WHATS NEW? - MARCH 2013

Students could face compulsory drug tests as rising numbers turn to 'cognitive enhancers'

Consider drugs decriminalisation system, MPs say

Therapy 'could cut teen drinking', researchers say

UK drug advisers reject khat ban

Police warn over 'fatal pink ecstasy' with AMT or 5-IT

Childhood asthma 'admissions down' after smoking ban

Amsterdam tourist cannabis ban rejected by mayor

Warning over laughing gas after student dies

Baby boomer alcohol harm 'more likely than in young'

Fewer young heroin users treated in England



Students could face compulsory drug tests as rising numbers turn to 'cognitive enhancers'


An increasing number of students are misusing legally prescribed drugs for psychiatric disorders in order to boost their academic performance, according to a major study.

The widespread use of "cognitive enhancers" within academia has led to growing concerns among colleges and universities that it may soon be necessary to start random drug testing, said one contributor to a report by four leading UK academies.

As many as 16 per cent of American students and about 10 per cent of UK students admit to using performance-enhancing drugs to improve their academic results, said Professor Barbara Sahakian, a psychiatrist at Cambridge University.

"People are starting to think about drug testing. Some of the students who don't use cognitive enhancers may demand it because they are concerned about cheating. Some admissions tutors are also concerned about it," Professor Sahakian said.

Prescription drugs used to treat recognised psychiatric disorders, such as Ritalin given for attention deficit hyperactivity disorder, and Modafinil used to treat sleep disorders, are ending up in the hands of students who misuse them to keep awake and alert in the revision period leading up to exams, she said.

Even senior academics have admitted to using cognitive enhancers on a regular basis for a variety of purposes ranging from keeping jet lag at bay to improving memory and mental performance during intensive periods of work, Professor Sahakian said.

"The head of one laboratory in the US said that all of his staff are on modafinil and that in the future there will be a clear division between those who use modafinil and those who don't," she added.

Modafinil, used to treat people who suffer from narcolepsy, has been shown in trials on sleep-deprived doctors to reduce impulsive behaviour as well as increasing "cognitive flexibility", leading to better decision making.

Modafinil may also increase the motivation and pleasure gained from performing routine cognitive tasks, the report says.

Unlike recreational drugs, many cognitive enhancers available on prescription do not produce rapid mood changes, such as a "high" or a "rush", and do not lead to any obvious physical dependence, the report says. However, Professor Sahakian warned that the safety of long-term use of cognitive enhancers has not been properly assessed.

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Consider drugs decriminalisation system, MPs say


The government is being urged by MPs to closely consider a system of drugs decriminalisation used in Portugal.

The Home Affairs Committee said it was impressed with the approach to cutting drug use where people found with small amounts are not always prosecuted. It also asks ministers to monitor the effects of cannabis legalisation in other parts of the world.

The Home Office rejected its call for a Royal Commission on UK drugs policy, saying that was "not necessary". However, the Home Office minister, Jeremy Browne, said the government was "open to new ways of thinking".

He told the BBC Radio 4's Today programme: "We are open-minded, we think it's a decent, thoughtful, balanced report. We will consider it carefully."

Official figures show that illegal drug use in England and Wales is at its lowest rate under current measurements since 1996. However, there is concern over the growth and prevalence of "legal highs", some of which are now banned, amid a recorded rise in deaths linked to their use.

The committee stops short of supporting a relaxation of legal sanctions for drug use, as suggested by experts at the UK Drug Policy Commission, but it does call on ministers to look in detail at the idea.

In its wide ranging report the cross-party Home Affairs Committee said MPs had visited Portugal as part of attempts to understand different systems of decriminalisation which were being used around the world to manage the harm of drugs, rather than just hand out penalties for their use.

Portugal has not legalised drugs - but it has a system of not imposing criminal penalties on drug users who enter into special programmes designed to end their habit.

"We were impressed by what we saw of the Portuguese depenalised system," said the MPs. "It had clearly reduced public concern about drug use in that country, and was supported by all political parties and the police.'

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Therapy 'could cut teen drinking' researchers say


Teenagers at risk of becoming binge-drinkers have been helped by mental health therapy, according to research carried out by King's College London.

A study carried out in 21 London schools targeted young people believed to be at risk of emotional or behavioural problems. Some were given training in psychological strategies to help them cope with their feelings.

Two years later, they were less likely to drink or binge-drink than high-risk students who had not had the therapy. The study was led by Patricia Conrod, of King's College London's Institute of Psychiatry, with the University of Montreal and Sainte-Justine University Hospital Center in Canada.

It was commissioned by the charity Action on Addiction and looked at the personalities and drinking behaviour of just over 2,500 pupils aged 13 and 14 and then monitored their drinking over two years. The students were classed as being at high or low risk of becoming dependent on alcohol in the future.

High-risk students were classed as those with certain personality traits, including having anxiety problems or "low" moods, as well as others judged to be impulsive or thrill-seekers.

Eleven of the schools were selected to run workshops designed to help about 700 teenagers seen as at high risk.Staff in each of these schools were trained to help the teenagers find psychological strategies to manage their feelings and impulses.

The researchers said after two years, high-risk students in those schools were 29% less likely to drink compared with high-risk students at the schools where the therapy had not been provided, and 43% less likely to binge drink.

And there seemed to be a benefit for other young people in the schools where the workshops had been run, the researchers argue.

Dr Conrod said: "Not only does the intervention have a significant effect on the teenagers most at risk of developing problematic drinking behaviour, there was also a significant positive effect on those who did not receive the intervention, but who attended schools where interventions were delivered to high-risk students.

"This 'herd effect' is very important... as it suggests that the benefits of mental health interventions on drinking behaviour also extend to the general population, possibly by reducing the number of drinking occasions young people are exposed to in early adolescence."

The research is published in the journal Jama Psychiatry.

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UK drug advisers reject khat ban


The UK government's official drugs advisory body has rejected calls to ban the herbal stimulant, khat. The Advisory Council on the Misuse of Drugs (ACMD) said there was "insufficient evidence" that khat caused health problems.

The stimulant is traditionally used by members of the Somali, Yemeni and Ethiopian communities. It has been outlawed by the US and Canada and in most European countries, most recently by the Netherlands. The review was commissioned by the Home Office.

The ACMD said there was "no evidence" khat, which contains the stimulant cathinone, was directly linked with serious or organised crime.It said khat, which consists of the leaves and shoots of a shrub cultivated in the Horn of Africa and the Arabian Peninsula, was chewed to obtain a "mild stimulant effect much less potent than stimulant drugs, such as amphetamine".

Khat is sold in bundles for about £3 to £6 each. Users often chew one or two bundles for up to six hours at a time.

Somali groups in the UK had told the council that use of khat, which acts as a stimulant when chewed, was a "significant social problem". Campaigners said it caused medical problems and family breakdowns. The herb also triggers withdrawal symptoms such as tiredness, depression, shaking and bad dreams, although the ACMD said this did not necessarily provide evidence of dependency.

But ACMD chairman Professor Les Iversen said the review "found insufficient evidence of either health or societal harms caused by the use of khat to justify its control in the UK".

He added: "We have listened to concerns of the community and recommend local authorities and the police address these through continued engagement."

The council's vice-chairman, Dr Hew Mathewson, said he gave "no credence" to links between the khat trade and the funding of al-Shabaab, the Somali-based cell of al-Qaeda.

The ACMD recommended that the NHS should include khat in prevention education when necessary and called on local authorities and police commissioners to engage with communities "to address any concerns of khat use causing social harm".

It also said khat usage data should be included in information provided by treatment and enforcement agencies so it could be examined in future research.

More than 2,500 tonnes of khat, worth about £13.8m, was imported by the UK in 2011/12, bringing in £2.8m of tax revenues, the ACMD added.

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Police warn over 'fatal pink ecstasy' with AMT or 5-IT


Scotland's largest police force has issued a warning about pink-coloured tablets being sold as ecstasy which contain "potentially fatal substances".

Strathclyde Police said anyone taking the pills, which contain AMT or 5-IT, could suffer increased heart rate, elevated core temperature and seizures.

The force said the tablets have been described as having a cherry logo on one side and a half score on the other. AMT or 5-IT are not classed as controlled substances.

Supt Kirk Kinnell said: "These substances are unreliable, unpredictable and very dangerous. Users may believe that they have taken ecstasy, and it is very likely that they will suffer from a significant negative reaction. Users need to be aware of the dangers and understand the potentially devastating effect these pills can have on their health," he said.

"We are continuing to take this matter extremely seriously and extensive police inquiries are ongoing to establish the source of these drugs and every effort is being made to track down and arrest those responsible for selling these drugs as quickly as possible."

Strathclyde Police said additional patrols had been deployed in Glasgow city centre to carry out searches at a number of venues connected to the inquiry.

It comes after nine people were admitted to hospital after taking a combination of tablets and powders in Glasgow city centre.

The force advised that clubbers in the area should avoid taking the pink tablets and notify police if they were being sold. Glasgow Royal Infirmary emergency medicine doctor Richard Stevenson said AMT and 5-IT had "been implicated in deaths in Europe".

He said: "Early assessment and intervention is paramount to prevent fatalities. There is also a real risk of interaction with commonly prescribed medications, as well as an interaction with alcohol, that may be fatal. Most cases experience a life-threatening rise in body temperature and extremely fast heart rate and can display a range of bizarre behaviours as well as being extremely confused.

"The body will overheat and there will be signs of delirium and agitation. Without immediate medical treatment this collection of symptoms could prove fatal."

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Childhood asthma 'admissions down' after smoking ban


There was a sharp fall in the number of children admitted to hospital with severe asthma after smoke-free legislation was introduced in England, according to research carried out by Imperial College in London.

A study showed a 12% drop in the first year after the law to stop smoking in enclosed public places came into force. The authors say there is growing evidence that many people are opting for smoke-free homes as well.

Researchers at Imperial College in London looked at NHS figures going back to April 2002. Presenting their findings in the journal Paediatrics, they said the number of children admitted to hospital with severe asthma attacks was rising by more than 2% a year before the restrictions were introduced in July 2007.

Taking that into account, they calculated the fall in admissions in the next 12 months was 12%, and a further 3% in each of the following two years. They say over the three-year period, this was equivalent to about 6,800 admissions.

The fall was seen among boys and girls of all ages, across wealthy and deprived neighbourhoods, in cities and in rural areas.

Prior to the smoke-free law much of the debate on the legislation centred on protection of bar workers from passive smoke. At the time many critics said smokers would respond by lighting up more at home - harming the health of their families. But the authors of this study say there is growing evidence that more people are insisting on smoke-free homes.

The lead researcher, Prof Christopher Millett, said the legislation has prompted unexpected, but very welcome, changes in behaviour.

"We increasingly think it's because people are adopting smoke-free homes when these smoke-free laws are introduced and this is because they see the benefits of smoke-free laws in public places such as restaurants and they increasingly want to adopt them in their home. This benefits children because they're less likely to be exposed to second hand smoke."

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Amsterdam tourist cannabis ban rejected by mayor


The Mayor of Amsterdam says he will not ban foreign tourists from using the city's famous cannabis cafes, after months of argument over new drug laws.

The move comes after the new government of the Netherlands said it would be up to local authorities whether or not to impose such a ban. Mayor Eberhard van der Laan said banning the sale of the drug to foreigners could lead to more crime.

Each year, around 1.5 million tourists visit Amsterdam to consume cannabis.

"The 1.5 million tourists will not say 'then no more marijuana', they will swarm all over the city looking for drugs," said Mayor Van der Laan, who has long opposed a ban.

"This would lead to more robberies, quarrels about fake drugs, and no control of the quality of drugs on the market - everything we have worked towards would be lost to misery."

Amsterdam also relies heavily on tourism, and cannabis users make up about a third of its total visitors.

Under laws introduced by the previous conservative-led Dutch government, a national ban on foreigners using cannabis was due to be rolled out to Amsterdam by the end of this year. It was intended to curb drug use and prevent drug dealers from operating in the Netherlands, and prevent them from buying drugs to sell abroad.

The move was strongly opposed by cafe owners, who said the law unfairly discriminated against other EU residents, and warned that 90% of their income came from foreign tourists.

There are an estimated 700 coffee shops selling cannabis in the Netherlands. It is not strictly legal to use cannabis, but its use is tolerated and possession of small amounts was decriminalised in the 1970s.

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Warning over laughing gas after student dies


The sister of a public school boy has warned of the dangers of the recreational use of nitrous oxide or 'laughing gas' after he fell into a coma and died using the drug.

Joseph Benett, 17, suffered a heart attack and brain damage after inhaling nitrous oxide from a canister with his friends. Joseph lay in a coma in hospital for four weeks but the student at University College School (UCS), in Hampstead, north London, never recovered because the damage was so severe.

Now Miss Benett, 27, has warned others to think about those they could hurt by experimenting with nitrous oxide which is used in hospital as a pain killer, especially during childbirth.

Miss Benett said: "He just never woke up. He had such terrible brain damage and his fits were getting worse. When he stopped breathing, my dad and I were holding his hand. I found it hard to leave him. As a big sister I felt a responsibility to look after my little brother. I think having experienced how much this hurts, people should think about whether they are putting themselves in danger. You do need to think about what you are doing, not just for yourself but for the sake of the people who love you."

Dr Alan McGlennan, a consultant anaesthetist at the Royal Free Hospital, said taking laughing gas recreationally was "in vogue" but it can starve the brain of oxygen.

Despite the legal high being widely available at music festivals, bars and nightclubs, it is against the law to sell laughing gas for recreational use. Nitrous oxide, also known as laughing gas, N2O and sweet air, gives users an intense euphoria.

It can however produce alarming side effects: strokes, hallucinations, seizures, blackouts, incontinence, stress on the heart, chronic depression and even in cases of prolonged use, depleted bone marrow. When inhaled, nitrous oxide dissolves in the bloodstream, depleting the blood of oxygen and reducing its flow to the brain and other vital organs. An overdose can be fatal. It is used in surgery and dentistry for its anaesthetic and analgesic effects. It is also used during childbirth when it is known as gas and air.

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Baby boomer alcohol harm 'more likely than in young'


More NHS money is spent treating alcohol-related illness in baby boomers than young people, a study says. The Alcohol Concern report found the cost of hospital admissions linked to heavy drinking 55 to 74-year-olds in 2010-11 was more than £825m.

That was 10 times the figure for 16 to 24-year-olds. In total, nearly £2bn was spent on alcohol-related in-patient admissions in England, the report found.This comes as more than 10 million people in England are drinking above the recommended levels, according to the report. The sum spent on treating the baby boomer generation went on 454,317 patients, compared with the 54,682 under-24s who were treated at a cost of £64m.

Problem drinking is a contributing factor for a host of diseases including liver, kidney and heart disease, as well as increasing the risk of injury.

It hopes the information will be used by councils when they take responsibility for problem drinking as part of their new remit covering public health under the shake-up of the NHS.

Alcohol Concern chief executive Eric Appleby said he hoped they would use the findings to help them focus their energy on schemes to tackle problem drinking.

"It is a common perception that young people are responsible for the increasing cost of alcohol misuse, but our findings show that in reality this is not the case. It is the middle-aged, and often middle-class drinkers, regularly drinking above recommended limits, who are actually requiring this complex and expensive NHS care."

Liver disease expert Sir Ian Gilmore, a former president of the Royal College of Physicians, who has long campaigned about alcohol misuse, agreed. He said: "It is the unwitting chronic middle-aged drinkers who are taking serious risks with their health."

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Fewer young heroin users treated in England


The number of young heroin addicts in England receiving treatment has dropped to its lowest recorded level, official figures suggest.

In 2011-12, 4,268 adults aged 18 to 24 started treatment, down from 11,309 six years earlier.The National Treatment Agency for Substance Misuse (NTA) said "the sharp drop... is particularly encouraging".

Heroin users aged over 40 were the largest group in treatment, with more than 16,000 starting in the past year.The latest figures come from NTA, an NHS special health authority dealing with the availability and effectiveness of drug treatment in England, in its report into long-term drug use and addiction trends.

Most addicts in treatment in England had taken heroin, with four in five of the 197,110 adults being treated for heroin or heroin and crack cocaine dependency.

A total of 96,343 were receiving help for heroin dependency while a further 63,199 were being treated for heroin and crack use.

The growing number of addicts over 40 was fuelled by an ageing population, rather than by new users, the NTA said.

NTA chief executive Paul Hayes said: "There's no evidence of swathes of people in their 40s and 50s beginning to use heroin and crack as they get older. It's a population that began using 20 or 30 years ago."

Mr Hayes said: "The number of heroin and crack addicts is shrinking as fewer are starting to use the most harmful drugs, and more of them are recovering from addiction. The sharp drop in the number of young adults needing treatment is particularly encouraging."

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