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International Journal of Drug Policy
Journal Prestige (SJR): 1.441
Citation Impact (citeScore): 3
Number of Followers: 449  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0955-3959
Published by Elsevier Homepage  [3162 journals]
  • 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.
  • Differences by sex in associations between injection drug risks and drug
           crime conviction among people who inject drugs in Almaty, Kazakhstan
    • Abstract: Publication date: October 2018Source: International Journal of Drug Policy, Volume 60Author(s): Phillip L. Marotta, Louisa Gilbert, Assel Terlikbayeva, Elwin Wu, Nabila El-Bassel BackgroundThe criminalization of drug use leads to high rates of drug crime convictions for engaging in injection drug use behaviors, introducing barriers to HIV prevention and drug treatment for PWID. Females (FWID) face unique vulnerabilities to HIV compared to males (MWID) in Kazakhstan. This study examined sex differences in associations between HIV/HCV infection, HIV knowledge, injection drug risk behaviors, and conviction for a drug crime in a sample of people who inject drugs (PWID) in Almaty, Kazakhstan.MethodsAnalyses were performed on baseline data from 510 PWID and stratified by males (MWID) (329) and females (FWID) (181) from Kazakhstan in a couples-focused HIV prevention intervention. Logistic regression analyses using mixed effects (AOR) examined associations between HIV/HCV infection, HIV knowledge, injection drug risk behaviors, drug use severity, drug treatment history and conviction for a drug crime.ResultsAbout three quarters of PWID reported drug crime conviction (73.92%, n = 377). HCV infection was associated with increased odds of drug crime conviction for FWID (AOR = 4.35, CI95 = 1.83–10.31, p 
  • Drug detection dogs at Australian outdoor music festivals: Deterrent,
           detection and iatrogenic effects
    • Abstract: Publication date: October 2018Source: International Journal of Drug Policy, Volume 60Author(s): Jodie Grigg, Monica J. Barratt, Simon Lenton BackgroundRecent drug-related deaths at Australian music festivals have led to increasing concern about the risk of future harm, but contention about how to effectively respond. One hotly debated strategy has been the use of drug detection dogs which currently operate at festivals across Australia, despite claims they are ineffective and contribute to risky drug use practices. This paper aims to investigate responses to the expected presence, and sightings, of drug dogs at the last festival attended.MethodsAn anonymous online survey was completed by almost 2000 Australian festival-goers. The largest subsample used in the analyses for this paper (n = 647) was 59% male and had a median age of 20 (IQR = 18–22).ResultsOf those who expected dogs to be present at their last festival (n = 647), only 4% reported that this threat led them to decide not to take drugs. Other responses included: concealing their drugs well (48%), getting someone else to carry their drugs (15%), buying their drugs inside (11%), taking less easily detected drugs (10%) and taking drugs before entering (7%). Of those who carried drugs in (n = 418), 10% concealed them internally and 1% swallowed them to retrieve inside. Of those who had drugs on their person when seeing a dog (n = 189), 10% reported consuming drugs in response. No respondents reported being detected with drugs due to a positive identification.ConclusionAlmost all festival-goers surveyed did not report being deterred from drug usage by the expected presence of drug dogs. Instead, a variety of alternative responses to avoid detection were reported, many of which could place festival-goers at greater risk of experiencing drug-related harms. In the face of mounting evidence of both ineffectiveness and iatrogenic effects, the use of drug detection dogs at Australian music festivals should be urgently reconsidered.
  • Mourning our dead: The impact of Mexico’s war on drugs on
           citizens’ depressive symptoms
    • Abstract: Publication date: October 2018Source: International Journal of Drug Policy, Volume 60Author(s): Iván Flores Martínez, Laura Helena Atuesta BackgroundResearch has shown the substantial impact on mental health for victims of drug-related crime in Mexico, especially individuals who have been heavily exposed to violence. However, the effect of drug-related violence in non-victims has been less studied because causal pathways via indirect violence are more ambiguous. We argue that drug-related violence does have an influence on the mental health of non-victims: For example, because of how violence is publicized by criminal groups, including their use of gruesome killing methods in executions, or via news about government confrontations with these criminal groups.MethodsWe estimate linear models of the effect of drug-related violence (CIDE-PPD database) on depression symptoms (MxFLS 2009–2012). We use lagged violence variables to match the time when individuals’ depression symptoms were reported, using different proxies of violence.FindingsOur findings suggest a negative effect of drug-related violence on the mental health of individuals, specifically in relation to communication used by criminal groups (narcomessages), the brutality of executions, and the confrontations between government forces (specifically local police) and criminal groups.ConclusionsOur findings suggest that the general population is a direct victim of the psychological violence imposed by the use of narcomessages. This additional effect of the war on drugs should be considered when deciding how to address the psychological effects of drug-related violence. The government should provide safer public spaces to improve perceptions about security, and more mental health services in communities that are most affected by organized crime violence. Mental health is also affected when police forces fight criminal groups. These findings corroborate the crisis of local institutions, the low confidence citizens have in police, and/or the infiltration of organized crime in local police corps. Mexico requires police reform, not only to avoid the involvement of the military in public security operations, but also to avoid social and psychological damage produced by weak police forces fighting organized crime.
  • Defining and defending drug-free bodybuilding: A current perspective from
           organisations and their key figures
    • Abstract: Publication date: October 2018Source: International Journal of Drug Policy, Volume 60Author(s): Dimitrios Liokaftos The use of performance- and image-enhancing drugs in the past seventy years or so has sparked a number of responses, including heated public debates, the creation of dedicated organisations and drug policies, as well as the emergence of communities of practice and belief in support of or in opposition to the phenomenon. Drug-free, known in the field as ‘natural’, bodybuilding has been developing since the 1970 s as a response to a dominant bodybuilding culture where the use of performance- and image-enhancing drugs has become normalised. Recent years have seen a multiplication of national and international governing bodies, competitions, and participants in drug-free bodybuilding in different parts of the globe. As the field grows, the questions of what constitutes natural bodybuilding and who can authentically represent it become central. Adopting a multi-method, qualitative approach, this article explores the ways organisations and their key figures define and defend their versions of drug-free bodybuilding. The discussion focus is on the policies, meanings and identities embedded in these different versions, and how their production and negotiation makes sense in light of antagonisms between players in the field of natural bodybuilding as well as their relation to drug-enhanced bodybuilding and the wider world of sport. In examining this previously uncharted body culture, the article explores how the use of performance- and image-enhancing drugs provokes responses and processes of contestation and differentiation. In the process, what becomes apparent is the designation and negotiation of drug-free, natural bodies as an ongoing, dynamic, social process.
  • 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.
  • Caring and curing: Considering the effects of hepatitis C
           pharmaceuticalisation in relation to non-clinical treatment outcomes
    • Abstract: Publication date: October 2018Source: International Journal of Drug Policy, Volume 60Author(s): Magdalena Harris, Tim Rhodes BackgroundThe development of simplified and effective hepatitis C (HCV) pharmaceuticals enables treatment scale up among the most marginalised. This potentiates a promise of viral elimination at the population level but also individual level clinical and non-clinical benefits. Reports of transformative non-clinical outcomes, such as changes in self-worth and substance use, are primarily associated with arduous interferon-based treatments that necessitate intensive care relationships. We consider the implications of simplified treatment provision in the era of direct acting antivirals (DAAs) for the realisation of non-clinical benefits.MethodsWe draw on qualitative data from ethnographic observations and longitudinal interviews with people receiving (n = 22) and providing (n = 10) HCV treatment in London during a transition in HCV biomedicine. First generation DAAs in conjunction with interferon were standard of care for most of this time, with the promise of simplified treatment provision on the horizon.FindingsPatient accounts of care accentuate the transformative value of interferon-based HCV treatment derived through non-clinical benefits linked to identity and lifestyle change. Such care is constituted as extending beyond the virus and its biomedical effects, with nurse specialists positioned as vital to this care being realised. Provider accounts emphasise the increased pharmaceuticalisation of HCV treatment; whereby care shifts from the facilitation of therapeutic relationships to pharmaceutical access.ConclusionHCV care in the interferon-era affords identity transformations for those receiving and providing treatment. Biomedical promise linked to the increasing pharmaceuticalisation of HCV treatment has disruptive potential, shifting how care is practised and potentially the realisation of non-clinical treatment outcomes.
  • Beyond deficit and harm reduction: Incorporating the spectrum of wellness
           as an interpretive framework for cannabis consumption
    • Abstract: Publication date: October 2018Source: International Journal of Drug Policy, Volume 60Author(s): Todd Subritzky The cannabis academic literature is informed by dominant deficit, public health and harm reduction frameworks. However, a large majority of cannabis consumption appears to place outside the scope of these models that prioritise the identification and limitation of negative impacts. As such there are apparent analytical blind spots pertaining to: non-problematic use of cannabis (as defined by Global Commission on Drug Policy); the intersection of medical and recreational intents of use; and pleasure. This paper explores the academic and grey literature relating to the spectrum of wellness to assess its suitability as a framework for cannabis scholars. For millennia cannabis use has been associated with wellness models, particularly at the nexus of mind, body, and spirit. Despite this seemingly obvious match, the academic literature that incorporates cannabis consumption patterns into wellness conceptions is thin. The spectrum of wellness has both advantages and disadvantages compared to existing models and may be useful as a complementary framework that allows for broader examination of cannabis consumer activity.
  • Should sterile needle and syringe wastage be included within
           individual-level needle and syringe coverage measures'
    • Abstract: Publication date: October 2018Source: International Journal of Drug Policy, Volume 60Author(s): O’Keefe Daniel, Aitken Campbell, Dietze Paul
  • Health-related work productivity loss is low for patients in a methadone
           maintenance program in Vietnam
    • Abstract: Publication date: October 2018Source: International Journal of Drug Policy, Volume 60Author(s): Bach Xuan Tran, Long Hoang Nguyen, Cuong Tat Nguyen, Carl A. Latkin BackgroundData on work productivity lost are an essential component of economic evaluation regarding social issues. However, there has been limited information about the loss of work productivity due to health among patients receiving methadone maintenance treatment (MMT) in Vietnam. The objectives of this study were to explore health-related work productivity loss between urban and rural MMT patients and to identify associated factors.MethodsA cross-sectional study was conducted in five MMT clinics in Hanoi and Nam Dinh provinces. Work Productivity and Activity Impairment Questionnaire: General Health (WPAI-GH) was used to measure health-related work productivity loss. In addition, data on socio-demographic, health status (measured by EuroQol-5 dimensions-5 levels – EQ-5D-5L, and EQ-Visual analogue scale – EQ-VAS) and substance use were collected. Multivariate Tobit regression was used to identify the potential factors associated with health-related work productivity loss.ResultsOf 1016 patients who participated in the study, 755 (74.6%) were employed. Of those, only 40/755 patients reported missing work due to health problems (5.3%), with the average absenteeism score of 30.6% (SD = 18.5%). Meanwhile, 164/755 respondents (21.7%) reported their impairment during work hours due to health problems. The mean weekly cost of absenteeism was at US$ 19.6 (SD = 11.8), and the mean weekly presenteeism cost was at US$ 8.7 (SD = 7.3). After adjusting for socio-economic status, having problems with mobility, usual activities, pain/discomfort, and anxiety/depression; as well as EQ-5D index and EQ-VAS score, were factors associated with work productivity loss due to health.ConclusionThe current study emphasizes the low degree of health-related work productivity loss, as well as the low rate of work impairment among MMT patients in Vietnamese urban and rural settings. Our study also highlights the necessity of appropriate pain and mental health management as well as vocational training, and the provision of job opportunities to promote the employability of patients taking MMT.
  • ‘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
    • 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‚Äôs 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
    • 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
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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