Children talk about living with problem drug and alcohol use.

‘She knew not to go near me in the morning ’til I had my foil, then ‘mummy would play’. In the mornings the sickness was the worst … I’d just be telling her to get away. Once I had the gear [drugs] into me I’d be the best mother on the earth.’ These words were spoken by a mother of a four-year-old girl interviewed as part of a research study in Ireland published last year. It is quoted in a new EMCDDA thematic paper on European children’s experiences and perceptions of drug and alcohol issues, published to mark International Children’s Day on 1 June.1 The purpose of the paper is to enhance drug policies and interventions for children and young people by highlighting children’s and young people’s perspectives and their needs. Comprising quotations selected from research studies and governmental and non-governmental reports in 14 EU countries, including Ireland, the thematic paper gives voice to four main issues: o living with harmful parental drinking or drug taking (neglect, violence, abuse, stigma or shame), o being separated from parents and looked after by relatives, foster carers or institutions, o experiences and perceptions of alcohol and drug consumption, and o experiences and perceptions of interventions to address alcohol and drug consumption. The authors consulted three Irish sources2 and used quotations from them to highlight issues associated with living with parents engaging in harmful substance use, and children’s and young people’s own experience of substance use. For example, an Irish child care worker is quoted on the effect of living with a parent engaging in harmful substance use: ‘They become adults very young; they’re like the carer to their parent. They actually know, you can see it in them, that they know when their parent isn’t well … it seems to be a constant worry.’ Looking back, a young Irish woman who had been abused by a member of her extended family during her childhood recalled her teenage years: ‘I turned 15 that January, I just went wild then you know after that like. I did have problems at home … Like when I was growing up, that would have been the start of it, but then I just used to go wild you know with the problems and the issues that I did have, I’d end up going drinking and taking drugs, you know, and not having any, no self-respect or anything for myself.’ In concluding the report, the authors make several observations: o given the complexity and diversity of children’s experiences, correspondingly flexible and holistic interventions need to be developed; o more qualitative drug and alcohol research is needed if Europe is to understand the real needs of children and young people and to implement fully the United Nations Convention on the Rights of the Child (UNCRC); o large numbers of parents with alcohol problems may generate more problems overall for children in the EU than the smaller number of children affected by parents with illicit drug problems; o the quotations highlight children’s extreme vulnerability, and yet also their desire and capacity to ‘cope’ with difficulties and to make rational judgements about their own situation based on objective information and personal experience; o while quality care and other drug and alcohol interventions are needed to grant children in the EU their right to ‘harmonious development and protection from harmful influences’, abuse, neglect and exploitation, the root cause for many children facing both drug and alcohol problems are poverty and social exclusion. 1. Olszewski D, Burkhart G and Bo A (2010) Children’s voices: experiences and perceptions of European children on drug and alcohol issues. Thematic paper. Luxembourg: The Publications Office of the European Union. Available at www.emcdda.europa.eu 2. The three Irish research studies used in the EMCDDA thematic paper were Bates T, Illback RJ, Scanlan F and Carroll L (2009) Somewhere to turn to, someone to talk to. Dublin: Headstrong – The National Centre for Youth Mental Health; Mayock P (2000) Choosers or losers: influences on young people’s choices about drugs in inner-city Dublin. Dublin: Children’s Research Centre, TCD; Mayock P and Carr N (2008) Not just homelessness … A study of ‘out of home’ young people in Cork city. Dublin: Children’s Research Centre, TCD. These three research reports are available at www.drugsandalcohol.i

Drugnet Ireland 39.

Contents: 1 New HRB trends paper on alcohol-related deaths 4 Standardising drinking survey methodologies 4 Report on incidence of alcohol-related brain injury 5 Cost of alcohol-attributable hospitalisations in Ireland 5 Harmful use of alcohol can result in substantial economic costs 6 Cochrane review of interventions for problem alcohol use in illicit drug users 7 Drugnet digest 8 Merging policies on psychoactive substances 9 Report on new psychoactive substances and the outlets supplying them 10 Acute liver failure following recreational use of psychotropic ‘head shop’ compounds 11 Report on innovative project in response to benzodiazepine use 12 Non-fatal overdoses and drug-related emergencies 15 Substance use among thirdlevel students in Limerick 16 Exploring illicit drug use in a Traveller community 17 UK expert group reports on recovery-oriented treatment 18 Updated Cochrane review of heroin maintenance treatment 20 Keltoi residential rehabilitation programme: outcome study 21 Drugs and crime data 23 Courts Service annual report 2010 24 National Registry of Deliberate Self Harm annual report 2010 24 National Poisons Information Centre (NPIC) 2010 report 25 Annual review of the Tallaght Rehabilitation Project 26 From Drugnet Europe 27 In brief 28 Southern Regional Drugs Task Force annual report 2010 28 Premier screening of RADE film, Birthday 29 Recent publications 31 Upcoming event

Producing the 'problem' of new psychoactive substances (NPS) in English prisons

Background: There has been a significant change in the types of substances consumed within English prison settings in the last eight years. There have been particular concerns regarding the acceleration in the use and availability of New Psychoactive Substances (NPS), mainly synthetic cannabinoids. Although NPS were identified as a ‘problem’ in prisons in 2011, government responses emerged only in 2015. As yet, there is no overarching policy document or strategy for dealing with NPS. This paper analyses the various strands of the response to NPS in prisons published from January 2015 to December 2016. Methods: Drawing on Bacchi’s ‘What’s the problem represented to be’ framework, the ways in which the NPS ‘problem’ in prisons has been represented is analysed through a number of related policy texts including press releases, new legislative and regulatory measures, government documents and training package. Results: From the various measures introduced to deal with the ‘problem’, NPS use is produced primarily as a law, order and control ‘problem’ requiring regulation, penalties and control, rather than a ‘demand problem’ calling for prevention, education, treatment and harm reduction or a ‘regime problem’ demanding greater emphasis and resources for purposeful activities such as education, training and work opportunities. This problematisation of drug use in prisons has a history dating back to the 1995 prison drug strategy and has become entrenched and reproduced within policy development over time. Conclusion: The law, order, and control problematization blames the volatility of the substances and the individual prisoners who use them as key factors contributing to the current prison crisis, rather than as consequences of the wider practices, cultures, contexts, and conditions. Multiple representations of the problem of NPS in prisons are needed in order to address the regime and structural issues which lead those imprisoned to use substances

New psychoactive substances in England: a review of the evidence.

Aims and approach: This report builds on chapter 2 of the report of the expert panel review, and provides an overview of the current available evidence on New Psychoactive Substances (NPS)1. Conclusion: • NPS is a new and developing area of study. Many innovative methodologies are being used and conventions surrounding how best to research NPS are still being established. • There is good evidence on the identification of new NPS, and evidence on the use of NPS is also well established, albeit with some limitations. • However, there are gaps in the evidence on: • the prevalence of use of NPS, and a total measure of NPS use; • the use of NPS among subgroups other than NTE participants; • the long-term health harms of NPS use; • acute health harms of NPS use; • the extent to which NPS use drives social harms; • the impact and effectiveness of legislation; • the motivations for the use of NPS other than mephedrone; • the exact factors and mechanisms that affect displacement and supplementation; and • the extent to which individuals within social groups purchase online and then distribute within their social group. This review has had a significant legislative focus. We also recognise the importance of continuing to focus on our wider, balanced approach to ensure that we invest in all strands of our Drug Strategy. This is why we asked the Panel to also consider our wider approach to prevention, treatment and information sharing

Towards a safer drug policy: challenges and opportunities arising from ‘legal highs’.

The All-Party Parliamentary Group for Drug Policy Reform launches the Report of its Inquiry into New Psychoactive Substances ('legal highs') on the 14th January 2013. The Inquiry began in 2011 and was initiated in response to the rapid development of new and unknown psychoactive substances and to examine whether alternative forms of regulation could prove more effective in minimising the potential harms of such substances than the current system of drug control. The Group has received evidence from the Chairman of the Advisory Council for the Misuse of Drugs, Association of Chief Police Officers, the Home Office, The Trading Standards Institute, the Independent Scientific Committee on Drugs – in all, 31 government departments, organisations and experts. It has also examined in detail initiatives from abroad which seek to regulate new substances particular the system of regulation for 'low risk' substances being planned in New Zealand. The Report recommends that there is a system of regulated supply of those new drugs which are the least harmful and further recomments the decriminalising the possession and use of all drugs. The report concludes that a review of the Misuse of Drugs Act 1971 is now necessary. The Report also recommends that politics be taken out of decisions on the classification of drugs, as it has been with respect to the setting of interest rates by the Monetary Policy Committee, and in determining which pharmaceutical drugs may be provided through the NHS. All these issues involve scientific judgements and are too sensitive for politicians to handle directly

Recent Changes in Drug Abuse Scenario: The Novel Psychoactive Substances (NPS) Phenomenon

copyright 2019 by the authors. Articles in this book are Open Access and distributed under the Creative Commons Attribution (CC BY) license, which allows users to download, copy and build upon published articles, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. The book as a whole is distributed by MDPI under the terms and conditions of the Creative Commons license CC BY-NC-ND.Final Published versio

Understanding the patterns of use, motives, and harms of New Psychoactive Substances in Scotland.

New or Novel Psychoactive Substances (NPS) imitate the effects of illegal drugs and are commonly (although misleadingly) referred to as „legal highs‟. Over the last decade the use of NPS has expanded in Scotland. Current data sources and anecdotal reports have identified a number of vulnerable or potentially at risk groups. This report presents results of mixed methods research on NPS use among five key target populations: vulnerable young people, people in contact with mental health services, people affected by homelessness, people who inject drugs (PWID) and men who have sex with men (MSM)

Evidence for public health on novel psychoactive substance use: a mixed-methods study

Background: Novel psychoactive substances (NPSs) contribute to the public health impact of substance misuse. This report provides research evidence addressing 11 research questions related to NPSs, covering types, patterns and settings of use; supply sources; and implications for policy and practice. Methods: The study used a conceptually linked three-phase mixed-methods design with a shared conceptual framework based on multiple-context risk and protective factors. Phase 1 was a quantitative phase involving secondary data analysis of the longitudinal Belfast Youth Development Study (BYDS), a latent class analysis using the 2039 BYDS participants. Phase 2 was an extensive qualitative analysis via narrative interviews with participants, sampled from BYDS, drug/alcohol services and prisons, to explore NPS use trajectories. Phase 3 was the final quantitative phase; generalisability of the shared risk factor part of the model was tested using the manual three-step approach to examine risk factors associated with latent class membership. The quantitative and qualitative analyses were integrated, thus allowing emerging findings to be further explored. Results: The data suggest that NPSs have a place within a range of polydrug use trajectories. Models showed no distinctive NPS class, with no clear evidence of differential risks for NPS use compared with the use of other substances. From the qualitative analysis, a taxonomy of groups was derived that explored how and where NPSs featured in a range of trajectories. This taxonomy was used to structure the analysis of factors linked to use within a risk and protective framework. Drivers for use were considered alongside knowledge, perceptions and experience of harms. Suggestions about how interventions could best respond to the various patterns of use – with special consideration of synthetic cannabinoids (SCs), including how they relate to the use of heroin and the potential for NPSs to operate as a ‘snare’ to more problem use – were also presented. Limitations: The study was conducted during 2016/17; generalisability beyond this sample and time point is limited. The level of missing data for some of the BYDS analysis was a limitation, as was the fact that the BYDS data were collected in 2011, so in a different context from the data collected during the narrative interviews. The Psychoactive Substances Act 2016 (Great Britain. Psychoactive Substances Act 2016. London: The Stationery Office; 2016) came into force during qualitative fieldwork and, although not particularly influential in this study, may be influential in future work. It is acknowledged that many of the data related to SCs and mephedrone. Although drug use was measured by self-report, the strength of rapport within interviews, reflective diaries and methodological acceptability checks helped to mitigate self-report bias. Conclusions: NPSs continue to present significant challenges for legislation and monitoring, researching and developing interventions. Understanding of usage patterns remains poor, with most information based on populations and settings where problems have already occurred. This research contributes to the evidence base by providing much needed further empirical data on the lived experiences of NPS users across a range of settings. In the light of these data, implications for policy and practice are discussed. Future work: Future research must generate improved epidemiological data on the extent, patterns and motivations for use longitudinally. The uniqueness of the information concerning SC use points to a specific set of findings not evidenced in other literature (e.g. intensity of SC withdrawal). Future research should focus on the symbiotic link between SC and heroin use