Equasy – An overlooked addiction with implications for the current debate on drug harms

“So what was her addiction – what is equasy? It is an addiction that produces the release of adrenaline and endorphins and
which is used by many millions of people in the UK including
children and young people. The harmful consequences are well
established – about 10 people a year die of it and many more
suffer permanent neurological damage as had my patient. It has
been estimated that there is a serious adverse event every 350
exposures and these are unpredictable, though more likely in
experienced users who take more risks with equasy. It is also
associated with over 100 road traffic accidents per year – often
with deaths. Equasy leads to gatherings of users that often are
associated with these groups engaging in violent conduct.
Dependence, as defined by the need to continue to use, has
been accepted by the courts in divorce settlements. Based on
these harms, it seems likely that the ACMD would recommend
control under the MDAct perhaps as a class A drug given it
appears more harmful than ecstasy (See Table 1).

Have you worked out what equasy is yet? It stands for
Equine Addiction Syndrome, a condition characterised by gaining pleasure from horses and being prepared to countenance the
consequences especially the harms from falling off/under the
horse. I suspect most people will be surprised that riding is
such a dangerous activity. The data are quite startling – people
die and are permanently damaged from falling – with neck and
spine fracture leading to permanent spinal injury (Silver and
Parry, 1991; Silver 2002). Head injury is four times more com-
mon though often less obvious and is the usual cause of death.
In the USA, approximately 11,500 cases of traumatic head
injury a year are due to riding (Thomas, et al., 2006), and we
can presume a proportionate number in the UK. Personality
change, reduced motor function and even early onset
Parkinson’s disease are well recognised especially in rural clinical practices where horse riding is very common. In some shire counties, it has been estimated that riding causes more head
injury than road traffic accidents. Violence is historically inti-mately associated with equasy – especially those who gather
together in hunting groups; initially, this was interspecies aggression but latterly has become specific person to person violence
between the pro and anti-hunt lobby groups.”

“So why are harmful sporting activities allowed, whereas relatively less harmful drugs are not? I believe this reflects a societal
approach which does not adequately balance the relative risks of
drugs against their harms. It is also a failure to understand the
motivations of, particularly younger people, who take drugs and
their assessment of the perceived risks compared with other
activities. The general public, especially the younger generation,
are disillusioned with the lack of balanced political debate about
drugs. This lack of rational debate can undermine the trust in
government in relation to drug misuse and thereby undermining
the government’s message in public information campaigns.”


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