SIH is found to be an effective way of treating heroin dependence refractory to standard treatment. SIH may be less safe than MMT and therefore requires more clinical attention to manage greater safety issues. This intensive intervention is for a patient population previously considered unresponsive to treatment. Inclusion of this low-volume, high-intensity treatment can now improve the impact of comprehensive healthcare provision.

No abstract

All previous studies of the sub-acute effects of ecstasy have failed to adequately control for group differences in psychopathology and past and concurrent substance use. The present study was designed to avoid these limitations. At an initial pre-drug baseline, a sample of 38 regular ecstasy users provided full substance histories and completed measures of personality and self-reported psychopathology. We then collected daily subjective measures of mood, cognitive impairment, restless sleep, sexual desire, craving for ecstasy and concomitant use of other substances for the next 9 days. The 20 participants who subsequently opted to take ecstasy during the 9-day assessment period reported modest sub-acute effects of ecstasy on negative mood and subjective cognitive impairment compared to those who did not after controlling for baseline group differences in psychopathology and frequency of ecstasy use. There were no significant sub-acute effects of ecstasy on interest in sexual activity or craving for ecstasy. After further controlling for co-use of alcohol with ecstasy, and the sub-acute effects of ecstasy on sleep, the sub-acute effect on mood remained marginally statistically significant but the subacute effect on cognitive impairment did not. The present findings suggest that the sub-acute effects of ecstasy in regular recreational users are relatively modest and transient but that such genuine effects may have been masked by, perhaps more clinically significant, chronic sequelae of regular ecstasy use in all previous studies of recreational ecstasy users.

In the WHO-EURO region, around 28 million people are currently living with chronic viral hepatitis, and 120,000 people die every year because of it. Lack of awareness and understanding combined with the social stigma and discrimination exacerbate barriers related to access to prevention, diagnosis and treatment services for those most in need. In addition, the persisting economic crisis has impacted on public health spending, thus posing challenges on the sustainable investment in promotion, primary and secondary prevention, diagnosis and treatment of viral hepatitis across European countries. The Hepatitis B and C Public Policy Association in cooperation with the Hellenic Center for Disease Prevention and Control together with 10 partner organizations discussed at the Athens High Level Meeting held in June 2014 recent policy developments, persisting and emerging challenges related to the prevention and management of viral hepatitis and the need for a de minimis framework of urgent priorities for action, reflected in a Call to Action (Appendix S1). The discussion confirmed that persisting barriers do not allow the full realisation of the public health potential of diagnosing and preventing hepatitis B and C, treating hepatitis B and curing hepatitis C. Such barriers are related to (a) lack of evidence-based knowledge of hepatitis B and C, (b) limited access to prevention, diagnosis and treatment services with poor patient pathways, (c) declining resources and (d) the presence of social stigma and discrimination. The discussion also confirmed the emerging importance of fiscal constraints on the ability of policymakers to adequately address viral hepatitis challenges, particularly through increasing coverage of newer therapies. In Europe, it is critical that public policy bodies urgently agree on a conceptual framework for addressing the existing and emerging barriers to managing viral hepatitis. Such a framework would ensure all health systems share a common understanding of definitions and indicators and look to integrate their responses to manage policy spillovers in the most cost-effective manner, while forging wide partnerships to sustainably and successfully address viral hepatitis.

The aim of this study was to differentiate the subacute from the chronic effects of ecstasy. Regular ecstasy users who subsequently chose to take ecstasy (experimental group: E, N = 16) were compared with regular ecstasy users who opted not to (control group: C, N = 16). Groups were assessed with neuropsychological and psychometric measures at drug-free baseline before ecstasy use and 1 and 4 days after use. Ecstasy users who consumed ecstasy (E) did not differ from those who did not (C) in relation to age, estimated IQ, personality or past substance use, including ecstasy. At baseline, E reported being more energetic, lively and cheerful whereas the day after ecstasy use they reported being more muddled, afraid, sad and dejected than C. However, this was not significant after controlling for sleep deprivation. Mood returned to baseline within 3 days and there were no group differences in Beck depression inventory scores at any of the three testing sessions. There were no subacute effects of ecstasy on working memory, story recall, impulsivity, or decision-making. However, at baseline and the day after use ecstasy users made poorer decisions, and were less sensitive to punishment, in the Somatic marker sensitivity test. These findings suggest that previous reports of marked subacute effects of ecstasy use may have been confounded by chronic polydrug use before use, co-substance use and sleep disturbances after use.