WHATS NEW? - June 2014

Synthetic cannabis causing serious health problems in prisons

350 New Psychoactive Substances Identified By UN Experts

Red wine health benefits 'overhyped'

More students using 'smart drugs' say health advisers

Cannabis legalisation in Uruguay: Details Unveiled

Minister still 'open-minded' on legal high solutions

Binge drinking 'link to overeating'

UK buying more drugs online, survey finds

Gay men warned on risks of 'chemsex'

Sharp rise in ChildLine drink and drug abuse calls

Synthetic cannabis causing serious health problems in prisons

Synthetic cannabis known as "spice" or "black mamba" is a growing problem in UK prisons with serious physical and mental health consequences, the chief inspector of prisons, Nick Hardwick has said.

Its popularity with inmates has surged because the psychoactive designer drug can be passed off as a tobacco roll-up, has no distinctive smell and it evades current drug testing capabilities in prisons. The Guardian analysed Her Majesty of Prisons Inspectorate (HMIP) reports that revealed it had become a problem in at least 28 prisons in England.

Several former prisoners said the drug was rife inside, having been thrown over the walls or otherwise smuggled in, and one said its lack of smell meant it could be smoked in front of the guards. Another, a remand prisoner currently at HMP Forest Bank near Manchester, said in a telephone interview that some of those using it were "going down like flies". He said it had led to multiple calls to the emergency services.

"I've never seen anything like it in prison. Guys are taking it and having psychotic episodes all over the place. Ambulances are coming in and out of the place more frequently than the escort vans," he said. It is not clear how many of these incidents involved other drugs in combination.

The recent Global Drugs Survey, which surveys thousands of drug users on their experiences, indicated that users of synthetic cannabis were seven times more likely to need hospital treatment than users of the natural form of the drug. Several deaths in the US have been blamed on spice, which is made from dried plants sprayed with engineered chemicals.

"What we can say for definitive is that spice is a significant problem in a number of prisons and it is rising," Hardwick told the Guardian.

"As opiate-based drugs become less popular, spice has become a more favoured option. We've seen examples where its affected people's heart and so have had to have emergency treatment. It has affected people's mental health and what it it seems to do is exacerbate people's existing conditions".

There was currently no effective test for the drug, he said.

The HMIP reports describe prisoners who have taken the drug experiencing seizures, psychosis, loss of motor control and an irregular heartbeat. At HM Prison Ford in West Sussex, the prison's drugs and alcohol recovery team said 85% of its prisoners were using or supplying spice.

A government ban on spice-like drugs in place since 2009 does not cover many newer and often more potent versions as the chemicals used to synthesise them are different. Spice-like drugs can still be bought on the high street and online on the basis that they are not for human consumption.

At HMP Wealstun in West Yorkshire, a notice issued to practitioners and visitors to the prison and made available to the Guardian reveals that in a two-week period in March, 13 prisoners required medical attention after using synthetic cannabis, and five cases were so severe that they were rushed to hospital.

Dr John Ramsey, a toxicologist based at St Georges University London, told the Guardian that testing for drugs such as spice was difficult because manufacturers change their composition changes so often. "The number of chemicals you can think of that would mimic cannabis is a very, very large number. Whatever you do, you can probably tinker with the molecule and find a way around it because they are a very diverse group of compounds."

The list of drugs prisoners are tested for has not been updated for five years and does not include synthetic agents, but a Ministry of Justice spokesman said it had commissioned scientists to devise a test for new psychoactive substances.

The government has also introduced an amendment to the criminal justice and courts bill to expand prisons' power to test for non-controlled drugs.

The terms spice initially referred one brand of synthetic cannabis, but now all forms of the drug. Other names also include K2 and clockwork orange.

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350 New Psychoactive Substances Identified By UN Experts

The number of 'legal highs', which are outside international control, is growing at an "unprecedented" rate, with almost 350 new designer drugs identified by the United Nations' drug experts.

"There is a dynamic and unprecedented global expansion of the synthetic drugs market both in scope and variety", Jean-Luc Lemahieu, director for policy analysis and public affairs at United Nations Office on Drugs And Crime, said.

"New substances are quickly created and marketed, challenging law enforcement efforts to keep up with the traffickers and curb public health risks."

Last year, the UNODC said the UK has the largest market for so-called "legal highs" in the European Union, according to the United Nations Office on Drugs and Crime
In the new Global Synthetic Drugs Assessment, the UNODC warns that designer drugs have gained popularity particularly among the young and are no long restricted to "niche" markets.

"Emergency services may therefore find themselves unable to identify life-threatening substances and powerless to administer the proper treatment to users," the report said.

The UNODC said usage data for the UK suggests controls may have led to a decline in the mephedrone market.

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Red wine health benefits 'overhyped'

Red wine may not be as good for you as hoped, say scientists who have studied the drink's ingredient that is purported to confer good health.

The team tracked the health of nearly 800 villagers from the Chianti region of Italy to see if their local tipple had any discernable impact. They found no proof that the wine ingredient resveratrol stops heart disease or prolongs life.

Experts say more research is needed to get a definitive answer. Many studies have sought to explain why there is a low incidence of heart disease in France, despite many of its inhabitants eating a high-fat diet.

Some put it down to moderate drinking of red wine. Studies have shown that consumption of red wine, dark chocolate and berries reduces inflammation, leading researchers to speculate that their common ingredient, resveratrol, explains why.
But Prof Richard Semba, of the Johns Hopkins University School of Medicine, and colleagues found no evidence for this.

They chose two small towns in Tuscany as their test ground, and 783 elderly people who were living there agreed to take part in their investigation. The volunteers gave details about their daily diets as well as urine samples for measurement of their resveratrol intake.

During the nine years of the study, 268 of the men and women died, 174 developed heart disease and 34 got cancer. But urinary resveratrol was not linked with death risk, heart disease risk or cancer risk. Nor was it associated with any markers of inflammation in the blood, the researchers report in JAMA Internal Medicine.

Prof Semba said: "The thinking was that certain foods are good for you because they contain resveratrol. We didn't find that at all. The story of resveratrol turns out to be another case where you get a lot of hype about health benefits that doesn't stand the test of time."

He says any benefits of drinking wine or eating dark chocolate or berries, if they are there, must come from other shared ingredients. And it's not clear how much you might need to eat or drink. These are complex foods, and all we really know from our study is that the benefits are probably not due to resveratrol."

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More students using 'smart drugs' say health advisers

The growing use of so-called smart drugs is a concern, government health advisers have said. The Home Office has announced that the Advisory Council on the Misuse of Drugs is to carry out a review of their use.

Some users of the drugs, which are legitimately prescribed for brain disorders, say they can help them stay awake longer so they can study.

Health experts say side effects can include psychiatric symptoms, prolonged anxiety and digestive problems. The most common smart drug is Modafinil, which is meant to be used to treat narcolepsy, a rare but serious brain disorder that causes a person to suddenly fall asleep at inappropriate times. It's not illegal to buy prescription-only drugs such as Modafinil but it is against the law to supply them, or sell it on to others.

Andrea Petroczi, a professor of Public Health at Kingston University, says there is little evidence that suggests taking them actually makes people more clever.

"It's not a magic pill," she said. "It doesn't work without putting the work in, it helps you to put more work in."

Modafinil is a stimulant and works by preventing excessive sleepiness during waking hours.

The NHS says that there are many users for whom it is not suitable, including people with behavioural problems.

Other side effects include headache and problems going to the toilet.

Professor Kevin Fenton, Director of Health and Wellbeing at Public Health England, said: "Public Health England is aware of anecdotal evidence of some students misusing prescription medicine, often bought off the internet, and other wakefulness-promoting drugs to enhance their study and academic performance."

Jack Rivlin, 24, is the editor of student paper The Tab in Farringdon, east London, told the BBC he had bought some tablets on a foreign website during the exam period and says the tablets helped him get through revision.

"It's kind of like putting the rest of your life on hold for the purpose of work," he said. "You're not socialising. You might snap at someone and I remember my girlfriend at the time thinking 'I don't want to be around you when you're on it'."

The Tab questioned more than 1,800 students in an online survey about smart drugs and almost one in five of the respondents revealed they had taken "smart drug" tablets including Modafinil.

The survey was self-selecting so it's not a reflection of the UK student population as a whole.

Jim McVeigh, from the Centre for Public Health, a research centre specialising in substance abuse, said: "There are a number of different concerns. One is the long-term use of a stimulant and the problems with that."

He said that when buying off the internet it was difficult to know exactly what you are getting: "The benefits people may get off these are probably similar to high doses of caffeine but we do know the effects of caffeine. We don't know the effects of these drugs."

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Cannabis legalisation in Uruguay: Details Unveiled

The Uruguayan authorities have revealed how marijuana will be produced and sold legally in the country. Licensed pharmacies will sell the drug for less than $1 a gram, with consumers allowed 40g (1.4oz) a month.

The bill specifies that each household may grow up to six cannabis plants, and that marijuana may be consumed in the same places as tobacco. Last year, Uruguay became the first country in the world to make it legal to grow, sell and consume marijuana. The bill proposed by President Jose Mujica comes into force in July.

Diego Canepa said the government expected to launch the licensing process for companies interested in growing the drug within the next month.

The use of cannabis will be allowed in most public spaces where tobacco smoking is permitted - but not at workplaces. Drivers caught "smoke-driving" will be subject to the same penalties as those under the influence of alcohol.

Uruguay's government hopes the bill will help tackle drug cartels, but critics say it will expose more people to drugs. A recent UN report criticised the legalisation of drugs, saying it posed a health danger.

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Minister still 'open-minded' on legal high solutions

Crime prevention minister Norman Baker has said "all options" are still being considered on the growing problem of legal highs, although the Home Office ruled out the licensing of shops.

"We have to come up with a solution," said Mr Baker, adding: "We haven't got a closed mind about any option."

Retailers wanting to sell "low harm" versions of drugs have formed a trade body to press for regulation. So-called legal highs claimed 68 lives in 2012, according to coroners' tests. Speaking to Radio 4, the Liberal Democrat minister described the growing legal high market as "challenging, complicated and difficult".

"There is already a vast array of substances being sold on our streets, in our shops, and that's what we have to try to deal with because many of these are actually quite dangerous," he said.

And new substances were being produced "on a weekly basis", with many coming from abroad.

"They are inaccurately and unhelpfully called legal highs - some of them are actually illegal - but they're certainly not safe and people are consuming them," he told the programme.

Pressed on the idea of regulation and licensing of legal high shops, Mr Baker said: "We have to come up with a solution. We're open-minded about what that solution is... the expert panel I've set up is looking at all options, we haven't got a closed mind about any option."

Earlier this year, Mr Baker was quoted by the Times as suggesting that licensed outlets selling legal highs could be treated like sex shops - with their windows blacked out and under-18s barred - to show they were not "harmless".

The Home Office said at the time it had no intention of licensing such shops. A Home Office source told the BBC that position had not changed.

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Binge drinking 'link to overeating'

Drinking more than three large glasses of wine can push people over a "tipping point", meaning they consume about 6,300 extra calories in the following 24 hours, a report has said. The extra calories could lead to gaining 2lb a week (900g), the survey of 2,042 people suggested.

About half (51%) of those who drank alcohol said crossing the threshold had made them binge on fast food. But experts warned the study showed trends and not "hard science".

Slimming World, which commissioned the research from YouGov, said 50% of the people who said drinking impacted their food choices had also cancelled physical activities the day after drinking more than 9.3 units, equivalent to slightly less than four pints of beer.

They had opted for bed, TV and using social media to stave off the hangover - along with another extra 2,051 calories, on top of their usual diet, the next day.

On the night, they had consumed about 2,829 calories extra in food and 1,476 extra calories in drink, the survey said. The following day, the drinkers ate on average 2,051 extra calories.

Dr Jacquie Lavin, head of nutrition and research at Slimming World, said alcohol loosened self-control. She said people who had consumed more alcohol tended to eat at a greater rate and for longer.

"Alcohol makes the food even more rewarding. It tastes good and feels even better than it would do normally," said Dr Lavin.

She called for the government to launch a communications campaign to inform people of the impact of drinking on weight gain, and for calories to be included on alcohol labels.

Dr Alison Tedstone, chief nutritionist at Public Health England (PHE), said: "The report raises awareness of the high calorie content in alcoholic drinks. Excess calorie intake can lead to being overweight and obese which increases your risk of heart disease, type 2 diabetes and some cancers."

Luciana Berger, shadow health minister, said the survey showed more needed to be done to raise awareness about the "ways excessive alcohol impacted on weight. With health problems associated with being overweight or obese costing the NHS more than £5bn every year, it is time the government took the bold action that the scale of this threat to our public health demands."

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UK buying more drugs online, survey finds

More drug users are buying their drugs online – including so-called legal highs as well as illegal drugs such as cannabis and MDMA – because they say the quality is better, there is more choice and it is more convenient, research has found.

The 2014 Global Drug Survey (GDS) – which questioned almost 80,000 drug users from 43 countries, and is the largest research of its kind – indicates that although the majority of drug users still use dealers, a growing number are following 21st-century shopping habits by going online.

Hidden online drug marketplaces such as Silk Road have sprung up and drug users are using the virtual currency bitcoin to make transactions. The UK is also at the vanguard of this shift online, with the highest percentage of people who had ever bought drugs over the internet. Almost a quarter of UK respondents to the survey said they had bought drugs over the internet. Just under 60% knew about Silk Road, and of these, 44% had accessed the site. The most likely drug to be bought online was cannabis, followed by MDMA, LSD and ketamine. Of the 22% who had bought drugs online, 44% had first done so in 2012 or 2013, suggesting a new trend, according to Dr Adam Winstock, a consultant addictions psychiatrist in London and director of the survey.

"The fact that 44% of respondents who had bought drugs online said they'd done it for the first time recently says to me there is growing recruitment," he said. "It is currently a minority way to get drugs, but it really mimics the growth in e-commerce – we buy things online because it is convenient, cheap, and there is a better product range."

The survey also reveals that the UK, more than any other country, is a nation of hedonists, said Winstock – 73.8% of respondents had taken at least one illegal drug over the last 12 months. Alcohol was the most common drug taken, followed by tobacco and cannabis. Just under 11% had bought "legal highs" sold as bath salts, research chemicals or legal highs.

"The UK just does not do things in moderation. We come out as some of the largest drug takers, taking a broader range of drugs that are reasonably cheap," he said. Winstock described the extent of alcohol abuse in the UK as "very worrying". "Many countries are clueless about alcohol, but the UK and Ireland are the most clueless, " he said. "People just have no idea when they are drinking at very dangerous levels." According to the survey, 60% of respondents demonstrated a medium, high or dependent level of alcohol problems. Just below 15% said they could not stop drinking once they had started at least monthly, while 17% reported feelings of guilt or regret after drinking at least monthly over the last year. Of the 7% who demonstrated dependency levels, only 39% recognised their drinking was dangerous, while 34.5% thought they drank an average or below-average amount.

The survey – which was taken by 78,820 people, 7,326 of them from the UK – also revealed that almost a third of drug users aged between 18 and 24 admitted taking a "mystery white powder". Last year, a fifth of 18- to 25-year-olds admitted doing so. Of the 11% of the whole sample who took mystery drugs in the last 12 months, 80% were already intoxicated. And more people had taken MDMA than had consumed energy drinks, with 45.2% of respondents taking the drug compared to admitting taking it compared to 44.7% who said they had drunk caffeinated energy drinks in the last year.

Alcohol remained the most likely drug to damage respondents' health, but the survey also revealed that people using synthetic cannabis had a much higher likelihood of being admitted to hospital than users of natural cannabis.

Almost one in 100 MDMA users sought emergency medical treatment, with two-thirds of those being admitted to hospital. Winstock said this was "a cause for concern for a drug that so many users consider safe" and called for a more "realistic" drugs debate focused on harm reduction.

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Gay men warned on risks of 'chemsex'

Gay men are suffering serious harm and are in danger of spreading HIV by having unprotected sex while under the influence of illegal drugs, the first British study into the growing popularity of 'chemsex.'

Men who use substances such as crystal meth while having sex are at risk of overdosing, being hospitalised, losing consciousness, having panic attacks or convulsions, serious mental health problems and sexual assault, according to research conducted among one of the country's largest gay populations.

Three-quarters of those interviewed had participated in reckless sexual behaviour while high on drugs, which ran the risk of fuelling the already rising rates of HIV and sexually transmitted infections (STIs) among men who have sex with men (MSM).

The worrying findings are contained in the Chemsex report, commissioned from the London School of Hygiene and Tropical Medicine (LSHTM) by the south London boroughs of Lambeth, Southwark and Lewisham.

Although the study involved in-depth interviews with just 30 men involved in chemsex, the fact that three out of four of them had engaged in sex with a high risk of passing on HIV or another STI has caused concern. Three had been sexually assaulted after passing out, and two others had seen that happening or heard of it happening from friends.

Paul Steinberg, Lambeth's HIV prevention and sexual health commissioning manager, said that the trend towards chemsex is being facilitated by a "perfect storm" of cheap, easily available drugs, a burgeoning number of social and sexual networking apps and websites that enable men to arrange to meet for sex at private parties.

"There has been a change in gay cultural, social and sexual networks. In the 1980s and 1990s gay men would meet in bars, clubs and community centres. But with the rise of the internet and social media apps, there has been a shift towards a technology- and home-based cultural scene", says Steinberg.

Adam Bourne, the LSHTM academic who led the research, says: "A vulnerable section of society is using new drugs in new ways that are putting them at serious risk."

The report found that the three most commonly used drugs in chemsex were crystal methamphetamine, GHB/GBL and mephedrone, though some used cocaine and ketamine too.

"They allow you to have sex for much longer, which may mean you choose to have sex with more people in that time. From an HIV transmission and STI transmission point of view, having sex for longer and with more partners means there's a higher likelihood of transmission, because of skin damage on and around the sexual organs, particularly if it's condomless sex, which is often a feature of chemsex", explains Bourne.

More than a quarter of those interviewed, all of whom were among the 13 participants who were HIV positive, had decided to have unprotected sex with men they believed were the same status. Worryingly, the report added: "Nearly a third of men found it difficult to control their behaviour while under the influence of drugs and engaged in HIV/STI transmission risk behaviour, which they subsequently regretted. These were often men who had pre-existing problems negotiating safer sex, which were exacerbated by the presence of drugs."

In 2012, the three councils commissioned the community services arm of nearby Guy's and St Thomas's NHS trust to set up a healthy gay business and community initiative. It involves an inspection regime for the 15 gay clubs and three saunas in the boroughs – a voluntary code of conduct, in effect. Council licensing officers, GPs, hospital doctors and gay men's sexual health charities are involved, as is Public Health England (PHE). The next stage is to start talking to those behind the apps and websites promoting casual sex. But no one pretends there are easy answers.

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Sharp rise in ChildLine drink and drug abuse calls

ChildLine counsellors in Scotland carried out almost a thousand sessions with children concerned about parents abusing drink or drugs last year. Across the UK, the number of calls to the charity about this has more than doubled. Almost three-quarters of those seeking counselling were aged under 15.

The Scottish government said it remained "hugely important" to educate children about the dangers of substance abuse in the home.

The charity estimates that 40-60,000 children in Scotland may be affected by problematic parental drug use. In addition, it reports that between 36-51,000 children in Scotland are living in homes where the parents are abusing alcohol.

During 2012-2013 ChildLine bases across the UK carried out 5,323 counselling sessions with children worried about parents abusing drink or drugs - up from 2,509 the previous year.

A quarter of all calls made to the charity by young people were handled by bases in Glasgow and Aberdeen. Over the past year, the two bases carried out 956 counselling sessions with children and young people via telephone, online chat and email who were concerned about parental drug and alcohol abuse. Many said they felt helpless and depressed, with some claiming they had suicidal thoughts.

Susan Dobson, ChildLine service manager, said: "It's heart-breaking that so many young people struggle alone because they do not know where to go for help or are unsure of what might happen if they speak to someone. They may fear being taken away from their families by social services and put into care and believe that they are protecting their family by keeping quiet.

"However, both they and their parents are in danger of suffering physical and psychological harm. So it's vital that the parents are offered help, and that these children get the protection they need and don't have to suffer in silence."

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