| 1. |
- Soussan, Christophe, et al.
(författare)
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The users of Novel Psychoactive Substances: Online survey about their characteristics, attitudes and motivations
- 2016
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Ingår i: International journal on drug policy. - elsevier : Elsevier BV. - 0955-3959 .- 1873-4758. ; 32, s. 77-84
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Tidskriftsartikel (refereegranskat)abstract
- Background: The increasing number of Novel Psychoactive Substances (NPS) constitutes a challenge for public health agencies and researchers worldwide. Scientific studies about NPS and their users are limited and there is a need to explore the general motivations for NPS use but also to examine if and how the motivations differ between substances from separate effect classes. The aim of the present study was to investigate the characteristics, including attitudes and motivations, of a self-selected sample of international NPS users.Methods: An online survey containing questions about drug use history, attitudes, motivations for use, and WHO-5 Wellbeing Index was promoted at the drug discussion forum bluelight.org. The data was analysed using SPSS. Results: The sample consisted of 619 international NPS users with overall good emotional well-being despite extensive experience of both traditional and novel drugs. The main incentive for use of NPS in general was pleasure and enjoyment. However, going beyond the general approach to NPS revealed significant variations between drug groups. For example, the use of hallucinogens was substantially motivated by self-exploration and spiritual attainment and showed very low levels of addiction potential while the use of opioids and especially GABA activating substances was mainly motivated by coping and showed much higher levels of addiction potential. Synthetic cannabinoids were the least appreciated and least likely to be used again, and were mainly motivated by circumstances such as availability and legality.Conclusion: Understanding the different motivations for NPS use in terms of drug groups could enable more effective prevention and consequently a reduction in harm.
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| 2. |
- Amundsen, Ellen J., et al.
(författare)
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Estimating incidence of problem drug use using the Horwitz-Thompson estimator - A new approach applied to people who inject drugs in Oslo 1985-2008
- 2016
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Ingår i: International journal on drug policy. - : Elsevier BV. - 0955-3959 .- 1873-4758. ; 27, s. 36-42
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Tidskriftsartikel (refereegranskat)abstract
- Background: The trend in the number of new problem drug users per year (incidence) is the most important measure for studying the diffusion of problem drug use. Due to sparse data sources and complicated statistical models, estimation of incidence of problem drug use is challenging. The aim of this study is to widen the palette of available methods and data types for estimating incidence of problem drug use over time, and for identifying the trends. Methods: This study presents a new method of incidence estimation, applied to people who inject drugs (PWID) in Oslo. The method took into account the transition between different phases of drug use progression - active use, temporary cessation, and permanent cessation. The Horwitz-Thompson estimator was applied. Data included 16 cross-sectional samples of problem drug users who reported their onset of injecting drug use. We explored variation in results for selected probable scenarios of parameter variation for disease progression, as well as the stability of the results based on fewer years of cross-sectional samples. Results: The method yielded incidence estimates of problem drug use, over time. When applied to people in Oslo who inject drugs, we found a significant reduction of incidence of 63% from 1985 to 2008. This downward trend was also present when the estimates were based on fewer surveys (five) and in the results of sensitivity analysis for likely scenarios of disease progression. Conclusion: This new method, which incorporates temporarily inactive problem drug users, may become a useful tool for estimating the incidence of problem drug use over time. The method may be less data intensive than other methods based on first entry to treatment and may be generalized to other groups of substance users. Further studies on drug use progression would improve the validity of the results.
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| 3. |
- Azim, T, et al.
(författare)
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Women, drugs and HIV
- 2015
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Ingår i: The International journal on drug policy. - : Elsevier BV. - 1873-4758 .- 0955-3959. ; 2626 Suppl 1, s. S16-S21
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Tidskriftsartikel (refereegranskat)
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| 4. |
- Edman, Johan
(författare)
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Depoliticising the political : Market solutions and the retreat of Swedish institutional drug treatment from state management
- 2016
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Ingår i: International journal on drug policy. - : Elsevier BV. - 0955-3959 .- 1873-4758. ; 32, s. 93-99
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Tidskriftsartikel (refereegranskat)abstract
- Background: This article examines developments in the Swedish drug treatment services in 1982-2000 and explores the ways in which political initiatives and the state administration's management have contributed to the major privatisations of institutional drug treatment during this period. Methods: The empirical basis for the textual analysis lies in official reports, parliamentary material and archived records from the Stockholm County Administrative Board's management of treatment facilities. Results: The major privatisations of drug treatment services in the 1980s were both unintentional and unwanted and mainly arose from a lack of bureaucratic control and ideological anchorage. The privatisations were, however, reinforced by ideologically driven NPM-oriented political initiatives in the 1990s. Conclusion: The market-oriented treatment services have failed to fulfil the needs for diversity and availability within a publicly financed sector, which deals with unevenly informed and often socio-economically weak citizens. New management models in this field must ensure that ideological considerations are taken into account to meet politically decided goals and means.
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| 5. |
- Fischer, Benedikt, et al.
(författare)
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Medical Marijuana programs : Implications for cannabis control policy – Observations from Canada
- 2015
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Ingår i: International journal of drug policy. - : Elsevier BV. - 0955-3959 .- 1873-4758. ; 26:1, s. 15-19
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Tidskriftsartikel (refereegranskat)abstract
- While prohibition has been the dominant regime of cannabis control in most countries for decades, an increasing number of countries have been implementing cannabis control reforms recently, including decriminalization or even legalization frameworks. Canada has held out from this trend, although it has among the highest cannabis use rates in the world. Cannabis use is universally criminalized, and the current (conservative) federal government has vowed not to implement any softening reforms to cannabis control. As a result of several higher court decisions, the then federal government was forced to implement a ‘medical marijuana access regulations’ program in 2001 to allow severely ill patients therapeutic use and access to therapeutic cannabis while shielding them from prosecution. The program's regulations and approval processes were complex and subject to extensive criticism; initial uptake was low and most medical marijuana users continued their use and supply outside the program's auspices. This year, the government introduced new ‘marijuana for medical purposes regulations’, which allow physicians to ‘authorize’ medical marijuana use for virtually any health condition for which this is considered beneficial; supply is facilitated by licensed commercial producers. It is expected that some 500,000 users, and dozens of commercial producers will soon be approved under the program, arguably constituting – as with medical marijuana schemes elsewhere, e.g. in California – de facto ‘legalization’. We discuss the question whether the evolving scope and realities of ‘medical cannabis’ provisions in Canada offer a ‘sneaky side door’ or a ‘better third way’ to cannabis control reform, and what the potential wider implications are of these developments.
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| 6. |
- Jones, Alan Wayne, et al.
(författare)
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High prevalence of previous arrests for illicit drug use and/or impaired driving among drivers killed in motor vehicle crashes in Sweden with amphetamine in blood at autopsy
- 2015
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Ingår i: International journal on drug policy. - : Elsevier. - 0955-3959 .- 1873-4758. ; 26:8, s. 790-793
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Tidskriftsartikel (refereegranskat)abstract
- Background: Amphetamine, and to a lesser extent the secondary amine methamphetamine, are major recreational drugs of abuse in Sweden. These central stimulant amines are identified in blood from roughly 50% of people arrested for driving under the influence of drugs (DUID). However, much less information is available about the presence of amphetamine in blood of drivers killed in road-traffic crashes.Methods: This retrospective 10-year study (2001-2010) used a forensic toxicology database (TOXBASE) to retrieve information about road-traffic crashes when the driver had amphetamine and/or methamphetamine in autopsy blood. Forensic toxicology results were available from over 95% of all drivers killed on Swedish roads during this 10-year period.Results: Amphetamine was present in the blood of 106 drivers (3.9%) either alone or together with other psychoactive substances (e.g. alcohol, cannabis, diazepam, alprazolam, etc.). The vast majority of fatalities were male (95%) with a mean age (+/- standard deviation) of 37 +/- 11.4 years (range 16-67 years). The mean (median) and highest concentrations of amphetamine in femoral blood were 1.36 mg/L (1.0 mg/L) and 6.74 mg/L, respectively. Many of the victims (75%) had been arrested previously for use of illicit drugs or DUID. The median number of previous arrests was 4 (range 0-83) and amphetamine or methamphetamine were among the drugs identified in blood samples from 89% of cases (0-100%).Conclusion: The high prevalence of repeat DUID offending and/or use of illicit drugs among the drivers killed in road-traffic crashes suggests that an early intervention and treatment for stimulant abuse might have been more beneficial than conventional punishments for such drug-related crimes. (C) 2015 Elsevier B.V. All rights reserved.
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| 7. |
- MacLean, Sarah, et al.
(författare)
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'You're repulsive' : Limits to acceptable drunken comportment for young adults
- 2018
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Ingår i: International journal on drug policy. - : Elsevier BV. - 0955-3959 .- 1873-4758. ; 53, s. 106-112
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Tidskriftsartikel (refereegranskat)abstract
- Background: Researchers have described a 'culture of intoxication' among young people. Yet drunkenness remains a socially risky practice with potential to evoke emotions of irritation and even disgust. We consider intoxicated practices that young adults in Melbourne, Australia, described as distasteful, to identify contemporary cultural forces that constrain intoxication and limit how it is enacted.Method: Interviews were conducted with 60 participants in Melbourne, Australia, each with recent drinking experience. Participants were asked to provide accounts of moments when they regarded their own or others' drunken comportment as unsociable or unpleasant. Transcripts were analysed to identify recurrent themes.Results: Despite amusement when recounting drunken antics, almost everyone in the study identified some discomfort at their own or other's drunkenness. We describe four interacting domains where lines delineating acceptable comportment appear be drawn. The first concerns intoxicated practices. Unpleasant drunken comportment often entailed a sense that the drunk person had disturbed others through an overflow of the self extruding intimacy, sexuality, violence or bodily fluids. The second domain was gendering, with women vulnerable to being regarded as sexually inappropriate, and men as threatening. Third, the settings where intoxicated behaviour occurred influenced whether intoxicated people risked censure. Finally, the relationships between the drunk person and others, including their respective social positions and drinking patterns, shaped how they were perceived.Conclusion: The capacity of alcohol to render people more open to the world is both sought and reviled. It is important to recognise that there remain limits on acceptable drunken comportment, although these are complex and contingent. These limits are enforced via people's affective responses to drunkenness. This is form of alcohol harm reduction that occurs outside of public health intervention. Thus, cultures that constrain drinking should be supported wherever it is possible to do so without reinforcing stigmatising identities.
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| 8. |
- Moeller, Kim
(författare)
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Sisters are never alike? Drug control intensity in the Nordic countries.
- 2019
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Ingår i: International journal on drug policy. - : Elsevier. - 0955-3959 .- 1873-4758. ; 73, s. 141-145
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Nordic countries — Denmark, Finland, Norway, and Sweden — have traditionally had different approaches to drug control policies. From the late 1980s to the early 1990s, Sweden and Norway were the most restrictive countries. Prior research has described how Nordic control policies became more repressive after this, but no research has examined this claim using the intensity of implementation as a measure. Methods: This study uses data collated by the EMCDDA to examine drug control intensity from 2000 to 2016. The four countries are compared on three measures: seizure numbers relative to total population, seizures numbers by type of drug relative to population, and cannabis seizures relative to the number of annual cannabis users. Standard bivariate tests for statistical significance are used to compare control intensity over time and between countries. Results: Compared to an earlier period from the late 1980s to the early 1990s, Denmark maintained the level of drug seizures to population from 2000 to 2016. Finland increased intensity by 176 percent but remained at the lowest level in the region. Norway increased by 18 percent and is currently the country with the highest enforcement intensity. Sweden reduced overall intensity by 57 percent, which decreases the level for the region by 22 percent. Sixty to seventy percent of all seizures in every country was for cannabis. Accounting for cannabis prevalence rates changes the ranking of enforcement intensity in the countries. Conclusion: Drug control intensity in the Nordic countries has harmonized over time. The disparity between the extremes of low control intensity in Finland and high intensity in Sweden has been reduced. Denmark is still comparatively lenient to users when considering high cannabis prevalence rates and Norway has taken the position as the strictest country on all control intensity measures.
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| 9. |
- Moore, David, et al.
(författare)
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Sameness and difference : Metaphor and politics in the constitution of addiction, social exclusion and gender in Australian and Swedish drug policy
- 2015
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Ingår i: International journal of drug policy. - : Elsevier BV. - 0955-3959 .- 1873-4758. ; 26:4, s. 420-428
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Tidskriftsartikel (refereegranskat)abstract
- Like any other discourse, drug policy is imagined and articulated through metaphors. In this article, we explore the metaphors and meanings at work in the current national drug policies of Australia and Sweden. Australia's approach to welfare is usually characterised as liberal-welfarist, emphasising individual difference and ‘freedom’. Sweden's approach is usually characterised as social-democratic, universalistic and paternalistic, with an emphasis on social rights, equity and sameness. How do these models of citizenship – difference versus sameness – play out in national drug policies? What are the risks and benefits of these models and the claims they allow? In the textual analysis presented here, we focus on metaphors and meanings relating to the themes of addiction, social exclusion and gender. We choose metaphor as our major analytical tool because we think that the risks and benefits of adopting different models of citizenship in drug policy need to be understood to operate at many levels and with a high degree of subtlety and abstraction. In the cases of addiction and social exclusion, a complicated picture emerges. In Australia, drug users are offered two options: sameness (and reintegration into society) or difference (and re-connection). In Sweden, drug users are excluded from society but not because they are fundamentally different from non-users. Because drug users are understood to be suffering from a temporary and curable personal affliction, the goal is to return them to sameness through care and treatment. With respect to gender, although differently expressed in the two national contexts and differently shaped by national imaginaries, both national policies adopt similar approaches: the unequal treatment of women transcends differences in national setting. Accounts of drug policy usually focus on the degree to which drug policy is, or should be, ‘evidence-based’, or on the complex political negotiations involving diverse stakeholders and interests. We suggest here another, complementary, perspective: that national imaginaries (i.e. culturally specific metaphors, symbols and beliefs, and national ideologies) shape drug policy in subtle but crucial ways.
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| 10. |
- Richert, Torkel
(författare)
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Wasted, overdosed, or beyond saving - to act or not to act? : Heroin users' views, assessments, and responses to witnessed overdoses in Malmö, Sweden
- 2015
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Ingår i: International journal on drug policy. - : Elsevier. - 0955-3959 .- 1873-4758. ; 26:1, s. 92-99
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Tidskriftsartikel (refereegranskat)abstract
- Background: Overdose is a significant cause of death among heroin users. Frequently, other heroin users are present when an overdose occurs, which means the victim's life could be saved. There is a lack of studies that, based on heroin users own stories, examine their views, assessments, and responses to witnessed overdoses. Methods: The study is based on qualitative interviews with thirty-five heroin users who witnessed someone else's overdose. Results: The heroin users generally had a positive attitude towards assisting peers who had overdosed. A number of factors and circumstances, however, contribute to witnesses often experiencing resistance to or ambivalence about responding. The witness's own high, the difficulty in assessing the seriousness of the situation, an unwillingness to disturb someone else's high, uncertainty about the motive behind the overdose and whether the victim does or does not want assistance as well as fear of police involvement, were common factors that acted as barriers to adequate responses in overdose situations. Conclusion: The fact that being high makes it difficult to respond to overdoses, using traditional methods, argues for simpler and more effective response techniques. This can include intranasal naloxone programs for heroin users. The findings regarding the uncertainty about the intention of the overdose victim and the sensitivity to the experience of a good high argue for more up-front communication and discussion amongst using peers so that they can make their intentions clear to each other. Issues like this can be addressed in overdose education interventions. Overdose prevention measures also need to address the fact that fear of the police acts as a barrier to call emergency services. (C) 2014 Elsevier B.V. All rights reserved.
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