Estimating the National and Local Prevalence of Problem Drug Misuse in Scotland

This report outlines the results of the third national study funded by the Scottish Government to provide estimates of the prevalence of problem drug misuse in Scotland. The estimates refer to the calendar year 2006

The Value of Providing Smokers with Free E-Cigarettes: Smoking Reduction and Cessation Associated with the Three-Month Provision to Smokers of a Refillable Tank-Style E-Cigarette

Despite the uptake of tobacco smoking declining in the United Kingdom (UK), smoking is still the leading cause of preventable poor health and premature death. While improved approaches to smoking cessation are necessary, encouraging and assisting smokers to switch by using substantially less toxic non-tobacco nicotine products may be a possible option. To date, few studies have investigated the rates of smoking cessation and smoking reduction that are associated with the provision of free electronic-cigarettes (e-cigarettes) to smokers. In this exploratory study, the Blu Pro e-cigarette was given to a convenience sample of adult smokers (n = 72) to assist them in reducing and quitting over a 90-day period. The rates of smoking abstinence and daily smoking patterns were assessed at baseline, 30 days, 60 days, and 90 days. The response rate was 87%. After 90 days, the complete abstinence rate was 36.5%, up from 0% at baseline. The frequency of daily smoking reduced from 88.7% to 17.5% (p < 0.001), and the median consumption of cigarettes/day reduced from 15 to five (p < 0.001). The median number of days per month that participants smoked also reduced from 30 to 13 after 90 days (p < 0.001). On the basis of these results, there may be value in smoking cessation services and other services ensuring that smokers are provided with e-cigarettes at zero or minimal costs for at least a short period of time

Contribution of problem drug users’ deaths to excess mortality in Scotland: secondary analysis of cohort study

Objectives To examine the “Scottish effect”—namely, the growing divergence between mortality in Scotland and England that is not explained by national differences in levels of deprivation—and, more specifically, to examine the extent to which the Scottish effect is explained by cross national differences in the prevalence of problem drug use

Conspicuous by their abstinence: the limited engagement of heroin users in English and Welsh Drug Recovery Wings

Background In recent years, an abstinence-focused, ‘recovery’ agenda has emerged in UK drug policy, largely in response to the perception that many opioid users had been ‘parked indefinitely’ on Opioid Substitution Therapy (OST). The introduction of ten pilot ‘Drug Recovery Wings’ (DRWs) in 2011 represents the application of this recovery agenda to prisons. This paper describes the DRWs’ operational models, the place of opiate dependent prisoners within them, and the challenges of delivering ‘recovery’ in prison. Methods In 2013, the implementation and operational models of all ten pilot DRWs were rapidly assessed. Up to three days were spent in each DRW, undertaking semi-structured interviews with a sample of 94 DRW staff and 102 DRW residents. Interviews were fully transcribed, and coded using grounded theory. Findings from the nine adult prisons are presented here. Results Four types of DRW were identified, distinguished by their size and selection criteria. Strikingly, no mid- or large-sized units regularly supported OST recipients through detoxification. Type A were large units whose residents were mostly on OST with long criminal records and few social or personal resources. Detoxification was rare, and medication reduction slow. Type B's mid-sized DRW was developed as a psychosocial support service for OST clients seeking detoxification. However, staff struggled to find such prisoners, and detoxification again proved rare. Type C DRWs focused on abstinence from all drugs, including OST. Though OST clients were not intentionally excluded, very few applied to these wings. Only Type D DRWs, offering intensive treatment on very small wings, regularly recruited OST recipients into abstinence-focused interventions. Conclusion Prison units wishing to support OST recipients in making greater progress towards abstinence may need to be small, intensive and take a stepped approach based on preparatory motivational work and extensive preparation for release. However, concerns about post-release deaths will remain

Establishing a 'Corstonian continuous care pathway for drug using female prisoners: Linking Drug Recovery Wings and Womens Community Services

This article outlines the findings from a rapid assessment of pilot Drug Recovery Wings (DRWs) in two women’s prisons and compares the DRW approach with work undertaken in Women’s Community Services (WCSs) commended by the Corston Report. The findings indicate that DRW1 was working more successfully in providing a ‘Corstonian’ approach than DRW2 and the reasons behind this are explored. The article argues that, while pockets of good practice such as WCSs and ‘Corstonian’ DRWs are to be commended, unless there is a continuous care pathway, modelled on Corston’s ideas for working with vulnerable female offenders such as recovering drug users, such work will be limited in its effectiveness. Ideas for how such a systematic approach might work will be outlined

Potential for non-combustible nicotine products to reduce socioeconomic inequalities in smoking: a systematic review and synthesis of best available evidence

While some experts have emphasised the potential for e-cigarettes to facilitate cessation among smokers with low socioeconomic status (SES), there is limited evidence of their likely equity impact. We assessed the potential for electronic cigarettes and other non-combustible nicotine-containing products (NCNPs) to reduce inequalities in smoking by systematically reviewing evidence on their use by SES in countries at stage IV of the cigarette epidemic

Random drug testing of schoolchildren: a shot in the arm or a shot in the foot for drug prevention?

The idea of randomly drug-testing UK schoolchildren to see if they have used illegal drugs has received supportive comments recently from both the Prime Minister and the Leader of the Opposition. This review of current literature draws together information from a range of sources to review all aspects of the issue. It considers evidence in support of drug testing, including experience in the US, where random drug-testing is commonplace. It asks whether such testing is in accordance with human rights legislation and the rights of the child. As well as ethical issues, it reviews practical questions of the feasibility of testing pupils in UK schools, as well as concerns about how such testing programmes might fundamentally alter children's experience of school. The author finds that such programmes, whilst they might help some pupils, may harm others. He concludes that, before random drug-testing programmes are widely developed in UK schools, this initiative should be subjected to rigorous and independent evaluation