HEAVY TOLL
Two million patients a year are presenting to
hospital emergency departments with alcohol-
related illness or injury, resulting in 640,000
hospital admissions, according to researchers
at University Hospitals, Bristol. The research
team extrapolated figures from Bristol Royal
Infirmary’s emergency department to England
and Wales as a whole. The annual cost to the
NHS of alcohol-related injury and illness is
estimated at £2.7bn.
Study at emj.bmj.com
GET RANDOM
Randomised control trials (RCTs) should be used
much more extensively in formulating public
policy, according to a study by Bad Science
author Ben Goldacre, director of the University of
York’s trials unit, David Torgersen and Laura
Haynes and Owain Service of the Home Office’s
behavioural insights team. Test, learn, adapt sets
out all the steps necessary to set up an RCT.
Available at www.cabinetoffice.gov.uk
A LIDDELL GONG
Scottish Drugs Forum (SDF) director David
Liddell has been awarded an OBE. Active in the
substance misuse and homelessness sector
for more than 30 years, he co-founded the SDF
in 1986 in response to Scotland’s growing
drugs problem. The award was ‘testament to
the effor ts of the incredibly gifted and
committed people – professionals, drug users
and their families – we have worked alongside
for many years and who continue to strive to
make better the lives of some of the most
stigmatised, marginalised and deprived
members of our society,’ he said.
NEW CQC HEAD
The Department of Health’s director general of
social care, local government and care
par tnerships, David Behan, has been
announced as the new chief executive of the
Care Quality Commission (CQC). A former chief
inspector of the Commission for Social Care
Inspection, he has worked in the health and
social care sector since 1978. ‘I am delighted
to have been given this opportunity to lead the
organisation that takes action where services
are poor and unsafe, whilst providing
assurance that our health and care services
achieve quality and outcomes for people which
are amongst the best in the world,’ he said.
Previous CQC head Cynthia Bower announced
her resignation earlier this year following a
number of high-profile controversies for the
regulator (DDN, March, page 5).
Opium production in Afghanistan has ‘rebounded’
to its previously high levels, according to the United
Nations Office on Drugs and Crime’s (UNODC)
2012
world drug report
. Despite this, opiate use in Europe
and North America appears to be declining, says
the report, although this is ‘offset’ by the continued
rise in synthetic drug production.
UNODC estimates that around 230m people used an
illicit drug in 2010, with the number of illicit drug users
worldwide likely to increase by another 65m by 2050 –
driven largely by population growth and increasing
urbanisation in the developing world – and potentially
reaching 300m by the end of the century. Overall, global
patterns of use and health consequences have largely
remained stable, says the document, which estimates that
problem drug users – primarily those dependent on heroin
or cocaine – number around 27m worldwide,
approximately 0.6 per cent of the world’s population.
However, clear data for Africa and Asia – which jointly
account for around 70 per cent of opiate users – is hard to
come by, raising the possibility of ‘increasing but
undetected’ use. The report estimates that there were
between 99,000 and 253,000 drug-related deaths in 2010,
including overdose, blood-borne viruses and suicide.
Afghan opium production in 2010 was severely affected
by plant disease, which wiped out almost half of crop yields
and led to high prices, while the total world area under
cocoa bush cultivation fell by 18 per cent in the three years
to 2010, mainly as a result of declining production in
Colombia, which primarily supplies the US. European
cocaine comes mainly from Bolivia and Peru.
Cannabis remains the world’s most widely used illegal
drug, with between 119m and 224m estimated users
worldwide, although in some countries, cannabis aside,
there is more non-medical use of prescription
pharmaceuticals than of controlled substances. A
shortage of heroin in some countries has also led to more
use of dangerous codeine-based substitutes such as
home-made desomorphine, or ‘krokodil’, which can pose
‘serious health problems even with limited use’.
‘Heroin, cocaine and other drugs continue to kill around
200,000 people a year, shattering families and bringing
misery to thousands of other people, insecurity and the
spread of HIV,’ said UNODC executive director Yury Fedotov.
‘The public health aspects of prevention, treatment,
rehabilitation, and reintegration all have to be recognised as
key elements in the global strategy to reduce drug demand.’
Despite ‘unintended consequences’ such as the
growth of an organised crime-dominated black market, the
drug control system ‘appears to have had the desirable
long-term effect of containing the expansion of the drug
problem and of limiting the spread of illicit drug use and
addiction,’ says the report.
The
Alternative world drug report
, however, launched
to coincide with UNODC’s document by collaborative
project Count the Costs – whose supporter organisations
include INPUD, Release, UKHRA and Transform – states
that it is ‘unacceptable that neither the UN or its member
governments’ have ‘meaningfully assessed’ the
unintended consequences of an enforcement-based
approach, which also include diversion of funding from
health and stigmatisation of drug users.
A new report from Harm Reduction International (HRI),
meanwhile, states that millions of dollars in international
funding for drug enforcement is going to countries with
‘extremely poor’ human rights records that are not being
held accountable for activities like arbitrary detention,
forced labour and executions.
Partners in crime
, which tracks enforcement funding from
donor states – often via UNODC – found that countries
opposed to the death penalty, including the UK, Germany and
France, have funded a UNODC border control project and
helped to boost intelligence-led investigations in Iran, which
executed more than 1,000 people for drug offences between
2010 and 2011 – more than three the times the number in the
previous two years. The report also describes funding projects
for detention centres in south east Asia where inmates can be
confined for years, often without trial, as well as abused and
forced to work for private companies.
‘In some cases donor states have effectively paid for
the capture of their own citizens only for them to be later
sentenced to death,’ said co-author and HRI deputy
director Damon Barrett. ‘There are no safeguards – when
the UN acts as a conduit for these funds, a further layer of
bureaucracy separates the money from the abuses.
Instead of the UN being a guardian of human rights it
becomes more like a laundry mechanism, washing the
funds of any form of accountability.’
2012 world drug report at www.unodc.org
The alternative world drug report: counting the costs of
the war on drugs at www.countthecosts.org
Partners in crime – international funding for drug control
and gross violations of human rights at www.ihra.net
4 |
drinkanddrugsnews
| July 2012
www.drinkanddrugsnews.com
300m drug users world-
wide by ‘end of century’
News |
Round-up
NEWS IN
BRIEF
Yury Fedotov: ‘The public health aspects of
prevention, treatment, rehabilitation, and
reintegration all have to be recognised as key
elements in the global strategy to reduce
drug demand.’