News and Notes

Abstract

By Francis Keaney, National Addiction Centre, London In June 2007 the United Kingdom Home Office and the Department of Health jointly produced ‘Safe. Sensible. Social. The Next Steps in the National Alcohol Strategy’[1]. This is a follow-up to the UK's first strategy document (2004) called ‘Alcohol Harm Reduction Strategy for England’. The ‘next steps’ strategy reviews progress and outlines further national and local action to achieve long-term reductions in alcohol-related ill health and crime. Three groups of drinkers are to be focused on especially: Young people under 18; 18–24 year old binge drinkers, some of whom are responsible for the majority of alcohol-related crime and disorder in the night-time economy; Harmful drinkers, many of whom are unaware that their drinking pattern is causing damage to their physical and mental health. Main action points of the strategy include: a review of NHS alcohol spending; public consultation on alcohol pricing and promotion through an independent review of the evidence exploring the relationship between promotional activity and harmful consumption particularly among young people, and posing the question: does the price of alcohol cause people to drink more? legal requirement on local communities to have a strategy to tackle crime, disorder and substance misuse (including alcohol-related disorder and misuse) in their area; toughened enforcement of under-age sales; increased criminal justice sanctions on those committing crime and antisocial behaviour when drunk; advice, support and treatment for offenders when appropriate; developing telephone helplines, interactive websites and support groups for people who want to drink less; guidance for parents and young people to make informed decisions about their drinking; a public information campaign to promote a new ‘sensible drinking’ culture to challenge the idea that drunken antisocial behaviour is acceptable or normal. For the first time the strategy contains helpful acknowledgement of harmful drinking, such as dependence on alcohol, liver damage and cirrhosis. It also seems to have left behind previous goals of living in a relaxed Mediterranean café culture. Unfortunately, as with the initial 2004 strategy, no funding is provided. 1. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_075218 (accessed 17 August 2007) By Michel Reynaud, Paul Brousse University Hospital, Paris The French Minister of Health announced the implementation of an ‘Addictions Management Policy’ on 15 November 2006 which aims to completely redefine addictions management practices in France over the next five years. The new system is designed to make it possible for anyone affected by an addiction and in need of appropriate assistance to know where, when and how he may find it. Access points must be clearly visible, easily accessible, non-stigmatising and capable of providing optimal community-based management. Programmes must be patient-orientated. Likewise, all health care providers must be capable of detecting and proposing possible solutions to those who suffer from addictions, even at an early stage. The budget will be 385 million euros between 2007 and 2011. There are six priority areas:— Improving addictions management within health care institutions by implementing specialised consultation and liaison teams in ‘addictology’ in every hospital with an emergency department. Hospital consultations will be offered to address tobacco, alcohol and drug addictions and non-substance addictions in a coordinated manner. Hospital liaison teams will detect patients with difficulties during their hospitalisation and guide them toward appropriate health care structures. It is planned that there will be at least one referral addictology department per 500 000 inhabitants. These will include outpatient clinics and inpatient services providing short- and long-term care. In addition, every university hospital will have an addiction department which will offer tertiary care and act as a regional centre for referrals, training and research. Improving addictions management in medico-social centres by unifying agencies managing the medico-social aspects of alcohol and drug use into Centres for Treatment, Support and Prevention in Addictology (CSAPA). These will have increased treatment capacity, including the creation of new therapeutic communities. Better coordination across sectors through the implementation of a National Addictions Commission and organisation of addictology networks with a view to improving involvement of primary care physicians in addictions management. Developing prevention strategies through launching a major communication campaign and establishing an addictions hotline. It will also involve developing systems in primary care for early detection and brief interventions to prevent alcohol problems, and assisting patient associations. Reinforce addictology training for professionals by creating a new addictology curriculum for medical professionals, reinforcing training for paramedical professionals and social workers and including addictology in continuing medical education. Further strengthen addictology research by developing improved clinical research and establishing a programme of research into non-drug addictions. It will also involve coordinating the research programmes in addiction. The UK Department of Health has launched a campaign to inform retailers and the public that the selling of tobacco products to under-18s will be illegal from 1 October 2007. The previous minimum age limit was 16 years. The change is aimed at reducing smoking prevalence rates among young people, which currently stand at around 9% of 11–15 year olds. Details of the campaign can be found at http://www.tobaccoagechange.co.uk. At the same time, and somewhat counter-intuitively, Action on Smoking and Health reports that the new Brown government has announced an increase in VAT on nicotine replacement patches from 5% back to 17.5% (the standard rate) from 1 July 2008. The tax was previously reduced in the run up to this year's smoking ban. It is estimated that, following the increase, the government stands to gain £10 million from smokers battling to give up. The two measures announced here would seem to signal some confusion in policy which might provide smokers with understandable cause for doubt when hearing smoking-related messages from the government. Source: http://tinyurl.com/3cvkdb (accessed 17 August 2007) The New South Wales parliament has passed legislation to extend the trial of Australia's only medically supervised injecting centre (MSIC) for a further four years, to the end of October 2011. The centre is based in King's Cross, an inner-city location of Sydney. Support for the bill came from the Greens, Independents and five Liberal MPs (who were allowed a conscience vote). Debate about the bill was heated, and parties opposed attacked the various reports tabled by the team of internationally recognised researchers from Australia's national centre in HIV epidemiology and clinical research who undertook the MSIC's evaluation. The Swedish National Criminal Investigation Department (Rikskriminalpolisen) reports that previous estimates of cannabis use have seriously underestimated the size of the country's cannabis market. Around 25–30 tonnes of cannabis are sold in Sweden every year, rather than the 3 tonnes previously estimated. The latest information is obtained from a wide-ranging survey taking in data from police forces, prosecutors, customs, coastguard and forensic experts, whereas previous estimates were based on the consumption of known cannabis users. It is reported that home-grown marijuana accounts for an increasing amount of the cannabis consumed in Sweden. It is also reported that industrial scale cultivation of the plant has been uncovered at sites in Stockholm, Gothenburg, Uppsala and Halmstad in recent years. Police are calling for systematic checks on vehicles on major motorways as part of efforts to tackle the problem. Source: http://www.thelocal.se/7565/20070611 (accessed 17 August 2007) The sound of claws clattering on the stairs announced the arrival of our reptilian editor, hauling with her a large pile of paper which she had obviously read and re-read. Claws tend to be rather rough on even the glossiest of reports. Iggy writes: ‘Recently I had a meeting the UK Minister of State for Public Health responsible for the new alcohol strategy. She described the British relationship with drink as “complicated”. In this context, I read with interest the UK government's new strategy whilst pondering the “complicated relationship” the government have with the alcohol industry and the alcohol health lobby. Frankly, I was never really sure whether the 2004 alcohol strategy was written for the government by the alcohol industry or written by the government for the alcohol industry. You humans just make things so complicated!’ ‘I was a touch concerned to see the alcohol industry welcome the new strategy. But, given its focus on individual responsibility and education, that should come as no surprise. I'm sure they can be confident that their influence remains undiminished. Only one of the action points, the investigation of the relationship between price and consumption, may affect profits at all. I'm sure this relationship will be “complicated”.’ ‘I have to congratulate the government on the inclusion of the dependent drinker in the “harmful” category – some one million people in the UK. This mention of the alcohol dependence syndrome breaks new ground for the Department of Health and comes only 31 years after the syndrome was first described. Sadly, any money attached is not ring-fenced and comes with no alcohol targets, almost guaranteeing that cash-strapped local health authorities will spend it elsewhere.’ ‘Lounging in the sun for most of the day I am left wondering just how complicated all this really is. We reptiles would probably use history to show us that unprotected funding gets spent elsewhere. We also learnt a long time ago that bodies such as the alcohol and tobacco industries prefer profits over public health. Not exactly complicated, is it?’ ISAM 2007. 9th annual meeting organised by the International Society of Addiction Medicine, 22–25 October 2007, Cairo, Egypt. Contact: http://www.isam2007cairo.com Meeting the Future—Innovative and Effective Policy and Practice. 4th Australasian Drug Strategy Conference, 22–25 October 2007. Conrad Jupiters, Gold Coast, Queensland. Contact: Sarah Jarman, tel. +61 (0)7 3364 4605; email ADSC2007@police.qld.gov.au/ADSC2007; website police.qld.gov.au/ADSC2007 Update to Two Nations, Ten Cultures. Combined APSAD and Cutting Edge conference, Auckland, New Zealand, 4–7 November 2007. Contact: http://www.twonationstencultures.co.nz Drugs, Alcohol and Healthcare: Systems, Scholarship and Solutions. 31st AMERSA Annual Conference. 8–10 November 2007, Hilton Embassy Row, Washington DC. Organised by the Association for Medical Education and Research in Substance Abuse. Contact: Doreen MacLane-Baeder, AMERSA, tel. +1 401 243-8460; e-mail: Doreen@amersa.org; website: http://www.amersa.org Responsible Gaming, Regulation and Recovery: Testing Conventional Wisdom. National Center for Responsible Gaming (NCRG) conference, 11–13 November 2007, Las Vegas, Nev. USA. Contact: Institute for Research on Pathological Gambling and Related Disorders: http://www.divisiononaddictions.org/institute Reducing the Harm Caused by Alcohol: A Co-ordinated European Response. Royal College of Physicians, London. 13 November 2007. Contact: RCP conference department, 11 St Andrews Place, Regent's Park, London NW1 4LE; tel. +44 (0)20 7935 1174 ext 436/252/300; fax +44 (0)20 7224 0719; e-mail conferences@rcplondon.ac.uk Theory, Policy and Practice in Addictions: How Are They Related? Annual Symposium of the Society for the Study of Addiction. Concurrent theme covers new developments in addictions treatment. 15–16 November 2007, Park Inn Hotel, York, United Kingdom. Contact: Graham Hunt, SSA Executive Office, 19 Springfield Mount, Leeds LS2 9NG; tel./fax +44 (0)113 295 1345; e-mail graham.hunt@leedsmh.nhs.uk; website http://www.addiction-ssa.org 5th World Assembly on Tobacco Counters Health (WATCH-2000). 2–5 December 2007, New Delhi, India. Contact: http://www.watch-2000.org Alcohol Policy 14: Engaging States and Local Communities in Prevention Policies. 27–30 January 2008, the Bahia Resort Hotel, Mission Bay, San Diego, California. Sponsored by the California Council on Alcohol Policy. Contact: http://www.cal-council.org/AP14/index.htm Looking Forward: New Directions in Research and Minimising Public Harm. 21–23 February 2008, Auckland, New Zealand. International gambling conference organized by the Gambling Research Centre at Auckland University of Technology, and the Problem Gambling Foundation Foundation of New Zealand. Contact: e-mail info@problem-gambling.info; website http://www.pgfnz.co.nz/2008conference Building Capacity for Action. European Alcohol Policy Conference. Barcelona, 3–5 April 2008. Contact: SuportServeis, tel. +34 93 201 7571; fax +34 93 201 9789; e-mail buildingcapacity@suuportserveis.com; website http://www.ias.org.uk/buildingcapacity/index.html News and Notes welcomes contributions from its readers. Send your material to Peter Miller, News and Notes Editor, Addiction, National Addiction Centre PO48, 4 Windsor Walk, London SE5 8AF. Fax +44 (0)20 7703 5787; e-mail peter@addictionjournal.org Conference entries should be sent to Susan Savva at susan@addictionjournal.org. Subject to editorial review, we will be glad to print, free of charge, details of your conference or event, up to 75 words and one entry only. Please send your notification three months ahead of time and specify in which issue you would like it to appear.