Not so Legal Highs

Well our government has once again put media hysteria before science and slapped a ban on mephedrone, miaow miaow, or whatever it is known as.... clearly they have been so impressed with the effect that criminalisation has had on the quantity and safety of consumption of other drugs that it just can't wait for the scientific evidence to deliberate one way or another. It may very well be that this drug is harmful, certainly I wouldn't want to be sticking plant food in my body - but all the evidence of past mistakes would suggest that the act of criminalisation will simply make it more attractive, put the profits up for the black market, and encourage even more dangerous substances to be sold masquerading as mephedrone, or indeed diluting it. ...

Not that I have any confidence that the other lot would have acted any differently.....

RCPsych Conference in Bristol

This year's RCPsych Faculty of Addiction conference is to be hosted in the South West, in Bristol on April 29 + 30, and is being organised by Alison Battersby of Plymouth. There is a really excellent programme you can see by clicking here, and Alison has asked me to emphasise that GPs with an interest in addiction work will be particulalrly welcome. Clearly Addiction Psychiatry contributes greatly to the theory, knowledge base, research as well as practice of addiction medicine, and if you have ever felt that you need something perhaps more academic and scientific than many of the other conferences, then this could be for you. You can also download the registration form by clicking here. This will be a great opportunity to network with our psychiatry colleagues locally, and share our ideas and experiences.

Anthrax!

The mini outbreak of anthrax amongst Glasgow injecting drug users has come south - there has been a confirmed case in London. We don't know how these infections have occurred: one can speculate, but it doesn't help much - the fact remains that injecting materials into your body that have no aseptic, regulated, pharmaceutical provenance has, and always will be, very dangerous. just as in clostridial infections we must be alert to abscesses: anything that is hot, spreading, and is associated with systemic upset should be sent to A&E as a matter of urgency, along with a phone call to the (often inexperienced) SHO, with your concerns about something he or she has probably never heard of.

David Nutt strikes back!

I am delighted to read that Professor Nutt is reconvening like minded experts into a new group, free of government bias, to deliver clear, authoritative and apolitical advice on the safety of drugs. You can read about it here. No doubt the upcoming General Election will have the parties competing for the "toughest" stance on drugs, whilst at the same time planning to disinvest from treatment - if any of my readers have the ear of their local MP, please give them this simple message: the harms that drug use cause health have far more to do with their legal status than the drug itself - and that education and treatment will be far more effective at reducing that harm if they are properly financed, and certainly far more effective than criminalisation.

Scandalous Sacking of David Nutt

All of you will share my shock and outrage that our colleague Professor David Nutt, has been sacked from his honorary position as Chair of The Advisory Council on the Misuse of Drugs. The principle function of the ACMD has been to examine the body of scientific evidence on the harms that psychopharmaceuticals cause, which in turn informs their status in their legal classification. As a Professor with an international research reputation on the harms that drugs cause, there could be noone better placed to Chair this committee. But you will be aware that the Government has ignored the advice of the ACMD with regard to the downgrading of category of cannabis from B to C, and ignored their call to include alcohol and tobacco in the tables, for reasons that are entirely political. David publicly questioned why the government should appoint a team of experts and then ignore their advice, and for that reason he was sacked. I would not pretend that the legal status of drugs is simple - and acknowledge that public health and behaviour have large political dimensions: it is precisely because the two forces of science and politics apparently conflict that we need to encourage open and honest debate - not attempt to silence it so crudely (and utterly ineffectively). It is ironic that in countries such as Afghanistan, we are trying to promote our notion of democracy: I wonder what they make of our democratically elected government which will sack a man for free speech, and expressing a scientifically based opinion that opposed the stance of political prejudice?

Stop Press - read David Colquoun's excellent commentary in the current BMJ here.

Trailblazers in the Southwest

Have you checked out the new copy of Network? lots of interesting stuff, much of which has been contributed by you in the South West: there is an excellent piece on Ketamine on the front page from Fergus Law and colleagues in Bristol; an informative article on pain management and addiction in the acute hospital by my colleague and friend Dawn Wintle in Yeovil Hospital (every hospital needs a Dawn Wintle), and an article on Young People's Drug and Alcohol services in Plymouth, By Charlie Lowe and Gerry Woodley.

And a couple of weeks ago I listened in abject admiration to Adam Ellery and Helen Hampton, on how they have set up a Hepatitis C treatment service for their drug using clients in Cornwall. Not (as I assumed) merely a satellite outpost for specialist hepatologists to simply get their medications delivered - but a commissioned, stand alone primary care treatment service for HCV - according to Adam, if you can prescribe methadone then you should be treating your HCV clients at the same time - I am sure this is a most important direction for GP drug misuse services to go in and Adam is showing the rest of the country how to do it well.

Fancy a Job at the SMU?

The RCGP Substance Misuse Unit is looking for a new Lead for the Part 1 Certificate in Drug Misuse - you need to be able to give a notional session a week and develop the course materials which are constantly under review. Even though the academic satisfaction, not to mention the kudos of working with the RCGP (ahem) would be reward enough for anyone, there is half-decent money attached as well - apply to Jo Betterton at the SMU. And we are also looking for Part 2 Tutors.... if you can spare the time. Ask Jo again...