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Editorial: Watching Canada’s experiment with legal cannabis

Diane Kelsall

CMAJ October 15, 2018 190 (41) E1218; DOI: https://doi.org/10.1503/cmaj.181287 

On Oct. 17, 2018, the government of Canada will launch a national, uncontrolled experiment in which the profits of cannabis producers and tax revenues are squarely pitched against the health of Canadians. When Bill C-45 comes into force in mid-October, access to recreational marijuana will be legal 1 making Canada one of a handful of countries to legalize recreational use of the drug. Given the known and unknown health hazards of cannabis,2,3 any increase in use of recreational cannabis after legalization, whether by adults or youth, should be viewed as a failure of this legislation. The government of Canada should commit to amending the act if cannabis use rises.

http://www.cmaj.ca/content/190/41/E1218

The HCV care continuum does not end with cure: A call to arms for the prevention of reinfection.

Falade-Nwulia O, Sulkowski M.

J Hepatol. 2017 Feb;66(2):267-269. doi: 10.1016/j.jhep.2016.10.027. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472097/

Pro-inflammatory effects of e-cigarette vapour condensate on human alveolar macrophages

Scott A, Lugg ST, Aldridge K, et al

Thorax Published Online First: 13 August 2018. doi: 10.1136/thoraxjnl-2018-211663 

https://thorax.bmj.com/content/early/2018/08/18/thoraxjnl-2018-211663

UK. Pregabalin and gabapentin to be controlled as class C drugs 

New controls over prescription drugs pregabalin and gabapentin following rising fatalities. (Home Office and Victoria Atkins MP, UK, 15.10.2018)

https://www.gov.uk/government/news/pregabalin-and-gabapentin-to-be-controlled-as-class-c-drugs

Naloxone - Training Video (injection)

(Drugreporter, Ungarn, 08.10.2018, Video, 08:29)

https://www.youtube.com/watch?v=2sep2lwYndo&feature

UK. Pregabalin and gabapentin to be controlled as class C drugs 

New controls over prescription drugs pregabalin and gabapentin following rising fatalities. (Home Office and Victoria Atkins MP, UK, 15.10.2018)

https://www.gov.uk/government/news/pregabalin-and-gabapentin-to-be-controlled-as-class-c-drugs

Nebenwirkungen online melden

Hier können Sie Nebenwirkungen (unerwünschte Wirkungen von Arzneimitteln und Impfstoffen) melden. Sie können für sich oder im Namen einer anderen Person melden. Die Meldung für andere Personen ist möglich, wenn Sie diese betreuen, z.B.im Namen Ihres Kindes oder eines Angehörigen. Die Meldung geht direkt an die zuständigen Bundesoberbehörden. (BfArM / Paul-Ehrlich-Institut, September 2018)

https://nebenwirkungen.pei.de/nw/DE/home/home_node.html

UK. Consultation outcome: Pregabalin and gabapentin: proposal to schedule under the Misuse of Drugs Regulations 2001 

Detail of outcome

On 13 November 2017, the Home Office asked for views on options whether, and how, to schedule pregabalin and gabapentin under the Misuse of Drugs Regulations 2001. This followed the recommendation by the Advisory Council on the Misuse of Drugs (ACMD) that pregabalin and gabapentin should be controlled as Class C drugs under the Misuse of Drugs Act 1971 (‘the 1971 Act’) and placed in Schedule 3 to the Misuse of Drugs Regulations 2001. The consultation lasted until 22 January 2018 and was UK-wide.

Responses were accepted from members of the public, healthcare professionals, institutions, all sectors within the supply chain including the pharmaceutical industry, wholesalers, and community pharmacies in the UK.

The Home Office is grateful for the views of those who responded to the consultation. On balance, the government is of the view that option 2 – to schedule the drugs under Schedule 3 to the 2001 Regulations but without the safe custody requirements – provides appropriate and necessary safeguards while ensuring that there are not unduly onerous storage requirements for pharmacists, wholesalers and others. (Home Office, UK, 15.10.2018)

https://www.gov.uk/government/consultations/pregabalin-and-gabapentin-proposal-to-schedule-under-the-misuse-of-drugs-regulations-2001

Australien. Australian Medical Association would like to see pill-testing at festivals

Dr Bartone (President of the Australian Medical Association , Anm.) called for pill testing trials after two young people died and three more were hospitalisedfollowing suspected drug overdoses at a recent Sydney music festival.

Dr Bartone said innovative approaches, under controlled circumstances, are needed to prevent future tragedies.

“We can’t continue to just use a law enforcement solution.” (AMA - Australian Medical Association, 27.09.2018)

https://ama.com.au/ausmed/ama-would-see-pill-testing-festivals

UK. Consultation outcome: Pregabalin and gabapentin: proposal to schedule under the Misuse of Drugs Regulations 2001 

Detail of outcome

On 13 November 2017, the Home Office asked for views on options whether, and how, to schedule pregabalin and gabapentin under the Misuse of Drugs Regulations 2001. This followed the recommendation by the Advisory Council on the Misuse of Drugs (ACMD) that pregabalin and gabapentin should be controlled as Class C drugs under the Misuse of Drugs Act 1971 (‘the 1971 Act’) and placed in Schedule 3 to the Misuse of Drugs Regulations 2001. The consultation lasted until 22 January 2018 and was UK-wide.

Responses were accepted from members of the public, healthcare professionals, institutions, all sectors within the supply chain including the pharmaceutical industry, wholesalers, and community pharmacies in the UK.

The Home Office is grateful for the views of those who responded to the consultation. On balance, the government is of the view that option 2 – to schedule the drugs under Schedule 3 to the 2001 Regulations but without the safe custody requirements – provides appropriate and necessary safeguards while ensuring that there are not unduly onerous storage requirements for pharmacists, wholesalers and others. (Home Office, UK, 15.10.2018)

https://www.gov.uk/government/consultations/pregabalin-and-gabapentin-proposal-to-schedule-under-the-misuse-of-drugs-regulations-2001

The abuse potential of medical psilocybin according to the 8 factors of the Controlled Substances Act.

Johnson MW, Griffiths RR, Hendricks PS, Henningfield JE.

Neuropharmacology. 2018 Jun 5. pii: S0028-3908(18)30229-6. doi: 10.1016/j.neuropharm.2018.05.012.

https://www.sciencedirect.com/science/article/pii/S0028390818302296?via%3Dihub

Cannabis use and driving-related performance in young recreational users: a within-subject randomized clinical trial 

Tatiana Ogourtsova, Maja Kalaba, Isabelle Gelinas, Nicol Korner-Bitensky and Mark A. Ware

Canadian Medical Association Journal- CMAJ Open - cmajo 6:E453-E462; published online October 14, 2018, doi:10.9778/cmajo.20180164

http://cmajopen.ca/content/6/4/E453.full

Trends and Outcomes Associated With Using Long-Acting Opioids During Delivery Hospitalizations.

Duffy CR, Wright JD, Landau R, Mourad MJ, Siddiq Z, Kern-Goldberger AR, D'Alton ME, Friedman AM.

Obstet Gynecol. 2018 Oct;132(4):937-947. doi: 10.1097/AOG.0000000000002861.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/30204694

Informationen zur Tabakkontrolle

(DKFZ – Deutsches Krebsforschungszentrum, 2018)

https://www.dkfz.de/de/tabakkontrolle/Informationen_zur_Tabakontrolle.html

Prenatal Treatment and Outcomes of Women With Opioid Use Disorder.

Brogly SB, Saia KE, Werler MM, Regan E, Hernández-Díaz S.

Obstet Gynecol. 2018 Oct;132(4):916-922. doi: 10.1097/AOG.0000000000002881.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/30204704

Study identifies effective ketamine doses for treatment-resistant depression 

A study led by Massachusetts General Hospital (MGH) investigators identifies two subanesthetic dosage levels of the anesthetic drug ketamine that appear to provide significant symptom relief to patients with treatment-resistant depression. In the October 2018 issue of Molecular Psychiatrythey describe finding that single intravenous doses of 0.5 mg/kg and 1.0 mg/kg were more effective than an active placebo in reducing depression symptoms over a three-day period. Two lower dosage levels that were tested did not provide significant symptom relief, although some improvement was noted with the lowest 0.1 mg/kg dose. 

"Treatment resistance in depression is a major issue, with more than half of patients not responding adequately to standard, appropriate antidepressant treatment," says Maurizio Fava, MD, executive director of the Clinical Trials Network & Institute in the MGH Department of Psychiatry and senior author of the Molecular Psychiatrypaper. "There are only a few approved therapies that can help some patients with treatment-resistant depression, so we critically need more options to choose from." (Massachusetts General Hospital, USA, 11.10.2018)

https://www.eurekalert.org/pub_releases/2018-10/mgh-sie101118.php

Methadone Metabolism And Drug-Drug Interactions: In Vitro And In Vivo Literature Review.

Volpe DA, Xu Y, Sahajwalla CG, Younis IR, Patel V.

J Pharm Sci. 2018 Sep 8. pii: S0022-3549(18)30526-4. doi: 10.1016/j.xphs.2018.08.025.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/30205091

Outcome Differences in Neonates Exposed In-Utero to Opioids Managed in the NICU Versus Pediatric Floor.

Lembeck AL, Tuttle D, Locke R, Lawler L, Jimenez P, Mackley A, Paul DA.

J Addict Med. 2018 Sep 24. doi: 10.1097/ADM.0000000000000455.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/30252690

Methadone maintenance treatment among patients exposed to illicit fentanyl in Rhode Island: Safety, dose, retention, and relapse at 6 months.

Stone AC, Carroll JJ, Rich JD, Green TC.

Drug Alcohol Depend. 2018 Aug 25;192:94-97. doi: 10.1016/j.drugalcdep.2018.07.019.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/30243145

Persistent feeding difficulties among infants with fetal opioid exposure: mechanisms and clinical reasoning.

Brandon J. Hart, Sreekanth Viswanathan & Sudarshan R. Jadcherla (2018) 

The Journal of Maternal-Fetal & Neonatal Medicine, DOI: 10.1080/14767058.2018.1469614 

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/30198364

Drug injection within prison in Kyrgyzstan: elevated HIV risk and implications for scaling up opioid agonist treatments.

Azbel L, Wegman MP, Polonsky M, Bachireddy C, Meyer J, Shumskaya N, Kurmanalieva A, Dvoryak S, Altice FL.

Int J Prison Health. 2018 Sep 10;14(3):175-187. doi: 10.1108/IJPH-03-2017-0016.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/30274558

Impact of psychiatric medication co-exposure on Neonatal Abstinence Syndrome severity.

Wachman EM, Warden AH, Thomas Z, Thomas-Lewis JA, Shrestha H, Nikita FNU, Shaw D, Saia K, Schiff DM.

Drug Alcohol Depend. 2018 Sep 1;192:45-50. doi: 10.1016/j.drugalcdep.2018.07.024. 

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/30205307

HCV seroconversion in a cohort of people who use drugs followed in a mobile harm reduction unit in Madrid: Breaking barriers for HCV elimination.

Valencia La Rosa J, Ryan P, Alvaro-Meca A, Troya J, Cuevas G, Gutiérrez J, et al. (2018) 

PLoS ONE 13(10): e0204795. doi.org/10.1371/journal.pone.0204795

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204795

Screening Pregnant Women and Their Neonates for Illicit Drug Use: Consideration of the Integrated Technical, Medical, Ethical, Legal, and Social Issues.

Price HR, Collier AC, Wright TE.

Front Pharmacol. 2018 Aug 28;9:961. doi: 10.3389/fphar.2018.00961. eCollection 2018. Review.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6120972/

Q-T interval prolongation in cirrhosis: Relationship and severity.

Hajiaghamohammadi AA, Daee MM, Zargar A, Ahmadi-Gooraji S, Rahban A, Attaran F.

Caspian J Intern Med. 2018 Summer;9(3):239-243. doi: 10.22088/cjim.9.3.239.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6121343/

Changing student attitudes and perceptions toward opioid use disorder.

Countey H, Steinbronn C, Grady SE.

Ment Health Clin. 2018 Aug 30;8(5):222-226. doi: 10.9740/mhc.2018.09.222. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125113/

Triphasic Waves and Encephalopathy in the Setting of Pregabalin Toxicity.

Anand P, Kaplan PW.

J Clin Neurophysiol. 2018 Sep 11. doi: 10.1097/WNP.0000000000000511. 

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/30222638

Perceived Stigma in People Living With HIV in Qom.

Pourmarzi D, Khoramirad A, Gaeeni M.

J Family Reprod Health. 2017 Dec;11(4):202-210.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6168756/

Gabapentin for Off-Label Use: Evidence-Based or Cause for Concern?

Peckham AM, Evoy KE, Ochs L, Covvey JR.

Subst Abuse. 2018 Sep 23;12:1178221818801311. doi: 10.1177/1178221818801311. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153543/

Research shows club drug GHB associated with brain and cognitive changes

Scientists have discovered that regular use of the party drug GHB, and especially unconsciousness following GHB use, is associated with brain changes including negative effects on long-term memory, working memory, IQ, and higher levels of stress and anxiety. This work is presented at the ECNP conference in Barcelona, following partial peer-review publication. (European College of Neuropsychopharmacology, 08.10.2018)

https://medicalxpress.com/news/2018-10-club-drug-ghb-brain-cognitive.html

Contingency management for tobacco smoking during opioid addiction treatment: a randomised pilot study.

Ainscough TS, Brose LS, Strang J, McNeill A.

BMJ Open. 2017 Sep 1;7(9):e017467. doi: 10.1136/bmjopen-2017-017467.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5589007/

Preventing overdose deaths in Europe

Introduction: More than 9 000 lives were reported to be lost to drug overdoses in Europe (28 EU Member States, Turkey and Norway) in 2016, the latest reporting year, and this is an underestimate. Reducing drug-related deaths therefore remains a major challenge for public health policy. This analysis describes some of the factors that increase the risk of fatal and non-fatal overdoses and a number of interventions developed to prevent these events. (EMCDDA, Lissabon, 03.10.2018)

http://www.emcdda.europa.eu/topics/pods/preventing-overdose-deaths

Patterns and sociodemographic characteristics of substance abuse in Al Qassim, Saudi Arabia: a retrospective study at a psychiatric rehabilitation center.

Ibrahim Y, Hussain SM, Alnasser S, Almohandes H, Sarhandi I.

Ann Saudi Med. 2018 Sep-Oct;38(5):319-325. doi: 10.5144/0256-4947.2018.319.

http://www.annsaudimed.net/files.php?force&file=PDF/2018_0214_OA_801828409.pdf

Nonaddictive drug compound could replace opioids for chronic pain sufferers

A new nonaddictive drug compound discovered by Purdue University researchers could lead to the treatment of chronic pain without the need to rely on opioids, just as a bipartisan package of bills moves through the U.S. House and Senate to battle the nation's opioid epidemic. (Puerdue University, USA, 05.10.2018)

https://medicalxpress.com/news/2018-10-nonaddictive-drug-compound-opioids-chronic.html

Reduced volumes of the external and internal globus pallidus in male heroin addicts: a postmortem study.

Müller UJ, Mawrin C, Frodl T, Dobrowolny H, Busse S, Bernstein HG, Bogerts B, Truebner K, Steiner J.

Eur Arch Psychiatry Clin Neurosci. 2018 Sep 1. doi: 10.1007/s00406-018-0939-6. 

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/30173319

ADDICTION, Volume 113, Issue 11, Pages: 1965-2152, November 2018

https://onlinelibrary.wiley.com/toc/13600443/2018/113/11