Prevention Update

A unique update on what is happening in the world of drug abuse prevention.

Welcome to Prevention Update, the Prevention Hub's comment on latest news, research, statistics, policy updates, information on resources and events. It is relevant in particular to practitioners and policy makers but equally valuable and interesting to all who form the drug prevention community.

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3rd International conference on “Wastewater – Based Drug Epidemiology”

Leading European and international experts will meet in Lisbon from 26–27 October 2017 to review the state of the art of a rapidly developing scientific discipline known as wastewater-based epidemiology.Organisers of the Third Testing the Waters conference are SCORE (Sewage analysis CORe group – Europe) and the EMCDDA

Call for abstracts closed Registration can be done via this website: Until 29 september
Conference fee: 250€ (reduced fee of 150€ for participants of Lisbon Addictions 2017

If you have any questions please email the the Organising Committee TTW

Targeted audience invited:
This conference will be of interest to drug use epidemiologists, analytical and environmental chemists, environmental engineers, pharmacologists, toxicologists, experts in forensics and stakeholders working in the areas of public health, addiction, prevention and law enforcement.

Conference themes
Bridging the fields of wastewater-based epidemiology and conventional drug epidemiology: Current research aims to bring together wastewater analysis and drug epidemiology by sharing knowledge from different disciplines.
New applications and future perspectives: Novel uses of the approach are explored, such as the early detection of new psychoactive substances on the drug market.

More information: http://score-cost.eu/network-activities/meetings/ttw2017/

Evaluation of the UKs Government Drug Strategy 2010

The Drug Strategy 2010 is structured around three themes: (a) reducing demand (b) restricting supply (c) building recovery in communities.

Findings on Their Early Intervention Activities:

• Early intervention activities were central to achieving the Drug Strategy 2010’s aim of reducing demand for illicit drugs.
• Designed to tackle the risk factors associated with drug misuse and other risky behaviours, early intervention activities can prevent a wide range of adverse social outcomes relating to offending, family, education and employment.
• However, due to the time-lag between interventions taking place and their (desired) effect, there is a lack of evidence supporting their long-term impact.
• When implemented according to the broader evidence base of what works, early intervention activity can be effective in reducing risk factors associated with drug use, and in turn drug use itself.
• Approaches most likely to be beneficial are those targeted at multiple risk behaviours, as opposed to targeting drug use alone.
• Interventions most likely to be effective include pre-school and family-based programmes.
• There is promising evidence that interventions such as Personal Social Health And Economic (PSHE) education, family nurse partnership programmes, family intervention projects and MyPlace can positively impact on reducing risky behaviours and subsequently drug use. However, the strongest evidence typically comes from the United States of America (which has different health and education structures), with evidence from the UK tending to be less robust methodologically.
• Estimates suggest that central government spending on early intervention activity under the Drug Strategy 2010 may have fallen from an estimated £269 million in 2010/11 to £215 million in 2014/15.
• Due to the absence of sufficient data (on expenditure, reach of early interventions, and drug use outcomes), it was not possible to produce value-for-money estimates for early intervention activities.

Full Report: http://findings.org.uk/PHP/dl.php?file=HM_Government_8.txt&s=eb

EMCDDA Insights: Prevention of Substance Abuse

Prevention of Substance Abuse by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is a report that draws on evidence-based research to assess substance use prevention interventions, in terms of their ability to effectively delay, reduce or prevent the use of alcohol, tobacco and illegal substances among children and young people.

It provides the following conclusions and recommendations for best practice:
•Comprehensive measures that combine training for parents, children and family units may be effective for preventing alcohol abuse.
•Interactive programmes that develop social-influence or life-skills models in a school setting may be effective for combating the use of a range of substances, both legal and illegal.
•It may be wise to avoid using one-off information sessions or isolated emotional-education initiatives/other non-interactive measure in school settings as a way to tackle substance use.
•Media campaigns combined with other preventative measures may be effective for reducing levels of tobacco usage.
•Using legislative measures to influence the price of alcohol and tobacco products may be effective for reducing levels of consumption.

Full Report: https://www.issup.net/knowledge-share/publications/2017-08/emcdda-insigh...

Changing patterns of substance misuse in adult prisons and service responses.

Changing patterns of substance misuse in adult prisons and service responses.
HM Inspectorate of Prisons [UK] HM Inspectorate of Prisons, 2015.

Inspection findings on individual prisons were supplemented by fieldwork in eight prisons in 2014 to generate an overall picture of drug use and responses to it in prisons and England and Wales. In the face of rapidly changing and varied drug use patterns, policy and operational responses were seen as insufficiently flexible and dynamic.

Prisoners are more likely than the general population to have histories of drug misuse, and in some cases this misuse continues in prison. When work on this inspection began, there had been a recognised shift away from the use of opiates and drugs controlled under class A of the Misuse of Drugs Act [such as heroin, cocaine and amphetamines] towards the misuse of medication in prisons. During this work patterns of substance misuse in prison changed again and the use of new psychoactive substances (NPS), and in particular synthetic cannabis, emerged as a major problem.

The inspection drew on 61 reports on prisons published by HM Inspectorate of Prisons between April 2014 and August 2015. A total of 10,702 survey responses were included in the analysis.

These inspection findings were supplemented with findings from fieldwork conducted in eight prisons between June and November 2014, including 1,218 responses to a confidential survey which asked prisoners about their drug use before going into custody and in their current prison.
Full Article: http://findings.org.uk/PHP/dl.php?file=HMIP_1.txt&s=eb

Drug abuse at Gem Fest in Georgia

Georgia Today
7 August 2020

A 22-year old girl died on Saturday allegedly due to an overdose of drugs at the famous month-long Georgian Electronic Music Festival (GEM Fest) in the Black Sea coastal town of Anaklia.

The girl was taken to Zugdidi Hospital but died eight hours later. It is alleged that she took the psychoactive drug “Bio,” also known as Gamma-Hydroxybutyrate (GHB), which has been seen increasingly throughout Georgia of late.

GHB is a central nervous system depressant that is commonly referred to as a “club” or “date rape” drug. GHB is used by teens and young adults at bars, parties, clubs and “raves” (all night dance parties), and is often placed in alcoholic beverages.

Over the last 5 days, around 20 people have been taken to hospital from the festival with similar symptoms to the deceased girl. One of them is a citizen of Ukraine. All but one of them were discharged from hospital on Monday.

Georgia’s Ministry of Internal Affairs (MIA) has so far detained five people for drug crimes at GEM Fest.

Community organization White Noise has asked the government to call an extraordinary parliamentary session to discuss the drug reform proposed by the National Platform for Drug Policy.

Their statement reads that, reportedly, several cases of intoxication by an unidentified psychoactive substance were reported at the festival but at this stage it is not known whether there is a link between this case and the 15 hospitalized festival attendees.

The organization is pushing for a more liberal drug policy to “solve the existing drug problems within the country”.

Full story : http://georgiatoday.ge/news/7222/GEM-Fest-Drug-Accusations%3A-One-Dead%2...

Selective school-based alcohol prevention programs targeting youth with personality risk factors for addiction and mental health problems

The objective was to report 24-month outcomes of the Teacher-Delivered Personality-Targeted Interventions for Substance Misuse Trial (Adventure trial) in which school staff were trained to provide interventions to students with 1 of 4 high-risk (HR) profiles: anxiety sensitivity, hopelessness, impulsivity, and sensation seeking and to examine the indirect herd effects of this program on the broader low-risk (LR) population of students who were not selected for intervention.

The design was a cluster randomized controlled trial in secondary schools in London, United Kingdom. Participant were a total of 1210 HR and 1433 LR students in the ninth grade (mean [SD] age, 13.7 [0.33] years).
Schools were randomized to provide brief personality-targeted interventions to HR youth or treatment as usual (statutory drug education in class). Participants were assessed for drinking, binge drinking, and problem drinking before randomization and at 6-monthly intervals for 2 years.

Two-part latent growth models indicated long-term effects of the intervention on drinking rates and binge drinking rates and growth in binge drinking and problem drinking for HR youth. The HR youth were also found to benefit from the interventions during the 24-month follow-up on drinking quantity, growth in drinking quantity, and growth in binge drinking frequency. Some herd effects in LR youth were observed, specifically on drinking rates and growth of binge drinking, during the 24-month follow-up.

Findings further support the personality-targeted approach to alcohol prevention and its effectiveness when provided by trained school staff. Particularly novel are the findings of some mild herd effects that result from this selective prevention program.

Full Article: http://jamanetwork.com/journals/jamapsychiatry/fullarticle/1558064

Conrod PJ, O’Leary-Barrett M, Newton N, Topper L, Castellanos-Ryan N, Mackie C, Girard A. Effectiveness of a Selective, Personality-Targeted Prevention Program for Adolescent Alcohol Use and MisuseA Cluster Randomized Controlled Trial. JAMA Psychiatry. 2013;70(3):334–342. doi:10.1001/jamapsychiatry.2013.651

August issue of the International Journal of Drug Policy

Many free full-text articles on #heroin and #fentanyl #overdoses and adulteration, from the August issue of the International Journal of #Drug Policy.

http://www.ijdp.org/issue/S0955395917X00078

The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.

The International Journal of Drug Policy is ranked 4th out of 36 journals in the SUBSTANCE ABUSE category in the 2014 Journal Citation Reports, published by Thomson Reuters, and has an Impact Factor of 3.191.

NIDA-funded study suggests that college students who regularly consume energy drinks are at higher risk for later drug and alcohol use

New research suggests that college students who regularly consume energy drinks are at a greater risk for future alcohol use disorder, cocaine use or nonmedical use (misuse) of prescription stimulants. The research was funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

Scientists from the University of Maryland, College Park, asked college students who were approximately 21 years old about their past-year use of energy drinks – highly caffeinated products marketed primarily to teens and young adults. Participants were followed over the next three years to determine whether probabilities of past-year energy drink use increased, decreased or remained consistent, and at year five were assessed for past-year substance use. In groups that showed consistent or increasing probabilities of using energy drinks over the years, researchers found higher rates of cocaine use, prescription stimulant misuse and alcohol use disorder – but not marijuana or tobacco use. This finding held true regardless of how often subjects consumed the drinks (infrequently, occasionally or frequently) and even after accounting for prior substance use and other risk factors.

Although these findings are consistent with animal studies suggesting that caffeine can prime the still-developing teen brain for later drug use, this study does not establish that energy drink consumption directly causes an increased risk for substance use in humans. Further research on energy drinks is needed to guide prevention and policy efforts in teens.
https://www.drugabuse.gov/news-events/news-releases/2017/08/energy-drink...

Associations of Parental Alcohol Use Disorders and Parental Separation with Offspring Initiation of Alcohol, Cigarette, and Cannabis Use and Sexual Debut in High-Risk Families

Parental alcohol use disorders (AUDs) and parental separation are associated with increased risk for early use of alcohol in offspring, but whether they increase risks for early use of other substances and for early sexual debut is under-studied. We focused on associations of parental AUDs and parental separation with substance initiation and sexual debut to (1) test the strength of the associations of parental AUDs and parental separation with time to initiation (age in years) of alcohol, tobacco, and cannabis use, and sexual debut, and (2) compare the strength of association of parental AUD and parental separation with initiation.

The design involved a prospective adolescent and young adult cohort of a high-risk family study, the Collaborative Study on the Genetics of Alcoholism (COGA). It took place in 6 sites in the United States with 3527 offspring (ages 14-33) first assessed in 2004 and sought for interview approximately every 2 years thereafter. 1945 (59.7%) offspring had a parent with an AUD.

The diagnostic interview data on offspring substance use and sexual debut were based on first report of these experiences. Parental lifetime AUD was based on their own self-report when parents were interviewed (1991-2005) for most parents, or on offspring and other family member reports for parents who were not interviewed. Parental separation was based on offspring reports of not living with both biological parents most of the time between ages 12 and 17 years.

Parental AUDs were associated with increased hazards for all outcomes, with cumulative hazards ranging from 1.2 to 2.7. Parental separation was also an independent and consistent predictor of early substance use and sexual debut, with hazards ranging from 1.2 to 2.3. The strength of association of parental separation with substance initiation was equal to that of having 2 AUD-affected parents, and its association with sexual debut was stronger than parental AUD in one or both parents.

Parental alcohol use disorders (AUDs) and parental separation are independent and consistent predictors of increased risk for early alcohol, tobacco and cannabis use and sexual debut in offspring from families with a high risk of parental AUDs.

Full article: http://onlinelibrary.wiley.com/doi/10.1111/add.14003/abstract;jsessionid...

McCutcheon, V. V., Agrawal, A., Kuo, S. I.-C., Su, J., Dick, D. M., Meyers, J. L., Edenberg, H. J., Nurnberger, J. I., Kramer, J. R., Kuperman, S., Schuckit, M. A., Hesselbrock, V. M., Brooks, A., Porjesz, B., and Bucholz, K. K. (2017) Associations of Parental Alcohol Use Disorders and Parental Separation with Offspring Initiation of Alcohol, Cigarette, and Cannabis Use and Sexual Debut in High-Risk Families. Addiction, doi: 10.1111/add.14003.

Legal Weed: An Accidental Solution to The Opioid Crisis?

The Conversation - 14 August 2020 - Full story: http://bit.ly/2vvW1lG

It’s hard to go a day in Canada without hearing about at least one of two types of drugs – but for vastly different reasons. One class of drug — opioids — kills four people a day in British Columbia. The other — cannabis — will be legal for adult purchase and consumption by this time next year.

The opioid overdose epidemic is Canada’s gravest public health crisis since the emergence of HIV in the 1980s. With its roots in the over-prescription of high-potency painkillers, sparked by the contamination of the illicit drug supply with fentanyl and related drugs, the crisis has reached across demographic divides. Experts agree on the need for creative responses based in scientific evidence.

Could cannabis legalization be a part of this solution? Increasingly, this is what the latest scientific research indicates.

The opioid crisis is a product of the medical system’s over-reliance on opioids for pain relief. Almost one in five Canadians live with some form of chronic pain. Twenty years ago, pharmaceutical companies began to develop slow-release formulations of opioids (e.g. OxyContin) and marketed them as safe and effective medications for the treatment of chronic non-cancer pain.

We know now that these drugs carry an extremely high risk of dependence and fatal overdose. Despite this, more than 20 million opioid prescriptions are filled each year in Canada. Drug overdoses are now the leading cause of death among Americans under the age of 50. And prescription opioids are involved in nearly half of these deaths. It is also becoming apparent that opioids might be less effective than initially thought in treating certain types of chronic non-cancer pain (e.g. neuropathic pain).

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