The Twenty-first World Health Assembly,
MISCELLANY - ADVERSE REACTIONS FROM THE USE OF LYSERGIDE IN THE UNITED KINGDOM
DRUG USE IN AN URBAN COLLEGE POPULATION
FREQUENCY OF HALLUCINOGENIC DRUG USE AND ITS IMPLICATIONS
SYSTEMIC INFECTIONS IN HEROIN ADDICTS
UNFAVOURABLE REACTIONS TO LSD
Pages: 1 to 2
Creation Date: 1968/01/01
Having received information concerning the increasing misuse, especially by young people, of central nervous system stimulants of the amphetamine type,
Considering the special problems of abuse of such stimulants, as reported by certain Member States,
Deeply concerned at the continuing and spreading problem posed by the abuse of psychotropic substances not under international control,
Recognizing the responsibilities of the World Health Organization and other competent organs within the framework of the United Nations in combating the very serious problems of drug abuse,
Recalling its resolutions adopted at the Eighteenth and Twentieth World Health Assemblies relating to control measures for psychotropic drugs,
Reiterating the high importance it attaches to the adoption and strict application by Member States of the measures of national control recommended in the aforementioned resolutions,
Recognizing the need for urgent consideration of measures of international control of psychotropic substances,
Notes that the Secretary-General of the United Nations, at the request of the United Nations Commission on Narcotic Drugs, has circulated to Governments a questionnaire seeking information on existing control measures and on the need for, and nature of, national and international controls required for psychotropic substances;
Notes further that replies from Governments to the aforementioned questionnaire must reach the Secretary-General by 15 June 1968, so as to enable the United Nations Commission on Narcotic Drugs to proceed without delay in completion of a draft of an international instrument for control of psychotropic substances;
Notes also that the Director-General of the World Health Organization is prepared to advise the SecretaryGeneral of the United Nations in the elaboration of such a draft international instrument, and in the identification of drugs that would be controlled thereunder;
Welcomes the action which the Commission on Narcotic Drugs is already taking and expresses the hope that the Commission will propose effective measures of international control of psychotropic substances at its next session;
Expresses the view that agreement should be reached as quickly as possible on effective international control provisions; and
Urges Member States to adopt the national controls earlier recommended in resolution WHA20.43 by the Twentieth World Health Assembly, and currently under discussion in the Economic and Social Council, pending the development and implementation of any necessary international instruments. (Resolution WHA21.42, 23 May 1968.)
Adverse reactions to LSD were studied by Bewley in the United Kingdom. He reported six (two fatal) cases as a consequence of the recent increase in the abuse of LSD in Great Britain. ( Brit. Med. Journal, 3, 28-30, 1967.)
S. Pearlman presented a report at the Forty-fourth Annual Meeting of the American Orthopsychiatric Association (1967) including the results of a questionnaire sent out to 2,270 seniors at Brooklyn College. The survey, which had a 55 per cent return rate, yielded a figure of 6.3 per cent who had used drugs regularly and 60 per cent who were only one-time or occasional users. Two-thirds of the drug takers, who listed what drugs they had tried, reported only marijuana. However, since over one-third of the users failed to specify which drugs they were taking this figure must be interpreted with caution. (H. D. Kleber, Journal Nerv. Mental Diseases, 144, 308, 1967.)
Dr. D. Fisher of the University of California, Los Angeles, has been studying in the past two years with Dr. J. T. Ungerleider the various adverse reactions to LSD, beginning with the first 70 cases seen in their Emergency Room (the number of cases gradually increased from five to twenty per month). The patients were predominantly single, white, male and young, the average age being 21. Most of those who came from the Los Angeles area were either students or unemployed. The incidence of LSD usage among students in California, in his opinion, ranges from the conservative estimates of 3 and 4 per cent to estimates as high as 30 per cent (in certain high schools in Los Angeles, 40 to 50 per cent). A survey conducted on the campus of California State College at Long Beach gave the number of 11 per cent of the students who had taken hallucinogenic drugs ( Journal of Amer. Coll. Hlth. Ass., 16, 20, 1967.)
Ch. E. Cherubin and J. Brown compare the incidence of pulmonary infections occurring in addicts admitted to a large New York City hospital serving the area of central Harlem in Manhattan with the frequency of such infections reported from England by J. H. Briggs et al. The studies on the incidence of pulmonary infections of addicts are important since pneumonia and pulmonary abscess are, after hepatitis, the most common causes for admission of addicts to hospitals. According to the author's data the incidence of pulmonary infections is 10 times less in Harlem than in London. There is a notable difference in the nature of the pneumonia cases at the two places. A further clinical difference is that the New York addict with pulmonary infection generally does not have on admission evidence of active cutaneous or venous sepsis. The authors suspect that most cases occur as an infection superimposed on the pulmonary oedema which follows intravenous injection of heroin causing the death of most of the nearly 360 identified addicts who die in New York hospitals each year.
As regards the risk of tetanus, the authors write, "If tetanus is rare or non-existent in English addicts, who seem to be as careless in their injections as our addicts, the difference might be due to the peculiar but uniform inclusion of quinine in the 'narcotic' that the New York City addict buys." ( The Lancet, 2; 1227, 1967 and Ibis, 7537, 1968.)
A review was made by Smart and Bateman of the reported unfavourable reactions to LSD. The 20 reports they studied on this subject contained details of 221 adverse reactions including 138 cases of prolonged psychotic reactions, 63 non-psychotic reactions, 19 attempted and 11 successful suicides, 4 attempted and 1 successful homicides. Users of LSD would appear to be mainly young male college students or former students in their early 20s. From the reactions reported, no one is able to guarantee a safe dosage or a personality which is certain to create no unfavourable reactions to LSD (most of the cases occurred in persons taking LSD in unprotected setting; two-thirds of the suicide attempts and the successful homicide occurred after attempted therapeutic use). ( Canadian Med. Assoc. Journal, 97, 1214, 1967.)