1. European Early Warning System Charlotte Davies

2. European Early Warning System Adopted in May 2005, the Council Decision 2005/387/JHA on the information exchange, risk-assessment and control of new psychoactive substances establishes a mechanism for the rapid exchange of information on new psychoactive substances and the assessment of the risks associated with new psychoactive substances. Council Decision 2005/387/JHA The UK Focal Point provides the UK component of the Early Warning System and is responsible for providing information to the EMCDDA on the manufacture, traffic and use of newly identified substances – coordinated by LJMU The UK network comprises forensic scientists, academics, law enforcement officials, government officials and clinicians 2European Early Warning System Primarily focussed on seizures and control orientated

3. Health harms Sharing of information on fatalities and intoxications European Database on New Drugs – alerts, health risks, case reports Relatively few biological samples Early stages of development of a database to collate information Joint Reports and Risk Assessments collate health harms more systematically Non-fatal intoxications Hospital emergencies Direct deaths Indirect deaths (e.g road traffic accidents) 3European Early Warning System

4. Recent evidence of harms AH-7921 - synthetic opioid analgesic First reported by UK in August 2012 Deaths in Norway and Sweden in 2013 Subject to full risk assessment 4-methylaminorex, para-methyl derivative First reported in Netherlands in December 2012 8 deaths in Hungary associated with this substance No seizures in UK but postal seizure in Finland from UK 25I-NBOMe - derivative of the phenethylamine hallucinogen 2C-I First reported in Sweden in June 2012 Non-fatal intoxications in Belgium and UK TCDO in UK, currently subject to formal risk assessment 4European Early Warning System

5. Current risk assessment process AH-7921 25I-NBOMe TCDO (June 2013) Methoxetamine TCDO (March 2012), MDA (Feb 2013) MDPV MDA (April 2010) Information exchange part of the system works well particularly regarding identification Provides a national and international network to share information Joint report, risk assessment, control decision is very slow 5European Early Warning System

6. 6 Whose assessment of risk? Based on what evidence? Harms?

7. Collecting evidence of harm and relative harm when no systematic hospital monitoring system exists for collecting information on the health harms of drugs What is the threshold for triggering Joint EMCDDA-Europol Report? While phenomenon exists across Europe, differences in type of substances used, the method of use and the harms associated with this use Where do harms related to medicines fit in? Subsidiarity – national response quicker and more appropriate? 7European Early Warning System Issues