The International journal on drug policy
-
Int. J. Drug Policy · Apr 2017
High risk injecting behaviour among people who inject pharmaceutical opioids in Australia.
Use of opioid analgesic medicines has doubled globally over the past decade, with a concomitant increase in prevalence of injection of pharmaceutical opioids (PO), including in Australia. This study investigates types of PO injected, methods used to prepare PO for injection and correlates of recent (last 6 months) PO injection among a large national sample of people who inject drugs (PWID). ⋯ PO injection is geographically widespread among Australian PWID and takes place in the context of poly-drug use. People who inject POs are at high risk of overdose, injection related injury and disease and blood borne viral infections. Harm reduction services that target this group, including in non-urban areas, should deliver health education regarding PO-specific overdose risks, the requirement to adequately filter PO before injection and to ensure that both naloxone and specialist pill filters are readily accessible.
-
Int. J. Drug Policy · Apr 2017
Medical cannabis access, use, and substitution for prescription opioids and other substances: A survey of authorized medical cannabis patients.
In 2014 Health Canada replaced the Marihuana for Medical Access Regulations (MMAR) with the Marihuana for Medical Purposes Regulations (MMPR). One of the primary changes in the new program has been to move from a single Licensed Producer (LP) of cannabis to multiple Licensed Producers. This is the first comprehensive survey of patients enrolled in the MMPR. ⋯ The finding that patients report its use as a substitute for prescription drugs supports prior research on medical cannabis users; however, this study is the first to specify the classes of prescription drugs for which cannabis it is used as a substitute, and to match this substitution to specific diagnostic categories. The findings that some authorized patients purchase cannabis from unregulated sources and that a significant percentage of patients were charged for medical cannabis recommendations highlight ongoing policy challenges for this federal program.
-
Int. J. Drug Policy · Apr 2017
Do recreational cannabis users, unlicensed and licensed medical cannabis users form distinct groups?
This study aims to gain a more nuanced perspective on the differences between recreationally and medically motivated cannabis use by distinguishing between people who use cannabis for recreational purposes, unlicensed and licensed medical users. ⋯ This study suggests that a sizable proportion of cannabis users in Israel self-prescribe cannabis and that licensed medical cannabis users differ from unlicensed users. This is, in turn, suggestive of a rigorous medicalized cannabis program that does not function as a backdoor for legal access to recreational use. However, due to methodological limitations this conclusion is only suggestive. The most meaningful differences across recreational, unlicensed and licensed users were mode and patterns of use rather than cannabis use problems. Current screening tools for cannabis use problems may, however, not be well suited to assess such problems in medically motivated users. Indeed, when screening for problematic cannabis use there is a need for a more careful consideration of whether or not cannabis use is medically motivated.
-
Int. J. Drug Policy · Mar 2017
Comparative StudyPharmaceutical opioid use among oral and intravenous users in Australia: A qualitative comparative study.
Between 1992 and 2012 dispensing episodes for pharmaceutical opioids (PO) in Australia increased from 500000 to 7500000. In the US, increases in the prescription of PO have been linked to increases in opioid-related morbidity and mortality and transitions to heroin injection. However, Australian data indicate that morbidity and mortality related to PO are relatively low, particularly when compared to heroin and other drugs. This paper explores the characteristics and patterns of non-medical pharmaceutical opioid (NMPO) use among a sample of young people in Sydney, Australia. ⋯ Results highlight the significance of social and structural factors in trajectories of opioid use and related harms. Factors such as stable housing and family relationships, disposable income and close social networks observed in young oral NMPO users may help to explain differences in patterns of NMPO use and related outcomes between the two groups.
-
Int. J. Drug Policy · Mar 2017
Randomized Controlled TrialThe deterrent effects of Australian street-level drug law enforcement on illicit drug offending at outdoor music festivals.
Australian and international street-level drug law enforcement deploy many strategies in efforts to prevent or deter illicit drug offending. Limited evidence of deterrence exists. This study assessed the likely impacts of four Australian policing strategies on the incidence and nature of drug use and supply at a common policing target: outdoor music festivals. ⋯ The findings suggest that street-level policing may deter some forms of drug offending at music festivals, but that most impacts will be small. Moreover, it may encourage some perverse impacts such as drug consumers opting to buy drugs within festival grounds rather than carry in their own. We use our findings to highlight trade-offs between the goals of public health promotion and crime control in street-level enforcement.