The International journal on drug policy
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Int. J. Drug Policy · Mar 2014
The Canadian war on drugs: structural violence and unequal treatment of Black Canadians.
This paper examines the impact of Canada's war on drugs on segments of the Black community, specifically with respect to the impact of structural violence, over-policing, and high incarceration rates. It offers evidence of the systemic nature of these dynamics by examining the early context of the war, growing stigma against Blacks, globalizing influences, and the punitive focus of funding and policy. ⋯ This commentary calls for an immediate dissolution of policies regulating the war on drugs as the first step in remedying the injustices experienced by Black Canadians. Due to the lack of Canadian data in this important area, the paper also emphasizes the critical need for more research to shed more light on the Canadian-specific complexities.
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Int. J. Drug Policy · Jan 2014
ReviewRevitalizing the HIV response in Pakistan: a systematic review and policy implications.
We sought to describe the epidemiology of HIV in Pakistan and prioritize interventions to improve the effectiveness and efficiency of the response to HIV. ⋯ Pakistan must continue to invest in targeted, evidence-based interventions to prevent the spread of HIV and curb the epidemic trajectory in Pakistan. A comprehensive range of services should include needle and syringe exchange, opiate substitution therapy for people who inject drugs, outreach and engagement with injecting drug users, Hijra' community as well as male and female sex workers and their clients and improved linkage between services and voluntary counseling, testing and anti-retroviral therapy.
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Int. J. Drug Policy · Jan 2014
Review Comparative StudyUnderage drinking in the UK: changing trends, impact and interventions. A rapid evidence synthesis.
The UK is a high prevalence country for underage alcohol use. We conducted an evidence synthesis to examine (1) the changing trends in underage drinking in the UK compared to Europe and the USA, (2) the impact of underage drinking in terms of hospital admissions, (3) the association between underage drinking and violent youth offending, and (4) the evidence base for the effectiveness of alcohol harm reduction interventions aimed at children and adolescents under the age of 18 years. The following databases were searched from November 2002 until November 2012: Cochrane Database of Systematic Reviews, National Institute for Health and Clinical Excellence, The Evidence for Policy and Practice Information, DARE, Medline, The Campbell Collaboration, CINAHL, Criminal Justice Abstracts, Psych INFO and Social Care Online. ⋯ All were characterised by a wide age range of participants, heterogeneous samples and high rates of refusal and attrition. The authors conclude that whilst the ED might be the best place to identify children and adolescents at risk of harm related to alcohol use it might not be the best place to deliver an intervention. Issues related to a lack of engagement with alcohol harm reduction interventions have been previously overlooked and warrant further investigation.
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Int. J. Drug Policy · Jan 2014
ReviewWhat has been achieved in HIV prevention, treatment and care for people who inject drugs, 2010-2012? A review of the six highest burden countries.
In 2010 the international HIV/AIDS community called on countries to take action to prevent HIV transmission among people who inject drugs (PWID). To set a baseline we proposed an "accountability matrix", focusing upon six countries accounting for half of the global population of PWID: China, Malaysia, Russia, Ukraine, Vietnam and the USA. Two years on, we review progress. ⋯ Prevention of HIV infection and access to HIV treatment for PWID is possible. Whether countries with concentrated epidemics among PWID will meet goals of achieving universal access and eliminating new HIV infections remains unknown. As long as law enforcement responses counter public health responses, health-seeking behaviour and health service delivery will be limited.
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Int. J. Drug Policy · Jan 2014
Brief overdose education can significantly increase accurate recognition of opioid overdose among heroin users.
In an effort to increase effective intervention following opioid overdose, the New York State Department of Health (NYSDOH) has implemented programs where bystanders are given brief education in recognizing the signs of opioid overdose and how to provide intervention, including the use of naloxone. The current study sought to assess the ability of NYSDOH training to increase accurate identification of opioid and non-opioid overdose, and naloxone use among heroin users. ⋯ The data indicate that overdose prevention training improves participants' knowledge of opioid overdose and naloxone use, but naloxone may be administered in some situations where it is not warranted. Training curriculum could be improved by teaching individuals to recognize symptoms of non-opioid drug over-intoxication.