News and Notes
Compiled by Jean O'Reilly and Peter Miller
ACTIVITY REPORT FROM THE INDEPENDENT SCIENTIFIC COMMITTEE ON DRUGS
Since its creation, the Independent Scientific Committee on Drugs (ISCD) has fast become a trusted source of objective information relating to drugs. The ISCD brings together leading experts (including its founder, Professor David Nutt) in the field to examine the evidence free from political concerns and communicate them to the public and professionals through the website http://www.drugscience.org.uk and through the media.
The ISCD has already played a role in the ongoing debate around legal highs and mephedrone, providing scientific evidence on the drugs and the issues surrounding them. Given the plethora of as yet unused chemicals that could be marketed as alternative legal highs; there is a need for reliable evidence on drug harms, both for those that might use the drugs and for those making policy decisions that could directly affect the health and future prospects of sections of society.
The Home Office Drug Strategy Consultation, results of which are due in December, provides an opportunity to reassess how the science of drug harms is taken into account in policymaking. The ISCD is committed to providing objective evidence to support the decision making process and welcomes this timely rethink on drug strategy. To keep up to date with the work of the ISCD, sign up to the newsletter at http://www.drugscience.org.uk/newsletter.html. The ISCD also recently hosted the Drug science and Drug policy: Building a consensus summit in partnership with the Lancet, bringing together scientists and decision makers from around the world to debate the way forward on reducing drug harms and how scientific evidence can support policymaking. More details on the event and how its outcomes will inform the ongoing work of the ISCD can be found at http://www.drugscience.org.uk/summit1nov.
Project Lead, Independent Scientific Committee on Drugs
PROFESSOR JIM ORFORD AWARDED THE 2010 E.M. JELLINEK AWARD
Professor Jim Orford has been awarded the 2010 E.M. Jellinek Award (Canada) for his contribution to the field of alcohol studies. He officially received the award at the Society for the Study of Addiction conference in York in November 2010. Professor Orford has focussed his research on alcohol, other drugs, and the family; the nature of addiction and its treatment; community psychology; the psychology of cultural diversity; and interpersonal behaviour. In particular, he is well known for his role in the UKATT (United Kingdom Alcohol Treatment Trial), his work on the nature of addiction, and his book, Excessive appetites: A psychological view of addictions.
E.M. Jellinek was a pioneering World Health Organisation psychiatrist. This is the premier international award for alcohol studies and we believe it has only twice before been awarded to a British scientist in its 45-year history. More information on the awards can be found at http://www.jellinekaward.org.
This award is recognition of Jim's extended and excellent research into the effects of alcohol addiction and more broadly, and the team at Addiction wishes to add its congratulations!
ROYAL AUSTRALASIAN COLLEGE OF PHYSICIANS CALLS FOR ‘TEMPORARY’ INJECTING CENTRE TO BE MADE PART OF NEW SOUTH WALES HEALTHCARE SYSTEM
The Royal Australasian College of Physicians has supported the New South Wales (NSW) Government's move to make a medically supervised injecting centre (MSIC) part of the NSW healthcare system. This move by the Government follows repeated calls from medical experts to make the centre part of the NSW healthcare system. The MSIC, which operates in the inner-city Kings Cross area of Sydney, has been operating on a trial basis since 2001.
As the only resource of its kind in Australia, the MSIC has broken considerable ground in the treatment of drug addiction, with more than 3,500 overdoses managed to the end of April 2010, without a fatality. Since the establishment of the MSIC, ambulance callouts to drug overdoses have fallen by 80% in the Kings Cross area, a significant achievement and key indicator of the benefits of the Centre. Two economic evaluations conducted in 2003 and 2008 provide evidence of the savings to the healthcare system, on top of the savings for the individuals involved in terms of their improved health, social well being and quality of life.
The College now calls on all parliamentarians to support making this move when legislation is introduced in coming weeks.
Source: RACP press release: http://www.racp.edu.au/index.cfm?objectid=D7FAA694-E371-4AB9-BE41B937879A52E1
ALCOHOL CONSUMPTION MAY INCREASE RECURRENCE OF BREAST CANCER
A study published in the Journal of Clinical Oncology argues that consuming three to four alcoholic drinks or more per week after a breast cancer diagnosis may increase risk of breast cancer recurrence, particularly among postmenopausal and overweight/obese women. The study reported no effect on total mortality associated with consumption of three to four or more drinks per week.
According to the authors, ‘regular drinking of at least three to four alcoholic drinks per week was associated with an increased risk of recurrence and death due to breast cancer among women previously diagnosed with early-stage breast cancer, independent of prognostic factors, and that the increased risk appeared to be confined to postmenopausal women and overweight/obese women [ . . . ] Our findings are consistent with alcohol's role in increasing risk of primary breast cancer.’
The researchers warn that because there are few studies that address the effect of alcohol on breast cancer prognosis, their results need confirmation from larger studies of breast cancer survivors with long-term follow-up.
Source: Kwan M.L., Kushi L.H., Weltzien E., Tam E.K., Castillo A., Sweeney C, and Caan B.J. (2010) Alcohol Consumption and Breast Cancer Recurrence and Survival Among Women With Early-Stage Breast Cancer: The Life After Cancer Epidemiology Study. Journal of Clinical Oncology, doi: 10.1200/JCO.2010.29.2730.
US NATIONAL SURVEY SHOWS SUBSTANCE USE UP FROM 2008 TO 2009
The use of illicit drugs among Americans increased between 2008 and 2009 according to a national survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA). The National Survey on Drug Use and Health (NSDUH) shows the overall rate of current illicit drug use in the United States rose from 8.0% of the population aged 12 and older in 2008 to 8.7% in 2009. This rise in overall drug use was driven in large part by increases in marijuana use.
The annual NSDUH survey also shows that the nonmedical use of prescription drugs rose from 2.5% of the population in 2008 to 2.8% in 2009. The estimated number of past-month ecstasy users rose from 555 000 in 2008 to 760 000 in 2009, and the number of methamphetamine users rose from 314 000 to 502 000 during that period.
According to the survey, 23.5 million Americans aged 12 or older (9.3% of this population) need specialized treatment for a substance abuse problem, but only 2.6 million (or roughly 11.2% of them) receive it.
There is some good news: the 2009 NSDUH shows that current cigarette use among people aged 12 years and older has reached a historic low level at 23.3%. The use of cocaine among those aged 12 or older has also declined 30% from 2006.
The complete survey findings are available on the SAMHSA website at: http://oas.samhsa.gov/nsduhLatest.htm.
Source: SAMHSA press release: http://www.samhsa.gov/newsroom/advisories/1009152021.aspx
REPORT ARGUES MILLIONS OF AMERICANS WITH ALCOHOL AND DRUG ADDICTIONS COULD BENEFIT FROM US HEALTH CARE REFORM
According to Defining the Addiction Treatment Gap, an analysis by the Closing the Addiction Treatment Gap (CATG) initiative, federal health care reform legislation could help to remove financial barriers to treatment for millions of Americans. The report reviews the annual National Survey on Drug Use and Health released by the Substance Abuse and Mental Health Services Administration (SAMHSA) and other national data sources.
The report provides a statistical context for efforts to close America's addiction treatment gap, including the following observations:
- • Twenty-three million Americans are currently addicted to alcohol and/or other drugs. Only one in 10 of them (2.6 million) receives the treatment needed. The result: a treatment gap of more than 20 million Americans.
- • Cost and lack of insurance is the primary obstacle cited by Americans who say they need but are unable to receive treatment. Among those able to access treatment, nearly half (48.4%) reported using their own money to pay for their care.
- • In contrast to other chronic diseases, funding for addiction treatment disproportionately comes from government sources. More than three-quarters—77%—of treatment costs are paid by federal, state and local governments, including Medicaid and Medicare.
- • Screening and treatment is not integrated into the health care delivery system.
CATG identifies four key elements that are necessary to maximize the opportunity presented by health care reform:
- • Develop a meaningful addiction treatment benefit that covers a full continuum of addiction services for both the patient and the patient's family, as appropriate;
- • Improve coordination and integration of available services, including wellness and prevention services, screening, intervention, treatment and other supports;
- • Monitor implementation to prevent new barriers to treatment, ensure full coverage for and access to appropriate care, including the utilization of strategies and interventions with demonstrated effectiveness; and
- • Preserve federal and state safety nets to ensure treatment is still available to individuals not covered by health care reform, unable to afford insurance coverage even with subsidies, or with insufficient coverage.
Source: Open Society Foundations press release: http://www.soros.org/initiatives/treatmentgap/news/health-care-reform-20100916
ANTI-EPILEPTIC DRUGS INCREASE SMOKERS' NICOTINE METABOLISM
Researchers from Robert Wood Johnson Medical School, New Jersey, have determined that two anti-epileptic drugs (AEDs), carbamazepine and oxycarbamazepine, increase nicotine metabolism in smokers. As nicotine metabolism increases, cravings for nicotine return more quickly which could lead to more frequent cigarette consumption among individuals who take these medications. AEDs are commonly used as adjunctive treatment for conditions other than epilepsy, including schizophrenia and bipolar disorder.
According to co-author Jill M. Williams, M.D., their findings have implications for smokers using AEDs and seeking smoking cessation treatment.
‘We will need to do more studies to see if carbamazepine or oxycarbamazepine affect smoking behavior or intake of tobacco smoke from cigarettes in groups of smokers who may or may not have mental illness, but they could increase smoking as well as craving for nicotine,’ Williams said.
‘Although the study was conducted in smokers with mental illness, it is unlikely that this effect was due to mental illness alone since we have found no difference in nicotine metabolite ratios in our other studies of smokers with mental illness not taking these drugs,’ she added.
Source: University of Medicine and Dentistry of New Jersey press release: http://www.medicalnewstoday.com/articles/201677.php
CANADA PRODUCES RANDOMISED CONTROLLED TRIAL OF SMOKED CANNABIS FOR CHRONIC NEUROPATHIC PAIN
In what may be the first outpatient clinical trial of smoked cannabis, a study to be published in the Canadian Medical Association Journal shows that people suffering from chronic pain can reduce pain, improve their mood, and help sleep by smoking cannabis.
A team of researchers from McGill University Health Centre (MUHC) and McGill University conducted a randomized controlled trial to investigate the analgesic effect of inhaled cannabis in 21 participants 18 years and older with chronic neuropathic pain. The researchers used three different potencies of active drug (THC levels of 2.5%, 6% and 9.4%) as well as a 0% placebo. Patients reported better sleep quality as the THC content increased. Anxiety and depression also decreased in the 9.4% THC group compared with the placebo group.
‘We found that 25 mg herbal cannabis with 9.4% THC, administered as a single smoked inhalation three times daily for five days, significantly reduces average pain intensity compared with a 0% THC cannabis placebo in adult subjects with chronic post traumatic/post surgical neuropathic pain,’ reports lead author Dr. Mark Ware, Director of Clinical Research at the Alan Edwards Pain Management Unit of the MUHC. ‘We found statistically significant improvements in measures of sleep quality and anxiety.’
Source: e! Science news story: http://esciencenews.com/articles/2010/08/30/smoked.cannabis.reduces.chronic.pain
SWEDISH STUDY LINKS SNUS TO STILLBIRTH RISK
According to a story from Reuters Health, pregnant women who use a smokeless form of tobacco called ‘snus’ or moist snuff may have a risk of stillbirth on par with women who smoke cigarettes, a large study of Swedish women suggests.
Snus originated in Sweden and is generally thought to be less harmful than cigarettes. Because it is ‘spitless’, the product has been advocated as a socially acceptable way for smokers to get their nicotine fix and cut down on cigarettes.
The study, published in the journal Epidemiology, found that women who reported using snus during pregnancy had a 60% higher risk of suffering a stillbirth than women who used no tobacco products. The risk was 40% higher for light smokers, and for heavy smokers it was more than double that of non-users of tobacco.
Although snus may appeal to pregnant women who are trying to avoid cigarettes, ‘using moist snuff is not a safe way to quit smoking when you are pregnant,’ lead researcher Dr. Anna-Karin Wikstrom told Reuters Health.
Brands such as Camel Snus and Marlboro Snus are now available in the U.S.
Source: Amy Norton, ‘Snus’ tobacco linked to stillbirth risk, Reuters, 17 September 2010: http://www.reuters.com/article/idUSTRE68G4RV20100917
CONFERENCES AND EVENTS
American Academy of Addiction Psychiatry 21st Annual Meeting and Symposium, 2–5 December 2010, Boca Raton Resort & Club, Boca Raton, FL, USA. Website: http://www2.aaap.org/announcements/aaap-21st-annual-meeting-and-symposium
Alcohol Policy Conference Series #15: Policies for Reducing Problems Associated with Alcohol Availability. 5–7 December 2010, Washington Marriott Wardman Park, Washington, DC, USA. A thematic meeting of the Kettil Bruun Society, organized by the Silver Gate Group. Website: http://www.silvergategroup.com/ap15/index.htm
Society for Research on Nicotine and Tobacco (SRNT) Annual Meeting, 16–19 February 2011, Westin Harbour Castle, Toronto, Canada. Website: http://www.srnt.org/conferences/index.cfm
European Conference on Tobacco or Health, 28–30 March 2011, Amsterdam, The Netherlands. Website: http://www.ectoh.org/
Collegium Internationale Neuro-Psychopharmacologicum (CINP) Thematic Meeting: Polypharmacy: The Good, the Bad and the Ugly, 1–3 April 2011, Groβe Universitätsaula, Salzburg, Austria. Website: http://cinp.org/congress/2011-thematic-meeting-salzburg/
International Harm Reduction Association's 22nd International Conference, 3–7 April 2011, Habtoor Grand Hotel, Beirut, Lebanon. Website: http://www.ihra.net/conference
American Society of Addiction Medicine (ASAM) 42cd Annual Medical-Scientific Conference, 14–17 April 2011, Washington DC, USA. Website: http://www.asam.org/AnnualMeeting.html
32nd Annual Meeting & Scientific Sessions of the Society of Behavioral Medicine, 27–30 April 2011, Washington, DC, USA. Website: http://www.sbm.org/meeting/2011/
Australian Drug Foundation's 6th International Drugs and Young People Conference, 2–4 May 2011, Melbourne Convention Centre, Melbourne, Australia. Website: http://www.adf.org.au
Royal College of General Practitioners 16th National Conference: Working with Drug and Alcohol Users in Primary Care 2011, 12–13 May 2011, Harrogate International Centre, Harrogate, UK. Website: http://www.rcgp.org.uk/
National Association of Addiction Treatment Providers Annual Conference, 14–17 May 2011, Wild Horse Pass, Phoenix, Arizona, USA. Website: http://www.naatp.org/conferences/annualconference.php
Fifth Annual Conference of the International Society for the Study of Drug Policy, 23–24 May 2011, Utrecht, The Netherlands. Website: http://www.issdp.org/conferences.htm
2011 UK National Smoking Cessation Conference, 13–14 June 2011, Novotel London West Hotel, London, UK. Website: http://www.uknscc.org/
College on Problems of Drug Dependence 73rd Annual Meeting, 18–23 June 2011, Westin Diplomat, Hollywood, Florida, USA. Website: http://www.cpdd.vcu.edu/
34th Annual Scientific Meeting of the Research Society on Alcoholism, 25–29 June 2011, Atlanta Georgia, USA. Website: http://www.rsoa.org/2011meet-Futures.htm
13th European Federation of Therapeutic Communities Conference, 20–23 September 2011, Keble College, Oxford University, Oxford, UK. Website: http://www.eftc-europe.com/oxfordtest2011/
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