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President Obama states in his introduction to the 2013 US National Drug Control Strategy that his “Administration remains committed to a balanced public health and public safety approach to drug policy.” The strategy has an emphasis on the neuroscience of addiction and continues the Obama Administration’s “third way” approach to drug policy, a policy that follows neither legalization nor a law enforcement-only “war on drugs.” The Harm Reduction Coalition had drawn attention to the strategy’s support for access to methadone and buprenorphine treatment, layperson access to naloxone and a recommendation for removing the federal ban on funding for syringe exchange services. A White House blog describes the strategy as “a science-driven plan for drug policy reform in America”, a policy that “underscores what we all know to be true: we cannot arrest or incarcerate our way out of the drug problem.” The Huffington Post notes that the White House budget proposal for fiscal 2014 earmarks 58 percent of drug control spending to punishment and interdiction, compared with 42 percent to treatment and prevention.
The Independent reports that the UK government has decided to delay its plan to follow the example of Australia and legislate for cigarettes to be sold in plain packets. The legislation was expected to be announced in the Queen’s Speech, which sets out the government’s legislative plans for the next year, in May. Government sources said that the plan was being delayed because ministers needed more time to see whether smoking levels had fallen in Australia. There has been a suggestion that ministers drew back from the packaging because it would be a distraction from their priorities of the economy, welfare reform and immigration. According to a report in The Observer, senior Department of Health officials have held meetings with tobacco industry representatives and one of the tobacco companies argued that the government’s plan would lead to job losses in the UK. A Department of Health spokeswoman said. "The government has an open mind on this issue, and any decisions to take further action will be taken only after full consideration of the evidence and the consultation responses."
Writing in the British Medical Journal, Professor Robert West, Cancer Research UK Director of Tobacco Studies at University College London, said “The Labour opposition party has said that it will support the legislation and ensure a speedy passage through parliament, most of the groundwork for the legislation has been done, and I estimate that it will save at least 1,000 lives a year. The principle of preventing the tobacco industry from marketing its deadly and addictive products is already established in Britain and attractive packaging represents an important marketing device. So there is no reason at all not to proceed, except for subservience to tobacco industry vested interests.”
National public health advocates have filed a Citizen Petition urging the U.S. Food and Drug Administration (FDA) to prohibit the use of menthol as a characterizing flavouring in cigarettes. The petition was delivered to the FDA by the Tobacco Control Legal Consortium on behalf of a list of co-signing organizations focused on public health in general, and organizations focused on racial and ethnic health outcome disparities in particular. The 2009 Family Smoking Prevention and Tobacco Control Act prohibited the use of fruity and candy-like "characterizing flavors" in cigarettes and cigarette smoke. Menthol was the one flavour that was exempted from this 2009 prohibition, but the US Congress gave the FDA the authority to prohibit menthol if "appropriate for public health." The law specifically made the issue of menthol in cigarettes a priority for FDA consideration. Following the filing of the Citizen Petition, the FDA is now required to begin a formal consideration process that could include the gathering of public testimony and will result in a formal FDA ruling on the matter.
The Statement of Concern about the conflict of interest between multinational alcohol companies and public health policies designed to tackle alcohol harm, which was drafted by a group of public health professionals, health scientists, and representatives of non-governmental organisations brought together under the auspices of the Global Alcohol Policy Alliance, has received a positive response from the World Health Organization. Responding to an article in the British Medical Journal covering the statement, the WHO Director General Dr. Margaret Chan said “The development of alcohol policies is the sole prerogative of national authorities. In the view of WHO, the alcohol industry has no role in the formulation of alcohol policies, which must be protected from distortion by commercial or vested interests.” Dr Chan added, “WHO appreciates the Statement of Concern issued by the Global Alcohol Policy Alliance and has invited representatives of the statement’s authors to meet senior WHO management to explore these concerns in greater detail.”
The United Nations Office on Drugs and Crime’s Afghanistan Opium Risk Assessment reports that poppy cultivation is not only expected to expand in areas where it already existed in 2012 but also in new areas or areas which had been poppy free. Just 14 of Afghanistan's 34 provinces are now poppy free, down from 20 in 2010. The report suggests that the growth in opium cultivation reflects both spreading instability and concerns about the future. "Opium cultivation is up for the third successive year, and production is heading towards record levels," said Jean-Luc Lemahieu, Afghanistan head of the UN Office on Drugs and Crime. "People are hedging against an insecure future both politically and economically."
A judicial review ruling in the Court of Session, Scotland's supreme civil court, has dismissed the challenge to the Scottish government’s plan to introduce a minimum price of 50 pence per alcohol unit. The case was brought by the Scottish Whisky Association (SWA) backed by two of the largest European wine and spirits organisations: the European Spirits Association and the Comité Européen Des Entreprises Vins. The SWA had argued that introducing minimum pricing was outside the Scottish parliament's legal powers as a devolved government and broke several parts of European law by conflicting with open border, common market rules. Lord Doherty rejected all those grounds, stating that the Alcohol (Minimum Pricing) (Scotland) Act 2012 was within the Scottish parliament’s legal powers, while the Act of Union between Scotland and the rest of the UK was not an impediment to the minimum pricing measures. Nor, he said, was it incompatible with EU law. He said that even if these measures did restrict some imports, they were justified under EU law "on the grounds of the protection of the life and health of humans." Gavin Hewitt, chief executive of the SWA, confirmed that it would immediately appeal against the decision.
The Independent reports that the review of the EU Tobacco Products Directive currently underway includes a proposed new regulation that would require any device containing more than 4mg of nicotine to be authorised as a medicinal product. The EU's review of the Tobacco Products Directive is aimed at making smoking in all its forms less attractive to young people in order to discourage them from taking it up. But there is concern that the proposed regulation would mean that e-cigarettes would have to undergo expensive clinical trials and applications for marketing licenses, making them commercially non-viable. Amanda Sandford, a spokesperson for Ash, the anti-smoking charity, said: "For the EU to treat e-cigarettes as tobacco products muddies the waters and causes confusion. It would be far better to treat them on a par with nicotine replacement products which are available over the counter through pharmacies and newsagents." Anti-smoking campaigners say "light touch" controls would ensure e-cigarettes are safe and effective but allow them to be sold in newsagents and supermarkets alongside cigarettes. Ms Sandford added that they should not "have to go through umpteen clinical trials." Manufacturers of e-cigarettes are also angry with the proposed new regulation. "We are not selling a medicinal product; we don't present e-cigarettes as having health benefits and they are not functionally a medicine. They are designed as an alternative to cigarettes," said Charles Hamshaw-Thomas, director of legal affairs at the E-Lites brand of electronic cigarettes. "Limitations on the wider availability of e-cigarettes will give cigarette companies an unfair advantage and perversely protect their existing markets."
The UK Royal College of Physicians and Royal College of Psychiatrists have published a report entitled Smoking and Mental Health. The report draws attention to the lack of change in smoking prevalence among those with mental health disorders compared to the fall in prevalence among the general population and says that much of the substantially lower life expectancy of people with mental disorders relates to smoking. The report also notes that smoking is often overlooked during the management and treatment of a mental health condition and that UK public health policy and clinical service provision must change.
The Independent reports that UK Prime Minister David Cameron has tacitly acknowledged he is abandoning government plans to introduce minimum pricing for alcohol. The Prime Minister was on record as backing plans for a 45p minimum unit price and had said the plan would result in 50,000 fewer crimes each year and 900 fewer alcohol-related deaths a year by 2020, stating that the "responsibility of being in government isn't always about doing the popular thing." In response to a question in the House of Commons about reports that the Prime Minister had had a change of mind about the plans, Mr Cameron said “There is a problem with deeply discounted alcohol in supermarkets and other stores and I am absolutely determined that we will deal with this.” He added “We published proposals, we are looking at the consultation and the results to those proposals, but, be in no doubt, we’ve got to deal with the problem of having 20p or 25p cans of lager available in supermarkets. It has got to change.” But Mr Cameron failed to mention minimum alcohol pricing in his response. Afterwards, the Prime Minister’s spokesman effectively admitted that the plan was dead. In a further development, The Independent reports that Public Health England (PHE), the body with responsibility for advising ministers on reducing deaths from preventable diseases, said there was clear evidence that increasing the price of drink would save lives. It added that while the Government's decision would obviously be "political," on medical grounds the arguments in favour were compelling. Professor Kevin Fenton, PHE's Director of Health, said it was vital that the Government used all the tools it had to reduce alcohol-related deaths. Professor Fenton added, "The evidence for minimum unit pricing is clear. So our recommendation to the Government would be to base their decision on (that) evidence." A Home Office spokesperson said: "The consultation on Minimum Alcohol Pricing closed on 6 February. We will listen to all views and set out a response in due course."
The Economist profiles the interest of an investment fund, Privateer Holdings, in the cannabis industry. The article reports that research by Brendan Kennedy, who set up the fund with a few partners, suggested that the US cannabis market is worth $50 billion. The fund’s first investment is a website, Leafly, which provides reviews of cannabis dispensaries and varieties of cannabis. Mr Kennedy says Privateer has received over 200 investor pitches since November 2012. Other funders are taking an interest in firms that supply cannabis-growing equipment or ancillary services while steering clear of cannabis farming and sales. The Los Angeles Times reports that Lazarus Investment Partners, a $60-million hedge fund in Denver, has invested in AeroGrow International Inc., a maker of hydroponic kitchen appliances for growing herbs, lettuce and tomatoes. Lazarus, which owns 15% of AeroGrow's shares, has suggested that the company modify its products to accommodate taller plants, including cannabis, said Justin Borus, the fund's managing partner.
The US government is abandoning its plan to require cigarette packs to carry a set of large and graphic warning labels depicting the dangers of smoking and encouraging smokers to quit. The 2009 Family Smoking Prevention and Tobacco Control Act gave the federal government authority to regulate tobacco. The Act also specified the text of nine warnings for cigarette packs depicting the dangers and harms of smoking to encourage smokers to quit. The Food and Drug Administration (FDA) was directed to adopt graphic images to accompany them. The warning labels were due to appear on packs in 2012. Tobacco companies argued that the proposed warnings went beyond factual information into anti-smoking advocacy. The government, however, argued the images were factual in conveying the dangers of tobacco. In February 2012 the U.S. District Court in the District of Columbia ruled that the FDA mandate violated the U.S. Constitution's free speech amendment, with the judge noting that the labels would not increase consumer awareness of risks associated with smoking, because the labels were intended to evoke an emotional response. In August 2012, a U.S. appeals court upheld that lower court ruling. The Wall Street Journal reports that in March the US Department of Justice decided not to ask the U.S. Supreme Court to review the appeals court decision. In a separate case, the use of graphic warning labels was upheld by the US District Court of Appeals for the 6th Circuit in March 2012 but was appealed to the US Supreme Court by the five tobacco companies that originally filed the case. According to a letter from Attorney General Eric Holder, the FDA now plans to revise its proposed label changes with labels that meet both the requirements of the Family Smoking Prevention and Tobacco Control Act and the rulings by the courts. The FDA did not provide a timeline for the revised labels.
After the states of Washington and Colorado passed laws legalising the recreational use of cannabis and setting up systems of state-licensed growers, processors and retail stores, Washington’s Liquor Control Board must determine how many growers and stores there should be, how much cannabis should be produced, how it should be packaged, and how it should be tested to ensure people safety. The Seattle Times reports that Washington is aiming to produce just enough cannabis to meet present demand: producing too little would drive up prices and help the black market flourish, while producing too much could lead to excess cannabis being trafficked out of state. While the board is doing a lot of its own research, it is also recruiting consultants. The board selected a Massachusetts company called Botec Analysis Corp., led by UCLA’s Professor Mark Kleiman, as the finalist for the cannabis consulting contract. Medical Marijuana Business Daily reports that the choice surprised industry professionals, primarily because Botec is a thinktank specializing in crime and drug policy rather than the business aspects of medical cannabis. But Brian Smith, communications director for the Washington State Liquor Control Board, told MMJ Business Daily that Botec was the “clear winner” in each of the main categories (product and industry knowledge; product quality standards and testing; product usage and consumption validation; and product regulation).
After support from parliament, the President of the Czech Republic, Vaclav Klaus, has approved the legalisation of cannabis for medical use. According to The New York Times, the new law allows cannabis to be imported and later grown locally by registered firms licensed to do this. Patients will need a prescription from a doctor to get the drug at pharmacies and treatment will not be covered by health insurance.
Norwegian Health Minister Jonas Gahr Støre has called the heroin overdose rate in Norway "shamefully" high and announced that he wants to allow addicts to smoke heroin under controlled circumstances. Støre thinks that the move will lower consumption and overdoses, and he has full support for his proposal from the rest of the government. Views and News from Norway reports that Støre said it would be up to local municipalities to provide the controlled circumstances, such as “smoking rooms” in facilities that have provided clean needles. The health ministry says that the measure is not a decriminalization and heroin itself will remain illegal.
The United Nations Office on Drugs and Crime (UNODC) launched the Global Synthetics Monitoring: Analyses, Reporting and Trends (SMART) Programme in September 2008. The Programme aims to enhance the capacity of Member States and authorities in priority regions; to generate, manage, analyse and report synthetic drug information; and to apply this scientific evidence-based knowledge to design the policies and programmes. The report is the first global situation assessment on new psychoactive substances. It outlines the emergence of different groups of new psychoactive substances in the regions and highlights several key issues associated with these substances, including reported adverse effects associated with their use, the challenges for the identification of these substances and their subsequent control through legislation.
The Guardian reports that the UK government plans to introduce plain packaging for cigarettes along the Australian model, with legislation in 2013. "We are going to follow what they have done in Australia. The evidence suggests it is going to deter young smokers. There is going to be legislation," said a senior Whitehall source. The Department of Health started a consultation in March 2011 on plain packaging, which ended last August. The legislation, to be announced in the Queen's speech in May, is also expected to ban smoking in cars carrying anyone aged under 16 years.
Don Calsyn died on 3 February 2013, aged 63. Don was a Professor in Psychiatry and Behavioral Sciences at the University of Washington. He was appointed Director of the Outpatient Services in the Veterans Affairs Puget Sound Healthcare System's Addiction Treatment Center in 1988 and was the clinical team leader for opiate agonist treatment for 23 years. In 2004, he retired from the VA but continued his association with the University of Washington’s Alcohol and Drug Abuse Institute as the substance use and HIV/AIDS expert on the Pacific Northwest Node of the National Institute on Drug Abuse (NIDA) National Drug Abuse Treatment Clinical Trials Network.
The Guardian reports that the Alcohol Health Alliance (AHA), a UK coalition of medical bodies and health charities, demands a range of measures to reduce the £55bn annual cost of alcohol misuse in the UK. The measures include a graphic warning about the health dangers of over-consumption on can and bottle labels, a ban on all alcohol advertising and sponsorship and restricting drink sales in shops and supermarkets to certain times. Sir Ian Gilmore, the AHA's chair, said action was especially urgent given that UK teenagers drink much more than the European average. Sir Richard Thompson, president of the Royal College of Physicians, which represents hospital doctors, said the report, Health First, "demonstrates the clear evidence that the government must push on with its commitment to introduce a minimum unit price for alcohol." A 50p minimum unit price could prevent over 3,000 drink-related deaths per year and 40,000 crimes annually in England, he added. But the Department of Health said: "Cigarette-style health warnings are not applicable to alcohol. All levels of smoking are bad for your health, but the same cannot be said for alcohol consumption."
In March last year, 12 United Nations agencies called for the closure of drug detention centres and the release of the people detained there “without delay.” Time reports that a recent United Nations report about torture and other abuses in healthcare settings reiterates this call and points to the need for donors to withdraw funds to compulsory drug detention centres. The report was presented to the UN Human Rights Council in Geneva on 4 March 2013 by the special rapporteur on torture, Juan Mendez. It says that people identified as drug users are held without due process in government-run detention centres where they face serious abuse, including physical and sexual violence and forced labour. The special rapporteur also calls on states to implement voluntary, evidence-based and rights-based health and social services in the community and to undertake investigations to ensure that abuses are not taking place in privately-run centres for the treatment of drug dependence.
The National Institute for Health and Clinical Excellence (NICE) has released Alcohol use disorders: Harmful drinking and alcohol dependence: Evidence update January 2013. The update provides a summary of selected new evidence relevant to NICE Clinical Guideline 115, Alcohol use disorders: Diagnosis, assessment and management of harmful drinking and alcohol dependence.
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