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NATIONAL CRIME AGENCY ISSUES FENTANYL WARNING

THE NATIONAL CRIME AGENCY ( NCA ) has taken the ‘ unusual step ’ of warning drug users to be vigilant following the detection of powerful synthetic opioid fentanyl in heroin supplies in the north east of England . Fentanyl and its analogue carfent anyl are thought to have contributed to recent deaths among drug users in the Yorkshire , Cleveland and Humber areas .

Fentanyl is a licensed medicine used to treat severe and terminal pain , and is around 100 times more potent than morphine , while carfentanyl is more powerful still . Even in the ‘ unlikely event ’ that users know their drugs contain fentanyl , the risk of overdose is high , warns the NCA .

The NCA and West Yorkshire Police recently targeted a laboratory suspected of producing the drugs , and there are concerns that the substances could have been ‘ distributed to drug dealers across a much wider area ’, putting people in other regions at risk . While initial toxicology revealed fentanyl analogues in ‘ a small number ’ of the north east deaths , ‘ specific retesting has started to indicate that the influence of fentanyl is greater than first suspected ’, said the NCA ’ s head of drugs threat and intelligence , Tony Saggers .

‘ We now believe UK customers beyond the north east region are likely to have received consignments of these drugs ,’ he continued . ‘ I am particularly concerned that drug dealers within established heroin markets may have purchased fentanyl , carfentanyl , or similar substances from this facility . They may not know how dangerous it is , both to them when they handle it , and to their customers .’ The criminal justice implications of supplying fentanyl mixed into other drugs would ‘ inevitably ’ be deemed aggravating , he stated , and ‘ claiming ignorance of the consequences ’ would be no defence .

PHARMACY FIRST

PHARMACIES IN URUGUAY will be able to sell cannabis for recreational use from July onwards , the country ’ s National Drug Board has announced . Uruguay legalised the cultivation , distribution and consumption of the drug in 2013 ( DDN , January 2014 , page 4 ), and so far 16 pharmacies have registered to sell five-gram containers of cannabis grown by state-licensed producers . Anyone wishing to buy the drug will need to sign up to a national registry , with maximum limits imposed on monthly purchases . Meanwhile , the Canadian government has introduced legislation to legalise and ‘ strictly regulate ’ cannabis , following its announcement at last year ’ s UNGASS ( DDN , May 2016 , page 4 ). Subject to parliamentary approval , the proposed Cannabis Act would create a legal framework for controlling the production , distribution , sale and possession of the drug , with sales to

Public Health England has also issued a drugs alert to emergency services , treatment agencies and other bodies , urging them to advise heroin users to ‘ be extra cautious about the sources from which they get their drugs , and about the drugs they take , maybe starting with just a quarter hit of a new supply ’. Drug services should also supply naloxone to ‘ all those at risk ’, it adds , while any areas seeing spikes in drug-related deaths should contact local coroners to establish if fentanyl is routinely screened for in toxicology results . ‘ If it is not , consideration should be given to resubmitting samples for retesting ,’ it states .

‘ We are urging heroin users to be extra careful about what they are taking ,’ said PHE ’ s director of drugs , alcohol and tobacco , Rosanna O ’ Connor . ‘ They need to look out for each other and be alert to any signs of an overdose , such as lack of consciousness , shallow or no breathing , “ snoring ”, and blueing of the lips and fingertips . If possible , they should use naloxone if someone overdoses , and immediately call for an ambulance . We strongly advise all dependent drug users to get support from local drug services .’

Drugs alert at https :// www . cas . dh . gov . uk / Home . aspx

anyone under 18 prohibited along with ‘ any products , promotion , packaging or labelling that could be appealing to young people ’, according to health minster Jane Philpott .

GLOBAL BURDEN

AROUND 1.75M PEOPLE WORLDWIDE were newly infected with HCV in 2015 , says the World Health Organization ’ s Global hepatitis report 2017 , bringing the total number of people living with hepatitis C to 71m . Injecting drug use and unsafe injections in healthcare settings remain the most common transmission routes , states the document , which calls for a ‘ scaling up of harm reduction services – particularly access to sterile injecting equipment and OST . ‘ Viral hepatitis is now recognized as a major public health challenge that requires an urgent response ,’ said WHO director general Dr Margaret Chan . Document at www . who . int / en http :// health . baltimorecity . gov / Fentanyl

CRIMINAL CASH

TRANSNATIONAL CRIME is now valued at between $ 1.6tn and $ 2.2tn annually , with drug trafficking accounting for between $ 426bn and $ 652bn of that , says a report from Global Financial Integrity ( GFI ). Only counterfeiting is more profitable than drugs , says Transnational crime and the developing world . ‘ The fight against transnational crime needs to be redirected to combating the money the crimes generate ,’ said GFI president Raymond Baker . ‘ This means shutting down the global shadow financial system that facilitates the moving and secreting of illicitly generated funds . None of this is technically difficult . It is a matter of political will .’ Report at www . gfintegrity . org

HARM ’ S WAY

HARM REDUCTION RESPONSES in Europe are being limited by ‘ austerity , international donor retreat and poor political support ’ according to a report from Harm Reduction International ( HRI ). Some EU member states are experiencing funding crises that ‘ must be addressed if public health emergencies are to be avoided ’, warns HRI . www . hri . global

INCENDIARY ISSUES

SMOKING CAUSES ONE IN TEN DEATHS GLOBALLY , according to a study published in The Lancet . While the scale-up of tobacco control is a ‘ public health success story ’, smoking remains ‘ a major risk ’ for early death and disability worldwide and requires sustained political commitment , says Smoking prevalence and attributable disease burden in 195 countries and territories , 1990- 2015 . Meanwhile , the Royal Society for Public Health ( RSPH ) is calling on UK vape retailers to adhere to a code of conduct after an undercover investigation found that nearly 90 per cent of shops were ‘ either knowingly or unwittingly ’ prepared to sell e-cigarettes to people who had never smoked or vaped . ‘ High street vape stores are the visible face of vaping in the UK , and so it is crucial that they are seen as responsible retailers of evidence-based quitting aids , rather than lifestyle products ,’ said RSPH chief executive Shirley

Cramer . Report at thelancet . com

It is crucial that vape products are seen as evidence-based quitting aids , rather than lifestyle products ’.

ShIrley Cramer

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