Published since 1884 by the Society for the Study of Addiction.
Editor-in-Chief, Robert West

We welcome suggestions and contributions from our readers. Send your material to John Witton, News and Notes Editor, Addiction, National Addiction Centre PO48, 4 Windsor Walk, London SE5 8AF. Fax +44 (0)20 7848 5966;
e-mail john.witton@kcl.ac.uk

Major Cannabis Report Published in US

Posted 06-Mar-17

The National Academies of Sciences, Engineering, and Medicine published The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research in January. The report reviews the research on cannabis or its constituents and health available since the Institute of Medicine’s report Marijuana and Medicine was published in 1999. The review was conducted by a committee of experts convened in March 2016 and, given the short time frame for the committee’s work, drew mainly on published systematic reviews. The eleven topic areas chosen for review were: therapeutic effects; cancer; cardiometabolic risk; respiratory disease; immunity; injury and death; prenatal, perinatal, and postnatal exposure to cannabis; psychosocial; mental health; problem cannabis use; and cannabis use and the abuse of other substances. Among the report’s conclusions are that there is  substantial evidence of a statistical association between cannabis use and increased risk of motor vehicle crashes, lower birthweight of offspring, and development of schizophrenia or other psychoses, and that initiating cannabis use at an earlier age is a risk factor for the development of problem cannabis use. The report also makes recommendations for a research agenda that will identify the most critical research questions regarding cannabis use and health outcomes that can be answered in the short term (within a 3-year time frame). An editorial in The New York Times drew attention to the report’s conclusion that research on the effects of cannabis is restricted by its status as a Schedule I substance under the US Controlled Substances Act.

Sources:

http://nationalacademies.org/hmd/reports/2017/health-effects-of-cannabis-and-cannabinoids.aspx

https://www.nytimes.com/2017/01/17/opinion/scientists-to-government-make-it-easier-to-study-marijuana.html?_r=0

New Tobacco Control Measures in France

Posted 06-Mar-17

A new law on plain packaging came fully into force in France on 1 January 2017. The Physicians for a Smoke-free Canada blogspot drew attention to other important new tobacco control measures that also came into force at the same time.  A new tax of 5.6% on tobacco company revenue is expected to raise about 130 million Euros per year (about 137 million US dollars) which will be administered  by a 12-member Board of Directors made up of the directors-general and directors of several health insurance funds; directors-general of the national Health Department, the Social Security Department, the Public Health Agency, and the National Cancer Institute; and two members at large appointed by the Minister of Health. Finally, in line with the an European Union (EU)  Directive that requires member states to restrict greatly tobacco product presentation, France issued a regulation on 1 February that lists all the brands of tobacco products available for sale in France.  The EU directive advises that neither the packaging nor the product shall include any element that “promotes a tobacco product or encourages its consumption” and the sale of a brand in France will only be allowed for one more year if any element of its name is judged to be contrary to the directive.

Source:

http://smoke-free-canada.blogspot.co.uk/

Dutch MPs Vote for Legal Cultivation of Cannabis

Posted 06-Mar-17

In February MPs in the  lower house of the Dutch Parliament voted by 77 votes to 72 in favour of the new law that would  allow the cultivation of cannabis in the country. The bill was put forward by an MP for the liberal party, D66, removing a legal grey area that allowed “coffee shops” to sell cannabis but left them unable to supply it themselves without fear of prosecution.  The proposed new law, the Closed Coffeeshop Chain Act, would create a regulated cannabis supply chain, with some suppliers permitted to cultivate the drug without facing arrest.  The proposed law “finally ends the current skew tolerance policy where you can sell weed [cannabis] but cannot grow or buy it,” said Vera Bergkamp, an MP with the D66 group.  It remained uncertain whether the bill will be approved by the Dutch Senate given the narrow majority of the vote in the lower house.

Source:

http://www.coffeeshopdirect.com/forum/viewtopic.php?t=33465

Public Consultation on Tobacco Control in Canada

Posted 06-Mar-17

According to Health Canada the smoking rate in Canada dropped from 22% in 2001 to 13% in 2015. A proposed tobacco control policy aims to reduce Canada's rate of tobacco use to less than 5% by 2035.  A 7-week public consultation on the future of tobacco control in Canada was launched in February.  Other tobacco control measures planned by the Government of Canada include adopting stringent plain packaging for tobacco products; banning the use of menthol in cigarettes, blunt wraps and most cigars; addressing the risks and benefits of vaping products starting with the introduction of new vaping legislation; supporting First Nation and Inuit communities in the development and implementation of tobacco control projects that are socially and culturally appropriate; and developing new and innovative multi-sectoral partnerships to address tobacco use as a common risk factor for chronic disease.  

Source:

https://www.canada.ca/en/health-canada/news/2017/02/government_of_canadalaunchespublicconsultationsonthefutureoftoba.html

Claims for the Economic Benefits of the Alcohol Industry Challenged

Posted 06-Mar-17

The UK Institute of Alcohol Studies report, Splitting the Bill: Alcohol’s Impact on the UK Economy, uses government and trade statistics and research evidence to demonstrate that raising the tax duty on alcohol is not likely to lead to a major cost to the UK economy. The report suggests that any reduction in employment and income resulting from lower spending on alcohol could be offset by spending on other goods; those data from US states suggest that a 10% decrease in alcohol consumption is associated with a 0.4% increase in per capita income growth; and that lower alcohol consumption could also reduce the economic costs of impaired workplace productivity, alcohol-related sickness, unemployment and premature death, which are estimated to cost the UK £8-11 billion per year.

Source:

http://www.ias.org.uk/uploads/pdf/IAS%20reports/rp23022017.pdf

Heroin and Fentanyl Related Overdose Deaths Continue to Rise in US

Posted 06-Mar-17

A report from the US Centers for Disease Control and Prevention using data from the National Vital Statistics System (NVSS) finds that the rate of fatal overdoses from all drugs has increased by more than 2.5 times since 1999, rising from 6.1 deaths per 100,000 people to 16.3 deaths in 2015. Heroin was involved in 8 percent of all drug overdose deaths in 2010 but involved in 25 percent of such deaths in 2015. Deaths related to fentanyl and other synthetic opioids (with the exception of methadone) rose from 8 percent in 2010 to 18 percent in 2015. The percentage of deaths caused by methadone, as well as by natural and semisynthetic opioids such as oxycodone and hydrocodone, dropped during this period. Adults between 45 and 54 years old had the highest death rate from drug overdoses at 30 deaths per 100,000 people in 2015 but the rate also grew among adults between 55 and 64 years old.

Source:

https://www.cdc.gov/nchs/data/databriefs/db273.pdf

Methamphetamine in Afghanistan

Posted 06-Mar-17

While data and information about synthetic drugs in Afghanistan and the wider South-Western and Central Asian region is scarce, Afghanistan Synthetic Drugs Situation Assessment from the United Nations Office on Drugs and Crime (UNODC) Global SMART programme concludes that there is evidence of increasing activity in the synthetic drug market in Afghanistan. Drawing on reports from law enforcement officials, drug treatment providers, forensic experts and drug users in Afghanistan the UNODC report found an increase in the number of methamphetamine seizures, reports of methamphetamine manufacture in the country and an increase in treatment registrations related to methamphetamine in certain parts of the country.

Source:

http://www.unodc.org/documents/Reports/2017_Afghanistan_Synthetic_Drugs_Assessment_report.pdf

Heroin Epidemic Is Election Issue in Punjab

Posted 06-Mar-17

The New York Times reports that the Aam Aadmi Party, launched in 2012 to address corruption in Indian politics, is contesting the Punjab state elections and drawing on local public anger about the state’s heroin epidemic.  The Punjab is a transit point for heroin crossing from Afghanistan to the heroin markets of the west and The Times reports that an estimated 230,000 men and women in the state are dependent on opioids. The Times also reports that, while government statistics suggest that police activities have had some success in reducing the supply of heroin, these have done little to dispel public anger and dissatisfaction with the ruling party in the state, the Shiromani Akali Dal party, which is seen by many in the Punjab to be involved in the heroin trade.  

Source:

https://www.nytimes.com/2017/02/03/world/asia/india-punjab-heroin.html?_r=0

National Cannabis Information Centre in Australia Is Closed Down

Posted 13-Feb-17

The Australian government withdrew its funding of the National Cannabis Prevention and Information Centre (NCPIC) and NCPIC ceased to operate on 31 December. A government spokesperson justified the decision, saying “There is a need to consider a more holistic, responsive and current approach to the provision of drug and alcohol research and information needs of the drug and alcohol sector and the community that is broader than focusing on a single substance,” adding, “In particular, consultations and information gathering over the past 18 months has identified a change in policy context and priorities, including the release of the National Ice Action Strategy.” In response, the centre's director, Professor Jan Copeland, said “Though ice may be more dramatic and noticeable, focusing only on it and other emerging drugs that aren't used by anywhere near as many people as cannabis, will be to the detriment of Australia.”

Source:

http://www.abc.net.au/news/2016-11-04/cannabis-support-centre-to-close-after-funding-cut/7994558

Report from Cannabis Legalization Task Force in Canada

Posted 13-Feb-17

The Task Force on Cannabis Legalization and Regulation presented its final report to the Canadian government on 30 November. The task force had been established in June 2016 to design a new legislative and regulatory framework for legal access to cannabis in Canada. The Canadian government has said it will introduce legislation to legalize cannabis in spring 2017. The proposed framework is the result of consultations with local governments, industry, indigenous governments, professional groups, patients and advocates as well as submissions from the public. The Globe and Mail reports that Anne McLellan, the chair of the task force, said “most Canadians think it’s time to move away from the system we have. But they are less clear about words like ‘decriminalization’ and ‘legalization’.” The report’s recommendations “reflect a public health approach to reduce harm and promote health,” McLellan added, and also took a “precautionary approach to minimize unintended consequences, given that the relevant evidence is often incomplete or inconclusive.”  The model proposed by the report is similar to the one in place for sales of tobacco and alcohol.  The report said that Canadians should be able to buy or carry 30 grams of cannabis for personal use, while those who want to grow their own could have four plants at home. The proposed system would incorporate both shop sales and mail-order distribution and encourage a wide range of suppliers beside the current suppliers of medicinal cannabis.

Sources:

http://healthycanadians.gc.ca/task-force-marijuana-groupe-etude/framework-cadre/alt/framework-cadre-eng.pdf

http://www.theglobeandmail.com/news/politics/marijuana-task-force-submits-report-outlining-framework-for-legal-system/article33118085

Report on Drug Treatment in England

Posted 13-Feb-17

A report from Public Health England (PHE) provides a comprehensive review of the evidence on the drug misuse treatment system in England and its expected outcomes. The review uses modelling to estimate the size, characteristics and needs of the drug treatment population in the next four years. The benefits of treatment are highlighted, with 60% of all opioid users in treatment and 97% of all users starting treatment within three weeks. However, the report registers concern with the number of drug-related deaths, which is predicted to continue to rise, and also with the numbers of people continuing to use opiates/heroin after starting treatment. There are challenges to meet the complex needs of older long-term heroin users. Services also need to be flexible and assist those seeking help for the first time get appropriate treatment, particularly with emerging problems such as novel psychoactive substances and the problematic use of medication.

Source:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/586111/PHE_Evidence_review_of_drug_treatment_outcomes.pdf

More Supervised Injecting Sites in Canada

Posted 13-Feb-17

Medical Xpress reports that Canada's health minister, Jane Philpott, approved the opening of new supervised injecting rooms in three sites in Montreal's downtown areas, Hochelaga-Maisonneuve and Ville-Marie. Vancouver established the first supervised injecting room in Canada in 2003, under special exemption from federal drug possession and trafficking laws. Ottawa, Toronto and several other Canadian cities are also considering opening their own sites according to Medical Xpress. In a statement, Philpott said the government had introduced legislative changes to Canada’s Controlled Drugs and Substances Act in December 2016 to streamline the process of applying for supervised injecting rooms.

Sources:

https://medicalxpress.com/news/2017-02-canada-authorizes-drug-consumption-rooms.html

http://news.gc.ca/web/article-en.do?nid=1185959&tp=980

Germany Legalizes the Use of Medicinal Cannabis

Posted 13-Feb-17

Reuters reports that the German lower house of parliament, the Bundestag, passed a law in January that legalizes the use of cannabis for medicinal purposes. Health Minister Hermann Groehe said:  "Those who are severely ill need to get the best possible treatment and that includes health insurance funds paying for cannabis as a medicine for those who are chronically ill if they can't be effectively treated any other way."  The law was likely to take effect in March 2017 after a procedural reading by the upper house of parliament, the Bundesrat, according to a Health Ministry spokesperson. State-supervised cannabis plantations will be set up in Germany in the future and until then cannabis will be imported from the Netherlands and Canada. According to Reuters the move toward the legalization of medical use of cannabis began in 1999 with a complaint to the Federal Constitutional Court against the prohibition of cannabis for severe illnesses by 8 patients with such illnesses. A Federal Administrative Court decision supporting the complaint on constitutional grounds followed in 2005, eventually leading to the new law.

Source:

http://uk.reuters.com/article/uk-germany-cannabis-idUKKBN1532Y5

Argentina's Government Targets Cocaine Paste with Law Reform

Posted 13-Feb-17

InSight Crime reports that the Argentine government submitted plans to modify the country's anti-narcotics laws in the final congressional session of 2016. The planned changes added provisions specifically related to paco, the Argentine name for the smokable drug made from raw cocaine base paste. The government proposal says that Argentines now consume 400,000 doses of paco every day, according to Insight Crime. The Argentine news website The Bubble observes that paco’s quantity and popularity coincide with Argentina’s increasing popularity as a cocaine export hub. The proposed reform will increase penalties for the production, trafficking and supply of paco from between four and fifteen years to between six and eighteen years.  Those supplying the drug free of charge could face sentences of between four and fifteen years, unless the "delivery, supply or facilitation was occasional, free of charge and for small quantities," in which case the sentence would be between one and four years. Paco users who have no previous drug convictions will be subject to judicial orders forcing them to attend rehabilitation treatment rather than being sent to prison.

Sources:

http://www.insightcrime.org/news-briefs/argentina-drug-law-reforms-target-cocaine-paste

http://www.thebubble.com/europe-argentina-cocaine/

New Report on Tobacco Control

Posted 13-Feb-17

A new evidence review from the World Health Organization and the US National Cancer Institute, The Economics of Tobacco and Tobacco Control, finds that policies to control tobacco use, including tobacco tax and price increases, can generate significant government revenues for health and development work. The measures can greatly reduce tobacco use and protect people’s health. The review examines the economics of tobacco control and the economic implications of global tobacco control efforts. Among the major conclusions of the review are that the health and economic burden of tobacco use is increasingly falling on low- and middle-income countries (LMICs) while the market power of tobacco companies has increased. Effective evidence-based strategies for controlling tobacco use and the resulting health and economic costs are not yet fully used by countries, including the United States. The report says that LMICs are too intimidated by threats and misinformation from the tobacco industry to introduce control measures. “They are afraid of being taken to court if they increase tobacco taxes,” said Jeremiah Paul of the WHO’s tobacco control economics unit in ExecReview, adding “They [the industry] will scare you that tobacco taxes are anti-poor, that government revenue will go down.” But there is no evidence to support any of these claims, he said.

Sources:

http://www.who.int/mediacentre/news/releases/2017/tobacco-control-lives/en/

http://www.execreview.com/2017/01/poorer-countries-fail-to-act-on-smoking-due-to-big-tobacco-threats-says-who/

ACMD Report on Drug-related Deaths

Posted 13-Feb-17

A report from the Advisory Council on the Misuse of Drugs (ACMD), Reducing Opiate-related Deaths in the UK, sees the recent rise in deaths as the result of the increasing vulnerability of the prematurely ageing cohort of heroin users whose drug use began in the 1980s. In a letter to the government’s Home Secretary accompanying the report, the ACMD’s chair, Professor Les Iversen, said: “The ACMD welcomes the considerable expansion in the use of OST (opioid substitution therapy) in the UK since the mid-1990s. The ACMD would like to reiterate the evidence that being in OST protects heroin users from overdose and increasing coverage of OST has had a substantial effect in limiting the increase in drug-related deaths that would otherwise have occurred. The most important recommendation in this report is that government ensures that investment in OST of optimal dosage and duration is at least maintained.”

Source:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/576560/ACMD-Drug-Related-Deaths-Report-161212.pdf

US Food and Drug Administration Removes Black Box Warning on Chantix

Posted 13-Jan-17

The US Food and Drug Administration (FDA) has approved dropping the black box warning regarding possible serious neuropsychiatric side effects with Pfizer's smoking cessation drug varenicline (Chantix, Champix). This follows extensive evidence showing no connection between the drug and side effects such as suicide and aggression, culminating in the EAGLES randomised controlled trial reported in the Lancet earlier this year. The FDA will also allow claims that Chantix/Champix has superior efficacy to the nicotine transdermal patch.

Sources:

http://www.medscape.com/viewarticle/873437

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30272-0/abstract

US Surgeon General Report on E-cigarettes and Young People

Posted 13-Jan-17

The US Surgeon General calls e-cigarette use among young people a major public health concern in the preface to his report, E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General. While acknowledging that there is a need for more research on e-cigarettes, Surgeon General Vivik Murthy said:  “My concern is e-cigarettes have the potential to create a whole new generation of kids who are addicted to nicotine,” adding “If that leads to the use of other tobacco-related products, then we are going to be moving backward instead of forward.” In The Guardian Kevin Fenton of Public Health England (PHE) responded to the report, saying the PHE’s review of the evidence “found e-cigarette use carries a fraction of the risk of smoking, a conclusion reiterated by the Royal College of Physicians earlier this year. No new evidence has been published to contradict this, however we are closely monitoring any emerging evidence.”

Sources:

http://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Full_Report_non-508.pdf

http://www.nytimes.com/2016/12/08/health/e-cigarettes-united-states.html?_r=0

https://www.theguardian.com/society/2016/dec/08/e-cigarettes-young-people-health-impact-warning-report

Government Funding for OST Programmes in Ukraine

Posted 13-Jan-17

The government of Ukraine has announced that in 2017 it will fully finance the national opioid substitution therapy (OST) programme from the national budget. Approximately US$500,000 will be allocated to enable 8,000 people to continue to access OST in 2017. OST has been available in Ukraine for the last 12 years, receiving financial support from the Global Fund to Fight AIDS, Tuberculosis and Malaria and technical support from UNAIDS.

Source:

http://www.unaids.org/en/resources/presscentre/featurestories/2016/november/20161103_ukraine

More Deaths in Drug War in the Philippines

Posted 13-Jan-17

6,180 people have been killed in the first six months of the national drug war introduced by the country’s President, Rodrigo Duterte, according to the Filipino social media site Rappler. Drawing on an analysis of police and media reports by Aljazeera, Rappler says two-thirds of the deaths were the result of extrajudicial or vigilante-style killings.  Aljazeera reports that children and an anti-drugs advocate were among the dead. President Duterte dismissed the international condemnation of his policy as a violation of human rights by US President Obama, Amnesty and UN special rapporteurs among others.  

Sources:

http://www.rappler.com/newsbreak/rich-media/rodrigo-duterte-war-on-drugs-2016

http://www.aljazeera.com/blogs/asia/2016/12/duterte-drug-war-death-toll-6000-161213132427022.html

http://www.ibtimes.com/philippines-drug-war-out-control-duterte-campaign-death-toll-grows-includes-teenagers-2461496

European Commission Rebuked for Secretive Tobacco Lobby Contacts

Posted 13-Jan-17

In 2015 the European Ombudsman Emily O'Reilly upheld a complaint by Corporate Europe Observatory (CEO) against the European Commission’s failure to comply with the World Health Organization's Framework Convention on Tobacco Control (WHO FCTC). Article 5.3 of the WHO FCTC is intended to protect decision-making "from commercial and other vested interests of the tobacco industry." Under this article, governments are obliged to limit interactions with the tobacco industry and ensure the transparency of interactions that do occur. In May 2014, CEO submitted a complaint about the Commission's failure properly to implement these rules. The Ombudsman’s investigation found that a top official from the Commission's legal service had declared no meetings with tobacco industry representatives despite having meetings with a lawyer working for Philip Morris. But the European Commission rejected the Ombudsman’s subsequent recommendation for greater transparency on tobacco lobbying across the institution. The Ombudsman closed her enquiry in December 2016 with a final ruling that rebuked the Commission for maladministration over its violation of the WHO FCTC.

Sources:

http://www.ombudsman.europa.eu/cases/decision.faces/en/73774/html.bookmark

http://blueandgreentomorrow.com/news/ombudsman-ruling-commissions-tobacco-lobby-secrecy-welcomed-ceo/

Cocaine Use on the Rise in the US

Posted 13-Jan-17

InSight Crime reports that cocaine use and availability is on the rise in the United States for the first time in nearly a decade. The US  Drug Enforcement Administration (DEA) report, 2016 National Drug Threat Assessment, using data from seizures and overdose deaths, suggests that the amount of cocaine reaching the US  increased from 2014 to 2015, the first such rise since 2007. The DEA claim that an estimated 67 percent increase in cocaine production in Colombia is the reason for the rise. Cocaine from Colombia dominates the US market, with DEA testing of seized shipments showing that 90.2 percent of the cocaine that reached the United States between 2014 and 2015 originated in Colombia.

Sources:

http://www.insightcrime.org/news-analysis/impact-colombia-cocaine-boom-hits-the-us-dea

https://www.dea.gov/resource-center/2016%20NDTA%20Summary.pdf

Naloxone Made Available in Moscow

Posted 13-Jan-17

In July 2016, drug treatment centres in Moscow began distributing naloxone to people who use heroin and other opiates, according to the online TalkingDrugs. Russia’s chief drug specialist, Evgeny Brun, told a news website that the government will evaluate the initiative in spring 2017.  However, the Andrey Rylkov Foundation (ARF), a grassroots harm reduction group in Russia, said that there has been no effort to provide naloxone to those who are not engaged in treatment.  With opioid substitution therapy banned in Russia and people reluctant to come forward for treatment, TalkingDrugs raises the questions of how many people the initiative will reach and whether it will be effective.

Source:

http://www.talkingdrugs.org/government-rolls-out-naloxone-in-moscow-but-is-it-enough

BMJ Says the War on Drugs Has Failed

Posted 13-Jan-17

A British Medical Journal (BMJ) editorial written by Fiona Godlee, Editor-in-Chief, and Richard Hurley, Features and Debates Editor of the BMJ argues that current drug laws have failed to curb either supply or demand, reduce addiction, cut violence or reduce profits for organised crime. Citing recent calls for drug policy reform, the editorial suggests that prescription drugs, alcohol, and tobacco provide lessons to inform potential models of drug regulation. The editorial concludes that “Change is coming, and doctors should use their authority to lead calls for pragmatic reform informed by science and ethics.”

Sources:

http://www.bmj.com/content/bmj/355/bmj.i6067.full.pdf

http://www.medscape.com/viewarticle/872007