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Connolly, Johnny and Lynn, Ena (2012) Drugnet digest. Drugnet Ireland, Issue 41, Spring 2012, p. 9.

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This section contains short summaries of recent reports and other developments of interest. 

Amphetamine: a report on the illicit market in Europe
This joint publication by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and the European Police Agency, Europol, is an in-depth study of the illicit market in amphetamine.1 Combining law enforcement data on measures such as drug seizures and detections of clandestine laboratories with drug-use prevalence data, the report shows that Europe is the world’s number one producer of amphetamine and a major consumer market. The highest levels of amphetamine use in Europe are reported in Norway, Denmark, Latvia and the UK, and the lowest levels in Greece, Cyprus, Malta and Romania. Ireland does not feature prominently in the report. Amphetamine seizures in Ireland decreased from 277 in 2006 to 89 in 2010.2 
Cannabis, possible cardiac deaths and the coroner in Ireland
A recently published article examined the role of cannabis in cardiac deaths in Ireland.3 Of the 3,193 coronial cases processed between 2009 and 2010 by the Department of Chemical Pathology based in Beaumont Hospital, 99 had a positive screening immunoassay for cannabis in the urine. Thirteen of these cases had enough clinical information provided to indicate a cardiac cause of death, and were included in the study.
This group of cases had a median age of 47 years (range 17 to 61 years), and 11 were male. Myocardial infarction was the primary cause of death in 54% (7) of cases. In only one case was cannabis mentioned on the death certificate, and then not as a cause of death. Other causes of death included sudden adult death syndrome, sudden death in epilepsy, and poisoning by alcohol and diazepam. The author states: ‘To attribute death due to cannabis smoking, published evidence indicates that the trigger window is about 2 h [two hours] and that plasma cannabis values are required to estimate the time of cannabis usage.’ None of the cases included in this paper had plasma tetrahydrocannabinol (THC) measured.
In conclusion, the author suggests that plasma THC should be measured where urine cannabinoids are positive. He states: ‘A positive urine cannabinoids immunoassay alone is insufficient evidence in the linkage of acute cardiac death and cannabis.’
(Contributors Johnny Connolly and Ena Lynn)
1. EMCDDA and EUROPOL (2011) Amphetamine: a European Union perspective in the global context. Luxembourg: Publications Office of the European Union. www.emcdda.europa.eu/publications/joint-publications/amphetamine
2. Irish Focal Point (2011) 2011 National Report (2010 data) to the EMCDDA by the Reitox National Focal Point. Ireland: new developments, trends and in-depth information on selected issues. Dublin: Health Research Board.
3. Tormey WP (2012) Cannabis, possible cardiac deaths and the coroner in Ireland. Irish Journal of Medical Science, Online First. 10 January 2012. www.drugsandalcohol.ie/16772

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