6 février 2020
Sommaire thématique
Epidémiologie / Epidemiology ... 3
Loi et son application / Law enforcement ... 15
Maladies infectieuses / Infectious diseases ... 16
Marché de la drogue / Drug market ... 17
Pathologie organique / Organic pathology ... 22
Prévention / Prevention ... 24
Produits, mode d'action, méthode de dépistage / Substances, action mode, screening methods .. 29
Psychopathologie / Psychopathology ... 38
Santé publique / Public health ... 40
Sciences humaines et sociales / Human and social sciences ... 45
Traitement et prise en charge / Treatment and care ... 55
Sélection bibliographique réalisée par le centre de documentation de l'OFDT à partir des abonnements, des acquisitions d'ouvrages et de la veille systématique effectuée à partir de différentes sources.
Un clic sur le titre d'une notice renvoie vers celle-ci dans la base documentaire de l'OFDT (https://bdoc.ofdt.fr).
Les liens vers les documents sur leurs sites d'origine sont indiqués lorsque ceux- ci sont disponibles gratuitement en ligne.
Pour les autres documents, merci de contacter le centre de documentation afin d'obtenir les modalités d'accès à l'adresse documentation@ofdt.fr.
Aucune photocopie ne peut être fournie.
This bibliographic selection is carried out by the OFDT's documentation centre and is based on journals subscriptions, books and reports acquisitions and current awareness of different sources.
A click on a title brings you to its descriptive record on the OFDT's bibliographic database (https://bdoc.ofdt.fr).
The links to the documents on their editor's website are displayed when the documents are free to download.
For the other documents, please contact the documentation centre for access details at documentation@ofdt.fr.
No paper copy can be provided.
Epidémiologie / Epidemiology
Alcohol-related mortality in the WHO European Region: Sex-specific trends and predictions
N. PRUCKNER, B. HINTERBUCHINGER, M. FELLINGER, D. KONIG, T. WALDHOER, O. M. LESCH, A. GMEINER, S. VYSSOKI, B. VYSSOKI
Alcohol and Alcoholism, Vol.54, n°6 (November 2019), 593-598 EUROPE; ALCOOL; MORTALITE; SEXE; FACTEUR PREDICTIF; EVOLUTION
AIMS: Alcohol is an important risk factor for morbidity and mortality, especially within the European region. Differences in per capita consumption and drinking patterns are possible reasons for regional differences and diverging trends in alcohol-related health outcomes.
METHODS: Twenty-nine countries within the World Health Organization (WHO) European region were evaluated for trends and predictions in alcohol-related deaths within the last four decades using data available from the WHO Health for All database.
RESULTS: Between 1979 and 2015, age-standardised death rates due to selected alcohol-related causes decreased significantly for both sexes in all assessed countries of the WHO European region, but regional differences are still pronounced. Assuming a similar trend in the future, the model predicted a further decrease until the year 2030.
CONCLUSION: Even though alcohol-related mortality may have decreased within the last decades, the detrimental effects of alcohol consumption and alcohol dependence remain a considerable burden of disease within Europe.
Associations between alcohol policies and adolescent alcohol use: A pooled analysis of GSHS and ESPAD Data
J. K. NOEL
Alcohol and Alcoholism, Vol.54, n°6 (November 2019), 639-646 INTERNATIONAL; EUROPE; ALCOOL; ADOLESCENT; ESPAD; ENQUETE;
POLITIQUE; MARKETING; PRIX; PREVENTION; AVERTISSEMENT SANITAIRE;
PREVALENCE
AIMS: Alcohol-attributable harm remains high worldwide, and alcohol use among adolescents is particularly concerning. The purpose of this study is to determine the effect of national alcohol control policies on adolescent alcohol use in low-, middle- and high-income countries and improve on previous cross- national attempts to estimate the impact of alcohol policy on this population.
METHODS: Data on adolescent (n = 277,110) alcohol consumption from 84 countries were pooled from the Global School-based Health Survey and the
European School Survey Project on Alcohol and Other Drugs. Alcohol use measures included lifetime alcohol use, current (past 30 days) alcohol use and current (past 30 days) binge drinking. Information on national alcohol control policies was obtained from the World Health Organization's Global Information System on Alcohol and Health and scored for effectiveness. Main effects were estimated using two-level, random intercept hierarchical linear models, and the models were adjusted for sex and age of the participants, and pattern of drinking score, gross domestic product based on purchasing power parity and study at the country level.
RESULTS: Availability (OR [95% CI] = 0.991 [0.983, 0.999]), marketing (OR [95%
CI] = 0.994 [0.988, 1.000]) and pricing (OR [95% CI] = 0.955 [0.918, 0.993]) policies were inversely associated with lifetime drinking status. Pricing policies were also inversely associated with current binge drinking status among current drinkers (OR [95% CI] = 0.939 [0.894, 0.986]). There were no associations between the included alcohol policies and current drinking status.
CONCLUSIONS: Strong availability, marketing and pricing policies can significantly and practically impact adolescent alcohol consumption.
Bulletins de santé publique - Alcool Santé publique France
Saint-Maurice : Santé publique France, 2020 (BSP)
https://www.santepubliquefrance.fr/les-actualites/2020/consommation-d- alcool-en-france-ou-en-sont-les-francais
SANTE PUBLIQUE FRANCE; FRANCE; AUVERGNE-RHONE-ALPES; BOURGOGNE- FRANCHE-COMTE; BRETAGNE; CENTRE-VAL-DE-LOIRE; GRAND-EST; HAUTS-DE- FRANCE; ILE-DE-FRANCE; NORMANDIE; NOUVELLE AQUITAINE; OCCITANIE;
PAYS-DE-LA-LOIRE; PROVENCE-ALPES-COTE D'AZUR; CORSE; GUADELOUPE;
GUYANE FRANCAISE; MARTINIQUE; LA REUNION; REGION; ALCOOL;
PREVALENCE; COMPARAISON; MORTALITE; URGENCE; ADOLESCENT;
PREVENTION; REPERE DE CONSOMMATION; ADULTE; CONSOMMATION; ABUS;
EVOLUTION; MORBIDITE; CANCER; BOISSON ALCOOLISEE
Santé publique France publie des données inédites avec une analyse régionale de la consommation d'alcool ainsi que des indicateurs régionaux et
départementaux de morbi-mortalité associée à l'alcool.
Bien que le volume global d'alcool pur consommé en France (11,7 litres par habitant de 15 ans et plus en 2017) soit en diminution depuis les années 1960, essentiellement en raison de la baisse de la consommation quotidienne de vin, la France reste parmi les pays les plus consommateurs d'alcool au monde, se situant au sixième rang parmi les 34 pays de l'OCDE.
La consommation d'alcool est significativement moins fréquente en Ile-de- France (7,1 %), Normandie (7,9 %) et Pays de la Loire (8,1 %), ainsi que dans l'ensemble des DROM. La Guadeloupe (6,9 %), la Guyane (5,2 %), la Martinique (7,0 %) et La Réunion (5,8 %) affichent des prévalences comparables entre
métropolitaine (source : baromètre santé DOM 2014). Les régions Hauts-de- France (11,5 %), Nouvelle-Aquitaine (12,3 %) et Occitanie (12,6 %) se distinguent par une consommation quotidienne d'alcool plus fréquente.
[Extraits du dossier de presse]
Changes in Australian prescription opioid use following codeine rescheduling:
A retrospective study using pharmaceutical benefits data M. MIDDLETON, S. NIELSEN
International Journal of Drug Policy, Vol.74 (December 2019), 170-173 AUSTRALIE; CODEINE; ETUDE RETROSPECTIVE; OPIOIDES; PRESCRIPTION MEDICALE; LEGISLATION; USAGE DETOURNE; ANTALGIQUES
Purpose: In February 2018, Australia up-scheduled the 'weak' opioid codeine to a prescription only medication. This study aimed to analyse the change in prescribing trends for codeine and other commonly prescribed opioids in Australia following this policy change to determine if removal of over-the- counter codeine resulted in an increase in opioid prescribing.
Methods: Data was obtained through the Australian Government Department of Human Services statistics website, and contained monthly data about subsidised national prescription numbers for codeine, oxycodone, oxycodone- naloxone, tapentadol, tramadol, morphine, and fentanyl, from January 2016 to December 2018. Segmented linear regression accounting for autocorrelation was used to assess the effect of codeine rescheduling on the supply trends of these opioids.
Results: Rescheduling codeine to remove over-the-counter (non-prescription) supply does not appear to have had an immediate effect on the prescription rates of codeine, and there is no significant change in these rates in the months following. Analysis of data showed decreasing trends for codeine and most other schedule 8 prescription opioids, with no increase in any prescribed opioids associated with codeine up scheduling.
Conclusions: Despite concerns, substitution of over-the-counter codeine with higher strength prescribed codeine has not been observed at a population level, nor has a shift to other prescribed opioids occurred. Overall, opioid prescribing in Australia has been decreasing since 2016, both for strong and weak opioids.
Cigarette prices, smuggling, and deaths in France and Canada P. JHA, C. HILL, D. C. N. WU, R. PETO
Lancet (The), Vol.395, n°10217 (4 January 2020), 27-28
http://www.sciencedirect.com/science/article/pii/S0140673619312917 FRANCE; CANADA; TABAC; PRIX; CONTREBANDE; CIGARETTE; MORTALITE;
EVOLUTION; CONSOMMATION; TAXE
Tripling real cigarette prices would approximately halve cigarette consumption worldwide. Although high excise taxes could increase smuggling, weak customs enforcement (rather than high price) is the main determinant of illegal cigarette sales. Importantly, the tobacco industry actively smuggles its own products.
Illegal sales affect not only revenue but overall sales, and hence mortality.
France and Canada illustrate the effects of price on consumption. [Extract]
Emergency department presentations related to acute toxicity following recreational use of cannabis products in Switzerland
Y. SCHMID, I. SCHOLZ, L. MUELLER, A. K. EXADAKTYLOS, A. CESCHI, M. E.
LIECHTI, E. LIAKONI
Drug and Alcohol Dependence, Vol.206 (January 2020), art. 107726 https://www.sciencedirect.com/science/article/pii/S0376871619305034 SUISSE; CANNABIS; URGENCE; TOXICITE; USAGE RECREATIF; ETUDE RETROSPECTIVE; SYMPTOME; EFFET SECONDAIRE; INTOXICATION;
POLYCONSOMMATION; COMPARAISON
BACKGROUND: Concomitant use of cannabis and other psychoactive substances is common and it is often difficult to differentiate its acute effects from those of other substances. This study aimed to characterize the acute toxicity of
cannabis with and without co-use of other substances.
METHODS: Retrospective analysis of cases presenting at the emergency
departments of three large hospitals in Switzerland due to acute toxicity related to cannabis recreational use.
RESULTS: Among 717 attendances related to acute cannabis toxicity, 186 (26 %) were due to use of cannabis alone. The median patient age was 26 years (range 14-68), and 73 % were male. Commonly reported symptoms/signs in lone- cannabis cases included nausea/vomiting (26 %), palpitations (25 %), anxiety (23 %), and chest pain (15 %); there were no fatalities and most intoxications were of minor severity (61 %). Most patients (83 %) using cannabis alone were discharged from the emergency department, 8 % were referred to psychiatric, and two (1 %) to the intensive care; severe complications included psychosis (7
%), coma (6 %), and seizures (5 %) and one patient (
CONCLUSION: Intoxication with cannabis alone was mostly associated with
admission to intensive or psychiatric care were also reported, which indicates that intoxication with cannabis alone does not exclude considerable health risks.
Highlights:
Lone-cannabis presentations were less common than co-use of other substances.
Presentations due to cannabis use alone were mostly of minor severity.
Common symptoms included anxiety, nausea, vomiting, and cardiovascular activation.
Severe cases requiring psychiatric or intensive care were also reported.
Les évolutions de la consommation d'alcool en France et ses conséquences 2000-2018
C. PALLE
Paris : OFDT, 2019, 18 p.
https://www.ofdt.fr/statistiques-et-infographie/tableau-de-bord-alcool/
FRANCE; ALCOOL; CONSOMMATION; EVOLUTION; PREVALENCE; BOISSON ALCOOLISEE; PRIX; MORTALITE; MORBIDITE; TAXE; AGE; ABUS; IVRESSE;
HOSPITALISATION; CSAPA; TRAITEMENT; ALCOOLEMIE; ACCIDENT;
CONDAMNATION
Ce bilan décrit les évolutions récentes de la consommation d'alcool en France et de ses conséquences sanitaires et sociales. Les tendances récentes ainsi décrites sont dans la mesure du possible resituées dans le contexte plus large des évolutions observées depuis le début des années 2000. Cette analyse des évolutions repose sur un ensemble d'indicateurs qui permettent de mesurer avec la même méthodologie les phénomènes observées. Dans le cadre de cette approche, l'objectif est avant tout d'apprécier les tendances. Ce tableau de bord ne vise pas à rendre compte de la totalité des connaissances disponibles sur la consommation d'alcool et de ses conséquences.
First-year French medical students consume antidepressants and anxiolytics while second-years consume non-medical drugs
G. FOND, A. BOURBON, M. BOUCEKINE, M. MESSIAEN, V. BARROW, P.
AUQUIER, C. LANÇON, L. BOYER
Journal of Affective Disorders, Vol.265 (15 March 2020), 71-76 FRANCE; MILIEU ETUDIANT; JEUNE; MEDECINE; PSYCHOTROPES;
MEDICAMENTS; ANXIOLYTIQUES; ANTIDEPRESSEURS; ALCOOL; TABAC;
PRODUIT ILLICITE; ETUDE TRANSVERSALE; SANTE MENTALE; ANXIETE Background: First year exams are a major source of stress amongst first-year medical students.
Objective: To explore antidepressant and anxiolytic consumption and addictive behavior of medical students before and after exams.
Methods: Medical students of the 35 French medical schools were recruited through mailing lists and social networks between December 2016 and May 2017 and completed online Internet anonymized questionnaires.
Results: Overall, 4345 medical students were included (3051 first year vs.
1294 second year). In multivariate analyses, compared to those in the first year of medicine, second year students were found to have lower anxiolytic
(adjusted odd ratio (aOR)=0.56, p = 0.01) and antidepressant consumption (aOR=0.21, p
Conclusion: First year medical students who are faced with challenges relating to studying consume more antidepressants and anxiolytics, whilst second year students have a higher consumption of recreational drugs for a range of reasons. This suggests that the first two years at medical school are an important contributor to adverse mental health and therefore present a window of opportunity for preventative intervention.
Highlights:
We found that first year consumed more anxiolytic and antidepressant.
Second year were more frequently followed-up by psychiatrist, smoked more tobacco and cannabis and drank more alcohol.
Second year medical students reported to have lower study difficulties.
They also reported to seek more disinhibition and alleviating anxiety, to seek to stimulate and sedate themselves and to follow group.
The two first years of medical studies are crucial to prevent later mental health issues.
Microdosing psychedelics: Motivations, subjective effects and harm reduction T. LEA, N. AMADA, H. JUNGABERLE, H. SCHECKE, M. KLEIN
International Journal of Drug Policy, Vol.75 (January 2020), art. 102600 http://www.sciencedirect.com/science/article/pii/S095539591930307X INTERNATIONAL; LSD; PSILOCYBINE; TYPE D'USAGE; COGNITION; ENQUETE;
MOTIVATION; HALLUCINOGENES; AUTOMEDICATION; ANXIETE; DEPRESSION;
REDUCTION DES RISQUES; EFFET RECHERCHE
Background: In recent years there has been growing media attention on microdosing psychedelics (e.g., LSD, psilocybin). This refers to people routinely taking small doses of psychedelic substances to improve mental health and
wellbeing, or to enhance cognitive performance. Research evidence is currently limited. This paper examines microdosing motivations, dosing practices,
perceived short-term benefits, unwanted effects, and harm reduction practices.
Methods: An international online survey was conducted in 2018 examining people's experiences of using psychedelics. Eligible participants were aged 16 years or older, had used psychedelics and could comprehend written English.
This paper focuses on 525 participants who were microdosing psychedelics at the time of the survey.
Results: Participants were primarily motivated to microdose to improve mental health (40%), for personal development (31%) and cognitive enhancement (18%). Most were microdosing with psilocybin (55%) or LSD/1P-LSD (48%).
Principal components analysis generated three factors examining perceived short-term benefits of microdosing: improved mood and anxiety, enhanced connection to others and environment, and cognitive enhancement; and three factors examining negative and potentially unwanted effects: stronger-than- expected psychedelic effects, anxiety-related effects, and physical adverse effects. Most participants (78%) reported at least one harm reduction practice they routinely performed while microdosing.
Conclusion: Our findings suggest that people microdosing are commonly doing so as a self-managed therapy for mental health, either as an alternative or adjunct to conventional treatments. This is despite psychedelics remaining prohibited substances in most jurisdictions. Recent findings from clinical trials with standard psychedelic doses for depression and anxiety suggest that a neurobiological effect beyond placebo is not unreasonable. Randomised controlled trials are needed, complemented by mixed methods social science research and the development of novel resources on microdosing harm reduction.
Mortality risk among cocaine users before and after the economic recession:
Results of a longitudinal study
R. M. PAVARIN, S. SANCHINI, S. MARANI, E. TURINO, L. TADONIO, B.
CANTARELLI
European Addiction Research, Vol.26, n°1 (January 2020), 10-19 https://doi.org/10.1159/000503343
ITALIE; COCAINE; ETUDE LONGITUDINALE; MORTALITE; CRISE ECONOMIQUE;
INSERTION; HEROINE; VOIE D'ADMINISTRATION; FACTEUR DE RISQUE BACKGROUND: Studies have highlighted 2 different groups of cocaine users (CUs): "socially integrated" (stable living conditions, regular employment, use cocaine alone or in combination with other psychoactive substances) and
"socially marginalized" (socioeconomic and health problems, former or current heroin users, many injecting cocaine). These differences are also found in the elevated mortality risk for CUs, higher among subjects with cocaine and heroin
use. This study targeted residents in Northern Italy who turned to a public treatment center for drug addiction following problems caused by primary cocaine use between 1982 and 2016.
OBJECTIVES: To estimate mortality risk for subjects who have never used heroin (CUs) compared to that of subjects who have used heroin (HCUs).
METHOD: Retrospective cohort study. We selected 1,993 subjects; 18,015 Person Years (PY).
RESULTS: Over time, the quota of subjects injecting cocaine and using heroin decreased, while patients not using heroin increased. Both new patients and crude mortality rates (CMR) decreased during the years 2009-2012 and increased in the following period. CMRs were 5.55 per 1,000 PY, higher for HCUs, men and subjects aged over 44 years. Standardized mortality rates were 3.49, higher for women, injecting cocaine and HCUS. Among CUs, most of the deaths were from injury excluding drug related and tumors; among HCUs, from drug-related causes and diseases of the cardiovascular system.
CONCLUSION: The study results show a change in the characteristics of SERD clients being treated for primary cocaine use, which are reflected both in mortality risk and causes of death. After a long period of a decrease, mortality risk increased in the period after the economic recession. Aspects concerning the effects of the economic recession on the problematic consumption of cocaine and on the risk of death are discussed.
National, regional, and global burdens of disease from 2000 to 2016 attributable to alcohol use: a comparative risk assessment study
K. SHIELD, J. MANTHEY, M. RYLETT, C. PROBST, A. WETTLAUFER, C. D. H. PARRY, J. REHM
Lancet Public Health (The), Vol.5, n°1 (January 2020), e51-e61
http://www.sciencedirect.com/science/article/pii/S2468266719302312 INTERNATIONAL; ALCOOL; MORBIDITE; COMPARAISON; FACTEUR DE RISQUE;
MORTALITE; DEVELOPPEMENT; GEOGRAPHIE; PATHOLOGIE
Background: Alcohol use has increased globally, with varying trends in different parts of the world. This study investigates gender, age, and geographical differences in the alcohol-attributable burden of disease from 2000 to 2016.
Methods: This comparative risk assessment study estimated the alcohol- attributable burden of disease. Population-attributable fractions (PAFs) were estimated by combining alcohol exposure data obtained from production and taxation statistics and from national surveys with corresponding relative risks obtained from meta-analyses and cohort studies. Mortality and morbidity data were obtained from the WHO Global Health Estimates, population data were obtained from the UN Population Division, and human development index (HDI) data were obtained from the UN Development Programme. Uncertainty
intervals (UIs) were estimated using a Monte Carlo-like approach.
Findings: Globally, we estimated that there were 3.0 million (95% UI 2.6-3.6) alcohol-attributable deaths and 131.4 million (119.4-154.4) disability-adjusted life-years (DALYs) in 2016, corresponding to 5.3% (4.6-6.3) of all deaths and 5.0% (4.6-5.9) of all DALYs. Alcohol use was a major risk factor for
communicable, maternal, perinatal, and nutritional diseases (PAF of 3.3% [1.9- 5.6]), non-communicable diseases (4.3% [3.6-5.1]), and injury (17.7% [14.3- 23.0]) deaths. The alcohol-attributable burden of disease was higher among men than among women, and the alcohol-attributable age-standardised burden of disease was highest in the eastern Europe and western, southern, and central sub-Saharan Africa regions, and in countries with low HDIs. 52.4% of all alcohol-attributable deaths occurred in people younger than 60 years.
Interpretation: As a leading risk factor for the burden of disease, alcohol use disproportionately affects people in low HDI countries and young people. Given the variations in the alcohol-attributable burden of disease, cost-effective local and national policy measures that can reduce alcohol use and the resulting burden of disease are needed, especially in low-income and middle-income countries.
Funding: None.
Report on drug use in the Americas 2019
Inter-American Drug Abuse Control Commission of American States (CICAD- OAS)
Washington, DC : OAS (Organization of American States), 2019, 280 p.
http://cicad.oas.org/main/pubs/Report%20on%20Drug%20Use%20in%20 the%20Americas%202019.pdf
ETATS-UNIS; AMERIQUE DU NORD; AMERIQUE DU SUD; AMERIQUE CENTRALE;
CARAIBES; ALCOOL; TABAC; CANNABIS; POPULATION GENERALE; ADOLESCENT;
INHALANTS; COCAINE; AMPHETAMINES; ECSTASY; DROGUES DE SYNTHESE;
PREVALENCE; MEDICAMENTS; USAGE DETOURNE
Drug use continues to represent a significant problem in the Americas, and one that challenges policy makers at the highest levels. The Inter-American Drug Abuse Control Commission (known by its Spanish language acronym, CICAD), of the Organization of American States (OAS), serves as the preeminent Western Hemisphere forum for policy discussion and hemispheric cooperation on drugs.
Along with other responsibilities, the Executive Secretariat of CICAD supports OAS member states by providing an evidence-based picture of the drug problem, both nationally and at the hemispheric level, so that member states can design and implement policies and programs to address the problem.
The Report on Drug Use in the Americas 2019 analyzes current drug use data in the Hemisphere. It features information on the most widely used drugs across the region, organized by drug and by population group, and highlights emerging issues of interest to policy-makers and to the public. The Report draws on data
obtained primarily through national surveys using the Inter-American Uniform Drug Use Data System (known by its Spanish language acronym, SIDUC), developed by the CICAD Executive Secretariat.
The contribution of alcohol use, other lifestyle factors and working conditions to socioeconomic differences in sickness absence J. LANDBERG, T. HEMMINGSSON, L. SYDEN, M. RAMSTEDT European Addiction Research, Vol.26, n°1 (January 2020), 40-51 https://doi.org/10.1159/000504437
SUEDE; COHORTE; ALCOOL; MILIEU PROFESSIONNEL; ABSENTEISME;
CATEGORIE SOCIO-PROFESSIONNELLE; STYLE DE VIE; PREVALENCE
INTRODUCTION: This study investigates how alcohol use contributes to the social gradient in sickness absence. Other factors assessed include lifestyle factors (smoking, physical activity and body mass index), physical and psychosocial working conditions.
METHODS: The study used baseline data from the Stockholm public health cohort 2006, with an analytical sample of 17,008 respondents aged 25-64 years. Outcome variables included self-reported short-term (14 days) sickness absence. Socioeconomic position (SEP) was measured by occupational class.
Alcohol use was measured by average weekly volume and frequency of heavy episodic drinking. Negative binominal regression was used to estimate sex- specific SEP differences in sickness absence, before and after adjusting for alcohol use and the additional explanatory factors.
RESULTS: Adjusting for alcohol use attenuated the SEP differences in long-term sickness absence by 20% for men and 14% for women. Alcohol use explained a smaller proportion of the differences in short-term sickness absence. Alcohol use in combination with other lifestyle factors attenuated the SEP differences (20-35%) for both outcomes. Physical working conditions explained more than half of the gradient in long-term sickness absence, whereas psychosocial conditions had greater impact on short-term sickness absence among men.
DISCUSSION/CONCLUSION: Alcohol use explains a substantial proportion of the SEP disparities in long-term sickness absence among men. The effect is smaller among women and for short-term sickness absence. Our findings support the notion that physical working conditions constitute the key
explanatory variable for SEP differences in long-term sickness absence, but add that psychosocial working conditions have greater impact on the gradient in short-term sickness absence among men.
L'usage de la cigarette électronique chez les adolescents en France : où en sommes-nous ?
S. CHYDERIOTIS, O. LE NEZET, E. JANSSEN, A. BRISSOT, A. PHILIPPON, S. SPILKA Actualité et Dossier en Santé Publique, n°108 (Septembre 2019), 8-13
OFDT; FRANCE; ADOLESCENT; CIGARETTE ELECTRONIQUE; TABAC;
PREVALENCE; ENQUETE; NARGUILE; INITIATION; NICOTINE
Chez les adolescents, l'utilisation régulière d'e-cigarette reste limitée et la cigarette demeure le produit psychoactif le plus consommé. Le nombre de jeunes n'utilisant ni l'une ni l'autre augmente.
Utilisateurs de la cigarette électronique dans la cohorte CONSTANCES : un mode de vie orienté vers la prévention de santé (Electronic cigarette users in CONSTANCES cohort: a lifestyle oriented to healthcare)
F. X. BERLEMONT, D. COZZOLINO
Courrier des Addictions (Le), Vol.21, n°4 (Octobre-novembre-décembre 2019), 18-23
FRANCE; COHORTE; CIGARETTE ELECTRONIQUE; TABAC; TYPE D'USAGE; STYLE DE VIE; PREVALENCE; PREVENTION; SANTE
FRANÇAIS :
Plusieurs études ont été publiées sur le sujet de la cigarette électronique et concluent sur la nécessité de poursuivre la recherche. Notre étude comparant les modes de vie de vapoteurs exclusifs et de consommateurs mixtes à une population de fumeurs ne montrent pas de lien entre l'utilisation de ce dispositif et prendre des mesures de prévention individuelle de santé portant sur d'autres sujets que le tabac. La cigarette électronique entretient l'addiction à la nicotine et devrait donc, en toute logique, être apparentée aux produits du tabac et soumise à la même réglementation et taxation.
ENGLISH:
Many studies have been published about electronic cigarette and concluded on the need to continue the research. Our study comparing the lifestyle of vapers and dual users to smokers only shows no link between using this device and taking health preventive measures about others topics than tobacco. Electronic cigarette maintains the nicotine addiction and, thus, should be related to tobacco products and submitted to the same regulation and taxation.
Loi et son application / Law enforcement
L'enfer carcéral des « mules » guyanaises J. FISCHMEISTER
Dedans Dehors, n°106 (Décembre 2019), 15-16
FRANCE; GUYANE FRANCAISE; PRISON; TRANSPORT IN CORPORE; SEXE FEMININ; INCARCERATION; REPRESSION; JUSTICE
Particulièrement représentées au sein de la population carcérale féminine, les « mules » font paradoxalement l'objet d'un désintérêt institutionnel profond.
Isolées tant géographiquement que linguistiquement, elles subissent encore plus que les autres détenues les carences de l'administration pénitentiaire.
Fixing transnational drug policy: Drug prohibition in the eyes of comparative law
R. COLSON
Journal of Law and Society, Vol.46, n°S1 (October 2019), S73-S94 ONU; INTERNATIONAL; PRODUIT ILLICITE; PROHIBITION; LEGISLATION;
COMPARAISON; CONTROLE DES STUPEFIANTS; CRIMINALITE; REPRESSION;
POLITIQUE; HISTOIRE
Drug prohibition allows us to study over a significant period of time how penal provisions framed at a supranational level flow, settle, and unsettle across different countries. At a time of growing doubt about the benefit of
criminalization of drug use, it also provides a case-study as to how epistemic communities may rely on comparative research to identify best practices and promote them as normative alternatives in the face of a long-entrenched legal dogma. In order to explore these issues, this article looks at the UN drug control system from the perspective of comparative law. It shows how the concept of legal transplant provides a useful tool to understand the limits of transnational criminal law designed on a global scale to tackle the 'drug problem', and it clarifies the various types of legal comparison that might contribute to addressing this failed transplant.
Maladies infectieuses / Infectious diseases
Shooting Up. Infections among people who injected drugs in the UK, 2018. An update, December 2019
Public Health England, Health Protection Scotland, Public Health Wales, Public Health Agency Northern Ireland
London : Public Health England, 2019, 52 p.
https://www.gov.uk/government/publications/shooting-up-infections-among- people-who-inject-drugs-in-the-uk
ROYAUME-UNI; INJECTION; ACTIVITE SEXUELLE; USAGER; INFECTION;
BACTERIE; VIRUS; HEPATITE; VIH; FACTEUR DE RISQUE; PARTAGE DE SERINGUE;
TYPE D'USAGE; DROGUES DE SYNTHESE; VACCINATION; EVOLUTION; COCAINE;
CRACK; INTERVENTION
* Preventable bacterial infections are increasing.
Over half of people who inject drugs (PWID) report having a recent symptom of a bacterial infection. Severe bacterial infections in PWID have been increasing since 2013/14. The cause of the rise is not clear and there are likely to be several factors involved, including an ageing population of PWID with poorer vein and skin health, changes in injection practices with a rise in groin injection in recent years, and a large proportion of PWID reporting homelessness, and likely conditions of poorer general hygiene and unsterile injecting.
* There is early evidence for a reduction in chronic hepatitis C prevalence, however rates of new infection are unchanged.
Hepatitis C (HCV) continues to be a major problem among PWID in the UK, with around 1 in every 4 currently infected with HCV. There is early evidence for a modest reduction in chronic hepatitis C prevalence concomitant with the scale- up of direct acting antiviral (DAA) treatment among PWID. [...]
* HIV levels remain low, but risks continue.
In the UK, around 1 in 100 PWID are living with HIV. Although the prevalence of HIV remains low, outbreaks of HIV among people who inject drugs continue to occur, notably the ongoing incident in Glasgow. Most PWID living with HIV have been diagnosed and are accessing HIV care. However, HIV is often diagnosed at a late stage among PWID. It is crucial that HIV testing is offered regularly, and that care pathways for HIV are maintained and adapt to changing patterns of risk.
* Hepatitis B vaccine uptake needs to be sustained, particularly in younger age groups.
* Continued sharing and re-use of injecting equipment remains a concern.
Sharing levels reported in England, Wales and Northern Ireland have not improved in recent years and only around 3 in 5 PWID reported adequate needle/syringe provision for their needs. Re-use of an individual's own injecting equipment is commonly reported in the UK and can also put individuals at risk of infection.
* Changes in psychoactive drug preferences could lead to riskier injecting
practices.
The changing patterns of psychoactive drug use remain a concern because changes in psychoactive drug preferences can lead to riskier injecting practices such as increased frequency of injecting, sharing equipment, or groin injecting.
Injection of crack cocaine has increased in England and Wales, and injection of powder cocaine has increased in Scotland.
* Provision of effective interventions need to be maintained and optimised.
The provision of effective harm reduction interventions to reduce risk and prevent and treat infections needs to be maintained and optimised. These interventions include NSP, OST and other treatments for drug misuse and dependence. Vaccinations and diagnostic tests for infections need to be
routinely and regularly offered to people who inject or have previously injected drugs. Care pathways and treatments should be optimised for those testing positive for blood borne viruses.
Marché de la drogue / Drug market
2019 National drug threat assessment
US Department of Justice, DEA Drug Enforcement Administration Washington, DC : Drug Enforcement Administration (DEA), 2019, 152 p.
https://www.dea.gov/press-releases/2020/01/30/dea-releases-2019-national- drug-threat-assessment
ETATS-UNIS; MEXIQUE; COLOMBIE; SURDOSE; MORTALITE; PRODUIT ILLICITE;
OPIOIDES; EVOLUTION; DROGUES DE SYNTHESE; FENTANYLOIDES;
METHAMPHETAMINE; COCAINE; MARCHE DE LA DROGUE; ORGANISATION CRIMINELLE; TRAFIC INTERNATIONAL; HEROINE; CANNABIS; DISPOSITIF DE SOIN; ADMISSION; DIFFUSION DES PRODUITS; MEDICAMENTS
The 2019 National Drug Threat Assessment (NDTA) is a comprehensive strategic assessment of the threat posed to the United States by domestic and
international drug trafficking and the abuse of both licit and illicit drugs.
Illicit drugs, and the criminal organizations that traffic them, continue to represent significant threats to public health, law enforcement, and national security in the United States. As the National Drug Threat Assessment describes, the opioid threat continues at epidemic levels, affecting large portions of the United States. Meanwhile, the stimulant threat, including methamphetamine and cocaine, is worsening and becoming more widespread as traffickers continue to sell increasing amounts outside of each drugs' traditional markets.
2019 NDTA findings of note:
The opioid threat (controlled prescription drugs, synthetic opioids, and heroin)
continues at ever-increasing epidemic levels, affecting large portions of the United States.
The stimulant threat (methamphetamine and cocaine) is worsening and becoming more widespread as traffickers continue to sell increasing amounts outside of each drugs' traditional markets.
New psychoactive substances remain challenging and the domestic marijuana situation is evolving as state-level medical and recreational legalization continues.
In 2017, drug poisoning deaths were the leading cause of injury death in the United States and reached their highest recorded level. Every year since 2011, drug poisoning deaths have outnumbered deaths by firearms, motor vehicle crashes, suicide, and homicide. Approximately 192 people died every day from drug poisoning in 2017.
The National Drug Threat Assessment provides a yearly assessment of the many drug abuse and drug trafficking challenges local communities face. Highlights in the report include usage and trafficking trends for drugs such as prescription drugs, heroin, methamphetamine, cocaine, marijuana and the hundreds of synthetic drugs. New to this year's assessment is an expanded section on gangs - including street gangs, prison gangs, and outlaw motorcycle gangs – which now details gang activity geographically by DEA field division. [From the press release]
Forensic drug intelligence and the rise of cryptomarkets. Part II: Combination of data from the physical and virtual markets
M. MORELATO, J. BROSEUS, A. DE GRAZIA, M. TAHTOUH, P. ESSEIVA, C. ROUX Forensic Science International, Vol.288 (July 2018), 201-210
AUSTRALIE; MARCHE DE LA DROGUE; INTERNET; PRODUIT ILLICITE;
COMPARAISON; ENQUETE; SAISIE; CANNABIS; AMPHETAMINES; TRAFIC INTERNATIONAL
Technology provides new ways to access customers and suppliers while enhancing the security of off-line criminal activity. Since the first cryptomarket, Silk Road, in 2011, cryptomarkets have transformed the traditional drug sale by facilitating the creation of a global network of vendors and buyers. Due to the fragmented nature of traces that result from illegal activities, combining the results of concurrent processes based on traces of different nature should provide supplementary benefit to understand the drug market.
This article compares the data of the Australian virtual market (in particular data extracted from cryptomarkets) to the data related to traditional market descriptors, namely national seizures and arrests, prevalence data, shipping countries of seized post shipments as well as outcomes of specific surveys targeting users' behaviour online. Results revealed the domestic nature of the online illicit drug trade in Australia which is dominated by amphetamine-type
substances (ATS), in particular methylamphetamine and cannabis. These illicit drugs were also the most seized drugs on the physical market. This article shows that the combination of different information offers a broader perspective of the illicit drug market in Australia and thus provides stronger arguments for policy makers. It also highlights the links between the virtual and physical markets.
Highlights:
Online data were compared to data related to traditional market descriptors.
The results highlighted a link between the virtual and physical markets.
Forensic drug intelligence processes rely on the combination of different information.
Le marché des stupéfiants dans le canton de Vaud. Partie 3 - Les cannabinoïdes
F. ZOBEL, P. ESSEIVA, R. UDRISARD, S. SAMITCA Lausanne : Addiction Suisse, 2020, 134 p.
https://www.addictionsuisse.ch/actualites/communiques-de-presse/article/le- marche-du-cannabis-sous-la-loupe/
SUISSE; MARCHE DE LA DROGUE; CANNABINOIDES; REGION; CANNABIS;
PRODUCTION; LEGALISATION; CONSOMMATION; METHODE; COMMERCE;
REVENU; TETRAHYDROCANNABINOL; EAUX USEES; SAISIE
Une équipe interdisciplinaire de chercheurs d'Addiction Suisse, de l'Ecole des Sciences Criminelles (UNIL) et d'Unisanté s'intéresse au marché des stupéfiants vaudois. Après l'héroïne et les stimulants, les travaux ont cette fois porté sur le cannabis. Son marché est le plus important parmi les stupéfiants mais le chiffre d'affaire reste inférieur à celui de la cocaïne. Le cannabis consommé provient de différentes sources avec une part importante d'importations et un rôle non- négligeable de la production domestique à petite échelle. On retrouve
désormais sur le marché aussi des mélanges de cannabis illégal et de cannabis légal (CBD). Plus de la moitié du cannabis est consommé par les usagers intensifs qui sont moins de 10% des consommateurs.
NPS in Switzerland: Current trends C. BISSIG, M. SCHLAPFER, C. BOGDAL
Toxicologie Analytique et Clinique, Vol.31, n°4 (Décembre 2019), 268-274 SUISSE; DROGUES DE SYNTHESE; CANNABINOIDES; HALLUCINOGENES;
OPIOIDES; MARCHE DE LA DROGUE; CHIMIE; STIMULANTS
In recent years, more and more new psychoactive substances (NPS) with complex chemical structures have appeared on the Swiss drug market. New structure parts, longer and more diverse side chains and substituents have been encountered. In order to adapt to this situation, the Swiss narcotics act was amended and is updated on a regular basis with individual and generic listings. Here, the current trends regarding the chemical structures of NPS in Switzerland are presented.
Rethinking the "drug dealer"
Drug Policy Alliance
New York, NY : Drug Policy Alliance, 2019, 76 p.
http://drugpolicy.org/drugsellers
ETATS-UNIS; MARCHE DE LA DROGUE; REVENDEUR; USAGER; CRIMINALITE;
LEGISLATION; RECOMMANDATION; POLITIQUE; TEMOIGNAGE;
STIGMATISATION Key facts:
- Current laws were created on the premise that they would reduce overall supply, and in turn, consumption. In reality, the opposite has occurred.
Meanwhile, we have increased the amount of people incarcerated for selling or distribution offenses by 3000% - from 15,000 in 1980 to 450,000 today - and drugs are more readily available, at significantly lower prices.
- There is significant overlap between drug sellers and people who use drugs. A 2012 survey found that 43% of people who reported having sold drugs in the past year also reported that they met the criteria for a substance use disorder.
- Laws against drug selling are so broadly written that it is easy for people caught with drugs for personal use to get charged as dealers, even if they were not involved in selling at all.
- The harsh criminalization of supply-side drug market activity may actually be making drug use more dangerous, increasing overdose deaths and leading to more violence in communities.
- While the criminal legal system purports to focus on high-level sellers, the data show that supply-side criminalization disproportionately impacts the lowest-level people on the supply chain.
- The current system has a discriminatory impact on communities of color,
Latinx people to report having sold drugs.
Drug prohibition and the criminalization of people who sell or distribute drugs does not reduce the harms of drug use or improve public safety. Our current approach is built on a foundation of stigma, ignorance and fear rather than evidence, and creates new problems while doing nothing to solve those that already exist.
The Drug Policy Alliance believes it is time to rethink the "drug dealer." We must urgently assess what type of people actually fall into this category and how we as a society can respond to them in ways that will keep people and communities safer and healthier. This work has been motivated by the leadership of formerly incarcerated people and drug users unions.
The Afghan Opiate Trade Project (AOTP). Opiate trafficking along the early stages of the Balkan route
Office des Nations Unies contre la drogue et le crime / United Nations Office on Drugs and Crime ONUDC / UNODC
Vienna : UNODC, 2020 (AOTP Update ; Vol.3), 16 p.
https://www.unodc.org/documents/data-and-
analysis/AOTP/UNODC_AOTP_VOL3_BALKANS_2020_web.pdf
TURQUIE; IRAK; SYRIE; EUROPE DE L'EST; AFGHANISTAN; PAKISTAN; IRAN;
TRAFIC INTERNATIONAL; OPIACES; MORPHINE; OPIUM; SAISIE; HEROINE;
PURETE; GEOGRAPHIE; PRODUCTION; CULTURE ILLICITE; MARCHE DE LA DROGUE
Afghanistan continues to be the major global source of opium production.
While heroin is primarily produced in Afghanistan, it is possible that heroin production also takes place outside Afghanistan. The opiates produced in Afghanistan are trafficked to every region of the world except Latin America.
The Balkan route continues to play a major role in supplying opiates to the markets in Islamic Republic of Iran, Turkey and Europe.
This Short Update is intended to provide an update on the latest developments in the early stages of the Balkan route from Afghanistan to Turkey, including latest developments in Iraq and Syria related to the Afghan opiate trade.
Pathologie organique / Organic pathology
Complications somatiques du cannabis (Cannabis use and somatic consequences)
N. FRANCHITTO
Revue du Praticien (La) - Monographie, Tome 70, n°1 (Janvier 2020), 69-77 CANNABIS; FACTEUR DE RISQUE; TETRAHYDROCANNABINOL; CANNABINOIDES;
SYMPTOME; COMPARAISON; DROGUES DE SYNTHESE; PATHOLOGIE ORGANIQUE; PSYCHOPATHOLOGIE; MORBIDITE; TOXICITE; APPAREIL
CARDIOVASCULAIRE; CERVEAU; APPAREIL DIGESTIF; APPAREIL RESPIRATOIRE FRANÇAIS :
Le cannabis reste la substance illicite la plus consommée dans le monde. La perception du cannabis comme une substance peu dangereuse au regard de son origine végétale participe à l'augmentation de son usage. La puissance du cannabis est définie par un ratio élevé entre les composants les plus importants du cannabis, c'est-à-dire le tétrahydrocannabinol et le cannabidiol. Les effets aigus et chroniques de l'usage du cannabis comportent un risque majoré de troubles psychiatriques, mais aussi de complications cardiovasculaires, neurovasculaires et neurocognitives, respiratoires et de sevrage en cas de dépendance. Avec l'apparition récente des cannabinoïdes de synthèse qui sont des substances chimiques contrairement au cannabis issu de la plante, des complications plus sévères sont décrites même lors d'usage unique. Ces nouvelles substances de synthèse, bien qu'appelées aussi cannabis par les utilisateurs, ont conduit à une modification des prises en charge des usagers en raison d'une toxicité aiguë et chronique plus sévère.
ENGLISH:
Cannabis is the most frequently used illicit psychoactive substance in the world.
It is perceived as a low-risk drug, as it is a plant, although many warnings in the medical literature underlined increased complications of cannabis use. Acute and chronic cannabis use is known to be harmful inducing psychiatric and addictive effects. An increase in the potency of cannabis as defined by a high ratio between the more important components, tetrahydrocannabinol and cannabidiol has been observed for years, which leads to more serious
complications. Evidence indicates that both acute and chronic consumptions of cannabis can be detrimental to both mental and physical health. Effects of cannabis use include mood disorders, exacerbation of psychotic disorders in vulnerable people, cannabis use disorders, withdrawal syndrome,
neurocognitive impairments, cardiovascular and respiratory and other diseases.
Synthetic cannabinoid has rapidly spread for the last few years; they are chemical substances inducing similar psychoactive effects to cannabis.
Although, cannabis users call these substances "cannabis", synthetic cannabinoids have different pharmacological properties, which make them dangerous substances leading to more serious complications. Physicians dealing
with cannabis users should be aware of these differences between vegetal cannabis and synthetic cannabinoids.
Hospitalizations for cardiovascular diseases attributable to tobacco smoking in France in 2015
C. BONALDI, A. PASQUEREAU, C. HILL, D. THOMAS, E. MOUTENGOU, V. N.
THANH, V. OLIÉ
European Journal of Preventive Cardiology, Online first 19/11/2019 (2019), 9 p., doi: 10.1177/2047487319885462
FRANCE; TABAC; PATHOLOGIE ORGANIQUE; APPAREIL CARDIOVASCULAIRE;
COEUR; HOSPITALISATION; FACTEUR DE RISQUE; PREVALENCE
AIMS: Tobacco smoking is a major risk factor for many cardiovascular diseases.
In France, the daily smoking prevalence is among the highest in high-income European countries. This study estimated the number of hospitalizations for cardiovascular diseases attributable to smoking in France in 2015, and the number of stays that could have been avoided if there had been 10% less current smokers or if the prevalence of current smokers had been 20%.
METHODS: Age- and sex-specific attributable fractions were calculated by combining relative risks extracted from the literature with the prevalence of smoking estimated in the 2014 Health Barometer, a national representative survey. These fractions were applied to hospitalization stays with a primary diagnosis for a cardiovascular disease whose risk is known to increase with smoking.
RESULTS: In France in 2015, 250,813 hospital stays (95% uncertainty
interval=234,869-269,807) related to a cardiovascular condition were estimated as attributable to smoking. This represented 21% of all stays for a
cardiovascular condition. Ischemic heart disease accounted for the largest share of smoking-related stays (39%). If the number of current smokers had been 10%
lower or if the prevalence of smoking in the population had dropped to below 20%, 5867 stays and 25,911 stays, respectively, would have been prevented.
CONCLUSIONS: In France, a large number of hospital stays for cardiovascular disease are attributable to tobacco smoking. A 10% reduction in smoking would avoid nearly 6000 hospital stays per year; more than 25,000 annual hospital stays if only 20% of the French population smoked.
Quantifying the evil for a more effective fight against tobacco [Editorial]
J. BLACHER, A. CINAUD, V. BLACHIER, A. VALLÉE, E. SORBETS
European Journal of Preventive Cardiology, Online first 03/12/2019 (2019), 2 p., doi: 10.1177/2047487319892400
https://doi.org/10.1177%2F2047487319892400
FRANCE; TABAC; LUTTE; COEUR; PATHOLOGIE ORGANIQUE; APPAREIL CARDIOVASCULAIRE; FACTEUR DE RISQUE; HOSPITALISATION
Prévention / Prevention
20 ans de prévention en milieu festif dans le canton de Vaud, enjeux et perspectives
S. CADUFF
Dépendances, n°66 (Décembre 2019), 6-9
SUISSE; MILIEU FESTIF; PREVENTION; ALCOOL; PRODUIT ILLICITE; REDUCTION DES RISQUES; METHODE
La prévention en milieu festif s'est beaucoup développée ces 20 dernières années. En deux décennies, de nombreux projets ont été lancés et déployés en Suisse romande. Mais que nous ont amené ces expériences ? Quels sont les enjeux actuels de la prévention en milieu festif et comment peut-elle encore évoluer et se développer dans le futur ? (réd.)
An examination of universal drug education programming in Ontario, Canada's elementary school system
T. L. BRUNO, R. CSIERNIK
International Journal of Mental Health and Addiction, Online first 28/08/2018 (2018), 13 p., doi: 10.1007/s11469-018-9977-6
https://doi.org/10.1007/s11469-018-9977-6
CANADA; PREVENTION; MILIEU SCOLAIRE; EDUCATION POUR LA SANTE;
PRODUIT ILLICITE; PROGRAMME; EVALUATION; EFFICACITE; MODELE;
RECOMMANDATION
School-based drug education initiatives are designed and marketed to prevent substance use and misuse. Over the past several decades, school-based drug education has evolved from delivering only information about drugs and the negative outcomes of their use to a multi-faceted, interactive approach, with
several programs now using a combination of information, decision-making, social competency and to a lesser extent, harm minimization. Our study using a case study of a sample of Ontario, Canada elementary schools, found that the majority of programs that are being offered are selected less by empirically supported outcome studies than popular belief and marketing. Based on our findings we recommend that a consistent set of criteria be established based upon best practices to assist educational decision makers select prevention programs rather than allowing marketing or ideological positions govern what is delivered.
International overdose awareness day: A vision to end the global overdose crisis. Partners' report 2019
Penington Institute
Carlton, VIC (Australia) : Penington Institute, 2019, 32 p.
https://www.overdoseday.com/wp-content/uploads/IOAD-Partners- Report2019.pdf
INTERNATIONAL; SURDOSE; CAMPAGNE DE PREVENTION; MEDIA;
COMMUNICATION; PREVENTION; FORMATION; NALOXONE; REDUCTION DES RISQUES; RESEAU SOCIAL; OUTIL DE PREVENTION
This year's International Overdose Awareness Day (IOAD) has seen our movement continue to grow and achieve real change. The final total of 874 events held in 39 countries is a new record, surpassing the previous high of 747 set last year.
And, just as in previous years, International Overdose Awareness Day is a chance to raise awareness of overdose, remember those we have lost, and call for change.
In addition to the final tally of events, there are several headline statistics which show how much our movement has grown. [...]
The other findings of the 2019 Partners' Report are based primarily on a survey conducted by Penington Institute, the convenor of IOAD, which asked
participants about their events and their experiences. Key findings gathered from responses to the survey include:
Knowledge about the IOAD community: our movement is made up of people who use drugs, loved ones of people who have been affected by drugs, harm reduction and health workers, advocates, and activists. Often, these
communities overlap.
Motivations: raising awareness of overdose, reducing stigma, and commemoration or memorial of those we've lost were the most popular responses.
Events: almost 95 per cent of respondents had held an IOAD event before.
Close to two-thirds of respondents said their event was attended by the general public, while 80 per cent said their event was attended by family and friends of
people affected by overdose, and health or community workers.
Satisfaction: 95 per cent of respondents believed their event was successful or very successful, while 96 per cent were satisfied or very satisfied with the resources on offer.
Media coverage: 75 per cent of respondents said their event received media coverage, and the campaign overall generated 2,550 news stories.
Outputs and Outcomes: increased awareness, naloxone training, the creation of shareable resources, Mayoral Proclamations, and politicians promising to do more to end overdose.
The Partners' Report concludes by reflecting on this year's campaign and setting some ambitious targets for next year, which will be the 20th International Overdose Awareness Day. [Extract from executive summary]
Interview de Gregor Burkhart G. BURKHART, M. PORTNER-HELFER
Dépendances, n°66 (Décembre 2019), 13-16
OEDT; PREVENTION; DEFINITION; EFFICACITE; ALCOOL; TABAC; PRODUIT ILLICITE
En matière de stratégie de prévention, il est souvent question de campagnes d'information à large échelle ou de mesures ciblées destinées à modifier les comportements des individus par rapport à leur consommation. En agissant davantage sur l'environnement dans lequel évoluent les produits et substances, la prévention structurelle semble pourtant amener de meilleurs résultats. Pour Gregor Burkhart, responsable du domaine de la prévention à l'Observatoire Européen des Drogues et des Toxicomanies, c'est notamment en limitant le champ des possibles avec des mesures concrètes que nous parviendrons à réduire les problèmes liés à la consommation de produits psychotropes. (réd.)
#MoisSansTabac 2018 : un bilan des actions recensées en Nouvelle-Aquitaine G. DUMONT, E. PROTHON, S. BARBETTE, P. CASTERA
Courrier des Addictions (Le), Vol.21, n°4 (Octobre-novembre-décembre 2019), 24-26
FRANCE; NOUVELLE AQUITAINE; TABAC; ACTION DE PREVENTION;
PREVENTION; SEVRAGE
Depuis novembre 2016, la campagne nationale de lutte contre le tabagisme
"#MoisSansTabac" ne cesse de prendre de l'ampleur et de gagner en popularité.
Elle fait indubitablement partie des facteurs ayant permis l'actuelle baisse du tabagisme en France. Chaque année, au mois de novembre, des acteurs aux profils variés se mobilisent sur le terrain pour faire exister l'événement.
L'objectif principal de cette étude était d'analyser en profondeur les actions recensées sur la plateforme OSCARS (observation et suivi cartographique des actions régionales de santé) pour le #MoisSansTabac 2018, en prenant
l'exemple de la Nouvelle-Aquitaine, région hétérogène fortement touchée par le tabagisme, mais néanmoins théâtre d'un investissement important de la part des acteurs locaux.
Prévention, quo vadis ?
Bulletin de Dépendances, n°66 (Décembre 2019), 32 p.
https://shop.addictionsuisse.ch/fr/accueil/211--dependances-n-66-prevention- quo-vadis.html
SOMMAIRE :
- Éditorial (G. Vittoz), p. 2.
- La prévention des addictions : quels défis pour demain ? (L. Ducarroz), p. 3-5.
- 20 ans de prévention en milieu festif dans le canton de Vaud, enjeux et perspectives (S. Caduff), p. 6-9.
- Des réseaux clandestins à un réseau autorisé du cannabis : quelles
conséquences pour la prévention au Québec ? (F. Gagnon, J. Loslier), p. 10-12.
- Interview de Gregor Burkhart (M. Portner-Helfer), p. 13-16.
- Prévention des addictions : un savant équilibre entre responsabilités individuelle et collective (R. Salveter), p. 17-20.
- La prévention, parent pauvre du parlement suisse (L. Fehlmann Rielle), p. 21- 23. - Adolescence, impulsivité et facteurs de risque d’addiction (B. Boutrel), p. 24- 27.
- Les nouveaux horizons de nos comportements numériques problématiques (O. Glassey), p. 29-31.
La prévention des addictions : quels défis pour demain ? L. DUCARROZ
Dépendances, n°66 (Décembre 2019), 3-5
PREVENTION; ADDICTION; EVOLUTION; METHODE
La prévention des addictions d'aujourd'hui revêt de multiples facettes, tant sur le plan de sa forme, de ses objectifs ou de ses contenus. Face à la complexité croissante des situations, la combinaison de plusieurs approches demeure nécessaire. Et demain ? À quels défis et enjeux la prévention des addictions sera-t-elle confrontée dans les années à venir ? Une brève sélection nous est proposée dans cet article. (réd.)
Prévention des addictions : un savant équilibre entre responsabilités individuelle et collective
R. SALVETER
Dépendances, n°66 (Décembre 2019), 17-20
SUISSE; PREVENTION; ADDICTION; RECOMMANDATION; EFFICACITE
Une addiction entraîne d'immenses souffrances pour la personne concernée et son entourage tout en ayant de lourdes conséquences pour ta collectivité. Si le cadre sociétal joue un rôle considérable dans la survenue du problème, il appartient aussi, selon l'OFSP, à chacune et chacun d'assumer la responsabilité de sa santé et de son comportement. (réd)
Des réseaux clandestins à un réseau autorisé du cannabis : quelles conséquences pour la prévention au Québec ?
F. GAGNON, J. LOSLIER
Dépendances, n°66 (Décembre 2019), 10-12
CANADA; QUEBEC; CANNABIS; PREVENTION; LEGALISATION; SANTE PUBLIQUE;
COMMERCE
En 2018, le Canada franchit le pas de la légalisation du cannabis sur son
territoire. Une année après rentrée en vigueur de la nouvelle loi, quels constats peuvent déjà être dressés en matière de prévention ? Quels sont les défis posés par cette légalisation ? (réd.)
Produits, mode d'action, méthode de dépistage / Substances, action mode, screening methods
About 5 cases with 3 Meo-PCP including 2 deaths and 3 non-fatal cases seen in France in 2018
F. GROSSENBACHER, Y. CAZAUBON, C. FELIU, A. AMELINE, P. KINTZ, O.
PASSOUANT, B. MOURVILLIER, Z. DJERADA
Toxicologie Analytique et Clinique, Vol.31, n°4 (Décembre 2019), 332-336 FRANCE; ETUDE DE CAS; DROGUES DE SYNTHESE; MORTALITE; ANALYSE CHIMIQUE; TOXICOLOGIE
We report five cases involving use of 3 Meo-PCP (3 methoxyphencyclidine) with 2 fatalities and 3 non-fatal cases seen in France in 2018. PCP (Phencyclidine) is an arylcyclohexanexylamine, synthesised by Maddox in 1956, and has a potent dissociative anaesthetic drug. One derivative 3 Meo-PCCP appeared on the street market in 2012 with potency slightly lower than PCP. The three non-fatal cases were a 36 Y.O. man presenting alternatively confusion, aggressiveness, logorrhoea and calmness. He was positive for alcohol, buprenorphine and tramadol. Others cases were a man admitted for hyperemesis syndrome and a methadone user during laboratory survey. CG-MS (qualitative) identified 3 Meo-PCP in urine. The two deaths were forensic cases. A 39 Y.O. woman was found murdered by ligature strangulation. UPLC-MS-MS (with quantitative) on blood samples showed cocaine, benzo-ecgonine; diazepam, nordiazepam and alcohol. 3 MeO-PCP was found on femoral blood 63 ng/mL, 94 ng/mL in urine and also in hair segments. The last case was a 41 y.o. male found dead at home without traumatic lesions, femoral blood level was 498 ng/mL and urines levels were 16, 700 ng/mL. Forensic data reported in literature have shown that fatal values for 3 Meo-PCP in blood ranged from 50 to 3,200 ng/mL and in urine from 0,4 to 120 ng/mL. There are no clear toxic and fatal concentrations established for 3-MeO-PCP, mainly because the drug is often associated to other recreative substances. In Europe during years 2017-8, 18 published related cases with 3 Meo-PCP have been shown with 10 fatalities and 8 non- fatal.
Abuse of 3-MMC and forensic aspects: About 4 cases and review of the literature
A. AMELINE, V. DUMESTRE-TOULET, J. S. RAUL, P. KINTZ
Toxicologie Analytique et Clinique, Vol.31, n°4 (Décembre 2019), 251-257 FRANCE; ETUDE DE CAS; DROGUES DE SYNTHESE; CATHINONES; MEPHEDRONE;
ABUS; ANALYSE CHIMIQUE; TOXICOLOGIE; DEPISTAGE
In recent years, the recreational use of new psychoactive substances (NPS) has increased all around the world. They are designed to cause similar effects to controlled drugs and are considered as alternative to illegal drugs. Among NPS, derivatives of cathinone, one of the psychoactive ingredients of the plant khat, have emerged in the recreational drug market. 3-methylmethcathinone or 3- MMC is a structural isomer of mephedrone (4-MMC) and a psychostimulant and hallucinogenic drug. Furthermore, to get intense recreational effect, 3- MMC can often be combined with other drugs, by chemsex practitioners. Users report a soft feeling of energy and increased concentration, as well as a feeling of well-being, euphoria and unbridled libido. There is a risk of significant psychological dependence after repetitive 3-MMC exposures. Very limited data about clinical, psychological and forensic aspects of 3-MMC abuse are available in the medical literature. The authors report 4 cases of subjects abusing 3-MMC and other drugs, involving two intoxications and two deaths. Biological samples were analysed by ultra-high performance liquid chromatography system coupled to a tandem mass spectrometry (UPLC-MS/MS™). 3-MMC was
detected in concentrations ranging from 3 to 613 ng/mL in blood, and from 14 pg/mg to 17.1 ng/mg in hair. In view of these values, and those from the very limited literature, it is difficult to establish an impairment concentration or a lethal threshold of 3-MMC.
Benzoylfentanyl and parafluorobutyrfentanyl: Some analytical and metabolism data
C. RICHEVAL, M. BAILLIEUX, G. PAWLAK, M. PHANITHAVONG, J. F. WIART, L.
HUMBERT, A. BATISSE, C. LAMOUREUX, G. PFAU, T. NÉFAU, D. ALLORGE, J. M.
GAULIER
Toxicologie Analytique et Clinique, Vol.31, n°4 (Décembre 2019), 258-267 FRANCE; ANALYSE CHIMIQUE; FENTANYLOIDES; METABOLITE; OPIOIDES;
DROGUES DE SYNTHESE; TOXICOLOGIE
Today, New Psychoactive Substances (NPS) are increasingly being related to post-mortem cases, and this problem drastically intensifies as a result of the New Synthetic Opioids (NSOs) surge. Among NSOs, fentanyl derivatives (FDs) consist in a myriad of drugs with a high turnover. FDs detection in human
metabolism. In this challenging context, this manuscript aims to report analytical data about two poorly documented FDs: benzoylfentanyl (BZF) and parafluorobutyrfentanyl (pFBF). In 2018, these FDs were identified in three samples (powders and blotting papers) in France. Nuclear magnetic resonance and liquid chromatography with high-resolution mass spectrometry detection (LC-HRMS) data including observed mass spectrometric fragmentation patterns were obtained. In addition, metabolites were investigated using human liver microsomes incubations and LC-HRMS analysis: norBZF, despropionylfentanyl and a hydroxylated-BZF were identified (and observed in hair) as BZF
metabolites; norpFBF, parafluorofentanyl and a hydroxylated-pFBF were identified as pFBF metabolites. In the worrisome context of NSOs detection, these preliminary data can be useful for toxicologists.
Cannabidiol : caractéristiques et intérêt dans la prise en charge des troubles addictifs (Cannabidiol: characteristics and interest in the management of addictive disorders)
T. GONZALEZ, C. LUCET, X. LAQUEILLE
Courrier des Addictions (Le), Vol.21, n°4 (Octobre-novembre-décembre 2019), 12-17
CANNABINOIDES; USAGE THERAPEUTIQUE; ADDICTION; EFFET SECONDAIRE;
REDUCTION DES RISQUES FRANÇAIS :
L'utilisation du cannabidiol (CBD) dans certaines formes d'épilepsie résistantes de l'enfant a été approuvée par la FDA aux États-Unis.
Du CBD non pharmaceutique est largement disponible dans le commerce.
Cependant, les taux affichés des produits vendus en boutique peuvent être loin du taux réel, et rendre son utilisation hasardeuse.
Il pourrait trouver une utilisation en addictologie, notamment en réduction des risques chez les fumeurs de cannabis. Les études animales montrent des résultats prometteurs dans l'alcoolodépendance (réduction de consommation, neuroprotection, hépatoprotection).
ENGLISH:
CBD was approved by the US Food and Drug Administration in rare form of children resistant epilepsy.
Non pharmaceutical CBD is widely available on the market. Nevertheless, alleged concentration of products sold in stores could be far from the actual content making it use uncertain.
CBD could be used in addictions as a risk reduction tool in cannabis smokers.
Animal studies showed promising result in alcohol use disorder (uptake reduction, neuroprotective and hepatoprotective effect).
A case report of carfentanil-related fatality in France
J. M. GAULIER, C. RICHEVAL, M. PHANITHAVONG, S. BRAULT, D. ALLORGE, V.
DUMESTRE-TOULET
Toxicologie Analytique et Clinique, Vol.31, n°4 (Décembre 2019), 323-331 FRANCE; ETUDE DE CAS; FENTANYLOIDES; MORTALITE; ANALYSE CHIMIQUE;
MEDECINE LEGALE; TOXICOLOGIE; METABOLITE
Today, NPS are increasingly being related to post-mortem cases, and this problem drastically intensifies as a result of the New Synthetic Opioids (NSOs) surge. Among NSOs, carfentanil (CaF) is the most potent fentanyl analogue and was central to a large number of NSOs-related fatalities in North America, as well as in UE, since 2016. In this worrisome context, this manuscript reports the first CaF-related fatality occurred in France. A 41-years-old man was found dead with a syringe planted under his tongue. This man has a psychiatric follow-up for opiate addiction and his recent medical history included intoxication with fentanyl derivatives. Toxicological investigations of post- mortem samples (blood, urine and hair), and syringe were requested. CaF (with several other psychoactive drugs at non-toxic level) was detected in biological samples and in syringe residue using LC-HRMS, and quantified using LC-MS/MS in blood, urine and hair (from proximal to distal hair section - 3cm length each) at 4.20, 0.40 µg/L and 54/114/166 pg/mg, respectively. The relatively high post-mortem CaF blood concentration together with the absence of metabolite (especially NorCaF) suggests a sudden death of the victim immediately
following a significant CaF dose intake (presumably injected) that can explain the decease.
La cigarette électronique et les dangers méconnus de la nicotine R. MOLIMARD
Courrier des Addictions (Le), Vol.21, n°4 (Octobre-novembre-décembre 2019), 27-28
NICOTINE; CIGARETTE ELECTRONIQUE; TABAC; MECANISME D'ACTION;
DEPENDANCE PSYCHIQUE
Contrairement à l'opinion générale, la nicotine n'est pas "la drogue du tabac", comme est la morphine celle de l'opium. Elle y est cependant liée. Une étude a élucidé ce mystère, mais elle heurte de considérables intérêts commerciaux.
Elle reste donc ignorée.
Une crise des gabapentinoïdes ? Réseau français d'addictovigilance
[S.l.] : Association des Centres d'Addictovigilance, 2019 (Addictovigilance ; n°11), 2 p.
http://www.addictovigilance.fr/IMG/pdf/bulletin_pregabaline.pdf FRANCE; ADDICTOVIGILANCE; ANTICONVULSIVANTS; MEDICAMENTS;
MECANISME D'ACTION; USAGE DETOURNE; ENQUETE; USAGE PROBLEMATIQUE; INTERACTION CHIMIQUE
La prégabaline (Lyrica® et génériques) est indiquée chez l'adulte, dans le traitement de l'épilepsie, des douleurs neuropathiques et du trouble anxieux généralisé.
Leading the next CBD wave - Safety and efficacy [Viewpoint]
Y. L. HURD
JAMA Psychiatry, Online first 15/01/2020 (2020), 2 p., doi:
10.1001/jamapsychiatry.2019.4157
CANNABINOIDES; USAGE THERAPEUTIQUE; SECURITE SANITAIRE; EFFICACITE;
PHENOMENE EMERGENT; ETUDE CLINIQUE
Cannabidiol (CBD), a phytocannabinoid with potential medicinal properties, has recently hit all levels of society with tidal wave force that very few saw coming.
After being virtually unknown by most people not even a decade ago, CBD is now in the general lexicon with numerous companies riding the CBD wave:
more than 1000 products are being sold through the internet, dispensaries, pharmacies, large national retail stores, boutique shops, and local bodegas.
This, along with extensive media coverage, has made CBD a household name and spawned an international business with an estimated market value of more than $60 billion within the next few years. [Extract]
