Bulletin on narcotics最新文献

In view of the recent call by the Sub-Commission on Illicit Drug Traffic and Related Matters in the Near and Middle East, for the "development of mechanisms to identify, with more precision and through laboratory analysis, the sources of opium seized from the illicit traffic" [1], the present paper reviews the rationale and preconditions for any practical and reliable characterization and origin-correlated classification of opium. In that context, the results of the early international efforts under the aegis of the United Nations from 1951 to 1967, as well as the rather sporadic investigations in this direction since 1968, are described. Finally, it is demonstrated that in spite of the application of modern computer-based technology, the main obstacle to comprehensive opium characterization and typology is still the lack of an extensive reference collection of opium samples of known origin.

The epidemic of drug abuse has overwhelmed men, women and children and caused incalculable damage to an honoured structure in human civilization--the family. Moreover, during the past decade, increasing numbers of pregnant drug-dependent women have been presenting themselves to medical facilities, some to receive ongoing prenatal care, but others only to deliver their babies without the benefit of any medical services. The present chapter reviews the current literature, as well as the experiences of the author, with regard to the sociomedical characteristics of pregnant, drug-dependent women. The effects of substances of abuse on pregnancy, the foetus and the newborn with respect to morbidity and mortality are presented. Recommendations for management of both the pregnant drug-dependent women and her child, on the basis of clinical research, are also outlined. Although overall medical advances have escalated during the past three decades, there is still much to learn with regard to the effects of drugs of abuse upon families. Moreover, methods of prevention and treatment still need considerable study. By re-evaluating the areas of strength and weakness in the body of available knowledge, future research will be able to enhance the ability to help those unfortunate families that are effected by substance abuse.

The programme of international cooperation of the European Community (EC) in the field of drugs has been in existence since 1987. The scope of the programme is wide and covers, in principle, all aspects of the drug problem in the partner countries. However, interdiction of illicit activities in drug production and trafficking has fallen so far outside the competence of EC, although it will be covered by the European Union once the Maastricht Treaty comes into force. Out of the experience gained in managing the programme, the author suggests that, to be effective, an integrated approach should provide an appropriate place for cooperating more fully in the field of law enforcement. The two priority areas of application of the programme should then be the prevention of drug abuse and the fight against trafficking-two areas which, in fact, tightly reinforce each other.

The development of chromatography technology, with the increasing availability of easier-to-use mass spectrometers combined with gas chromatography (GC), the use of diode-array or programmable variable-wavelength ultraviolet absorption detectors in conjunction with high-performance liquid chromatography (HPLC), and the availability of scanners capable of reading thin-layer chromatography (TLC) plates in the ultraviolet and visible regions, has made for easier, quicker and more positive identification of cannabis samples that standard analytical laboratories are occasionally required to undertake in the effort to combat drug addiction. At laboratories that do not possess the technique of GC combined with mass spectrometry, which provides an irrefutable identification, the following procedure involving HPLC or TLC techniques may be used: identification of the chromatographic peaks corresponding to each of the three main cannabis constituents-cannabidiol (CBD), delta-9-tetrahydrocannabinol (delta-9-THC) and cannabinol (CBN)-by comparison with published data in conjunction with a specific absorption spectrum for each of those constituents obtained between 200 and 300 nm. The collection of the fractions corresponding to the three major cannabinoids at the HPLC system outlet and the cross-checking of their identity in the GC process with flame ionization detection can further corroborate the identification and minimize possible errors due to interference.

The present paper presents a review of the current practice and experience in drug and alcohol testing in the workplace, focusing primarily on the United States of America. After reviewing the history of workplace drug screening, the author describes the growth and impact of the drug-testing industry. He outlines the four most common rationales for workplace drug testing: safety, productivity, decreasing drug use and legislative/regulatory requirements. He summarizes the best studies on the prevalence of workplace drug testing in the United States and describes employer attitudes in that country. The author reviews in some detail the association between drugs, alcohol, occupational injuries and other adverse employment outcomes. He then reviews the literature on cost-benefit analysis of workplace drug testing. The author concludes that relatively little is known about the role of alcohol and drugs in the workplace. The important association between substance abuse and occupational injury has not been established. If there is such an association, it is much weaker than previously believed. The contradictory findings in different studies suggest that substance abuse may well play different roles in different occupational and cultural settings. Thus, caution should be exercised in transposing results from one setting to another. Finally, the review of cost-benefit analyses suggests that any economic analysis of workplace drug screening is likely to be greatly influenced by the prevalence of drugs in the population screened.

A flashpoint in the debate over workplace responses to alcohol and drug use by members of the workforce centres on the chemical testing of current employees and job applicants for alcohol and drug use. Drug testing may be the most contentious issue faced by enterprises struggling to develop fair and effective programmes to deal with the consequences of substance use in the workplace. The present paper examines scientific evidence on the nature and extent of alcohol and drug use by members of the workforce, evidence linking alcohol and drug use to workplace problems, workplace strategies for managing alcohol- and drug-related difficulties, and arguments for and against drug and alcohol testing. To date, the evidence supportive of alcohol and drug testing is inconclusive. Testing programmes may be useful in identifying drug users in the workforce. Their deterrent value is uncertain, however, and they are not efficient tools for linking drug users to assistance programmes. Enterprises that are contemplating establishing testing programmes should consider: (a) whether substance use is a problem in their setting; (b) whether testing will respond to the problem; (c) the costs and benefits of testing; and (d) any ethical and legal questions raised by the programmes.

Manipur, a north-eastern state of India bordering Myanmar, has experienced very rapid transmission of the human immunodeficiency virus (HIV) among its vast drug-injecting population. Seroprevalence among intravenous drug users increased from 0 per cent in September 1989 to 50 per cent within six months. With a minimum injecting population of 15,000 and seropositivity of over 50 per cent, the infection quickly spread to the population at large. One per cent of antenatal mothers tested seropositive by 1991. Forming part of the area of South-East Asia known as the Golden Triangle, and producing opium and its derivatives, Myanmar shares a long international border with four States of the region, and populations with a common language and culture move freely across borders. Two other north-eastern states of India bordering Myanmar have faced a similar epidemic within a short period of time. As a result of serosurveillance for HIV since 1986, the epidemic could be detected at an early stage. The present paper provides an account of the results of ongoing comprehensive studies conducted in the north-eastern states of India on drug-related HIV infection, already a serious problem, but possibly still restricted to that region of the country. The prevalence of intravenous drug users, their HIV serological status, the demographic profile, risk behaviour, the spread of the infection to other groups and the problems of harm minimization are also covered.

The paper identifies and reviews some critical issues in the field of human immunodeficiency virus (HIV) transmission among intravenous drug users. First, it discusses political denial and compartmentalization of the problem, giving an example from the United States that illustrates the lack of a coherent national strategy. It then reviews the role that stereotypes play in policy-making and points out that behaviour change can be considerable, giving details of successful safer injection programmes. The conditions that foster injection as a mode of ingesting drugs are reviewed, as in the role of drug trans-shipment patterns, particularly as a possible conduit of HIV. Finally, the role of prisons as places for the spread of HIV, and therefore for its prevention, is discussed.

The proponents of drug and alcohol testing advance several safety and productivity arguments in support of their position. It is asserted that persons who test positively for drug and alcohol at the workplace experience higher levels of absenteeism and use sick leave to a much greater extent than non-users. Moreover, it is claimed that they have levels of productivity from 10 to 60 per cent lower than persons who do not test positively for drugs or alcohol. Perhaps the greatest argument advanced by those in favour of testing, however, is the safety element. Persons who abuse drugs or who consume alcohol to excess are involved in significantly more accidents than those who test negatively. In other words, proponents take the position that persons who test positively for the presence of drugs or alcohol form a category of individuals and that being in this category is grounds for labelling them as problematic employees. Moreover, so the reasoning goes, the only way to find out if an employee is a member of the category of drug or alcohol users is to test. Opponents of alcohol testing feel that the goal of ensuring a drug- and alcohol-free workplace is reached at too high a social cost and that the testing process constitutes an unwarranted invasion of the privacy of the individual. The provision of urine for analysis is a search, which, if conducted without consent or reason, would constitute an assault. Some opponents to testing feel that the real motivation for testing is controlling employee behaviour. Enterprises impose behavioural constraints on employees that may extend to off-duty times. Moreover, it is advanced that the testing process itself is humiliating to many people. In order to obtain a sample for testing, the person being tested must urinate in the presence of an attendant or supervisor. Often, medical standards are not used. Another moral issue is the implication of discrimination as a result of drug or alcohol testing. Perhaps the greatest concern is the systemic discrimination against disabled persons, persons with acquired immunodeficiency syndrome (AIDS), visible minorities and pregnant women that testing may engender. Again, different countries have addressed the discrimination issue in varying ways. Finally, opponents to drug and alcohol testing question the need to test. It is asserted that all testing shows is that, at some point in time, the person being tested ingested the screened substance.(ABSTRACT TRUNCATED AT 400 WORDS)

The article begins with a discussion of the common features of drug-testing programmes. Regulations, procedures and methods for the collection of biological specimens, the subsequent handling and analysis of the specimens and the reporting of the interpreted results are all important aspects to be dealt with in testing programmes. Different types of testing are examined. Pre-employment testing is a popular type of screening but a number of other programmes exist, including post-accident, reasonable suspicion, post-treatment, random and voluntary testing programmes. The goals of these programmes range from improvement of employees' health, safety, quality of life in the workplace and productivity to reduction of drug misuse in society at large. Emphasis is placed on the need for scientific evaluation and on examining whether those goals have been achieved. In the absence of such evaluation, drug-testing programmes should be carried out with caution; some modifications of existing programmes are suggested.