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Psychiatry and the global drugs debate: what every psychiatrist needs to know

  • Owen Bowden-Jones (a1), Julia Sinclair (a2) and Anne Lingford-Hughes (a3)

Summary

There are few topics that divide public opinion as sharply as the use of psychoactive substances and it is easy to see why. Substance use is complex and can be examined from numerous perspectives, including legal, health, economic, cultural and ethical. These varying approaches can lead to a range of different conclusions. Here we explore some of the common approaches adopted towards drug policy and suggest a number of principles, which may inform a psychiatrist's own view.

Declaration of interest

A.L.-H. has received honoraria paid into her institutional funds for speaking and chairing engagements from Lundbeck, Lundbeck Institute UK, Janssen-Cilag, Pfizer and Servier; received research grants or support from Lundbeck and GSK; consulted for Silence, NET Device Corps and Sanofi-Aventis; and also consulted for, but received no monies from, Britannia Pharmaceuticals, GLG, Opiant, Lightlake and Dobrin. O.B.-J. and J.S. have no conflicts of interest to disclose.

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Copyright

Corresponding author

Correspondence: Owen Bowden-Jones, Central North West London NHS Foundation Trust, NWL Club Drug Clinic, 69 Warwick Road, Earl's Court, London SW5 9HB, UK. Email: owen.bowdenjones@nhs.net

References

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1World Health Organization (WHO). International Statistical Classification of Diseases and Related Health Problems (11th Revision). WHO, 2018 (https://icd.who.int/en/).
2Clinical Guidelines on Drug Misuse and Dependence Update 2017 Independent Expert Working Group. Drug Misuse and Dependence: UK Guidelines on Clinical Management. Department of Health, 2017 (https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/673978/clinical_guidelines_2017.pdf).
3Lingford-Hughes, A, Welch, S, Peters, L, Nutt, D, on behalf of expert group. Evidence-based guidelines for the pharmacological management of substance misuse, addiction and comorbidity: recommendations from BAP. J Psychopharmacology 2012; 26(7): 899952.
4National Institute for Health and Care Excellence (NICE). Methadone and Buprenorphine for the Management of Opioid Dependence. NICE (TA114), January 2007 (https://www.nice.org.uk/guidance/ta114).
5Burkinshaw, P, Knight, J, Anders, P, Eastwood, B, Musto, V, White, M, et al. An Evidence Review of the Outcome That Can be Expected of Drug Misuse Treatment in England. Public Health England, 2017 (https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/586111/PHE_Evidence_review_of_drug_treatment_outcomes.pdf).

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Psychiatry and the global drugs debate: what every psychiatrist needs to know

  • Owen Bowden-Jones (a1), Julia Sinclair (a2) and Anne Lingford-Hughes (a3)
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