Drug and alcohol review
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Drug and alcohol review · Nov 2006
ReviewInternational control of alcohol: alternative paths forward.
Alcohol was the first psychoactive substance to be subject to international control, but these agreements between colonial powers have long since fallen away. In the wake of the entry into force of the Framework Convention on Tobacco Control (FCTC), paths forward for international control of alcohol are considered. ⋯ An alternative would be scheduling alcohol under one or more of the international drug conventions, most probably the 1971 convention, although the convention would have to be amended to allow use outside 'medical and scientific purposes' and without a prescription regime. In considering potential contents of an alcohol convention, it is noted that both the FCTC and the drug conventions are concerned at least as much with domestic markets as with international trade.
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Drug and alcohol review · Nov 2006
ReviewA review of the efficacy and effectiveness of harm reduction strategies for alcohol, tobacco and illicit drugs.
Harm reduction is both a policy approach and used to describe a specific set of interventions. These interventions aim to reduce the harms associated with drug use. Employing a strict definition of harm reduction, evidence for the efficacy and effectiveness of alcohol, tobacco and illicit drug harm reduction interventions were reviewed. ⋯ There is sufficient evidence to support the wide-spread adoption of harm reduction interventions and to use harm reduction as an overarching policy approach in relation to illicit drugs. The same cannot be concluded for alcohol or tobacco. Research at a broad policy level is required, especially in light of the failure by many policy makers to adopt cost-effective harm reduction interventions.
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Drug and alcohol review · Nov 2006
ReviewCivil society-a leader in HIV prevention and tobacco control.
Many civil society organisations (CSOs) have been at the forefront of identifying new ideas and implementing innovative models regarding health and health systems around the world. Their activities become highly charged, however, when they engage in advocacy efforts designed to influence change in policies and systems linked with more controversial or complicated public health issues. Policies, laws and regulations regarding illicit drugs and tobacco fall directly into that category. ⋯ This leadership role has helped influence and shape policy, especially in recent years. This paper examines civil society's involvement in efforts to change drug and tobacco policy in selected countries in Central and Eastern Europe and the former Soviet Union (CEE/FSU). It concludes that in Poland and Kazakhstan, in terms of tobacco control, and increasingly in Ukraine and parts of Central Asia in terms of harm reduction, multi-sectoral approaches are the most effective way to engage citizens and to implement comprehensive strategies to change behaviour by supportive measures, not punitive ones.
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Drug and alcohol review · Nov 2006
ReviewCommunity-based interventions and alcohol, tobacco and other drugs: foci, outcomes and implications.
The social, health and economic burdens from alcohol, tobacco and other drugs have impacts globally, national and locally. Effective interventions are needed at each level in order to reduce the extensive harm and attendant costs. This paper examines four topics: options available to the local community, evidence of effectiveness, links between local experiences and national and regional initiatives and implications for future research and intervention. ⋯ There is also not a consistent relationship between local and national interventions, although some themes are apparent: in tobacco control there may be good synergy across jurisdictional levels, for alcohol there is evidence that as national control measures are eroded local communities are encouraged or required to take up these agendas, and with regard to illicit drugs there may be tension between law enforcement priorities at the national level and harm reduction orientations locally. Future initiatives need to have appropriate evaluations as a standardised part of prevention initiatives, and include the development of national databases of what is going on locally. These initiatives should promote national policies that include setting parameters and guidelines, but nevertheless do not dictate specific steps and strategies how to achieve local goals in reducing risk and harm.
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Drug and alcohol review · Nov 2006
ReviewInternational trade agreements challenge tobacco and alcohol control policies.
This report reviews aspects of trade agreements that challenge tobacco and alcohol control policies. Trade agreements reduce barriers, increase competition, lower prices and promote consumption. ⋯ Advocates must recognise the inherent conflicts between free trade and public health and work to exclude alcohol and tobacco from trade agreements. The Framework Convention on Tobacco Control has potential to protect tobacco policies and serve as a model for alcohol control.