Drug Policy

In todays changing world where treatment has become increasingly client-centered and accepting of incremental change, it makes to sense to re-examine how we view addiction, reccovery, abstinence and sobriety and the overall process of postive change

Over the past 15-20 years, domestic cultivation of cannabis has been established in a number of European countries. New techniques have made such cultivation easier; however, the bulk of growers remain small-scale. In this study, we explore the factors that prevent small-scale growers from increasing their production. The study is based on 1 year of ethnographic fieldwork and qualitative interviews conducted with 45 Norwegian cannabis growers, 10 of whom were growing on a large-scale and 35 on a small-scale. The study identifies five mechanisms that prevent small-scale indoor growers from going large-scale. First, large-scale operations involve a number of people, large sums of money, a high work-load and a high risk of detection, and thus demand a higher level of organizational skills than for small growing operations. Second, financial assets are needed to start a large 'grow-site'. Housing rent, electricity, equipment and nutrients are expensive. Third, to be able to sell...

Background Alcohol, tobacco, and illegal drug use cause considerable morbidity and mortality, but good cross-national epidemiological data are limited. This paper describes such data from the first 17 countries participating in the World Health Organization's (WHO's) World Mental Health (WMH) Survey Initiative.

Background Effective case management is central to reducing malaria mortality and morbidity worldwide, but only a minority of those affected by malaria, have access to prompt effective treatment. In Kenya, the Division of Malaria Control is committed to ensuring that 80 percent of childhood fevers are treated with effective anti-malarial medicines within 24 hours of fever onset, but this target is largely unmet. This review aimed to document evidence on access to effective malaria treatment in Kenya, identify factors that influence access, and make recommendations on how to improve prompt access to effective malaria treatment. Since treatment-seeking patterns for malaria are similar in many settings in sub-Saharan Africa, the findings presented in this review have important lessons for other malaria endemic countries. Methods Internet searches were conducted in PUBMED (MEDLINE) and HINARI databases using specific search terms and strategies. Grey literature was obtained by soliciting reports from individual researchers working in the treatment-seeking field, from websites of major organizations involved in malaria control and from international reports. Results The review indicated that malaria treatment-seeking occurs mostly in the informal sector; that most fevers are treated, but treatment is often ineffective. Irrational drug use was identified as a problem in most studies, but determinants of this behaviour were not documented. Availability of non-recommended medicines over-the-counter and the presence of substandard anti-malarials in the market are well documented. Demand side determinants of access include perception of illness causes, severity and timing of treatment, perceptions of treatment efficacy, simplicity of regimens and ability to pay. Supply side determinants include distance to health facilities, availability of medicines, prescribing and dispensing practices and quality of medicines. Policy level factors are around the complexity and unclear messages regarding drug policy changes. Conclusion Kenya, like many other African countries, is still far from achieving the Abuja targets. The government, with support from donors, should invest adequately in mechanisms that promote access to effective treatment. Such approaches should focus on factors influencing multiple dimensions of access and will require the cooperation of all stakeholders working in malaria control.

A number of studies suggest that the lack of “gender sensitive” drug treatment services for women represents a pressing social problem, second only to the problem of “women's substance abuse” itself. This article interrogates these “problem representations” by asking on what basis they are considered uniquely problematic. Through a critical analysis of research on women published between 1990–2012 in relevant high impact journals, the article identifies a dominant view of women in the drug field as a “special population” with “unique treatment needs.” The article suggests that this view not only reinforces a limited understanding of the harms associated with women's substance abuse, but might also paradoxically enable programs and services for women to remain as “add-ons” and/or narrow the range of “gender sensitive” approaches adopted.

This paper examines the policy response of Australian governments to petrol sniffing in Indigenous communities from the 1980s until the present. During this period, despite the formation of numerous inquiries, working parties and intergovernmental committees, there has been little accumulation of knowledge about the nature and causes of sniffing, or about the effectiveness of interventions. Policies are fragmentary; programmes are rarely evaluated, and most rely on short-term funding. The paper sets out to explain why this should be so. It draws upon a conceptual framework known as 'analytics of government' to examine the ways in which petrol sniffing comes to the attention of government agencies and is perceived as an issue; the mechanisms deployed by governments to address petrol sniffing; ways in which knowledge about sniffing is generated; and the underlying assumptions about people that inform policy-making. Drawing upon case studies of policy responses, the paper argue...

Habeas Coca sostiene que el programa de control social de la coca de Bolivia es una alternativa rentable y menos violenta a la erradicación forzosa de la coca, vigente en Colombia y Perú.Más de dos décadas de políticas de erradicación han sido un fracaso demostrable en los tres países andinos, generando pobreza y graves violaciones a los derechos humanos. Asimismo, estas estrategias fallidas fortalecieron a los grupos insurgentes de Colombia yPerú, alejándose del cumplimento de los objetivos de control de los cultivos de coca y la disminución del comercio ilegal de cocaína.

Si bien la política de Bolivia redujo efectivamente el cultivo de coca en un 34 por ciento desde 2010 hasta 2014,5 para comprender los alcances de sus políticas, es de vital importancia reconocer que ellas no están diseñadas para, ni pueden, limitar el tráfico de drogas. Debido a que el precio de la hoja de coca ha aumentado a causa del programa actual, la coca peruana, más barata, y sus derivados pasan por Bolivia hacia países de tránsito y consumo, como Brasil. Es la demanda, y no la oferta, la que impulsa el tráfico de drogas, y ésta se origina casi por completo fuera de las fronteras bolivianas.

La iniciativa de Bolivia busca principalmente reducir el daño a los productores de coca sustituyendo el modelo de la erradicación forzosa basada en la intervención de fuerzas policiales y militares, por otro en el que participen activamente los productores como ciudadanos, incrementando su participación en la determinación del futuro de sus comunidades. Este modelo es más eficiente en áreas donde los residentes apoyan al gobierno actual. Sin
embargo, necesita consolidarse más en áreas donde no existe una fuerte influencia del gobierno, y donde las organizaciones sindicales de cultivadores de coca están en conflicto
entre sí. En el Chapare, la región del presidente Evo Morales, la combinación del nuevo enfoque con otras políticas gubernamentales ha reducido dramáticamente el número de muertes y lesiones de los productores de coca, relacionadas con la erradicación forzosa, lo cual ha hecho posible que los cocaleros diversifiquen sus fuentes de ingreso. Esta iniciativa se estructura en torno a la negociación y el reconocimiento de las organizaciones locales como socias, lo cual garantiza a los productores de coca un ingreso para subsistir. Esto se combina con el establecimiento de sus identidades legales como cocaleros registrados, lo cual genera, a su vez, un nuevo sentido de los derechos ciudadanos, lo cual los compromete a limitar los
cultivos de coca, y ayuda a producir resultados transparentes y verificables. El resultado es un programa que la Organización de los Estados Americanos (OEA) llama “buenas prácticas... disponibles para uso o réplica.” El embajador de la Unión Europea (UE) en Bolivia, Timothy Torlot, describió el programa como “Para mí, el trabajo que hemos hecho es exitoso, los resultados también se ven en la reducción exitosa y sostenida de la producción de coca del país,… nuestra experiencia como Unión Europea ha sido muy positiva”.

Si bien Bolivia ha desarrollado un primer programa muy prometedor de control de la oferta, que refleja ampliamente los principios de la reducción del daño que han sido implementados
en algunos países en cuanto a la demanda, su mismo éxito ilustra claramente el efecto mínimo que tienen los esfuerzos para controlar la oferta de drogas, sobre la restricción de la demanda de drogas ilícitas.

Una reforma efectiva y pragmática de la política de drogas debe ir más allá de los límites tradicionales de la erradicación, las incautaciones y arrestos, y moverse hacia indicadores más genuinos y válidos, como son los derechos humanos, el bienestar social de las poblaciones afectadas, la estabilidad económica, la ciudadanía, el estado de derecho, la desmilitarización, el compromiso positivo con el estado, la transparencia, y la habilidad de monitorear efectiva y cuantitativamente el impacto y la sostenibilidad.

This chapter will: explore the social context in which ‘problem drug users’ and ‘inadequate parents’ are constructed; outline key issues and difficulties involved in working with problem drug users whose children are considered to be at risk of abuse or neglect; draw on research carried out with social workers, health visitors, drugs clinic workers and parents to examine the barriers of working together to assess children’s needs where parents misuse drugs; and  explore strategies for better partnership approaches.

Terence McKenna argued that sovereignty over one’s consciousness is the next great civil rights struggle after sexism, racism, and homophobia. “Coming out” about one’s psychedelic identity, interests, and/or experiences is an important part of redefining the public perception of psychedelics and of those who choose to experience their effects. Even non-using “allies” (comparable to LGBTQ allies) can join the conversation in supportive roles. In light of the shifting legal status of psychoactive plants and chemicals, what might it mean to identify as psychedelic in a post-prohibition world?

The rise of crack cocaine in the late 1980s propelled the war on drugs. The experience of Canton, Ohio, shows how the response to crack solidified mass incarceration. A declining industrial city of 84,000 people in northeast Ohio with deep-seated racial divides, it was overwhelmed by aggressive, enterprising crack dealers from outside the city. In response, politicians and residents united behind the strategy of incessant arrests and drastic prison sentences. The law-enforcement offensive worsened conditions while pursuing African Americans at blatantly disproportionate rates, but few people engaged in reframing the drug problem. Instead, a punitive citizenry positioned punishment as the principal remedy. The emergency foreclosed on more comprehensive assessments of the city’s tribulations, while the criminal justice system emerged as the paramount institution.

In Europe, the extent of drug use and drug trafficking vary greatly from region to region. This is also true of domestic drug policies which, against many indicators, are very diverse. However, the deepening of the integration process of the continent and the rise of subnational actors in the design of local responses to drug issues have led to a progressive convergence. A policy discourse and a legal attitude that favor treating and reintegrating drug users rather than depriving them of their liberty has been developing at the transnational level. A cultural model for drug policy is emerging with enough cohesion to be able to claim that the European Union and European states (including non-EU Member States) have reached shared positions on the political acceptability of harm-reduction measures. Meanwhile medicinal cannabis is increasingly making inroads in the field of conventional medicine and several jurisdictions have been developing tolerant policies regarding recreational cannabis.

The current research measured explicit (self-reported) and implicit (or unconscious) attitudes of health care workers and their drug injecting clients with hepatitis C virus (HCV) toward each other, and the association of these attitudes with contact. Sixty health care workers and 120 of their clients with HCV acquired from injecting drug use were administered attitude measures to determine whether greater contact with HCV positive clients would result in more favourable attitudes on the part of health care workers toward these clients, and also on the part of these clients towards their health care workers. Findings suggest that increased contact with clients with HCV is associated with more favourable explicit attitudes and more negative implicit attitudes among health care workers toward injecting drug users. Health care workers who had greater contact with HCV positive clients also had HCV positive clients who held more favourable explicit attitudes toward health care workers, b...

The use of drugs is as old as history. However, it was only fairly recently that, following the rise of modern medicine, the concept of 'drug addiction' was born and came to be seen as a clinical and a social disorder. Focusing on the period from 1800 to the end of World War II, The Two Births of Addiction traces the way this idea developed in two very different countries: Germany and the United States. It also explains why alcohol is legal, whereas heroin and cocaine are not; follows the links between America's war on drugs on one hand and its racism on the other; and demonstrates the very different roles played by the medical establishments in the two countries under consideration. For anyone interested in the history of drugs and medicine as well as their interaction with politics, justice and the law, this book is a must.

BACKGROUND: Drug treatment courts (DTCs) have proliferated on the basis of their promise to reduce criminal recidivism among the burgeoning numbers of drug-related offenders. Empirical research on the effectiveness of DTCs indicates that they produce reductions in recidivism, primarily drawn from experiences in the US. There are no published outcome studies on Canadian DTCs. Canada's second DTC has operated in Vancouver's Downtown Eastside since 2001. We examine longitudinal changes in recidivism and characteristics of participants in the DTC in Vancouver (DTCV). METHODS: DTCV participants (n=180) were included in a longitudinal cohort design (intent-to-treat), and a comparison group was derived using the propensity score matching method. Matching variables represented the domains of health, offending, and socio-economic histories as well as demographics. Annualized rates of offending were compared for the two years prior to entering DTCV and two years following programme ...

Public action increasingly takes place in self-organizing networks that are remote from direct governmental control. While these transformations have been subject to scrutiny in regard to their efficiency, less attention has been paid to their democratic quality. This article discusses governance-induced problems of democracy by isolating two major criticisms. Deliberative criticism argues that governance, rather than allowing for true deliberation in the public space, may lead to a loss of accountability. Participatory criticism stresses that governance impinges on participatory venues. The article discusses these criticisms theoretically and empirically, drawing from research on drug policy in Switzerland. The findings show that the criticisms are relevant, albeit not entirely justified.

Background: This research examines free pouring behavior and provides an account of how Body Mass Index (BMI) and gender might lead to the overpouring, and consequently the overconsumption of wine. Methods: An observational study with young adults investigated how BMI and gender affect free-pouring of wine over a variety of pouring scenarios, and how rules-of-thumb in pouring affect the quantities of alcohol poured by men and women across BMI categories. Results: For men, the amount poured was positively related to BMI. However, BMI did not affect pours by women. The use of the "half glass" rule-of-thumb in pouring reduced the volume of wine poured by over 20% for both men and women. Importantly, this rule-of-thumb substantially attenuated the pours by men at high BMI levels. Conclusion: Increasing awareness of pouring biases represents an early and effective step toward curbing alcohol consumption among men, and especially those who are overweight. Additionally, using a s...