Drink and Drugs News DDN September 2019 | Page 5

read the full stories, and more, online www.drinkanddrugsnews.com MORE RESEARCH NEEDED ON MEDICINAL CANNABIS, SAYS NICE MORE RESEARCH IS NEEDED on cannabis-based medicinal products before they can be widely prescribed, says the National Institute for Health and Care Excellence (NICE). Medicinal cannabis products were re-classified last year to allow specialist doctors to prescribe them where the needs of patients could not be met by licensed medicines. The decision followed the high-profile cases of two children with epilepsy whose parents were unable to legally access cannabis oil-based medicines to prevent their seizures (DDN, July /August 2018, page 5). NICE has issued draft guidance for public consultation on the use of cannabis-based products for people with severe treatment- resistant epilepsy, chronic pain, spasticity and intractable nausea and vomiting as a result of chemotherapy. The guidance makes a range of recommendations for further research based on the ‘overall lack of clinical and cost-effectiveness evidence’ for the products. The guidance states that, other than pure cannabidiol (CBD) used ‘on its own in the context of a clinical trial’, no cannabis-based products should be used for treating chronic pain, while Sativex should not be used for treating spasticity in people with multiple sclerosis as it was not found to be cost-effective in relation to its benefits. NHS England has also published a review of the ‘we recognise that some people will be disappointed that we have not been able to recommend the wider use of cannabis-based medicinal products’ STUBBED OUT barriers to prescribing the products, which states that the lack of evidence regarding their long-term safety and effectiveness has ‘weighed heavily on prescribing decisions’ and recommends that two major clinical trials be set up. It also states that ‘consistency is key’ when making decisions about the use of medicinal cannabis for children with severe epilepsy, as without sufficient clinical trial evidence clinicians were ‘very reluctant’ to prescribe. ‘We heard loud and clear the concerns and frustration the children’s families are feeling, but these recommendations aim to help us develop the evidence base to understand how safe these products are, and ensure education and expert advice is available to support clinicians across the UK,’ said chief pharmaceutical officer at NHS England, Dr Keith Ridge. ‘We recognise that some people will be disappointed that we have not been able to recommend the wider use of cannabis-based medicinal products,’ added director of NICE’s centre for guidelines, Paul Chrisp. ‘However, we were concerned when we began developing this guidance that a robust evidence base for these mostly unlicensed products was probably lacking. Having now considered all the available evidence it’s therefore not surprising that the committee has not been able to make many positive recommendations about their use.’ Director of external affairs for the MS Society, Genevieve Edwards, said her organisation was ‘bitterly disappointed’ by the guidelines. ‘NICE’s refusal to recommend cannabis for pain and muscles spasms, or to fund Sativex on the NHS, means thousands of people with MS will continue to be denied an effective treatment,’ she said. ‘MS is relentless and painful, yet not a single person with MS has benefited from medicinal cannabis being legalised nine months ago.’ Draft guidance at www.nice.org.uk/guidance/indevelopment/gid- ng10124/documents. NHS review at www.england.nhs.uk/medicines/support-for- prescribers/cannabis-based-products-for-medicinal-use/ JUST 16 PER CENT OF SECONDARY-SCHOOL PUPILS HAVE SMOKED TOBACCO compared to almost 50 per cent in 1996, according to the latest figures from NHS Digital. Almost a quarter have tried drugs, however, while 17 per cent drink alcohol at least once a month – rising to almost 40 per cent of 15-year-olds. Half of the young people who had recently drunk, taken drugs or smoked cigarettes experienced ‘low levels’ of happiness, the report adds. Smoking, drinking and drug use among young people 2018 at digital.nhs.uk www.drinkanddrugsnews.com through the use of home visits. Learning from tragedies: an analysis of alcohol-related safeguarding adult reviews at alcoholchange.org.uk SHARE AWARE MANY PEOPLE DELIVERING HEPATITIS C TESTING or treatment do not understand which data can be shared or with whom, according to a new report from the London Joint Working Group on Substance Use and Hepatitis C (LJWG). Clear guidance and training is needed to ensure progress towards eliminating hep C, says Joining the dots: linking pathways to hepatitis C diagnosis and treatment. Report at ljwg.org.uk. See news focus, page 8 DRUG DELUGE THE PRISON SERVICE RESPONSE to the ‘deluge of drugs flowing into many prisons’ in recent years has been slow and ‘neither robust nor sophisticated’, according to the chief inspector of prisons’ annual report. Last year had been another ‘deeply troubling’ year for parts of the prison estate, with many establishments still ‘plagued by drugs, violence, appalling living conditions and a lack of access to meaningful rehabilitative activity’, the report states. The government has since promised a ‘crime crackdown’ in prisons, with ‘airport- style’ security to tackle smuggling of drugs and weapons. ‘We cannot allow our prisons to become factories for making bad people worse,’ said Prime Minister Boris Johnson. HM chief inspector of prisons’ annual report for 2018-19 at www.justiceinspectorates.gov.uk CHALLENGING ISSUES NEXT LEVEL VULNERABLE ADULTS’ ALCOHOL USE IS BEING ‘MISSED OR POORLY MANAGED’, according to a report from Alcohol Change UK, with the mismanagement of severe alcohol problems among people with complex needs increasing their risk of harm and even death. All professionals working with alcohol- dependent people should be fully trained to recognise the ‘complicated role that alcohol plays in adult safeguarding’, says the document, and stresses that a person’s refusal of care needs to be ‘constantly challenged’. The refusal of alcohol treatment should not lead to someone being deemed beyond help, it says, and treatment services may need to adapt their models, for example THE FIRST POST-INTRODUCTORY LEVEL INTERPERSONAL GROUP THERAPY COURSE IN THE UK has been launched by Action on Addiction. Based on a collaborative adult learning model, the practice-based course is designed to equip people with a full understanding of how interpersonal group therapy can be effective in facilitating character change. Teaching takes place one Saturday per month in Warminster from 16 November onwards. Meanwhile, applications are open for the foundation degree in addictions counselling at University of Bath, offering a mixture of academic study and work-based learning. For more information email [email protected] September 2019 | drinkanddrugsnews | 5