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OPIUM INCREASE
Opium poppy cultivation in Afghanistan
rose by 7 per cent to more than 220,000
hectares in 2013, according to UNODC
figures, with opium production this year
potentially up by 17 per cent and prices
falling as a result. ‘We cannot afford to
see the long-term stability of Afghanistan
– and the wider region – derailed by the
threat of opiates,’ said UNODC chief
executive Yury Fedotov.
2014 Afghanistan
opium survey at www.unodc.org
NALOXONE ALERT
A patient safety alert on the use of
naloxone has been issued by NHS
England, where the drug is used to
provide pain relief following surgery. There
is a ‘risk of distress and death from
inappropriate doses of naloxone in
patients on long-term opioid/opiate
treatment’ says the warning, with the NHS
receiving details of three patient safety
incidents – two fatal – resulting from
failure to follow British National Formulary
(BNF) guidelines.
More information at
www.england.nhs.uk/2014/11/20/psa-
naloxone
ON THE RADAR
Greater Manchester West Mental Health
NHS Foundation Trust’s RADAR (Rapid
Access to Alcohol Detoxification Acute
Referral) service has been named non-age
specific psychiatric team of the year by
the Royal College of Psychiatrists. The
service takes referrals from 11 acute
hospitals, with a 97 per cent successful
detox rate on its eight-bed ward. ‘Our
RADAR ward is the first of its kind in the
country and we are hugely proud of the
service and the exceptional team who run
it,’ said the trust’s director of nursing and
operations, Gill Green.
CARER QUESTIONS
A ten-minute survey on professional
training and development and the needs
of carers has been launched as part of
the Recovery Partnership/Alcohol
Concern review of alcohol services.
The survey can be found at
https://www.surveymonkey.com/s/XRPWR
3J until the start of next year.
ONLINE ANXIETY
A new online learning tool on anxiety
disorders has been launched by NICE,
aimed at drug and alcohol teams, mental
health professionals and GPs.
Available free at elearning.nice.org.uk
Time limits on heroin substitution treatment such
as methadone would ‘not benefit’ drug users’
recovery and would increase the possibility of
relapse, according to a new report from the
Advisory Council on the Misuse of Drugs (ACMD).
Imposing a time limit could also lead to other
‘significant unintended consequences’, it says, such as
increased rates of overdose, blood-borne viruses and
drug-related crime. The ACMD had been asked to
consider whether there was a case for a maximum time
limit by the Inter-Ministerial Group on Drugs.
Although there are no recommended time frames for
OST maintenance in UK clinical guidelines, the issue of
people being ‘parked’ on methadone has long been a
controversial one. The report, however, found that while a
‘small minority’ of 10-15 per cent of service users
received OST for five years or more, a larger minority
‘may not be in OST long enough to derive long-term
benefit’. OST use is ‘episodic and relatively short’ for the
majority of people, it says, with nearly 40 per cent
stopping within six months. ‘The “being parked” analogy
may not be correct,’ states the document. ‘Most people
get out of the car and walk away.’
However, it was unhelpful to ‘focus on the medication
alone’, stresses the report, with ‘concomitant
psychosocial interventions and recovery support’ vital.
OST should be seen as a ‘stepping stone’ on a path to
overcoming dependency, said ACMD chair Professor Sir
Les Iversen.
‘All the evidence suggests restricting access to OST
leads to an increased risk of people relapsing, turning to
crime to fuel their habits – and even dying from an
overdose,’ said co-chair of the ACMD’s recovery
committee, Annette Dale-Perera. ‘However, it is important
to remember that medication alone will not lead to a
successful recovery. OST should be delivered alongside
therapy designed to change behaviour, as well as
recovery interventions, to help people tackle their
addiction and rebuild their lives.’
The findings were welcomed by DrugScope. ‘The
notion that somebody who has been in the grip of a
serious drug dependency for many years could be
successfully treated to an artificial timetable has always
been deeply flawed,’ said chief executive Marcus
Roberts. ‘It also goes against the widely held consensus
in the drug treatment and rehabilitation field that recovery
should be self-determined as it is in mental health.’
However, his organisation remained concerned by
anecdotal reports that some local commissioners ‘may
be indicating their preference for time-limited solutions in
the tendering process’, he said, adding that DrugScope
would be ‘monitoring’ the situation.
The Home Office has also announced that it has
accepted the ACMD’s advice to control the new
psychoactive substances 4,4’-DMAR – known as
‘serotoni’ – and MT-45 as class A substances, following
concerns about their safety.
Time limiting opioid substitution therapy at www.gov.uk
4 |
drinkanddrugsnews
| December 2014
www.drinkanddrugsnews.com
News |
Round-up
NEWS IN BRIEF
ACMD rejects time-limited
substitution treatments
Around half of people living with hepatitis C infections
are unaware that they have the virus, according to a new
Public Health England (PHE) report. Nearly 14,000
hepatitis C infections were diagnosed in the UK last year,
around 90 per cent of which were acquired through
injecting drug use, says
Shooting up: infections among
people who inject drugs in the United Kingdom 2013
.
Around two in five people who inject psychoactive
drugs are now living with hepatitis C, says PHE, with half of
the infections remaining undiagnosed, while about one in
30 of those who inject image and performance-enhancing
drugs are also living with the virus. Interventions to reduce
infections and diagnose them earlier need to be expanded,
the agency stresses, with vaccinations and diagnostic tests
‘routinely offered’ to people who inject drugs and
treatment made available to anyone testing positive.
Although reported rates of needle and syringe sharing
have halved over the last decade, around one in seven people
injecting psychoactive drugs still share needles and syringes
and ‘almost one in three had injected with a used needle
that they had attempted to clean’, says the document, with
recent increases in the injection of drugs such as
amphetamines and mephedrone also ‘cause for concern’.
‘With around half of those people living with hepatitis
C still unaware of their infection, we need to do more to
increase diagnosis rates,’ said PHE infections expert Dr
Vivian Hope. ‘Ultimately, this will help reduce the current
high level of infection we’re still seeing among people who
inject drugs. Obtaining blood from people living with
hepatitis C who inject drugs can be difficult due to poor
venous access. Dry blood spot testing is an alternative
method that avoids puncturing veins, and which has been
proven to be reliable and simple, and acceptable to both
people who inject drugs and drug service staff.’
There are now almost 110,000 people living with HIV in
the UK, according to another PHE report, although the
number of people being diagnosed with a late stage of
infection has fallen from 57 per cent to 42 per cent in the
last decade.
Shooting up: infections among people who inject drugs
in the United Kingdom 2013, and HIV in the United
Kingdom: 2014 report at www.gov.uk
Half of those living with hep C
unaware of their condition