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Vaping is increasingly common among young people. It is less harmful than smoking, but not without risk, particularly for people who have never smoked. Researchers surveyed 39,214 young people and found that: those who vaped were more likely to have breathing issues than those who did not the more they vaped, the higher their chance of breathing issues. The researchers call for more research on the overall safety of vaping in young people, and on the effects of different types of nicotine and vapes and the various flavours. They say that improved labelling would allow thorough investigation of ingredients.

It is widely recognised that pharmaceutical marketing contributed to the ongoing US opioid epidemic, but less is understood about how the opioid industry used scientific evidence to generate product demand, shape opioid regulation and change healthcare professionals' behaviour. This qualitative study looks at select scientific articles used by industry to support safety and effectiveness claims and uses a novel database, the Opioid Industry Documents Archive, to look at industry and non-industry documents citing the scientific articles to advance each claim. The authors found that 15 scientific articles were collectively mentioned in 3666 documents supporting five common, inaccurate claims: Opioids are effective for treatment of chronic, non-cancer pain. Opioids are “rarely” addictive. “Pseudo-addiction” is due to inadequate pain management No opioid dose is too high Screening tools can identify those at risk of developing addiction. The articles contributed to the eventual normalisation of these claims by: symbolically associating the claims with scientific evidence building credibility expanding and diversifying audiences and the parties asserting the claims obfuscating conflicts of interest. These findings have implications for regulators of industry products and corporate activity and can inform efforts to prevent similar public health crises.

Too many women are dying from disadvantage in one of the poorest parts of England, according to ground breaking new research which serves as an urgent wake-up call for levelling up efforts.  The report by Agenda Alliance and Changing Lives, Dismantling disadvantage has found that in 2021 a woman in the North East of England was 1.7 times more likely to die early as a result of suicide, addiction, or murder by a partner or family member than in the rest of England and Wales. Today’s new research was conducted to better understand the lives and needs of disadvantaged women in the North East, including Newcastle, coastal areas and Gateshead and Sunderland; some of the poorest regions in the country. Working with women with lived experience at every stage, the study involved 18 in-depth interviews, 47 survey responses; focus groups; data analysis and multiple meetings with affected women, practitioners and policy makers.

The World Health Organization (WHO) has published the third edition of the Mental Health Gap Action Programme (mhGAP) guideline which includes important new, and updated, recommendations for the treatment and care of mental, neurological and substance use (MNS) disorders. MNS disorders are major contributors to morbidity and premature mortality in all regions of the world. Yet it is estimated that over 75% of people with MNS disorders are unable to access the treatment or care they need. The mhGAP guideline supports countries to strengthen capacity to deal with the growing burden of these conditions. It is intended for use by doctors, nurses, other health workers working in non-specialist settings at primary health care level, as well as health planners and managers. The guideline contains a new module on anxiety reflecting the increased number of people with anxiety disorders, which are among the world’s most common mental disorders. The module includes the following recommendations: Psychological interventions based on cognitive behavioural therapy (CBT) should be offered to adults with generalized anxiety disorder and/or panic disorder. These interventions can be offered in a variety of formats including online, in-person, in groups, or self-guided. Stress management techniques should be considered for adults with generalised anxiety and/or panic disorder. Selective Serotonin Reuptake Inhibitors (SSRIs) should be considered for treating adults with generalized anxiety and/or panic disorder. Psychological and psychosocial interventions The guideline sets out the continuing importance of psychological treatments for a range of MNS conditions. The mhGAP guideline contains new recommendations on psychosocial interventions for carers of persons with psychosis or bipolar disorder as well as new recommendations on psychosocial interventions for psychosis, alcohol dependence, substance use, dementia, and children and adolescents with neurodevelopmental disorders including autism, ADHD and cerebral palsy. Women and girls who want to become pregnant or may become pregnant should not use valproic acid (sodium valproate) The guideline contains an updated recommendation which advises against the use of valproic acid (sodium valproate), a medicine for the treatment of epilepsy and bipolar disorder, due to risk of birth defects if taken during pregnancy. The guideline recommends the following: Valproic acid (sodium valproate) should not be prescribed to women and girls who want to become pregnant or may become pregnant because of the high risk of birth defects and developmental disorders in children exposed to valproic acid in the womb. For women and girls currently prescribed valproic acid (sodium valproate), advice should be provided on use of effective contraception. It is important that women and girls do not stop taking valproic acid (sodium valproate) without first discussing it with their doctor. Women should be advised to consult their physician as soon as they are planning pregnancy and the need to urgently consult their physician in case of pregnancy. Every effort should be made to switch to appropriate alternative treatment prior to conception. A specialist should periodically review whether valproic acid (sodium valproate) is the most suitable treatment for the person. Other recommendations: Digitally-delivered psychological and psychosocial interventions feature across multiple modules - alcohol use disorders, anxiety, conditions related to stress, drug use disorders, and self-harm and suicide Recommendations for non-pharmacological interventions to improve outcomes for people with dementia have been updated to include physical exercise, CBT, cognitive stimulation therapy and cognitive training. The antipsychotic medicines quetiapine, aripiprazole, olanzapine, paliperidone, and the long-acting antipsychotics haloperidol and zuclopenthixol are included for treatment of psychosis and bipolar disorder. Levetiracetam and lamotrigine are included for treatment of epilepsy.

The public health grant is paid to local authorities from the Department for Health and Social Care (DHSC) budget. It is used to provide vital preventative services that help to support health. This includes smoking cessation, drug and alcohol services, children's health services and sexual health services, as well as broader public health support across local authorities and the NHS. Key points: The public health grant has been cut by 26% on a real-terms per person basis since 2015/16. Additional but time-limited funding for drug and alcohol treatment has been allocated to local authorities. Taking account of this additional spend leaves broader public health funding 21% lower on a real terms per person basis since 2015/16. Some of the largest reductions in spend over this period were for stop smoking services and tobacco control, falling by 45% in real terms, as well as drug and alcohol services for adults (17%) and sexual health services (29%). Poor health is strongly associated with living in socioeconomically deprived areas. A girl born today in the most deprived 10% of local areas is expected to live 19 fewer years in good health than a girl born in the least deprived. However, real-terms per person cuts to the grant have tended to be greater in more deprived areas. In Blackpool, ranked as the most deprived upper tier local authority in England, the cut to the grant (including new drug and alcohol treatment funding) has been one of the largest – at £33 in real terms per person since 2015/16. Local authority public health interventions funded by the grant provide excellent value for money, with each additional year of good health achieved in the population by public health interventions costing £3,800. This is three to four times lower than the cost resulting from NHS interventions of £13,500.

The opioid crisis in the United States (US) is one of the most high-profile public health scandals of the 21st century with millions of people unknowingly becoming dependent on opioids. The United Kingdom (UK) had the world’s highest rate of opioid consumption in 2019, and opiate-related drug poisoning deaths have increased by 388% since 1993 in England and Wales. This article, published in the British Journal of Pain, explores the epidemiological definitions of public health emergencies and epidemics in the context of opioid use, misuse, and mortality in England, to establish whether England is facing an opioid crisis.

The United States has been the site of significant social and economic fallout during the course of the coronavirus (COVID-19) pandemic. The last year has been marked by high rates of unemployment, stress, economic insecurity, and uncertainty. And for people with mental health and substance use disorders, the consequences of the pandemic have been felt deeply. As vaccines for people in the United States become more widely available, understanding the impact of the pandemic on substance abuse and treatment remains important for determining the next steps and helping those in need of care. In this blog, AddictionResource.net describe some of the ways that the coronavirus pandemic has affected the lives of people with substance use disorders over the past year.

This is the report of the Scottish Government's Ministerial Task Force on Health Inequalities. The report brings together thinking on poverty, lack of employment, children's lives and support for families and physical and social environments, as well as on health and wellbeing. It makes clear that the Scottish Government will not only respond to the consequences of health inequalities, but also tackle its causes.

The rise in opioid overdoses warrants a review of the symptoms of akathisia writes Russell Copelan. Before the coronavirus pandemic, the nation was struggling with escalating drug overdose deaths. Now, there are some who are convinced that the COVID-19 pandemic has led to further increases in opioid overdoses. Public services were disrupted. Some treatment programmes had to restrict access, reduce staffing, and increase supply between limited provider visits. Many addicts are homeless and do not have Internet or telemedicine contact. Social distancing may have prevented some individuals from having anyone around to administer naloxone (Narcan, Evzio). Inadequate border restrictions have likely increased drug supply with higher potency. These conjoint "opioid epidemics" have heightened and stirred conversations about prescribing and regulatory practices, "war on drugs" rhetoric, the "fifth vital sign," opioid accessibility, prescription rates, and effectiveness of opioids for non-cancer chronic pain, among many others. With the rise in opioid use and death, a review of the many and sometimes paradoxical expressions of akathisia is warranted.