Correspondence

ACMD work programme 2024 (accessible)

Updated 5 April 2024

ACMD Chair: Professor Owen Bowden-Jones ACMD
Secretary: Zahi Sulaiman
1st Floor (NE), Peel Building
2 Marsham Street
London SW1P 4DF

ACMD@homeoffice.gov.uk

Rt Hon James Cleverly MP
Home Secretary
2 Marsham Street
London
SW1P 4DF

14 February 2024

Dear Home Secretary,

RE: ACMD Work Programme 2024

In my final term as Chair of the Advisory Council on the Misuse of Drugs (ACMD), I am writing to provide reflections on some of the Council’s advice over the last year and to set out the ACMD’s current work programme for 2024.

Over the past year, in the area of novel psychoactive substances we have provided further updates to our advice on ‘nitazene’ (2-benzyl benzimidazole) opioids. We also responded to the ministerial request for harms assessments on Cumyl-PeGaClone and other recently encountered synthetic cannabinoid receptor agonists (SCRAs) as well as Diphenidine and related substances.

The ACMD also provided advice on drug legislation including a harms assessment and scheduling of nitrous oxide, barriers to research for Schedule 1 controlled drugs and advice on NHS-England electronic prescribing proposals.

We are currently working at full capacity on our work programme for 2024. This has been guided by several existing ministerial commissions as well work the ACMD has chosen to undertake on its own volition, including continuous improvements to how we provide recommendations to government. Each workstream listed below includes a brief update and an expected timeline for publication.

Ongoing government Commissioned Workstreams

Xylazine harms assessment

Status: Ongoing, expected completion by February 2024.

On 19 June 2023, the ACMD was commissioned to provide advice on the harms of the veterinary medicine xylazine, including the appropriate control under the Misuse of Drugs Act 1971 and schedule under the Misuse of Drugs Regulations 2001.

2-Methyl-AP-237 classification and scheduling

Status: Ongoing, expected completion by April 2024.

Following the 66th session of the United Nations Commission on Narcotic Drugs, 2- Methyl-AP-237 was added to the relevant Schedule 1 of the Single Convention on Narcotic Drugs of 1961, as amended by the 1972 Protocol. On 19 June 2023, the government commissioned the ACMD to review the harms and consider control of 2-Methyl-AP-237, to comply with our international obligations.

Prevention of drug use in children and young people

Status: Ongoing, first stage of commission to be completed by April 2024 to align with future funding allocation for the work. The work would build past April 2024.

On 27 July 2023, the government commissioned the ACMD to provide advice on what a whole system response, nationally and locally, could look like to prevent and reduce drug use and harm amongst 11–24-year-olds over the 10-year scope of the Drugs Strategy. The ACMD has recently commenced this work.

Alkyl nitrites updated harms assessment

Status: Ongoing, expected completion by June 2024.

On 6 August 2020, the then Home Secretary commissioned the ACMD to provide advice on exempting alkyl nitrites (‘poppers’) from the Psychoactive Substances Act 2016. This work was initially delayed while awaiting further clarification from government.

Drivers of powder cocaine use

Status: Ongoing, expected completion by June 2024.

On 6 August 2020, the then Home Secretary commissioned the ACMD to begin work into understanding the drivers of powder cocaine use in young people.

This work was recently initiated, under an expanded scope, to look at the drivers of cocaine use for both young people and adults. The work will additionally review the increasing anecdotal evidence around the injection of powder cocaine.

Synthetic cathinones updated harms assessment

Status: Ongoing, expected completion by December 2024.

On 10 May 2023, the government commissioned the ACMD to provide an updated harms assessment of synthetic cathinones under the Misuse of Drugs Act 1971 and whether certain synthetic cathinones, such as MDPHP and others termed ‘monkey dust’, are significantly more harmful than others and may therefore merit a separate approach.

Internet facilitated drugs markets

Status: Ongoing, expected completion by December 2024.

On 6 August 2020, the then Home Secretary commissioned the ACMD to provide advice in relation to the sale of drugs online, and how could this inform an effective guide for enforcement when monitoring and intervening in drug trafficking on the dark and clear net.

On hold government commissioned workstreams

‘Swift, Certain, Tough: New Consequences for Drug Possession’ white paper

Status: Not yet commenced, awaiting clarification from the Home Office.

On 4 October 2022, the ACMD was commissioned to establish a working group to provide advice on the implementation of the ‘Swift, Certain, Tough: New consequences for drug possession’ white paper. The ACMD is awaiting clarification from the Home Office regarding the scope and aims of the commission.

Ongoing self-commissioned workstreams

Gidazepam, desalkyl gidazepam and other recently encountered uncontrolled benzodiazepines

Status: Ongoing, expected completion by April 2024.

Following publication of ACMD advice on ‘designer’ benzodiazepines in 2020, the ACMD monitoring group has become aware of the non-medical use of further novel benzodiazepines in the UK, including gidazepam and desalkyl gidazepam. In view of evidence of / potential for emerging use and harms in the UK, the ACMD has decided to provide advice on the appropriate domestic controls for these benzodiazepines under the Misuse of Drugs Act 1971, the Misuse of Drugs Regulations 2001 and, where appropriate, the Misuse of Drugs (Designation) Order 2015.

Cognition enhancers

Status: Ongoing, expected completion by April 2024.

There has been concern about a rise in the use of cognitive enhancers (‘nootropics’) that might be associated with harms amongst a range of populations: notably students, but also some professionals in high performance environments.

Drug use in ethnic minority groups

Status: Ongoing, expected completion by September 2024.

The ACMD has previously investigated vulnerability and risk factors to developing substance use and vulnerability of specific groups including young people, older people using drug services, and homeless people. Following this work the ACMD has agreed to provide advice on drug use in ethnic minority groups.

Self-commissioned workstreams on continuous improvement

Update to ACMD’s Standard Operating Procedure (SOP) on use of evidence

The ACMD is developing an SOP to support making consistent recommendations to government on classification decisions under the Misuse of Drugs Act 1971. This follows the development of SOPs for using evidence to assess the health and social harms of drugs, and for providing recommendations on drug scheduling.

Improving the tracking of ACMD recommendations

ACMD recommendations are typically targeted to lead departments and submitted with metrics for assessing their intended effect. Where lead departments have decided to accept recommendations, there is currently no mechanism for the ACMD to track the status or progress of these recommendations. A working group is trialling mechanisms for improved tracking of the implementation of recommendations.

New or resuming self-commissioned workstreams

Drug Use in the LGBTQ+ Community / Chemsex

Chemsex is a term used to describe sex occurring under the influence of certain drugs taken for the specific purpose of enhancing the sexual experience. The drugs typically include methamphetamine, mephedrone and GHB/GBL, and the practice is especially prevalent within men who have sex with men (MSM).

The ACMD began work in 2020 on a report covering LGBTQ+ drug use more widely, with a specific focus on Chemsex, however following an urgent government commission on GHB and related compounds, the working group focused on delivering this government priority. This report was published in November 2020.

The wider work on drug use in the LGBTQ+ community will shortly be resuming after being held pending additional secretariat resource.

Gabapentinoids

Following the publication of the recent Crime Survey Statistics, there has been concern around the increased prevalence of misuse of Gabapentinoids, such as Pregabalin. The ACMD is consequently looking to launch an updated harms assessment for Gabapentinoids, to review the position of these drugs under Class C drugs of the Misuse of Drugs Act 1971.

I would welcome the opportunity to meet with you to discuss the above work and its prioritisation. A meeting would additionally be a good opportunity to discuss any areas of specific focus not highlighted in this letter as well as discussing any priorities for government during the remainder of my term.

Yours sincerely,

Professor Owen Bowden-Jones

Chair of the ACMD