Drug Use - Fall and Rise

It was surely not a coincidence that drug abuse declined during the Reagan years.
Dr.Herbert Kleber, interviewed on PBS's Frontline* told the truth.
"To diminish drug use, you need to de-glamorize and de-normalise drug use" in the manner of the Just Say No campaign, which "had a good effect in terms of decreasing initiation and use".
From l980 to 1991, marijuana use among high school seniors decreased from 33% to
12%, "an enormous decrease" according to Dr. Kleber. 21985-1986 turned out to be the high point of the cocaine epidemic".

Tragically, marijuana use increased rapidly again between l992 and l997 he added.
*(http://www.pbs.org/wgbh/pages/frontline/shows/drugs/interviews/kleber.html)

The reason for the increase was because funding for prevention was cut - the
Government believing that the drug problem had been solved. It is essential that prevention funding and prevention messages continue even when there is a downturn in drug use. It will take more tha one generation to revert to the very low rates of illegal drug use in the 1950's. It is also interesting to note that research has shown that regular use of marijuana leads to the use of cocaine - thus prevention of marijuana use will also have a prevention of cocaine effect.

Is Addiction a Brain Disease?

A bill introduced by Sen. Joe Biden (D-DE) that would define addiction as a brain disease is moving in the Senate. Treatment professionals, mainstream scientists, and recovery advocates see it as a good thing. There are some skeptics, though.
The bill, the Recognizing Addiction as a Disease Act of 2007 (S. 1011), would also change the name of the National Institute on Drug Abuse (NIDA) to the National Institute on Diseases of Addiction, and change the name of the National Institute on Alcohol Abuse and Alcoholism to the National Institute on Alcohol Disorders and Health.
"Addiction is a neurobiological disease -- not a lifestyle choice -- and it's about time we start treating it as such," said Sen. Biden in a statement when he introduced this bill this spring. "We must lead by example and change the names of our federal research institutes to accurately reflect this reality. By changing the way we talk about addiction, we change the way people think about addiction, both of which are critical steps in getting past the social stigma too often associated with the disease. This bill is a small but important step towards stripping away the social stigma surrounding the treatment of diseases of addiction," said Sen. Biden.
The measure is garnering bipartisan support. It passed out of the Senate Health, Education, Labor and Pensions (HELP) committee in June with the backing of Sen. Mike Enzi (R-WY), the ranking minority committee member. "Science shows us the addiction to alcohol or any other drug is a disease," Enzi said in a statement marking the vote. "While the initial decision to use drugs is a choice, there comes a time when continued use turns on the addiction switch in the brain. That time can vary depending on factors ranging from genetics to environment to type of drug and frequency of use. Because of that and the continued stereotypes and challenges that are often barriers to people with addiction issues seeking treatment I am proud to support this legislation. Although the names of the Institutes will change, their mission -- preventing and treating drug and alcohol addiction -- will remain the same."
The politicians are taking their cue from neurological researchers led by NIDA scientists who have been working for years to find the magic link between the brain and compulsive drug use. Dr. Nora Volkow, current head of NIDA, has been leading the charge, and Biden and Enzi could have been reading from her briefing book.
"Drug addiction is a brain disease," said Volkow in a typical NIDA news release. "Although initial drug use might be voluntary, once addiction develops this control is markedly disrupted. Imaging studies have shown specific abnormalities in the brains of some, but not all, addicted individuals. While scientific advancements in the understanding of addiction have occurred at unprecedented speed in recent years, unanswered questions remain that highlight the need for further research to better define the neurobiological processes involved in addiction."
Not surprisingly, the treatment and recovery communities, anxious to see the social climate shift to one of more support and less punishment for the addicted, support the legislation. "Recognizing addiction is the next step forward," said Daniel Guarnera, government relations liaison for the NAADAC -- The Association for Addiction Professionals. "NIDA and its scientists have demonstrated overwhelmingly that addiction is not a behavioral trait, but rather is caused by physiological changes to the body that make people want to use addictive substances. This bill allows the terminology to catch up with the science."
Although the bill does little more than make a congressional pronouncement and rename a couple of institutes, it is still an important step, said Guarnera. "Yes, it's symbolic, but that symbolism is hugely important, because language should reflect medical knowledge, and medical knowledge has demonstrated that drug abuse is a physical phenomenon."
"We utterly endorse this bill," said Pat Taylor, executive director of Faces and Voices of Recovery, a treatment and recovery advocacy umbrella organization. "I think it's a great idea to rename the agencies. People with drug and alcohol problems can and do recover from addiction. Calling them 'abusers' just stigmatizes them."
Taylor and her organization are actively supporting the bill, she said. "We've sent letters of endorsement for the bill," she said. "People blame people for their drug and alcohol problems, so this is an important issue for the recovery community. We need to rethink how we talk about this."
Is addiction in fact a brain disease? Some researchers think that's too simple. Scott Lilienfeld, a professor of psychology at Emory University told ABC News last week: "What I find troubling with the brain disease rhetoric is that it's grossly oversimplified, it boils down an incredibly complex problem to not necessarily the most important explanation. You can view a psychological problem on many levels. Low level explanation refers to molecules in the brain. There are other levels including people's personality traits and moods, people's parents, environment. Higher level than this is community."
"Every level tells you something useful," Lilienfeld continued. "Brain disease is only one level among many and not even the most helpful. Implying it's the only level of explanation, that's counterproductive."
Some mavericks go even further. "No, addiction is not a brain disease," said Dr. Jeffrey Schaler, a psychologist and professor in the Department of Justice, Law and Society at American University in Washington, DC, and author of "The Myth of Addiction." "Diseases are physical wounds, cellular abnormalities. Addiction is a behavior, something that a person does. Diseases are things a person has," he argued.
"You can't will away a real disease," Schaler continued. "But people will away behaviors they don't like all the time."
Others feel that the concept of addiction itself is too imprecise. "There is no clear conception of what people mean by the word 'addiction,' and there are numerous papers on this unsatisfactory concept," said Professor John Davies, head of the Center for Applied Social Psychology at the University of Strathclyde in Scotland, another prominent critic of the "addiction is a brain disease" model. Using drugs and 'addiction' are not synonymous," Davies continued, noting that many "fun drug users" become "addicts" as soon as they end up in court.
"Of course, people can and do get into an awful mess when they fail to manage their habit effectively," Davies concedes. "But look at the data. Harmful damaging drug use is heavily social-class related whereas drug use per se is less so. People give up the so-called 'disease' when their lives change, they get a new partner, a new job, a move of house."
Vietnam war veterans picked up opiate habits, but for the most part rapidly shed them upon returning home.These vets used chronically and were said to be addicted. What happened to their addictions?" "The feared epidemic did not materialize because the social factors that sustained heroin use in Vietnam had all but disappeared upon returning."
Davies sees the addiction label as having pernicious consequences for problem users as well. "It makes things far worse," he said. It makes people believe that the roots of their behavior are beyond their capacity to control, which is the last thing you need when you're trying to get someone to change their behavior."
"Those are political concerns, however, If 'disease' is a scientifically imprecise term for describing the set of conditions that are commonly known as 'addiction' -- and it seems to me that it probably is -- then Congress and NIDA probably shouldn't be using the term for that purpose. I'd be more comfortable with the bill if it used slightly different language." Still, he thinks it's probably a net positive. "I think the obvious message of the terminology shift would be to say that people with drug problems are not really criminals, and that's a good thing."
"Plus if addiction isn't a disease, there's still obviously some condition that some people have, physical for at least some of them, that makes it harder for them to make favorable choices," Borden added. "Otherwise I don't think there would be thousands of people risking arrest or overdose to inject themselves daily with heroin, or millions knowingly doing what they're doing to themselves with cigarette smoking. So I'm not sure that the imprecision in the term chosen for the discussion is such a big problem."
In principle, neither Congressional fiat, nor therapists' concerns over what the right message is to send to patients, nor advocates' concerns over what will ultimately lead to better policies, should take a second seat in this debate -- the question is fundamentally a scientific one, and a philosophical one. With Congress holding the purse strings for the bulk of addictions research in this country, however, Congress' choices now may indeed affect the language being used in the future for some time to come. And language can indeed have an impact in ways going beyond its initial purposes.
Source: Daily Dose 11th August 2007

Federal anti-drug campaign will educate youth on 'harms of illicit drug use'

OTTAWA -- A new national program designed to prevent youth from using drugs received $10 million from the federal government Wednesday.

The money is slated to go toward the Drug Prevention Strategy for Youth, a new five-year plan led by the Canadian Centre on Substance Abuse, the government-supported national agency for substance abuse. The strategy will target youth between the ages of 10 and 24 and will have several goals: to reduce the number of youth using illegal drugs, to delay and deter the onset of drug use, to reduce the frequency of drug use, and to reduce multiple drug use among those young people who do use.

The funding comes out of the government's $64-million National Anti-Drug Strategy, launched last fall. Part of that plan includes a two-year mass media campaign by Health Canada aimed specifically at youth. Health Minister Tony Clement, speaking at the Ottawa-based CCSA, said there hasn't been a "serious or significant" anti-drug campaign in almost 20 years, and one is long overdue. He said the CCSA's national prevention strategy is key to the government's plan.

"This project will reach out to young people and will provide them and their parents the plain truth on the harms of illicit drug use," said Clement. "We will discourage young people from thinking there are 'safe' amounts, or 'safe' drugs. And we will highlight the fact that, for young people, having clear and unimpaired judgment is a safety issue," the health minister said.

The CCSA's strategy will complement Health Canada's media blitz with a new consortium media corporations, marketing and advertising agencies, youth agencies and parent groups. It will reinforce many of Health Canada's messages, but on a wider platform, and with high-risk populations targeted.

According to the CCSA, the average age a Canadian tries an illegal drug for the first time is around 14 or 15, so prevention messages need to start as early as 10 years of age. Sixty per cent of illegal drug users in Canada are 15 to 24 years old, according to the national substance abuse agency, and young people are the most likely to use and abuse substances, and to experience harm as a result.

Source: Canwest News Service January 31, 2008

http://www.canada.com/vancouversun/news/story.html?id=a9d26354-09a5-4fc0-a6aa-89d120ed22b1

Call to halt trade in cocaine 'cutting' agent

THE spiralling use of a dental anaesthetic by criminals to bulk-out cocaine deals has prompted talks between police and the government over a clampdown on its trade, The Scotsman has learned.
Several meetings have taken place between senior officers and civil servants on the supply of lidocaine, which generates tens of millions of pounds for crime gangs.
The Serious Organised Crime Agency (SOCA) is understood to have lobbied the Westminster government to introduce legislation restricting the ability of drug dealers and middlemen to buy large amounts of Lidocaine from overseas.
Senior detectives from Scotland have also held talks with counterparts south of the Border and government officials over similar moves. Sources have told The Scotsman they are pushing ministers to introduce a licensing scheme that would force individuals importing large quantities of potential cutting agents to prove they are for legitimate use.
Also known as Lignocaine, the anaesthetic is used in liquid form by dentists and other medical practitioners. Government restrictions ensure that most lidocaine supplied within the UK ends up in legitimate hands. But it can also be freely purchased in powder form from dealers overseas, leading to the emergence of a black market.
Lidocaine - along with other commonly-used cocaine cutting agents such as benzocaine and phenacetin - are a huge money-spinner for the dealers.
Cocaine is between 80 and 90 per cent pure when it arrives in the UK, where a kilo will cost around £35,000. Sold on the street, a kilo is nominally worth about £50,000. Diluting it twice over with a cutting agent turns a £15,000 profit into a £100,000-plus reward for dealers.
A spokeswoman for SOCA said: "The use of cutting agents is at high, if not record, levels. They are often carcinogenic and, clearly, people are not getting what they've paid for. "You can import Lidocaine but it is illegal to import large quantities with the purpose of mixing it with cocaine."
A senior Scottish police source added: "The availability of these agents is a major concern. Although some are harmless in themselves they are generating massive amounts of money for organised drug-dealers."
Steven Ward, crime co-ordinator at the Scottish Crime and Drug Enforcement Agency, said police were "taking all steps possible to disrupt the ability of organised-crime groups to traffic cocaine". As The Scotsman revealed yesterday, police are urging so-called recreational users to consider the social and human cost of producing and supplying cocaine - a change in tactics that reflects the growth in demand for the drug in recent years.
Tom Wood, chairman of the Scottish Association of Alcohol and Drug Action Teams, gave cautious support to the proposed restrictions. "This makes a lot of sense. But it has to be thought through - if you reduce the availability of benign substances, dealers may move to less inert cutting agents."
How added chemicals boost dealers' profits
LIDOCAINE, benzocaine, phenacetin and manitol have been identified as commonly used agents for cutting cocaine in the UK.
Phenacetin is principally used as an analgesic. Lidocaine and benzocaine are used as local anaesthetics. Manitol is used in the food industry as a sweetener. Phenacetin is believed to be carcinogenic and toxic to the kidneys, while the other three are harmless.
The cutting agents can be obtained easily and cheaply from overseas. Licences are only required if the chemicals are to be altered or re-packaged before selling on. Personal imports and use of these agents have been rising in the last 18-24 months.
Phenacetin is one of the most desired cutting agents because of its similarity in appearance to cocaine. Cocaine cut with phenacetin can thus be sold to buyers further down the supply chain as being of high purity.
Cocaine sold at street level has decreased in purity from 30-40 per cent to 20-30 per cent in the last two years, indicating a growth in the use of cutting agents after import into the UK.
Source: The Scotsman 15th May 2007

Abuse of cannabis puts 500 a week in hospital

The public health impact of the Government's decision to downgrade cannabis is disclosed today in official figures showing a 50 per cent rise in the number of people requiring medical treatment after using the drug.

Since cannabis was downgraded from a Class B to a Class C drug, the number of adults being treated in hospitals and clinics in England for its effects has risen to more than 16,500 a year. In addition, the number of children needing medical attention after smoking the drug has risen to more than 9,200.Doctors say cannabis abuse can contribute to a series of mental health problems


Almost 500 adults and children are treated in hospitals and clinics
every week for the effects of cannabis.Its health toll is revealed in official data compiled by health authorities and obtained by The Daily Telegraph.

Drug campaigners last night said the figures proved Labour's decision to reclassify cannabis in January 2004, which made the penalties for its possession less severe, was badly mistaken and had sent out the wrong signals about it being a "soft" drug.

Doctors say cannabis abuse can contribute to mental health problems
including forms of psychosis, paranoia and schizophrenia. There can be
harmful physical side-effects, disrupting blood pressure and
exacerbating heart and circulation disorders. The data will add to the pressure on Gordon Brown to reverse its reclassification when a review of the decision by Home Office scientific advisers concludes in the Spring.

Elizabeth Burton-Phillips, a leading campaigner on drug issues since her son, Nick Mills, killed himself in despair at his addiction four years ago, said: "These results are shocking and dreadful. What more evidence do you need? You cannot sweep this under the carpet any longer. Children have to be told of the dangers of this what is wrongly called a young minds."

James Clappison, a Conservative member of the Commons home affairs
committee, said: "The reclassification of cannabis sent the wrong
message and was clearly the wrong decision. These figures show the
evident dangers of cannabis abuse and support the case for the drug
being restored to Category B."

The health authority figures show that 16,685 adults were treated by
English hospital trusts after abusing cannabis in 2006-07. The previous
year, it was 14,828 - up from 11,057 in 2004-05.

The data also shows that the number of children treated for using
cannabis has risen from 8,014 in 2005-06 to 9,259 last year. In total,
25,944 people were treated for cannabis use last year - around 498 a
week. In addition, around 70,000 people are treated for mental disorder
as outpatients each year.

The figures suggest health authorities are treating more people for
cannabis abuse than there are patients who have heart bypass operations
or treatment for colon cancer. Some 21,000 people a year have a bypass
operation and colon cancer is contracted by some 22,000 people a year.

Downgrading cannabis to a Class C drug placed it alongside steroids and
some prescription anti-depressants. Possession of them can lead to a
two-year prison sentence, but charges are rarely brought against people
found with small quantities of such drugs. Class B drugs however, include more dangerous substances such as amphetamines. People found in possession of Class B drugs can face a five-year jail term and an unlimited fine.

There is no "substitute medication" available to treat cannabis
problems, so the majority of National Health Service treatment is
carried out by psychiatrists, therapists and counsellors.

The independent review into its reclassification, by the Advisory
Council on the Misuse of Drugs, was prompted by growing concern about
the increasing prevalence of new high-strength forms of cannabis.
So-called "super-skunk" leaves can be twice as potent as more
traditional cannabis resin. Advocates of downgrading or legalising cannabis say the risks are low compared to those of alcohol and tobacco. Some sufferers of chronic conditions like multiple sclerosis say the drug provides vital pain relief.

Many doctors say the risks outweigh the benefits, and the British
Medical Association yesterday said the latest treatment figures
strengthened its opposition to the decision to downgrade the drug.
A BMA spokesman said: "This is drug that is mostly smoked, so that can
cause lung damage and cancer. There are also concerns about the
potential negative effect cannabis has on users' psychiatric state."

Addaction, a charity that treats people with drug problems, warned that
children suffered particularly from cannabis abuse. "Young people often
use cannabis at crucial development stages in their lives, and it does
have serious impacts on mental health and physical development," a
spokesman said.

Last night, the Department of Health insisted that the rising numbers of treatments reflect improvements in drug treatment and not rising
cannabis use.

However, the department also announced yesterday that the budget for the National Treatment Agency, which co-ordinates drug treatment, will be frozen at 2007 levels for the next three years. The agency will also be expected to find "efficiency savings" of £50 million a year from its
£398 million annual budget. Despite the freeze in his budget, Paul Hayes, the head of the agency, insisted that the number of drug treatments it can fund will rise.

"By becoming more efficient at delivering the best outcomes for
individuals we will be able to continue to increase the number of people into treatment, while increasing treatment effectiveness," he said.

Andrew Lansley, the Conservative health spokesman, said Labour was
wasting vast amounts of money. "The Government is ignoring the fact that its drug treatment policy is fundamentally misguided. Conservatives have promised to introduce abstinence-based treatment for drug addicts to help them get off drugs for good," he said.

Source: http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/01/11/ncnbis111.

Cannabis link to 80 per cent of new mental cases


By MATTHEW HICKLEY


Eighty per cent of patients newly-diagnosed with schizophrenia and other psychiatric illnesses are heavy users of cannabis, scientists have warned ministers.

The shocking figure emerged in a dossier submitted to Whitehall drug advisers as Gordon Brown weighs up whether or not to reverse Labour's "softly-softly" policy of downgrading cannabis. Campaigners have pointed to a flood of scientific evidence on the devastating damage the drug can do to mental and physical health.

Much of it has come in the four years since David Blunkett decided to reclassify cannabis from Class B to Class C, so that most users caught by police no longer face arrest or a criminal record. The Prime Minister ordered a review of that policy last summer following years of warnings that stronger "skunk" varieties of cannabis are wreaking havoc on users' mental health.

The Government's Advisory Council on the Misuse of Drugs will take evidence from leading academics next week before sending its latest official advice to ministers. Psychiatrist Professor Peter Jones, of Cambridge University, says in the dossier that eight out of ten newly-diagnosed psychiatric disorders affect heavy or dependent cannabis users.

He warns that children who are starting to smoke cannabis as young as ten or 11 could be trebling their risk of schizophrenia. Other new evidence of harm to mental health includes a UK study suggesting that by 2010 as many as 25 per cent of all cases of schizophrenia would be actually triggered by cannabis use. In a letter published in the Times yesterday, leading researchers and policy experts urged ministers to read the evidence and to toughen the law again.

A U.S. study found that smoking just half a cannabis joint could trigger schizophrenia-related symptoms.

Biologist Mary Brett of the Europe Against Drugs campaign, a signatory to the letter, said: "Every single piece of research around the world now emerging is bad news." A Home Office spokesman said: "We have always said that cannabis is an illegal and harmful drug. But to tackle drugs in the most effective way we need to monitor and review the ways in which we reduce the harm caused by illegal substances. That is why we are reviewing cannabis classification."

Source:http://www.dailymail.co.uk/pages/live/articles/health Jan 2008

'ENDING BINGE DRINKING HOLDS KEY TO SOLVING DRUG PROBLEM'

Delegates at the Acpos annual drugs conference this week will be shown a DVD of boys in Polmont young offenders institute, describing the natural transition for them from binge drinking to taking cannabis and other drugs, including heroin and cocaine. For many of them, this was the reason they ended up behind bars.

The progression of young people trying cannabis and then moving on to harder drugs is a well-known argument against legalising cannabis but Graeme Pearson, the head of the Scottish Crime and Drugs Enforcement Agency (SCDEA), says it is time to tackle the problem much earlier, from before the stage of underage binge drinking.

"Reducing binge drinking among 11 to 15-year-olds will decrease the numbers who go on to be involved in drugs," he says, after speaking to scores of offenders about their experiences.

To the people, including the advocate Donald Findlay, who have recently called for cannabis to be decriminalised and regulated in the same way as alcohol, he suggests looking at Scotland's worsening public health record on drinking.

National statistics revealed last week that, despite having only 8.5% of the UK population, Scotland has three-quarters of the worst 20 areas for drink-related fatalities. Between 2004 and 2005, there were 3500 psychiatric discharges where the main diagnosis was linked to alcohol. In the same period there were 931 drug-related discharges.

"Why would we want drugs to be managed or licensed in the same way as drink and see the problems more than triple?" he asks. "I see the Scottish habit of abusing alcohol as being inextricably tied into our experience of drug abuse at the user level. Evidence from prisoners reinforces this view. The link to an alcohol strategy will be critical. One without the other will not work."

There is growing concern not only about the increas-ing use and cultivation of cannabis since it was reclassified, but about its strength. According to the European Monitoring Centre for Drugs and Drug Addiction THC, the active ingredient in herbal cannabis, has doubled in strength between 1995 and 2002.

Mr Pearson says educating young people about the dangers of substances such as cannabis and using treatment to help people come off drugs, is vital. Sweden takes a hard line on alcohol and drugs misuse. It also has one of the lowest prevalence of cannabis use in Europe.

Its policy of a "drug-free society" has brought the introduction of new laws since the 1980s, calling for the prosecution of all drugs cases, even the very minor. Those caught for possession can be imprisoned for up to six months. Mr Pearson said: "Sweden has taken a very hard line on drugs. But it is still about a package of education, protection and enforcement.

"Scotland surprisingly accepted the challenge of public smoking and proved it could accept the impossible. If we can change behaviour in respect of smoking after 200 years of a love affair, we should surely be capable of facing the challenge of alcohol and drugs."

Source: The Herald, Pubdate: Wed, 28 Feb 2007

Beyond 2008

On January 24th and 25th, Drug Free America Foundation and Project: SUNDIAL hosted "Beyond 2008: Non-Governmental Organizations and United Nations Collaboration on Global Drug Policy," one of nine regional gatherings held around the world. More than 60 representatives from key stakeholders in the drug policy, prevention and treatment fields from the US and Canada gathered in St. Petersburg, Florida, to contribute their expertise to help shape international drug policy and develop partnerships between the UN and NGOs around the world. The findings of this and the remaining consultations will be presented to the UN at the General Assembly Special Session in 2009.
Source: DFAF Press Release Jan. 2008

Cirrhosis in young people doubles over last decade

The number of cases of alcohol related cirrhosis of the liver has more than doubled amongst young people aged 25-34 over the last decade, according to figures obtained by the Liberal Democrats. The new figures from parliamentary answers provide a breakdown by age group of the total number of cases of alcohol related cirrhosis of the liver, which has also soared nearly threefold.
Commenting, Liberal Democrat Health Spokesperson, Sandra Gidley MP said: “The UK has one of the worst binge drinking problems in Europe. Ministers should have woken up to this issue and taken action years ago. It is especially worrying to think how early these young people must have started drinking to get so ill. These tragic cases are symptomatic of the serious and growing problem of underage drinking. Health professionals have repeatedly warned ministers about the increasing danger of binge drinking amongst our young people, but too little has been done.
"The Government’s obsession with hospital waiting times means it has ignored prevention. The root causes of ill-health must be understood and the balance shifted towards prevention rather than cure.” 24dash.com
The Parliamentary question from Sandra Gidley: To ask the Secretary of State for Health how many diagnoses of alcohol-related cirrhosis of the liver there were in each of the last10 years, broken down by age.
The figures are available on Hansard here.

Source: Alcohol Policy UK March 21, 2007