Drug science, policy and law最新文献

{"title":"Does the co-use of cannabis exacerbate the effect of alcohol on the risk of crashing? A systematic review and meta-analysis","authors":"M. White, N. Burns","doi":"10.1177/20503245231177334","DOIUrl":"https://doi.org/10.1177/20503245231177334","url":null,"abstract":"This is the second of two closely related systematic literature reviews with meta-analyses by the same authors. The first concluded that there is no convincing epidemiological evidence that the prior use of cannabis (as indicated by the presence of THC in a body fluid) directly increases the risk of crashing. The purpose of this second review is to consider the possibility that the co-use of cannabis indirectly increases the risk of crashing by exacerbating the effect of alcohol on the risk of crashing. The starting point for both reviews is a systematic literature search that identifies seventeen epidemiological studies of the relationship between the prior use of cannabis and the risk of crashing. Twelve of those studies also investigated the joint effects of cannabis and alcohol on the risk of crashing. Although the authors of some studies claimed to have found an exacerbation (or equivalent) effect, the results of a meta-analysis of exacerbation odds ratios failed to support the claim. It is concluded that there is no credible evidence from the twelve epidemiological studies that the co-use of cannabis exacerbates the effect of alcohol on the risk of crashing.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75189948","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":"Impact of the introduction of medical cannabis in the UK on risk perception and recreational use of cannabis: A longitudinal and cross-sectional analysis","authors":"Jon Waldron, M. Grabski, T. Freeman, M. V. van Laar, H. Curran","doi":"10.1177/20503245231168392","DOIUrl":"https://doi.org/10.1177/20503245231168392","url":null,"abstract":"Cannabis was rescheduled in the UK in November 2018 so that it can now be prescribed as a treatment for certain medical conditions. It is not yet known whether this has had an impact on peoples’ perception of its risk or on their recreational use of cannabis. This study used data from longitudinal and cross-sectional components of an online survey investigating drug use and nightlife behaviours, comparing data before and after rescheduling of cannabis in November 2018. Participants’ awareness of the change in policy and its impact on cannabis use were assessed for participants in both the cross-sectional and longitudinal arms. The perception of the risk of recreational cannabis use, past 12-month use and use frequency were assessed pre- and post-policy change among the longitudinal sample. 414 longitudinal (57.3% response rate) and 2001 cross-sectional participants completed the online survey, resulting in a total sample size of 2415. Just over half the sample (53.5%) were aware of the change in policy to allow for the medical provision of cannabis, with almost 90% saying this would have no impact on their recreational and approximately 80% no impact on their medical use of cannabis, irrespective of prior awareness. No significant differences were found with respect to risk perception, past 12-month cannabis use, or use frequency pre- and post-policy change among the longitudinal sample. The change in UK policy to allow for the medical provision of cannabis for some conditions had a limited impact on intentions to use cannabis, and was not associated with longitudinal changes in risk perception or temporal use patterns.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87287634","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":"Medication sparing after medical cannabis initiation: A case study of a chronic pain patient in Project Twenty21","authors":"Peter Sunderland, D. Nutt, A. Schlag","doi":"10.1177/20503245231157489","DOIUrl":"https://doi.org/10.1177/20503245231157489","url":null,"abstract":"Prescribed cannabinoids are legal in the UK and are increasingly being used for a variety of conditions, with one of the most frequent conditions being chronic pain. Within this cohort, there is developing evidence that cannabis-based medicinal products are associated with opioid and other medication sparing. However, at present, the National Institute for Health and Care Excellence (NICE) does not recommend the prescription of cannabis-based medicinal products to treat chronic pain due to the lack of randomised controlled trial evidence for this condition. Here we present a case study of a 61-year-old woman with idiopathic small fibre neuropathy, who was prescribed the gabapentinoid pregabalin, in combination at different times with various other agents including amitriptyline, duloxetine, lamotrigine, meloxicam and topical capsaicin, over a 17-year period for the associated neuropathic pain. Although her pain was relatively well controlled, the patient reported hearing loss, sleepiness, tinnitus, confusion and worsening anxiety possibly as a result of prolonged pregabalin use. Efforts were made to reduce the pregabalin dose but any attempts to reduce below a total daily dose of 350 mg resulted in unacceptable pain for the patient. In 2021, the patient was enrolled in Project Twenty21, the UK's first medical cannabis registry, and prescribed full plant extract delta-9-tetrahydrocannabinol 10 mg: cannabidiol 15 mg/mL of oil, prescribed at a dose range of 0.1–0.5 mL twice daily. As a result, the patient managed to reduce her pregabalin down to 37.5 mg total daily dose. The patient now feels she has ‘been given a second chance at life’ and her husband describes her as ‘a new woman’. This patient feels that she is in a position to finally stop treatment with pregabalin, as a result of medical cannabis controlling her pain. Highlighting the potential benefits of cannabis-based medicinal products to treat chronic pain, our case study indicates the value of including real-world evidence when assessing the benefits and safety of cannabis-based medicinal products.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81038016","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":"Medicinal cannabis for pain: Real-world data on three-month changes in symptoms and quality of life","authors":"Kylie O’Brien, Justin Beilby, Michelle Frans, M. Lynskey, M. Barnes, Mihindu Jayasuriya, Alkyoni Athanasiou-Fragkouli, Philip Blair, D. Nutt","doi":"10.1177/20503245231172535","DOIUrl":"https://doi.org/10.1177/20503245231172535","url":null,"abstract":"Internationally, one of the most common conditions for which people seek medicinal cannabis (MC) is chronic pain. However, relatively little is known about the effectiveness of cannabis for reducing pain in Australia. Medicinal cannabis was made legally available in Australia in 2016. Project Twenty21 Australia is an observational study that follows patients prescribed MC for chronic pain, anxiety, PTSD and multiple sclerosis for up to 12 months. It commenced recruitment in February 2022. This paper describes some preliminary findings for a cohort of patients with chronic pain. Participants seeking treatment for chronic pain are prescribed MC from within a Project Formulary, and complete questionnaires at baseline then three monthly for up to 12 months. Pain severity and interference are assessed using the Brief Pain Index while standardised measures of quality of life, mood and sleep quality are also applied. By 30 November 2022, 55 participants with chronic pain had completed the first three-month follow-up. Patients reported a low quality of life and high levels of co-morbidity. Three-month data indicate that MC use was associated with significant reductions in self-reported pain intensity and pain interference (Effect sizes = 0.66 [95% CI = 0.34–0.98] and 0.56 [0.24–0.88], respectively). Additionally, there were significant improvements in quality of life, general health, mood/depression and sleep (Effect sizes = 0.53–0.63). One adverse reaction was reported which was mild in nature. Preliminary evidence suggests that MC may be effective in reducing both pain severity and pain interference while also improving quality of life, general health, mood and sleep in patients with chronic pain. Increasing uptake of MC coupled with growing evidence of both the effectiveness and safety of these medications indicate a need both to make MC more widely available and to reduce financial costs associated with its use.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87863039","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":"Decriminalization of drug possession in Oregon: Analysis and early lessons","authors":"Kellen Russoniello, Sheila P. Vakharia, Jules Netherland, Theshia Naidoo, H. Wheelock, Tera Hurst, Saba Rouhani","doi":"10.1177/20503245231167407","DOIUrl":"https://doi.org/10.1177/20503245231167407","url":null,"abstract":"In November 2020, Oregon voters approved Measure 110, a ballot initiative that decriminalized possession of small quantities of all drugs and allocated hundreds of millions of dollars annually to health services for people who use drugs. Implementation of Measure 110 is ongoing, but several effects are noticeable in the first two years since the measure passed. Among these are substantial decreases in possession of controlled substances arrests and an infusion of funding into harm reduction services that have not traditionally enjoyed a sustainable funding source. This paper analyzes the provisions of Measure 110, examines its early impacts, successes, and challenges, and outlines lessons that jurisdictions contemplating decriminalizing drug possession in the U.S. and globally should consider.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"49 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91119152","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":"No laughing matter: The nonsense plan for placing nitrous oxide in the MDAct1971","authors":"D. Nutt","doi":"10.1177/20503245231170039","DOIUrl":"https://doi.org/10.1177/20503245231170039","url":null,"abstract":"","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77383722","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 Cathinone Hydra: Increased Cathinone and caffeine adulteration in the English MDMA market after Brexit and COVID-19 lockdowns","authors":"Pascoe Mj, Radley S, Simmons Htd, Measham F","doi":"10.1177/20503245221099209","DOIUrl":"https://doi.org/10.1177/20503245221099209","url":null,"abstract":"Adulteration poses additional unknown risks to the health of people who use illicit drugs. In this study, we sought to determine the extent and nature of adulteration of ‘MDMA’ in circulation at English summer music festivals in 2021, following Brexit, COVID-19 lockdowns and various regulatory changes overseas. At three festivals in 2019 and 2021, 1648 surrendered substances were analysed with Fourier-transform infrared spectroscopy and colourimetric reagents in a mobile laboratory as part of a harm reduction project. Form, mass, appearance and main psychoactive component were recorded. Analytical results were compared to a parallel self-report survey with 1124 attendees at the same events, as part of the annual English Festival Study. In 2019 and 2021, 417 and 377 samples strongly resembling MDMA (e.g. ecstasy tablets) were tested. Detection of MDMA in such samples decreased from 93% to 55% between the two years. Whilst virtually absent in 2019, synthetic cathinones and caffeine each constituted approximately one fifth of 2021 samples. 4-Chloromethcathinone (4-CMC), 3-methylmethcathinone (3-MMC) and N-ethylbutylone (eutylone) were the most prevalent cathinones detected. In both years, >35% of survey respondents reported use and/or intention to use MDMA on the fieldwork day; ≤1% reported cathinone or caffeine use, suggesting their consumption was predominantly unintentional. The sharp rise in synthetic cathinone prevalence in the summer 2021 UK market coincided with a unique combination of events including Brexit and the reopening of nightlife after 16 months of lockdowns, months ahead of other European nations. Echoing similar periods over the past decade, the cathinone hydra reared its head to satisfy the buoyant demand for MDMA at a time of scarcity, through substitution with substances legally obtainable in the Netherlands at the time of data collection. Alerts issued on social media led to >360,000 engagements, demonstrating extensive public engagement with illicit market monitoring and harm reduction advice.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79577391","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 United Kingdom's Psychoactive Substances Act 2016. Where are we now?","authors":"Christopher Humphries","doi":"10.1177/20503245221138735","DOIUrl":"https://doi.org/10.1177/20503245221138735","url":null,"abstract":"This narrative review describes the background to the introduction of the UK Psychoactive Substances Act 2016, and developments since the Home Office review of the Act in 2018. It discusses the challenges when measuring illicit drug proliferation, and triangulates the impact of the Act by using data from multiple public sources. It looks at both the direct impacts of the Act, and indirect impacts on other forms of drug use, and identifies the discrepancy between politically expedient legislation and real-world harm reduction.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"205 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80605494","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":"Corrigendum for The risk of being culpable for or involved in a road crash after using cannabis: A systematic review and meta-analyses","authors":"","doi":"10.1177/20503245221090014","DOIUrl":"https://doi.org/10.1177/20503245221090014","url":null,"abstract":"Jeff Brubacher was the corresponding author for one (Brubacher et al., 2019) of the 13 papers that we covered in our review of the relationship between the prior use of cannabis and the risk of being culpable for a road crash (White and Burns, 2021). Jeff identified an error in the value we selected to represent Brubacher et al’s adjusted cannabis-culpability odds ratio (OR) in our cannabis-culpability meta-analysis and meta-regression. We selected the value of 1.07 (0.98-1.20) that Brubacher et al. provided in their Table 3 for the “Model with THC in ng/ml”. Unfortunately, that value was for the slope of the (non-significant) linear relationship between the concentration of THC (in ng/ml) and the risk of being culpable for a crash, and not for the relationship of interest: the effect of the presence vs absence of THC on the risk of being culpable for a crash. Surprisingly, the value that we sought for the dichotomous cannabis variable was not provided anywhere in Brubacher et al’s paper.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76162695","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":"Farmability and pharmability: Transforming the drug market to a health-and human rights-centred approach from self-cultivation to safe supply of controlled substances","authors":"Fabian P. Steinmetz, Maja Kohek","doi":"10.1177/20503245221097797","DOIUrl":"https://doi.org/10.1177/20503245221097797","url":null,"abstract":"Background The supply chains addressing the global demand for major recreational drugs are hardly addressed due to international contracts, particularly the UN Single Convention on Narcotic Drugs. Currently applied regulatory changes have several disadvantages ranging from political tensions to the neglect of ecological aspects. The aim of this study is to show some implications associated with a transformation of the recreational drug market that is focused on self-supply of different categories of drugs. The concepts of \"farmability\", the feasibility to cultivate relevant plants and fungi, and \"pharmability\", the feasibility to refine materials to drugs by chemical synthesis, purification etc., are addressed. Methods 68 drug experts were invited to fill out an online survey on the feasibility of self-supply of different categories of drugs. The online survey was a five-point Likert scale and had seven questions. Results 26 experts (38.2%) responded to the online questionnaire. Cannabinoids were considered easy to cultivate/manufacture, depressants and psychedelics were ranked with moderate difficulty, opioids and stimulants were regarded as difficult to cultivate/manufacture, and empathogens/entactogens and dissociatives were ranked very difficult. The study found that some controlled substances, in particular cannabis, could be decriminalised without the need for a commercial market. However, some drug categories, such as dissociatives and empathogens/entactogens, would require the establishment of professional manufacturers. Psychedelics and depressants are ranked in between. Conclusion Different drugs are associated with different cultivation and/or manufacturing steps with contrasting difficulty levels. Those differences are likely to shape use prevalence to more accessible and safer drug markets which also decrease the involvement of organised crime groups. Hence, when decriminalising the possession of drugs for personal use, it is therefore recommended to allow also for personal cultivation or cultivation within social clubs. This is particularly relevant for drugs with moderate to high farmability but also if pharmability is sufficiently high.","PeriodicalId":92502,"journal":{"name":"Drug science, policy and law","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84851429","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}