Pub Date : 2022-12-01DOI: 10.1177/00914509221100925
S. Aguiar, Clara Musto
Background: Uruguay was the first country in the world to explicitly authorize the personal cultivation of cannabis in 2013 within a comprehensive market regulation model. This policy development provides a unique opportunity to gauge the first impact of cannabis regulation on domestic cannabis growing and to have a more accurate picture of the characteristics of cannabis growers, a topic largely neglected by previous research in the country. Method: The Survey on Regulated Cannabis in Uruguay was conducted between October and December of 2017 to a random sample of the population between 15 and 65 years of age (n = 2,181). Using face-to-face interviews, the survey asked about the use of cannabis (forms, amounts, access, motivations, etc.) and other drugs, included a sociodemographic module, and a specific section on domestic cultivation (n = 213). The questions were formulated to ensure comparability with previous international surveys (ICCQ-GCCRC) conducted in 13 industrialized countries. Results: After regulation, the type of product consumed in Uruguay changed completely, with a significant increase in the preference for domestically grown cannabis. Most growers are experienced and frequent cannabis users. In the comparison with other countries, important similarities appear, as the quantity produced or the ages of growers, as well as relevant differences. While there is a predominance of men, a higher number of women got involved in growing after the law was adopted. Most cannabis is produced outdoors and with low costs per harvest. Conclusions: In a context of scarcity of legally sold cannabis, both registered and unregistered cannabis personal growing increased in Uruguay, though mostly through “experimental” attempts and motivations.
{"title":"The Regulation Backyard: Home Growing Cannabis in Uruguay","authors":"S. Aguiar, Clara Musto","doi":"10.1177/00914509221100925","DOIUrl":"https://doi.org/10.1177/00914509221100925","url":null,"abstract":"Background: Uruguay was the first country in the world to explicitly authorize the personal cultivation of cannabis in 2013 within a comprehensive market regulation model. This policy development provides a unique opportunity to gauge the first impact of cannabis regulation on domestic cannabis growing and to have a more accurate picture of the characteristics of cannabis growers, a topic largely neglected by previous research in the country. Method: The Survey on Regulated Cannabis in Uruguay was conducted between October and December of 2017 to a random sample of the population between 15 and 65 years of age (n = 2,181). Using face-to-face interviews, the survey asked about the use of cannabis (forms, amounts, access, motivations, etc.) and other drugs, included a sociodemographic module, and a specific section on domestic cultivation (n = 213). The questions were formulated to ensure comparability with previous international surveys (ICCQ-GCCRC) conducted in 13 industrialized countries. Results: After regulation, the type of product consumed in Uruguay changed completely, with a significant increase in the preference for domestically grown cannabis. Most growers are experienced and frequent cannabis users. In the comparison with other countries, important similarities appear, as the quantity produced or the ages of growers, as well as relevant differences. While there is a predominance of men, a higher number of women got involved in growing after the law was adopted. Most cannabis is produced outdoors and with low costs per harvest. Conclusions: In a context of scarcity of legally sold cannabis, both registered and unregistered cannabis personal growing increased in Uruguay, though mostly through “experimental” attempts and motivations.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44763629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-01DOI: 10.1177/00914509221122704
Angus Bancroft, Tessa Parkes, Idil Galip, Catriona Matheson, Emma Crawshaw, Vicki Craik, Joshua Dumbrell, Joe Schofield
The impact of COVID-19 itself and societal responses to it have affected people who use drugs and the illicit drug economy. This paper is part of a project investigating the health impacts of COVID-19 related control measures on people who use drugs in Scotland. It examines their roles and decisions as economically situated actors. It does this within a moral economy perspective that places economic decisions and calculations within a context of the network of social obligations and moral decisions. The paper uses a mixed methods approach, reporting on a drug trend survey and in-depth interviews with people who use drugs. It finds they were affected by restrictions in the drug consumption context and changes in the supply context, both in terms of what was supplied and changes in the relationship between sellers and buyers. Face to face selling became more fraught. Participants in more economically precarious circumstances were faced with dilemmas about whether to move into drug selling. The double impact of loss of income and reduced access to support networks were particularly difficult for them. Despite the perception that the pandemic had increased the power of sellers in relation to their customers, many full-time sellers were reported to be keeping their prices stable in order to maintain their relationships with customers, instead extending credit or adulterating their products. The effect of spatial controls on movement during the pandemic also meant that the digital divide became more apparent. People with good access to digital markets and easy drug delivery through apps were in a better position to manage disruption to drug sales contexts. We make recommendations in relation to how policy can respond to the interests of people who use drugs in a pandemic.
{"title":"Negotiating an Illicit Economy in the Time of COVID-19: Selling and Buying Dilemmas in the Lives of People Who Use Drugs in Scotland.","authors":"Angus Bancroft, Tessa Parkes, Idil Galip, Catriona Matheson, Emma Crawshaw, Vicki Craik, Joshua Dumbrell, Joe Schofield","doi":"10.1177/00914509221122704","DOIUrl":"https://doi.org/10.1177/00914509221122704","url":null,"abstract":"<p><p>The impact of COVID-19 itself and societal responses to it have affected people who use drugs and the illicit drug economy. This paper is part of a project investigating the health impacts of COVID-19 related control measures on people who use drugs in Scotland. It examines their roles and decisions as economically situated actors. It does this within a moral economy perspective that places economic decisions and calculations within a context of the network of social obligations and moral decisions. The paper uses a mixed methods approach, reporting on a drug trend survey and in-depth interviews with people who use drugs. It finds they were affected by restrictions in the drug consumption context and changes in the supply context, both in terms of what was supplied and changes in the relationship between sellers and buyers. Face to face selling became more fraught. Participants in more economically precarious circumstances were faced with dilemmas about whether to move into drug selling. The double impact of loss of income and reduced access to support networks were particularly difficult for them. Despite the perception that the pandemic had increased the power of sellers in relation to their customers, many full-time sellers were reported to be keeping their prices stable in order to maintain their relationships with customers, instead extending credit or adulterating their products. The effect of spatial controls on movement during the pandemic also meant that the digital divide became more apparent. People with good access to digital markets and easy drug delivery through apps were in a better position to manage disruption to drug sales contexts. We make recommendations in relation to how policy can respond to the interests of people who use drugs in a pandemic.</p>","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9597153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9179142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-01DOI: 10.1177/00914509221101403
Y. Le Hénaff
Relying on the (classic interactionist) notion of “career,” this paper attempts to explore the alcohol trajectories of a sample of young adults in France. To reconstruct each career, we conducted 30 in-depth interviews with young adults from 19 to 25 years of age. Three distinct stages were identified. The first consists of trying the product; the second involves experimenting with the physical and sensory effects of drinking; the third sets the person on a course toward diversifying consumption patterns.
{"title":"From Initiation to Apprenticeship in Taste: A Career-Based Approach to Alcohol Consumption in France","authors":"Y. Le Hénaff","doi":"10.1177/00914509221101403","DOIUrl":"https://doi.org/10.1177/00914509221101403","url":null,"abstract":"Relying on the (classic interactionist) notion of “career,” this paper attempts to explore the alcohol trajectories of a sample of young adults in France. To reconstruct each career, we conducted 30 in-depth interviews with young adults from 19 to 25 years of age. Three distinct stages were identified. The first consists of trying the product; the second involves experimenting with the physical and sensory effects of drinking; the third sets the person on a course toward diversifying consumption patterns.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48710262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-29DOI: 10.1177/00914509221140959
K. Lancaster, Sandra Gendera, C. Treloar, T. Rhodes, Jeyran Shahbazi, M. Byrne, L. Degenhardt, M. Farrell
Aims: This study examined the social, material and temporal effects of extended-release buprenorphine depot treatment (BUP-XR), among a group of participants commencing BUP-XR in Australia, and considered the situated potentials of these new opioid agonist treatment technologies. Methods: Using a longitudinal qualitative design, 36 participants (25 men, 11 women; mean age 44 years) were interviewed, with 32 followed-up, to generate accounts of BUP-XR experiences. Analysis was informed by sociological approaches which attend to the multiple effects of novel health interventions as they are put to use and made to work, with a focus on tracing change over time. Analysis: The shift from daily to monthly dosing altered how opioid agonist treatment was experienced, reconfigured participants’ relationship to treatment, and affected the temporal patterns of participants’ lives. Extending temporal relations released participants from short-term cycles of living and produced different forms of subjectivity, bringing about both transformation and loss. Monthly dosing, and a sense of normalcy characterized by absenting the routines and felt effects of drugs or treatment medications, potentiated a feeling of stability for many participants. For some, disrupting daily routines precipitated disconnection from treatment and social care relations. The transition from daily to monthly dosing required adaptation and new ways of engaging with treatment and care, with medication acting as a bridge to care without necessarily being the focal point. Conclusions: As BUP-XR treatment gains traction internationally, it will be important to attend to the multiple, and sometimes unexpected, effects this intervention makes in the social and material lives of clients. How choice, social connection, and care can be maintained to help secure BUP-XR’s longer-term impact, and how clients can be supported to adjust to what is felt to be a new normal, will be considerations in future treatment delivery.
{"title":"The Social, Material, and Temporal Effects of Monthly Extended-Release Buprenorphine Depot Treatment for Opioid Dependence: An Australian Qualitative Study","authors":"K. Lancaster, Sandra Gendera, C. Treloar, T. Rhodes, Jeyran Shahbazi, M. Byrne, L. Degenhardt, M. Farrell","doi":"10.1177/00914509221140959","DOIUrl":"https://doi.org/10.1177/00914509221140959","url":null,"abstract":"Aims: This study examined the social, material and temporal effects of extended-release buprenorphine depot treatment (BUP-XR), among a group of participants commencing BUP-XR in Australia, and considered the situated potentials of these new opioid agonist treatment technologies. Methods: Using a longitudinal qualitative design, 36 participants (25 men, 11 women; mean age 44 years) were interviewed, with 32 followed-up, to generate accounts of BUP-XR experiences. Analysis was informed by sociological approaches which attend to the multiple effects of novel health interventions as they are put to use and made to work, with a focus on tracing change over time. Analysis: The shift from daily to monthly dosing altered how opioid agonist treatment was experienced, reconfigured participants’ relationship to treatment, and affected the temporal patterns of participants’ lives. Extending temporal relations released participants from short-term cycles of living and produced different forms of subjectivity, bringing about both transformation and loss. Monthly dosing, and a sense of normalcy characterized by absenting the routines and felt effects of drugs or treatment medications, potentiated a feeling of stability for many participants. For some, disrupting daily routines precipitated disconnection from treatment and social care relations. The transition from daily to monthly dosing required adaptation and new ways of engaging with treatment and care, with medication acting as a bridge to care without necessarily being the focal point. Conclusions: As BUP-XR treatment gains traction internationally, it will be important to attend to the multiple, and sometimes unexpected, effects this intervention makes in the social and material lives of clients. How choice, social connection, and care can be maintained to help secure BUP-XR’s longer-term impact, and how clients can be supported to adjust to what is felt to be a new normal, will be considerations in future treatment delivery.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47930163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-18DOI: 10.1177/00914509221136913
K. Footer, Glenna J. Urquhart, B. Silberzahn, Saba Rouhani, N. Weicker, J. Owczarzak, J. Park, Miles Morris, S. Sherman
In this paper we explore people who use drugs (PWUD) perceptions and experiences of drug-related law enforcement in a major U.S. city. Maryland recently implemented several harm reduction policies/interventions aiming to improve PWUD-police relationships, such as the Good Samaritan Law (GSL), intended to avoid criminalizing police encounters with PWUD in cases of overdose. PWUD, though most impacted by these efforts, are seldom included in the decision making process. Data collection occurred in Baltimore City, a majority-Black city with a history of structural racism, where high overdose fatalities necessitate collaborative interventions, but where over-policing and abusive practices have generated widespread community mistrust of police. Between October 2018 and December 2019, we conducted in-depth interviews with 20 PWUD in Baltimore City to understand their perspectives of policing and its impact on harm reduction practices (specifically willingness to seek overdose assistance) in the context of the GSL. PWUD reported ongoing police mistrust, which impacted their harm reduction practices and experiences of laws such as the GSL. Results question whether police, as first responders to overdose, can ever avoid criminalizing the encounter. Findings intend to guide future public health-law enforcement collaboration efforts in the context of the current de-policing debate.
{"title":"PWUD Experiences of Criminal Justice Reform: Enduring Tensions Between Policing and Harm Reduction in Baltimore, MD","authors":"K. Footer, Glenna J. Urquhart, B. Silberzahn, Saba Rouhani, N. Weicker, J. Owczarzak, J. Park, Miles Morris, S. Sherman","doi":"10.1177/00914509221136913","DOIUrl":"https://doi.org/10.1177/00914509221136913","url":null,"abstract":"In this paper we explore people who use drugs (PWUD) perceptions and experiences of drug-related law enforcement in a major U.S. city. Maryland recently implemented several harm reduction policies/interventions aiming to improve PWUD-police relationships, such as the Good Samaritan Law (GSL), intended to avoid criminalizing police encounters with PWUD in cases of overdose. PWUD, though most impacted by these efforts, are seldom included in the decision making process. Data collection occurred in Baltimore City, a majority-Black city with a history of structural racism, where high overdose fatalities necessitate collaborative interventions, but where over-policing and abusive practices have generated widespread community mistrust of police. Between October 2018 and December 2019, we conducted in-depth interviews with 20 PWUD in Baltimore City to understand their perspectives of policing and its impact on harm reduction practices (specifically willingness to seek overdose assistance) in the context of the GSL. PWUD reported ongoing police mistrust, which impacted their harm reduction practices and experiences of laws such as the GSL. Results question whether police, as first responders to overdose, can ever avoid criminalizing the encounter. Findings intend to guide future public health-law enforcement collaboration efforts in the context of the current de-policing debate.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64956611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-31DOI: 10.1177/00914509221134716
G. Dertadian, Kenneth Yates
Drug consumption room literature often presents overdose as a stable phenomenon, which can be responded to in the same way from one context to the next. The literature is dominated by a clinical paradigm that implies that consumption rooms are effective because they provide sterile spaces and medical supervision, yet this is not the only way in which such services are delivered, nor is it the only component of the care provided at centers with a clinical focus. A growing body of critically oriented social science literature has highlighted the way different socio-material relations of care produce different capacities for service delivery. In order to expand the field’s understanding of care beyond an avowed a-political approach to clinical supervision, we conducted qualitative interviews with staff at Sydney Medically Supervised Injecting Centre (MSIC) about how they respond to overdose. Drawing on feminist notions of the politics of care we argue that overdoses are ontologically multiple phenomena, which are enacted at MSIC in ways that are explicitly differentiated from how they are understood and responded to in more traditional clinical settings. This illustrates how a desirable clinical intervention (saving lives) is made possible at MSIC through a set of constitutive relations (and politics) of care that are aimed at more than simply ensuring the client’s heart keeps beating.
{"title":"“Overdose Has Many Faces”: The Politics of Care in Responding to Overdose at Sydney’s Medically Supervised Injecting Centre","authors":"G. Dertadian, Kenneth Yates","doi":"10.1177/00914509221134716","DOIUrl":"https://doi.org/10.1177/00914509221134716","url":null,"abstract":"Drug consumption room literature often presents overdose as a stable phenomenon, which can be responded to in the same way from one context to the next. The literature is dominated by a clinical paradigm that implies that consumption rooms are effective because they provide sterile spaces and medical supervision, yet this is not the only way in which such services are delivered, nor is it the only component of the care provided at centers with a clinical focus. A growing body of critically oriented social science literature has highlighted the way different socio-material relations of care produce different capacities for service delivery. In order to expand the field’s understanding of care beyond an avowed a-political approach to clinical supervision, we conducted qualitative interviews with staff at Sydney Medically Supervised Injecting Centre (MSIC) about how they respond to overdose. Drawing on feminist notions of the politics of care we argue that overdoses are ontologically multiple phenomena, which are enacted at MSIC in ways that are explicitly differentiated from how they are understood and responded to in more traditional clinical settings. This illustrates how a desirable clinical intervention (saving lives) is made possible at MSIC through a set of constitutive relations (and politics) of care that are aimed at more than simply ensuring the client’s heart keeps beating.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41580561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-06DOI: 10.1177/00914509221129300
A. Vinther
Despite persistent efforts in many countries to prevent the use of anabolic androgenic steroids (AAS) and other image and performance-enhancing drugs (IPEDs), very little is known about effective prevention strategies. This study aimed to explore experts’ views on strategies to prevent AAS use in the context of recreational strength training in gyms. The study builds on in-depth interviews with 46 researchers and practitioners from 15 countries, whose main area of expertise is IPED use, prevention and education in physical activity settings (IPED experts). Participants were asked about their views on AAS use prevention and what intervention strategies may be effective in preventing this behavior. Data were analyzed using thematic content analysis in accordance with recommendations for this technique. The findings showed that the IPED experts generally agree that some, but not all, instances of AAS use can be prevented through targeted prevention in gyms. They pointed to three key priorities for AAS use prevention in gyms: (1) make the case for drug-free training, (2) promote safe and effective ways to enhance muscularity, and (3) attempt to change the physical and social environment in the gym to make the training milieu less conducive to AAS use. Importantly, however, none of the experts were able to pinpoint any specific behavior change strategies that have proven effective.
{"title":"“The Challenge Is That Steroids Are So Effective”: A Qualitative Study of Experts’ Views on Strategies to Prevent Men’s Use of Anabolic Steroids","authors":"A. Vinther","doi":"10.1177/00914509221129300","DOIUrl":"https://doi.org/10.1177/00914509221129300","url":null,"abstract":"Despite persistent efforts in many countries to prevent the use of anabolic androgenic steroids (AAS) and other image and performance-enhancing drugs (IPEDs), very little is known about effective prevention strategies. This study aimed to explore experts’ views on strategies to prevent AAS use in the context of recreational strength training in gyms. The study builds on in-depth interviews with 46 researchers and practitioners from 15 countries, whose main area of expertise is IPED use, prevention and education in physical activity settings (IPED experts). Participants were asked about their views on AAS use prevention and what intervention strategies may be effective in preventing this behavior. Data were analyzed using thematic content analysis in accordance with recommendations for this technique. The findings showed that the IPED experts generally agree that some, but not all, instances of AAS use can be prevented through targeted prevention in gyms. They pointed to three key priorities for AAS use prevention in gyms: (1) make the case for drug-free training, (2) promote safe and effective ways to enhance muscularity, and (3) attempt to change the physical and social environment in the gym to make the training milieu less conducive to AAS use. Importantly, however, none of the experts were able to pinpoint any specific behavior change strategies that have proven effective.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43163667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-21DOI: 10.1177/00914509221126549
R. Pack, Grace Hilton, F. Garcia-Bournissen, T. Taylor
Substance use in pregnancy has been a prominent public health concern for the last several decades. Since the legalization of cannabis in Canada and across several American states, cannabis use during pregnancy has gained considerable public health, scientific, and media attention. This critical interpretive synthesis explores how the problem of cannabis use in pregnancy is constructed in the scientific literature and illuminates clinical, social, and political responses this construction engenders. The state of empirical evidence regarding the impact of perinatal cannabis use is fraught; a number of studies, of variable quality, have found no associations between cannabis use and adverse neonatal outcomes, while others have found cannabis to be associated with low birthweight and prematurity among other risks. Despite the inconsistent nature of the evidence base, the literature is underpinned by two important assumptions: prenatal cannabis exposure is an asocial phenomenon that can be disentangled from the social determinants of health, and cannabis exposure has detrimental effects on fetal and neonatal health. These assumptions shape indicators of signal and noise in the data by influencing the significance ascribed to particular findings, producing patterns of data interpretation that ultimately transform evidence of potential harms into certain risks and creates the mirage of a cohesive, unambiguous evidence base. We argue that the way that cannabis use in pregnancy is framed as a scientific and public health problem in the literature contributes to the stigmatization of pregnant people who use substances. We caution that failure to consider the interplay between environment, resources and other social determinants of health may ultimately cause undue harm to families and foreclose opportunities for investments that may promote health and well-being.
{"title":"Transforming Possible Risk Into Certain Harm: A Critical Interpretive Synthesis of the Literature on Perinatal Cannabis Use","authors":"R. Pack, Grace Hilton, F. Garcia-Bournissen, T. Taylor","doi":"10.1177/00914509221126549","DOIUrl":"https://doi.org/10.1177/00914509221126549","url":null,"abstract":"Substance use in pregnancy has been a prominent public health concern for the last several decades. Since the legalization of cannabis in Canada and across several American states, cannabis use during pregnancy has gained considerable public health, scientific, and media attention. This critical interpretive synthesis explores how the problem of cannabis use in pregnancy is constructed in the scientific literature and illuminates clinical, social, and political responses this construction engenders. The state of empirical evidence regarding the impact of perinatal cannabis use is fraught; a number of studies, of variable quality, have found no associations between cannabis use and adverse neonatal outcomes, while others have found cannabis to be associated with low birthweight and prematurity among other risks. Despite the inconsistent nature of the evidence base, the literature is underpinned by two important assumptions: prenatal cannabis exposure is an asocial phenomenon that can be disentangled from the social determinants of health, and cannabis exposure has detrimental effects on fetal and neonatal health. These assumptions shape indicators of signal and noise in the data by influencing the significance ascribed to particular findings, producing patterns of data interpretation that ultimately transform evidence of potential harms into certain risks and creates the mirage of a cohesive, unambiguous evidence base. We argue that the way that cannabis use in pregnancy is framed as a scientific and public health problem in the literature contributes to the stigmatization of pregnant people who use substances. We caution that failure to consider the interplay between environment, resources and other social determinants of health may ultimately cause undue harm to families and foreclose opportunities for investments that may promote health and well-being.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49235821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-21DOI: 10.1177/00914509221127444
Ediomo-ubong E. Nelson
Recent studies on women’s substance use have emphasized the role of structural and environmental contexts in shaping substance use patterns and harms, but the dynamics constitutive of specific substance use contexts are seldom unpacked. This study works with Cameron Duff’s elaboration of context as an assemblage of space, embodiment and practice to explore the contextual dynamics that mediate substance use practices among socially marginalized women. In-depth interviews were used to gather data from a purposive sample of street-involved women who use drugs (n = 16) in Uyo, Nigeria. Data revealed that substance use was mediated by actors, social norms and processes within social networks developed in street environments. The women used substances to achieve particular affective states such as pleasure, stress relief and coping with trauma. Social network dynamics combined with the use of drugs to manage trauma and social stress, within a wider context of social and material deprivations, to foster substance use practices that created risk for harm. Drug harms were not inherent to the substance use experience or incidental to benefits and pleasures. Instead, they were unintended, but inevitable, outcomes of the embodied practices of beneficial substance use. On the other hand, corporeal techniques of controlled drug use served to minimize drug harms. Findings indicate a need to address the contextual dynamics that influence harmful patterns of substance use, and to leverage the harm reducing potentials of controlled use practices.
{"title":"Nuancing Drug Harms: Exploring the Context of Substance Use Among Street-Involved Women in Uyo, Nigeria","authors":"Ediomo-ubong E. Nelson","doi":"10.1177/00914509221127444","DOIUrl":"https://doi.org/10.1177/00914509221127444","url":null,"abstract":"Recent studies on women’s substance use have emphasized the role of structural and environmental contexts in shaping substance use patterns and harms, but the dynamics constitutive of specific substance use contexts are seldom unpacked. This study works with Cameron Duff’s elaboration of context as an assemblage of space, embodiment and practice to explore the contextual dynamics that mediate substance use practices among socially marginalized women. In-depth interviews were used to gather data from a purposive sample of street-involved women who use drugs (n = 16) in Uyo, Nigeria. Data revealed that substance use was mediated by actors, social norms and processes within social networks developed in street environments. The women used substances to achieve particular affective states such as pleasure, stress relief and coping with trauma. Social network dynamics combined with the use of drugs to manage trauma and social stress, within a wider context of social and material deprivations, to foster substance use practices that created risk for harm. Drug harms were not inherent to the substance use experience or incidental to benefits and pleasures. Instead, they were unintended, but inevitable, outcomes of the embodied practices of beneficial substance use. On the other hand, corporeal techniques of controlled drug use served to minimize drug harms. Findings indicate a need to address the contextual dynamics that influence harmful patterns of substance use, and to leverage the harm reducing potentials of controlled use practices.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42292753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-08DOI: 10.1177/00914509221123001
R. Mellor, M. Kearnes, K. Lancaster, L. McLauchlan, A. Ritter
In this paper we document and analyze emergent participatory processes in drug policy, focusing on the relations between established modes of engagement and emergent participatory formats. We do this through analysis of a case example, attending to policy changes to opioid pharmacotherapy treatment in the context of COVID-19 in Australia. Semistructured interviews (n = 22) were undertaken between August 2020 and March 2021 with people closely involved in the recent policy changes and discussions surrounding opioid pharmacotherapy treatment in Australia. The analysis of the interview accounts followed work which has forged relational, co-productionist and materialist understandings of participation. Two figures of participation were encountered in the interview accounts: the tables of participation and the huddles of participation. The tables seemingly represented a standardized set of bureaucratic mechanisms for the inclusion of the “voices” of people who use drugs. The huddles emerged as a responsive and less coherent set of ad hoc participatory collectives in the context of rapid policy changes during COVID-19. Instead of viewing emergence as distinct from existing participatory formats, emergence was conceptualized ecologically in this article—that is in relation to established forms of participation. As the institutionally mandated tables served the basis for the emergent huddles of participation in this case study, it demonstrates that even the most foreclosed participatory structures can adapt and be responsive to evolving situations of need, perhaps also in ordinary times and not just in emergency conditions.
{"title":"Established Tables and Emergent Huddles: Exploring the Processes of Participation Associated With the Policy Changes to Opioid Pharmacotherapy Treatment in Australia in the Context of COVID-19","authors":"R. Mellor, M. Kearnes, K. Lancaster, L. McLauchlan, A. Ritter","doi":"10.1177/00914509221123001","DOIUrl":"https://doi.org/10.1177/00914509221123001","url":null,"abstract":"In this paper we document and analyze emergent participatory processes in drug policy, focusing on the relations between established modes of engagement and emergent participatory formats. We do this through analysis of a case example, attending to policy changes to opioid pharmacotherapy treatment in the context of COVID-19 in Australia. Semistructured interviews (n = 22) were undertaken between August 2020 and March 2021 with people closely involved in the recent policy changes and discussions surrounding opioid pharmacotherapy treatment in Australia. The analysis of the interview accounts followed work which has forged relational, co-productionist and materialist understandings of participation. Two figures of participation were encountered in the interview accounts: the tables of participation and the huddles of participation. The tables seemingly represented a standardized set of bureaucratic mechanisms for the inclusion of the “voices” of people who use drugs. The huddles emerged as a responsive and less coherent set of ad hoc participatory collectives in the context of rapid policy changes during COVID-19. Instead of viewing emergence as distinct from existing participatory formats, emergence was conceptualized ecologically in this article—that is in relation to established forms of participation. As the institutionally mandated tables served the basis for the emergent huddles of participation in this case study, it demonstrates that even the most foreclosed participatory structures can adapt and be responsive to evolving situations of need, perhaps also in ordinary times and not just in emergency conditions.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45658355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：