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Connolly, Johnny and Lyons, Suzi (2012) Drugnet digest. Drugnet Ireland, Issue 42, Summer 2012, p. 8.

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

Dublin Lord Mayor’s Commission on anti-social behaviour
As part of the Lord Mayor of Dublin’s commission on anti-social behaviour, a conference entitled ‘Preventing and responding to anti-social behaviour’ was held in the Croke Park conference centre in February. A number of presentations were made. Dr Graham Connon, senior clinical psychologist with the Health Service Executive spoke on the topic ‘Anti-social behaviour in young people – Prevention and early intervention’. Ebun Akpoveta, training and employment officer with EPIC (Employment for people from immigrant communities), spoke on the topic ‘Intersection between discrimination, prejudice and anti-social behaviour’. Mark Finnis, from the Hull Centre for Restorative Practice in the United Kingdom spoke on the topic Towards a restorative city – Preventing and responding to anti-social behaviour’. The final presentation was by Mary Keane, national co-ordinator with the National Behaviour Support Services and Dr Ailish Rogers, chartered educational and child psychologist. The title of their paper was ‘Promoting positive behaviour and mental health in secondary schools’. PowerPoint presentations of all papers can be viewed on the Lord Mayor’s website at www.lordmayorofdublin.ie
INCB annual report 2011
The International Narcotics Control Board (INCB) is responsible for overseeing the operation of the international drug treaties, management of markets in medicines controlled by the treaties, and ensuring the supply of opioids for pain and other medical uses.1 The Board, which comprises 13 experts elected by the United Nations Economic and Social Council, deems itself the guardian of the treaties and is often critical of countries it judges as having violated their provisions. In its annual report for 2011,2 the state of Bolivia comes in for severe condemnation for denouncing aspects of the treaty provisions and defending traditional uses of the coca leaf in the Andean region. In his foreword to the report, Hamid Ghodse, President of the INCB, expressed the Board’s regret at the step taken by Bolivia, and said: ‘If the international community were to adopt an approach whereby States parties
would use the mechanism of denunciation and reaccession with reservations, the integrity of the international drug control system would be undermined and the achievements of the past 100 years in drug control would be compromised.’ Ireland comes in for milder criticism. As one of the ‘major manufacturers and exporters of psychotropic substances’, Ireland is cited for not having submitted the required annual statistical report on psychotropic substances by the appropriate deadline (p.19).
Addendum to best practice guidelines on treatment for opiate users
The Irish College of General Practitioners (ICGP) has issued an addendum3 to Working with opiate users in community based primary care,4 the best practice guidelines published in 2008. The addendum clarifies four items in the guidelines, as follows:
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·         To the sentence ‘Increments should be no greater than 10mg at a time’ is added ‘total dose increases should not exceed 20-30mg in one week’.
·         The sentence ‘Patients usually stabilise on doses between 60mg to 80mg’ is changed to ‘Patients usually stabilise on doses between 60mg to 120mg’. The ICGP states that this change is in line with international best practice, but they recommend that ‘this statement is read in the context of the complete section on commencing doses’.
·         The sentence starting ‘Higher doses of methadone (>80mg) may be required…’ is changed to ‘Higher doses of methadone may be required...’. The ICGP states: ‘It is not intended to suggest that >80mg would be interpreted as a high dose.’
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·         A similar rationale relating to dosage applies to the sentence starting ‘If a patient requires a dose >80mgs and you have limited experience ...’ , which is now changed to ‘If a patient requires a higher dose and you have limited experience ...’.
These changes will be made to the on-line version of the guideline document only, as new national guidelines on opiate treatment are currently being developed by a group comprising representatives of the HSE, the ICGP, the Irish College of Psychiatrists and the Pharmaceutical Society of Ireland.
(Contributors Johnny Connolly and Suzi Lyons)
1. For a recent article on the international drug conventions, see Room R and Reuter P (2012) How well do international drug conventions protect public health? The Lancet, 379(9810): 84–91.
2. For a copy of the full report see www.incb.org
3. The text of the addendum, in the form of a letter to colleagues, dated December 2011, from Dr Ide Delargy, Director of the ICGP Substance Misuse Programme, is available at www.drugsandalcohol.ie/17079
4. Irish College of General Practitioners (2008) Working with opiate users in community based primary care. Dublin: ICGP. Available at www.drugsandalcohol.ie/17079

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