The International journal on drug policy
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Int. J. Drug Policy · Mar 2011
Human rights abuses and suicidal ideation among male injecting drug users in Delhi, India.
Human rights abuses, denial of care, police surveillance, and violence directed at IDUs have been found to impact HIV prevention efforts due to decreased attendance in harm reduction programs. The association of mental health status with rights abuses has not been examined extensively among drug users. In India, drug control laws are often in conflict with harm reduction policies, thus increasing the likelihood of rights abuses against IDUs. The purpose of this study was to describe human rights abuses occurring among IDUs in Delhi and examine their association with suicidal ideation. ⋯ These findings demonstrate that there is a high prevalence of human rights abuses among IDUs in Delhi. Given the alarming rate of suicidal ideation and its close relationship with human rights abuses it is essential that IDU interventions are executed within a rights-based framework.
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Int. J. Drug Policy · Mar 2011
Avoidable alcohol-attributable criminality and its costs due to selected interventions in Canada.
Alcohol causes a considerable criminal burden on the Canadian society. The purpose of this study is to estimate the avoidable burden and avoidable costs of alcohol-attributable criminality in Canada for the year 2002. ⋯ This study demonstrates that the implementation of proven effective population-based interventions can reduce alcohol-attributable criminal burden and its costs to the Canadian society to a considerable degree.
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Int. J. Drug Policy · Mar 2011
Experiences with mephedrone pre- and post-legislative controls: perceptions of safety and sources of supply.
Drug scenes within several countries have changed in recent years to incorporate a range of licit psychoactive products, collectively known as "legal highs." Hundreds of different legal high products have been described in the literature. Many of these products contain synthetic stimulants that allegedly "mirror" the effects of some illicit drugs. In 2009-2010, growing concern by the UK and Irish governments focused on mephedrone, a synthetic stimulant that had become embedded within several drug scenes in Britain and Ireland. In April 2010, mephedrone and related cathinone derivatives were banned under the UK's Misuse of Drugs Act 1971. Setting aside "worse case scenarios" that have been portrayed by UK and Irish media, little is known about mephedrone use from the consumer's perspective. The purpose of this paper was to (1) explore respondents' experiences with mephedrone, (2) examine users' perceptions about the safety of mephedrone, and primarily to (3) examine sources of mephedrone supply during the pre- and post-ban periods. ⋯ The findings are discussed in the context of what appears to be a rapidly changing mephedrone market. We discuss the possible implications of criminalising mephedrone, including the potential displacement effects and the development of an illicit market.
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Int. J. Drug Policy · Jan 2011
Impact of training for healthcare professionals on how to manage an opioid overdose with naloxone: effective, but dissemination is challenging.
Opioid overdose has a high mortality, but is often reversible with appropriate overdose management and naloxone (opioid antagonist). Training in these skills has been successfully trialled internationally with opioid users themselves. Healthcare professionals working in substance misuse are in a prime position to deliver overdose prevention training to drug users and may themselves witness opioid overdoses. The best method of training dissemination has not been identified. The study assessed post-training change in clinician knowledge for managing an opioid overdose and administering naloxone, evaluated the 'cascade method' for disseminating training, and identified barriers to implementation. ⋯ Training clinicians how to manage an opioid overdose and administer naloxone was effective. However the 'cascade method' was only modestly successful for disseminating training to a large clinician workforce, with a range of clinician and service perceived obstacles. Drug policy changes and improvements to educational programmes for drug services would be important to ensure successful implementation of overdose training internationally.
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Int. J. Drug Policy · Jan 2011
Multicenter Study"Should I stay or should I go?" Coming off methadone and buprenorphine treatment.
This study aimed to investigate patient perspectives regarding coming off maintenance opioid substitution treatment (OST). The study explored previous experiences, current interest and concerns about stopping treatment, and perceptions of how and when coming off treatment should be supported. ⋯ While some patients may require lifetime maintenance, the issue of coming off treatment is important to many patients and should be discussed regularly throughout treatment and where appropriate supported by a menu of clinical options.