News and Notes

CLINICAL GUIDELINES FOR WITHDRAWAL MANAGEMENT AND TREATMENT OF DRUG DEPENDENCE IN CLOSED SETTINGS

The WHO and Australia's National Drug and Alcohol Research Centre have released new guidelines designed to assist staff of closed settings in providing safe and effective withdrawal management and treatment services for people who use drugs in the Western Pacific Region. The guidelines provide information about drugs and drug dependence, the management of drug withdrawal, and approaches to treatment for drug dependence. For the purposes of this document, ‘closed settings’ refers to prisons, work camps, compulsory drug treatment centres and any other institutions in which people are detained.

These guidelines take a public health approach to drug use and dependence. This approach recognizes that the health of one individual affects the health of the community.

The WHO Western Pacific Regional Office recognizes that incarceration of people who use drugs is a reality in the region, although it is not an appropriate solution for the use of drugs or for the health of people who use drugs. Therefore, the reality imposes the need for these transitional guidelines of appropriate drug treatment in anticipation of a better solution for the drug problem in the region.

This training manual has been written as a companion to the WHO Clinical Guidelines for Withdrawal Management & Treatment of Drug Dependence in Closed Settings. It contains comprehensive trainer's notes and participant handouts. Throughout the trainer's notes are sections of boxed text containing references to participant handouts. These should be used to ensure participants are looking at the correct handouts. Also in boxed text are suggested activities. The trainer may wish to use these, or to use other activities that he or she has found useful in training.

The Training Manual for Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings is available at: http://www.wpro.who.int/publications/PUB_9789290614319.htm

KATE DOLAN
Program of International Research and Training, National Drug and Alcohol Research Centre, UNSW, Australia

EMCDDA–EUROPOL ANNUAL REPORT REVIEWS NEW DRUGS ENTERING THE MARKET

In 2009, a record number of new drugs were officially reported to the EMCDDA and Europol via the EU early-warning system (EWS) on new psychoactive substances. This is according to the EMCDDA–Europol 2009 annual report on the implementation of the three-step legal instrument through which Europe monitors and acts on new substances [1].

According to the report, 24 new psychoactive substances were officially reported for the first time to the two agencies in 2009. This represents the largest number of substances ever reported in a single year and almost double the number notified in 2008. All of the new compounds were synthetic, including two substances with medicinal properties. A full list of the substances notified is annexed to the report.

Highlighted as significant new developments in 2009 were the emergence of new, smokable herbal products laced with synthetic cannabinoids (the so-called ‘Spice’ phenomenon) and the growing popularity of synthetic cathinones. A total of nine synthetic cannabinoids, from four distinct chemical groups, were reported via the EWS in 2009, as well as four synthetic cathinones. The latter are derivatives of the parent compound cathinone, which is structurally related to amphetamine.

Towards the end of 2009, increased evidence of the use and availability of one synthetic cathinone, mephedrone (4-methylmethcathinone), prompted the EMCDDA and Europol to embark on a formal data-collection exercise on the substance (Step I of the legal process). This led to a joint report on mephedrone, submitted to the EU institutions and the European Medicines Agency in March, paving the way for a possible risk assessment on the drug (Step II).

The appearance of a large number of new unregulated synthetic compounds, marketed on the internet as ‘legal highs’ or ‘not for human consumption’, states the report, presents a growing challenge for monitoring, responding to, and controlling the use of new psychoactive substances.

The piperazine mCPP, extensively covered in previous years, is also given attention in this year's report. Data from various sources highlight a marked increase of the percentage of ‘ecstasy’ tablets containing this substance, while the availability of MDMA on the market appears to be decreasing. It is noteworthy that no new piperazines or psychoactive plants were reported in 2009.

The report concludes that the EWS has high reporting capabilities and the capacity to triangulate information from different sources. Over 110 substances have been reported by Member States to the EMCDDA and Europol since the EWS was created in 1997.

For more on the Council decision see: http://www.emcdda.europa.eu/drug-situation/new-drugs

LEAHRN WEBSITE IS NOW LIVE

The Law Enforcement and Harm Reduction Network (LEAHRN) website is now live, and can be accessed through http://www.leahrn.org. LEAHRN aims to bring law enforcement and harm reduction closer together. It connects people who want to know more about how police and harm reduction services can work together more effectively. LEAHRN also seeks to promote harmony and a better understanding between police and health service providers so that more programs involving clean needles and syringes, methadone, condoms and supervised injecting facilities can be successfully delivered. The website is still in its formative stages and will undergo further development over the next few weeks, including additional resources and updated information being added regularly.

TRAINING PACKAGE RELEASED FOR IMPLEMENTING AUSTRALIA'S NATIONAL COMORBIDITY GUIDELINES IN CLINICAL PRACTICE

A training package has been developed to facilitate the implementation of the Guidelines on the Management of Co-Occurring Alcohol and Other Drug and Mental Health Conditions in Alcohol and Other Drug Treatment Settings in clinical practice. The training package was developed by Alison Bell for the National Drug and Alcohol Research Centre (NDARC) with funding from the Australian Government Department of Health and Ageing.

The aim of the training package is to provide clinical educators, team leaders and other suitably qualified personnel with information to deliver training on the Guidelines within the workplace. It is hoped that by delivering targeted, workplace-based training on the information within the Guidelines, AOD and related professionals will significantly improve their knowledge, skills and confidence when working with clients with co-occurring AOD and mental health concerns. The training package may be downloaded by following the links on the Guidelines website: http://ndarc.med.unsw.edu.au/comorbidity.

SMART RECOVERY MANUAL PROMOTES NEW APPROACH TO PEER SUPPORT

The Alcohol Concern SMART Recovery project in the UK has produced guidance to alcohol services and others working with alcohol misusing clients as to how they can help the establishment and development of SMART Recovery groups in their area. SMART recovery is an alternative model of peer support to the widely used 12 step programmes commonly adopted by Alcoholics Anonymous (AA) and other recovery models. The manual, ‘Developing choice in peer support: how alcohol services can support SMART recovery’, provides practical advice and resources for anyone who wishes to support the establishment of SMART Recovery meetings in his or her area.

The manual can be downloaded at: http://www.alcoholconcern.org.uk/assets/files/Publications/Developing%20choice%20in%20peer%20support%281%29.pdf

AUSTRALIA INTRODUCES PLAIN CIGARETTE PACKAGING AND RAISES TAXES

The Australian government has introduced a series of measures to crack down on smoking, including new laws that will force cigarette companies to adopt plain packaging from 2012. Other countries, including the UK, are also considering plain packaging – which bans logos, colours and brand imagery – but Australia believes it will be the world's first nation to have the changes enshrined in law.

Kevin Rudd, Australia's prime minister, said that the government would also increase excise taxes on cigarettes by 25% and introduce restrictions on internet advertising. The government will also allocate A$28m (US$25.9m) in funding for new anti-smoking campaigns.

Sources:

The Independent, 29 April 2010: http://bit.ly/cax0dp

Business Week, 29 April 2010: http://bit.ly/coDsBQ

Sydney Morning Herald, 29 April 2010: http://bit.ly/bipaS0

UK REMAINS AMONGST TOP EU COUNTRIES FOR BINGE DRINKING

Alcohol Policy UK reports that new research on UK drinking trends has been released, continuing to show that the UK and Ireland have the highest reported rates of binge drinking, using the EU definition of five drinks or more on any one occasion. According to the report, entitled ‘EU citizens' attitudes towards alcohol’, alcohol consumption in the EU is at a similar level to four years ago and the countries within the EU15 with the highest average number of drinks per day in 2003 were Ireland, Finland, Denmark and the UK. It also reported that young people aged 15–24 years are the most likely to binge drink five drinks or more on any one occasion every week. Per-capita consumption of alcohol in the UK rose 19% between 1980 and 2007, compared with a 13% decline for all 30 countries in the Organization for Economic Cooperation and Development.

This report comes at the same time as the UK government introduced new laws aimed at reducing irresponsible drinks promotions. Owners of bars and pubs will be banned from offering ‘all you can drink’ alcohol promotions, drinking games and free drinks for women, or face six months in jail. Other deals that are made unlawful are ‘dentists' chairs’, where drinks are poured directly into the mouths of customers, making it impossible for them to control the amount they are drinking. In a third measure, bars and clubs will be forced to ensure that tap water is available, free of charge, for all drinkers, following similar measures being introduced in other countries such as Australia.

The report may be accessed at: http://ec.europa.eu/public_opinion/archives/ebs/ebs_331_en.pdf

Source: Telegraph, 06 Apr 2010: http://www.telegraph.co.uk/news/newstopics/politics/lawandorder/7556935/Owners-of-bars-and-clubs-face-six-months-in-jail-if-they-allow-all-you-can-drink-deals.html

CONFERENCES AND EVENTS

The International Narcotics Research Conference, 11–16 July 2010, Hilton Hotel, Malmö, Sweden. Website: http://www.inrcworld.org/2010/2010mtg.htm

The International AIDS Society's 18th International AIDS Conference (AIDS 2010), 18–23 July 2010, Vienna, Austria. Website: http://www.aids2010.org/

Translational Research in Methamphetamine Addiction Conference, 19–21 July 2010, Chico Hot Springs and Day Spa, Pray, Montana, USA. Website: http://academicdepartments.musc.edu/neurosciences/TRMA2010/

The 20th Annual Symposium of the International Cannabinoid Research Society, 24–27 July 2010, Scandic Star, Lund, Sweden. Website: http://www.cannabinoidsociety.org/SYMPOSIUM.2010/index.html

7^th Annual Conference of the International Network on Brief Interventions for Alcohol Problems (INEBRIA), 9–10 September 2010, Gothenburg, Sweden. Website: http://www.inebria.net/Du14/html/en/dir1339/doc17916.html

International Society for Biomedical Research on Alcoholism (ISBRA) 2010 Congress, 13–16 September 2010, Paris, France. Website: http://www.isbra2010paris.org/

Specialist Clinical Addiction Network (SCAN) Conference 2010, 30-September–1 October 2010, Hotel Diagonal Zero, Barcelona, Spain. Website: http://www.scan.uk.net, or contact Rebecca Murchie at [email protected]

International Workshop Conference: Urban Drug Policies in the Globalised World, 30 September–2 October, Prague, Czech Republic. Website: http://www.urbandrugpolicy.com

International Society of Addiction Journal Editors (ISAJE) Annual Meeting, 30 September–3 October 2010, Hotel Josef, Prague, Czech Republic. Website: http://www.parint.org/isajewebsite/meetings2010.htm

The International Society of Addiction Medicine 12^th Annual Meeting, 4–7 October 2010, University of Milano-Bicocca, Milan, Italy. Website: http://www.isam2010.medicina.unimib.it/

Congrès International Francophone d'Addictologie—Prévenir et Traiter les Addictions Sans Drogue: Un Defi Societal, 6–8 October 2010, Nantes Cité Internationale des Congrès, Nantes, France. Website: http://www.crje.fr/congres_2010_annonce.html

International Nurses Society on Addictions Annual Educational Conference—Learning from Each Other: A Global Perspective on Addictions, 20–23 October 2010, Greenwich, Connecticut, USA. Website: http://www.intnsa.org/events.php

The American Association of for the Treatment of Opioid Dependence National Conference, 23–27 October 2010, Chicago, Illinois, USA. Website: http://www.aatod.org/2010chicago.html

Addictions 2010. The New Frontier in Addiction Treatment: Evidence-Based Policy and Practice, 28–31 October 2010, Sheraton National, Arlington, VA, USA. Website: http://www.addictions-conference.elsevier.com

53^rd International Council on Alcohol and Addictions (ICAA) Conference on Dependencies, 2–6 November 2010, Cancún, Mexico. Website: http://www.icaa.ch/mexico2010.html

Association for Medical Education and Research in Substance Abuse (AMERSA) 34th Annual National Conference, 4–6 November 2010, Bethesda, Maryland, USA. Website: http://www.amersa.org, or contact Doreen Baeder at [email protected]

American Public Health Association Annual Meeting and Exposition, 6–10 November 2010, Denver, Colorado, USA. Website: http://www.apha.org/meetings/

Society for the Study of Addiction Annual Symposium, 11–12 November 2010, Park Inn, York, UK. Themes: ‘Dissemination and implementation of addiction research’ and ‘Addictions and commonly co-existing problems’. Society lecture by Sally Casswell. Delegate abstracts for oral and poster presentations now welcome. Website: http://www.addiction-ssa.org/ssa_10.htm

Society for Neuroscience Annual Meeting, 13–17 November, San Diego, California, USA. Website: http://www.sfn.org/am2010/

Australasian Professional Society on Alcohol and other Drugs (APSAD) Annual Conference, 28 November–1 December 2010, Canberra, Australia. Website: http://www.apsadconference.com.au/

American Academy of Addiction Psychiatry 21^st 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

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