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Positive signs that teenagers increasingly shun the most problematic drugs The number of teenagers entering treatment for heroin and crack has fallen by a third in four years according to the NTA report ‘Substance misuse among young people – The data for 2008/09’; this echoes the trend already seen in young adults (aged 18-24) in drug treatment. The overall number of under-18s accessing specialist substance misuse services in England during 2008/9 was 24,053. This is a modest increase of about 150 over 2007/8, and indicates that demand for such services is levelling out. The vast majority of these young people are receiving help for problems associated with the misuse of cannabis and/or alcohol, which are treated with structured counselling. Drug treatment services in England are now widely available and anyone who needs help can get it quickly. Reported trends show:
Rosanna O’Connor, NTA Director of Delivery, said: “The pattern of decline echoes a similar generational shift away from heroin and crack use among young adults in treatment, which is a further indication that the heroin epidemic may have peaked. It would also suggest that young people are getting help for substance misuse before their problems become entrenched. “Most young people receiving substance misuse interventions cannot be described as addicts in the same way as adults in treatment. Addiction is normally the result of regular, consistent use of substances over time; most under-18s who have problems have not pursued drug taking long enough to result in dependency.” Nearly three quarters of all young people receiving help in 2008/09 received psychosocial interventions such as counselling, to address the underlying causes and behavioural consequences of substance misuse. Over a fifth received a mix of psychosocial, family work and harm reduction interventions. The NTA report is available at www.nta.nhs.uk and updates the broad picture of drug and alcohol misuse in under-18s in England established by the publication of the first comprehensive report on the issue in January 2009 ‘Getting to grips with substance misuse among young people.’ Drugs Tests for Exam Students ‘inevitable’ "Smart drugs" that are claimed to boost academic performance have proliferated in recent years, making the introduction of routine drug-testing for students inevitable, according to Vince Cakic, a psychologist at the University of Sydney in Australia. Ritalin, a stimulant drug best known as a treatment for hyperactive children, has also found a market among students, especially in the US, who are desperate to succeed and are turning to it in preference to traditional stimulants such as coffee and cigarettes. Users say it helps them to focus and concentrate and this has been confirmed in research studies on adults. Other drugs with potential as "brain boosters" include modafinil (Provigil), a stimulant prescribed for the sleep disorder narcolepsy, donepezil (Aricept), prescribed for Alzheimer's disease to improve memory, and selegiline (Eldepryl), prescribed for Parkinson's disease to increase motivation. One in four students at some US universities are reported to have taken stimulants, particularly in colleges with more competitive admissions criteria, Mr Cakic said. Anecdotal reports suggest their use has spread to Britain. Writing in the Journal of Medical Ethics, he said the the spread of academic doping posed challenges for society. Banning the drugs would be almost impossible, leaving the option of testing students in the same way that elite athletes are tested, but despite the ban on drugs in sport, 95 per cent of elite athletes are said to have used them. "It is apparent that the failures and inconsistencies inherent in anti-doping policy in sport will be mirrored in academia unless a reasonable and realistic approach to the issue of brain-boosting drugs is adopted," he wrote. "As laughable as it may seem, it is possible that scenarios such as urine testing could very well come to fruition in the future. Given that the benefits of the drugs could also be derived during periods of study at any time leading up to the examinations, this would require drug testing during non-exam periods." But Mr Cakic said it was not clear that using drugs was necessarily wrong. Arguing that they should be banned because they confer an unfair advantage is like suggesting that private tuition should be banned because it favours those who can afford it. Professor John Harris, the director of the Institute for Science, Ethics and Innovation at the University of Manchester, and the editor-in-chief of the Journal of Medical Ethics, agrees. He defended the use of smart drugs on the grounds that it was "not rational to be against human enhancement". In the British Medical Journal in June, he said that the use of cognitive enhancing drugs should be seen as a natural extension of the education process. He said drug regulatory agencies should assess the benefits and risks as they would any other medical intervention. But the long-term safety of the drugs is unknown. In the US, Ritalin carries the most serious warning because of its high potential for abuse, serious risks to the heart and chance of sudden death. Caffeine, by contrast, carries no warnings and enhances sporting and academic performance. But this form of "cheating" was tolerated because it was relatively harmless, Mr Cakic said. Middle Class Women Hit The Bottle Hardest The research, released by the University of Lancaster, suggests that moral panic over “ladette” culture with its images of binge-drinking young women causing chaos in town centres is misplaced and is leading to them being unfairly demonised. Instead, the study found that the higher the household income, the higher the alcohol consumption amongst women — and it suggests that there is a reluctance to address an apparent increase in the “hidden harm” from frequent drinking into middle age by educated women. The researchers claim that society’s desire to dwell on young people’s public excesses also acts as a diversion, consolidating middle-class, middle-aged drinking as “comparatively civilised and unproblematic”. The findings, published in Probation Journal, on the drinking habits of middle-class women revealed how they routinely drank half a bottle or more every evening. “Like a huge number of women I am mildly drunk every single evening,” said one woman. “In a tableau played out across the UK, we’re climbing the stairs for bed, pretty woozy on our feet, grinning gently to ourselves.” The paper, by Fiona Measham, senior lecturer in criminology at the University of Lancaster and Dr Jeanette Ostergaard at the University of Copenhagen, argues for a more nuanced understanding of the relationship between alcohol, women’s changing lives and northern European drinking cultures. The academics analysed data from both the UK and Denmark, both countries with high levels of alcohol consumption for young people and adults. Danish girls aged 16-20 are the heaviest drinking in Europe, with an average of 6.8 cubic litres of pure alcohol consumed on the last drinking day, whilst consumption by British girls was also relatively high, at 5.7 cubic litres. The girls drank less frequently and less heavily than boys. But evidence shows stability and decline in girls’ alcohol consumption. Self-reported lifetime and past month drunkenness, frequent drinking and heavy episodic drinking amongst the young remained stable or declined moderately in both countries in the past decade. Furthermore, fewer girls were getting intoxicated for that first time at 13 or younger. Historically, said the study, young women are the focus for social anxieties surrounding changing patterns of alcohol consumption. But the figures show immoderate drinking peaked at 42 per cent (of 16-24 year old women in the UK) in 1998 and has since fallen to 35 per cent in 2006; while binge drinking peaked at 26 per cent in 2000-2 and fell to 21 per cent in 2006. The proportion of young British women drinking more than 14 units of alcohol a week has fallen from 33 per cent to 20 per cent in 2006. And while young women remain the heaviest-drinking age group, they are only slightly higher in consumption than older women. Those aged 16-24 consumed an average weekly 11.3 units, with 25 per cent drinking more than 14 units, compared to 24-44 year olds who drank an average of 10.2 units a week, with 24 per cent drinking more than 14 units. Women aged 45-64 drank an average of 9.9 units a week, with 22 per cent drinking more than 14 units. However, national statistics show that it is women in managerial and professional occupations who report drinking both more frequently and more heavily. Such women are more likely to drink at home than those in routine and manual occupations. “Given that professional women’s alcohol consumption is more likely to be within the home — with less acute health and crime related consequences — their drinking has received less attention and has only recently been recognised as a ‘hidden harm’,” said the researchers. British women drink more wine than men, and consumption increases with age. A recent Danish health survey suggests immoderate drinking is more prevalent among 45-65 year old women (15 per cent) compared to 16-24-year-old girls (10 per cent). Furthermore, the older women’s trend was increasing, while the younger trend decreasing. The researchers say a key factor fuelling the trend has been the falling cost of alcohol — which in 2007 was 69 per cent more affordable in the UK than it was in 1980. They also query whether the UK’s policy of encouraging ‘sensible’, supposedly civilised European café bar and home-based drinking, whilst demonising working class adult ‘problem drinking’, has been the right one. “It may be that it is this idealised Mediterranean model of more frequent wine drinking within the home which presents less acute but possibly more chronic alcohol related problems when overlaid on traditional British and Danish drinking cultures,” say the researchers. They also highlight the point that the problematising of young people's public excesses also functions to consolidate middle-class, middle-aged drinking as comparatively civilised and unproblematic. Dr Measham said: “Current alcohol trends challenge some of these enduring stereotypes of problem drinking and lead us to question why we are so eager to demonise young people yet so reluctant to recognise that drinking trends can go down as well as up.” Growing concern over Ketamine use and kidney failure Some users have needed to have their bladders removed and must now wear catheters. Other users have suffered serious kidney problems, breathing difficulties, addiction, bouts of unconsciousness and trouble with urinating. The drug also involves a heightened risk of heart attack. Some users also end up with cocaine-style damage to the inside of their nose, because the drug is often snorted in powder form, though it can also be injected, taken as a pill or swallowed as a liquid. Researchers say ketamine is increasing in popularity partly because it is cheaper than cocaine and, as the purity of cocaine falls, gives a more reliable high. It usually sells for about half the price of cocaine, at about £20 per gram, but can be obtained for as little as £5 a gram. "The quality of heroin and cocaine is so poor that people are turning to ketamine, which is cheap and available," said Dr Chris Ford, a GP and the clinical lead for substance misuse management in general practice in the London borough of Brent. Dr Angela Cottrell, a urologist attached to the Bristol Urological Institute at the city's Southmead Hospital, has studied the health problems caused by ketamine. She saw her first patient with severe bladder problems in mid-2007 and has seen a growing number of cases since. "About one-third of ketamine users develop severe problems with the drug. There's something about the way that it's metabolised that is causing these problems," said Cottrell. "One of the most alarming things is that the long-term effects on the body are not known. We don't know if things get better over time or whether people will develop kidney failure in the long-term." The damage to vital organs may be irreversible, Cottrell warned. Ketamine is both a stimulant and an hallucinogenic. In 2007, Professor David Nutt, recently sacked as the chairman of the government's drugs advisory panel, published research in The Lancet which ranked ketamine as the sixth most harmful substance out of 20 studied. It came behind heroin, cocaine, barbituates, street methadone and alcohol, but ahead of cannabis and ecstasy, in 11th and 18th places. The drug is known as K, Special K and, because of the youth of many users, "kiddie smack". The Addaction specialist drugs service in Lincoln sees about 200 children under 18 every year. In 2007, none said they used ketamine. Between June and November 2008, one teenager said it was their main drug and six said it was their secondary choice, usually behind alcohol or cannabis. But in the same period this year, four 15- to 18-year-olds said it was their preferred way of getting high, and 15 as their next most favourite. Elliot Elam, of Addaction, said: "It's not an epidemic, but it is an emerging trend. There's a new generation for whom ketamine use is acceptable." According to the British Crime Survey, only 1.8% of people in England and Wales have ever used ketamine, but that figure is doubled among 16- to 24-year-olds. It estimated that 113,000 people used it at least once in 2007-08. Research published last week in the journal Addiction blamed the drug for memory loss and mild delusions. A "normal" dose of ketamine is 60mg to 100mg, but some users are taking 5g or 10g a day. Twenty-three people are believed to have died between 1993 and 2006 after walking into traffic and risking other dangers after losing their sense of reality. ‘Young People and Drugs 2010’ Courses The ‘Young People and Drugs 2010’ course will be taking place in Cardiff in February, Swansea, North Wales, Sheffield, York and Leeds in March and in Coventry, Birmingham and Wolverhampton in April 2010. If you would like to receive information about a course near you, and a booking form, then please e-mail us at: office@drugstraining.com. Alternatively please click here for link to download a booking form. First UK death solely linked to GBL reported GBL is one of a number of "legal high" drugs now banned under the Misuse of Drugs Act 1971. The substance is now officially a Class C drug, possession of which may incur a penalty of up to two years imprisonment. The crackdown followed the high profile case of Brighton medical student Hester Stewart, 21, who died in April after taking GBL. The student was said to have been killed by a combination of the drug and alcohol. However the new case reported is the first fatality in the UK to involve GBL alone. Doctors writing in the Journal of the Royal Society of Medicine said the 25-year-old male was found unconscious in bed by his partner, who attempted to resuscitate him and called an ambulance. He had taken GBL the previous evening while out clubbing, and had been "acting strangely" after returning home six hours before he was found. Attempts to revive the man on the way to hospital and on arrival proved in vain. He suffered a prolonged cardiac arrest and died. A post-mortem examination revealed evidence of GBL but no sign of any other drugs, including alcohol. The medical team, led by Dr Paul Dargan from Guy's and St Thomas' NHS Foundation Trust in London, wrote: "We report here the first UK case of a fatality related to confirmed, isolated GBL toxicity.. "GBL is widely used in the UK chemical industry and it is reported that over 1,000 tonnes are imported into the UK per year for industrial purposes. It is used as an intermediate solvent in the electronics industry and in the production of domestic and industrial cleaning products and paints." Nurses offer binge drink advice Patients who return to hospital for treatment after a drink-related injury will receive advice from nurses about their alcohol intake. The Assembly government-led scheme will start across Wales in February. The Chief Nursing Officer for Wales said the binge-drinking culture was "getting worse" and this could help reduce long term damage to health. A recent report suggested 1,000 deaths each year in Wales are linked to alcohol misuse. Research by Professor Jonathan Shepherd, of Cardiff University's Violence Research Group, has found it is possible to detect alcohol misuse and treat it using "brief interventions when patients with injuries return to hospital". He said: "Excessive drinking is a major cause of illness, injury, and behavioural problems in Wales. "The Chief Medical Officer for Wales' latest annual report found that some 45,000 hospital admissions and 1,000 deaths every year in Wales are linked to alcohol misuse. "One way to address this is through brief interventions. Hospital treatment can be a sobering experience for people and evidence shows that people are more receptive to healthcare messages when they are delivered in a clinical setting." The initiative, which is part of a partnership between NHS Wales and Cardiff University, is designed to target drinkers who do not need specialist alcohol treatment but whose drinking is likely to eventually damage their health. Nurses who work in trauma and maxillofacial clinics are being encouraged to be trained to provide the advice. Chief Medical Officer for Wales Dr Tony Jewell said the Assembly Government's Substance Misuse Strategy had provided the impetus for the development. "In my recent letter to the service I highlighted the need to educate people about the health risks associated with exceeding safe drinking limits and make sure the health service takes this opportunity to engage fully in this training programme." Rosemary Kennedy, Chief Nursing Officer for Wales said: "Binge-drinking culture is getting worse in Wales. Evidence-based interventions will help reduce the long-term damage from excessive drinking and the increasing burden on the NHS." Prozac rise 'down to serial use' Researchers looked at UK prescriptions over nearly a decade, and found that the number of new patients diagnosed with depression had fallen. However, the number of prescriptions doubled over the same period of time. Writing in the BMJ, researchers called for new guidance on long-term prescribing and regular reviews. The Southampton University team looked at all new cases of depression between 1993 and 2005 from the anonymous records of UK general practitioners. Incidence in young women aged between 18 and 30 did rise but, overall, the number of new cases fell by almost 25%. Nevertheless, anti-depressant prescribing doubled during the period, with the number of prescriptions issued per patient rising from 2.8 in 1993 to 5.6 in 2004. The increase in anti-depressant prescribing has frequently made headlines amid concerns about both cost and efficacy. Official data shows these prescriptions rose 36% between 2000 and 2005. Selective Serotonin Reuptake Inhibitors (SSRIs), a family of drugs which includes Seroxat and Prozac, accounted for half of all prescriptions and costs. A major review of these drugs, published last year, suggested they had only marginal effect but this has been vigorously rejected by the manufacturers. Rather than there being a lower threshold for treatment - as is often suggested - "the dramatic changes in antidepressant prescribing volumes between 1993 and 2005 seem to be largely because more patients are on long-term medication and this group consumes the most drugs," said lead author Professor Tony Kendrick. "In order to better understand the rise in antidepressant prescribing, research needs to focus on chronic prescribing and policy needs to focus on encouraging appropriate high quality monitoring and review of those patients who become established on long-term prescriptions." Dr Tim Kendall, of the National Collaborating Centre for Mental Health, said the study's findings suggested doctors were prescribing drugs to people who no longer needed them. "Unfortunately, the SSRI antidepressants have a withdrawal syndrome and many people find it hard to stop them; so whether they are depressed in the first place or just unhappy, they end up needing them for longer than is probably good for them. "Depression is a big problem in the UK and talking treatments, such as cognitive behavioural therapy or interpersonal therapy can be very effective indeed for many people; they also don't have a withdrawal syndrome. "We don't have to depend so much on antidepressants which are hard to stop and easy to prescribe." Marjorie Wallace, SANE's Chief Executive, said: "It is important that any drug used to treat a person's mood or mental state should be taken particularly seriously and kept under constant review and those being prescribed such medications should be given more information about possible side effects. "For mild to moderate depression, talking therapy is recommended as first-line treatment, with anti-depressants used preferably in combination," she said. "It is a pity that with so many people having to wait for such therapies, still in some places an anti-depressant is the only thing a doctor is able to prescribe." Motorists in North Wales face roadside Drug Test Trial The roadside trials will allow the force to get an idea of how prevalent drug-driving is in the region after Ministers drew up plans to create a new offence of driving with any illegal drug in the bloodstream. Officers using the devices, which are capable of detecting up to six commonly used drugs, would stop motorists where they believe there is a possibility that they are under the influence of an illegal substance. Drivers would not be obliged to co-operate and because the equipment has yet to receive Home Office approval for roadside use, officers will not be able to prosecute a driver who gives a positive reading. They would only be able to act under existing law if they could prove the motorist's performance was hampered by illegal drugs. This is assessed by what is known as a Field Impairment - or FIT - test, similar to that used for drink driving before the introduction of the breathalyzer in 1967. The test requires a driver to demonstrate their co-ordination by, for example, standing on one leg without falling over. However the Government is planning to introduce a new law which would make it illegal to drive with any illegal drugs in the bloodstream. This would entail officers being issued with equipment which would allow them to screen for an array of substances including cannabis, ecstasy and cocaine. The machine which is due to be used for the roadside trials is already in use for testing drivers in a number of countries and can provide a reading within about five minutes. It is also in use at more than 170 police stations where it is used to screen anyone arrested for a criminal offence. The latest trials were welcomed by Edmund King, the AA's president. "For some time we have believed that drug driving is as prevalent as drink driving, but the problem is that official figures do not reflect this. "Even if someone is involved in a fatal road crash, the coroner does not always investigate to see if there were drugs in the system." However Mr King was puzzled what would happen if the roadside test did discover that a drug was under the influence of drugs. "They couldn't let someone get back in the car, because that would be illegal." Treatments helping addicts, says drug study The National Treatment Agency, which funded the study, greeted the results with enthusiasm, saying they will "give the public further confidence that their investment is being spent well", in addition to helping drug services become more effective and value for money. The study involved 14,656 people who were addicted to heroin, crack cocaine or both and joined a community treatment programme. Most were stabilised on drugs to stop the craving that compels them to get a fix of illegal drugs, which often involves crime to fund the habit. "Heroin and crack cocaine cause a severe addiction," said Dr John Marsden of the Institute of Psychiatry, King's College London, lead author of the paper published online tomorrow by the Lancet medical journal. "It is being unable to stop using, unable to control how often and how much is used in spite of a piling up of individual relationship, familial and societal harms that make the whole thing illogical." The addicts in the study were given the chance to stabilise their lives – mostly on medication. The data collected related only to the first six months, and cannot throw any light on their long-term chances of coming off drugs completely. Pupils can be searched for drugs and alcohol They will get the legal right to frisk pupils and search their bags as part of a drive to stop a culture of drug-taking and underage drinking spreading into schools. The move, enshrined in new legislation given Royal Assent in December, extends the existing right of teachers to look for weapons. Ed Balls, the Schools Secretary, said the powers would ensure all pupils knew that a “teacher’s authority in the classroom in unquestionable”. But teachers’ leaders have given a guarded response to the move, which come into force in September 2010. Mary Bousted, general secretary of the Association of Teachers and Lecturers, said: “I welcome the extension of teachers’ rights to search but it is not without its problems. “We know classroom teachers face false allegations of assault from pupils and searches mean they can be put in a vulnerable situation. Teachers need the training to enable them to exercise this right confidently.” At the moment, all primary and secondary schools can search pupils for knives and other weapons by patting down their clothing and screening them using airport-style metal detectors. They can also ask pupils suspected of bringing banned items into school to turn out pockets or open bags. But only police can frisk children for drugs or other items and teachers are expected to call the local force if searches are needed. “Low level behavioural problems can sometimes be a forerunner to more serious issues and I want to help schools step in early to prevent problems further down the line," Mr Balls said. “We need to ensure schools have the powers and support they need to maintain good behaviour and to stop problems in the wider community, such as drugs and alcohol use, entering the school grounds.” The powers are set out in the Apprenticeships, Skills, Children and Learning Act 2009. It also requires schools to record and report “significant incidents” in which staff have used forced to restrain a pupil. All schools must also join new-style “behaviour partnerships” – groups of local secondaries sharing resources to crackdown on unruly pupils. Controversially, it forces schools to share expelled children to ensure the worst-behaved pupils are not concentrated in one place. The move has been criticised by the Conservatives who claim it risks undermining headteachers’ authority. The Act also reforms the way schools are inspected by Ofsted. At the moment, most schools in England are inspected every three or four years. But under the Act, the best schools will be left for up to six years while those considered to be struggling will be vetted annually. Ketamine drug use 'harms memory' The University College London team carried out a range of memory and psychological tests on 120 people. They found frequent users performed poorly on skills such as recalling names, conversations and patterns. Previous studies said the drug might cause kidney and bladder damage. The London team and charity Drugscope said users should be aware of the risks. Ketamine - or Special K as it has been dubbed - acts as a stimulant and induces hallucinations. It has been increasing in popularity, particularly as an alternative to ecstasy among clubbers, as the price has fallen over recent years. The study split the participants into five groups - those using the drug each day, recreational users who took the drug once or twice a month, former users, those who used other drugs and people who did not take any drugs. All of the people took part in a series of memory tests as well as completing questionnaires and were then followed up a year later, the Addiction journal reported. Researchers found the frequent users group performed significantly worse on the memory tests - in some they made twice as many errors. The study also showed performance worsened over the course of the year. There was no significant difference between the other groups. "However, many young people who use this drug may be largely unaware of its damaging properties and its potential for addiction. "We need to ensure that users are informed of the potentially negative consequences of heavy ketamine use." Martin Barnes, chief executive of Drugscope, said the charity had already raised concerns about the drug and the study provided "further evidence" of the risk of using it. It is important that people are aware of the harms associated with the drug and that treatment services are equipped to provide necessary support. " |
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Positive signs that teenagers increasingly shun the most problematic drugs Drugs Tests for Exam Students ‘inevitable’ Middle Class Women Hit The Bottle Hardest Growing concern over Ketamine use and kidney failure ‘Young People and Drugs 2010’ Courses First UK death solely linked to GBL reported Nurses offer binge drink advice Prozac rise 'down to serial use' Motorists in North Wales face roadside Drug Test Trial Treatments helping addicts, says drug study Pupils can be searched for drugs and alcohol Ketamine drug use 'harms memory'
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