Improving Care. Mobile-learning modules on the harms and management of non-medical prescription drug use. https://addiction-to-medication.org/atomic/ My thanks to Dima for an engaging and insightful interview.