Promoting Innovation and Excellence to Face the Rapid Diffusion of Novel Psychoactive Substances in the EU: The Outcomes of the ReDNet Project.

Promoting innovation and excellence to face the rapid diffusion of Novel Psychoactive Substances in the EU: the outcomes of the ReDNet project.

Hum Psychopharmacol. 2013 Jul; 28(4): 317-23
Corazza O, Assi S, Simonato P, Corkery J, Bersani S, Demetrovics Z, Stair J, Fergus S, Pezzolesi C, Pasinetti M, Deluca P, Drummond C, Davey Z, Blaszko U, Moskalewicz J, Mervo B, Furia LD, Farre M, Flesland L, Pisarska A, Shapiro H, Siemann H, Skutle A, Sferrazza E, Torrens M, Sambola F, van der Kreeft P, Scherbaum N, Schifano F

The recent emergence of new psychoactive compounds (novel psychoactive substances (NPS)) has raised prominent challenges in the fields of drug policy, substance use research, public health and service provision. The Recreational Drugs European Network project, funded by the European Commission, was implemented to improve the information stream to young people and professionals about effects/risks of NPS by identifying online products and disseminating relevant information through technological tools.Regular multilingual qualitative assessments of websites, drugs fora and other online resources were carried out using the Google search engine in eight languages from collaborating countries. These included the following: the UK, Norway, Belgium, Germany, Hungary, Poland, Italy and Spain. Products were tested and prevention messages were developed and disseminated via technological tools such as interactive websites, SMS alert, social networking (Facebook, Twitter), Multimedia (You Tube), Smartphone applications (iPhone) and virtual learning environments (Second Life).The Recreational Drugs European Network project established itself as the first Europe-wide prevention programme designed for NPS based on the efficacy of novel information and communication technology-based forms of intervention. More than 650 NPS products and combinations were identified; relevant information was disseminated to target population and advice was given to both European Union/international agencies and national policy makers.Web-monitoring activities are essential for mapping the diffusion of NPS and the use of technological tools can be successfully incorporated in specific prevention programmes. Furthermore, the involvement of multi-disciplinary international partnerships was and continues to be fundamental for responding to such a prominent challenge. Copyright © 2013 John Wiley & Sons, Ltd. HubMed – addiction

Legal controls on cannabimimetics: An international dilemma?

Drug Test Anal. 2013 Jul 23;
King LA

Since early 2009, over 80 illicitly produced synthetic cannabinoid receptor agonists have been notified to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Yet more have been reported in other countries or offered for sale on websites. These cannabinoids typically act as agonists at CB1 receptors, and mimic the effects of ?(9) -tetrahydrocannabinol (THC), the principal psychoactive constituent of Cannabis L. As with other ‘new psychoactive substances’, they have shown the limitations of current drug control procedures. First, the regular appearance of new compounds makes specific listing impractical and overwhelms any attempt to create risk assessments on a substance-by-substance basis. Secondly, the lack of human pharmacological and toxicological data hinders any objective attempt to show that synthetic cannabinoids are harmful. The UK has had a long experience of using generic legislation to control groups of compounds. However, cannabimimetic activity arises in a large number of distinct chemical families, and it is clear that generic control can no longer cope with this diversity whilst remaining intelligible to non-chemists. Analogue control presents further difficulties, and does not appear to offer an acceptable solution. For these reasons, legislatures in many countries are creating novel forms of regulation separate from domestic drug laws. The generic definition of classical cannabinoids, introduced into the UK Misuse of Drugs Act in 1971, also shows signs of weakness. Thus the growing interest in the clinical potential of tetrahydrocannabivarin (THCV) is inhibited, at least in the UK, by its unintended status as a Schedule 1 substance. Copyright © 2013 John Wiley & Sons, Ltd. HubMed – addiction

Comparison of escitalopram and paroxetine in the treatment of major depressive disorder.

Int Clin Psychopharmacol. 2013 Jul 19;
Lin HL, Hsu YT, Liu CY, Chen CH, Hsiao MC, Liu YL, Shen WW, Hsiao CF, Liu SI, Chang LH, Tang HS, Lai HL, Lin PS, Lin KM, Tsou HH

This is a single-blind, parallel, flexible-dose study to compare the efficacy and tolerability of escitalopram and paroxetine in the treatment of patients with major depressive disorder. We recruited 399 patients from the outpatient clinics of five hospitals in northern Taiwan. Patients were administered either escitalopram (10-30 mg) or paroxetine (20-40 mg) according to the judgment of clinicians. These patients were assessed using the Hamilton Rating Scale for Depression (HAM-D) and the Hamilton Rating Scale for Anxiety at weeks 0, 1, 2, 4, 6, and 8. A total of 302 patients fulfilled the evaluation criteria and were included in a statistical analysis. We found that escitalopram induced more significant symptom reduction and response rate in terms of the mean HAM-D scores at week 6 (P<0.05) and week 8 (P<0.05) than paroxetine, but that there were no significant differences between the two groups in the remission rate. Escitalopram induced significantly less frequency of adverse effects of weakness (P<0.01), nausea and vomiting (P<0.001), drowsiness (P<0.01) as well as somnolence (P<0.01) than paroxetine, although all these side effects were mild and tolerable. However for a more definitive result, future prospective trials with the inclusion of a placebo group and a double-blind design are needed. In patients who did not have severe depression (HAM-D score at baseline<21), but not in severely depressed patients, escitalopram was statistically superior to paroxetine, as shown by the mean change in the HAM-D score. HubMed – addiction

Higher methadone doses are associated with lower mortality in patients of opioid dependence in Taiwan.

J Psychiatr Res. 2013 Jul 20;
Liao DL, Chen PC, Chen CH, Hsieh CJ, Huang YF, Shih WY, Cheng JJ

Optimal methadone dosage and service profile is challenging in treatment of opioid dependence. This study explores the impact of methadone dosage on the mortality of opioid-dependent patients in methadone maintenance therapy by using a large-scale and continual supervised dosing registry information system. Database of nationwide enrolled opioid-dependent patients at methadone clinics in Taiwan during 2006-2008 was assessed. The relative risk of age, sex, marital status, HIV infection and methadone dosage were analyzed by Cox regression analysis. Among all of the 33,549 recruited patients, the crude mortality rate was 134.78/10,000 person-years, and the standardized mortality ratio was 4.68. A dose-response relationship of higher- vs. lower-dosage groups on the risk of mortality risk was observed (adjusted HR = 0.68, P = 0.016). In further sub-grouping analysis, this trend was more significant in HIV positive patients, in subgroup of patients who continuously staying in MMT, and in subgroup of patients who re-enter MMT. This dosage effect is not significantly seen in patients receiving MMT more than 365 days. Further exploration of other treatment-related factors may be important for understanding the long-term treatment outcome of opioid addiction patients. HubMed – addiction

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