Pub Date : 2020-11-23DOI: 10.1108/dat-09-2020-0062
V. A. Frank, S. Maclean, M. Herold
Nitrous oxide (N2O) use for recreational purposes appears to have increased among young people in several countries, including Denmark, Australia, The Netherlands and the UK. This increase has prompted concern among health authorities and politicians. The purpose of this paper is to map out findings in the available literature about N2O use among young people to better understand current trends and contextualize the public concerns and the new policy responses to it.,The authors draw here on a range of sources, including research literature, reports and policy documents in English and Danish. Given the broad aim, the authors used a scoping study approach (Arksey and O’Malley, 2005).,The authors found literature on prevalence of use, health effects and policy regulations. The literature suggests that health harms associated with N2O use are generally associated with intensive and long-term use, and death is more likely where the means of administration entails a risk of suffocation. Overall, however, the analysis shows that substantial gaps exist in the available literature. The authors lack detailed knowledge on several issues, including comparable prevalence data of N2O use; the extent to which N2O is used with other drugs; how one can distinguish between harmful and non-harmful use in terms of both quantity inhaled and mode of administration; and on intended and unintended consequences of policy responses to this use.,The current increase and trend in inhaling N2O for intoxication among young people is under researched. This general review maps out what kind of knowledge would be valuable to have for prevention, harm reduction and policy interventions.
{"title":"Nitrous oxide use among young people – new trends, policy challenges, and knowledge gaps","authors":"V. A. Frank, S. Maclean, M. Herold","doi":"10.1108/dat-09-2020-0062","DOIUrl":"https://doi.org/10.1108/dat-09-2020-0062","url":null,"abstract":"Nitrous oxide (N2O) use for recreational purposes appears to have increased among young people in several countries, including Denmark, Australia, The Netherlands and the UK. This increase has prompted concern among health authorities and politicians. The purpose of this paper is to map out findings in the available literature about N2O use among young people to better understand current trends and contextualize the public concerns and the new policy responses to it.,The authors draw here on a range of sources, including research literature, reports and policy documents in English and Danish. Given the broad aim, the authors used a scoping study approach (Arksey and O’Malley, 2005).,The authors found literature on prevalence of use, health effects and policy regulations. The literature suggests that health harms associated with N2O use are generally associated with intensive and long-term use, and death is more likely where the means of administration entails a risk of suffocation. Overall, however, the analysis shows that substantial gaps exist in the available literature. The authors lack detailed knowledge on several issues, including comparable prevalence data of N2O use; the extent to which N2O is used with other drugs; how one can distinguish between harmful and non-harmful use in terms of both quantity inhaled and mode of administration; and on intended and unintended consequences of policy responses to this use.,The current increase and trend in inhaling N2O for intoxication among young people is under researched. This general review maps out what kind of knowledge would be valuable to have for prevention, harm reduction and policy interventions.","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44891893","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 : 2020-11-11DOI: 10.1108/dat-07-2020-0046
T. Seddon
Purpose This extended review of Stimson and Oppenheimer’s classic book Heroin Addiction aims to highlight its contribution to the literature and consider its contemporary relevance for research, policy and practice. Design/methodology/approach The review examines the core themes of the longitudinal study that the book presents by bringing it in to dialogue with a recent “living history” project on John Marks’ radical heroin prescribing in the 1980s and 1990s. Findings The three core themes explored are treatment as containment; the balance between therapy and social control; and the benefits of heroin versus methadone. Originality/value The book is a “timeless classic” that still resonates with contemporary concerns and has much to tell us about heroin addiction and its treatment.
{"title":"Heroin addiction: the clinic system, John Marks and a timeless classic","authors":"T. Seddon","doi":"10.1108/dat-07-2020-0046","DOIUrl":"https://doi.org/10.1108/dat-07-2020-0046","url":null,"abstract":"\u0000Purpose\u0000This extended review of Stimson and Oppenheimer’s classic book Heroin Addiction aims to highlight its contribution to the literature and consider its contemporary relevance for research, policy and practice.\u0000\u0000\u0000Design/methodology/approach\u0000The review examines the core themes of the longitudinal study that the book presents by bringing it in to dialogue with a recent “living history” project on John Marks’ radical heroin prescribing in the 1980s and 1990s.\u0000\u0000\u0000Findings\u0000The three core themes explored are treatment as containment; the balance between therapy and social control; and the benefits of heroin versus methadone.\u0000\u0000\u0000Originality/value\u0000The book is a “timeless classic” that still resonates with contemporary concerns and has much to tell us about heroin addiction and its treatment.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-07-2020-0046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47319663","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 : 2020-10-30DOI: 10.1108/dat-12-2019-0052
J. Strizek, Alexandra Karden, J. Matias
Purpose The purpose of this paper is to assess the relevance of cryptomarkets, characteristics of purchasers and possibilities for survey research by approaching users directly on cryptomarkets. Design/methodology/approach Cross-country comparison of the results from the European Web Survey on Drugs (EWSD) and summarizing lessons learned during the data collection was carried out. Findings Purchasers of drugs on cryptomarkets are still a rather small segment of all drug purchasers, and most people who use cryptomarkets also use other sources of supply to buy drugs. The percentage of people using cryptomarkets is unevenly distributed across countries and substances. Purchasers on cryptomarkets in most countries are more likely to be men and more likely, on average, to use more substances. Other characteristics such as age or place of residence do not show a consistent pattern across countries. Recruitment of respondents on cryptomarkets calls for specific techniques and procedures. Specific attention should be paid to build trust and guarantee credibility and anonymity. Research limitations/implications Interpretation of the quantitative results is limited by nonprobabilistic sampling and different recruitment strategies in different countries. Practical implications Users of cryptomarkets show some specific characteristics, providing a challenge for research and prevention agencies to keep up with digital technology. Increasing knowledge about characteristics of users of cryptomarkets may help to create adequate responses for harm reduction measures in different supply settings. However, collecting self-reported data from users on cryptomarkets is limited owing to significant privacy concerns and requires specific skills and strategies. Originality/value The EWSD provides a rare opportunity for detailed analyses of consumption patterns and characteristics of active drug users across several European countries. Furthermore, experiences of a new recruitment strategy are discussed.
{"title":"Relevance of cryptomarkets, characteristics of purchasers and possibilities for survey research: experience from the European Web Survey on Drugs","authors":"J. Strizek, Alexandra Karden, J. Matias","doi":"10.1108/dat-12-2019-0052","DOIUrl":"https://doi.org/10.1108/dat-12-2019-0052","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to assess the relevance of cryptomarkets, characteristics of purchasers and possibilities for survey research by approaching users directly on cryptomarkets.\u0000\u0000\u0000Design/methodology/approach\u0000Cross-country comparison of the results from the European Web Survey on Drugs (EWSD) and summarizing lessons learned during the data collection was carried out.\u0000\u0000\u0000Findings\u0000Purchasers of drugs on cryptomarkets are still a rather small segment of all drug purchasers, and most people who use cryptomarkets also use other sources of supply to buy drugs. The percentage of people using cryptomarkets is unevenly distributed across countries and substances. Purchasers on cryptomarkets in most countries are more likely to be men and more likely, on average, to use more substances. Other characteristics such as age or place of residence do not show a consistent pattern across countries. Recruitment of respondents on cryptomarkets calls for specific techniques and procedures. Specific attention should be paid to build trust and guarantee credibility and anonymity.\u0000\u0000\u0000Research limitations/implications\u0000Interpretation of the quantitative results is limited by nonprobabilistic sampling and different recruitment strategies in different countries.\u0000\u0000\u0000Practical implications\u0000Users of cryptomarkets show some specific characteristics, providing a challenge for research and prevention agencies to keep up with digital technology. Increasing knowledge about characteristics of users of cryptomarkets may help to create adequate responses for harm reduction measures in different supply settings. However, collecting self-reported data from users on cryptomarkets is limited owing to significant privacy concerns and requires specific skills and strategies.\u0000\u0000\u0000Originality/value\u0000The EWSD provides a rare opportunity for detailed analyses of consumption patterns and characteristics of active drug users across several European countries. Furthermore, experiences of a new recruitment strategy are discussed.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-12-2019-0052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42150192","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 : 2020-10-16DOI: 10.1108/dat-07-2020-0049
M. Schaub
Purpose The aim of this paper is to reveal these problems and to derive recommendations for improvement. In the field of alcohol use disorders (AUDs), two common complaints are the large treatment gap that exists because only a small percentage of people with an AUD are in treatment; and the prolonged lag that typically exists between the emergence of problematic symptoms and actual on set of treatment. However, there also are no clear definitions for these terms – “treatment gap” and “treatment lag” – and, therefore, no consensus regarding how to quantify them. For this reason, it is difficult to compare the results of studies assessing either of these measures. Design/methodology/approach A non-systematic literature search and logical-analytical investigation was performed of immanent problems related to definitions and measurements aiming to enhance understanding in this area and derive suggestions for improvement. Findings The following four fundamental questions were identified: How does one operationalise the need to change substance use behaviours? Which interventions can justifiably be called treatment? Is treatment always necessary? and How regularly do patients need to be in contact with a treatment system to be considered “in treatment”? Potential approaches to answering these questions are discussed and recommendations made for future studies to determine how the treatment gap and treatment lag should be derived. Originality/value The derived recommendations should make the calculation of treatment gap and treatment lag more transparent and comparable between studies. They also may serve as checklists for future studies on the treatment gap and lag in the AUD field.
{"title":"How to achieve greater comparability-suggested ways to improve the determination of treatment gap and treatment lag","authors":"M. Schaub","doi":"10.1108/dat-07-2020-0049","DOIUrl":"https://doi.org/10.1108/dat-07-2020-0049","url":null,"abstract":"\u0000Purpose\u0000The aim of this paper is to reveal these problems and to derive recommendations for improvement. In the field of alcohol use disorders (AUDs), two common complaints are the large treatment gap that exists because only a small percentage of people with an AUD are in treatment; and the prolonged lag that typically exists between the emergence of problematic symptoms and actual on set of treatment. However, there also are no clear definitions for these terms – “treatment gap” and “treatment lag” – and, therefore, no consensus regarding how to quantify them. For this reason, it is difficult to compare the results of studies assessing either of these measures.\u0000\u0000\u0000Design/methodology/approach\u0000A non-systematic literature search and logical-analytical investigation was performed of immanent problems related to definitions and measurements aiming to enhance understanding in this area and derive suggestions for improvement.\u0000\u0000\u0000Findings\u0000The following four fundamental questions were identified: How does one operationalise the need to change substance use behaviours? Which interventions can justifiably be called treatment? Is treatment always necessary? and How regularly do patients need to be in contact with a treatment system to be considered “in treatment”? Potential approaches to answering these questions are discussed and recommendations made for future studies to determine how the treatment gap and treatment lag should be derived.\u0000\u0000\u0000Originality/value\u0000The derived recommendations should make the calculation of treatment gap and treatment lag more transparent and comparable between studies. They also may serve as checklists for future studies on the treatment gap and lag in the AUD field.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-07-2020-0049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43208697","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 : 2020-10-08DOI: 10.1108/dat-06-2020-0037
L. Bell, R. Herring, F. Annand
The purpose of this paper is to review the following research questions from the available literature: What evidence is there to suggest that substance misuse specifically by fathers (including alcohol and other drugs) causes wider harms, including child welfare concerns? substance misuse, recovery, parents, fathers, fathering, drugs/ alcohol services. How do professionals respond specifically to substance misuse by fathers? Do interventions aimed at parental substance misuse (particularly in the UK) include both mothers and fathers and if so how?,A scoping literature review was conducted which identified 34 papers (including scoping reviews published in 2006 and 2008, covering the period 1990-2005) and 26 additional studies published between 2002 and 2020.,The review in this paper is organised into six themes: Negative impact of men’s substance misuse problems on their parenting behaviours; quality of the relationship between parents affected by substance misuse of the fathers, in turn affecting the parenting behaviour and outcomes for children; importance to fathers of their fathering role (for example, as a financial provider); difficulties fathers may face in developing their fathering role; sidelining of the fathering role in substance misuse services; and professionals tending to focus on the mother’s role in parenting inventions and services.,This paper focusses on fathers and substance misuse, which is an under-researched field within the wider contexts of fathering research and research into parental substance misuse.
{"title":"Fathers and substance misuse: a literature review","authors":"L. Bell, R. Herring, F. Annand","doi":"10.1108/dat-06-2020-0037","DOIUrl":"https://doi.org/10.1108/dat-06-2020-0037","url":null,"abstract":"The purpose of this paper is to review the following research questions from the available literature: What evidence is there to suggest that substance misuse specifically by fathers (including alcohol and other drugs) causes wider harms, including child welfare concerns? substance misuse, recovery, parents, fathers, fathering, drugs/ alcohol services. How do professionals respond specifically to substance misuse by fathers? Do interventions aimed at parental substance misuse (particularly in the UK) include both mothers and fathers and if so how?,A scoping literature review was conducted which identified 34 papers (including scoping reviews published in 2006 and 2008, covering the period 1990-2005) and 26 additional studies published between 2002 and 2020.,The review in this paper is organised into six themes: Negative impact of men’s substance misuse problems on their parenting behaviours; quality of the relationship between parents affected by substance misuse of the fathers, in turn affecting the parenting behaviour and outcomes for children; importance to fathers of their fathering role (for example, as a financial provider); difficulties fathers may face in developing their fathering role; sidelining of the fathering role in substance misuse services; and professionals tending to focus on the mother’s role in parenting inventions and services.,This paper focusses on fathers and substance misuse, which is an under-researched field within the wider contexts of fathering research and research into parental substance misuse.","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-06-2020-0037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42941101","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 : 2020-09-24DOI: 10.1108/DAT-05-2020-0024
Iain McPhee, B. Sheridan
In response to Scottish Government assertions that an ageing cohort explained increases in drug-related death (DRD), the previous research by the authors established that socio-economic inequalities were additional risk factors explaining the significant increases in DRD in Scotland. This paper aims to subject the drug policy narratives provided by Scottish Government in relation to the governance of drug and alcohol services to critical scrutiny and reveal the social consequences of the funding formula used to direct funding to services via NHS Scotland Boards, and Alcohol and Drug Partnerships (ADP).,The paper provides a narrative review in the context of the AUDIT Scotland reports “Drug and Alcohol Services in Scotland” from 2009 and follow-up report published in 2019. The authors refer to the recommendations made in the 2009 report on effectiveness of drug and alcohol services and subject Scottish Government funding processes, and governance of drug and alcohol services to critical scrutiny.,This analysis provides robust evidence that Scottish Government funding processes and governance of drug and alcohol services increased risk to vulnerable drug users and document evidence that link these risk factors to increased DRD.,The authors have focused on Scottish drug policy and drug services funding. Alcohol services funding is not subject to critical analysis due to limitations of time and resources.,This case study investigates AUDIT Scotland’s recommendations in 2009 to Scottish Government to provide researchers, government policy advisors and media with robust critical analysis that links drug policy decisions to increased DRD.,Drug policy governance by the Scottish Government and NHS Scotland since 2009 have disproportionately affected communities of interest and communities of place already experiencing stark inequalities. These budget decisions have resulted in widening inequalities, and increased DRD within communities in Scotland. The authors conclude that in diverging politically and ideologically from Public Health England, and the Westminster Parliament, Scottish Government drug policy and financial governance of drugs services contributes to increased risk factors explaining DRD within deprived communities.,The 2009 AUDIT Scotland recommendations to Scottish Government subject their governance of drug services to critical scrutiny. This analysis provides a counterpoint to the explanations that rising DRD are unconnected to drug policy and drug services governance.
{"title":"AUDIT Scotland 10 years on: explaining how funding decisions link to increased risk for drug related deaths among the poor","authors":"Iain McPhee, B. Sheridan","doi":"10.1108/DAT-05-2020-0024","DOIUrl":"https://doi.org/10.1108/DAT-05-2020-0024","url":null,"abstract":"In response to Scottish Government assertions that an ageing cohort explained increases in drug-related death (DRD), the previous research by the authors established that socio-economic inequalities were additional risk factors explaining the significant increases in DRD in Scotland. This paper aims to subject the drug policy narratives provided by Scottish Government in relation to the governance of drug and alcohol services to critical scrutiny and reveal the social consequences of the funding formula used to direct funding to services via NHS Scotland Boards, and Alcohol and Drug Partnerships (ADP).,The paper provides a narrative review in the context of the AUDIT Scotland reports “Drug and Alcohol Services in Scotland” from 2009 and follow-up report published in 2019. The authors refer to the recommendations made in the 2009 report on effectiveness of drug and alcohol services and subject Scottish Government funding processes, and governance of drug and alcohol services to critical scrutiny.,This analysis provides robust evidence that Scottish Government funding processes and governance of drug and alcohol services increased risk to vulnerable drug users and document evidence that link these risk factors to increased DRD.,The authors have focused on Scottish drug policy and drug services funding. Alcohol services funding is not subject to critical analysis due to limitations of time and resources.,This case study investigates AUDIT Scotland’s recommendations in 2009 to Scottish Government to provide researchers, government policy advisors and media with robust critical analysis that links drug policy decisions to increased DRD.,Drug policy governance by the Scottish Government and NHS Scotland since 2009 have disproportionately affected communities of interest and communities of place already experiencing stark inequalities. These budget decisions have resulted in widening inequalities, and increased DRD within communities in Scotland. The authors conclude that in diverging politically and ideologically from Public Health England, and the Westminster Parliament, Scottish Government drug policy and financial governance of drugs services contributes to increased risk factors explaining DRD within deprived communities.,The 2009 AUDIT Scotland recommendations to Scottish Government subject their governance of drug services to critical scrutiny. This analysis provides a counterpoint to the explanations that rising DRD are unconnected to drug policy and drug services governance.","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/DAT-05-2020-0024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44184595","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 : 2020-09-23DOI: 10.1108/DAT-07-2020-0048
K. Poikolainen
Purpose The purpose of this paper is to investigate to what degree scientific evidence supports contemporary paternalistic alcohol policy practices targeting fully competent adults. Design/methodology/approach Paternalism may be acceptable if it is effective, fair and protects the safety of the citizen or a third party from the harms caused by the citizen’s autonomic actions. To be justifiable, paternalistic actions should bring about clearly more benefits than harms. Otherwise, autonomy should prevail. The evidence related to alcohol control policies is assessed against these principles. Findings In peaceful civilized societies, alcohol control policies (high prices, restrictions on supply and marketing) have no or only insignificant effectiveness. Some policies are unfair and may bring about more harms than benefits. There is strong evidence showing that brief interventions aiming to reduce alcohol intake are inefficient. Wide-scale screening for such interventions is likely to waste health service resources. There is sufficient evidence to refute the claim that the previously mentioned policies are effective measures to reduce alcohol-related harms. Heavy alcohol use during pregnancy and driving motor vehicles while intoxicated may bring about harm to others than the user. Behavioural interventions to reduce heavy use in pregnancy have been shown to be inefficient. Light alcohol use may have no harmful effect on the developing embryo, whereas heavy use is likely to cause harm. There is moderate evidence for enforcing legal blood alcohol concentration limits to reduce traffic accidents and fatalities. Originality/value This is the first review on the acceptability of paternalism in currently recommended alcohol policies. It shows that in only a few cases, paternalism is effective and compatible with freedom and fairness.
{"title":"Paternalism and alcohol policy","authors":"K. Poikolainen","doi":"10.1108/DAT-07-2020-0048","DOIUrl":"https://doi.org/10.1108/DAT-07-2020-0048","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to investigate to what degree scientific evidence supports contemporary paternalistic alcohol policy practices targeting fully competent adults.\u0000\u0000\u0000Design/methodology/approach\u0000Paternalism may be acceptable if it is effective, fair and protects the safety of the citizen or a third party from the harms caused by the citizen’s autonomic actions. To be justifiable, paternalistic actions should bring about clearly more benefits than harms. Otherwise, autonomy should prevail. The evidence related to alcohol control policies is assessed against these principles.\u0000\u0000\u0000Findings\u0000In peaceful civilized societies, alcohol control policies (high prices, restrictions on supply and marketing) have no or only insignificant effectiveness. Some policies are unfair and may bring about more harms than benefits. There is strong evidence showing that brief interventions aiming to reduce alcohol intake are inefficient. Wide-scale screening for such interventions is likely to waste health service resources. There is sufficient evidence to refute the claim that the previously mentioned policies are effective measures to reduce alcohol-related harms. Heavy alcohol use during pregnancy and driving motor vehicles while intoxicated may bring about harm to others than the user. Behavioural interventions to reduce heavy use in pregnancy have been shown to be inefficient. Light alcohol use may have no harmful effect on the developing embryo, whereas heavy use is likely to cause harm. There is moderate evidence for enforcing legal blood alcohol concentration limits to reduce traffic accidents and fatalities.\u0000\u0000\u0000Originality/value\u0000This is the first review on the acceptability of paternalism in currently recommended alcohol policies. It shows that in only a few cases, paternalism is effective and compatible with freedom and fairness.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/DAT-07-2020-0048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41840431","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 : 2020-09-11DOI: 10.1108/dat-04-2020-0023
B. Love, A. Vetere, P. Davis
Purpose Psychological developmental informed theories imply that addiction is not exclusively due to the addictive properties of the substance but that early psycho-social experiences are influential on later life. The purpose of this paper is to understand substance dependency, relapse and recovery amongst community-based substance using offenders in relation to their childhoods, relationships and significant life events, from their perspective. A key aim was to help better inform policy and practice. Design/methodology/approach A qualitative study (interpretative phenomenological analysis) was used to understand the impact of childhood, relationships and significant life events amongst (N = 17) adult ex/offenders with substance use dependency problems, (who were part of the UK Government rehabilitation programme), to understand their substance use and recovery from their own perspectives. Findings Four main superordinate themes were developed illustrating participants extremely adverse childhoods. Substance use was a means to cope with current and past trauma and crises and to help manage the emotions and mental health which could accompany these difficulties. Managing recovery was about learning to manage life itself, including emotions, mental health problems, trauma/responses, relationships and everyday life. Originality/value This group is under researched where qualitative methods have been used. The study focussed on early-psycho-social experiences and relationships and the influence of these throughout the life cycle, in relation to their substance use. The study was informed by theories often used in therapeutic settings but rarely in research, (Orford, 2008; Khantzian, 2012; Flores, 2012, Van Der Kolk, 2014).
目的心理发展知情理论表明，成瘾不仅仅是由于物质的成瘾特性，早期的心理社会经历对以后的生活有影响。本文的目的是从他们的角度了解社区吸毒罪犯的药物依赖性、复发和康复与他们的童年、关系和重大生活事件的关系。一个关键目标是帮助更好地为政策和实践提供信息。设计/方法/方法一项定性研究（解释性现象学分析）用于了解（N=17）有药物使用依赖问题的成年前科/罪犯（他们是英国政府康复计划的一部分）的童年、关系和重大生活事件的影响，以从他们自己的角度了解他们的药物使用和康复。发现四个主要的上级主题被开发出来，说明了参与者极其不利的童年。药物使用是应对当前和过去创伤和危机的一种手段，有助于管理可能伴随这些困难的情绪和心理健康。管理康复是关于学会管理生活本身，包括情绪、心理健康问题、创伤/反应、人际关系和日常生活。独创性/价值在使用了定性方法的情况下，该小组正在进行研究。这项研究的重点是早期的心理社会经历和关系，以及这些经历和关系在整个生命周期中对其物质使用的影响。该研究采用了通常用于治疗环境但很少用于研究的理论（Orford，2008；Khantzian，2012；Flores，2012，Van Der Kolk，2014）。
{"title":"Understanding addiction, relapse and recovery amongst substance using offenders – a qualitative study informed by developmental psychological theories","authors":"B. Love, A. Vetere, P. Davis","doi":"10.1108/dat-04-2020-0023","DOIUrl":"https://doi.org/10.1108/dat-04-2020-0023","url":null,"abstract":"\u0000Purpose\u0000Psychological developmental informed theories imply that addiction is not exclusively due to the addictive properties of the substance but that early psycho-social experiences are influential on later life. The purpose of this paper is to understand substance dependency, relapse and recovery amongst community-based substance using offenders in relation to their childhoods, relationships and significant life events, from their perspective. A key aim was to help better inform policy and practice.\u0000\u0000\u0000Design/methodology/approach\u0000A qualitative study (interpretative phenomenological analysis) was used to understand the impact of childhood, relationships and significant life events amongst (N = 17) adult ex/offenders with substance use dependency problems, (who were part of the UK Government rehabilitation programme), to understand their substance use and recovery from their own perspectives.\u0000\u0000\u0000Findings\u0000Four main superordinate themes were developed illustrating participants extremely adverse childhoods. Substance use was a means to cope with current and past trauma and crises and to help manage the emotions and mental health which could accompany these difficulties. Managing recovery was about learning to manage life itself, including emotions, mental health problems, trauma/responses, relationships and everyday life.\u0000\u0000\u0000Originality/value\u0000This group is under researched where qualitative methods have been used. The study focussed on early-psycho-social experiences and relationships and the influence of these throughout the life cycle, in relation to their substance use. The study was informed by theories often used in therapeutic settings but rarely in research, (Orford, 2008; Khantzian, 2012; Flores, 2012, Van Der Kolk, 2014).\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-04-2020-0023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42260394","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 : 2020-09-02DOI: 10.1108/dat-05-2020-0031
Ediomo-ubong E. Nelson, M. U. Nnam
Purpose The purpose of this study is to explore the contextual determinants of HIV risk among people who inject drugs (PWID) in public settings in Nigeria. Design/methodology/approach In-depth, individual interviews were conducted with 29 street-based PWID recruited through snowball sampling in Uyo, Nigeria. Interviews were tape-recorded, transcribed, coded and analysed hematically. Findings Homelessness and withdrawal pains encouraged consumption of drugs in public spaces (e.g. bunks, public parks). Conversely, the benefits of participation in street drug-use scenes, including reciprocity norms that guarantee free drugs during withdrawal and protection during overdose, fostered a preference for public injecting. Although participants recognized the need to inject with sterile syringes, scarcity of syringes compelled them to improvise with old syringes or share syringes, increasing risk for HIV transmission. HIV risk was exacerbated by unlawful and discriminatory policing practices, which deterred possession of syringes and encouraged risky behaviours such as rushing injection and sharing of equipment. Practical implications Contextual factors are key determinants of HIV risk for street-based PWID. Implementation of needle and syringe programmes as well as reforming legal frameworks and policing practices to support harm reduction are needed responses. Originality/value This is one of very few qualitative studies that explore risk factors for HIV transmission among PWID in West Africa. The focus on scarcity of sterile syringes and HIV risk is unique and has important policy implications.
{"title":"“…I can use any syringe I find”: contextual determinants of HIV risk in public injecting settings in Nigeria","authors":"Ediomo-ubong E. Nelson, M. U. Nnam","doi":"10.1108/dat-05-2020-0031","DOIUrl":"https://doi.org/10.1108/dat-05-2020-0031","url":null,"abstract":"\u0000Purpose\u0000The purpose of this study is to explore the contextual determinants of HIV risk among people who inject drugs (PWID) in public settings in Nigeria.\u0000\u0000\u0000Design/methodology/approach\u0000In-depth, individual interviews were conducted with 29 street-based PWID recruited through snowball sampling in Uyo, Nigeria. Interviews were tape-recorded, transcribed, coded and analysed hematically.\u0000\u0000\u0000Findings\u0000Homelessness and withdrawal pains encouraged consumption of drugs in public spaces (e.g. bunks, public parks). Conversely, the benefits of participation in street drug-use scenes, including reciprocity norms that guarantee free drugs during withdrawal and protection during overdose, fostered a preference for public injecting. Although participants recognized the need to inject with sterile syringes, scarcity of syringes compelled them to improvise with old syringes or share syringes, increasing risk for HIV transmission. HIV risk was exacerbated by unlawful and discriminatory policing practices, which deterred possession of syringes and encouraged risky behaviours such as rushing injection and sharing of equipment.\u0000\u0000\u0000Practical implications\u0000Contextual factors are key determinants of HIV risk for street-based PWID. Implementation of needle and syringe programmes as well as reforming legal frameworks and policing practices to support harm reduction are needed responses.\u0000\u0000\u0000Originality/value\u0000This is one of very few qualitative studies that explore risk factors for HIV transmission among PWID in West Africa. The focus on scarcity of sterile syringes and HIV risk is unique and has important policy implications.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-05-2020-0031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49395759","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 : 2020-08-03DOI: 10.1108/dat-03-2020-0016
Jani Pestana, Franca Beccaria, Enrico Petrilli
Purpose The purpose of this paper is to investigate motives and modalities of psychedelic substance use in the psychonaut community that is hosted on the Reddit platform (r/psychonaut). Psychonauts are sometimes described as responsible drug users. Elements of responsible use include sharing stories, advice and experiences, reagent testing substances, proper dosing and education on harm reduction and its practical implication. Investigating psychonauts’ substance use can highlight what responsible use means for them and could inform best practices for psychedelic use. Design/methodology/approach Qualitative content analysis of posts and comments on the r/psychonaut subreddit was completed. In total, 350 posts were investigated. A combination of deductive and inductive methods was used to both structure the research and to allow room for novel information. To investigate participant’s motives, this combination was used to both collect and analyse the data. To examine modalities, concepts and keywords were formed out of the collected data and then analysed. Findings Motives for use ranged from self-knowledge, self-investigation and self-medication to increasing artistic expression, curiosity and recreation. Concerning modalities, the respondents put a high emphasis on preparation, set and setting, integration, dosage and gathering and sharing information through research, articles and trip reports. These features are identified in the literature as elements of responsible drug use. This investigation can help by unearthing best practices already in use by the community to inform the bourgeoning movement of psychedelic substance use – both in a medical and self-reflexive setting. Originality/value This paper is framed in the context of paucity of the academic literature on people taking psychedelic substances in Western society in non-rave and non-medical settings, with findings that indicate important change happening in the psychonaut subculture.
{"title":"Psychedelic substance use in the Reddit psychonaut community. A qualitative study on motives and modalities","authors":"Jani Pestana, Franca Beccaria, Enrico Petrilli","doi":"10.1108/dat-03-2020-0016","DOIUrl":"https://doi.org/10.1108/dat-03-2020-0016","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to investigate motives and modalities of psychedelic substance use in the psychonaut community that is hosted on the Reddit platform (r/psychonaut). Psychonauts are sometimes described as responsible drug users. Elements of responsible use include sharing stories, advice and experiences, reagent testing substances, proper dosing and education on harm reduction and its practical implication. Investigating psychonauts’ substance use can highlight what responsible use means for them and could inform best practices for psychedelic use.\u0000\u0000\u0000Design/methodology/approach\u0000Qualitative content analysis of posts and comments on the r/psychonaut subreddit was completed. In total, 350 posts were investigated. A combination of deductive and inductive methods was used to both structure the research and to allow room for novel information. To investigate participant’s motives, this combination was used to both collect and analyse the data. To examine modalities, concepts and keywords were formed out of the collected data and then analysed.\u0000\u0000\u0000Findings\u0000Motives for use ranged from self-knowledge, self-investigation and self-medication to increasing artistic expression, curiosity and recreation. Concerning modalities, the respondents put a high emphasis on preparation, set and setting, integration, dosage and gathering and sharing information through research, articles and trip reports. These features are identified in the literature as elements of responsible drug use. This investigation can help by unearthing best practices already in use by the community to inform the bourgeoning movement of psychedelic substance use – both in a medical and self-reflexive setting.\u0000\u0000\u0000Originality/value\u0000This paper is framed in the context of paucity of the academic literature on people taking psychedelic substances in Western society in non-rave and non-medical settings, with findings that indicate important change happening in the psychonaut subculture.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-03-2020-0016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45785234","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}
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