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There have always been traditional differences between the various regions of the British Isles. For example, meat consumption is greater in the North than the South; most families take some meat at every meal and this extends to the children. The North is the home of the savoury meat products, eg., faggots, rissoles and similar preparations and a high meat content for such foods as sausages is expected; between 80 and 90% with the cereal only present for binding purposes. Present minimum meat contents would be considered a swindle, also the nature of the lean meat and the lean meat/fat ratio. The high water content similarly would have been unacceptable.

Public health experts and advocates have long raised concerns about the pandemic preparedness of prison systems worldwide – an issue that became increasingly salient at the start of the COVID-19 pandemic. People in prison experience poorer health outcomes compared to the general population, making timely access to adequate health services in prison critical for their health and wellbeing. This study aims to identify the extent of the literature on initial changes in mental health and substance use services for people in prison during the COVID-19 pandemic, summarize and synthesize the findings and identify areas in need of further study.

The authors conducted a review of the academic literature published internationally in English between 2019 and December 1, 2020 to describe the disruptions and adaptations to mental health and substance use services in prisons during the onset of the COVID-19 pandemic.

The authors found that mental health and substance use services in prisons around the world were widely disrupted due to the COVID-19 pandemic – predominantly consisting of the complete suspension of services, discontinuation of transfers to off-site treatment sites and limitations on service capacity. Adaptations ranged from virtual service delivery and changes to treatment dispensation processes to information sessions on overdose prevention.

To the best of the authors’ knowledge, this is the first review to examine the nature and extent of the literature on delivery of mental health and substance use services in prisons during the COVID-19 pandemic.

THE IFLA Conference—or to be more precise—the 34th Session of the General Council of IFLA—met at Frankfurt am Main from the 18th to the 24th of August, 1968. Note the dates, for they include the 21st of August, the day when the delegates heard, as did the rest of the world, of the invasion of Czechoslovakia. Until then the Conference had been proceeding happily, and with the smoothness inborn of German organisation. During and after that date, a blight was cast over the proceedings, and although the Conference carried out its formal and informal programmes as planned, concentrations were disturbed as delegates sometimes gathered round transistor radios, their thoughts on Eastern Europe.

The misuse of pharmaceutical opioid analgesics is identified as a global public health concern. Codeine represents an interesting quandary in terms of its regulated status, with individuals varying in their metabolism of codeine, estimation of safe dosages, risk of adverse health consequences and abuse potential. Efforts to quantify and address hidden non-compliant medical codeine use, overuse and intentional misuse is compromised by availability to the public in prescribed and over the counter forms. The paper aims to discuss these issues.

A review of literature on codeine use, misuse and dependence, and associated innovative medical and pharmacy interventions is presented, and was conducted as part of a larger scoping review on codeine.

The review highlights the complexities associated with monitoring public health awareness of codeine's abuse potential, and customer/patients trends in non-compliant codeine use for therapeutic and recreational purposes. Aberrant codeine behaviours centre on visiting multiple doctors for prescriptions, repeated lost or stolen prescriptions, forging prescriptions and use of multiple pharmacies. Innovations to monitor misuse of codeine include national prescription databases and recent developments in real-time monitoring of dispensing activity.

Further development of real-time monitoring processes with process evaluation is advised.

This viewpoint is intended to demonstrate how efforts to quantify and address codeine use are compromised by its availability. It intends to encourage further policy and practitioner dialogue on how to monitor, support and intervene with consumers misusing codeine.