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Objective. The objective of this study was to examine practices and policies in place for the provision of targeted prevention and treatment of cocaine and Amphetamine Type Stimulant (ATS) users in prison in nine European countries. Methodology. Across nine European member states (Belgium, the Netherlands, Czech Republic, Lithuania, Slovenia, Sweden, Malta, Ireland and Portugal), interviews were conducted with ministerial representatives and professionals (i.e. service providers and security officials) working in prisons and a total of 16 focus groups with a total of 125 prisoners. Results. The use of stimulants in prison is associated with aggression and violence, financial problems, and psychological and physical problems in prisoners (depression, anxiety and psychological craving). Both security and healthcare staff in prison often feel ill‐equipped to deal with stimulant‐related problems, leading to a lack of equivalence of care for stimulant users in prison, therefore the variety and quality of drug services outside is not reflected sufficiently inside prison. There is a need for more specific product information and harm reduction material on stimulants, for clear guidelines for the management of acute stimulant intoxication and stimulant withdrawal, for structural adjustments to improve potential diagnosis of personality and psychiatric disorders, for more non‐pharmacological treatment strategies and more opportunities for prisoners to engage in purposeful activities.

The purpose of this paper is to determine whether trends in arrests for heroin, amphetamine‐type substances (ATS) and cocaine can be used as indicators of trends in the use of these drugs.

The question was addressed using ARIMA models to analyse the relationship between arrests and emergency department (ED) admissions for narcotics, amphetamine type substances (ATS) and cocaine.

Strong positive correlations were found for the narcotics and cocaine series between arrests and EDs in the same month (contemporaneous correlation) and between arrests in the current month and overdoses in earlier months (lagged correlation). The contemporaneous correlation between ATS arrests and EDs was slightly less strong than the lagged correlations at two and four months. A jump in ATS EDs, was followed by a jump in arrests in the same month and then two and four months later.

Arrests for narcotics use/possession, ATS use/possession and cocaine use/possession may in some circumstances provide useful intelligence about drug trends and/or a basis for evaluating the impact of police drug law enforcement activity on the use of narcotics, ATS and cocaine when other stronger measures of drug use are not available.

Efforts to evaluate local drug law enforcement activity on illicit drug use have been hampered by poor measures of trends in illicit drug use at small area levels. This is the only study the authors are aware of that has examined the long‐term relationship between illicit drug arrests and emergency department admissions for illicit drug use.

The purpose of this paper is to provide health professionals with novel psychoactive substances (NPS) clients with up to date information relating to the background, clinical pharmacology and, when possible, clinical management for each of these categories.

The world of NPS is complex and diverse, including a range of different molecules such as: psychedelic phenethylamines; synthetic cannabinoids, cathinone derivatives; novel stimulants; synthetic opiates/opioids; tryptamine derivatives; phencyclidine-like dissociatives; piperazines; GABA-A/GABA-B receptor agonists; a range of prescribing medications; psychactive plants/herbs; and a large series of performance and image-enhancing drugs. These molecules are sought by users for their psychactive effects.

The NPS categorization and classification provided here is an attempt to identify and better understand some of these substances. Given the vast range of medical and psychopathological issues associated with the NPS described it is crucial for health professionals to be aware of the effects and toxicity of NPS. The EU-MADNESS project aims to both better understand the pharmacology of the available/forthcoming NPS and to disseminate the most current NPS-related information to practising and training health professionals.

Further studies are required to identify a range of evidence-based, NPS-focused, clinical management and treatment strategies.

The rapid pace of change in the NPS online market constitutes a major challenge to the provision of current and reliable scientific knowledge on these substances.

The present review will provide an overview of the clinical and pharmacological issues related to a few hundred NPS.

Secure Children’s Homes are safe environments where many of the most troubled children in British society are resident. These children are from either a criminal background or referred for protection of themselves and others from harm. There is often a history of drug use and diagnoses of mental health problems before admission. The purpose of this paper is to examine one Secure Children’s Home to determine the level of drug use prior to admission compared to surveys of children not in this environment and to examine the veracity of the mental health diagnoses.

This paper is a retrospective examination of case notes for admissions from 2014 to 2015.

The study found much higher levels of drug use than in the general population at similar age and a wide diagnosis of mental health problems prior to admission.

Levels of harm from traumatic childhood events need to be recognised by referrers as maybe leading to attachment disorders and not mental health problems. More research is needed into the outcomes form Secure Children’s Homes in the long term.

The children in these homes do have as anticipated much higher levels of drug use than in the general population and high levels of mental health diagnoses which are not always borne out during their admission to the children’s home.

This is an examination of a special population of young people indicating high levels of drug use and mental health problems.

The landscape for international drug policy is shifting rapidly as the tensions between the objectives, assumptions and activities that are being introduced at local level are tearing apart the assumptions on which the system was founded. Countries are divided into camps that pursue different aims with drug policy. In addition to an established distinction between those that seek to reduce drug harms and those pursuing a vision of a drug-free world, some UN member states have established licit markets for products that the conventions hold are available for medical and scientific purposes. This incongruence is matched by states in the other camp who apply capital and corporal punishment ostensibly in pursuit of a public health objective. These differences over underlying values, but also in the use of evidence, and interpreting the purpose of the drug control system are no longer reconcilable. While there is pressure on maintaining the system, it no longer serves an organic function and continues mainly for the benefit of constituent members. With the dissolution of US leadership, drug policy is no longer operating within an effective international framework.

Recreational drug use is widespread. It is argued that it has reached a phase of ‘normalisation’ among youth and has become a part of mainstream culture. While there is a substantive body of literature addressing substance use in club settings, the world of music festivals is underexplored. The research aims to fill this gap by analysing patterns of drug use and implementation of harm reduction measures among Polish and Hungarian women at music festivals. This explorative inquiry used an online questionnaire, which was shared via social media channels. The data collection lasted for one month during the summer of 2017.

The study found that over 95% (N=510) of women use psychoactive substances at festivals. The most popular drugs are alcohol and cannabis, and the least popular cocaine and psilocybin. The majority of women declare moderate use of alcohol and light to moderate use of cannabis. One-fifth of the respondents report a moderately heavy use of 3,4-methylenedioxymethamphetamine and 8% heavy use of amphetamine. There are numerous positive weak relationships between the intensity of use of various substances. Increased use of drugs is also related to increased frequency of combining them. Low prevalence of illicit drugs testing is observed. There seems to be a negative correlation between the intensity of substance use and the adoption of harm reduction measures. The results have high practical relevance primarily for harm reduction and medical services. Especially cases of moderately heavy and heavy use should be of interest, even more so given that combining substances seems to be prevalent. The data suggest that we can distinguish between two groups: one aware and implementing various measures of harm reduction and second not adopting any of them. There is a need for more widespread drug education and harm reduction promotion, which should be implemented in a favourable legal and policy environment.