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International Journal of Drug Policy
Journal Prestige (SJR): 1.441
Citation Impact (citeScore): 3
Number of Followers: 455  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0955-3959
Published by Elsevier Homepage  [3162 journals]
  • Peer-to-peer injection: Demographic, drug use, and injection-related risk
           factors
    • Abstract: Publication date: November 2018Source: International Journal of Drug Policy, Volume 61Author(s): Shona Lamb, Alex H. Kral, Karina Dominguez-Gonzalez, Lynn D. Wenger, Ricky N. Bluthenthal BackgroundPeer-to-peer injection (either providing or receiving an injection to/from a person who injects drugs [PWID]) is common (19%–50%) among PWID. Most studies of peer-to-peer injection have focused on receiving injection assistance, with fewer examining providing injection assistance and none considering characteristics of PWID who do both. We examined characteristics of PWID by peer-to-peer injection categories (receiving, providing, both, and neither) and determined if these behaviors were associated with receptive and distributive syringe sharing.MethodsLos Angeles and San Francisco PWID (N = 777) were recruited using targeted sampling methods and interviewed during 2011–2013. Multinomial logistic regression was used to determine characteristics associated with peer-to-peer injection categories and logistic regression was used to examine if peer-to-peer categories were independently associated with distributive and receptive syringe sharing.ResultsRecent peer-to-peer injection was reported by 42% of PWID (18% provider; 14% recipient; 10% both). In multinomial regression analysis, PWID reporting any peer-to-peer injection were more likely to inject with others than those who did neither. Injection providers and those who did both were associated with more frequent injection, illegal income source, and methamphetamine injection while injection recipients were associated with fewer years of injection. Injection providers were younger, had more years of injecting, and were more likely to inject heroin than PWID who did neither. In multivariate analyses, we found that providers and PWID who did both were significantly more likely to report receptive and distributive syringe sharing than PWID who did neither.ConclusionPeer-to-peer injection is associated with HIV/HCV risk. Current prevention strategies may not sufficiently address these behaviors. Modification of existing interventions and development of new interventions to better respond to peer-to-peer injection is urgently needed.
       
  • Direct acting antiviral-based treatment of hepatitis C virus infection
           among people who inject drugs in Georgia: A prospective cohort study
    • Abstract: Publication date: December 2018Source: International Journal of Drug Policy, Volume 62Author(s): Julie Bouscaillou, Tamar Kikvidze, Maia Butsashvili, Konstantine Labartkava, Ina Inaridze, Aurélie Etienne, Diane Le Pluart, George Kamkamidze, Ana Gamezardashvili, David Kharshiladze, Elisabeth Avril, Niklas Luhmann BackgroundPeople who inject drugs (PWID) are often excluded from HCV treatment programs due to concerns about their ability to adhere to care. Georgia has a high prevalence of HCV infection (5.4% of chronic cases in general population) with an epidemic concentrated among PWID. We evaluated adherence to care and sustained virologic response (SVR) among PWID in Georgia.MethodsIn this observational study, participants with recent injecting drug use (previous 6 months) and chronic HCV attending a needle- and syringe-program were included. Participants received sofosbuvir and ribavirin +/- pegylated interferon, with peer-based support during treatment. The primary endpoint was undetectable HCV RNA 12 weeks post-treatment (SVR12). Factors associated with SVR were assessed using logistic regression.ResultsAmong 244 participants [HCV genotype (GT) 3, 52%; GT2, 25%; GT1, 19%; mixed GT, 4%]; 55% had cirrhosis. Overall, 24% were receiving OST and 50% injected drugs in the previous month. 98% (239 of 244) completed treatment, with 88% (210 of 239) having never delayed a medical appointment and 79% (189 of 239) never missing a dose of medication. Overall, SVR was 84.8% (207 of 244). SVR was 88.5% (207 of 234) among participants who attended 12-week follow up appointment for HCV RNA testing. In multivariate analyses, SVR was significantly associated with adherence (no missed doses) to treatment [vs. missed doses; adjusted OR (aOR) 2.77; 95% confidence interval (95%CI), 1.01–7.51), and genotype (vs. GT1; GT2, aOR 0.27; 95%CI 0.06–1.21; GT3, aOR 1.09; 95%CI 0.27–4.50; and mixed GT, aOR 0.14; 95%CI 0.02-0.97).ConclusionIn this real-life study in a middle-income country, PWID treated for HCV and receiving a simple peer-support intervention demonstrated an excellent treatment response and good adherence, not associated with injecting drug use during treatment and OST at treatment initiation.
       
  • Generating sustainable collective action: Models of community control and
           governance of alcohol supply in Indigenous minority populations
    • Abstract: Publication date: December 2018Source: International Journal of Drug Policy, Volume 62Author(s): Janani Shanthosh, Blake Angell, Andrew Wilson, Jane Latimer, Maree L. Hackett, Anne-Marie Eades, Stephen Jan Restrictions on the supply of alcohol are amongst the most effective and cost effective interventions to address harmful use. However, despite international human rights bodies recognising that self determination must be pre-eminent in efforts to improve Indigenous health, little is known about the role of Indigenous communities in designing and implementing alcohol controls as well as the degree to which government resourcing and/or regulation is utilised. This commentary explores Australian examples of the governance models used to ensure Indigenous participation and leadership when developing regulatory interventions for alcohol control within communities. We identify four models of Indigenous governance: alcohol control interventions that were community conceived and implemented, government-facilitated community-led, community coalitions backed by government intervention and government initiated community partnerships. Each model is underpinned by specific governance arrangements which incorporate rules and processes that determine authority, accountability and Indigenous participation in decision-making. The aim of this paper is to benchmark these models of governance along a spectrum of community engagement beginning with forms of non-participation and ending with full citizen control. In addition, we put forward recommendations for governments at all levels to facilitate culturally acceptable and robust models of Indigenous governance that have the potential to improve health and social outcomes.
       
  • Law enforcement practices in the first two states in U.S. to legalize
           recreational marijuana
    • Abstract: Publication date: November 2018Source: International Journal of Drug Policy, Volume 61Author(s): Terra Wiens, Kathleen M. Lenk, Lindsey E.A. Fabian, Darin J. Erickson BackgroundThere is a lack of research regarding law enforcement practices where recreational marijuana sales are legal. Given that legalization of recreational marijuana is expanding, lessons learned from areas with existing legalization can help inform future practices. This pilot study is an evaluation of enforcement of marijuana laws in the first two states in the U.S. to legalize sales of recreational marijuana, Colorado and Washington, several years post legalization.MethodsWe surveyed a random sample of local law enforcement agencies in the two states (25 agencies per state). We also attempted to survey the state-level marijuana enforcement agency but only Washington responded. Surveys focused on youth marijuana use, youth access to marijuana, and impaired driving but included other topics. Chi-square tests assessed differences between states (p 
       
  • Chemsex among gay, bisexual, and other men who have sex with men in
           Singapore and the challenges ahead: A qualitative study
    • Abstract: Publication date: November 2018Source: International Journal of Drug Policy, Volume 61Author(s): Rayner Kay Jin Tan, Christina Misa Wong, Mark I-Cheng Chen, Yin Ying Chan, Muhamad Alif Bin Ibrahim, Oliver Zikai Lim, Martin Tze-Wei Chio, Chen Seong Wong, Roy Kum Wah Chan, Lynette J. Chua, Bryan Chee Hong Choong BackgroundSexualised substance use, or 'chemsex' has been shown to be a major factor driving the syndemic of HIV/AIDS in communities of gay, bisexual, and other men who have sex with men (GBMSM) around the world. However, there is a paucity of research on chemsex among GBMSM in Singapore due to punitive drug laws and the criminalisation of sexual behaviour between men. This qualitative descriptive study is the first to explore perceptions towards, motivators to engaging in, and the barriers to addressing the harms associated with chemsex among GBMSM in Singapore.MethodsWe conducted 30 semi-structured in-depth interviews with self-identifying GBMSM between the ages of 18–39 in Singapore following a purposive sampling strategy. Interview topics included participants' perceptions of drug use among GBMSM in Singapore, perceptions towards chemsex, reasons for drug use and chemsex, and recommendations to address the harms associated with chemsex in Singapore. Interviews were audio-recorded, transcribed, coded, and analysed using thematic analysis.ResultsParticipants reported that it was common to encounter chemsex among GBMSM in Singapore as it could be easily accessed or initiated using social networking phone apps. Enhancement and prolongation of sexual experiences, fear of rejection from sexual partners and peers, and its use as a means of coping with societal rejection were three main reasons cited for engaging in chemsex. The impact of punitive drug laws on disclosure and stigmatisation of GBMSM who use drugs were reported to be key barriers towards addressing chemsex. Participants suggested using gay-specific commercial venues as avenues for awareness and educational campaigns, and social media to reach out to younger GBMSM.ConclusionsThis study highlights the complexities behind chemsex use among GBMSM in Singapore, and the range of individual to institutional factors to be addressed. We recommend that community-based organisations and policy-makers find ways to destigmatise discussion of chemsex and provide safe spaces to seek help for drug use.
       
  • Perspectives on supervised injection facilities among service industry
           employees in New York City: A qualitative exploration
    • Abstract: Publication date: December 2018Source: International Journal of Drug Policy, Volume 62Author(s): Brett Wolfson-Stofko, Luther Elliott, Alex S. Bennett, Ric Curtis, Marya Gwadz BackgroundApproximately 100 supervised injection facilities (SIFs) operate in 66 cities around the world to reduce overdose deaths, the spread of disease and public disorder, though none legally exist in the United States. Public bathrooms are among the most common public places for injection reported by people who inject drugs in New York City (NYC) and service industry employees (SIEs) inadvertently become first-responders when overdoses occur in business bathrooms. The goal of this study was to assess SIE acceptability of SIFs and the perceived effects that SIFs would have on them, their colleagues, their businesses and communities.MethodsSemi-structured qualitative interviews were conducted with 15 SIEs recruited through convenience sampling throughout NYC. Participants were provided with peer-reviewed scientific evidence prior to discussing SIFs. Data were analysed using a hybrid deductive and inductive approach.ResultsMost SIEs had encountered drug use (93%, n = 14/15) and syringes (73%, n = 11/15) in their business bathrooms and three had encountered unresponsive individuals. Nearly all workers (93%, n = 14/15) were supportive of SIFs and believed SIFs would reduce injection drug use in their business bathrooms. Participants also believed that ‘not in my backyard’ arguments from community boards may impede SIF operation.ConclusionsService industry employees are critical stakeholders due to their exposure to occupational health hazards related to public injection. Those interviewed were amenable to SIF operation as a form of occupational harm reduction and their experiences provide an important dimension to the political debate surrounding SIFs.
       
  • A qualitative study of methamphetamine initiation among Chinese male
           users: Patterns and policy implications
    • Abstract: Publication date: December 2018Source: International Journal of Drug Policy, Volume 62Author(s): Liu Liu, Wing Hong Chui, Xiangnan Chai China is a major producer and distributor of methamphetamine (meth) worldwide. Within the last two decades, China has seen rapid growth in meth use, especially among young men. However, patterns of Chinese male users’ initiation of meth is rarely explored. To address this void in the literature, this study adopts China’s mian’zi culture to explore Chinese male meth users’ initiation patterns qualitatively. Semi-structured interviews were conducted with 35 male meth users from seven Chinese compulsory drug treatment institutions. Thematic analysis was applied to data analysis. Most participants reported their beginning to use meth as a strategy or approach to handling peer influence stemming from structured social networking. The motivation to have fun with friends, colleagues, or business fellows to maintain these people’s mian’zi, together with the curiosity about meth and lack of understanding that meth is a potentially addictive drug, contribute to male users’ meth initiation. Moreover, we found that most male meth users’ initiation occurs in enclosed locations, such as nightclubs, karaoke rooms, hotels, and private residences because these locations were considered “safe.” Additionally, some participants initiated meth use because they perceived it could be a way of harm reduction from heroin or alcoholism. However, such perception neglects the harmful outcomes of the concomitant use of meth with other drugs or alcohol. We suggested social support programs for young Chinese men who are located in high-risk social networking where meth use is accepted as a way of interaction. Up-to-date drug education on meth is also necessary for school students, and mass media could play its role in educating the public about potential risks of meth use.
       
  • Drug checking as a potential strategic overdose response in the fentanyl
           era
    • Abstract: Publication date: December 2018Source: International Journal of Drug Policy, Volume 62Author(s): Matthew K. Laing, Kenneth W. Tupper, Nadia Fairbairn Adulteration of illicit drug supplies with synthetic opioids such as fentanyl has contributed to a dramatic rise in overdose morbidity and mortality in North America. One promising response to this crisis is the implementation of “drug checking” services. Drug checking encompasses a range of interventions used to assess the constituents of illicit drug samples, such as colour-spot testing, gas or liquid chromatography, and various methods of spectroscopy. Testing may be performed on-site at events or harm reduction service locales, performed independently by consumers, or sent to a centralized lab for analysis. This information may then serve to inform individual decision-making, enhance harm reduction efforts and strengthen public health surveillance and response strategies to prevent harms associated with illicit drug use. Historical examples of drug checking services that emerged with the 1990s synthetic “party drug” movement in Europe provide a theoretical and practical basis for the adaptation of these services for use in context of the current opioid overdose crisis. Potential harm reduction benefits of drug checking for synthetic opioid adulterants include individuals being more likely to use drugs more safely or to dispose of drugs found to contain harmful adulterants. Public health benefits of drug checking may also include negative feedback on the illicit drug supply with decreased availability or consumption of drugs from sources adulterated with synthetic opioids following public health warning campaigns. As part of the response to the current synthetic opioid epidemic in BC, pilot efforts are being undertaken in Vancouver to determine the feasibility and effectiveness of drug checking as an overdose response strategy. Models of drug checking service delivery and comparison of differing technologies, including unique challenges and potential solutions related to access to these services, legal obstacles, and sensitivity and specificity of testing technologies, are explored, alongside suggestions for future research and directions.
       
  • Individual, social, and structural factors affecting antiretroviral
           therapy adherence among HIV-positive people who inject drugs in Kazakhstan
           
    • Abstract: Publication date: December 2018Source: International Journal of Drug Policy, Volume 62Author(s): Alissa Davis, Tara McCrimmon, Anindita Dasgupta, Louisa Gilbert, Assel Terlikbayeva, Timothy Hunt, Sholpan Primbetova, Elwin Wu, Meruyert Darisheva, Nabila El-Bassel BackgroundHIV-infected people who inject drugs (PWID) are particularly vulnerable to suboptimal ART adherence. The fastest-growing HIV epidemics globally are driven by injection drug use, but only a small percentage of HIV-positive PWID have achieved viral suppression. Virally suppressed individuals have better HIV-related health outcomes and effectively no risk of transmitting HIV to others. Hence, ART adherence is important for both HIV treatment and HIV prevention. There is a paucity of data on barriers and facilitators of ART adherence among PWID in low and middle income countries, which is problematic given the growing HIV epidemics among PWID in these countries.MethodsUsing the Theory of Triadic Influence, this paper examines individual, interpersonal, and structural barriers and facilitators of ART adherence among HIV-positive PWID in four cities in Kazakhstan. Eight focus groups were conducted (two in each city) with a total of 57 participants. Data were coded and analyzed by three researchers.ResultsWe found a number of barriers and facilitators to ART adherence among PWID at the individual, interpersonal, and structural levels. Individual barriers to ART adherence include misperceptions about ART, forgetfulness due to the effects of illicit drug use, and medication side effects. Interpersonal facilitators of ART adherence include social support and good relationships with healthcare providers. Structural barriers include poverty, legal challenges, disruptions in the ART supply, and stigma and discrimination.ConclusionThe paper highlights important factors related to ART adherence for HIV-positive PWID and identifies potential strategies for intervention efforts, including couple-based interventions, electronic reminders, linkage to drug treatment services, and patient navigation. Effectively enhancing adherence to ART among PWID will likely require multi-level approaches and strategies. Further research should be conducted on potential methods and interventions for improving ART adherence among this vulnerable population.
       
  • Can vendors’ age limit control measures increase compliance with the
           alcohol age limit' An evaluation of measures implemented by three
           Dutch liquor store chains
    • Abstract: Publication date: November 2018Source: International Journal of Drug Policy, Volume 61Author(s): Ruud T.J. Roodbeen, Karen Schelleman-Offermans, Paul H.H.M. Lemmens BackgroundDutch liquor store (off license) chains have voluntarily developed and implemented age limit control measures to increase compliance with the Licensing and Catering Act (LCA), aimed at prohibiting vendors from selling alcohol to minors (
       
  • Determinants of high availability of methamphetamine, cannabis, LSD and
           ecstasy in New Zealand: Are drug dealers promoting methamphetamine rather
           than cannabis'
    • Abstract: Publication date: November 2018Source: International Journal of Drug Policy, Volume 61Author(s): Chris Wilkins, Jose S. Romeo, Marta Rychert, Jitesh Prasad, Thomas Graydon-Guy BackgroundSmall towns in New Zealand have reported high availability of methamphetamine, and conversely a shortage of cannabis. Stakeholders have suggested drug dealers are purposely promoting methamphetamine rather than cannabis.Aims(1) To compare the availability of methamphetamine and cannabis in different size communities; (2) Identify determinants of the high availability of methamphetamine, including low availability of cannabis.MethodAn online drug survey was promoted via a broadly targeted Facebook™ campaign. Participants were asked if they lived in a “city”, “small town” or “rural area”, their drug use patterns, and local drug market characteristics, including current availability. A total of 6311 people completed the survey. Logistic regression models were constructed to identify independent predictors of reporting high availability of methamphetamine, cannabis, ecstasy and LSD respectively, with low availability of cannabis included as a predictor in the non-cannabis markets.ResultsMethamphetamine was reported to be more available than cannabis in all regions. Methamphetamine was more available in towns/rural areas than in cities. Significant predictors of high availability of methamphetamine were living in a town/rural area (OR = 1.38), purchasing from a gang member (OR = 1.88), daily methamphetamine use (OR = 2.41), Maori ethnicity (OR = 1.36) and reporting low availability of cannabis (OR = 1.89). Low availability of cannabis was not a predictor of high availability of ecstasy or LSD. Living in a town/rural area was not a predictor of high availability of cannabis, LSD or ecstasy. Purchasing from a gang member was a predictor of high availability of cannabis (OR = 1.80) and LSD (OR = 4.61).ConclusionsFurther research is required to identify what causal relationships, if any, there are between the statistical associations of high methamphetamine availability, living in a small town, purchasing from a gang, and low cannabis availability. It may be the case that small towns offer an environment where a gang can control the local drugs market.
       
  • Creating and sustaining cooperative relationships between supervised
           injection services and police: A qualitative interview study of
           international stakeholders
    • Abstract: Publication date: November 2018Source: International Journal of Drug Policy, Volume 61Author(s): Tara Marie Watson, Ahmed M. Bayoumi, Shaun Hopkins, Amy Wright, Renuka Naraine, Triti Khorasheh, Laurel Challacombe, Carol Strike BackgroundSupervised injection services (SIS) operate with special exemptions from drug law enforcement. Given the expansion of SIS and the opioid overdose crisis in numerous jurisdictions, now is a critical time to examine factors that contribute to cooperative SIS-police relationships. We sought to learn about SIS-police relationships from international jurisdictions with well-established as well as newer SIS.MethodsWe conducted 16 semi-structured telephone interviews with SIS managers (n = 10) and police liaisons (n = 6) from 10 cities in seven different countries (Australia, Canada, Denmark, France, Germany, Netherlands, and Spain). All participants provided informed consent. We focused our coding and analysis on themes that emerged from the data.ResultsFive key contributors to cooperative SIS-police relationships emerged from the data: early engagement and dialogues; supportive police chiefs; dedicated police liaisons; negotiated boundary agreements; and regular face-to-face contact. Most participants perceived the less formalised, on-the-ground approach to relationship-building between police and SIS adopted in their city to be working well in general. SIS managers and police participants reported a lack of formal police training on harm reduction, and some thought that training was unnecessary given the relatively positive local SIS-police relationships they reported.ConclusionOur qualitative study provides new, in-depth empirical examples of how police in varied international jurisdictions can come to accept and work cooperatively with, not against, SIS staff and clients. Investing ongoing effort in SIS-police relationships, in a manner that best suits local needs, may hold greater and more sustainable public health value than delivering specific curricula to police.
       
  • Situating the syringe
    • Abstract: Publication date: Available online 9 August 2018Source: International Journal of Drug PolicyAuthor(s): Nicole Vitellone What’s at stake when the syringe becomes a tool for thinking' Reflecting on the production of Social Science of the Syringe, this commentary describes the empirical challenges of encountering injecting drug users directly affected by Harm Reduction policies as significant stakeholders in the expression of drug problems.
       
  • ‘Good enough’ parenting: Negotiating standards and stigma
    • Abstract: Publication date: Available online 29 July 2018Source: International Journal of Drug PolicyAuthor(s): kylie valentine, Ciara Smyth, Jamee Newland BackgroundPolicy concern with families has led to the framing of ‘good parenting’ as a skill set that parents must acquire while ‘poor parenting’ is linked to a raft of social problems, including child maltreatment. A range of professionals are responsible for monitoring parents for evidence of ‘poor parenting’, and for reporting those parents to statutory child protection authorities. Little is known about how parents in vulnerable circumstances negotiate these dual pressures of ‘good parenting’ and surveillance.MethodsEight parents who use drugs were interviewed about raising children well. The data is drawn from a project that used a positive deviance approach to understand the practices and norms that contribute to positive child outcomes in communities where positive outcomes are unexpected or statistically anomalous.ResultsParents use a range of strategies to minimise risk of harm from drug use. Participants resist negative stereotypes that portray their parenting primarily in terms of risk; and in contrast to previous research, describe feelings of guilt but not shame. Systemic barriers to safe environments include the nature of illicit drug markets and the surveillance and policing responsibilities of service agencies.ConclusionThe findings contribute to an understanding of safe and competent parenting by parents who use drugs and highlight how drug laws and fear of intervention can work against the creation of safe family environments.
       
  • Problematisation and regulation: Bodies, risk, and recovery within the
           context of Neonatal Abstinence Syndrome
    • Abstract: Publication date: Available online 17 July 2018Source: International Journal of Drug PolicyAuthor(s): Anne Whittaker, Amy Chandler, Sarah Cunningham-Burley, Paula Midgley, Lawrie Elliott, Sarah Cooper BackgroundNeonatal Abstinence Syndrome (NAS) is an anticipated effect of maternal drug use during pregnancy. Yet it remains a contested area of policy and practice. In this paper, we contribute to ongoing debates about the way NAS is understood and responded to, through different treatment regimes, or logics of care. Our analysis examines the role of risk and recovery discourses, and the way in which the bodies of women and babies are conceptualised within these.MethodsQualitative interviews with 16 parents (9 mothers, 7 fathers) and four focus groups with 27 health and social care professionals based in Scotland. All the mothers were prescribed opioid replacement therapy and parents were interviewed after their baby was born. Data collection explored understandings about the causes and consequences of NAS and experiences of preparing for, and caring for, a baby with NAS. Data were analysed using a narrative and discursive approach.ResultsParent and professional accounts simultaneously upheld and subverted logics of care which govern maternal drug use and the assessment and care of mother and baby. Despite acknowledging the unpredictability of NAS symptoms and the inability of the women who are opioid-dependent to prevent NAS, logics of care centred on ‘proving’ risk and recovery. Strategies appealed to the need for caution, intervening and control, and obscured alternative logics of care that focus on improving support for mother-infant dyads and the family as a whole.ConclusionDiffering notions of risk and recovery that govern maternal drug use, child welfare and family life both compel and trouble all logics of care. The contentious nature of NAS reflects wider socio-political and moral agendas that ultimately have little to do with meeting the needs of mothers and babies. Fundamental changes in the principles, quality and delivery of care could improve outcomes for families affected by NAS.
       
  • Tensions and contradictions in family court innovation with high risk
           parents: The place of family drug treatment courts in contemporary family
           justice
    • Abstract: Publication date: Available online 29 June 2018Source: International Journal of Drug PolicyAuthor(s): Judith Harwin, Karen Broadhurst, Caroline Cooper, Stephanie Taplin Parental substance misuse is a leading factor in child abuse and neglect and frequently results in court-mandated permanent child removal. Family drug treatment courts, which originated in the USA and are only found in adversarial family justice systems, are a radical innovation to tackle this problem. Unlike ordinary court, they treat parents within the court arena as well as adjudicating, and in this way they seek to draw a new balance between parental needs and the child’s right to timely permanency. Family drug treatment courts have spread to England, Australia and Northern Ireland and international research has found they have higher rates of parental substance misuse cessation and family reunification and lower foster care costs than ordinary courts. Yet their growth has been far from straightforward. In the USA they have not kept pace with the rise of criminal drug treatment courts and in England and Australia their numbers remain small. The central purpose of this article is to explore why the family drug treatment movement has not achieved wider impact and to consider opportunities and challenges for its future development. To address these questions we draw on evidence and experience from the USA, England and Australia. We discuss the operational challenges, tensions between children’s needs for stability and parental timescales for recovery, the impact of wider economic and political change, and issues in data evaluation. We conclude that despite the promise of family drug treatment courts as a new paradigm to address risky parenting, effecting systemic change in the courts is extremely difficult.
       
  • Making a difference' Applying Vitellone’s Social Science of the
           Syringe to performance and image enhancing drug injecting
    • Abstract: Publication date: Available online 19 April 2018Source: International Journal of Drug PolicyAuthor(s): Aaron Hart Vitellone’s Social Science of the Syringe investigates epistemologies of injecting drug use. She argues for a methodology that can be simultaneously sensitive to biopolitical power regimes; the trajectories of social stratification; and the resistance, creativity and dignity of human agency. She proposes a methodological focus on the syringe-in-use as an active participant in these dynamics. Harm reduction policy and service provision frameworks have paid little attention to the phenomena of performance and image enhancing drug (PIEDs) injection. One way of assessing the merit of Vitellone’s proposal is to use it to investigate these phenomena. I argue that Vitellone’s method can be used to articulate a range of significant differences between people who inject PIEDs and other people who inject drugs, and that these differences can inform harm reduction initiatives. When compared to the heroin syringe, the PIED syringe participates in different socio-economic and material contexts, gendered identities, and biopolitical governance regimes. These differences materialise in different rates of syringe sharing and blood-borne virus transmission; and different experiences of needle exchange services. I offer a thought experiment demonstrating how a different syringe might alter the structural dynamics, biopolitical governance, and the agentic choices of people who inject PIEDs. Judging by the productive effects of diffracting Vitellone’s analysis through an empirical concern with PIED injecting, I concur with Vitellone’s proposition that ‘something objective may be gained from an empirical investigation of the syringe-in-use’ (p. 33).
       
  • Call for papers: Problematizations in drug use policy, practice and
           research
    • Abstract: Publication date: Available online 27 March 2018Source: International Journal of Drug PolicyAuthor(s):
       
  • The object in hand: Social science of the syringe
    • Abstract: Publication date: Available online 26 March 2018Source: International Journal of Drug PolicyAuthor(s): Helen Keane
       
 
 
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