Three additional benzodiazepines to become class C drugs

 

Crime and Policing Minister Kit Malthouse has announced that three benzodiazepines will be made Class C drugs.

 

Flualprazolam, flunitrazolam and norfludiazepam will be controlled as Class C drugs under the Misuse of Drugs Act 1971 and placed in Schedule 1 to the Misuse of Drugs Regulations 2001, following a recommendation from the Advisory Council on the Misuse of Drugs (ACMD).

 

As of March 2020, there had been 12 flualprazolam-associated deaths in the UK.

 

Crime and Policing Minister Kit Malthouse said:

 

“Illegal drugs ruin lives and corrode the foundations of our society.

 

“It’s clear from the expert advice that we have received that these drugs can cause serious harm, which is why we are taking this action.”

 

Loader Loading...
EAD Logo Taking too long?

Reload Reload document
| Open Open in new tab

 

This article is being shared under the Open Government Copyright licence.

 

 

Drug-related deaths involving fentanyl on the increase

 

A recently published report by the Advisory Council on the Misuse of Drugs has warned of the pharmacology and toxic effects of fentanyl and related analogues. The report says that it can be concluded that fentanyl and fentanyl-analogues present a significant ongoing risk to UK public health.

 

Episodes of fentanyl toxicity and deaths in the UK have been sporadic and have not approached the very high numbers seen in North America.

 

However, rates of registered deaths involving fentanyls have recently increased and may be under-estimated because sufficiently detailed forensic analysis of drug causes is sometimes not carried out. Consequently, the role of a fentanyl in the death may not be recognised.

 

The public health risk associated with the misuse of fentanyl and its analogues relates to the high potency of these substances a report has highlighted. Compared to morphine, the amount of fentanyl required to produce the same analgesic effects is 50-100 times lower.

 

Fentanyl and its analogues are potent compounds that therefore carry a high risk of accidental overdose that may be fatal.

 

The report warns of the ongoing risk of fentanyls and other new synthetic opioids increasingly infiltrating the UK heroin market and increasing rates of drug-related deaths.

 

The report makes a number of recommendations including the following:

 

  • Research should be commissioned to study diversion and non-medical use of strong opioids to identify trends, drug products involved and populations at risk.
  • Government departments should conduct a full review of international drug strategy approaches to fentanyl markets, in particular, the North American experience, and consider interdiction controls that can be applied to the UK situation.
  • Toxicology analysis of samples of all deaths related to drug poisoning should include analysis for fentanyl and fentanyl analogues as nonsystematic screening hinders our capacity to understand trends in drug death.
  • Toxicology reports from all deaths related to drug poisoning should include a clear statement as to whether fentanyl and/or its analogues were included in the testing. This would enable meaningful monitoring of trends in fentanyl-associated deaths.
  • Research should be commissioned to monitor the local and national prevalence of fentanyl and fentanyl analogues in:
    • Drug seizures, including heroin preparations and counterfeit medicines.
    • Non-fatal episodes of heroin toxicity requiring hospital treatment.
  • Increased funding should be made available to the Defence, Science and Technology Laboratory Forensic Early Warning System (DSTL FEWS) programme to increase capacity to analyse un-adopted police and border force seizures.
  • Agencies with responsibilities relating to drugs of misuse should monitor the international situation and share available UK data. There should also be a comprehensive early warning system which has access to up to date consolidated UK-wide drug misuse data sets.
  • If materials are encountered in the UK or Europe that retain potency but fall outside the UK generic control on fentanyls, a small amendment to that generic control should be applied to address these.
  • Following a consultation with the research community the Home Office should expand the precursor controls to cover simple variants of ANPP, the immediate precursor to fentanyl (further details are included in this report).

 

You can read the full report below.

 

Loader Loading...
EAD Logo Taking too long?

Reload Reload document
| Open Open in new tab

Download [801.01 KB]

Scotland’s drug-deaths highest in Europe

 

There has been a 27% increase in drug-related deaths registered in Scotland since 2017, figures published recently show. The statistics, published by the National Records of Scotland, provide details of 1,187 drug-related deaths that occurred in Scotland in 2018.

 

A widely predicted rise, this is the largest number of such deaths since records started in 1996 and more than double the figure for 2008, when 574 people died. Although the way in which such deaths are recorded varies across Europe, the latest figures show Scotland has suffered the highest death rate for any EU country and a rate nearly three times that of the UK as a whole.

 

Public Health Minister, Joe FitzPatrick, has reiterated calls for the UK Government to allow the Scottish Government to establish safer drug-consumption facilities to try to bring down the number of deaths occurring north of the border.

 

“The number of people who have lost their lives because of drug use is shocking,” the Minister said.

 

“It is vital this tragedy is treated as a public health issue, and we are prepared to take innovative and bold measures in order to save the lives of those most at risk.

 

“Last week, I gave evidence to the Scottish Affairs Committee and I asked for help in persuading the UK Government to either act now to enable us to implement a range of public health-focused responses – including the introduction of supervised drug consumption facilities – or devolve the power to the Scottish Parliament so that we can act.”

 

Earlier this month, Professor Catriona Matheson – a leading drugs expert at the University of Stirling was appointed by the Scottish Government as chair of a new taskforce to combat the rising numbers of deaths linked to substance misuse.

 

“I want to ensure that the work of the new taskforce which I have established is driven by strong evidence and the voices of those with experience of using drugs, and their families, are heard,” continued Mr FitzPatrick.

 

“I am determined to shape our services in every walk of life to prevent harm and reduce the appalling number of deaths.

 

“So I will give consideration to any proposals they bring forward which may help to tackle this issue and, ultimately, save lives.”

 

Appearing before the Westminster Scottish Affairs Committee this month, the Public Health Minister said among the options the task force would consider, he fully expected decriminalisation to be included.

 

The largest proportion of deaths occurred within NHS Greater Glasgow & Clyde – 394 – while 152 died within NHS Lothian, 130 in NHS Lanarkshire, and 109 in NHS Tayside.

 

This story was supplied as part of our partnership with healthandcare.scot. 

What can Scotland learn from British Columbia’s approach to overdose deaths?

 

Part of the answer to mounting drugs-related deaths in Scotland lies in grassroots charities, community groups and experts with lived experience taking a lead role, a Canadian substance use researcher says.

 

Professor Bernie Pauly of the Canadian Institute for Substance Use Research was in Scotland last week to speak at a Dundee harm reduction event organised by the Scottish Drugs Forum.

 

In Vancouver, the setting up of unsanctioned ‘pop up’ overdose prevention sites to save lives in the face of a rising tide of overdose deaths led to the provincial government backing these sites across the province, Professor Pauly, who is also a nurse at the University of Victoria School of Nursing, tells healthandcare.scot.

 

Her comments come amid an ongoing standoff over a safe consumption room in Glasgow. The Home Office refuses to allow such a facility, which campaigners, local politicians and the Scottish Government say has been proven to “save lives”.

 

British Columbia is home to just over five million people, compared to just under five and a half million for Scotland.

 

Like Scotland, it has also struggled with drugs. In 2015, overdoses became the highest cause of unnatural deaths, outstripping suicides and traffic accidents.

 

Fatalities have remained stubbornly high, with more than 1,500 people losing their lives in 2018 and, for the first time in recent history, life expectancy is falling.

 

In Scotland, 934 drug-related deaths were recorded in 2017.

 

Professor Pauly explains how, in light of long processes for federal approval of drug consumption rooms, activists and campaigners moved to provide an “essential health service” themselves.

 

“There were people, particularly in Vancouver, who started by setting up unsanctioned sites – often called pop-ups, because they were in tents. One of the ones in Vancouver was basically a tent in an alleyway where people could be observed and Naloxone administered immediately in the event of an overdose.

 

“People knew there were evidence based-interventions that would save lives – so why weren’t we doing that?”

 

Following the declaration of a public health emergency in 2016, the provincial government sanctioned overdose prevention sites – a move opposition politicians in Scotland have been calling for.

 

Overdose prevention sites are small-scale, “welcoming and friendly” spaces typically staffed by harm reduction workers, including staff with lived experience of drug use.

 

As well as expanding access to overdose prevention, they created “a space that was safe, where people felt like they wouldn’t be judged, with opportunities to develop trust and facilitate opportunities to access other services.”

 

In Canada, larger drug consumption spaces – of the kind proposed for Glasgow – have a broader range of staff, including nurses and counsellors. But while British Columbia is held up as an exemplar when it comes to harm reduction policy, Professor Pauly says a comprehensive response is critical.

 

Alongside overdose prevention sites, there was rapid scale-up of the provincial Take Home Naloxone Program and Opioid Substitution Therapy – but, she argues, more is needed. While no deaths occurred at supervised consumption or overdose prevention sites, British Columbia still saw 104 suspected overdose deaths in March.

 

Ultimately, these spaces are still “emergency measures,” Professor Pauly says. The ‘real prevention’ is ensuring a safe supply.

 

One idea being proposed in Canada’s western-most province is ‘compassion clubs’, in which members would be able to access a safe source of heroin.

 

It’s hoped this would undermine the illegal market, reduce poisonings and overdose deaths caused by impurities.

 

Asked what lessons Scotland could draw from the Canadian experience, Professor Pauly says:

 

“One is engaging people with experience right from the start because so many innovations are driven by them. The establishment of safe consumption sites…were really led by people with expertise and lived experience.”

 

Ultimately, she returns to the issue of supply, which is “something that should be addressed from the start.”

 

“You can scale up things like overdose prevention,” Professor Pauly says, “but you really have to address the fact there is an unsafe supply and really focus on changing policy to ensure a safe supply – that’s the real prevention.”

 

This story was supplied as part of our partnership with healthandcare.scot. 

Drug users need compassion, not custody

Westminster committee hears voices of Scots with experience of addiction during an inquiry into problem drug use.

 

The current approach of criminalising people who use drugs is making the problem worse and needs to be drastically overhauled, an influential committee of MPs has been told by Scots with personal experience of addiction.

 

Westminster’s Scottish Affairs Committee is investigating problem drug use in Scotland, including whether the Scottish Parliament needs more powers to deal with rising drugs deaths. Drug-related deaths are at the highest level on record in Scotland, outstripping England and many European countries.

 

Meanwhile, the Scottish Government and the Home Office are locked in a standoff over whether to allow a safe injecting facility in Glasgow. Supporters say the facilities, which are used in Canada, are proven to save lives but the UK Government has refused to change the law to allow such a move.

 

At an evidence session held last week, witnesses said prison sentences were harming, not helping, people who use drugs.

 

Hannah Snow, a 26-year old from Aberdeen who grappled with misuse and addiction for 13 years and who has been abstinent for the past 18 months, said:

 

“I experienced custodial prison sentences for supply of a controlled substance, so selling drugs, and possession of drugs, is not a deterrent — for me, anyway; I can only speak for myself.”

 

She continued: “What benefits are you getting from sending a known drug user into prison to do a drug sentence, who will get released to do the same thing? Enforce an order that has to put them through a recovery-based programme, instead of putting them into a criminal procedure programme where the cycle just starts again.”

 

“…A third of criminals who are released from prison are in addiction or have had addiction problems since they went into prison,” she added. “What hope do they have if they are just released?”

 

Elsewhere in the session witnesses told MPs their time in prison had been introduced them to more harmful substances such as heroin.

 

Also giving evidence was 45-year old Scott Ferguson, who called for possession of drugs for personal use to be decriminalised along the same lines of Portugal and Canada, and the money released from the justice system diverted into treatment and recovery programmes.

 

He went on to suggest a compassionate response was key, telling the panel of MPs the “first bit of empathy” he received from a support worker had given him hope he could recover:

 

“My “[criminal justice worker] was doing a lot of linked casework with my community alcohol and drug services worker, so they were singing off the same hymn sheet and knew what stage I was at.

 

“That was the first bit of compassion and empathy…I felt worthless because that was where my direction had taken me.

 

“I was in and out of homeless accommodation and I just couldn’t get it until I got shown that compassion and empathy, and I got that sense of belief in myself for the first time that I could maybe change.”

 

This story was supplied as part of our partnership with healthandcare.scot.