EMCDDA DOCUMENTATION CENTRE
INFORMATION BULLETIN
GENERAL INFORMATION BULLETIN
18 March 2016
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EVENT
Improving Outcomes in the Treatment of Opioid Dependence (IOTOD) 2016
21–23 June 2016
Bristol, UK
IOTOD 2016 will continue and extend the well-received interactive format of previous meetings, with case-based workshops, plenary sessions, panels, and presentations by leading international experts. As in previous years, our practically focused and highly interactive forum promises to condense a wealth of international experience and insight into a stimulating 3 days, during which attendees will be invited to contribute to developing ways of applying the evidence base to clinical practice. Attended by up to 250international clinicians working in the opioid dependence field, this is also an important opportunity to extend networks amongst treatment providers.
We look forward to IOTOD 2016, which promises to be an enlightening and engaging meeting, providing delegates with the opportunity to enhance clinical knowledge – thereby improving outcomes for both clinicians and their patients.
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GREY LITERATURE
IDPC drug policy guide – 3rd Edition
International Drug Policy Consortium (IDPC)
London: March 2016
It brings us great pleasure to present the third edition of the IDPC Drug Policy Guide as the IDPC network celebrates its 10th anniversary. This edition is more comprehensive and forward looking than ever before, and embodies the breadth and diversity of the consortium, which has grown both geographically and in thematic diversity since IDPC’s inception ten years ago.
This Guide brings together global evidence, best practice and experiences to provide expert analysis across the spectrum of drug policy. This analysis has been made possible through the contributions from many IDPC members – including networks of key affected populations – and is the only document of its kind to provide such a broad and comprehensive investigation of what works and what doesn’t in drug control policies.
The alternative World Drug Report – 2nd Edition
Rolles, S; Murkin, G; Powell, M; Kushlick, D; Slater, J;
Count the Costs
London: March 2016
In April, the world will come together at the UN to discuss the future of international drug policy. It will be the first time that far-reaching drug policy reforms are meaningfully discussed at such a high level.
The current enforcement-based, UN-led drug control system is coming under unparalleled scrutiny over its failure to deliver a promised “drug-free world”, and for what the UN Office on Drugs and Crime (UNODC) describes as its negative “unintended consequences”. It is unacceptable that despite acknowledging these negative impacts, the UNODC does not include them in its annual World Drug Report, and neither the UN nor its member states have meaningfully assessed whether these unintended consequences outweigh the intended consequences.
The second edition of the Alternative World Drug Report fills this gap by detailing the full range of negative impacts caused by the drug war. It demonstrates that the current approach is creating crime, harming health, and fatally undermining all “three pillars” of the UN’s work – peace and security, development, and human rights.
The stark failure of the current system has meant that alternative drug policy approaches are a growing reality. This report therefore explores a range of options for reform, including decriminalisation and legal regulation, that could deliver better outcomes,.
The global prohibitionist consensus has broken, and cannot be fixed. This Alternative World Drug Report is intended to help policymakers shape what succeeds it.
New Psychoactive Substances - Leaflet and poster
UNODC
Vienna: March 2016
Neuroscience in youth drug prevention programs
Canadian Centre on Substance Abuse (CCSA)
Ottawa: March 2016
Evaluations of prevention programs based on neuroscience are promising in terms of enhancing awareness about the effects of drugs on the brain among youth.
Although research is limited, in some cases neuroscience-based programs can influence perceptions of drug-related risks.
Prevention programs that incorporate neuroscience should be evaluated over a longer period to examine their impact in preventing substance use.
Substance abuse during pregnancy
[State Policies In Brief]
Guttmacher Institute
New York, NY: 1 March 2016
El cannabis: una droga inofensiva?
Miñaro López, J; Bueno Cañigral, F-J; Benavent, R A (eds.)
Universitat de Valencia
Valencia: 24 November 2015
Methamphetamine in Sydney: perspectives from DUMA [Drug Use Monitoring in Australia] police detainees
Eileen Patterson, Susan Goldsmid & Alexandra Gannoni
Australian Institute of Criminology: Research in Practice 47
Canberra: March 2016
Addiction, self-signalling, and the deep self
Holton, R
Richard Holton, 2016
[FULL TEXT AVAILABLE]
Principles of substance abuse prevention for early childhood
National Institute on Drug Abuse (NIDA)
March 2016
This special supplement to that volume reflects a growing body of research that has continued to accumulate showing that providing a stable home environment, adequate nutrition, physical and cognitive stimulation, warm supportive parenting, and good classroom management in the early years of a child’s life (prenatal through age 8) can lead the child to develop strong self-regulation | NIDA, USA
Assessing the utility of Project STOP in reducing pseudoephedrine diversion to clandestine laboratories
Ferris, J; Devaney, M; Mazerolle, L; Sparkes-Carroll, M
Trends & Issues in Crime and Criminal Justice no.509
Australian Institute of Criminology
Canberra: March 2016
Driving under influence: drugs
To ask the Secretary of State for Transport, what plans his Department has to update the Drug Driving (Specified Limits) (England and Wales) Regulations 2014, so as to reduce the amount of a drug that can be detected in blood for the purposes of the definition of that offence | They Work for You, UK
Naloxone
To ask the Secretary of State for Health, pursuant to the Answer of 1 December 2015 to Question 17278, what progress Public Health England has made on investigating the use of Office for National Statistics data on drug-related deaths to assess the impact of increased naloxone availability; and if he will make a statement | They work for you, UK
Drugs Strategy
To ask the Scottish Government whether it considers that its drugs strategy, “The Road to Recovery”, is working effectively | They work for you, UK
A public health approach to drug use in Asia: Principles and practices for decriminalisation
IDPC
London: 10 March 2016
In this report, the International Drug Policy Consortium offers recommendations based on evidence and examples of good practice to inform a shift in policy responses to drug use in Asia away from criminalisation and punishment, and towards public health and harm reduction | IDPC, UK
Striving for system-wide coherence: An analysis of the official contributions of United Nations entities for the UNGASS on drugs – Briefing
IDPC
London: 10 March 2016
In April 2016, the General Assembly of the United Nations (UN) will convene its 30th Special Session (or ‘UNGASS’) – and the third to focus on the ‘world drug problem’. The General Assembly has called for an ‘inclusive preparatory process that includes extensive substantive consultations, allowing organs, entities and specialized agencies of the United Nations system, relevant international and regional organizations, civil society and other relevant stakeholders to fully contribute to the process’ | IDPC, UK (PDF)
Terminology and information on drugs, 3rd Edition
UNODC
Geneva: March 2016
The UNODC publication Terminology and Information on Drugs introduces basic concepts and materials on substances under international control, which are most frequently manufactured or processed and/or abused, as well as definitions of scientific terms used in this context. The current revision of this publication is being prepared as a response to changes in drug markets and scheduling decisions of the Commission on Narcotic Drugs in recent years | UNODC, Austria
A quiet revolution: drug decriminalisation across the globe
Eastwood, N; Fox, E; Rosmarin, A
Release
London: March 2016
This is the second edition of ‘A quiet revolution: drug decriminalisation across the globe’. The first edition was released in July 2012 and has since been cited by a wide range of organisations and agencies, including: the World Health Organisation, the Office of the United Nations High Commissioner for Human Rights, and the Global Commission on Drug Policy. This edition builds on the 2012 publication, providing updates on the jurisdictions originally covered and highlighting a number of new countries that have adopted a non-criminal justice response to the possession of drugs for personal use.
Many countries continue to incarcerate and criminalise people for possession or use of drugs, with criminalisation alone undermining employment, education and housing opportunities. In addition, many people who use drugs are often subject to human rights abuses by the state in jurisdictions which continue to criminalise them. The continued targeting of this group has not only a negative impact on the individuals in question, but their families and broader society as a whole. The aim of this report is to inform the public and policymakers alike on the impact of decriminalising drug possession offences, showing that decriminalisation does not lead to increased rates of use while equally demonstrating that law enforcement led approaches have little impact on this metric. Rather, the decision to end the criminalisation of people who use drugs can negate the harms highlighted above when done effectively and produce positive social, health and economic outcomes, not just for the individual, but for society as a whole.
JOURNAL ARTICLES
Estimating the number of regular and dependent methamphetamine users in Australia, 2002-2014
Degenhardt, L; Lamey, S; Chan, G; Dobbins, T; Weier, M; Roxburgh, A; Hall, W D; McKetin, R
Medical Journal of Australia
204 (4) 1.e1-1.e6
Objective:
To estimate the number of regular and dependent methamphetamine users in Australia.
Design:
Indirect prevalence estimates were made for each year from 2002e03 to 2013e14. We applied multiplier methods to data on treatment episodes for amphetamines (eg, counselling, rehabilitation, detoxification) and amphetamine-related hospitalisations to estimate the numbers of regular (at least monthly) and dependent methamphetamine users for each year. Dependent users comprised a subgroup of those who used the drug regularly, so that estimates of the sizes of these two populations were not additive.
Results:
We estimated that during 2013e14 there were 268000 regular methamphetamine users (95% CI, 187000e385000) and 160000 dependent users (95% CI, 110000e232000) aged 15e54 years in Australia. This equated to population rates of 2.09% (95% CI, 1.45e3.00%) for regular and 1.24% (95% CI, 0.85e1.81%) for dependent use. The rate of dependent use had increased since 2009e10 (when the rate was estimated to be 0.74%), and was higher than the previous peak (1.22% in 2006e07). The highest rates were consistently among those aged 25e34 years, in whom the rate of dependent use during 2012e2013 was estimated to be 1.50% (95% CI, 1.05e2.22%). There had also been an increase in the rate of dependent use among those aged 15e24 years (in 2012e13 reaching 1.14%; 95% CI, 0.80e 1.69%).
Conclusions:
There have been increases over the past 12 years in the numbers of regular and dependent methamphetamine users in Australia. Our estimates suggest that the most recent numbers are the highest for this period, and that the increase has been most marked among young adults (those aged 15e34 years).
Implications:
There is an increasing need for health services to engage with people who have developed problems related to their methamphetamine use.
[FULL TEXT AVAILABLE]
Naloxone without the needle-systematic review of candidate routes for non-injectable naloxone for opioid overdose reversal
Strang, J, McDonald, R, Alqurshi, A, Royall, P, Taylor, D, & Forbes, B
Drug and Alcohol Dependence, February 2016, 10.1016/j.drugalcdep.2016.02.042
Introduction:
Deaths from opioid overdose can be prevented through administration of the antagonist naloxone, which has been licensed for injection since the 1970s. To support wider availability of naloxone in community settings, novel non-injectable naloxone formulations are being developed, suitable for emergency use by nonmedical personnel.
Objectives:
1) Identify candidate routes of injection-free naloxone administration potentially suitable for emergency overdose reversal; 2) consider pathways for developing and evaluating novel naloxone formulations.
Methods:
A three-stage analysis of candidate routes of administration was conducted: 1) Assessment of all 112 routes of administration identified by FDA against exclusion criteria. 2) Scrutiny of empirical data for identified candidate routes, searching PubMed and WHO International Clinical Trials Registry Platform using search terms “naloxone AND [route of administration]”. 3) Examination of routes for feasibility and against the inclusion criteria.
Results:
Only three routes of administration met inclusion criteria: nasal, sublingual and buccal. Products are currently in development and being studied. Pharmacokinetic data exist only for nasal naloxone, for which product development is more advanced, and one concentrated nasal spray was granted licence in the US in 2015. However, buccal naloxone may also be viable and may have different characteristics.
Conclusion:
After 40 years of injection-based naloxone treatment, non-injectable routes are finally being developed. Nasal naloxone has recently been approved and will soon be field-tested, buccal naloxone holds promise, and it is unclear what sublingual naloxone will contribute. Development and approval of reliable non-injectable formulations will facilitate wider naloxone provision across the community internationally.
[FULL TEXT AVAILABLE]
The cutting of cocaine and heroin: a critical review
Broseus, J; Gentile, N; Esseiva, P
Forensic Science International
26 February 2016
doi:10.1016/j.forsciint.2016.02.033
The illicit drug cutting represents a complex problem that requires the sharing of knowledge from addiction studies, toxicology, criminology and criminalistics. Therefore, cutting is not well known by the forensic community.
Thus, this review aims at deciphering the different aspects of cutting, by gathering information mainly from criminology and criminalistics. It tackles essentially specificities of cocaine and heroin cutting. The article presents the detected cutting agents (adulterants and diluents), their evolution in time and space and the analytical methodology implemented by forensic laboratories. Furthermore, it discusses when, in the history of the illicit drug, cutting may take place. Moreover, researches studying how much cutting occurs in the country of destination are analysed. Lastly, the reasons for cutting are addressed.
According to the literature, adulterants are added during production of the illicit drug or at a relatively high level of its distribution chain (e.g. before the product arrives in the country of destination or just after its importation in the latter). Their addition seems hardly justified by the only desire to increase profits or to harm consumers’ health. Instead, adulteration would be performed to enhance or to mimic the illicit drug effects or to facilitate administration of the drug. Nowadays, caffeine, diltiazem, hydroxyzine, levamisole, lidocaïne and phenacetin are frequently detected in cocaine specimens, while paracetamol and caffeine are almost exclusively identified in heroin specimens. This may reveal differences in the respective structures of production and/or distribution of cocaine and heroin.
As the relevant information about cutting is spread across different scientific fields, a close collaboration should be set up to collect essential and unified data to improve knowledge and provide information for monitoring, control and harm reduction purposes. More research, on several areas of investigation, should be carried out to gather relevant information.
Substance use among Dutch homeless people, a follow-up study: prevalence, pattern and housing status
Barbara Van Straaten, Gerda Rodenburg, Jorien Van der Laan, Sandra N. Boersma, Judith R.L.M. Wolf, Dike Van de Mheen
European Journal of Public Health
6 August 2015
DOI:
Background:
Previous studies have shown that substance use among homeless people is a prevalent problem that is associated with longer durations of homelessness. Most studies of substance use among the homeless were carried out outside Europe and have limited generalizability to European countries. This study therefore aimed to address the prevalence of substance use among homeless people in the Netherlands, the pattern of their use and the relationship with housing status at follow-up.
Methods:
This study included 344 participants (67.1% of the initial cohort) who were followed from baseline to 18 months after the baseline interview. Multinomial logistic regression analyses examined the relationship between substance use and housing status.
Results:
The most reported substances which were used among these homeless people were cannabis (43.9%) and alcohol (?5 units on one occasion) (30.7%). Other substances were used by around 5% or less of the participants. Twenty-seven percent were classified as substance misuser and 20.9% as substance dependent. The odds to be marginally housed (4.14) or institutionalized (2.12) at follow-up compared to being housed of participants who were substance users were significantly higher than those of participants who did not use substances. The odds to be homeless were more than twice as high (2.80) for participants who were substance dependent compared with those who were not.
Conclusion:
Homeless people who use substances have a more disadvantageous housing situation at follow-up than homeless people who do not use substances. Attention is needed to prevent and reduce long-term homelessness among substance-using homeless people.
Patterns of drug abuse among drug users with regular and irregular attendance for treatment as detected by comprehensive UHPLC-HR-TOF-MS
Sundström M, Pelander A, Simojoki K, Ojanperä I
Drug Testing and Analysis
8 (1) p.39-46, 2016
The most severe consequences of drug abuse include infectious diseases, overdoses, and drug-related deaths. As the range of toxicologically relevant compounds is continually changing due to the emergence of new psychoactive substances (NPS), laboratories are encountering analytical challenges. Current immunoassays are insufficient for determining the whole range of the drugs abused, and a broad-spectrum screening method is therefore needed. Here, the patterns of drug abuse in two groups of drug users were studied from urine samples using a comprehensive screening method based on high-resolution time-of-flight mass spectrometry. The two groups comprised drug abusers undergoing opioid maintenance treatment (OMT) or drug withdrawal therapy and routinely visiting a rehabilitation clinic, and drug abusers with irregular attendance at a harm reduction unit (HRU) and suspected of potential NPS abuse. Polydrug abuse was observed in both groups, but was more pronounced among the HRU subjects with a mean number of concurrent drugs per sample of 3.9, whereas among the regularly treated subjects the corresponding number was 2.1. NPS and pregabalin were more frequent among HRU subjects, and their abuse was always related to drug co-use. The most common drug combination for an HRU subject included amphetamine, cannabis, buprenorphine, benzodiazepine, and alpha-pyrrolidinovalerophenone. A typical set of drugs for treated subjects was buprenorphine, benzodiazepine, and occasionally amphetamine. Abuse of several concurrent drugs poses a higher risk of drug intoxication and a threat of premature termination of OMT. Since the subjects attending treatment used fewer concurrent drugs, this treatment could be valuable in reducing polydrug abuse.