Contemporary Drug Problems最新文献

{"title":"No Thanks! A Mixed-Methods Exploration of the Social Processes Shaping Persistent Non-Initiation of Amphetamine-Type Stimulants","authors":"N. Liebregts, W. McGovern, L. Spencer, A. O'Donnell","doi":"10.1177/00914509221084388","DOIUrl":"https://doi.org/10.1177/00914509221084388","url":null,"abstract":"Amphetamine-Type Stimulants (ATS), such as amphetamines, MDMA, and methamphetamine are a commonly used class of illicit drugs in Europe. There is a large existing literature on motives for the use of illicit drugs, often focusing on initiation. However, few studies have explored the reasons why some people choose not to use drugs (non-use), and even fewer focus on the social processes influencing non-use of ATS specifically. We explored social processes related to normalization, and how persistent non-users negotiate their non-use in social contexts where ATS is used, using qualitative interview (n = 21) and survey questionnaire (n = 126) data from a mixed-method study conducted in the Netherlands and England. Our findings showed that in both countries, most participants were repeatedly exposed to ATS use, often in social or nightlife settings. Participants abstained from use for a number of reasons, including: lack of interest in illicit drug use in general; desire to maintain control over their own behavior and environment; and to avoid the associated health risks. Social processes also shaped persistent non-use of ATS, via conscious socialization with, and selection of, other non-using peers over time. Our findings contribute to the literature on the normalization thesis, showing that recreational ATS use is only partly socially accommodated and normalized among persistent non-users, suggesting differentiated normalization.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48997477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Spaces Between Fault/Lines: Collaborative Politics of Addiction in Japan","authors":"Selim Gokce Atici","doi":"10.1177/00914509221084383","DOIUrl":"https://doi.org/10.1177/00914509221084383","url":null,"abstract":"In the last decade, the Japanese welfare system has dramatically expanded health-care services and introduced new therapeutic programs for people diagnosed with addiction problems. Staff and members of volunteer-led non-profit rehabilitation centers (known as DARCs) together with medical professionals, developed pilot clinical therapies and critical studies of current clinical models. By encouraging encounters between professionals and DARC volunteers, these programs serve as a basis for new social and economic welfare policies. They incorporate critical assessments of causality and responsibility in the context of social marginalization and the lack of medical care. Scholars of Japanese welfare and a wider scholarship of governmentality and drug policies have analyzed deinvestment in marginalized populations by focusing on medicalization and criminalization. However, the Japanese therapeutic expansion produced alternative experiential, moral, and medical understandings of drug use, as it enabled grassroots participation through new forms of citizenship, peer studies, and alliances across medical, penal, and welfare fields. This article therefore focuses on how grassroots activists engage with medical professionals and welfare officials through self-studies and research about these collectives. Drawing on the anthropology of addiction literature and critical drug studies, and 6 months of anthropological fieldwork in Japan, I interrogate the emerging collaborative politics of addiction in Japan, focusing on alliances between various actors and institutions, the organization of care in a time of economic abandonment of marginalized social classes, and the making of grassroots solidarity. Finally, I reflect on the politics of fault and practices of space-making that characterize these pragmatic alliances. I consider these alliances as interventions into the hegemonic understandings of fault and responsibility in the context of social assistance and addiction-specific welfare policies.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44071330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CommunityStat: A Public Health Intervention to Reduce Opioid Overdose Deaths in Burlington, Vermont, 2017-2020.","authors":"Brandon Del Pozo","doi":"10.1177/00914509211052107","DOIUrl":"https://doi.org/10.1177/00914509211052107","url":null,"abstract":"<p><p>From 2017 to early 2020, the US city of Burlington, Vermont led a county-wide effort to reduce opioid overdose deaths by concentrating on the widespread, low-barrier distribution of medications for opioid use disorder. As a small city without a public health staff, the initiative was led out of the police department-with an understanding that it would not be enforcement-oriented-and centered on a local adaptation of CompStat, a management and accountability program developed by the New York City Police Department that has been cited as both yielding improvements in public safety and overemphasizing counterproductive police performance metrics if not carefully directed. The initiative was instrumental to the implementation of several novel interventions: low-threshold buprenorphine prescribing at the city's syringe service program, induction into buprenorphine-based treatment at the local hospital emergency department, elimination of the regional waiting list for medications for opioid use disorder (MOUD), and the de-facto decriminalization of diverted buprenorphine by the chief of police and county prosecutor. An effort by local legislators resulted in a state law requiring all inmates with opioid use disorder be provided with MOUD as well. By the end of 2018, these interventions were collectively associated with a 50% (17 vs. 34) reduction in the county's fatal overdose deaths, while deaths increased 20% in the remainder of Vermont. The reduction was sustained through the end of 2019. This article describes the effort undertaken by officials in Burlington to implement these interventions. It provides an example that other municipalities can use to take an evidence-based approach to reducing opioid deaths, provided stakeholders assent to sustained collaboration in the furtherance of a commitment to save lives. In doing so, it highlights that police-led public health interventions are the exception, and addressing the overdose crisis will require reform that shifts away from criminalization as a community's default framework for substance use.</p>","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8782438/pdf/nihms-1747499.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9374351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>\"BLURRING THE LINE:\"</i> INTOXICATION, GENDER, CONSENT AND SEXUAL ENCOUNTERS AMONG YOUNG ADULTS.","authors":"Geoffrey Hunt,&nbsp;Emile Sanders,&nbsp;Margit Anne Petersen,&nbsp;Alexandra Bogren","doi":"10.1177/00914509211058900","DOIUrl":"https://doi.org/10.1177/00914509211058900","url":null,"abstract":"<p><p>Social concern about sexual practices and sexual consent among young adults has increased significantly in recent years, and intoxication has often played a key role in such debates. While many studies have long suggested that alcohol plays a role in facilitating (casual) sexual encounters, intoxication has largely either been conceptualized as a risk factor, or researchers have focused on the pharmacological effects of alcohol on behaviors associated with sexual interaction and consent. To date little work has explored how young adults define and negotiate acceptable and unacceptable levels of intoxication during sexual encounters, nor the ways in which different levels of intoxication influence gendered sexual scripts and meanings of consent. This paper explores the latter two research questions using data from 145 in-depth, qualitative interviews with cisgender, heterosexual young adults ages 18-25 in the San Francisco Bay Area. In examining these interview data, by exploring the relationship between intoxication and sexual consent, and the ways in which gender plays out in notions of acceptable and unacceptable intoxicated sexual encounters, we highlight how different levels of intoxication signal different sexual scripts. Narratives about sexual encounters at low levels of intoxication highlighted the role of intoxication in achieving sexual sociability, but they also relied on the notion that intoxicated consent was dependent on the social relationship between the partners outside drinking contexts. Narratives about sexual encounters in heavy drinking situations were more explicitly gendered, often in keeping with traditionally gendered sexual scripts. In general we found that when men discussed their own levels of intoxication, their narratives were more focused on sexual performance and low status sex partners, while women's and some men's narratives about women's levels of intoxication were focused on women's consent, safety, and respectability. Finally, some participants rely on 'consent as a contract' and 'intoxication parity'- the idea that potential sexual partners should be equally intoxicated - to handle relations of power in interpersonal sexual scripts. Since these notions are sometimes deployed strategically, we suggest that they may serve to \"black-box\" gendered inequalities in power between the parties involved.</p>","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9455916/pdf/nihms-1790003.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9912864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Rising Social Media and Declining Alcohol Use: The Case of Finnish Teenagers","authors":"Jari Luomanen, Pertti Alasuutari","doi":"10.1177/00914509221077349","DOIUrl":"https://doi.org/10.1177/00914509221077349","url":null,"abstract":"The article aims to make understandable a significant change that has taken place in the adolescent drinking habits: throughout the world, the teens are drinking much less than previous generations. Previous research has approached this phenomenon through survey research methodology, trying to identify the variables that correlate with individuals’ alcohol consumption level, thereby explaining the phenomenon. The impact of social media use on drinking habits has been identified as one possible explanation, but the results have been contradictory. The article hypothesizes that the rise of social media created an institutional change in young people’s conditions for and patterns of socializing. Using qualitative interviews with Finnish teenagers as empirical data, the article concludes that since socializing with peers and initiating romantic relationships takes place primarily in virtual contexts, there are less occasions in which alcohol would serve as a social lubricant. Consequently, compared with previous generations, alcoholic beverages play a smaller role in young people’s lives. The current living conditions molded by the social media concern everyone, which is why individual-level correlations between social media use and alcohol consumption level do not capture the aggregate effect that the changed living conditions have brought about.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48319038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"With Medicine in Mind? Exploring the Relevance of Having Recreational Experience When Becoming a Medicinal Cannabis User","authors":"Sinikka L. Kvamme","doi":"10.1177/00914509211070741","DOIUrl":"https://doi.org/10.1177/00914509211070741","url":null,"abstract":"Background: Beyond the legal use of medical cannabis in Denmark for selected patient groups, a large unregulated use of medicinal (non-prescribed) cannabis occurs. However, little is known about the paths to becoming a medicinal cannabis user and the role that previous recreational experience plays in this process. Aim: Inspired by Becker’s social learning approach to becoming a cannabis user, this study explores sources of inspiration for medicinal cannabis use, the social control factors related to use, and the relevance of recreational experience (RE) with cannabis. Methods: An anonymous survey was made available online to a convenience sample of 2,281 adults (≥18 years) who self-medicate with non-prescribed cannabis. Logistic regression analysis compared users with no RE (46.1%) to users with occasional RE (27.4%) and regular RE (26.5%) in terms of user characteristics, initiation of medicinal use, and experiences with social control factors. Results: Compared to users with RE, users with no RE were significantly more likely to be women, older, more frequent users, and to treat somatic conditions and use low potency CBD-oil. Users with no RE were more likely to rely on social networks for information on medicinal cannabis, use online sources for supply, and find supply stable. Moreover, users with no RE were less likely to keep use secret and find use problematic. Also, when medicinal use develops on a gradual transition from recreational use it is associated with increased odds of treating mental health conditions and with use of smoking as form of intake. Conclusion: The heterogeneity among medicinal cannabis users in Denmark, in terms of demographics, motives for use, and patterns of use, is related to the level of previous recreational experience and to whether medicinal use developed on a gradual transition from recreational use.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47661608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addiction Treatment as Prison Governance: A Critical Discourse Analysis of Methadone Delivery in Kyrgyz Prisons","authors":"L. Azbel, Daniel J. Bromberg, Sergii Dvoryak, F. Altice","doi":"10.1177/00914509211060723","DOIUrl":"https://doi.org/10.1177/00914509211060723","url":null,"abstract":"Methadone treatment is prescribed by evidence-based medicine as the most effective tool for the treatment of opioid addiction. Its implementation into high-need prison settings worldwide has been met with challenges, particularly in Eastern Europe and Central Asia where the opioid epidemic continues to expand. To address these impasses to intervention translation, we turn to post-structural approaches to policy analysis. These approaches open space for (re)thinking the ways that translated interventions emerge locally, by treating policy texts as social practices that make interventions in specific, sometimes unexpected, ways. We leverage Carol Bacchi’s post-structuralist analytic framework to interrogate how the object of methadone is constituted in Kyrgyz prisons through an analysis of the national legislative document, the “Government Program,” which provides the legislative basis for opioid addiction treatment administration in the Kyrgyz Republic. Rather than the medicalized methadone for the treatment of opioid use disorder, contained in the distinct objectivization of methadone emerging from this policy text, is the previously unexamined assumption that methadone is a particular type of governance. We describe a methadone object tied up with the shifting social structures that govern Kyrgyz prisons, divided between formal (state-run) and informal (prisoner-run) governance. In Kyrgyz prisons, where opioid policy discourse produces a divide between formal and informal governance, methadone emerges as a tool of the formal prison administration to regain control of the prisons from the practices of prisoner subculture. Although this study takes the Kyrgyz case as an example, the enactment of methadone as formal governance is likely to resonate throughout Eastern Europe and Central Asia, where there is a strong legacy of self-governing prisons. We conclude with a call for global health policymakers to consider how opioid addiction treatment is constituted within local governing relations, in ways that may depart sharply from the evidence base.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42788518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Opioid Agonist Therapy in the Post-Soviet Limbo","authors":"A. Dmitrieva, V. Stepanov, Alyona Mazhnaya","doi":"10.1177/00914509211063587","DOIUrl":"https://doi.org/10.1177/00914509211063587","url":null,"abstract":"According to Dante, “Limbo” is the first circle of Hell located at its edge. Unlike other residents of Hell, the Limbo population suffers no torment other than their lack of hope. We argue that a lack of hope in post-Soviet Ukraine is expressed by a lack of conditions for a better future since the past is overrepresented in the present. Therefore, every movement transforms under the past’s pressure, changing its course in order to reproduce and perpetuate ghosts of what is long gone. We argue that the current state of Ukraine can be framed as “post-Soviet limbo.” If the great stability of the Soviet regime was a result of overregulation and extensive control, or of “uncertainty avoidance,” then a post-Soviet limbo is a result of “managing uncertainty” simultaneously influenced by Soviet legacies and neoliberal promises of growth, calculability, and deregulation on the part of the State. “Soviet legacies” are dominant and represent a mix of formal overregulation explicitly presented through laws and policies and informality which, according to some authors, became even more widespread in the post-Soviet period than it used to be under the Soviet rule. We do not aim to consider the past legacies as being opposite to neoliberal features and futures, but negotiate the way the two are interrelated and mutually reinforced in the present to produce the post-Soviet limbo. Ukraine’s performance of Opioid Agonist Therapy (OAT) coverage is consistently estimated as insufficient and needing further improvement. However, we argue that that there are two modes of OAT implementation in Ukraine: state-funded (formal) and privately-funded (informal). The latter’s size does not fall into official estimates since the national reports on OAT performance never include the numbers of patients involved in informal treatment. We suggest, that the informal mode of OAT implementation appeared as a result of contrasting efforts towards intensive regulation and extensive growth. To understand how these two modes are produced in the context of post-Soviet narcology, how they differ and where their paths cross, we analyze two types of texts: legal and policy documents regulating substance use disorder (SUD) treatment, mainly OAT; and qualitative data, including interviews with OAT patients and field notes reflecting the environment of OAT programs. Finally, the presented article seeks to answer how the state’s contrasting efforts to manage the uncertainty of SUD treatment through OAT regulation and implementation reproduce the post-Soviet limbo and, thus, people with SUD as “patients of the state” who are frozen in a hopeless wait for changes.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47946186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enacting Safety and Omitting Gender: Australian Human Rights Scrutiny Processes Concerning Alcohol and Other Drug Laws","authors":"Kate Seear, S. Mulcahy","doi":"10.1177/00914509211065141","DOIUrl":"https://doi.org/10.1177/00914509211065141","url":null,"abstract":"Global momentum for drug law reform is building. But how might such reform be achieved? Many argue that human rights offer a possible normative framework for guiding such reform. There has been very little research on whether human rights processes can actually achieve such aims, however. This paper responds to this knowledge gap. It explores how one human rights mechanism—the “parliamentary rights scrutiny process”—deals with alcohol and other drugs. We consider how four Australian parliaments scrutinized proposed new laws that would deal with alcohol and other drugs for their human rights “compatibility.” We find that laws that would limit the rights of people who use alcohol and other drugs were routinely seen as justifiable on the basis that alcohol and other drugs were inherently “unsafe.” Crucially, safety was conceptualized in a gender-neutral way, without regard to the potential role of gender, including specific masculinities, in the production of phenomena such as family violence and sexual violence and other public safety problems. Instead, such problems were regularly constituted as consequences, simply, of alcohol or other drug consumption. In making this argument, we build on the pioneering work of David Moore and colleagues (e.g., 2020). Their work asks important questions about how the causes of violence are constituted across different settings, including research and policy. Drawing on ideas from scholars such as Carol Bacchi and John Law, they identify “gendering practices” and “collateral realities” in research and policy on violence, in which the role of men and masculinities are routinely obscured, displaced or rendered invisible. We find similar problems underway within human rights law. In highlighting these gendering practices and collateral realities, we aim to draw attention to the limitations of some human rights processes and the need for more work in this area.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42947892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trade-offs in Substitution Treatment: A Qualitative Study of an Opioid Substitution Therapy Clinic as an Enabling and a Risk-Environment","authors":"J. Jakobsen, Malene Lindgaard Kloster, Louise Christensen, K. Johansen, N. Kappel, Mette Kronbæk, K. Fahnøe, Esben Houborg","doi":"10.1177/00914509211058988","DOIUrl":"https://doi.org/10.1177/00914509211058988","url":null,"abstract":"This article present results from a study of clients experiences of attending a substitution treatment clinic in Copenhagen, Denmark. The study is part of a research project about the everyday lives of marginalized drug users in Copenhagen, their risk environments and their access to formal and informal resources. Thirty-eight clients participated in structured interviews, covering topics concerning, drug use, income, housing, social relations, violence, use of health and social services. A risk environment/enabling environment framework was developed to analyze the data. The research shows that the methadone clinic give the clients access to different material, social and affective resources, but that access to resources often involve different trade-offs. Such trade-offs include accepting control or socializing with drug users to get access to substitution medicine. Some clients accept such trade-offs, others do not and choose find other ways to get resources, exposing themselves to potential harm. This means that the clinic can function as an enabling, constraining and a risky environment for different clients.","PeriodicalId":35813,"journal":{"name":"Contemporary Drug Problems","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44557413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}