Substance use & misuse
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Substance use & misuse · Jan 2005
Epidemiology of MDMA and associated club drugs in the Seattle area.
Club drug use, MDMA in particular, appeared as a growing problem in the Seattle area in the late 1990s. To understand more about the patterns of MDMA use and to evaluate the current state of MDMA use, multiple data sources were examined. The seven data sources utilized included local community-based club drug surveys collected in 2003 at raves, treatment agencies, and gay-oriented bars and sex clubs; school surveys (collected in 2002); mortality data (deaths between 2000 and 2002); data from the sexually transmitted disease clinic (October 2002 to October 2003); focus groups (2003) with men who have sex with men; emergency department drug mentions (1995 to 2002); and drug treatment admissions (1999 to 2003). ⋯ However, there are several areas of concern including possible mental health effects and high levels of suspected adulteration of MDMA. Some data point to a relationship between MDMA use and risky behaviors including unprotected sex. Implications for prevention, intervention, and treatment are discussed.
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Substance use & misuse · Jan 2005
The rise of club drugs in a heroin society: the case of Hong Kong.
Although the contemporary dance drug scene is a global phenomenon, with many countries and cultures reporting similar developments with ecstasy and other club drug use, the scene, in many respects, is a reflection and expression of local culture. This article examines the rise of the dance drug scene in a society long associated with opiate use. ⋯ The paper discusses the reasons for the rise and popularity of club drugs in the context of other locally available drugs, in particular, heroin. This discussion draws from three studies that tracked drug use trends from 1995 to 2002 through a variety of data sources, including official statistics, field observations, individual interviews with 20 law enforcement officials, 16 focus groups with outreach and drug treatment workers, teachers, and representatives from different communities, and in-depth interviews with 27 club drug users.
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Persons experiencing pain, whether acute or chronic, seek and deserve relief from their discomfort and loss of function. However, opioid analgesics have the capacity to induce tolerance, physical dependence, and addiction. ⋯ Prescription of opioids could trigger a relapse to the original drug of choice or could initiate a new bout of addiction with the prescribed drug. This article explores the relationship between addiction and pain, including signs of developing addiction and approaches to managing pain in those with addiction.
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Thinking about addictions has been dominated by two models: the medical model, which treats addiction as a disease and related behaviors as signs and symptoms, and the moral model, which views addiction and related behaviors as indications of moral failure. This article describes both models and their implications, with special emphasis on the moral model. ⋯ Nonetheless, both models have desirable characteristics, and sound public policy should not be based solely on either. The implications for criminal justice of employing both models to guide policy are explored.
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This article discusses the conceptual, ethical, and policy issues raised by the legal classification of drug addiction as an impairment, and of some nonusing drug addicts as people with disabilities. It focuses on the questions of (1) what moral judgments, if any, underlie the classification of addiction as an impairment; (2) whether it makes sense to apportion the burdens of drug addiction between chemical, biological, social, political, and other causes; (3) how considerations of distributive justice may compel or constrain measures to ease the burdens of drug addiction; and (4) whether it is justifiable to deny the current users of illegal substances legal protections available to the current users of legal substances.