Abstract: This publication is the first in a series dedicated to prevalent illicit synthetic stimulant drugs, also known as amphetamine-type stimulants (ATS). The ATS category is made up of two groups of substances. This study focuses on the supply and use of methamphetamine in Europe, set in a global context. Methamphetamine is probably the most widely consumed synthetic stimulant in the world. In many countries across the globe it is reportedly the second most prevalent illicit drug after cannabis.

Abstract: This practical guide on “Opioid Substitution Treatment in Custodial Settings” is to support prison doctors, contracted doctors, prison health care workers, prison administration, NGOs and others in delivering or supporting substitution treatment to opioid dependent prisoners. Drug dependence has to be treated as a severe disease and everyone has a part to play to ensure the best treatment for prisoners and also to ensure that drug related harm is kept as low as possible. Applying the recommendations in this guide will contribute to a healthier prison for prisoners with drug dependence with satisfying roles for staff members and a marked reduction in the harm that drug use in prisons can create.

Abstract: This paper presents the findings of the first ever Irish follow-up study to establish the effectiveness of syringe exchanges as a harm reduction strategy in the context of public health. The study was conducted in collaboration with 370 injecting drug users who attended the Merchant’s Quay Project’s Health Promotion Unit between May 1st 1997 and October 31st 1998. Data was collected from respondents by means of a structured interview at first visit and three-months after initial contact. Evidence from the study demonstrates that syringe exchanges play an important contributing role in significantly reducing the numbers reporting both the use of heroin as a primary drug (n=41; McNemar x2=10.1;p<0.01), and its frequency of use (n=70; McNemar x2=4.13;p<0.05) at follow-up. Moreover, there were significant reductions in the reported borrowing (n=60; McNemar x2=10.1;p<0.01) and lending (n=42: McNemar x2=7.9;p<0.01) of used injecting equipment. There was however no significant change in the reported sharing of injecting paraphernalia or in levels of reported condom use. The results of this study illustrate that low threshold services such as the Health Promotion Unit have the ability to attract injecting drug users not in contact with other drug treatment services. Furthermore, this type of service has been shown to be effective in maintaining contact with injecting drug users and promoting safer drug use among attendees. Even though the distribution of sterile injecting equipment reduces the situational sharing, this is hampered by the limited availability of sterile injecting equipment in Dublin. There is a need to continue to develop strategies to prevent HIV and hepatitis C transmission. One such approach would be to develop effective outreach as a means of reaching greater numbers of drug users earlier in their injecting histories. Other areas for future HIV and HCV prevention include discouraging the transition from smoking to injecting, and among those who inject, encouraging further reductions in sharing, sustaining risk reduction over time, and encouraging the adoption of safer sexual behaviour.

Abstract: This paper offers a perspective on the research evidence for minimum pricing for alcohol as a public health measure from a country where this policy idea originated. It looks at the current data on the negative impacts from heavy drinking in the UK, framing the need for an effective policy response, and gives an overview of the evidence to support minimum unit pricing (MUP) as a means of addressing the issue. In presenting the evidence to support MUP, this paper addresses some common criticisms of the policy, including those that have originated from alcohol industry sources. It concludes that policymakers can be confident that substantial total net health and social benefits will follow if MUP is introduced in the UK.

Abstract: This paper focuses on the often neglected set of individuals who engage in both the use and selling of illicit drugs; user-dealers. It reports the findings of a qualitative study conducted among cocaine dealers operating in Parisian techno parties; highlighting the routes into and out of using-dealing, the particular risks faced by this population, and the need for health and criminal justice agencies to better understand and address these issues.