bluuebunny/crossref_metadata_2025 huggingface dataset:
From Salt Injection to Naloxone: Accuracy and Myths in Peer Resuscitation Methods for Opiate Overdose
Authors: Beswick Tracy , Best David , Bearn Jenny , Rees Sian , Gossop Michael , Coomber Ross , Strang John
Published: March 2012

One hundred and eight opiate addicts attending an in-patient opiate treatment unit were interviewed, using a mixed quantitative–qualitative approach, to investigate their experiences of witnessing overdoses, the associated interpretations and perceived cause of the overdose. Poly drug use and frequency of witnessed overdose was high among the sample. Use of 14 different combinations of drugs were reported, 8 of which involved the use of alcohol, and 7 benzodiazepines. Perceived cause of overdose involved attributions relating to the use of alcohol, in particular strong lager, small quantities of heroin and low levels of current opiate tolerance. Peer initiated resuscitation techniques revealed a range of responses from the probably valuable (recovery position, summon ambulance, administer naloxone) to the ineffective or frankly harmful (injecting with salt solution, immersing in a cold bath). The findings highlight the need for an overdose prevention program during in-patient detoxification and rehabilitation.
Evaluation of a Shared-Care Program for Methadone Treatment of Drug Abuse: An International Perspective
Authors: Cox W. Miles
Published: March 2012

The North Wales (United Kingdom) Shared-Care Program for methadone treatment of drug abuse was evaluated. The program involves shared care, inasmuch as general practitioners, pharmacists, and community drug workers are jointly involved in the methadone treatment of persons with drug abuse. Evaluation aimed to determine the program's (a) extent of use, (b) impact on patients, (c) positive and negative consequences for methadone reduction or discontinuation, and (d) advantages and disadvantages. Results suggested that the program is successful but identified targets for future improvement.
A Drug Court Outcome Evaluation Comparing Arrests in a Two Year Follow-Up Period
Authors: Wolfe Ellen , Guydish Joseph , Termondt Jenna
Published: March 2012

Since the first drug court in Miami in 1989, the drug court movement has spread throughout the United States, influencing how drug-involved offenders are treated in the criminal justice system. This paper reports on an outcome evaluation of a drug court in San Mateo County, California. Arrest rates were compared for drug court participants (N=618) and nonparticipants (N=75), and for graduates (N=257) and nongraduates (N=361). Factors associated with rearrest were assessed for participants in both groups. During a two-year follow-up period, there were no significant differences in rearrest rates between the participant and non-participant groups. Comparisons between graduates and nongraduates showed lower rearrest rates for graduates (19% vs. 53%, χ2(1)=73.5, p< 0.01). In a model including participants and nonparticipants, only a prior history of conviction predicted an increased likelihood of rearrest whereas being female and older decreased the likelihood of rearrest. In addition, among drug court participants only, graduating decreased the likelihood of rearrest.
UNCOPE: A Brief Substance Dependence Screen for Use with Arrestees
Authors: Hoffmann Norman G. , Hunt Dana E. , Rhodes William M. , Riley K. Jack
Published: March 2012

A national multi-site monitoring system for determining prevalence of alcohol and drug involvement in arrestees sought to refine the screening for substance dependence among persons arrested and incarcerated in local jails. Fifteen items were selected from the content of existing alcohol and drug abuse screens. These items were evaluated against a detailed diagnostic interview covering criteria of the DSM-IV. A total of 310 prisoners incarcerated within the previous 48 hours were recruited as subjects. Almost 65% of the subjects had a positive diagnosis of dependence for one or more substances. A six-item screen identified by the acronym UNCOPE emerged as the best set of screening items for identifying dependence on alcohol and/or drugs. The UNCOPE had sensitivity of 88% and specificity of 83% for the sample as a whole. It performed similarly irrespective of gender or ethnicity and appears to have potential utility in a wide range of populations.
Exploring Arrestee Drug Use in Rural Nebraska
Authors: Herz Denise C. , Murray Rebecca
Published: March 2012

Since 1987, the Arrestee Drug Abuse Monitoring Program (ADAM—formerly known as the Drug Use Forecasting Program) has documented the prevalence and type of arrestee drug use across the nation. Unfortunately, this research is limited to urban or metropolitan areas, possibly because of presumed low levels of both crime and drugs in rural areas. The purpose of this paper is to present the importance of researching arrestee drug use in rural areas using data collected from the Rural ADAM Pilot Program. Specifically, this study examines the prevalence and type of arrestee drug use in four rural Nebraska counties and compares these results to those found in Omaha, Nebraska, which is a current ADAM site. Results indicated that arrestee drug use is similar to that in urban areas and the type of arrestee drug use varies across rural counties as well as between rural and urban areas. Most importantly, rural arrestee methamphetamine use appeared to exceed Omaha arrestee use in one rural area. These findings have substantial implications for planning at the local, state, and federal levels.
The Utility of Debriefing Questions in a Household Survey on Drug Abuse
Authors: Fendrich Michael , Wislar Joseph S. , Johnson Timothy P.
Published: March 2012

Since subjects are often uncomfortable disclosing sensitive information, questions gauging respondent reaction to survey questions about drug abuse may aid in the interpretation of responses. Such debriefing questions can be worded subjectively, i.e., asking subjects about their own reactions to questions, or projectively, i.e., asking subjects about their perceptions of the reactions of others to questions. Using data from a study employing both types of debriefing questions, we examined whether question wording made any difference. We evaluated the extent to which drug reporting was associated with respondent reaction to the survey and whether reactions varied by type of debriefing question. A factor analysis of debriefing questions appended to an experimental household survey on drug abuse yielded factors reflecting distinct subjective and projective dimensions. Analyses suggested that debriefing question wording does make a difference with respect to respondent reaction. Contrary to expectations, analyses suggested that those reporting drug use expressed less comfort on subjectively worded items and more comfort on projectively worded items. Subjects who self-administered their survey also reported lower levels of subjective comfort. The projective measures derived from analyses were associated with three demographic variables: Younger subjects reported higher levels of projective ease than older subjects. Those with some college reported higher levels of projective ease than those with the least amount of formal education. African-Americans reported lower levels of projective ease than White/Other subjects. Implications for the design, interpretation, and analysis of drug use surveys are considered.
Extrinsic Barriers to Substance Abuse Treatment among Pregnant Drug Dependent Women
Authors: Jessup Martha A. , Humphreys Janice C. , Brindis Claire D. , Lee Kathryn A.
Published: March 2012

The objective of this qualitative study was to examine extrinsic barriers to substance abuse treatment among pregnant and parenting women enrolled in residential perinatal substance abuse treatment programs in Northern California. Life history interviews were conducted with 36 women to examine help-seeking behaviors before treatment enrollment. Data analysis used the analytic framework of Mandelbaum (1973) to describe dimensions, turnings, and adaptations of participants. Results indicated that the majority (n = 34) of participants sought prenatal care but identified fear of punitive actions from helping institutions and individuals as a major barrier. Other extrinsic barriers included substance abuse treatment program barriers, partners, the status of opiate dependency, and the status of pregnancy. Biological, socio-cultural, and psychosocial dimensions of participants' care-seeking experiences were identified. The turning was pregnancy and adaptations included preserving the family, managing fear and manifesting faith. Findings describe the transformation of the therapeutic alliance and the gendered impact of two decades of the War on Drugs in the United States. Participants' coping strategies suggest that the desire for child custody and concern for fetal and child well-being was a priority and motivated care seeking despite extrinsic barriers perceived to be threatening to the woman's safety and autonomy.
Using Cannabis Therapeutically in the UK: A Qualitative Analysis
Authors: Coomber Ross , Oliver Michael , Morris Craig
Published: March 2012

Thirty-three therapeutic cannabis users in England were interviewed about their experiences using an illegal drug for therapeutic purposes. Interviews were semi-structured, and responses highly qualitative. Particular issues included how and why cannabis was used therapeutically; what problems its illegality posed in terms of access, cost, reliability of supply, and quality of the product; the perceived beneficial effects of its use; and unwanted effects (problems in relation to family, friends, partners, the criminal justice system, and the health care system). The study did not seek to prove or disprove the efficacy of cannabis used as a therapeutic agent merely to report the experiences of those who use it in that way. It was found that users perceived cannabis to be highly effective in treating their symptoms, to complement existing medication, and to produce fewer unwanted effects. Smoking was the preferred method of administration, permitting greater control over dose and administration. Problems related to prescribed medication motivated many to use cannabis therapeutically. Few problems were experienced with friends, family, partners, and the criminal justice or health care systems, although other concerns about cannabis's illegality were reported. Although most were relatively unconcerned about the risk involved and were determined to continue use, many resented that they felt they were being forced to break the law. Problems relating to access to the drug (in an illegal context) and managing its administration were reported. A brief discussion of the continued prohibition of cannabis for this group is undertaken, and a harm reduction approach is suggested.
Drug Reform Principles and Policy Debates: Harm Reduction Prospects for Cannabis in Canada
Authors: Hathaway Andrew D. , Erickson Patricia G.
Published: March 2012

Contrasting the official harm reduction aims of Canada's 10-year national drug strategy with the actual evolution of the Controlled Drugs and Substances Act, the authors find little evidence of harm reduction, and much of sustained and punitive prohibition. The example of the criminal sanctions currently being applied to cannabis possession offences serves to illustrate the limits of what can be achieved in reducing the impact of criminalization when the fundamental ban on personal use and access is retained. Theoretically informed by constructionist analyses of the styles and strategies of social problems discourse, a moral basis of drug use entitlement is expounded from which rational reform might be more fruitfully argued. Despite its official mandate in Canada to develop more pragmatic drug policy alternatives, the harm reduction movement, posing public health solutions based on empirical analysis, is nonetheless needful of a rhetorical foundation by which to denounce prohibition as a morally objectionable intervention in the private lives of individuals.
The Sydney Medically Supervised Injecting Centre: A Clinical Model
Authors: van Beek Ingrid
Published: March 2012

The Sydney Medically Supervised Injecting Centre (MSIC) is the first supervised injecting facility (SIF) in Australia and the English-speaking world. It commenced operations in May 2001 as a trial to be independently evaluated. The MSIC was to be the only SIF in Sydney's Kings Cross, a “red-light” area where the drug-using population had previously injected in public or in illegal “shooting galleries” that had proliferated in nearby commercial sex premises since 1990. The aim of the MSIC is to reduce the public health and public order issues arising from unsupervised and public injecting at a local community level. A clinical service model was developed, which would maximize the number of injecting episodes accommodated in a professionally supervised setting and integrate with the other harm reduction services nearby. In its first two years of operation 4,719 registered IDUs made 88,324 visits to inject at the MSIC. There were 553 drug overdoses (81% heroin) managed on site, with no fatalities. Among 1,852 client referrals made for further assistance, 44% were for the treatment of drug dependence. This early experience suggests that the MSIC's clinical model has been acceptable to a significant number of the street-based drug injecting population in this setting.
The Sydney Medically Supervised Injecting Centre: Client Characteristics and Predictors of Frequent Attendance during the First 12 Months of Operation
Authors: Kimber Jo , MacDonald Margaret , van Beek Ingrid , Kaldor John , Weatherburn Don , Lapsley Helen , Mattick Richard P.
Published: March 2012

This paper describes characteristics of clients registered in the first 12 months of the Sydney Medically Supervised Injecting Centre's (MSIC) operation, as well as predictors of frequent attendance. The study is based on information collected from clients at their initial registration and subsequent service utilization. Most of the 2,719 clients were male (71%), almost half had previously experienced at least one nonfatal heroin overdose, and one quarter had accessed formal drug treatment in the previous 12 months. Characteristics associated with frequent attendance at the MSIC were reporting previous attendance at the local primary health service for injection drug users (IDU), injecting drugs other than amphetamine, reporting sex work, injecting at least daily, and injecting in a public place in the month before registration.
Drug Consumption Rooms in Hamburg, Germany: Evaluation of the Effects on Harm Reduction and the Reduction of Public Nuisance
Authors: Zurhold Heike , Degkwitz Peter , Verthein Uwe , Haasen Christian
Published: March 2012

In order to evaluate the impact of consumption rooms (CRs) on the promotion of health among drug users and the reduction of the public nuisance of drug use, a study examining CRs in three countries was carried out in 2000. The study, supported by the European Commission, examined CRs in Rotterdam (The Netherlands), Innsbruck (Austria), and Hamburg (Germany). This paper evaluates the findings from the study of Hamburg CRs. In order to get evidence-based information on the effects of CRs, 616 drug users in the Hamburg drug scene or in the vicinity of low-threshold institutions were investigated with a standardized questionnaire. Qualitative problem-centered interviews were also carried out with staff members of the CRs, and representatives from the community, including neighborhood residents, business people, police, and politicians. Research findings show that the Hamburg CRs reached the target group of drug users who practice risky behaviors and engage in public drug use. Findings also show that the Hamburg CRs lead to positive changes in health-related behavior for drug users. In addition, the findings indicate that the Hamburg CRs played an important role in the reduction of public disturbances in the vicinity of open drug scenes.
Navigation and Engagement: How Does One Measure Success?
Authors: Reisinger Heather Schacht , Bush Trevor , Colom M. Alejandra , Agar Michael , Battjes Robert
Published: March 2012

At first glance, substance abuse treatment outcomes appear fairly easy to measure. Typical outcome measures include successful program completion, reduced drug use and illegal activity, and improved employment or school status. However, ethnographic examination of an adolescent treatment program shows that traditional outcome measures may differ from clients' experiences in treatment. While observing an outpatient adolescent treatment program and interviewing the clients, the authors documented the lived experiences of the youth and analyzed the cases comparatively. In this paper, two contrasting cases are presented to illustrate the complexity and contradictions between traditional outcome measures and perspectives on success held by clients and counselors. The concepts of navigation and engagement are applied to explore these perspectives of success. At the end of the article, some implications of these experience-based concepts for programs are considered, based not only on youth interviews, but also on our interviews with counselors. Finally, a general model that ties outcome evaluations more directly to the details of program experience is developed.
Adolescent Social Relationships and the Treatment Process: Findings from Quantitative and Qualitative Analyses
Authors: Riehman Kara S. , Bluthenthal Ricky , Juvonen Jaana , Morral Andrew
Published: March 2012

Juvenile justice systems increasingly rely on placement of substance-involved adolescents in residential group homes. Research finds differences in pathways to drug abuse, but few studies explore whether gender differences affect treatment response. We describe the association between girls' and boys' relationship patterns and their experiences in treatment. Data come from a quantitative study of 449 criminally involved adolescents mandated to residential treatment programs throughout Los Angeles, and 30 semi-structured interviews with a similar group of seven boys and three girls attending a residential treatment program. Quantitative data show that girls had more problematic families and peers and reported more depressive symptoms than boys. Qualitative data indicate that girls' pretreatment networks were almost exclusively comprised of older males acting as “protectors” and sexual partners, while boys' included same-sex, same-aged peers. Girls emphasized sexuality in their discussions of in-treatment relationships and had difficulty developing friendships with other girls in the program. Our findings highlight gender differences in relationship patterns that merit further study as potentially important influences on adolescents' treatment responses.
There's No Such Thing as a Free Lunch: How “Freebies” and “Credit” Operate as Part of Rational Drug Market Activity
Authors: Coomber Ross
Published: March 2012

Twenty-one incarcerated drug dealers and 60 opiate users were questioned about the provision of “freebies” (free drugs) and credit in drug market transactions in London and the UK. In particular, each group was asked about the context within which either of these activities might occur and the underlying rationales for them. In contradiction to the common image of drug dealers providing “freebies” as an attempt to secure the custom of nonaddicted individuals (often portrayed as children), it emerged that the provision of free drugs and credit took place within tightly circumscribed conditions. Primarily, the provision of free drugs and credit (two distinct modes of operation with differing outcomes) were available to those known and “trusted” by the dealer and used to cultivate and bond customer relations (freebies) as well as facilitate continued business with the reliable (credit). Credit was not used to “trap” individuals into a dealing relationship. Rather, both parties approach it cautiously. How the provision of free drugs and credit are representative of broader aspects of dealer/user seller/buyer relationships, with particular emphasis on the management of that relationship, is discussed. Brief consideration is also given to the context of drug sales at raves and other dance events, as it is often the case that “the offer” in this context may be made to users unknown to the dealer.
Unobtrusive Observations of Smoking in Urban California Bars
Authors: Lee Juliet P. , Moore Roland S. , Martin Scott E.
Published: March 2012

This paper describes initial findings from a project utilizing unobtrusive participant observation to investigate noncompliance with workplace tobacco control regulations within stand-alone bars in one California city. Early findings indicate that half of the bars in the sample fully complied with the law, while other bars could be described as in transition from smoking to nonsmoking, and a minority of bars remained consistently noncompliant. No smoking at all was observed in 50.4% of bars. Of the 49.6% of bars in which smoking was observed at least once, 14.9% were characterized by endemic smoking. Nine percent of smoking bars may have converted from smoking to nonsmoking over the course of the study, and the remaining bars were characterized by incidental smoking (including doorway smoking, lone smokers, and closing time smoking). Implications for enhancing compliance with tobacco control policies are discussed.
Early Sexual Abuse, Street Adversity, and Drug Use among Female Homeless and Runaway Adolescents in the Midwest
Authors: Chen Xiaojin , Tyler Kimberly A. , Whitbeck Les B. , Hoyt Dan R.
Published: March 2012

Research on homeless and runaway adolescents has shown that this population is at high risk for illicit drug use. Though sexual abuse has been widely considered in the etiology of illicit drug use, we know less about how early sexual abuse affects young people's decisions to run away, to use drugs, and to engage in other deviant behavior on the streets. Based on interviews with 361 female homeless and runaway adolescents in four midwestern states, the current study revealed a high prevalence of drug use, especially use of cocaine among youths with sexual abuse histories. Path analyses showed that early sexual abuse indirectly affected drug use on the streets via running away at an earlier age, spending more time on the street, and use of deviant strategies to survive (e.g., affiliation with deviant peers, trading sex, and use of nonsexual deviant subsistence strategies).
Place and Attrition from Substance Abuse Treatment
Authors: Jacobson Jerry O.
Published: March 2012

High rates of attrition are one of the greatest problems interfering with the effectiveness of substance abuse treatment programs. Though unexamined to date, this paper argues that where a client lives, where treatment is delivered, and the relationship between these locations may influence both voluntary and involuntary dropout. The notion of a “treatment ecology” is presented, and theories of mechanisms by which location may impact attrition are developed through a review of related literature. In other fields, lack of attention to theory prior to empirical investigations of contextual effects has prompted criticism and made interpretation of empirical results difficult. Neighborhood disadvantage, drug availability, community resources, restorative qualities of the neighborhood, and travel burden are identified as promising areas for study. Current conceptual models of treatment outcomes are first reviewed to identify how they might accommodate attention to place. Policy implications and special considerations for future empirical work on this topic are discussed briefly.
Looking inside the “Black Box” of Drug Court Treatment Services Using Direct Observations
Authors: Bouffard Jeff , Taxman Faye
Published: March 2012

Drug courts have received a great deal of attention from both researchers and practitioners nationwide over the last decade. In fact, a number of recent evaluations have demonstrated the effectiveness of the approach for reducing both substance abuse and criminal involvement among participants. Recently, however, calls for thorough process evaluations (inside the black box of treatment) of these courts have often not been met or have not been adequately conducted. The current study examined the delivery of substance abuse and allied social services in a sample of four adult drug courts, using a combined qualitative/quantitative methodology (direct observation as well as traditional surveys and interviews of treatment staff) to explore the type and amount of treatment services offered within these courts. Results suggest that improvements in several areas could be made that would likely enhance the overall effectiveness of these courts, especially in terms of the delivery of scientifically-established (i.e., cognitive-behavioral) treatment approaches.
Respondent Misreporting of Drug use in Self-Reports: Social Desirability and other Correlates
Authors: Sloan John J. , Bodapati Madhava R. , Tucker Tanya A.
Published: March 2012

When it comes to measuring and analyzing the extent of drug problems … there is an abundance of numbers, but the glass of insight is, at best, half full. (Caulkins, 2000, p. 433)

To assess possible validity problems associated with self-reported drug use, drug use forecasting (DUF) data collected in 1995 from the Birmingham (AL) catchment area were used to examine the statistical correlates of arrestees misreporting their drug use by comparing self-reported drug use involving (1) marijuana, (2) cocaine, and (3) both cocaine and marijuana with results of urinalysis tests performed on the arrestees. We used the social desirability theory to explain why some arrestees misreported using drugs while others did not. Multivariate analyses revealed, as predicted by the theory, differences between the two groups based on drugs consumed and personal, legal, and other factors. Our results have implications for the validity of larger-scale self-reported estimates of the extent and nature of drug use in the U.S. that must be addressed before realistic policy choices can occur.
Projecting and Monitoring the Life Course of the Marijuana/Blunts Generation
Authors: Golub Andrew , Johnson Bruce D. , Dunlap Eloise , Sifaneck Stephen
Published: March 2012

Since the 1990s, marijuana has been the drug of choice among American youths, especially those that tend to sustain arrests. Previous birth cohorts had greater use of crack, powder cocaine, or heroin. This paper summarizes prior research that strongly suggests drug eras tend to follow a regular course. These insights then serve as the basis for projecting trends in marijuana use both for the general population nationwide and for Manhattan arrestees. To the extent that current trends persist, the prospects for the “Marijuana/Blunts Generation” (born 1970 and later) may be relatively good. These young persons may successfully avoid “hard drugs” as well as the attendant health, social, and legal problems for their entire life, but they may experience higher levels of smoking-related ailments. The conclusion presents issues for continued drug surveillance and ethnographic research to more accurately understand the Marijuana/Blunts Era and to provide an indicator of future changes as they occur.
“Ordinary” People with “Normal” Lives? a Longitudinal Study of Ecstasy and other Drug use among Norwegian Youth
Authors: Pape Hilde , Rossow Ingeborg
Published: March 2012

Ecstasy users have been described as “ordinary people” with “normal lives” in recent literature, but little empirical evidence exists to support this portrayal. One may assume, however, that such a rosy portrayal is more likely to fit individuals who consume drugs that are more commonly used (e.g., cannabis). With this in mind, we have explored characteristics of different categories of drug users by analyzing data from a general population study of young people in Norway (n = 2,761). Respondents were assessed three times over a period of seven years (mean age at time 3 = 21.6 years). Results showed that ecstasy users, cannabis users, and users of “traditional” hard drugs were all relatively unremarkable with respect to socio-economic characteristics. On the other hand, they all tended to have a less favorable family background than nonusers of drugs, and their rates of past and present legal substance use, mental health problems, and antisocial behavior were also much higher. Individuals who included ecstasy in their drug-taking repertoire had a somewhat more deviant profile than other drug users, indicating that their public image of being ordinary and well adjusted is highly overstated. This image did not fit “pure” cannabis users very well either.
Gender Differences in Treatment Outcomes over a Three-Year Period: A Path Model Analysis
Authors: Hser Yih-Ing , Huang Yu-Chuang , Teruya Cheryl , Anglin M. Douglas
Published: March 2012

Gender differences in longitudinal patterns of treatment utilization and outcomes over three yearly time points were examined among a sample of 511 patients recruited from drug treatment programs across Los Angeles County. Face-to-face interviews were conducted at baseline and one-year follow-up. Retrospectively recalled natural history data were collected at the follow-up interview. Over the three observational years, compared to men, women generally reported greater involvement in drug abuse treatment, lower levels of drug use and employment, and higher levels of drug use by their spouses. The path model showed that women's drug use and criminality were negatively related to formal treatment and self-help group participation, but positively related to their spouse's drug use. Fewer factors significantly impacted men's drug use and crime over time. Implications of these gender differences are discussed.
Research Note — Review of Corrections-Based Therapy for Opiate-Dependent Patients: Implications for Buprenorphine Treatment among Correctional Populations
Authors: Smith-Rohrberg Duncan , Bruce R. Douglas , Altice Frederick L.
Published: March 2012

Inmates with a history of opiate dependence represent a substantial proportion of the correctional population in the United States. Opiate use has negative consequences for both the inmate and society, including increased recidivism rates, increased infectious disease prevalence, avoidable emergency room use, decreased access to primary care services, and overdose. While there have been great successes in community-based treatment of opiate dependence, these successes have not yet been achieved in correctional settings. This paper reviews the pharmacological treatment options for opiate-dependent inmates, along with potential application for community-to-correctional approaches. The recent approval by the Food and Drug Administration (FDA) of physician-prescribed buprenorphine and the new opportunities it presents to corrections-based treatment are also explored in depth. Successful implementation of such strategies is likely to result in desirable health and social outcomes for both the inmate and the community at large.
Drug Law and Policy in Germany and the European Community: Recent Developments
Authors: Böllinger Lorenz
Published: March 2012

This paper begins with an outline of the current German drug control system. Drug use and drug control are viewed theoretically as complementary components of a complex social and historical process that integrates sociology, the sociology of law, political science, and social psychology. The German drug control system is viewed as a byproduct of these different disciplines. Within this context, the evolution of pertinent drug laws and their implementation are discussed. Recent developments are viewed as taking place in a series of stages based on three paradigms: (1) criminalization, (2) medicalization, and (3) acceptance. Over time there seems to have been a slow transition from the first to the last of these paradigms, implying that elements of all three approaches have been integrated into various policies and strategies that differ between states and regions of Germany, as well as between different levels of drug policy and drug care.
A Brief History of Cannabis Policies in Spain (1968–2003)
Authors: Gamella Juan F. , Rodrigo Maria Luisa Jiménez
Published: March 2012

Spain was one of the first countries in Europe to decriminalize drug use and one of the last to embrace harm reduction. As such, Spain's drug policies often appear to be rather contradictory. In this paper we will review the current status of drug laws and the major drug policies that have been implemented in Spain over the last 25 years concerning cannabis; their demographic, political, and economic contexts; and their apparent consequences. We will follow a chronological approach that outlines every major change that occurred during that period while trying to provide some sociopolitical background. We have divided the period under study into four major phases. Each phase addresses a major political change or shift in the social response to drug-related problems. In this account, we will apply to cannabis policies the conceptual distinctions introduced by MacCoun and Reuter in their recent revision of alternative drug policies (2001), especially their tripartite division between punitive, depenalizing, and legalizing regimes and the associated processes of promotion and commercialization. One essential question that concerns the Spanish case is the relationship between legal changes, their implementation, and long-term oscillations in consumption rates.
“Sending the Wrong Message”: Did Medical Marijuana Legalization in California Change Attitudes about and use of Marijuana?
Authors: Khatapoush Shereen , Hallfors Denise
Published: March 2012

This study was designed to assess the affect of legalization of medical marijuana on drug-related attitudes and use among youths and young adults in selected communities in California and other states. Telephone survey data, collected as part of a study of the Robert Wood Johnson Foundation's Fighting Back initiative, was utilized to examine reported attitudes about and use of drugs in California and other states before and after Californians passed Proposition 215 in 1996. Descriptive, bivariate, and logistic regression analyses were used to examine attitudes and use among 16 to 25 year olds in California and 10 other states. This study found that although some marijuana-related attitudes changed between 1995 and 1999, use did not increase. These findings suggest that recent policy changes have had little impact on marijuana-related behavior.
U.S. Drug Control Policies: Federal Spending on Law Enforcement versus Treatment in Public Health Outcomes
Authors: Shepard Edward , Blackley Paul R.
Published: March 2012

This paper evaluates the relationships among federal anti-drug law enforcement expenditures, education and treatment expenditures, and public health outcomes. The data include four types of spending: criminal justice system, interdiction and international intelligence, education in the community and workplace, and drug treatment. These data were combined with mortality rates for drug abuse, a public health outcome. The empirical findings support the hypothesis that resources allocated to drug prevention and treatment have benefited the public health. Conversely, a 10% reduction in enforcement expenditures is associated with a long-run reduction of approximately 3,000 deaths per year.
Characteristics and HIV Risk Behaviors among Injection Drug Users in St. Petersburg, Russia: A Comparison of Needle Exchange Program Attenders and Nonattenders
Authors: Ksobiech Kate , Somlai Anton M. , Kelly Jeffrey A. , Benotsch Eric , Gore-Felton Cheryl , McAuliffe Timothy , Ostrovski Dmitri , Kozlov Andrei P.
Published: March 2012

The purpose of this descriptive study was to compare young Russian NEP attenders (N = 209) and nonattenders (N = 207) on a multitude of dependent variables related to drug and sexual knowledge, attitudes, and behaviors. Questionnaire data found NEP attenders were more likely to be female, inject more frequently, use heroin heavily, be in long-term relationships, use clean needles, have more unprotected vaginal sex acts, and have drug-using friends with positive safer sex attitudes. Comparisons were also made between male and female NEP attenders, male NEP attenders and nonattenders, female NEP attenders and nonattenders, and male and female NEP nonattenders. Significant differences between those subgroups were found. A logistic regression was run to determine which variables served to predict NEP attendance. Four variables accounted for 17% of the variance and predicted NEP attendance in two thirds of the cases: safer sex attitudes of drug-using friends, heroin use, using new needles to inject, and relationship status.
Characteristics and Patterns of use among Regular Heroin Sniffers
Authors: Kaufman Joanne M. , Chitwood Dale D. , Comerford Mary , Koo Dixie
Published: March 2012

The purpose of this paper is to characterize persons who sniff heroin by examining their experiences prior to first heroin use, experiences at first use, current drug use patterns, and factors associated with progression to the daily use of heroin. Relatively little has been published about the lives and career trajectories of heroin sniffers who have little or no history of drug injection. A sample of 250 African-American, Hispanic/Latino, and non-Hispanic White men and women who sniffed heroin were interviewed for this study. Most people first sniffed heroin in a social setting where heroin use was not preplanned. Heroin sniffing has become a sustained pattern of use for many of these users; the majority have progressed to daily sniffing of heroin and are polydrug users for whom crack is an important substance; and heroin sniffers have experienced a range of life and health problems including a high prevalence of HIV.
Correlates of Safe Syringe Acquisition and Disposal Practices among Young IDUs: Broadening our Notion of Risk
Authors: Sherman Susan G. , Rusch Melanie , Golub Elizabeth T.
Published: March 2012

The current study examines the relationship of syringe use patterns with acquisition and disposal practices among injection drug users (IDUs). Study participants (N = 294) were IDUs between 15 and 30 years old in Baltimore, Maryland, who had initiated drug injection within the past five years. Safe acquisition was defined as obtaining syringes from the Baltimore syringe exchange program and pharmacies. Safe disposal was defined as depositing syringes at the syringe exchange program or in a closed container. Participants were primarily male, White, and had low levels of education. In the six months prior to being interviewed, 25% reported safe syringe acquisition and 47% reported safe disposal. In a multivariate model controlling for demographic variables, factors that were significantly associated with safe acquisition were injecting for more than two years, obtaining two or more syringes per pickup, using a syringe for five or more injections, and safe disposal of syringes. In a multivariate model controlling for demographic variables, factors that were that were significantly associated with safe disposal were injecting daily and safe syringe acquisition. Infectious disease prevention efforts need to specifically target young and newly initiated IDUs in promoting safe syringe acquisition and disposal practices.
An Empirical Study of the School Zone Anti-Drug Law in Three Cities in Massachusetts
Authors: Brownsberger William N. , Aromaa Susan E. , Brownsberger Carl N. , Brownsberger Susan C.
Published: March 2012

This study reviewed the role of a law providing enhanced penalties for drug dealing within 1,000 feet of a school in 443 drug-dealing cases in three cities in Massachusetts: Fall River, New Bedford, and Springfield. We reviewed district attorneys' case files and mapped drug-dealing incidents using a combination of geographic information systems and location visits with a hand-held geographic positioning system. School zones – the areas within 1,000 feet of schools – cover 29% of the areas of the study cities and 56% of the high-poverty areas within the cities. Although less than 1% of the drug-dealing cases involved sales to minors, approximately 80% of the cases occurred within school zones, apparently because of the density of schools in high-poverty/high-drug-dealing areas. Most school zone cases are “broken down” – defendants plead to lesser charges and receive less than the two-year mandatory minimum sentence for dealing in a school zone. Decisions to “break down” charges are not influenced by proximity to schools or time of day. Most drug dealers commit their offenses close to home, and most dealers charged with dealing in school zones reside in school zones. Overlapping school zone boundaries are chaotic and confusing in the inner city areas studied. The school zone statute fails to push drug dealing away from schools: the density of dealing within 250 feet of schools is similar to the density of dealing at greater distances.
Research Note: What If We're Wrong? Some Possible Implications of Systematic Distortions in Adolescents' Self-Reports of Sensitive Behaviors
Authors: Johnson Patrick B. , Richter Linda
Published: March 2012

Research in the social sciences is inherently plagued by the problem of biased or distorted self-reports of sensitive information. Participants in studies, when asked to provide truthful information about their own sensitive behaviors, might distort their responses because of self-presentation concerns or fear that their responses may not actually be completely anonymous or confidential. Researchers who study substance use and other problem behaviors must recognize the possibility that their findings may contain systematic distortions, must try to reduce such biases whenever possible, and must acknowledge them as limitations when little else can be done. This paper was written from the premise that systematic distortion is present in self-reports of substance use and other sensitive behaviors. We consider some of the most widely accepted theories and models from the fields of substance use and problem behavior from the perspective of this premise. Our purpose is not to suggest that these theories or findings are unfounded, but rather that the implications of systematic distortion for this field should be seriously considered when evaluating the validity of research findings and theory.
Research Note: Cannabis and Driving — Research Needs and Issues for Transportation Policy
Authors: Laberge Jason C. , Ward Nicholas J.
Published: March 2012

This paper summarizes current knowledge regarding the effects of cannabis use on driving. Psychopharmacological evidence has shown that cannabis, unlike alcohol, can be detected several days after consumption. Prevalence data has revealed that cannabis use is increasing, and that as many as 90% of study participants were willing to drive after consuming a typical dose. A review of laboratory studies found that cannabis and alcohol affect different driving tasks. When cannabis and alcohol use were evaluated in simulated and on-road driving situations, drivers were more aware of being intoxicated after using cannabis and thus invoked greater compensatory effort to offset impairment in the driving task. The effect of cannabis use on crash risk has shown that recent use increases crash risk, but not as much as alcohol consumption. This paper concludes that further research is needed before specific transportation policy can be developed for cannabis.
Construction and Contestation of Criminal Identities: The Case of the “Cocaleros” in the Colombian Western Amazon
Authors: Ramírez María Clemencia
Published: March 2012

Peasants who settled in the Colombian Amazon region as a result of different waves of migration, and who today grow coca, have been stigmatized as criminals with no regional identity. The central state does not accord them a place within national society except as guerrilla auxiliaries or drug traffickers. As such, they can be the object of state violence. The collective identities in the Amazon region are shaped by the sense of exclusion from and abandonment by the central state, and politicized identities emerge as a protest against exclusion and misrecognition.
Illegal Armed Groups and Local Politics in Colombia
Authors: Rubio Mauricio
Published: March 2012

This paper studies the factors associated with the presence of guerrilla, paramilitary, and drug trafficking groups in the municipalities of Colombia. Statistical analysis shows three kinds of results. Some of these tend to corroborate explanations that are commonly accepted in Colombia, while others defy deeply rooted beliefs. As a result, some rather curious associations emerge. The availability of energy resources appears to be a crucial factor of attraction for guerrilla and paramilitary groups, but not for drug traffickers. The conflict also seems to affect both the municipalities' ability to impose taxes, as well as the latter's composition. Against conventional wisdom, drug traffickers appear to have the closest ties to the political sphere. This group shows the greatest capacity to influence civil society, has the most corrosive effect on elections, and exerts the greatest influence on the composition of municipal expenditures. A very popular explanation of violence in Colombia posits a strong and positive association between economic conditions, the so-called objective causes, and the armed conflict. The data does not support the arguments that poverty is responsible for it. In contrast, the data suggest that the age of the population, a purely demographic factor, is determinant. The effect of other social variables is more ambiguous. Curiously, the existence of communications infrastructure is the best indicator of the conflict's geography. The administrative disorganization in public expenditures also appears to be related to the influence of armed groups. However, on an almost anecdotal level, an office for municipal planning is positively associated with the influence of drug trafficking.
The Numbers Game: Let's All Guess the Size of the Illegal Drug Industry!
Authors: Thoumi Francisco E.
Published: March 2012

Narco-trafficking moves between 20 and 30 percent of the world economy. (Ríos, FARC-EP, 2000, p. 154)

Drugs provide Colombia's biggest source of foreign income, nearly 36 percent of its total gross national product. (Freemantle, 1986, p. 211)
Trajectories of Marijuana use during the Transition to Adulthood: The Big Picture Based on National Panel Data
Authors: Schulenberg John E. , Merline Alicia C. , Johnston Lloyd D. , O'Malley Patrick M. , Bachman Jerald G. , Laetz Virginia B.
Published: March 2012

The purposes of this study were to identify trajectory groups of frequent marijuana use during emerging adulthood; distinguish among trajectory groups according to demographic and lifestyle characteristics; and examine how the trajectory groups relate to behavioral, attitudinal, and social-emotional correlates over time. National panel data from the Monitoring the Future study were used: 18 cohorts of high school seniors (classes of 1977–1994) were followed biennially through age 24. Frequent marijuana use was defined as 3+ occasions of use in past month and/or 20 to 40+ occasions in past year. Based on four waves of complete longitudinal data (N=19,952), six frequent marijuana use trajectory groups were identified: chronic, decreased, increased, fling, rare, and abstain. Categorical analyses revealed trajectory group differences in demographic and lifestyle characteristics at senior year and age 24. The trajectory groups varied significantly in longitudinal patterns of other substance use, problem behaviors, and well-being.