WHATS NEW? - December 2014

New 'legal weed' fuelling growing levels of violence in British jails, annual prison report warns

Drug recommended to help cut drink dependence

Britons spend more on drugs and prostitutes than beer and wine

One in five new students admits taking 'legal highs'

Clubbers warned of overdose risk from super-strength ecstasy

Alcoholism warning for women aged 60 or over

No link between tough penalties and drug use – new report

£200,000 'smart' drugs seizure prompts alarm over rising UK sales

Cannabis drug for multiple sclerosis 'too costly' for England but not Wales

Workplace drug testing 'on the rise', say providers

New 'legal weed' fuelling growing levels of violence in British jails, annual prison report warns

The soaring use of synthetic cannabinoids in prisons has fuelled growing levels of violence and bullying behind bars, the Chief Inspector of Prisons warned in his annual report today.

In a bleak picture of deteriorating conditions in English and Welsh prisons, Nick Hardwick said jails were 99 per cent full, while the suicide rate had reached a 10-year high and numbers of serious assaults rose 38 per cent.

He pointed to the widespread use of legal highs (particularly the synthetic cannabinoids known as 'Spice') as a key factor behind the increased instability in prisons. Chemical compounds designed to mimic banned substances – and which are not detected in routine testing – are now the most commonly used drug in some jails, Mr Hardwick said.

He said: "The increased availability in prisons of 'new psychoactive substances' was a source of debt and associated bullying and a threat to health."
He said the prevalence of Spice and Black Mamba, chemical alternatives to cannabis, presented particular "cause for concern" in more than one third of the jails inspected.

The inspector raised the alarm over a dramatic increase in "incidents of height", when inmates clamber on to netting or railings in the hope they will be taken to segregation units and then "shipped out" of the prison to a safer jail.
The number nearly doubled in from 591 in 2012-13 to 1,007 this year. Mr Hardwick said: "This should be regarded as a major concern."

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Drug recommended to help cut drink dependence

A pill designed to reduce alcohol consumption among problem drinkers looks set to be made available to NHS patients in England and Wales.

Nalmefene should be made available to people who regularly drink high amounts of alcohol, the National Institute for Health and Care Excellence (NICE) said. Costing just over £3 a tablet, it is already prescribed in Scotland.

Nalmefene, which is also called Selincro, is taken as a tablet once a day and reduces the urge to drink alcohol. The drug is licensed for use along with psychosocial support. NICE says 600,000 people would be eligible for the drug.

If it receives final approval, it will be made available on the NHS in England and Wales. Prof Carole Longson, NICE Health Technology Evaluation Centre director, said alcohol dependence was a serious issue for many people.

"Those who could be prescribed nalmefene have already taken the first big steps by visiting their doctor, engaging with support services and taking part in therapy programmes," she said. "We are pleased to be able to recommend the use of namelfene to support people further in their efforts to fight alcohol dependence. When used alongside psychosocial support nalmefene is clinically and cost effective for the NHS compared with psychosocial support alone."

The World Health Organization defines high alcohol consumption as drinking more than 7.5 units per day for men and more than 5 units per day for women.

For men, that is three pints of beer or cider at 5% strength. For women, two pints of similar strength alcohol would put them into the high consumption category.

However, Dr Niamh Fitzgerald, Lecturer in Alcohol Studies at the University of Stirling, said there were reasons to be concerned about what the introduction of nalmefene would mean in practice.

"The fact that alcohol problems are widespread in society is an important principle for effective policy options such as minimum unit pricing and restrictions on marketing of alcohol," she said.

"It would be unfortunate if the availability of nalmefene led to a sense that the appropriate response to these widespread problems was for the NHS to medicate large numbers of people, rather than initiating these other more effective and less costly approaches to reduce consumption."

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Britons spend more on drugs and prostitutes than beer and wine

Britons spend more on drugs and prostitutes than on beer and wine, the first official study of money spent on "illegal" activities has found.

The Office for National Statistics, which tracks changes in spending habits across the country, found an enormous £12.3 billion last year on illegal substances and sexual services. This was more than the amount spent on wine and beer in 2013, which was just under £11 billion, according to the ONS data.

The statistics body had been forced by the European Union to investigate the amount of money spent on illegal drugs and prostitution. The EU said the figures were necessary to create a fair comparison of different national economies.

David Matthewson, a statistician at the ONS, said: "For a long time we have made adjustments to our calculations to account for smuggling, and some of that would have included alcohol and other substances. But smuggling, of course, is not as commonplace as it once was. This was the first time we have allowed spending on narcotic drugs and prostitution into our calculations for the economy."

"As might be expected, data on this sort of activity is not exactly forthcoming, so we used a number of previous studies which looked at different elements of the equation, from the number of prostitutes in the UK to price at which drugs are bought."

The ONS estimated that including spending on drugs such as cocaine and heroin in the national accounts would add £6.7 billion a year to spending across the UK. The figure was an estimated based on data covering the period between 1997 and 2013 from various sources, including the Home Office and a study undertaken by the United Nations.

Spending on prostitution was believed to be £4.3 billion a year during this period, with data derived from a 2004 government study and "extrapolated". The overall estimate for drugs and prostitution for 2013, taking into account inflation, was £12.3 billion.

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One in five new students admits taking 'legal highs'

Two groups of so called 'legal highs' that imitate the hallucinogenic effects of LSD and of heroin are to be banned as Class A drugs on the recommendation of the governments drug advisors.

Almost one in five new students starting university this term has experimented with New Psychoactive Substances (so-called 'legal highs') a new survey has found.
A study conducted among fresher's arriving at a large university in southern England, found that 19 per cent admitted trying at least one of the new legal substances in the past. A further 36 per cent of those questioned said they had been offered the drugs, while 61 per cent claimed to have a friend who had taken them.

The UN Office of Drugs and Crime estimates the number of people in the UK aged between 15 and 24 who have tried new legal drugs could be in excess of 670,000, making this country the highest consumer in Europe.

The Angelus Foundation, which is the only British charity dedicated to raising awareness about the dangers of new psychoactive substances and carried out the freshers' survey is urging students and parents to get educated about the array of substances currently on the market.

Maryon Stewart, who was inspired to set up the charity after her own daughter died taking the drug GBL (which was legal at the time), said students were particularly vulnerable to experimenting with these new drugs.

She said: "There is no group more vulnerable to exposure to legal highs than students. Naturally, many take the opportunity to try new experiences and our survey shows one in four have already taken a legal high. Their prevalence appears to be rife. This revelation will be deeply worrying to many parents. These substances can have highly unpredictable effects and are marketed with little regard for the serious damage they may inflict."

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Clubbers warned of overdose risk from super-strength ecstasy

Clubbers are being warned about a heightened risk of overdosing on ecstasy, amid evidence that the purity of the drug has increased to potentially dangerous levels. Tests have shown that the average pill now has 100mg of active ingredient MDMA, compared with 20-30mg seen a few years ago.

Tests on pills and MDMA powder confiscated at festivals this summer as well as at the Warehouse Project (WHP) club in Manchester show that ecstasy purity is at its highest level for about 10 years.

The rise in fatalities may partially be explained by the availability of "super-strength" ecstasy – either in pill or crystallised powder form. One recent formulation reportedly contained nearly two and a half times the standard dose of MDMA (ecstasy's active ingredient) per pill, according to drugs charity DrugScope.

Fiona Measham, professor of criminology at Durham University, who regularly tests drugs at the Warehouse Project and elsewhere, says the average ecstasy tablet now contains 100mg of MDMA; in 2009, seen by experts as a nadir in drug purity, the average ecstasy pill contained just 20-30mg. An "acceptable" dose for an average-sized adult during one drug-taking session is 70-75mg, according to Measham.

"Our concern now is that people who over the years have been used to taking two or three tablets in a night might still do the same. With the purity, the results could be severe," said Sacha Lord, who runs WHP.

Deaths caused by ecstasy in England and Wales have increased steadily in recent years, from eight in 2010 to 43 in 2013, figures from the Office for National Statistics show.

Earlier this year the mother of a 15-year-old girl who died in Oxford in 2013 after swallowing 0.5g of 91% pure MDMA called for drugs to be legalised to prevent similar tragedies. Anne – Marie Cockburn urged politicians to change UK drug policy after the inquest into the death of her daughter, Martha Fernback.

Measham said the increased purity of ecstasy was probably due to manufacturers finding new ways to synthesise the drug. "The reason the purity dropped so low a few years ago was because law enforcement agencies managed to disrupt the supply chain of the precursor ingredients used to make ecstasy," she said.

"Now we think that manufacturers have figured out a new way of making ecstasy without it. It's like making a cake: there's more than one ways to make one, you can use butter or margarine. But we don't know for sure. Naturally, the industrial manufacture of class-A drugs is shrouded in mystery."

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Alcoholism warning for women aged 60 or over

Nearly one in 10 of those starting formal treatment for alcoholism is now a woman aged 60 or over, according to figures – up from 6% five years ago.

In contrast, women beginning treatment for alcoholism between the ages of 18 and 29 went down from 18% five years ago to 14%, according to Public Health England figures. The figures show a similar trend among older men – with 8% of those males entering treatment being over 60 compared with 6% five years ago.
The number of men aged between 18 and 29 entering treatment was 15% last year from 19% in 2008-09.

There were 835 deaths during treatment in 2013-14.
Dr Paul McLaren, a consultant psychiatrist at the Priory, said: "A common pattern is for regular drinkers, who have had their consumption constrained by the structure of working, tipping into harmful drinking in retirement"

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No link between tough penalties and drug use – new report

There is "no obvious" link between tough laws and levels of illegal drug use, a new Home Office report has found.

The Home Office report compared the UK's approach to drug misuse with that of 13 other countries. After examining a range of approaches, from zero-tolerance to decriminalisation, it concluded drug use was influenced by factors "more complex and nuanced than legislation and enforcement alone".

But it found there had been a "considerable" improvement in the health of drug users in Portugal since the country made drug possession a health issue rather than a criminal one in 2001. The Home Office said these outcomes could not be attributed to decriminalisation alone.

The Home Office looked at methods used to control drug use in various countries:

9 have sanctioned "drug consumption rooms", including Canada, Denmark and Switzerland

8 are trialling the treatment of addicts with pure heroin rather than methadone, including Switzerland, the Netherlands and the UK

4 have special "drug courts", where people pleading guilty to drug offences can opt for treatment rather than prison, including the US

1 has set up "dissuasion commissions" - Portugal

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£200,000 'smart' drugs seizure prompts alarm over rising UK sales

A record haul of "smart" drugs, sold to students to enhance their memory and thought processes, stay awake and improve concentration, have been seized from a UK website by the medicines regulator.

The seizure, worth £200,000, illustrates the increasing internet trade in cognitive enhancement drugs and suggests people who want to stay focused and sharp are moving on from Red Bull and legally available caffeine tablets.
Most of the seized drugs are medicines that should only be available on a doctor's prescription. One, Sunifiram, however is entirely experimental and has never been tested on humans in clinical trials.

Investigators from the Medicines and Healthcare Products Regulatory Authority (MHRA) are worried at what they see as a new phenomenon – the polished, plausible, commercial website targeting students and others who are looking for a mental edge over the competition. In addition to Ritalin, the drug that helps young people with attention deficit disorder (ADD) focus in class and while writing essays, and Modafinil (sold as Provigil), licensed in the US for people with narcolepsy, they are also offering experimental drugs and research chemicals.

MHRA head of enforcement, Alastair Jeffrey, said the increase in people buying cognitive-enhancing drugs or "nootropics" is recent and very worrying. "The idea that people are willing to put their overall health at risk in order to attempt to get an intellectual edge over others is deeply troubling," he said.

"The fact of the matter is that if you are acquiring medicines over the internet without a prescription then you are purchasing from an unknown, unregulated and ultimately an unlawful source that has one objective – to take your money."

It also worries Barbara Sahakian, professor of clinical neuropsychology at the Department of Psychiatry, University of Cambridge School of Clinical Medicine. Sahakian has been warning about the growing interest in drugs to enhance the workings of the brain. "I am extremely concerned that young people are accessing these cognitive-enhancing drugs via the internet, which is very unsafe, as it is unclear what the drug sent actually contains.

"There are also no long-term safety studies of the effects of these cognitive-enhancing drugs in healthy people. Healthy people are using these drugs without consultation from a doctor."

The drugs could be harmful for people who have particular medical problems or are taking other medication, she adds.

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Cannabis drug for multiple sclerosis 'too costly' for England but not Wales

A drug derived from cannabis, which many people with multiple sclerosis say helps ease their symptoms, has been ruled too expensive to be used by the NHS in England even though it is approved for Wales.

In new guidelines for the diagnosis and treatment of people with the disabling disease, the National Institute for Health and Care Excellence (Nice) says the price set by the manufacturer of Sativex (nabiximols) is too high for the benefit it gives patients. But the decision opens up the sort of "postcode lottery" that Nice was set up to end, with MS patients in Wales able to use the drug on the NHS while those in England either have to buy it themselves or go without.

A second drug, Fampyra (fampridine), designed to improve people's ability to walk, has been rejected by both England and Wales. Neither drug is routinely available in Scotland.

"The substantial cost of Sativex and fampridine compared to the modest benefit does not justify their use; there are better ways to improve care for people with MS," said Dr Paul Cooper, a consultant neurologist who chaired the guideline development group.

But the MS Society's chief executive, Michelle Mitchell, said the rejection of the two drugs by Nice was disappointing. "Surely we should be striving for the most innovative treatment and care to be made available to people with MS, not limiting options even further," she said.

The charity published a survey of nearly 4,000 people with MS that found 82% of those taking Sativex considered it essential or a high priority. The main reasons people gave for not taking Sativex were that it was not available where they lived – prior to Nice's decisions, the NHS makes local decisions about funding the drug – or that they would have to pay privately.

"I experience very painful spasms around my ribs, the MS hug, and tightness in my arms and legs. I've been told that Sativex could give me some relief but it seems so out of reach," said Shona Garrett, 38, from Lowestoft, who was diagnosed two years ago and is on a waiting list for the drug in her area. "I also experience nerve pain like constant pins and needles in my feet, and I've heard Sativex could help with this too. No one has offered me any other options."

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Workplace drug testing 'on the rise', say providers

Workplace drug testing has increased significantly in the UK, four leading screening companies have said.

They have seen rises in the number of annual tests carried out of between 40% and 470% over four years. Although workers cannot be made to take a drugs test, if they refuse when the employer has good grounds for testing, they may face disciplinary action. Business leaders' increased awareness of workplace drug use is a large factor behind the growth, said LGC Group.

It added that the adoption of a drugs-testing policy is "mainly due to insurance purposes". The four companies are Alere, Synergy Health, LGC Group and BioClinics. The last two saw rises of 100% and 470% respectively over the four years in the number of drugs tests they conduct annually, although they started from a smaller base.

Lianne Gray, LGC Group's strategic account manager for occupational drug testing, said employees in safety-critical roles - such as operating heavy machinery or driving - and government agencies were most likely to be screened.

But she said there was a growing trend for drug testing to be conducted in "more normalised industries", including retail and health companies, as businesses look to "safeguard not only the business, but also the reputation in the field they work in". Ms Gray said there had been changes in the types of drugs for which businesses wished to screen.

"Traditionally we see requests for amphetamines, cocaine, cannabis, opiates," she said. "Now we're seeing more requests for things like ketamine, steroids, and also for novel psychoactive substances - or legal highs as they're otherwise known."
Under current law, businesses must have the consent of employees whom they wish to screen for drugs, and usually this will be in the contract or staff handbook.
Drugs testing is normally performed at random. It is also sometimes enforced prior to employment, on cause - following an accident or incident - or on suspicion.
The increases in drug testing have angered civil liberties groups, who say that the practice is an invasion of people's privacy outside of safety critical roles.

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