A new assessment tool may allow doctors to evaluate the impact of methamphetamine on babies exposed in the womb. The tool may help identify which babies will go on to develop problems due to exposure to the drug, according to a new study.

Medical News Today reports that doctors at the Warren Alpert Medical School of Brown University andWomen & InfantsHospital inProvidence,RI, looked at the effects of prenatal exposure to methamphetamine in 185 newborns and compared them with 195 newborns who were not exposed to meth, but were exposed to alcohol, tobacco or marijuana before birth.

They reported at the Pediatric Academic Societies meeting inDenver that an assessment tool called the NICU Network Neurobehavioral Scale (NNNS) was used to evaluate the babies during the first four days of life and again when they were one month old.  The tool evaluates the babies’ muscle tone, reflexes, behavior, motor development and stress.

The researchers said that the tests could help identify which babies are doing well and which are the ones who could benefit from intervention and prevention services.

Source: www.drugfree.org/join-together  3^rd May 2011

The blood pressure drug propranolol may help treat cocaine addiction, a new animal study suggests. The study investigated the behavior of rats repeatedly given injections of cocaine in a particular cage. The rats learned to associate the positive feelings of cocaine with the cage, much as humans associate the high of cocaine with the environment in which they use the drug, Time reports.

The researchers found that rats given propranolol before they were allowed to enter the cocaine cage, no longer showed a preference for it over any other cage. Rats who were given shots of saline instead of the blood pressure drug continued to seek out the cocaine cage for at least two weeks.

In humans, propranolol might dull the pleasant associations of cocaine, the article says. The cravings that accompany those feelings might also dissipate, and that in turn could reduce the risk of a relapse. The article notes that propranolol has been studied as a treatment for post-traumatic stress disorder, with mixed results.

The new study appears in the journal Neuropsychopharmacology

Source:www.drugfree.org.  July 2011

The true cost of Scotland’s drug habit has been set out by a leading academic, who says a single addict sets the country back more than £60,000 a year.

Professor Neil McKeganey, director of the Centre for Drug Misuse Research at the University of Glasgow, has criticised Scottish Government policy and said the nation is “paying a massive price” for its drugs problem.  Scotland has some 55,000 addicts, so the annual bill in health care, criminal activity, drug driving and other social costs comes to almost £3.5 billion.

Writing in today’s Scotsman, Prof McKeganey argues Scottish society has grown too accepting of all forms of drug abuse and needs instead to preach a doctrine of abstinence. He questions the Scottish Government’s reliance on methadone as a substitute for heroin abusers and argues more effort is required to get addicts off drugs through abstinence.

“At the moment, we have about 22,000 addicts on methadone in Scotland,” he says. “When Scottish ministers are asked whether they have any plans for reducing that number, the typical answer is to say that prescribing methadone is the responsibility of individual doctors.  “Our political leaders, surrounded by those who counsel them on the benefits of methadone, find themselves passing responsibility for our national methadone programme on to the shoulders of those who are prescribing the drug in the first place. This situation is going to get worse.”

Prof McKeganey says Scotland’s drug problem is “virtually without equal anywhere in Europe” and that concern over “legal high” mephedrone, a substance sold as plant food which has become popular as a recreational drug and has been linked to a number of deaths, is just another symptom of the “culture of addiction”.

“What… should we make of a situation in Scotland where young people are prepared to consume plant food to obtain a desired high?” he says.

The Centre for Drug Misuse Research has estimated each problem drug user costs £60,703 a year, while a recreational drug user costs the state only £134.  The costs were calculated by considering the addict’s actions in terms of health, work, driving, crime and other social consequences, such as children in care and even addicts’ deaths.

In 2007, for example, problem drug users made 45,034 visits to accident and emergency departments at a total cost of £9,804,388, while the annual shoplifting bill is £50,611,921.

Prof McKeganey believes that key to tackling Scotland’s drug problem lies in a greater focus on abstinence. “If we are going to change the culture of acceptance around drugs, we need to do something that is almost beyond comprehension – we need to normalise abstinence,” he says.

The growing culture of middle-class drug use, where users argue it is a just reward for personal success, must he tackled, he argues, and there should be more visits to schools by drug addicts and their families to highlight the consequences of addiction.

Last night, a spokeswoman for the Scottish Drugs Forum defended the use of methadone for drug addicts and the necessity for support systems to help drug addicts, even during times of financial hardship.  “Methadone – along with psycho-social support to supplement the pharmaceutical prescription – has an important part to play in helping many people stabilise chaotic drug use, but other approaches must be available, including abstinence-based treatment, for people who want them and who could benefit from them,” she said.  “What matters most is having a range of high-quality and readily accessible treatment which best meets the needs of each individual at each stage of their journey away from harmful drug use.”

Tim Richley, of offenders’ charity Sacro, supported Prof McKeganey’s long-term goal, but said it would require gradual change. “I do understand the argument he is making and I would come down on the side of total abstinence as a good goal that we are trying to achieve, but other factors can help,” he said. “If they were to ditch methadone overnight, there would be a huge rise in criminal activity as addicts seek the money to buy heroin.”

A spokesman for the Scottish Government said it had invested a record £28.6 million in drug treatment and services. He went on:  “It is for individual clinicians to decide on the most appropriate medical treatment for any person, taking into account their lifestyle and what stage they are on the road to recovery.

“The Scottish Government’s new drugs strategy offers a blueprint for all our drug treatment and rehabilitation services based on the principle of recovery, not extending addiction, tailored to the personal needs of individuals.”
Source:  www.scotsman.com 29^th March 2010

 

Background

Alcohol is responsible for a significant portion of the global burden of disease. There is widespread concern reported in the media and other sources about drinking trends among young people, particularly heavy episodic or “binge” drinking. Prominent among policy responses, in theUKand elsewhere, have been attempts to manage antisocial behaviour related to intoxication in public spaces. Much less attention has been given to the longer term effects of excessive drinking in adolescence on later adult health and well-being. Some studies suggest that individuals “mature out” of late adolescent drinking behaviour, whilst others identify enduring effects on drinking and broader health and social outcomes in adulthood.

If adolescent drinking does not cause later difficulties in adulthood then intervention approaches aimed at addressing the acute consequences of alcohol, such as unintentional injuries and anti-social behaviour, may be the most appropriate solution. If causal relationships do exist, however, this approach will not address the cumulative harms produced by alcohol, unless such intervention successfully modifies the long-term relationship with alcohol, which seems unlikely. To address this issue a systematic review of cohort studies was conducted, as this approach provides the strongest observational study design to evaluate evidence for causal inference.

Methods

A systematic review was undertaken of the available literature using relevant online databases and standard systematic review literature search techniques. The search parameters included database articles from 1964 to 2008. This approach was supplemented through the use of hand searching of key journals, citation searching and contact with the primary authors of relevant studies. A data collection protocol was developed and the entire process was undertaken independently on two occasions by different researchers. All subsequent study tasks were also duplicated. Only peer-reviewed published data were used and further unpublished information was not sought from authors.

Studies of drinking behaviour were included if they collected data on at least two points in time, were at least 3 years apart, and from the same cohort. Cohorts formed from general population sources, including college students and military conscripts, were included. Studies based on selected or special populations such as children of alcoholics, mental health patients, and offenders were excluded.

We evaluated the strength of causal inference possible in these studies by assessing whether all possible contributing factors (confounders) had been taken into account. We also gave greater weight to studies that had follow-up rates of 80% or greater, and which had sample sizes of 1,000 participants or more.

Results

Fifty-four studies were eligible for inclusion in this review. Approximately half of all reports (n = 26) were from US studies, ten were fromSweden, eight fromBritain, four fromNew Zealand, three fromAustralia, two fromFinland, and one from theNetherlands. More than half (n = 30) originated from school-based cohorts. Birth cohorts were more likely to be the subject of multiple studies (n = 11/14). Nineteen (35%) studies, based on eight different cohorts, were assessed as having stronger capacity for causal inference), and we focussed primarily on these studies.

The main results were as follows –

• The majority of the studies provided evidence for a link between adolescent drinking and drinking behaviour in later adulthood.
• All studies assessing alcohol problems or dependence in adulthood found statistically significant associations with late adolescent drinking.
• Mortality was examined in only one cohort; the Swedish Conscript Study. It found that late adolescent heavy drinkers were twice as likely to have died compared to moderate drinkers by the mid-thirties. The majority of these deaths were due to car crashes and suicides. The risk of death due to alcohol specific causes (e.g. alcohol intoxication, liver cirrhosis) was also higher for this group.
• One study found no effect of adolescent drinking on court convictions or property offences by age 21, however one other study found that adolescent alcohol problems were predictive of official recorded criminal convictions by the mid-thirties.
• There was no effect of adolescent drinking on any of the mental health outcomes included in the studies, apart from the study noted above which did find that heavier adolescent drinkers had a higher risk of suicide in adulthood.
• One of the studies identified a small but significant effect of adolescent alcohol use on later tobacco use, however a similar relationship was not observed in other studies once confounding factors present in late adolescence were controlled.
• The majority of studies found that there was no association between adolescent drinking and drug use or dependence, after controlling for confounding.
• One study found a link between adolescent drinking at age 16 and educational attainment at age 42, however this effect was only evident in men.

Discussion

This systematic review investigated whether late adolescent alcohol consumption is a time-limited activity without significant longer term consequences or whether it impacts upon adult health and well being. It is clear that the evidence base on long-term consequences is not as extensive nor as compelling as it could be. There is a large evidence base attesting to the ongoing impacts of late adolescent drinking on adult drinking behaviours, though most studies cannot strongly support causal inferences because of their designs. There is robust evidence from one US National school cohort that apparent effects on later alcohol consumption persist beyond the age of 30, which is longer than had previously been understood. Possible effects on subsequent alcohol problems including dependence are somewhat more complex than effects upon subsequent alcohol consumption per se. Evidence from multiple well-designed cohort studies indicates that other factors indicative of heightened psychosocial risk more broadly are also implicated. It is nonetheless striking that effects on alcohol problems assessed at ages in the mid 30s appear to have been produced by elevated consumption in late adolescence. Findings from a rigorousNew Zealandbirth cohort study on nonalcohol outcomes, however, demonstrate that many apparent effects of late adolescent drinking are actually due to other factors. Certainty about the long-term consequences of late adolescent drinking is thus not easily achieved.

Notwithstanding the limitations of the evidence base and of this review, and attenuations over time in the strength of the direct effects, late adolescent alcohol consumption appears a probable cause of increased drinking well into adulthood, through to ages at which adult social roles have been achieved. Heavier drinking seems most likely, however, to be only one component in a complex causal process. The contribution of adolescent drinking has probably been overestimated in previous studies through not taking accouint of other possible explanations. There are also uncertainties induced by self-reported data. The importance of these findings is highlighted in the context of work showing strong stability of drinking patterns through the fourth and fifth decades of life. A wide range of health and other harms, such as liver cirrhosis, are caused by alcohol at middle and older ages. Late adolescent drinking, by virtue of its probable effect on long-term adult alcohol consumption is likely to contribute to the burden of alcohol-related disease. Continuities from adolescence to adulthood in drinking patterns have been observed across a range of measures including frequency of consumption and heavy drinking.

In this study it seems that alcohol consumption confers additional risk of alcohol problems both on those who are already more vulnerable in various ways to poorer health and psychosocial outcomes, and strikingly also among those who are not otherwise vulnerable. Possible effects on adult alcohol problems and dependence including hospitalisation identified here result from heavier drinking in adolescence without necessarily involving problems at younger ages. If these effects are confirmed, there are two important implications: (1) Reducing late adolescent alcohol consumption in the general population may be expected to make a long-term contribution to reducing the incidence of adult alcohol problems; (2) In more vulnerable populations, late adolescent drinking may be one cause among many of later difficulties, and its effects may be more severe and long-lasting than for other groups. Having relatively secure psychosocial resources may somewhat buffer these risks, and their consequent potential for adverse effects, but it does not remove them. These statements should be read with some caution given studies of mediators and moderators of these effects are lacking, limiting our understanding of their nature. Nevertheless, this systematic review affords more secure inference of the likely existence of these effects than has been possible previously. It is possible that relationships with alcohol forged during late adolescence may have cumulative lifetime drinking related consequences that are also simply not well captured by the existing literature.

In addition to making both alcohol and heavy drinking less available, less acceptable, and more expensive, these findings indicate a need for policy makers to encourage young people to be more cognisant of the long-term risks to adult health and well-being, and to act on this awareness in their decision making about whether and how much to drink. This encouragement requires much more than the provision of accurate information about risks if it is to have any real prospect of influencing actual behaviour. Alcohol harm reduction has largely been concerned with reducing various risks inherent in drinking situations and their immediate aftermaths. This study demonstrates the need to develop a longer term perspective on harm reduction.

Source:Alcohol Insights No.80

Abstract

A review of the existing literature on the occurrence of challenging behavior among children with prenatal drug exposure was conducted. While a large number of studies were identified that evaluated various outcomes of prenatal drug exposure, only 37 were found that directly evaluated challenging behaviors. Of the 37 studies, 23 focused on prenatal cocaine exposure, and 14 focused on prenatal alcohol exposure; most studies relied on broadband measures such as the CBCL for the assessment of challenging behavior. Among the 37 studies, a clear role for the postnatal environment on developing challenging behaviors was evident; however, prenatal alcohol exposure showed a much clearer independent effect upon challenging behaviors than was noted in the prenatal cocaine studies. Additionally, only 3 of the 37 studies addressed interventions for challenging behaviors, each of which showed an improvement in child behavior or parent-child interactions. As researchers have continued to show the importance of the postnatal environment, it is likely that interventions addressing specific environmental risk factors will be helpful to reduce or prevent challenging behaviors among this population.

Source:  http://www.ncbi.nlm.nih.gov/pubmed/18037268  Dec. 2008

A growing body of research is showing that when it comes to treatments for alcohol use disorders, women’s needs are different from men’s. Scientists who recently presented studies at the Research Society on Alcoholism are exploring gender differences in alcohol treatment and moving beyond a one-size-fits-all strategy.

“Women have different barriers to treatment than men,” says Elizabeth Epstein, PhD, Research Professor in the Clinical Division of theCenterofAlcohol StudiesatRutgersUniversityinNew Brunswick,NJ. “They are less likely to seek alcohol treatment in a dedicated alcohol facility, and more likely to seek treatment with a general practitioner or psychiatrist for depression or fatigue.” However, many of these doctors don’t routinely screen for an alcohol or drug use problem, she explains.

“We know that 85 percent of people who have alcohol problems in their lifetime don’t seek treatment for it, so we are focusing most of our treatment research resources on the 15 percent who do,” according to Dr. Epstein. “We need to look beyond that, to who is struggling without treatment.” More training in alcohol use disorders is needed for emergency department physicians, obstetrician/gynecologists and family practitioners, she states. “We need to develop interventions that allow doctors to screen for alcohol use problems, since we know that women are not likely to come in and say they drink too much.”

Alcohol tends to affect women more than men for several reasons. Dr. Epstein explains, “A woman who weighs the same as a man and consumes the same amount of alcohol over the same length of time is likely to have a higher blood alcohol level. Women have less body water than men, leading to a higher blood alcohol concentration, and they also have less lean muscle mass and fewer enzymes in the stomach that break down alcohol. That means more ethanol is going into the bloodstream and directly to organs like the heart, brain and liver, and doing damage.”

She notes that women develop a host of alcohol-related health problems more quickly than men, even though they tend to start drinking later. “Older womens’ bodies are not processing anything as well as younger women, including alcohol,” she says. “And we are seeing younger women’s drinking patterns catching up with men’s, which is not a good thing. That means that as this generation progresses, we’ll see more and more older women with alcohol problems.”

Success With Individual Therapy

Dr. Epstein is leading the Rutgers Women’s Treatment Project at the Center of Alcohol Studies. This five-year clinical research study, funded by the National Institute of Alcohol Abuse and Alcoholism, is testing the effectiveness of therapies for women with drinking problems.

She and her colleague, Dr. Barbara McCrady, looked at marital therapy combined with alcohol therapy for women, testing it against individual alcohol therapy for women. “The women in both groups did very well, reducing their drinking days from an average of about 70 percent before the study, to 20-30 percent while in and after treatment,” states Dr. Epstein. The coupled treatment conferred a slight advantage in terms of maintaining the gains in the year following treatment. That study required women to be in a committed relationship or marriage to a male to be eligible. Many women didn’t want to sign up, because their spouse had to be involved.

Both doctors then offered a choice of either individual therapy or couples therapy in a two-armed clinical research study to treat alcohol use disorders. For that study, women had to be in a committed relationship, but did not need to bring their partner in if they chose individual therapy. Most women in that study chose individual therapy. Women who chose individual therapy were randomly assigned to regular cognitive behavioral therapy (CBT) or female-specific CBT. In CBT, emphasis is placed on the importance of breaking the drinking habit and learning coping skills.

The female-specific treatment also emphasized womens’ rights to care for themselves, and helped them feel more self-confident and less sensitive to what other people thought about them. The treatment provided assertiveness training and helped women address how to deal with a partner who drinks heavily, and with anxiety and depression. Women learned about anger management and how to make connections with sober people who treat them well and don’t abuse them.

While women in both groups showed improvement in their drinking, Dr. Epstein and her colleagues found that women who chose individual therapy were more likely to stick with therapy than those who chose couples therapy.

Currently Dr. Epstein is investigating the effectiveness of female-specific-CBT treatment delivered in women-only groups. She explains, “We want to be able to develop treatments for a broad range of women, which could be integrated into community-based therapy.”

Trauma and Substance Abuse Linked

Many women with substance abuse disorders also suffer from post-traumatic stress syndrome (PTSD), resulting from interpersonal violence, says Denise Hien, PhD, ABPP, who presented data at the meeting about promising treatments for women who suffer from PTSD and substance use disorders. “They drink in response to trauma,” says Dr. Hien, Professor at the City University of New York, and Adjunct Senior Research Scientist at Columbia University College of Physicians and Surgeons in New York.

Dr. Hien compared a type of CBT called “Seeking Safety” for substance abuse and PTSD with a relapse prevention treatment. “Seeking Safety” is a short-term treatment for both trauma and substance abuse in women. Both disorders are treated at the same time by the same clinician. Secondary analyses indicate that trauma therapy may be most effective for women who are also receiving some type of self-help, such as being part of a 12-step group. “If a person is not affiliated with a self-help group, she may actually get worse from trauma therapy alone,” Dr. Hien says.

Last year, she published a study in the American Journal of Psychiatry that found if you treat the PTSD symptoms first, in women who suffer from both substance abuse and PTSD, it led to a reduction in substance abuse. The study found little evidence that treating substance abuse first improved PTSD symptoms. Currently, patients who suffer from both disorders often are not treated for PTSD until they receive addiction treatment and stop using drugs and alcohol. This sequence is based on the assumption that addressing trauma could worsen a person’s substance abuse.

Dr. Hien is also conducting a clinical trial that is examining whether adding the antidepressant sertraline HCI (Zoloft) to trauma therapy benefits women with PTSD and alcohol misuse or alcohol use disorders.

Source: The Partnership@DrugFree.org  July 2011

 

 

Harm Reduction: More than just side effects!

 The recent stance from the managing editor of the South African Medical Journal in favor of the extremely controversial practice of decriminalizing drugs of abuse (Harm Reduction) is both surprising and disconcerting. It shows a mixture of “arm chair medicine”, selective quoting of studies and conventions, and some really flawed reasoning.

 One wonders when last he has sat in front of a drug addict who’s lost their family, through being consumed by an overriding passion for drugs, or lost their job due to multiple accidents in the workplace related to the abuse of cannabis, heroin or other drugs. Or when last has he treated a marijuana smoker who has developed schizophrenia as a result of his marijuana smoking, a complication which has become increasingly well established in medical publications over the last 4 years?

 Medical Science is exploding with new research on virtually a weekly basis, that proves the harmful effects of marijuana use including:

•  Causing psychosis in healthy people.^[1]
• Harming the brains of teenagers.^[2]
• Increasing the risk of testicular cancer.^[3]
• Poor foetal growth.^[4]
• Suppression of the immune system. ^[5]

 I suppose he has also not had to treat wash-out drug addicts from Switzerland like some of us have had to, where they have tried to regulate substance abuse through the medical provision of clean needles, syringes and drugs.

 The archaic argument that we cannot root out drug abuse by keeping it a crime is also a strange way of thinking to Doctors for Life. Since time began we have not managed to root out one single crime, but we are far from considering decriminalizing murder, rape, theft and fraud, to name but a few. Really, to use the example of Jackie Selebi’s corruption as a argument to legalize drugs is an illogical and distorted way of reasoning.

 Even though the article has quite a few references and appears very scientific, one is kind of left wondering what has happened to common sense. Dr van Niekerk keeps on quoting the fact that more harm is caused by legal drugs such as tobacco and alcohol (90% of all drug related deaths in theUK!) than illegal drugs, and somehow seems to miss the obvious point that having legalized them did not reduce the harm done by them. On the contrary, it appears to have increased the harm they cause. The implications of legalizing the use of drugs of abuse for the benefit of the economy of the country are vast. To mention just a few:

 Politoxemia, the simultaneous addiction to different drugs.

• The financial implication of increased accidents in the workplace.
• An increase in hours off work.
• Medical expenses for treating the complications of substance abuse.

 It also includes the expense of establishing an infrastructure of medical personal to oversee the handing out of these drugs (and that in a country where our health system is already overloaded). DFL finds the reasoning justifying decriminalization immature.

 Dr. van Niekerk also quotes the UN Single Convention on Narcotic Drugs of 1961, but does not mention the UNODC’s 52nd session of the Annual Commission on Narcotic Drugs March 2009, to whichSouth Africa is a co-signatory. When some parties tried to slip in a Harm Reduction policy (such as Dr. van Niekerk is supporting),Sweden,Russia,Japan,USA,Colombia,Sri Lanka andCuba refused to sign the document unless the reference to harm reduction was removed.

 Experiences of a few countries that have moved in the direction of decriminalisation should also be taken note of:

 The Alaska Supreme Court ruled in 1975 that the state could not interfere with an adult’s possession of marijuana for personal consumption in the home. Although the ruling was limited to persons 19 and over, a 1988 University of Alaskastudy, the state’s 12 to 17-year-olds used marijuana at more than twice the national average for their age group.Alaska’s residents voted in 1990 to re-criminalize the possession of marijuana, demonstrating their belief that increased use was too high a price to pay

 In Holland the Dutch government started closing down a third of their coffee shops because they found that many of the coffee shops had become a legal outlet for the illegal drug trade and after 15 years of legalised marijuana use, they were unable to separate the illegal and crime related activities from the legal trade. With the South African Police Force struggling to effectively police crime in the country, how do we think we ever are going to better the Dutch!

 The U.K.first reclassified marijuana as a less harmful Class C drug, but in January 2009 moved it back to a more dangerous Class B drug.

 Doctors For Life International is all in favour of doing more regarding the rehabilitation of drug addicts. But we do feel that having a prison sentence as an alternative to being sent for rehabilitation is a powerful incentive for many substance abusers to try and get help. To this end we would argue for more government funding to established rehabilitation units, and for NGO’s, who to a large extent have taken over the responsibility of the government in this regard.

 Doctors for Life International, represents more than 1800 medical doctors and specialists, three-quarters of whom practice in South Africa. Since 1991 DFL has been actively promoting sound science in the medical profession and health care that is safe and efficient for all South Africans. For more information visit: http://www.doctorsforlife.co.za

 References:

 ^[1] Causing psychosis in healthy people:                 

Dr Theresa Moore, Theresa HM Moore MSc, Dr Stanley Zammit PhD, Anne Lingford-Hughes PhD, Thomas RE Barnes DSc, Peter B Jones PhD, Margaret Burke MSc, Glyn Lewis PhD

Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review.UniversityofBristol, InstituteofPsychiatryinCardiffUniversity, Wales.

The Lancet, Volume 370, Issue 9584, Pages 319 – 328, 28 July 2007

 ^[2] Harming the brains of teenagers:                     

Manzar Ashtari, Ph.D: Children’sHospitalofPhiladelphia

Staci A. Gruber:HarvardMedical School

http://news.harvard.edu/gazette/story/2010/11/marijuana-study/

 ^[3] Increased risk of testicular cancer:                            

FredHutchinsonCancerResearchCenter: Stephen Schwartz

Association of Marijuana Use and the Incidence of Testicular Germ Cell Tumours

http://www.fhcrc.org/about/ne/news/2009/02/09/marijuana.html

Kristen Woodward, 206-667-5095 or kwoodwar@fhcrc.org

 ^[4] Poor foetal growth:                                            

Hanan El Marroun, Henning Tiemeier, Eric A.P. Steegers, Vincent W.V. Jaddoe, Albert Hofman, Frank C. Verhulst, Wim van den Brink, Anja C. Huizink.
Intrauterine Cannabis Exposure Affects Fetal Growth Trajectories: The Generation R Study
Journal of the American Academy of Child & Adolescent Psychiatry
December 2009 (Vol. 48, Issue 12, Pages 1173-1181)

 ^[5] Suppression of the immune system:                     

Venkatesh L. Hegde, Mitzi Nagarkatti and Prakash S. Nagarkatti.

Cannabinoid receptor activation leads to massive mobilization of myeloid-derived suppressor cells with potent immunosuppressive properties.

European Journal of Immunology, 2010; 40 (12): 3358-3371 DOI: 10.1002/eji.201040667

 Source:  Doctors for Life International, Dr.Thomas Gray 032 4815550  Jan 2011

David Raynes. Executive Councillor UK National Drug Prevention Alliance wrote to the BBC following the Any Questions programme on BBC Radio 4 with the following response.  Subsequently David appeared on the follow up programme.

 ANY QUESTIONS BBC Radio 4. The drugs policy debate

Date: Sat, 4 Jun 2011

 Dear Sir

Since our organisation, the NDPA, was mentioned several times in the programme please allow me to respond.

 Nadine Dorries was correct that much modern cannabis is stronger than years ago but we do not agree with her figures. Typically modern cannabis is three to four times stronger in THC (the psychoactive ingredient) than the /strongest/ cannabis of the 60s & 70s.

 This has been achieved by selective breeding and in response to consumer demand. But the picture is more complex than /just/ THC strength, the presence (or rather absence in modern forms) of another chemical, CBD, appears to have aggravated the ever present brain damaging potential of cannabis.

 Use has also changed, age of first use & regular use, is earlier than in the 60s and that is another damaging factor. The evidence caused theUKgovernment, with cross-party agreement, to reclassify cannabis upwards, two years ago.

 With Prime Minister David Cameron saying, (SKY NEWS SUNDAY APRIL 6TH APRIL 2008) that a parliamentary committee of which he had been a member, had been wrong about lowering the classification of cannabis.

 Lessons have been learned and are unlikely to be overturned.  We say that cannabis contributes substantially to academic  under achievement and very poor mental health, regardless of other effects.

 On the wider question of decriminalisation and even legalisation of all drugs, the NDPA says that a monstrous, well financed and very slick fraud is being perpetrated internationally and that this fraud has fooled some of the “great & good” who have signed up as supporters.

 There is no evidence at all that either measure could reduce the  total harm from drugs. The reverse is very much the case, with academic opinion saying that either measure would inevitably normalise and increase, use. The manifest harm from the legal drugs and the legislation on alcohol & tobacco, as variously applied around the world, confirms that.

 Comment from the panel on the good effects from decriminalisation was profoundly incorrect and just reflects implanted manipulative messages.

 For years we have been bombarded with theNetherlands as THE example of sound drug policy, this despite the fact that the country, through it’s policies, created the largest base for drugs related criminality inEuropewith supply, warehousing, distribution and manufacture at astonishing levels. At one stage the Netherlandshad more drug related murder than anywhere else inEurope. The Netherlandsis changing, it spends proportionally more than the UK on enforcement and is currently more effective and better organised.

 Portugaland decriminalisation appears now to be “the new orthodoxy” for those with a certain direction of travel and for those “user advocates” who want more freedom to use, regardless of the wider social effects.

ButPortugalis being misrepresented:

 1.       The number of new cases of HIV and Hepatitis C inPortugalis eight times the average in other EU countries

 2       Portugal has the most cases of injected drug related AIDS with 85 new cases per one million citizens. Other EU countries averaging 5 per million.

 3.       Since decriminalisation, drug related homicides have increased 40%.

 4.       Drug overdoses have increased substantially, over 30% in 2005

 5.       There has been an increase of 45% in post mortems testing positive for illegal drugs

 6.       Amphetamine & cocaine consumption has doubled inPortugalwith cocaine seizures increasing sevenfold between 2001 and 2006.

 Finally the suggestion that legalisation would somehow remove criminality from drug supply is ridiculous. Criminality loves use-reinforcing substances and behaviours. More than 20% of the UK tobacco market is smuggled, counterfeit, or both. In some other countries it is much worse.

 Legalisation or decriminalisation, of substances unfit for human consumption, should only occur if a demonstrable “public good” can be evidenced.

 The problem for the legalisation lobby is that it cannot.

 David Raynes. Executive Councillor UK National Drug PreventionAlliance