The International journal on drug policy
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Int. J. Drug Policy · Apr 2019
The tripping point: The potential role of psychedelic-assisted therapy in the response to the opioid crisis.
The increasing contamination of the drug supply with illicitly manufactured fentanyl and related analogs in North America has resulted in the most severe drug-overdose crisis in history. Available pharmacotherapy options for the treatment of opioid use disorder have had limited success in curbing the current crisis, and a growing body of evidence highlights the need for innovative interventions that target underlying social-structural drivers of opioid use disorder. Re-emerging clinical research suggests that psychedelic-assisted therapy has potential as an alternative treatment for refractory substance use disorders and related comorbidities. Based on the available evidence, our viewpoint supports advancing research on the potential role of psychedelic-assisted therapy within a multifaceted response to the opioid crisis.
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Int. J. Drug Policy · Apr 2019
Social network ties to nightlife and healthcare professionals and prescription drug misuse among young adults.
Nightlife scenes have been characterized as risk environments where social ecology and network ties facilitate substance use. In contrast to other substances, the prescription drug problem also has been shaped by the healthcare system. How network ties to professionals in these domains are associated with prescription drug misuse remains a key area of study. ⋯ Embeddedness in nightlife networks is related to patterns of prescription drug misuse, and some of this association can be explained by multiple mechanisms of social networks. By contrast, ties to healthcare professionals are not associated with patterns of misuse among such young adults.
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Int. J. Drug Policy · Jan 2019
Patients' and clinicians' perspectives of co-use of cannabis and opioids for chronic non-cancer pain management in primary care.
The prevalence of opioid-associated morbidity and mortality underscores the need for research on non-opioid treatments for chronic non-cancer pain (CNCP). Pain is the most common medical condition for which patients request medical cannabis. Limited research indicates that patients are interested in cannabis as a potential addition to or replacement for opioid medication. This analysis reports on CNCP patient and clinician perceptions about the co-use of cannabis and opioids for CNCP management. ⋯ Clinicians are hampered by a lack of clinically relevant information about cannabis use, efficacy and side-effects. Currently no guidelines exist for clinicians to address opioid and cannabis co-use, or to discuss the risk and benefits of cannabis for CNCP management, including side effects. Cannabis and opioid co-use was commonly reported by patients in our sample, yet rarely addressed during clinical CNCP care. Further research is needed on the risks and benefits of cannabis and opioid co-use.
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Int. J. Drug Policy · Oct 2018
Historical ArticleRethinking 'flexibilities' in the international drug control system-Potential, precedents and models for reforms.
Much international drug policy debate centres on, what policies are permissible under the international drug treaties, whether member states are openly 'breaching' these treaties by changing national regulatory frameworks and shifting priorities away from a 'war on drugs' approach, and what 'flexibility' exists for policy reform and experimentation at national and local levels. Orthodox interpretations hold that the current system is a US-led 'prohibition regime' that was constructed in an extremely repressive and restrictive manner with almost no flexibility for significant national deviations. This paper challenges these orthodox interpretive frameworks and suggests no absolute and clear dichotomy between strict adherence and 'breaches' of the international treaties. ⋯ UNGASS 2016 inaugurated a new era based on an evolving understanding of the UN drug control system. In this 'post-'war on drugs' era', national and local policy choices will increasingly hold greater relevance than international ones. Further, based on numerous historical precedents, international legal interpretations will likely continue to evolve and serve a reactive functional role in providing the formal scope to justify national and local deviations from past global norms. These shifting interpretations are, and will continue to be, reflected in an interim reliance on treaty 'flexibilities' to explain sustained international cooperation, even as that cooperation shifts to an entirely new implementation framework.
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Int. J. Drug Policy · Oct 2018
Global drug policy at an impasse: Examining the politics of the 2016 United Nations General Assembly Special Session.
The 2016 United Nations General Assembly's Special Session on the World Drug Problem (UNGASS) was a 'critical moment' in recent global drug policy history. ⋯ Global governance in the sphere of drug policy has reached an impasse but this should have limited impact on the ongoing efforts of reformers to shift the debate so long as civil society actors have access to funding and opportunities to participate in key future global drug policy events.