Neighborhood drug markets: a risk environment for bacterial sexually transmitted infections among urban youth

We hypothesized that neighborhoods with drug markets, as compared to those without, have a greater concentration of infected sex partners, i.e. core transmitters, and that in these areas, there is an increased risk environment for STIs. This study determined if neighborhood drug markets were associated with a high-risk sex partnership and, separately, with a current bacterial STI (chlamydia and/or gonorrhea) after controlling for individual demographic and sexual risk factors among a household sample of young people in Baltimore City, MD. Analyses also tested whether links were independent of neighborhood socioeconomic status. Data for this study were collected from a household study, systematic social observations and police arrest, public health STI surveillance and U.S. census data. Nonlinear multilevel models showed that living in neighborhoods with household survey-reported drug markets increased the likelihood of having a high-risk sex partnership after controlling for individual-level demographic factors and illicit drug use and neighborhood socioeconomic status. Further, living in neighborhoods with survey-reported drug markets increased the likelihood of having a current bacterial STI after controlling for individual-level demographic and sexual risk factors and neighborhood socioeconomic status. The results suggest that local conditions in neighborhoods with drug markets may play an important role in setting-up risk environments for high-risk sex partnerships and bacterial STIs. Patterns observed appeared dependent on the type of drug market indicator used. Future studies should explore how conditions in areas with local drug markets may alter sexual networks structures and whether specific types of drug markets are particularly important in determining STI risk.

Illegal drug impersonators: the synthetic drug abuse boom

The Internet has opened the door to marketers of products that contain substances that when ingested mimic the effects of illegal drugs such as marijuana, cocaine, and LSD. This article traces the history of synthetic drugs, describes some of the newest substances on the market and their physiologic and psychological effects, and discusses efforts aimed at curbing their sale and use.

[Prevalence of the drug consumption among Chilean university students]

BACKGROUND

Drug abuse is one of the main public health problems and mostly involves young people.

AIM

To determine the prevalence of drug consumption among university students and its associated social factors.

MATERIAL AND METHODS

A questionnaire exploring consumption of drugs and social-demographic, economic and religious variables, was applied to 1577 third year students aged 22 ± 2 years (54% females) of a public university.

RESULTS

Sixty eight percent of the students were of middle socioeconomic class, 71 % belonged to some religion and 29% declared themselves as agnostic. Ninety six percent drank alcohol at least once and 29% never smoked. Among illicit drugs, marijuana was consumed by 22% followed by cocaine in 5.3%o, hallucinogenic drugs in 2.6 % >, inhalants in 2.3% > and cocaine free base in 1.4%). Six percent consumed stimulants and 13.8%>, sedatives. A higher economic income facilitated drug consumption and the adscription to a religion was protective against it.

CONCLUSIONS

Alcohol is the most commonly consumed drug, and is the substance that generates more problems to students.

Are methamphetamine precursor control laws effective tools to fight the methamphetamine epidemic?

One of the most notable trends in illegal substance use among Americans over the past decade is the dramatic growth and spread of methamphetamine use. In response to the dramatic rise in methamphetamine use and its associated burden, a broad range of legislations has been passed to combat the problem. In this paper, we assess the impact of retail-level laws intended to restrict chemicals used to manufacture methamphetamine (methamphetamine precursor laws) in reducing indicators of domestic production, methamphetamine availability, and the consequences of methamphetamine use. Specifically, we examine trends in these indicators of methamphetamine supply and use over a period spanning the implementation of the federal Methamphetamine Anti-Proliferation Act (MAPA) (October 2000) and a more stringent state-level restriction enacted in California (January 2000). The results are mixed in terms of the effectiveness of legislative efforts to control methamphetamine production and use, depending on the strength of the legislation (California Uniform Controlled Substances Act versus federal MAPA), the specification of the comparison group, and the particular outcome of interest. Some evidence suggests that domestic production was impacted by these legislative efforts, but there is also evidence that prices fell, purities rose, and treatment episodes increased.

Mephedrone use and associated adverse effects in school and college/university students before the UK legislation change

BACKGROUND

Mephedrone is a synthetic cathinone that is commonly used as a recreational drug among those who attend nightclubs. There have been increasing reports of toxicity associated with its use and it was controlled as a Class B drug under the Misuse of Drugs Act (1971) in the UK on 16 April 2010. There has been a suggestion from media reports that mephedrone use is common in children/students but there is no data on the prevalence of its use among the general population. The aim of this study was to determine the prevalence and frequency of use of mephedrone among school and college/university aged individuals and to collect data on the sources of mephedrone and acute harm related to its use.

METHODS

Data was collected using a questionnaire survey in schools, colleges and universities in the Tayside area of Scotland, UK in February 2010.

RESULTS

A total of 1006 individuals completed the survey [501 (49.8%) males and 505 (50.2%) females], of whom 349 classified their educational institute as a school and 657 as a college/university. Among them 205 (20.3%) reported previous use of mephedrone; 23.4% reported using only using mephedrone on one occasion previously, although 4.4% reported daily use. A total of 56% of those who had used mephedrone, reported at least one unwanted effect associated with its use. A total of 17.6% of users reported 'addiction or dependence' symptoms associated with their mephedrone use. A total of 48.8% of users sourced mephedrone from street level dealers, 10.7% from the Internet.

CONCLUSION

We have shown in this study that the use of mephedrone among school and college/university students is common and that users found it easy to obtain. There was a high prevalence of unwanted effects associated with its use. Further work is needed to determine the impact of the recent changes in the UK legislation relating to mephedrone and other related cathinones and whether this has been effective in reducing the prevalence of mephedrone use.

Buying 'legal' recreational drugs does not mean that you are not breaking the law

BACKGROUND

Recreational drug use in the UK is common; sources of recreational drugs are changing, with increasing purchase of legal highs from the Internet. Previous studies have shown that there is not consistency of active ingredient(s) in legal highs purchased from the Internet.

AIM

The aim of this study was to determine the impact of the 16 April 2010 change to the Misuse of Drugs Act (1971) on the content of 'legal highs' purchased over the Internet and supplied within the UK.

METHODS

Legal highs were purchased from a number of different Internet suppliers and the active ingredients determined by analysis undertaken within a Home Office approved and licensed laboratory set in a UK academic institution. The active ingredient(s) detected on screening were then compared to the UK legislation in force at the time of purchase to determine whether each individual 'legal' high was in fact legal or not.

RESULTS

All 18 products purchased prior to the change in the UK legislation contained active ingredients that were legal under the Misuse of Drugs Act (1971) in force at that time. Six products were purchased and analysed after the changes to the UK Misuse of Drugs Act (1971) on the 16 April 2010. Five of the products contained information, either on the Internet site or the packaging, stating that the product contained legal substances; the final product did not specify the active ingredient and so purchasers would be unable to determine if this was truly a legal product. Five of the six products contained an active ingredient that is a Class B drug under the Misuse of Drugs Act (1971); the other product contained an unlicensed medicine not controlled under the Misuse of Drugs Act (1971).

CONCLUSION

We have shown in this study that some drugs sold as 'legal' highs contain drugs that are controlled under the Misuse of Drugs Act (1971). Under current UK legislation, individuals purchasing legal highs that contained controlled drugs would be subject to the same penalties as if they had knowingly purchased a controlled drug. Dissemination of information on the harm associated with the use of legal highs should also inform individuals that they may be purchasing controlled substances and the potential legal consequences of this.

Drug Policy and the Public Good: a summary of the book

Drug Policy and the Public Good was written by an international group of scientists from the fields of addiction, public health, criminology and policy studies to improve the linkages between drug research and drug policy. The book provides a conceptual basis for evidence-informed drug policy and describes epidemiological data on the global dimensions of drug misuse. The core of the book is a critical review of the cumulative scientific evidence in five general areas of drug policy: primary prevention programmes in schools and other settings; health and social services for drug users; attempts to control the supply of drugs, including the international treaty system; law enforcement and ventures into decriminalization; and control of the psychotropic substance market through prescription drug regimes. The final chapters discuss the current state of drug policies in different parts of the world and describe the need for future approaches to drug policy that are coordinated and informed by evidence.

Estimating the dollar value of the illicit market for cannabis in New Zealand

New data collected on the procurement and purchase of cannabis in the 2001 New Zealand National Drug Survey are used to estimate the dollar value of the illicit market for cannabis as well conduct other economic analyses of the illicit purchase of cannabis in New Zealand. Eighty-four per cent of last-year cannabis users received at least some of their cannabis 'free', 38% 'bought' at least some of their cannabis, while only 8% grew any of their supply. By proportion of the total dollar value of the cannabis market, sales of 'tinnies' (1.5 g) had the biggest share of the market (30%), followed closely by 50 NZ dollars bags (4 g) (29%) and ounces (28 g) (26%). The average price paid per gram of cannabis fell steadily from 20.50 NZ dollars per gram for a joint to 5.63 per gram for a pound (NZ dollars). The distribution of spending on cannabis was positively skewed (average 1313 NZ dollars, median 400 NZ dollars, mode 100, range 5 - 55,200, interquartile range 100 - 1200) (NZ dollars). The bottom 50% of cannabis buyers spent a median amount on cannabis of 100 NZ dollars a year while the top 5% spent a median amount of 7425 a year (NZ dollars). The dollar value of the illicit cannabis market was estimated to be 190 million (131 - 249 million) (NZ dollars). Three limitations are acknowledged with the market estimate calculated: (i) the truncated age range of the survey data (13 - 45 years); (ii) the likely underestimation of heavy cannabis use in household drug surveys; (iii) a degree of 'double-counting' when the same cannabis is bought and sold a number of times.

Heroin in brown, black and white: structural factors and medical consequences in the US heroin market

BACKGROUND

Heroin coming into the United States historically comes from three widely dispersed geographical regions: Southwest Asia, Southeast Asia and Mexico. A fourth source of US-bound heroin, from Colombia, originated in the early 1990s. The fact that the four heroin sources produce differing morphologies and qualities of heroin has not been critically examined. In addition, it is not well established how the contemporary competing dynamics of interdiction, or restriction of heroin flows across international boundaries, and neoliberal, e.g., global expansion of free trade, policies are affecting heroin markets. This paper will highlight changes in the US heroin market, including source trends, the political economy of the now dominant source and the resultant effects on the heroin risk environment by US region.

METHODS

Using a structural and historical framework this paper examines two decades of secondary data sources, including government and drug control agency documents, on heroin flows together with published work on the political and economic dynamics in Latin America.

RESULTS

Co-occurring neoliberal economic reforms may have contributed to paradoxical effects of US/Colombian interdiction efforts. Since entering the US market, heroin from Colombia has been distributed at a much higher quality and lower retail price. An increasingly exclusive market has developed with Mexican and Colombian heroin gaining market share and displacing Asian heroin. These trends have had dramatic effects on the risk environment for heroin consumers. An intriguing factor is that different global sources of heroin produce substantially different products. Plausible associations exist between heroin source/form and drug use behaviours and harms. For example, cold water-soluble powdered heroin (sources: Asia, Colombia) may be associated with higher HIV prevalence in the US, while low-solubility "black tar" heroin (BTH; source: Mexico) is historically used in areas with reduced HIV prevalence. BTH is associated with soft tissue infections caused by Clostridium bacteria.

CONCLUSION

Source and type of heroin are structural factors in the risk environment of heroin users: source dictates distribution and type predicts practice. How specific types of heroin are used and with what risk is therefore distributed geographically. Continued flux in the heroin market and its effects on the risk environment for drug users deserves further attention.

The War on Drugs: Methamphetamine, Public Health, and Crime

In mid-1995, a government effort to reduce the supply of methamphetamine precursors successfully disrupted the methamphetamine market and interrupted a trajectory of increasing usage. The price of methamphetamine tripled and purity declined from 90 percent to 20 percent. Simultaneously, amphetaminerelated hospital and treatment admissions dropped 50 percent and 35 percent, respectively. Methamphetamine use among arrestees declined 55 percent. Although felony methamphetamine arrests fell 50 percent, there is no evidence of substantial reductions in property or violent crime. The impact was largely temporary. The price returned to its original level within four months; purity, hospital admissions, treatment admissions, and arrests approached preintervention levels within eighteen months. (JEL I12, K42).

Psychoactive substance use among Arab adolescent school dropouts in Israel: a phenomenon and its implications

This comprehensive study is the first to examine rates of legal and illegal psychoactive substance use and their predictors specifically among Arab adolescent school dropouts. It investigates the links between sociodemographic, interpersonal, cognitive and personality characteristics and use rates. Four hundred and seventy-six Arab adolescents aged 12-18 from throughout Israel, who had dropped out of school, participated in the study in late 2004. Sampling was done using a cluster method in order to choose specific localities. Participants completed self-report questionnaires assessing substance use and other variables. Legal substances--alcohol and tobacco--were used by 36% and 30% of the respondents, respectively, in the previous year. Being male, non-religious and having higher behavioural intentions and positive attitudes regarding use increased the odds of substance use. The best predictors of alcohol use were gender and religiosity, each raising the odds of use by 3.5. The best predictor of tobacco use was gender, raising the odds by 12.7. The best predictors of illegal use, behavioural intentions and risk perception, each doubled the odds of use. These and other results facilitate a better understanding of substance use among Arab adolescent dropouts and can foster the development of appropriate prevention and intervention programmes for this underserved population.