The International journal on drug policy
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Int. J. Drug Policy · Jan 2016
The Global Fund to Fight AIDS, Tuberculosis and Malaria's investments in harm reduction through the rounds-based funding model (2002-2014).
Harm reduction is an evidence-based, effective response to HIV transmission and other harms faced by people who inject drugs, and is explicitly supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria. In spite of this, people who inject drugs continue to have poor and inequitable access to these services and face widespread stigma and discrimination. In 2013, the Global Fund launched a new funding model-signalling the end of the previous rounds-based model that had operated since its founding in 2002. This study updates previous analyses to assess Global Fund investments in harm reduction interventions for the duration of the rounds-based model, from 2002 to 2014. ⋯ This study represents an updated, comprehensive assessment of Global Fund investments in harm reduction from its founding (2002) until the start of the new funding model (2014). It also highlights the overall shortfall of harm reduction funding, with the estimated global need being US$ 2.3 billion for harm reduction in 2015 alone. Using this baseline, the Global Fund must carefully monitor its new funding model and ensure that investments in harm reduction are maintained or scaled-up. There are widespread concerns regarding the withdrawal from middle-income countries where harm reduction remains essential and unfunded through other sources: for example, 15% of the identified investments were for countries which are now ineligible for Global Fund support.
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Int. J. Drug Policy · Jan 2016
Misuse of non-prescription codeine containing products: Recommendations for detection and reduction of risk in community pharmacies.
Misuse of opioid analgesics is an emergent global public health concern. Codeine has an identified abuse liability, given its effect and development of tolerance within a short timeframe on regular or excessive use. Estimation and management of misuse of over the counter (OTC) codeine containing products are hampered by widespread and easy availability and the heterogeneous and hidden nature of misuse. ⋯ Limited up scheduling that still enables purchase of codeine products without a prescription, and varied measures of pharmacist intervention at point of sale have not succeeded in curtailing therapeutic and non-therapeutic forms of misuse. This commentary broadly discusses the concepts of medication misuse, codeine's potential for misuse and dependence, characteristics of codeine misuse in general, harms from OTC codeine products in particular, 'unique issues' with OTC codeine products, the problems with scheduling solutions and pharmacy based interventions targeting users, along with the supports needed for these interventions. The recent introduction of new OTC combinations of non-opioid agents which provide greater analgesic efficacy than OTC codeine combination analgesics with no risk of opioid dependence provides a satisfactory alternative to these widely misused products.
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A number of states in the United States legally allow the use of cannabis as a medical therapy to treat an illness or to alleviate symptoms. Concern persists as to whether these types of laws are increasing juvenile recreational cannabis use. It is also plausible that medical cannabis laws engender an escalation of illicit non-cannabis drug use among juveniles because cannabis is frequently considered to be a gateway drug. ⋯ Based on our findings, it seems reasonable to speculate that medical cannabis laws amplify juveniles' use of cannabis by allaying the social stigma associated with recreational cannabis use and by placating the fear that cannabis use could potentially result in a negative health outcome.