WHATS NEW? - January 2017

MDMA may pose greater danger to women than men, say scientists

New studies find psychedelics can dramatically improve the well-being and positivity of terminally ill cancer patients

Regular cannabis use could damage eyesight, study suggests

The British Medical Journal has called for the legalisation of illicit drugs for the first time

Alcohol dependence tied to lack of key enzyme, reducing stigma for those with addiction

Just one in four cannabis users are charged and arrests have fallen by almost 50% since 2010, new figures show

ACMD tells ministers drug-related deaths will continue to rise if treatment programmes are not maintained

Free Drug Testing Kits Being Planned for University Students in Northern Ireland

Cannabis vapouriser being tested for potential use in NHS

MDMA may pose greater danger to women than men, say scientists

People in the UK are using more MDMA (aka Ecstasy or Mandy) than ever before. According to recent The Global Drug Survey 2016, this seems to be the "worst time" in a generation to be using the drug.

And, there is even more bad news for female users as Ecstasy seems to have worse effects on women than men. According to research, scientists believe that this could be because the drug interacts with the body's chemistry differently.

The report stated that in the past three years, there has been a four-fold increase in British female clubbers seeking emergency medical treatment and women are two to three times more likely to seek emergency treatment than men.

One theory is that MDMA, the active ingredient in ecstasy, causes users' bodies to retain more water, which in some cases can lead to dangerous brain swelling. Oestrogen, the female hormone, impairs cells' ability to release water, meaning that women are particularly at risk from the effect.

Dr Adam Winstock, the founder of GDS said "Everyone has to be careful, but I think women need to pay extra attention to things like how much they are using, how they are mixing, where they are and who they're with."

In 2016, 10 women died after taking Ecstasy pills or MDMA powder, more than double the number from last year when four cases were recorded.

While the numbers are still fairly low, considering that more than 200,000 people take the drug every weekend, Winstock explained that the effects are still unpredictable and users need to take extreme care with dosage.

"With ecstasy-related deaths approaching the highest they have ever been, alongside some of the highest and most variable strength ecstasy pills in circulation, it's more important than ever this coming party season to take extra care," said Fiona Measham, professor of criminology at Durham University and founder of drug-testing charity The Loop.

For harm reduction information around MDMA and other drugs please visit www.wearetheloop.co.uk.

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New studies find psychedelics can dramatically improve the well-being and positivity of terminally ill cancer patients

In a ground-breaking development in the field of psychiatry, two new studies were published in the Journal of Psychopharmacology showing that a single dose of psilocybin – a powerful, naturally occurring psychedelic compound found in "magic mushrooms" – can radically improve the well-being and positivity of terminally ill cancer patients.

The research, completed at NYU and Johns Hopkins University, gave participants diagnosed with advanced cancer a moderate to high dose of psilocybin in a controlled environment with psychological support from highly qualified guides. Results demonstrated immediate and marked reductions in their levels of anxiety and depression that, remarkably, still persisted 6 months later in 80 per cent of the participants.

Presently, end-of-life care consists of supportive counselling and pharmaceutical treatments, such as antidepressants, to quell feelings of isolation, depression and anxiety commonly associated with a diagnosis of terminal illness. However most medications, along with psychotherapy, can take months to start working and are not effective for all patients. Commonly prescribed drugs such as benzodiazepines may be addictive and can have other unpleasant side effects.

The approach highlighted today, known as "psychedelic-assisted psychotherapy" makes use of the "magic mushroom" ingredient psilocybin. Various studies using this approach over the last decade have shown that giving people psychedelics, with the support of psychotherapy, can provide fundamental and enduring changes much quicker than counselling alone. As a result, in recent years, psilocybin has received increasing attention in the clinical and scientific research communities.

Earlier this year, the Beckley/Imperial Psilocybin and Depression study showed that two low to medium doses of psilocybin reduced depressive symptoms in 67 per cent of participants, with 42 per cent remaining depression-free after three months. Participants in this study had all suffered from depression for at least 18 years and been completely unresponsive to any other forms of treatment. Next year, a larger, placebo-controlled study will be conducted to verify these findings.

In addition to the focus of psychedelic-assisted therapy for depression and anxiety, the Johns Hopkins team also conducted a pilot study investigating smoking addiction treatment with psilocybin. Results showed 80 per cent of the smokers still hadn't had a cigarette at the six month check-up. Most interestingly, the research showed that people were most likely to successfully stop smoking if they reported having mystical experiences on the days they were treated with psychedelics. These experiences were variously described by people as "mystical", "spiritual", "ego-dissolution" and "feelings of oneness". It seems that when people reported these feelings, it correlated with a transformation of previously entrenched thoughts patterns that made them keep repeating the same negative habits."

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Regular cannabis use could damage eyesight, study suggests

Regularly smoking cannabis may damage users' eyesight by triggering an abnormality in the retina, a new study has found. Researchers in France tested 128 cannabis smokers and 124 people who did not use the drug to see how well their retinal cells responded to electrical signals.

A small but significant delay was found in the time taken for the signals to be processed by the retina of the marijuana users by comparison with the control group.

"This finding provides evidence for a delay of approximately 10 milliseconds in the transmission of action potentials evoked by the retinal ganglion cells," the researchers wrote in the JAMA Ophthalmology.

"As this signal is transmitted along the visual pathway to the visual cortex, this anomaly might account for altered vision in regular cannabis users. Our findings may be important from a public health perspective since they could highlight the neurotoxic effects of cannabis use on the central nervous system as a result of how it affects retinal processing."

A statement issued by the Journal of the American Medical Association described the study as "small" and "preliminary".

But the researchers, led by Dr Vincent Laprevote, of the Pole Hospitalo-Universitaire de Psychiatrie du Grand Nancy, added: "Independent of debates about its legalisation, it is necessary to gain more knowledge about the different effects of cannabis so that the public can be informed.

"Future studies may shed light on the potential consequences of these retinal dysfunctions for visual cortical processing and whether these dysfunctions are permanent or disappear after cannabis withdrawal."

In a related article commenting on the research, Dr Christopher Lyons, of the University of British Columbia in Vancouver, and Dr Anthony Robson, of Moorfields Eye Hospital, London, wrote that it dealt with "an important and neglected issue, namely the possible toxic effects of cannabis, with all its implications for the many users of this ubiquitous drug".

"Addressing this issue through the visual system, as the authors have done, is an elegant concept. Any deleterious effect on the visual system would also have implications for driving, work and other activities and thus warrants further study," they added.

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The British Medical Journal has called for the legalisation of illicit drugs for the first time

Prohibition laws have failed to curb either supply or demand, reduce addiction, cut violence or reduce profits for organised crime, the BMJ has argued, saying the so-called 'War on Drugs' had been a failure.

It said the ban on the production, supply, possession and use of some drugs for non-medical purposes was causing huge harm.

"There is an imperative to investigate more effective alternatives to criminalisation of drug use and supply," the BMJ said in an editorial.

The paper's editor-in-chief, Dr Fiona Godlee, and features and debates editor, Richard Hurley, pointed to the fact drug use has grown substantially worldwide, with a quarter of a billion adults worldwide having potentially taken illegal drugs such as cannabis, cocaine or heroin in 2014.

For example, Portugal replaced criminal sanctions for drug use with civil penalties and health interventions 15 years ago, while the UK's new Psychoactive Substances Act criminalises the supply but not the use of synthetic drugs. Some US states such as California have legal cannabis markets and the Netherlands has tolerated regulated cannabis sales for years. The editors called for doctors to be at the centre of the debate on alternative policies to promote health and respect people's dignity.

"Health should be at the centre of this debate, and so, therefore, should healthcare professionals," they argued. "Change is coming, and doctors should use their authority to lead calls for pragmatic reform informed by science and ethics."

In the same issue, former Liberal Democrat leader Nick Clegg and Baroness Molly Meacher said the UK's drug policy has been irrational for 55 years and argued this was the right time to establish a wider review of drug policy.

They urged the Government to reschedule cannabis for medical use and review policy on heroin-assisted treatment, which they said had shown positive results in Switzerland, such as a decline in drug use and crime and improvements in health and rehabilitation. The Parliamentarians also called for an end to criminal sanctions for the personal possession and use of all drugs.

"British politicians should seriously consider introducing a version of the Portuguese model in the UK, involving a significant transfer of resources from criminal justice to treatment services," they said.

They added that steps towards decriminalisation in the UK have already begun, with the Psychoactive Substances Act 2016, and argued changes to drug prohibition "could be good for the UK".

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Alcohol dependence tied to lack of key enzyme, reducing stigma for those with addiction

The lack of a key enzyme may be tied to alcohol dependence, scientists have said. Its absence in the brain means people have a harder time to control their impulses.

The findings are published in the journal Molecular Psychiatry. They are based on years of research by the University of Linköping (Sweden) into alcoholism and other addictive illnesses.

Scientists there have investigated the origins of such diseases by conducting advanced brain research. Indeed, it has long been hypothesised that alcohol dependence is linked to impaired brain function – in particular problems in the frontal lobes of the brain. However, no studies had managed to explain the molecular and neurological mechanisms responsible for such impairment.

After conducting a series of experiments on rats, the team identified an enzyme known as PRDM2, which had previously been studied in relation to cancer. They showed that when it was switched off in nerve cells of the frontal lobe, alcohol dependency tended to develop. The animals appeared incapable to stop consuming alcohol, despite a negative impact on their health and well-being. The rats used in the study were made alcohol dependent. The researchers observed that the addiction was associated with a down-regulation of enzyme PRDM2 production, which stopped being produced absent from the brains' frontal lobe. This led to a disruption of the rats' impulse control.

The animals continued to consume alcohol, even if this was not pleasant for them. Stressed rats who had been dependent in the past were also more likely to relapse and turn to alcohol in the absence of this enzyme.

"PRDM2 controls the expression of several genes that are necessary for effective signalling between nerve cells. When too little enzyme is produced, no effective signals are sent from the cells that are supposed to stop the impulse," lead author Markus Heilig explains.

The next step of the research was to verify the role of PRDM2, checking whether it was a cause of alcohol dependence and not a consequence by knocking out its production from the brains of rats with no alcohol dependence. The behaviour of these animals changed as a result, with a clear disruption of their impulse control – and a higher risk of developing an addiction.

The scientists hope that this discovery will lead to new studies on the topic, with the aim of coming up with new methods to treat alcoholism. They also believe that identifying biological causes to alcoholism will make it easier for society to accepts patients who suffer from the devastating addictive disease.

"We see how a single molecular manipulation gives rise to important characteristics of an addictive illness. Over the long term, we want to contribute to developing effective medicines, but over the short term the important thing, perhaps, is to do away with the stigmatisation of alcoholism," Heilig concludes.

For further information: www.jmolecularpsychiatry.biomedcentral.com/articles

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Just one in four cannabis users are charged and arrests have fallen by almost 50% since 2010, new figures show

Just one in four people caught with cannabis are charged by police across England and Wales, new figures reveal, while arrests and cautions have fallen by almost half and charges have fallen by a third since 2010.

In some areas as few as 14 per cent of those caught with the class B drug are charged. But overall, 27 per cent of people caught are charged, while 40 per cent receive the lighter reprimand of a caution.

According to figures obtained through a Freedom of Information request by the BBC in which 31 out of 43 England and Wales police forces responded, there were 471,202 cases of cannabis possession between 2011 and 2015. Of those, 126,789 people (27 per cent) were charged and 193,260 (41 per cent) received warnings. A further 22 per cent were either given cautions of fixed penalty notices.

Warnings are less severe than police cautions and do not mean those caught are given a criminal record. A caution is not a criminal conviction but can be used in court as evidence at a later date.

Despite the general trend for leniency, some police forces are still pursuing cannabis users. In Hampshire 65 per cent of those caught with the drug are charged or end up with a summons. In Cheshire 64 per cent caught are charged, while in South Wales the figure is 60 per cent as police forces continue to target users.

But in Cambridge, the police figures reveal just 14 per cent of users are charged and the figure is only slightly higher at 16 per cent in Staffordshire, Hertfordshire, Cornwall and Devon.

Meanwhile, the Centre for Policy Studies' Kathy Gyngell said: "These figures show the police have given up on cannabis. It represents a total failure to protect the interests of young people. The correct sanction at the right age might just save them from a dangerous drug."

Some police forces have said they are not looking to "seek out" people who use cannabis and one police force said officers are no longer targeting those who grow cannabis for personal use.

Bucking the downward trend for arrests, West Midlands police reported a 40 per cent surge in arrests for cannabis earlier this year.

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ACMD tells ministers drug-related deaths will continue to rise if treatment programmes are not maintained

Maintaining the capacity and quality of drug treatment is essential to prevent further increases in opioid-related deaths, government drug advisers have told the Home Secretary.

Over the last 4 years, the number of reported drug misuse deaths involving opioids (including heroin) rose by 58% in England, 23% in Wales and 21% in Scotland.

A report published on 12th December by the Advisory Council on the Misuse of Drugs (ACMD) investigates the causes of the increase and potential responses.

The ACMD's Drug-Related Deaths (DRDs) Working Group found that there is a sizeable number of people who have used heroin since the 1980s and 1990s with complex health problems. These people are increasingly vulnerable to opioid-related deaths as they age. The report, 'Reducing opioid-related deaths in the UK', says:

We can assert with a good degree of confidence that the increasing vulnerability of the UK's ageing cohort of heroin or opioid users with increasingly complex health needs (including long-term conditions and poly-substance use), social care needs, and continuing multiple risk behaviours is highly likely to have contributed to recent increases in drug-related deaths. The panel of experts also outlines other potentially important issues:

Other factors, including changes in the availability of street heroin, socio-economic changes (including cuts to health and social care, welfare benefits and local authority services) and changes in treatment services and commissioning practices may also have contributed to these increases.

In response to the increase in opioid-related deaths, the report makes the following recommendations:

The expert panel raised concerns that 'drug treatment and prevention services in England are planned to be among those public health services that receive the most substantial funding cuts as a consequence of the government's decision to cut the public health grant'.

Annette Dale-Perera, co-chair of the ACMD's Drug-Related Deaths Working Group, said: We can assert with a good degree of confidence that the ageing profile of heroin users with increasingly complex health needs, social care needs and continuing multiple risk behaviours has contributed to recent increases in drug-related deaths.

The greater availability of heroin at street level, the deepening of socio-economic deprivation since the financial crisis of 2008, changes to drug treatment and commissioning practices, and the lack of access to mainstream mental and physical health services for this ageing cohort have also potentially had an impact.

To read the full report click: www.gov.uk/government/organisations/advisory-council-on-the-misuse-of-drugs

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Free Drug Testing Kits Being Planned for University Students in Northern Ireland

Plans are under way which could see drug testing kits provided for students at universities in northern Ireland.

Free kits could soon be offered at the students unions of both Ulster University and QUB, to help undergraduates make an "informed choice" on illegal drugs including ecstasy, cocaine and heroin.

Ulster University Student Council has confirmed it is "exploring the possibility" of making drug testing kits available as part of an awareness campaign early next year.

And in a separate development QUB is being considered as one of 10 UK campuses targeted by the Students for Sensible Drug Policy (SSDP) organisation, which also hopes to provide free test kits for college students.

An SSDP pilot scheme saw students at Newcastle University handed free kits earlier this year to show what was in substances they were taking.

The kits use chemical reactions to change colours when in contact with illegal Class A drugs such as MDMA (ecstasy), cocaine, heroin and LSD, along with a range of former 'legal highs'.

They can detect dangerous additives in pills including PMA and PMMA - chemicals often sold as ecstasy that can be fatal if taken in large doses.

The plan has been revealed following the death of 22-year-old Jamie Burns at a dance music event at Queen's Students' Union in November.

The call centre worker is believed to have taken two pills before collapsing and being taken to hospital, where he was pronounced dead. Ciarán Weir is SSDP's UK executive director, and told the Irish News that the campaign to provide kits for universities was not about promoting drug use.

"This is about helping students who are going to take drugs anyway, make an informed choice about what they are doing," said Ciarán, a postgraduate from Lurgan who intends to return to Queen's to study next year.

"We want people to be safe on a night out, and to know what they are putting into their bodies. It blows my mind that statistics show drug use is falling, but the level of harm caused by drugs is actually rising. Attitudes need to change."

For further information on the work of SSDP click: https://ssdp.org/.

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Cannabis vapouriser being tested for potential use in NHS

A cannabidiol (CBD) vaporiser that has been used by thousands of people suffering from a variety of conditions is being tested by an NHS unit, an unprecedented step that could increase scrutiny on cannabis' medical benefits and have a huge impact on the UK's legislation on it.

The MediPen legal way to consume CBD, which, unlike tetrahydrocannabinol (THC), is non-psychoactive, has been on sale for a year now and has been used by people to help with everything from depression and anxiety to arthritis and fibromyalgia.

The company has been consulting with a group of production and regulatory support pharmacists from the NHS for the past few months, who have been testing their proprietary cannabis oil formulation.

A detailed public report outlining the testing process and extraction methodology will follow, and though it is only about confirming purity and cannabinoid profile at this stage, this is a big first step for the medical cannabis industry in the UK.

MediPen is confident that by setting a precedent for testing cannabis products with the NHS, it will have a huge impact on the public's perception of cannabis.

"Over the past year the MediPen has quickly become without a doubt one of the most highly-rated CBD products in the world," said managing director Jordan Owen. "We've recently been working very closely with a team of NHS production and regulatory support pharmacists who've been able to meticulously analyse our proprietary formulation for both safety and cannabinoid concentration. As the first consumer cannabis product to be tested by the NHS, we are confident that this will go a long way towards creating a properly regulated cannabis market in the UK and are extremely excited to see what the future holds."

The NHS was unable to comment due to a non-disclosure agreement preventing them from sharing any client information, with the exemption of official government bodies such as the Medicines and Healthcare products Regulatory Agency (MHRA). It did however point out that cannabidiol is present in the authorised multiple sclerosis spray product Sativex, though this is prescription only.

For further information about the Medipen visit www.medipen.co.

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