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Crossin R, Cleland L, Wilkins C, Rychert M, Adamson S, Potiki T, Pomerleau AC, MacDonald B, Faletanoai D, Hutton F, Noller G, Lambie I, Sheridan JL, George J, Mercier K, Maynard K, Leonard L, Walsh P, Ponton R, Bagshaw S, Muthukumaraswamy S, McIntosh T, Poot E, Gordon P, Sharry P, Nutt D, Boden J. The New Zealand drug harms ranking study: A multi-criteria decision analysis. J Psychopharmacol 2023; 37:891-903. [PMID: 37353972 PMCID: PMC10481626 DOI: 10.1177/02698811231182012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
AIMS The harms arising from psychoactive drug use are complex, and harm reduction strategies should be informed by a detailed understanding of the extent and nature of that harm. Drug harm is also context specific, and so any comprehensive assessment of drug harm should be relevant to the characteristics of the population in question. This study aimed to evaluate and rank drug harms within Aotearoa New Zealand using a multi-criteria decision analysis (MCDA) framework, and to separately consider harm within the total population, and among youth. METHODS Two facilitated workshops involved the separate ranking of harm for the total population, and then for youth aged 12-17, by two expert panels. In the total population workshop, 23 drugs were scored against 17 harm criteria, and those criteria were then evaluated using a swing weighting process. Scoring and weighting were subsequently updated during the youth-specific workshop. All results were recorded and analysed using specialised MCDA software. RESULTS When considering overall harm, the MCDA modelling results indicated that alcohol, methamphetamine and synthetic cannabinoids were the most harmful to both the overall population and the youth, followed by tobacco in the total population. Alcohol remained the most harmful drug for the total population when separately considering harm to those who use it, and harm to others. CONCLUSIONS The results provide detailed and context-specific insight into the harm associated with psychoactive drugs use within Aotearoa New Zealand. The findings also demonstrate the value of separately considering harm for different countries, and for different population subgroups.
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Affiliation(s)
- Rose Crossin
- Department of Population Health, University of Otago, Christchurch, New Zealand
| | - Lana Cleland
- Department of Population Health, University of Otago, Christchurch, New Zealand
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Chris Wilkins
- SHORE & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Marta Rychert
- SHORE & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Simon Adamson
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Tuari Potiki
- Office of Māori Development, University of Otago, Dunedin, New Zealand
| | - Adam C Pomerleau
- National Poisons Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Blair MacDonald
- National Drug Intelligence Bureau, New Zealand Police, Wellington, New Zealand
| | - Dwaine Faletanoai
- Pacific Mental Health and Addictions Services (Takanga a Fohe), Waitemata District Health Board, Takapuna, New Zealand
| | - Fiona Hutton
- Institute of Criminology, Victoria University of Wellington, Wellington, New Zealand
| | - Geoff Noller
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
- New Zealand Needle Exchange Programme, National Office, Christchurch, New Zealand
| | - Ian Lambie
- Department of Psychology, University of Auckland, Auckland, New Zealand
| | - Jane L Sheridan
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jason George
- New Zealand Needle Exchange Programme, National Office, Christchurch, New Zealand
| | - Kali Mercier
- New Zealand Drug Foundation, Wellington, New Zealand
| | | | - Louise Leonard
- Community and Other Drug Service, Waikato District Health Board, Waikato, New Zealand
| | | | - Rhys Ponton
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sue Bagshaw
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - Suresh Muthukumaraswamy
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tracey McIntosh
- School of Māori Studies and Pacific Studies, Faculty of Arts, University of Auckland, Auckland, New Zealand
- Ministry of Social Development, Wellington, New Zealand
| | | | | | - Patrick Sharry
- People and Decisions, Sydney, Australia
- Australian Graduate School of Management, University of New South Wales, Sydney, Australia
| | - David Nutt
- Centre for Neuropsychopharmacology, Imperial College, London, UK
| | - Joseph Boden
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Hasan M, Sarker SA. New Psychoactive Substances: A Potential Threat to Developing Countries. ADDICTION & HEALTH 2023; 15:136-143. [PMID: 37560390 PMCID: PMC10408757 DOI: 10.34172/ahj.2023.1411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/30/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND New psychoactive substances (NPS) have become a global phenomenon, with over 134 countries and territories from all world regions reporting them. Since December 2021, governments, laboratories, and partner agencies have confirmed to the UNODC Early Warning Advisory (EWA) on NPS over 1124 substances. It is agreed that NPS control is one of the most challenging tasks for developing countries. Identifying the present and future threads of NPS is the most challenging task for law enforcement officials. The NPS research has a great impact on substance abuse policy-making and harm reduction strategies. METHODS The data in this study were collected from the official websites of online journals, Google Scholar, UNODC, International Narcotics Control Board (INCB), and the Department of Narcotics Control (DNC). FINDINGS Among the eleven groups of NPS, synthetic cannabinoids and cathinones are the most prevalent and alarming in developing countries. In Bangladesh, NPS abuse has been first identified in 2016. Almost 60 countries adopted legislative solutions to manage NPS by 2021, with many using or amending existing legislation and others employing novel legal mechanisms. It is widely agreed by researchers that reducing the menace of NPS requires increased awareness among all stakeholders. CONCLUSION In the fight against the spread of NPS and its severe effects, law enforcement authorities and healthcare professional training must be seen as crucial aspects as well. Financing is also crucial for international organizations dealing with the NPS impact to continue fighting this war. The only way for policymakers to reduce NPS spread globally is through national and international cooperation.
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Affiliation(s)
- Mehedi Hasan
- Deputy Director, Department of Narcotics Control, Security Services Division, Ministry of Home Affairs, Bangladesh
| | - Shahjahan Ali Sarker
- Department of Microbiology and Hygiene, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh
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Moury C, Escada M. Understanding successful policy innovation: The case of Portuguese drug policy. Addiction 2022; 118:967-978. [PMID: 36426667 DOI: 10.1111/add.16099] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 11/11/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION In 2000, the Portuguese minority socialist government decriminalized the possession and consumption of drugs. This law made Portugal unique in having a formal system that directs the person using drugs to a panel under the purview of the Ministry of Health, as opposed to the Ministry of Justice, and hence constitutes an 'original innovation'. In this article, we ask under which conditions such kinds of reforms are introduced and successfully implemented. AIMS AND DESIGN After discussing the limitations of the existing literature, we present a new theoretical framework: the 'six-stars' framework. We argue that successful policy innovation in democracies will only occur and persist when six institutional and individual 'stars' are aligned: attention, motivation to innovate, a new solution, political strategies, quality and legitimacy of the decision-making process and guarantees for full implementation. We then apply this framework to the Portuguese Drug Policy Case through theory-testing/process-tracing. Relying upon a qualitative analysis of three different types of data-primary and secondary sources, official documents emitted by key actors and interviews-we identify the presence of the six aligned 'stars'. CONCLUSIONS The proposed 'six-stars' framework of successful drug policy innovation shows the importance of electoral mandates, communication, inclusion, transparency, deliberation and evaluation when designing innovative drug policies. It also illustrates the importance of ensuring the support of implementing agents and quickly creating visible, positive policy feedback.
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Pacula RL. Commentary on Rychert and Wilkins (2021) 'Why did New Zealand's referendum to legalise recreational cannabis fail?'. Drug Alcohol Rev 2021; 40:884-885. [PMID: 34002906 DOI: 10.1111/dar.13300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/05/2021] [Accepted: 03/06/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Rosalie Liccardo Pacula
- Department of Health Policy and Management, Sol Price School of Public Policy and Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, USA
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Wilkins C, Rychert M. Assessing New Zealand's Cannabis Legalization and Control Bill: prospects and challenges. Addiction 2021; 116:222-230. [PMID: 32621400 DOI: 10.1111/add.15144] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/23/2020] [Accepted: 06/03/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Few countries have developed detailed legislative proposals for legalizing cannabis. New Zealand recently released the Cannabis Legalization and Control Bill (CLCB) that will be the subject of a referendum in September 2020. AIMS To assess the CLCB, drawing on emerging evidence from cannabis legalization overseas, public health research on alcohol and tobacco and the attempt to establish a regulated market for 'legal highs' in New Zealand. DISCUSSION The CLCB proposes a strictly regulated commercial cannabis market that resembles the Canadian approach, but notably without on-line sales or regional heterogeneity in retail distribution. The objective of the CLCB of lowering cannabis use over time appears at odds with the largely commercial cannabis sector that will focus on expanding sales. The CLCB includes provision for home cultivation and social benefit operators, but it is not clear what priority these operators will receive. A potency cap of 15% tetrahydrocannabinol (THC) for cannabis plants is included, and this is at the high end of black-market cannabis. The proposed progressive product tax based on THC will be challenging to implement. There is no formal minimum price, but rather discretionary powers to raise the excise if the price drops too much. The CLCB includes a comprehensive ban on advertising, but non-conventional on-line promotion will be difficult to suppress. The central government cannabis authority is tasked with developing local retail outlet policies. We caution against the temptation to employ an interim regulatory regime following a positive referendum result, because a partially regulated market will expose users to health risks and undermine public support. CONCLUSIONS New Zealand's Cannabis Legalization and Control Bill's objective of reducing cannabis use via a commercial market will be challenging to achieve. The bill could be strengthened with formal minimum pricing, lower potency cap and greater clarity concerning social benefit operators and the role of local government.
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Affiliation(s)
- Chris Wilkins
- SHORE & Whariki Research Centre, Massey University, P.O. Box 6137, Victoria Street West, Auckland, 1142, New Zealand
| | - Marta Rychert
- SHORE & Whariki Research Centre, Massey University, P.O. Box 6137, Victoria Street West, Auckland, 1142, New Zealand
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Robson H, Braund R, Glass M, Ashton J, Tatley M. Synthetic cannabis: adverse events reported to the New Zealand Pharmacovigilance Centre. Clin Toxicol (Phila) 2020; 59:472-479. [DOI: 10.1080/15563650.2020.1828592] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Hunter Robson
- Department of Pharmacology and Toxicology, University of Otago, Dunedin, New Zealand
| | - Rhiannon Braund
- New Zealand Pharmacovigilance Centre, University of Otago, Dunedin, New Zealand
| | - Michelle Glass
- Department of Pharmacology and Toxicology, University of Otago, Dunedin, New Zealand
| | - Janelle Ashton
- New Zealand Pharmacovigilance Centre, University of Otago, Dunedin, New Zealand
| | - Michael Tatley
- New Zealand Pharmacovigilance Centre, University of Otago, Dunedin, New Zealand
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Stansfield C, Somerville R, Hassan V, Kolbe E, Partington H, Walsh K, Johnson C. Effects of external influences on synthetic cannabinoid trends in New Zealand, 2014 to 2020. Forensic Sci Int 2020; 316:110485. [DOI: 10.1016/j.forsciint.2020.110485] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/30/2020] [Accepted: 08/31/2020] [Indexed: 10/23/2022]
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Abstract
PURPOSE OF REVIEW The aim of this review is to provide an update on recent trends of New Psychoactive Substances (NPS) and the current global strategies implemented to manage them. RECENT FINDINGS The number of NPS has increased from 166 in 2009 to 892 in 2018, with about 36% having stimulant effects. Such trend revels some unprecedented patterns. The decline in the emergence of new synthetic cannabinoids has coincided with rising deaths due to overdose of fentanyl and non-fentanyl compounds in North America and Europe. The detection of new stimulant NPS has stabilized since 2015. Although the level of seizures of mephedrone have risen since then, they are still below the levels reported before international control. The legal status of kratom still remains unclear, whereas calls for research on its benefits continue. The nonmedical use of tramadol in Africa and Middle East is a cause of growing concern. SUMMARY Although the rise of NPS is a cause for concern, evidence suggests that the strategy to face the challenge should include updating international data collection systems, integrating scientific-based interventions for drug use, strengthening national monitoring, and increasing collaborative research and forensic capabilities. The legal, regulatory framework and clinical guidelines should remain dynamic, whereas enforcement agencies should measure success by destroying drug networks as seizures rarely dismantle drug markets.
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Abstract
PURPOSE OF REVIEW We present information on cannabis policy, demand, and supply in the Asia-Pacific region. METHOD A systematic review of peer-reviewed articles using PubMed, MEDLINE, and reliable sources was conducted. We classified the policy implemented in each country into conducting research, legalization of medical and recreational use, decriminalization, cultivation, and others. RECENT FINDINGS In Australia, New Zealand, and Thailand, medical use has been approved, whereas it is limited in South Korea and Singapore and illegal in other countries. Except Australia, none of the Asia-Pacific region countries allows recreational use. China and Japan are expected to approve medical use, whereas Australia and New Zealand work on decriminalization. Most cultivation is allowed and regulated for medical use. Cannabis seizures have changed in accordance with these policies. Although the national surveys of four countries, that is, Australia, New Zealand, Japan, and Thailand were conducted in different years, the use of cannabis among the general population has increased. SUMMARY Any change in the legal status of cannabis must be undertaken with caution and fully evaluated at each stage to determine the extent to which these changes are leading to increased numbers of users, oversupply, and health risks including cannabis-related harm.
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Grigg J, Killian JJ, Matthews S, Scott D, Arunogiri S, Manning V, Taylor DA, Crossin R, Smith K, Lubman DI. The impact of legislation on acute synthetic cannabinoid harms resulting in ambulance attendance. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 79:102720. [PMID: 32279004 DOI: 10.1016/j.drugpo.2020.102720] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 02/28/2020] [Accepted: 03/04/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Synthetic cannabinoid receptor agonists (SCRAs) have been challenging current drug policy due to the rapid emergence of new variants, and their propensity for acute harm. In Australia, as in other parts of the world, multiple regulatory changes have occurred in response to these new psychoactive compounds, and population surveys indicate use is declining. This suggests that related harms would also be declining. We examined the impact of drug legislative changes on acute SCRA-related harms resulting in ambulance attendance. Secondary aims were to describe patient and attendance characteristics. METHODS A retrospective analysis of coded ambulance attendance data from Victoria, Australia (January 2014-December 2018). Interrupted time-series was used to analyse the trajectories of SCRA-related attendances relative to legislative changes. RESULTS During the study period, 3727 SCRA-related ambulance attendances were identified. There was an upward trend in attendances following legislation scheduling specific SCRAs in Victoria in October 2016 (slope = 1.31, 95% CI 1.17, 1.45). A downward trend in attendances followed 'blanket' legislation targeting all new psychoactive substances, implemented in Victoria in November 2017 (slope = -1.87, 95% CI -2.27, -1.46). Patient median age was 33 years, 80.5% were male, co-occurring substance use was identified in 30.4% cases, and 15.2% had >1 SCRA-related attendance. Overall, 69.4% cases were transported to hospital, with the odds of transport to hospital increasing each year from 2016. CONCLUSION This study represents a population-level examination of the impact of drug policy on acute SCRA-related harms resulting in ambulance attendance. Scheduling of specific SCRAs was associated with a spike in attendances, likely due to the introduction of more harmful variants in the drug market. Blanket legislation was associated with a reduction in SCRA-related attendances, however, a corresponding increase in cases transported to hospital indicates a greater severity of harm that may have been inadvertently promoted by this policy.
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Affiliation(s)
- Jasmin Grigg
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia.
| | - Jessica J Killian
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Sharon Matthews
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Debbie Scott
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Shalini Arunogiri
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Victoria Manning
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | | | - Rose Crossin
- Turning Point, Eastern Health, Melbourne, Australia
| | - Karen Smith
- Centre for Research and Evaluation, Ambulance Victoria, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia
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Halter S, Haschimi B, Mogler L, Auwärter V. Impact of legislation on NPS markets in Germany – The rise and fall of 5F‐ADB. Drug Test Anal 2020; 12:853-856. [DOI: 10.1002/dta.2786] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Sebastian Halter
- Institute of Forensic MedicineForensic Toxicology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany
- Hermann Staudinger Graduate SchoolUniversity of Freiburg Freiburg Germany
| | - Belal Haschimi
- Institute of Forensic MedicineForensic Toxicology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany
- Hermann Staudinger Graduate SchoolUniversity of Freiburg Freiburg Germany
| | - Lukas Mogler
- Institute of Forensic MedicineForensic Toxicology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany
| | - Volker Auwärter
- Institute of Forensic MedicineForensic Toxicology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany
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Smyth BP, Daly A, Elmusharaf K, McDonald C, Clarke M, Craig S, Cullen W. Legislation targeting head shops selling new psychoactive substances and changes in drug-related psychiatric admissions: A national database study. Early Interv Psychiatry 2020; 14:53-60. [PMID: 30945460 DOI: 10.1111/eip.12807] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/04/2019] [Accepted: 02/17/2019] [Indexed: 11/26/2022]
Abstract
AIM New psychoactive substance (NPS) use can negatively impact mental health and may result in drug-related psychiatric admissions (DRPA). Irish youth reported very high rates of NPS use by international standards, the most common being synthetic cannabinoids and cathinones. This occurred in the context of a rapid expansion in specialist high street shops, called head shops, selling NPS in 2010. Government responded to public protests about head shops by enacting legislation in May and August 2010 to end this trade. Many academics argued that such actions were futile. We sought to determine if changes in head shop activity coincided with changes in DRPA. METHOD The national database on psychiatric admissions was examined focusing on young adults admitted from 2008 to 2012. Joinpoint regression analysis was utilized to examine for the presence of trend changes in DRPA. RESULTS The monthly rate of DRPA was higher in 2010 than 2008, 2009 and 2012 (P < 0.01). Joinpoint regression analysis identified a significant downward trend change which occurred in July 2010 (95% CI Feb 2010 to April 2011). Young males aged 18 to 24 years showed evidence of greatest change, DRPA falling by 1.4% per month (95% CI 0.7 to 3.7% decline) from May 2010 to December 2012. CONCLUSIONS Cessation of NPS sale by head shops coincided with a reversal in the upward trend of DRPA, this change being most evident in young men. While correlation does not imply causation, legislation which successfully targets the sale of NPS may result in reduced drug-related mental disorders.
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Affiliation(s)
- Bobby P Smyth
- Department of Public Health & Primary Care, Trinity College Dublin, Ireland.,Graduate Entry Medical School, University of Limerick, Limerick, Ireland.,HSE Addiction Service, Bridge House, Cherry Orchard Hospital, Dublin, Ireland
| | - Antoinette Daly
- National Health Information Systems, Health Research Board, Dublin, Ireland
| | - Khalifa Elmusharaf
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | | | - Mary Clarke
- School of Medicine, University College Dublin, Ireland
| | - Sarah Craig
- National Health Information Systems, Health Research Board, Dublin, Ireland
| | - Walter Cullen
- School of Medicine, University College Dublin, Ireland
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13
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Themes of agency and communion and rehabilitation from substance misuse. Drug Alcohol Depend 2019; 205:107611. [PMID: 31648106 DOI: 10.1016/j.drugalcdep.2019.107611] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 07/12/2019] [Accepted: 08/27/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Current models of identity transformation in substance misuse recovery emphasise either communal or agentic growth processes. Building on life narrative studies of addicted males, the present study proposes that agency and communion themes distinguish the narrative identities of rehabilitated substance users from active users. METHOD The 'Life as a Film' (LAAF) task was used to record narratives in an opportunity sample of 32 participants (23 males, 9 females) with ongoing or substance misuse history. Transcripts were coded for agency and communion, and external measures of rehabilitation were assessed using a recovery inventory. RESULTS Four types of narrative were revealed, according to the presence or absence of agency and communion themes in LAAF accounts. Analysis determined a significant correlation between descriptions of agency and communion and rehabilitation outcomes (0.91 - p < 0.01), showing that both identity themes are important to recovery. Participants illustrating either theme showed moderate outcomes and those depicting neither theme showed poor outcomes. Case studies were used to illustrate the instrumentality of agentic and communal growth to behavioural change. CONCLUSIONS The LAAF method demonstrated value in a narrative approach for expanding current perspectives, indicating that both agency and communion shape identity transformation in recovery from substance misuse. These findings highlight unique intervention needs corresponding with presenting narrative identity.
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Ong RS, Kappatos DC, Russell SG, Poulsen HA, Banister SD, Gerona RR, Glass M, Johnson CS, McCarthy M. Simultaneous analysis of 29 synthetic cannabinoids and metabolites, amphetamines, and cannabinoids in human whole blood by liquid chromatography–tandem mass spectrometry – A New Zealand perspective of use in 2018. Drug Test Anal 2019; 12:195-214. [DOI: 10.1002/dta.2697] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 09/10/2019] [Accepted: 09/11/2019] [Indexed: 01/19/2023]
Affiliation(s)
- Rui Shen Ong
- Forensic Toxicology LaboratoryInstitute of Environmental Science and Research Limited (ESR) Porirua New Zealand
| | - Diana C. Kappatos
- Forensic Toxicology LaboratoryInstitute of Environmental Science and Research Limited (ESR) Porirua New Zealand
| | - Sarah G.G. Russell
- Forensic Toxicology LaboratoryInstitute of Environmental Science and Research Limited (ESR) Porirua New Zealand
| | - Helen A. Poulsen
- Forensic Toxicology LaboratoryInstitute of Environmental Science and Research Limited (ESR) Porirua New Zealand
| | - Samuel D. Banister
- Faculty of Science and School of ChemistryThe University of Sydney NSW Australia
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind CentreThe University of Sydney NSW Australia
| | - Roy R. Gerona
- Clinical Toxicology and Environmental Biomonitoring LaboratoryUniversity of California San Francisco CA USA
| | - Michelle Glass
- Department of Pharmacology and ToxicologyUniversity of Otago Dunedin New Zealand
| | - Cameron S. Johnson
- Drug Chemistry LaboratoryInstitute of Environmental Science and Research Limited (ESR) Auckland New Zealand
| | - Mary‐Jane McCarthy
- Forensic Toxicology LaboratoryInstitute of Environmental Science and Research Limited (ESR) Porirua New Zealand
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Peacock A, Bruno R, Gisev N, Degenhardt L, Hall W, Sedefov R, White J, Thomas KV, Farrell M, Griffiths P. New psychoactive substances: challenges for drug surveillance, control, and public health responses. Lancet 2019; 394:1668-1684. [PMID: 31668410 DOI: 10.1016/s0140-6736(19)32231-7] [Citation(s) in RCA: 137] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 06/05/2019] [Accepted: 08/08/2019] [Indexed: 12/30/2022]
Abstract
The rapid emergence since the mid-2000s of a large and diverse range of substances originally designed as legal alternatives to more established illicit drugs (pragmatically clustered and termed new psychoactive substances; [NPS]) has challenged traditional approaches to drug monitoring, surveillance, control, and public health responses. In this section of the Series, we describe the emergence of NPS and consider opportunities for strengthening the detection, identification, and responses to future substances of concern. First, we explore the definitional complexity of the term NPS. Second, we describe the origins and drivers surrounding NPS, including motivations for use. Third, we summarise evidence on NPS availability, use, and associated harms. Finally, we use NPS as a case example to explore challenges and opportunities for future drug monitoring, surveillance, control, and public health responses. We posit that the current means of responding to emerging substances might no longer be fit for purpose in a world in which different substances can be rapidly introduced, and where people who use drugs can change preferences on the basis of market availability.
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Affiliation(s)
- Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia; School of Psychology, University of Tasmania, Hobart, TAS, Australia.
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia; School of Psychology, University of Tasmania, Hobart, TAS, Australia
| | - Natasa Gisev
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Wayne Hall
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia; Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Roumen Sedefov
- European Monitoring Centre on Drugs and Drug Addiction, Lisbon, Portugal
| | - Jason White
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Paul Griffiths
- European Monitoring Centre on Drugs and Drug Addiction, Lisbon, Portugal
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16
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Rychert M, Wilkins C. New Zealand's review of the Psychoactive Substances Act 2013: a missed learning opportunity ahead of the national cannabis law reform referendum? Addiction 2019; 114:1129-1130. [PMID: 30801839 DOI: 10.1111/add.14589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 02/13/2019] [Accepted: 02/14/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Marta Rychert
- SHORE and Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Chris Wilkins
- SHORE and Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
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17
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Caulkins JP, Kilborn ML. Cannabis legalization, regulation, & control: a review of key challenges for local, state, and provincial officials. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:689-697. [DOI: 10.1080/00952990.2019.1611840] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
| | - Michelle L. Kilborn
- Alberta Health Services, Population, Public and Indigenous Health Unit, Edmonton, Canada
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18
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Johnson CS, Copp BR, Lewis A. New psychoactive substances detected at the New Zealand border, 2014-2018. Drug Test Anal 2018; 11:341-346. [PMID: 30346116 DOI: 10.1002/dta.2522] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/05/2018] [Accepted: 10/12/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Cameron S Johnson
- Institute of Environmental Science and Research Limited, Mt Albert Science Centre, Auckland, New Zealand
| | - Brent R Copp
- School of Chemical Sciences, University of Auckland, Auckland, New Zealand
| | - Aaron Lewis
- New Zealand Customs Service, Auckland, New Zealand
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