Drug and alcohol review
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Drug and alcohol review · Dec 2004
Harm reduction and the global drug control regime: contemporary problems and future prospects.
Countries committed to a harm-reduction approach to drugs have exploited the latitude which exists within the UN global drug control regime to implement strategies which deviate from the strict prohibition ethos of the conventions. These nations risk pressure being brought to bear through the UN drug control regime, principally by the United States, determined to prevent what it sees as foreign challenges to its domestic 'zero tolerance' approach and its internationalisation. In this paper, based on his presentation to the International Conference on the Reduction of Drug Related Harm in Melbourne this year, David Bewley-Taylor, describes the conventions and the 'wiggle room' which exists, but also imagines ways like-minded states might together challenge and reform the conventions so that harm reduction can be accepted and hard wired into the UN drug control system itself.
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Drug and alcohol review · Sep 2004
Other people, other drugs: the policy response to petrol sniffing among indigenous Australians.
This paper examines the policy response of Australian governments to petrol sniffing in Indigenous communities from the 1980s until the present. During this period, despite the formation of numerous inquiries, working parties and intergovernmental committees, there has been little accumulation of knowledge about the nature and causes of sniffing, or about the effectiveness of interventions. Policies are fragmentary; programmes are rarely evaluated, and most rely on short-term funding. ⋯ It draws upon a conceptual framework known as 'analytics of government' to examine the ways in which petrol sniffing comes to the attention of government agencies and is perceived as an issue; the mechanisms deployed by governments to address petrol sniffing; ways in which knowledge about sniffing is generated; and the underlying assumptions about people that inform policy-making. Drawing upon case studies of policy responses, the paper argues that a number of structural factors combine to marginalize petrol sniffing as an issue, and to encourage reliance on short-term, one-off interventions in place of a sustained policy commitment. Four recommendations are advanced to help overcome these factors: (1) agreements should be reached within and between levels of government on steps to be taken to reduce risk factors before the eruption of petrol-sniffing crises; (2) the evidence base relevant to petrol sniffing (and other inhalants) should be improved by funding and directing one or more existing national drug research centres to collate data on inhalant-caused mortality and morbidity, and to conduct or commission research into prevalence patterns, effectiveness of interventions and other gaps in knowledge; (3) the current pattern of short-term, pilot and project funding should be replaced with longer-term, evidence-based interventions that address the multiple risk and protective factors present in communities; and (4) insistence by governments that communities must take 'ownership' of the problem should be replaced by a commitment to genuine partnerships involving governments, non-government and community sectors.
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Drug and alcohol review · Jun 2004
Non-injecting routes of administration among entrants to three treatment modalities for heroin dependence.
A sample of 535 entrants to opioid dependence treatments across three treatment modalities were administered a structured interview to ascertain the prevalence of non-injecting heroin use. Ten per cent of participants had used heroin primarily by smoking/inhaling in the month preceding interview, and 9% had used heroin and other drugs exclusively by non-injecting routes. Non-injectors were younger (25.3 vs. 29.5 years), had higher levels of education (10.6 vs. 10.0 years), were more likely to be employed (33 vs. 18%) and had lower levels of recent crime (31 vs. 56%). ⋯ While non-injectors had a lower level of post-traumatic stress disorder (29% vs. 34%), there were no differences in levels of major depression, attempted suicide, antisocial personality disorder, or borderline personality disorder. A substantial minority of Australian treatment entrants are now using heroin exclusively by non-injecting routes. While this group is younger, and has substantially reduced risk of overdose and blood borne virus transmission, the physical and psychological health of non-injectors mirrors that of injectors.
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Drawing on a recent review of studies of the impact of alcohol control changes in the Nordic countries (particularly Finland, Norway and Sweden), this paper reviews the development of research traditions of such studies in the Nordic countries. From the Nordic experience, there is evidence of variation in the effects of policy changes by demographic segment, by type of problem and by drinking pattern and amount. Policy changes have often had their greatest effect on heavier drinkers. Big reductions in alcohol taxes in Denmark in 2003 and Finland in 2004 offer a new chance to study whose drinking changes how much, and in what contexts, in a collaborative study comparing northern Sweden with Finland, Denmark and southern Sweden.