WHATS NEW? - June 2017

Online 'virtual counselling' service launches for gay men struggling with drugs and chemsex

National Warnings Over Fentanyl Being Mixed in with Heroin

Universities must do more to tackle use of smart drugs, say experts

Prison smoking ban could see 'massive rise' in drug use and violence in British jails, experts warn

Spice: 'More Potent' And Less Controlled Since Psychoactive Substances Bill, Experts Warn

New 'RIDR' System launched to help tackle harms from new psychoactive substances

Stressed teachers are becoming reliant on alcohol and prescription drugs, poll suggests

More middle-aged men taking steroids to look younger

Mixing alcohol and energy drinks 'may be a risky cocktail'

More than half of UK vapers 'have given up smoking'

More than a quarter of young adults in the UK do not drink alcohol

NHS gives first medical cannabis prescription to 11-year-old boy with severe epilepsy

Online 'virtual counselling' service launches for gay men struggling with drugs and chemsex

Two leading charities have launched an online counselling service for gay and bisexual men to get support around drugs, sex and alcohol. Terrence Higgins Trust and London Friend launched the new service via Friday/Monday, a website which offers information about sex and drugs for gay and bisexual men.

The groundbreaking new project includes an online support group and one-to-one virtual counselling, which the charities hope will make it easier for men in rural areas to access support.

The new online services will be delivered by video chat software Zoom, via the Friday/Monday website. People will be able to see their counsellor on the screen, or up to 10 people in a support group, while they talk through their issues around drugs or alcohol.

Cary James, Head of Health Promotion at Terrence Higgins Trust, said: "We're delighted to be working with London Friend to deliver this important and much needed project. Mainstream services often don't meet the needs of gay men whose drug and alcohol use is linked to their sex life. This can leave them feeling isolated. These online services will reach out to these men and provide specialist support from people who really understand and who will not judge, helping people to get back in control of their sexual and mental health."

Monty Moncrieff, Chief Executive of London Friend, said: "If you find yourself stuck in a cycle, these online services can help you understand the role that drugs and alcohol are playing in your life and give you the knowledge and tools to make the changes you want. Wherever you live, and whether you want to cut back a bit, be safer or quit entirely, we'll be there at the click of a button to support, help and guide you through it."

The groundbreaking project was awarded funding by the Public Health England HIV Prevention Innovation Fund. Find out more and sign up on the Friday/Monday website visit: www.fridaymonday.org.uk

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National Warnings Over Fentanyl Being Mixed in with Heroin

A warning has been issued that a new deadly batch of heroin - already responsible for several deaths in the north east of England and said to be up to 100 times stronger than conventional substances – is now becoming widely used across the U.K.

One of the Government's top public health experts that says that drug users are at risk of overdosing on Fentanyl and a similar substance called carfentanyl.

Warnings have been passed on to providers of drug treatment and prevention services along with other relevant services that have contact with drug users in an effort to warn of the potentially deadly development.

Professor Paul Cosford, executive director of health protection services for the Health Protection Agency said: "Fentanyl, which is up to 100 times stronger than street heroin, and its analogue carfentanyl which is 100 times stronger again, are believed to have caused several recent deaths in the Yorkshire, Humber and Cleveland areas.

"An National Crime Agency and West Yorkshire Police operation, targeting a laboratory suspected of producing fentanyl and carfentanyl, has led to concerns that the substances could have been distributed to drug dealers across a much wider area and that drug users in other regions are now also at risk.

"There is significant evidence from a small number of post-mortem results of recent drug user deaths and from police seizures that some heroin may contain fentanyl or carfentanyl added by dealers. These are highly potent synthetic opioids and very small amounts can cause severe or even fatal toxicity. Those of you in contact with heroin users should be alert to the increased possibility of overdose arising from heroin cut with these synthetic opioids, be able to recognise possible symptoms of overdose and respond appropriately."

Tony Saggers, Head of Drugs Threat and Intelligence at the National Crime Agency, added: "We have taken the unusual step of appealing to people to be vigilant. First, because whilst initial toxicology revealed fentanyl analogues in a small number of these deaths, specific re-testing has started to indicate that the influence of fentanyl is greater than first suspected."

Second, the NCA's operation with West Yorkshire Police to locate and disrupt an illicit drugs laboratory has indicated that it may be a source for the production of fentanyl and other analogues. In particular we now believe UK customers beyond the north east region are likely to have received consignments of these drugs.

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Universities must do more to tackle use of smart drugs, say experts

Universities must do more to tackle the growing number of students turning to "smart drugs" to cope with exam stress, leading academics have said.

UK institutions are being called on to consider measures such as drug testing to stem the rise of cognitive enhancement drugs being used by young people to improve their academic performance.

As hundreds of thousands of students across the UK prepare to sit their summer exams in coming weeks, Thomas Lancaster, an associate dean at Staffordshire University, said we were entering a "dangerous world" where students have access to the "study drugs". He called on universities to have "frank discussions" with students and to develop policies around their use. are normally used to treat disorders such as narcolepsy and attention deficit hyperactivity disorder.

Larissa Maier, a research associate at the University of Zurich, called for more education about the risks associated with the substances. Her concerns were echoed by Prof Tim Hales, the head of neuroscience at Dundee University. He said: "In the short term some of these drugs may not be harmful, but we don't know about their potentially harmful cumulative effects. Different students will respond differently, particularly when taking other medications, alcohol or recreational drugs at the same time."

The growth of smart drugs over the past five years has been well documented, especially in top institutions such as Oxford University. In May 2016 the Oxford student newspaper, the Cherwell, published a survey that showed 25.6% of students knowingly took Modafinil or another such drug without prescription.

Oxford has introduced workshops to educate young people about smart drugs.

A recent European study co-authored by Robert Dempsey, a lecturer in psychology at Staffordshire University, found that the majority of university students believe it is normal to use such drugs to enhance academic performance.

Maier said current estimates indicate about 10% to 25% of students have tried to enhance their cognitive performance with prescription drugs, alcohol or illegal drugs at least once. With a UK student population of 2.3 million, this works out at least 230,000 people.

Dr Dominique Thompson, the director of the students' health service at Bristol University, said she sees students who come in suffering the side-effects of the medications, such as insomnia. She put the rise in use down to increased competition and pressure on young people.

Thompson said: "There is a huge pressure to do well and excel and be different to everyone else as well as financial pressure now. That may be another factor as to why students feel they need to use any means to do well."

Non-prescription sale of Noopept, a fine white powder that its makers claim enhances cognitive ability, was banned in the UK last year under the Psychoactive Substances Act. However, several British websites still actively and openly sell the substance.

Modup, a website selling Modafinil, state that during exam time the volume of Modafinil shipped to the UK doubles. It claimed the campuses it mainly sent stock to were Oxford and Cambridge, followed by the London institutions Imperial and the London School of Economics.

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Prison smoking ban could see 'massive rise' in drug use and violence in British jails, experts warn

Violence and drug use is likely to increase in some of the UK's prisons, experts have warned, after it was announced that a smoking ban would be implemented by the end of the summer.

Prisoners in long term and maximum security jails have been encouraged to sign up for courses and apply for nicotine patches, according to a letter given to some inmates. The policy is expected to come in on 31 August.

The ban is being introduced to help protect the health of staff and inmates, of whom more than 80 per cent smoke, bringing prisons in line with the UK-wide ban on smoking in workplaces.

The letter, which was distributed to inmates at HMP Frankland in Durham, stated: "We have now received confirmation that all long term and high security establishments will become completely smoke-free by 31 August. We will continue to support prisoners who currently smoke by increasing the number of staff who can deliver 'stop smoking' services through the establishment. I encourage you to start your preparation now and apply for 'stop smoking' services."

A pilot scheme introduced in Wales last year saw 21 prisons become smoke-free, but this is the first time the policy will be implemented in high security jails which house the most dangerous prisoners.

Criminal justice experts have warned that the move is likely to cause a rise in prisoners seeking out illicit substances to alleviate their addiction, as well as increased levels of self-harm and violence as inmates struggling to cope with stress are unable to turn to tobacco.

An independent report into the smoking ban implemented at HMP Cardiff last year found there was a sharp rise in vandalism and violence, which was thought to be partly down to the stress of withdrawal.

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Spice: 'More Potent' And Less Controlled Since Psychoactive Substances Bill, Experts Warn

The drug known as 'Spice' is becoming 'more potent and dangerous' since it was outlawed by the government last year, fuelling an explosion in incidents linked to the substance, according to many drugs workers and police officers.

Spice, a synthetic cannabinoid has now become the preserve of organised crime leaving fewer clues as to its true chemical composition. Drug researchers working alongside police have reported a dramatic rise in the strength of the chemicals since it was outlawed, while drugs and social workers have described a current batch on the streets as "really, really dangerous".

"The government didn't really think through the consequences of banning Spice and criminalising the supply of Spice," says Tony Lloyd, Manchester's Police and Crime Commissioner and interim Mayor. "It should have been thought through as to what the impact would be if it lead to less control over supply. Previously, while Spice and its variations were considered dangerous, they were sold by online stores and in head shops where supply chains were more easily tracked and controlled. Some products carried detailed labelling. The way it's happened meant [we've gone] from having a fairly regulated trade in the past [when] if a bad batch of Spice came through then, before the legal ban, the police or others could prevail on the local suppliers, and through them the supply chain, and say 'Get that off our streets'," Lloyd said. "But now of course with the illegal trade there is no capacity to say 'Please would you'd be kind enough to remove that from our streets,' so it makes it much more random."

Chief Superintendent Wasim Chaudhry of Greater Manchester Police (GMP) told the BBC: "I do think that because of the fact now it's being manufactured by, potentially, drug dealers then it cannot be controlled. The fact that it is being mixed in places, potentially in people's homes, there is absolutely no control. We don't know what it's being mixed with and therefore the effect on the user is particularly concerning."

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New 'RIDR' System launched to help tackle harms from new psychoactive substances

Last year, according to the 2015 to 2016 Crime Survey for England and Wales, one in 40 (2.5%) young adults aged 16 to 24 took a new psychoactive substance and there is evidence of widespread use among vulnerable adults such as prisoners and homeless people. Whilst specialist services are responding, these harms are often poorly understood in frontline healthcare services and there is little guidance available to them.

Public Health England (PHE) in collaboration with the Medicines and Healthcare products Regulatory Agency (MHRA) is piloting a national system to help better monitor the negative effects of NPS and share best treatment practice across a variety of settings, including A&E, sexual health clinics, mental health services, prison health services, drug treatment services and GP surgeries.

The UK-wide, easy to use Report Illicit Drug Reaction (RIDR) system will be accessible to all front line health staff. Information about the drug and its effects will be recorded anonymously using an online portal. Data from the tool will be analysed by experts to identify patterns of symptoms and harms. This will be used to inform treatment guidance and help staff deal more quickly with unknown substances, and improve patient safety.

Rosanna O'Connor, Director of Alcohol, Drugs and Tobacco at PHE, said:

"The contents of NPS frequently change and their effects can be dangerous and unpredictable. These substances can cause serious problems to both mental and physical health. Last year's ban has helped reduce their easy availability, but we are still seeing the most vulnerable groups, particularly, the homeless, prisoners and some young people, suffering the greatest harm from these substances."

The new RIDR system will help health staff better deal with the emerging challenges we are seeing. We want to encourage all frontline staff in settings such as A&E, sexual health clinics, prisons, drug and mental health services, to use the system, which over time will greatly increase our knowledge of these new substances and ultimately improve patient care.

More information, including on how to register, is available on the RIDR website.

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Stressed teachers are becoming reliant on alcohol and prescription drugs, poll suggests

Stress at work is leading some teachers to become increasingly reliant on alcohol, caffeine, and prescription drugs, while a number have seen relationships breakdown, it has been suggested.

A new poll indicates that more than four-fifths of school staff (83 per cent) think that their job has had a negative impact on their health and wellbeing in the last 12 months.

Given a list of issues and symptoms they may have experienced, some 84 per cent of those polled by the NASUWT teaching union said that they have lost sleep due to their work, while three in four (54 per cent) have experienced anxiousness and a similar proportion (74 per cent) reported low energy levels.

More than a fifth (22 per cent) had been turning to alcohol more often, and the same percentage (22 per cent) said they had increased their caffeine intake. Just under a fifth (19%) said they had lost their appetite and over one in 10 (11 per cent) said they had started to use, or increased their use, of anti-depressants. Around nine per cent had had a relationship break down, while around seven per cent had started to take, or were taking more, prescription drugs.

One NASUWT member told the union: "My husband has left me because I'm always working", and another said that their teaching job had led to the breakdown of a 16-year marriage.

A third said: "I lose sleep worrying. I feel guilty if I am off sick or not working evenings and weekends."

More than half of those polled (56 per cent) by the NASUWT, which is meeting for its annual conference in Manchester, said that their job satisfaction has declined in the last 12 months, 37 per cent said it had stayed the same and the rest said it had improved.

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More middle-aged men taking steroids to look younger

Growing numbers of middle-aged men are turning to anabolic steroids to make themselves look and feel more youthful and boost their sexual performance, experts say.

Image-obsessed young males use drug to build muscle but growing health toll includes HIV infection rate equal to that of heroin users. People who work with users have raised concern about a new trend among men in their 40s and 50s, and some even in their 60s and 70s, who are taking the drug to boost energy levels and fight some of the effects of ageing, such as weight gain and a lower libido. Steroids can cause a range of health problems such as heart disease and blood clots.

"We have come across a lot of older men using. It's almost like hormone replacement therapy [used to relieve symptoms of the menopause] for females. Steroids can help you lose body fat as well," said Julien Baker, an applied physiology professor at the University of the West of Scotland.

"It is a major problem, but the evidence isn't there about what the long-term impact is yet. We are not sure what these drugs are doing to you at that age, but everyone perceives it as safe."

As men get older their testosterone levels drop, which can sometimes lead to a reduced sex drive, weight gain and muscle reduction. Baker says men get information from magazines and online about the drug, which mimics the effects of testosterone and boosts muscle growth, though some are also prescribed it.

Joseph Kean, visiting research fellow at Liverpool John Moores University, said while over-50s still accounted for only a small proportion of the image- and performance-enhancing drugs population, their numbers have doubled over the past five years. He estimated there were between 15,000 and 30,000 over-40s using in the UK.

"Guys are saying they just want to stand a bit taller and feel they can stand alongside the younger generation who are much more aware of how they look," Kean said. He explained that older men typically used smaller amounts of the drug less frequently than their younger counterparts.

A typical steroid cycle can be about three months, starting with less and building up before tapering off. "At its peak you could be taking steroids daily and injecting around four times a week," said Kean. "Older guys tend to take less, but for much longer – one injection every seven to 10 days and sometimes almost consistently."

The Juice Clinic in Sheffield, a service for people using steroids and image-enhancing drugs, has noted an increase in older men asking for help.

"Steroid use for older men is often about the youthful effects, and about body image and energy levels," said Sid Wiffen, the clinic's team leader. "I hear talk of men feeling more pressure now to look good, so they are more likely to go to the gym and dress well.

"It can be dangerous and it does worry me. Lots of people we see are keen to make an informed decision about their steroid use, but some get information elsewhere and it's not always good."

Once users begin to decrease or discontinue use of steroids, withdrawal symptoms such as low mood and anxiety can occur.

Commentators say the growing popularity of such drugs could be the result of societal changes, with people living longer and expecting more from life.

"With an ageing population there are now more key points in people's lives when they are concerned about appearance," said Jim McVeigh, an expert on steroid use at Liverpool John Moores University. "For men who get to a certain age where they are unable to maintain a particular physique naturally, you can see how they would be tempted to try other means to get a body they may be found easier to achieve 15-20 years ago. Wanting to look good is no longer just the domain of the young."

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Mixing alcohol and energy drinks 'may be a risky cocktail'

Mixing energy drinks with alcohol could be a risky combination, leading to a greater risk of accidents and injuries, according to new research. A review of evidence found a number of potential risks, but the picture was not as clear-cut as reported.

Energy drinks are drinks that contain high amounts of caffeine. Some people mix them with spirits such as vodka.

Canadian researchers aimed to look at the published evidence on whether mixing alcohol with energy drinks is linked to an increased risk of harm or injury.

The researchers identified 13 studies – overall, 10 of them reported an increased risk of injury when drinking the mixture compared with alcohol on its own.

One possible factor discussed in the review is that the stimulant effects of caffeine could combine with the inhibition-lowering effects of alcohol, making people more prone to taking risks.

Caffeine could also mask the sedative effects of alcohol, so people become less aware of how much alcohol they've drunk – a phenomenon referred to as being "wide-awake drunk". However, the studies included in the review varied considerably in their methods, including the lifestyle factors they took into account, such as alcohol or drug use.

The study was carried out by two researchers from the Centre for Addictions Research at the University of Victoria in British Columbia, Canada.

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More than half of UK vapers 'have given up smoking'

For the first time, more than half of the UK's electronic-cigarette users have since given up smoking tobacco, a study suggests.

Some 1.5 million vapers are ex-smokers, compared with 1.3 million who still use tobacco, a survey of 12,000 adults for Action on Smoking and Health found. But Ash said the message that vaping was much less harmful than smoking had not yet got through to all smokers.

Some nine million still smoke in the UK despite a big rise in e-cigarette use. In 2012, there were 700,000 vapers in the UK; now there are 2.9 million.

The main reason ex-smokers give for vaping is to help them stop smoking. Current smokers say they do it principally to reduce the amount they smoke. Scientists say current evidence suggests that the risks of exposure to toxins for e-cigarette users are likely to be low - and much lower than with tobacco.

Deborah Arnott, the campaigning health charity's chief executive, said the figures on vapers who had quit smoking were "excellent news" but that the rate of people switching to electronic versions had peaked. "The rapid growth in e-cigarette use has come to an end," she said.

This is because more than a third of smokers have still never tried e-cigarettes, as a result of concerns about the safety and addictiveness of e-cigarettes. But research suggests that 26% of people think e-cigarettes are more - or equally as - harmful as smoking tobacco while only 13% believe they are a lot less harmful.

"It's very important smokers realise that vaping is much, much less harmful than smoking," she added.

Ann McNeill, professor of tobacco addiction at King's College London, said: "The message for the 1.3 million vapers who still smoke is that they need to go further and switch completely."

People who combine electronic and standard cigarette smoking are still being exposed to the cancer-causing substances in tobacco smoke, increasing their risk of lung cancers, bronchitis and other diseases, although Public Health England believes levels of nicotine in e-cigarettes are unlikely to pose any significant health risk.

But critics say there is no convincing evidence that e-cigarettes help people quit smoking and argue they could even encourage non-smokers to start.

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More than a quarter of young adults in the UK do not drink alcohol

Young adults in the UK are more likely to be teetotallers than their older counterparts, according to figures released this month. More than a quarter of 16- to 24-year-olds do not drink, compared with just over a fifth of the broader adult population.

Last year, just under 21% of people surveyed in England, Scotland and Wales said they did not drink alcohol, equivalent to around 10.6 million adults aged 16 or over. That's two percentage points higher than in 2005, when the ONS first collected data on alcohol consumption.

But the proportion of 16- to 24-year-olds who say they do not drink has accelerated at almost four times that pace. Ten years ago, 19% of young adults said they did not drink alcohol, compared with 27% last year.

Conversely, teetotalism among those aged 65 and over is falling: in 2005, almost 30% of people in that age category said they did not drink; last year, it was 25%.

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NHS gives first medical cannabis prescription to 11-year-old boy with severe epilepsy

The first NHS prescription for medical marijuana has been given to an 11-year-old boy with severe epilepsy. Billy Caldwell began taking cannabis oil for his seizures after seeing a childhood epilepsy expert in California, where medical marijuana became legal last year.

Douglas Nordli, director of paediatric neurology at the Children's Hospital Los Angeles, gave Billy the medicine, which contains a compound found in cannabis plants known as CBD. Billy's mother Charlotte Caldwell said the results were "incredible" and asked her GP in Northern Ireland to prescribe her son some more when it ran out.

Scientists have called for further research into the medical use of marijuana – an "area of huge untapped potential," according to an Oxford associate professor involved in a new academic programme in the field.

But they have also warned stories such as Billy's do not prove the efficacy of cannabis as a medicine until properly controlled clinical trials have taken place, as there could be a number of reasons for a patient's recovery.

Ms Caldwell said she was "delighted" her local GP had signed the prescription, while doctor Brendan O'Hare said he had prescribed the CBD oil as it was a "unique and unusual" situation.

The oil was supplied by Dublin-based pharmaceutical start-up GreenLight Medicines, which develops cannabis-based medicine.

Cannabis is a Class B drug in the UK, but the cannabidiol CBD, which does not create the 'high' associated with recreational use, has been reclassified as a medicine by the Medicines & Healthcare products Regulatory Agency (MHRA).

This means doctors can, in exceptional cases, prescribe medicines containing CBD to be manufactured or imported for a patient's use. Ms Caldwell, 49, said Billy has suffered from epilepsy since he was a baby and during his worst periods had 100 fits a day. But since the US trip in November, his seizures reduced from around 25 a month to about eight, and he has not had one for the past three months.

"I'm very grateful because the only alternative that was left for us was to fly to the US and have Dr Douglas Nordli prescribe it from there and bring it back into the country," said Ms Caldwell. "We went down to our surgery today and picked it up. It was as simple as that, no one has broken any laws and the meds will be with us before Billy needs them on Friday."

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