Addiction (1998) 93(6), 941 ± 943

News and Notes

COMPILED BY SARAH WELCH

M isuse of alcohol and other drugs by doc-

tors

Over the past year, a Working Group hosted by

the British Medical Association has met on a

number of occasions to address the problems

associated with misuse of alcohol and other

drugs by doctors. Their recommendations have

now been published. The report acknowledges

that doctors belong to ª a culture that resists

psychological stress, is reluctant to support con-

structively or confront colleagues, and is at times

overly stigmatizing or overly tolerant of alcohol

misuseº . These factors, with other practical con-

siderations, may hinder doctors from getting

help for dif® culties with alcohol and other drugs,

though it is known that once engaged in treat-

ment, medical practitioners do very well, and

that early recognition and treatment increase the

chance of successful rehabilitation. Among their

speci® c recommendations, the Working Group

recognises the need for inter-regional arrange-

ments to allow doctors where necessary to be

treated in different health authorities from those

in which they may be too well-known to the local

medical community for con® dentiality to be pre-

served in treatment.

The paradox of impaired access to health care

for addicted doctors is also the focus of a recent

editorial in the British Medical Journal (Strang et

al., 1998). The authors argue for a dedicated

service for doctors, stressing the need for accessi-

bility, including at times of crisis; for care pro-

vision by staff with experience of working with

health professionals as patients; and for special

arrangements for supervision and monitoring af-

ter return to work. The editorial draws attention

to the ª impaired physicianº schemes in the USA,

and argues that greater awareness and better

services in the UK would help to prevent dam-

age to doctors and to the patients in their care.

WORKING GROUP ON THE M ISUSE O F ALCOHOL AND

OTHER DRUGS BY DOCTO RS (1998) The Misuse of

Alcohol and Other Drugs by Doctors (British MedicalAssociation, BMA House, Tavistock Square, Lon-don WC1H 9JP).

STRANG , J., W ILKS, M., WELLS, B. & M ARSHALL, J.(1998 ) Missed problems and missed opportunitiesfor addicted doctors, British Medical Journal, 316,405± 406.

UK government comm ittee calls for evi-

dence on cannabis

A UK government select committee, on Science

and Technology (Sub-Committee I) is calling for

evidence concerning the science behind the argu-

ments over the use of cannabis and its derivatives

for medical and recreational purposes. A report

will be made to the House of Lords by Novem-

ber 1998. Written evidence can be submitted

concerning the physiological and psychological

effects of cannabis in its various preparations and

methods of administration; the extent to which it

is addictive, and to which tolerance can be devel-

oped; and the evidence for valuable medicinal

actions, including the case for promoting clinical

trials. The committee will consider the strength

of scienti® c evidence for medical use, and the

evidence for maintaining prohibition of rec-

reational use. Evidence must be submitted by 12

May 1998. For further information, contact the:

Clerk, Andrew M akower, House of Lords, London

SW 1A 0PW . Tel: 0171 219 6075; fax 0171 219

6715.

HIV and injecting drug use in the Nether-

lands

Part of the Amsterdam cohort studies among

drug users has been published as a volume of

papers concerning the transmission of HIV in

Amsterdam (Fennema, 1997). The papers pre-

sent an analysis of trends in injection drug use,

trends in HIV risk behaviours and incidence in

recent onset and young drug injectors, and data

concerning sexually transmitted diseases in drug-

0965 ± 2140/98/060941 ± 03 $9.50 Ó Society for the Study of Addiction to Alcohol and Other Drugs

Carfax Publishing Limited

942 News and Notes

using and non-drug-using sex workers in Am-

sterdam. The researchers found considerable

proportions of drug injectors to be under 25 or

to have started injecting within the past three

years, and also found that HIV prevalence

among young and recent onset injectors was

already moderate to high. Recent onset of injec-

tion was an independent predictor for serocon-

version. Preventive efforts since the mid-1980s

therefore appear to have been insuf® cient in

preventing drug users from starting to inject and

in preventing HIV infection, and the researchers

suggest that more innovative preventive efforts

need to be targeted at young and recent-onset

users.

FENNEM A, J.S.A. (1997) HIV infection among drug users

and the potential for heterosexual spread. Division ofPublic Health and Environment of the MunicipalHealth Service of Amsterdam, the Netherlands.

HIV and injecting drug use in China

Richard Tomlinson of the British M edical Journal

has recently reported on a new national plan for

HIV prevention which is being mounted in

China, including public information and edu-

cation plans. China had recorded 8303 cases of

HIV infection by the end of October 1997, with

positive tests from all but one of the provinces.

About two-thirds of the infected individuals were

thought to have become infected through inject-

ing drug use. The recorded ® gures are thought

to be a large underestimate, and the concerns are

that with high rates of injecting drug use, a

thriving sex industry and a large population of

migrant workers, the stage is set for further dis-

semination of HIV.

TOMLINSON , R. (1998 ) News, British Medica l Journal,14 Feb.

Albanian anti-alcoholic association

The Albanian Anti-alcoholic Association (AAA)

has sent Addiction a copy of a document regard-

ing the association’ s programme. This document

raises concern about increasing alcohol con-

sumption in Albania over the past decade, which

the organization attributes to a number of fac-

tors: anxieties which accompany a period of ma-

jor political change; unemployment, together

with opportunities to make easy temporary

pro® ts; money being sent in by those who have

emigrated; the lack of cultural events and their

replacement with gambling; and an unpre-

cedented increase in networks for distribution of

spirits. Other factors noted are the lack of state

and legal controls, the lack of an alcohol policy,

and insuf® cient teaching and training in schools,

health services, judicial institutions and organisa-

tions concerned with the well-being of young

people. The AAA has set out a broadly-based

strategy to be implemented nationally through

use of the mass-media, and locally by AAA’s

organization on a district, city and commune

basis. This involves action in primary health care

services, schools and workplaces, the judicial sys-

tem and police, and customs and excise. They

hope to form new policies and ongoing scienti® c

programmes, building on expertise from other

countries with more developed alcohol policies.

Smoking news from round the world

· Documentation has been obtained showing

that a major American tobacco company com-

missioned studies of the smoking habits and

brand preferences of adolescents as young as

14, describing the 14± 24 age market as tomor-

row’ s cigarette business.

· The German parliament has rejected a bill

proposing to ban smoking on public transport,

in public buildings and in the workplace.

· Anti-smoking laws have been passed in the

Philippines, including the stopping of cigarette

advertising in the written and broadcast media

over the next four years; banning of smoking

in public places; and introducing penalties for

selling cigarettes to children (though concerns

have been raised that many sellers of tobacco

are children themselves).

Changes in UK ª drink-driveº lim it

The UK transport minister Dr Gavin Strang has

launched a consultation paper entitled Combating

Drink-Driving Ð Next Steps, which seeks views on

lowering the legal alcohol limit for British driv-

ers. The document states that impairment for

many drivers begins well below the current limit

of 80 mg/ml. One suggestion is that the 12

month disquali® cation should still be reserved

for drivers above the 80 mg/ml limit, while

lighter penalties such as ® nes could be exacted

for drivers whose levels are between 50 mg/ml

and 80 mg/ml. This could have some advan-

tages, but will it confuse people to have two

limits? View are also sought on other issues such

as lower limits for young or newly-quali® ed

drivers; the penalties for repeat offenders; and

News and Notes 943

whether self-testing breathalysers are helpful or

whether they will encourage drivers to drink up

to the limit. The consultation document is avail-

able on the Internet (www.detr.gov.uk/con-

sult.htm).

Needle disposal site on a London railway

station

I have just been sent a press release about a small

local collaborative project which aims both to

make a community safer for local people and

also to help drug users within that community. A

local council and a railway company in Tower

Hamlets, East London have worked together to

set up and maintain a needle disposal site in a

local railway station. This station is regularly

used by drug injectors, resulting in discarded

needles being left on the station ¯ oor and track.

West Anglia and Great Northern Railways will

pay to have the site built, and the council will

pay for its maintenance, which will be carried

out by a local voluntary organization for drug

users.

Conferences and events

First International M eeting of the Society for Re-

search on Nicotine and Tobacco, 22± 23 August,

1998, University of Copenhagen Medical

School. The major aim of this conference is to

increase communication among European scien-

tists working on nicotine and tobacco issues. The

meeting’ s sponsors include the European Medi-

cal Association on Smoking and Health, the

International Council on Alcoholism and Addic-

tion. For information contact: Jude Woodward,

Conference Director, Society for Research on Nic-

otine and Tobacco, 401 R. Jefferson Street, Suite

205, Rockville, M D 20850, USA. Tel: 1 1 (301)

251 9133 Fax: 1 1 (301) 279 6749. E-mail emi-

geninfo@srnt.org

The Centennial of Heroin: a conference sponsored

by the Yale Child Study Center and the Yale Section

of History of M edicine in conjunc tion with the

National Institute on Drug Abuse, 18± 20

September, 1998, New Haven, Connecticut,

USA. This conference commemorates the initial

marketing of heroin for medical purposes in

1898 and will explore the drug’ s subsequent role

as a public health problem in the USA and

around the world. Noted experts from academia,

the health professions and government sched-

uled to speak include David C. Courtwright,

Ph.D., of the University of North Florida;

Robert L. DuPont, M.D., Former Director of

the National Institute on Drug Abuse; Jerome H.

Jaffe, M.D., who led federal treatment programs

in the early 1970s; Bruce Johnson, Ph.D.,

Director of the Institute for Special Populations

Research at the National Development and Re-

search Institutes, New York, NY; Jill Jonnes,

Ph.D., author of Hep Cats, Narcs and Pipe

Dreams: A History of America’ s Romance with

Illegal Drugs; Egil Krogh, Jr. who managed fed-

eral drug control policy in the Nixon White

House; Kathryn Meyer, Ph.D., of Lafayette Col-

lege; Eric J. Nestler, M.D., Professor of Psy-

chiatry and Pharmacology at the Yale School of

Medicine; Peter Reuter, Ph.D., of the University

of Maryland; Richard Schottenfeld, M.D., Di-

rector of the Substance Abuse Treatment Unit at

Yale New Haven Hospital; and William L.

White, Senior Research Consultant at the Light-

house Institute. Senator Daniel Patrick Moyni-

han (D., NY) will open the conference with an

address on his long-standing experience with

federal drug policy.

For details, please contact: David F. Musto

M .D., Yale Child Study Center, P.O. Box 207900,

New Haven, CT 06520, USA. Tel: 1 1 (203)

785 ± 4258. E-mail: david.musto@yale.edu

Children of Problem Drinking Parents, London,

UK, 16 July 1998. This is a National Conference

hosted by Alcohol Concern, Childline, NCH

Action for Children and NSPCC. Further details

from: Karen Polycarpides, Alcohol Concern, W ater-

bridge House, 32-36 Loman Street, London SE1

0EE. Tel: 1 44(0) 171 9287377. Fax: 1 44(0)

171 9284644. Email: alccon@ popmail.dircon.co.uk

Editorial note

In the article published by Arciniega L.T. and

Miller W.R. (1997) ª Where to publish? Some

considerations among English language addic-

tions journalsº , Addiction , 92, 1639 ± 1648, Dr

Ernest Drucker was identi® ed as editor of the

journal Addiction Research. We understand that

Dr Drucker (Monte¯ ore Medical Center) is the

Editor-in-Chief who receives manuscripts for

that journal from North and South America and

the Far East, while Professor John Booth Davies

(Centre for Applied Social Psychology at the

University of Strathclyde) is the Editor-in-Chief

receiving manuscripts from the UK, Europe,

Scandinavia, Australia and New Zealand. The

journal is compiled at Professor Davies’ s Unit.

We are very happy to provide this additional

information.