The International journal on drug policy
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Int. J. Drug Policy · Aug 2018
Going knock-Recurrent comatose GHB intoxication in the Netherlands & Flanders (Belgium).
Gamma-hydroxybutyrate (GHB) overdose is an important concern in the Netherlands and Flanders, Belgium and accounts for most overdoses reported by emergency services. Few stu dies have focused on GHB overdose. Appropriate public health responses have yet to be developed. We report an explorative survey of people who use GHB and their experience with GHB overdose, aiming to identify risk and protective factors associated with comatose intoxication after GHB ingestion. ⋯ We found extremely high rates of comatose intoxication after GHB use and the strongest association with GHB overdose concerned the lifetime number of GHB consumption episodes. Poly-drug consumption appears to be the norm in our entire sample, but does not necessarily distinguish heavy or high risk consumption from more recreational use. Using in the company of friends may offer some level of protection against GHB overdose. Overdose prevention, stabilizing heavy and harmful drug consumption patterns and reducing the harms associated therewith should become an important priority in the Dutch response to GHB.
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Int. J. Drug Policy · Aug 2018
Comparative StudyAssessing the effectiveness of New York's 911 Good Samaritan Law-Evidence from a natural experiment.
Drug overdose is the leading cause of accidental death in the United States. Nationally, opioids are the primary drugs associated with accidental overdoses. In response to increasing overdose deaths, 40 states and the District of Columbia have enacted Good Samaritan Laws (GSLs). Generally, these policies attempt to encourage witnesses or those experiencing an overdose to call 911 by providing limited immunity from arrest, charge and/or prosecution of possession of narcotics. The aim of the current study is to evaluate the effectiveness of New York State's 911 GSL. ⋯ Accidental heroin overdose emergency department visits and inpatient hospital admissions increased in New York State after the enactment of the 911 GSL, consistent with the intended effect of the GSL. Preliminary evidence suggests that either persons who use heroin and/or those around them were impacted by the policy change.
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Int. J. Drug Policy · Jul 2018
Opioid-related mortality in rural America: Geographic heterogeneity and intervention strategies.
Over the last two decades, opioid-related mortality rates have increased dramatically to become a serious public health concern in the United States. Opioid-related mortality has reached epidemic levels in certain rural areas of the U. S., such as Appalachia, New England, and the Mountain West, while remaining relatively low in others, such as the Delta South and Great Plains. ⋯ This paper 1) describes geographic heterogeneity in opioid-related mortality, with a focus on rural areas, 2) summarizes factors that likely contribute to this heterogeneity, and 3) discusses potential strategies for addressing the opioid epidemic in the hardest-hit rural communities. The information presented in this paper dispels the myth that the opioid epidemic is disproportionately rural, and demonstrates that the magnitude of the epidemic has varied considerably across different rural areas. This paper provides important insights for public health professionals, treatment practitioners, researchers, and policymakers as they work toward solutions that take into account the diversity of rural communities and the dynamic nature of the opioid epidemic.
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Int. J. Drug Policy · Jun 2018
Predicting pharmacy syringe sales to people who inject drugs: Policy, practice and perceptions.
Pharmacies have much to contribute to the health of people who inject drugs (PWID) and to community efforts in HIV and hepatitis C (HCV) prevention through syringe access. However, little is known about what predicts pharmacy syringe sales without a prescription. ⋯ As communities with high rates of opioid overdose mortality were less likely to have pharmacies that dispensed syringes to PWID, a concerted effort with these communities and their pharmacies should be made to understand opportunities to increase syringe access. Future studies should explore nuances between theoretical support for syringe access by PWID without a prescription and actual dispensing behaviors. Addressing potential policy conflicts and offering continuing education on non-prescription syringe distribution for pharmacists may improve comfort distributing syringes to PWID, and therefore increase pharmacy syringe sales.
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Int. J. Drug Policy · Jun 2018
Comparative StudyDrug-related police encounters across the globe: How do they compare?
Drug law enforcement subsumes the majority of drug policy expenditure across the globe. Fuelled by knowledge that much of this investment is ineffective or counter-productive there have been increasing calls for cross-national comparisons to identify where policing approaches differ and what types of approaches may be more effective. Yet, to date cross-national comparison of drug law enforcement has proven a methodologically hazardous affair. Using a new drug policing module added to the 2017 Global Drug Survey, this study seeks to provide the first cross-national comparison of the incidence, nature and intensity of illicit drug-related police encounters amongst people who use drugs. ⋯ The findings unearth significant cross-national differences in the incidence and nature of drug-related policing of people who use drugs. This suggests that there may be opportunities for countries to learn from each other about how and why they differ, and the potential benefits of switching to lower intensity modes of drug policing.