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There has been recent UK media attention on the global impact of the cocaine trade and the morality of personal use of cocaine powder. In this study we investigated whether people who use cocaine engage in moral disengagement (MD) strategies to reduce anticipated guilt associated with use. Participants read text describing the impact of the global cocaine market on others and completed a range of measures including assessments of substance use, MD, anticipated guilt, internalised moral identity, and empathy. We hypothesised that cocaine-related MD would positively predict cocaine use, and this would be partly mediated by anticipated guilt. Complete data were obtained from 254 participants through an anonymous cross-sectional survey (59.8% Female; mean age 30.8 ± 12.6 years). Our hypotheses were supported; (i) MD predicted cocaine use positively and anticipated guilt negatively; (ii) anticipated guilt negatively predicted cocaine use; anticipated guilt partially mediated the relationship between MD and cocaine use. People who use powder cocaine may use MD to reduce the anticipated guilt associated with knowledge of the harms associated with the drugs trade. Campaigns that focus on the morality of cocaine use or ethical choices may therefore have limited impact unless MD is challenged as part of these campaigns. [ABSTRACT FROM AUTHOR]

• UK law changed in 2018 to permit cannabis prescribing. Cannabis remains otherwise criminalised. Participants experienced benefits from cannabis across a broad range of conditions. • Most people who need a cannabis prescription in the UK still cannot access one. • Poor implementation of cannabis prescribing policy creates heath inequalities. • Intractable prohibition policy context continues to create social harms. This paper reports on the first qualitative study to interview people prescribed cannabis in the UK. Cannabis is a class B controlled substance under the 1971 Misuse of Drugs (MoD) Act, but a 2018 change to UK regulations provided for the prescription of cannabis for medical purposes. Relatively few people have been able to access a prescription, despite this policy change. This paper examines their experiences. Qualitative, semi-structured interviews were conducted with 24 people with a prescription for cannabis, or their carers. Data was analysed using a reflextive thematic analysis approach. The findings are discussed using a zemiology (social harms) perspective which provides a language for critical reflection on the current cannabis policy context. All participants reported that cannabis had significantly improved their mental and/or physical health, across a broad range of conditions. Many had been able to reduce their use of conventional medicines and reported that cannabis had relatively few side effects. Despite the potentially life-enhancing benefits of cannabis medicine, patients in the UK face multiple barriers to access. These include a lack of funding streams, bureaucratic supply problems, and a lack of training for doctors and police. Even for the few people able to obtain a prescription, the ongoing criminalisation of cannabis in the UK contributed to their experiences of stigmatisation. This often made it difficult and anxiety-inducing to take their medicine in public spaces. The UK government's lack of implementation of medical cannabis legalisation, combined with their ongoing prohibition position, is producing multiple harms to people who need cannabis medicine. The policy context is perpetuating stigmatising attitudes to cannabis which, as we demonstrate, contribute to social harms. We make recommendations on equality of patient access, and highlight the importance of education and policy change as means of combatting stigma. [ABSTRACT FROM AUTHOR]

Background: Little is known about the knowledge and use of technology-based interventions (TBIs) by health personnel working in the addiction field across Europe. Methods: An online questionnaire was designed using SurveyMonkey® in order to determine the level of knowledge, use and perceived efficacy of TBIs in substance use disorders (SUDs), among health professionals across six EU Member States: Germany, Italy, UK, France, Poland and the Netherlands. The survey was sent to a convenience sample of 1200 addiction experts. Results: Surveyed participants (311, response rate 26%), had a mean professional addiction experience of 17 years; 23% stated to have good knowledge of TBIs, while 12% use them in their clinical practice. Forty-six percent consider TBIs useful in the treatment of addiction, and 44% foresee a significant increase of them in the future. TBIs were considered important for people facing barriers to accessing treatment (63%) and for providing support outside the formal care settings (60%). Lack of technical support (48%), poor infrastructure and equipment (42%), and lack of digital literacy among health workers (38%) were identified as the main obstacles in the diffusion of TBIs. Conclusions: Knowledge and utilisation of TBIs among health workers in drug addiction field is low. Nevertheless, TBIs are perceived as a possible means of facilitation in providing access to treatment, and as therapeutic tools which will become more important in the future. The need to improve training policies, awareness and attitudes towards TBIs among EU health professionals, working in the field of addiction is paramount. [ABSTRACT FROM AUTHOR]

Introduction: The rapid rise in trade and use of NPS and the lack of information concerning their potential toxicity pose serious challenges to public health authorities across the world. Policy measures towards NPS taken so far have a special focus on their legal status, while the implementation of a public health strategy seems to be still missing. The aim of this study is to perform a general assessment of NPS-related policy (including regulatory measures and public health strategies) implemented by six European countries: Portugal, the Netherlands, Czech Republic, Poland, the United Kingdom and Sweden. Methods: Six EU countries were included in this scoping review study. Drug policies (including legal responses and public health strategies) were analysed. UNODC drug policy classification system was used as a benchmark, while path dependency approach was used for data analysis; a net of inter-dependencies between international, EU and national policies was highlighted. Results and discussion: The countries included in this study can be placed in a wide spectrum according to their formulation of drug policy, from Portugal and the UK that have specific legal responses to NPS but have differently focused on harm reduction strategies at one end, to Sweden whose drug-free society goal is not translated into a specific regulation of NPS at the other end. Conclusion: The findings of the study reveal limited development towards harmonisation of national drug policies–particularly with regard to NPS. To tackle the challenge presented by NPS, EU Member states have formulated legislation and public health strategies independently. National approaches to NPS are therefore in line with their already existing drug policies, reflecting cultural values towards substance abuse and national political interests, while the homogenization at an international level has so far mostly been focused on law enforcement and drugs use preventive strategies. [ABSTRACT FROM AUTHOR]

Background: With drug-related deaths at record levels in the UK, the government faces two potential sources of pressure to implement more effective policies. One source is the individuals and families who are most likely to suffer from such deaths; i.e. working class people living in de-industrialised areas. The other source is experts who argue for different policy on the basis of research evidences.Aim: This article aims to explain why, in the face of these two potential sources of pressure, the UK government has not implemented effective measures to reduce deaths.Method: The article uses critical realist discourse analysis of official documents and ministerial speeches on recent British drug policy (2016-2018). It explore this discourse through the theoretical lens of Archer's (2000) ideas on 'being human' and by drawing on Sayer's (2005) work on the 'moral significance of class'.Results: Members of economically 'residual' groups (including working class people who use heroin) are excluded from articulating their interests in 'late welfare capitalism' in a project of depersonalising 'class contempt' through which politicians cast the people most likely to die as passive, 'vulnerable' 'abjects'. Conservative politicians dismiss 'evidence-based' ideas on the reduction of drug-related death through a 'moral sidestep'. They defend policy on the basis of its relevance to conservative moral principles, not effectiveness. This is consistent with the broader moral and political pursuit of partial state shrinkage which Conservative politicians and the social groups they represent have pursued since the 1970s. [ABSTRACT FROM AUTHOR]

Jalal et al. discovered that between 1979 and 2020 total rates and counts of fatal drug overdoses in the United States exhibited exponential growth at a very steady rate even though deaths from individual drugs did not. That is a startling result because it means that the different drugs are in effect "taking turns", with one growing faster just as another drug's death rate growth ebbs. That raises the question of whether this steadiness in the all-drug death rates is in some sense just a coincidence peculiar to the United States or whether it might reflect some more general phenomenon and so manifest in other countries. We fit the same model used by Jalal et al. to data on drug-related death rates for the countries of the United Kingdom. The main finding is largely a failure to replicate the United States result. Simple graphical display of the trends and a number of statistical measures show that the growth in the United Kingdom was not only slower than in the United States, it was also less steady, with the exception of Northern Ireland. Steady exponential growth in the all-drugs mortality rate may be a phenomenon specific to certain contexts. It remains an open question whether the explanation of steady exponential growth in the United States and Northern Ireland relates to demand and supply mechanisms, to social and political conditions, or to coincidence. [ABSTRACT FROM AUTHOR]

The history of opiate treatment in the United Kingdom (UK) since the early 1980s is a rich source of learning about the benefits and pitfalls of drug treatment policy. We present five possible lessons to be learnt about how factors outside the clinic, including government, charities and researchers can influence treatment and outcomes. First, do not let a crisis go to waste. The philosophical shift from abstinence to harm reduction in the 1980s, in response to an HIV outbreak in injecting users, facilitated expansion in addiction services and made a harm reduction approach more acceptable. Second, studies of drug-related deaths can lead to advances in care. By elucidating the pattern of mortality, and designing interventions to address the causes, researchers have improved patient safety in certain contexts, though significant investment in Scotland has not arrested rising mortality. Third, collection of longitudinal data and its use to inform clinical guidelines, as pursued from the mid-1990s, can form an enduring evidence base and shape policy, sometimes in unintended ways. Fourth, beware of the presentation of harm reduction and recovery as in conflict. At the least, this reduces patient choice, and at worst, it has caused some services to be redesigned in a manner that jeopardises patient safety. Fifth, the relationship between the third and state sectors must be carefully nurtured. In the UK, early collaboration has been replaced by competition, driven by changes in funding, to the detriment of service provision. [ABSTRACT FROM AUTHOR]

Introduction: International drug policy has traditionally been based on the premise that illegal drugs are more harmful than legal substances. Here, we investigate how students in the UK and Norway now perceive possible harms related to tobacco and alcohol—which are legal—and cannabis—which is illegal. Methods: Social science undergraduates at a university in the UK (n = 473) and Norway (n = 472) completed an anonymous survey. They were asked to rate the harms of tobacco, alcohol, and cannabis across five domains: (i) physical harms, (ii) mental health conditions, (iii) dependence, (iv) injuries, and (v) social consequences. Bivariate and multivariate analyses were used to compare the relative harms of the three substances across all the domains as well as possible differences between participants from the UK and Norway. Results: Tobacco was rated as most harmful with regard to physical harm and dependence; alcohol was rated as most harmful with regard to injuries and social consequences, while cannabis was rated as most harmful with regard to mental health. The total harms scores for alcohol were highest, slightly above those of cannabis. British students reported higher tobacco and alcohol harm scores than Norwegian students, while the opposite pattern was true for cannabis. Conclusions: The legal substance alcohol was rated by students as more harmful than the illegal substance cannabis. The findings may imply that young people in the years to come may be less supportive of a traditional drug policy based on criminalization, at least when it comes to cannabis. At the same time, one may hypothesize that liberal alcohol policies may receive little support, given students’ perception of the possible harms associated with alcohol. [ABSTRACT FROM AUTHOR]

This paper reimagines drug policy--specifically psychedelic drug policy--through the prism of human rights. Challenges to the incumbent prohibitionist paradigm that have been brought from this perspective to date--namely by calling for exemptions from criminalisation on therapeutic or religious grounds--are considered, before the assertion is made that there is a need to go beyond such reified constructs, calling for an end to psychedelic drug prohibitions on the basis of the more fundamental right to cognitive liberty. This central concept is explicated, asserted as being a crucial component of freedom of thought, as enshrined within Article 9 of the European Convention on Human Rights (ECHR). It is argued that the right to cognitive liberty is routinely breached by the existence of the system of drug prohibition in the United Kingdom (UK), as encoded within the Misuse of Drugs Act 1971 (MDA). On this basis, it is proposed that Article 9 could be wielded to challenge the prohibitive system in the courts. This legal argument is supported by a parallel and entwined argument grounded in the political philosophy of classical liberalism: namely, that the state should only deploy the criminal law where an individual's actions demonstrably run a high risk of causing harm to others. Beyond the courts, it is recommended that this liberal, rights-based approach also inform psychedelic drug policy activism, moving past the current predominant focus on harm reduction, towards a prioritization of benefit maximization. How this might translate in to a different regulatory model for psychedelic drugs, a third way, distinct from the traditional criminal and medical systems of control, is tentatively considered. However, given the dominant political climate in the UK--with its move away from rights and towards a more authoritarian drug policy--the possibility that it is only through underground movements that cognitive liberty will be assured in the foreseeable future is contemplated. [ABSTRACT FROM AUTHOR]

The notion of ‘recovery’ as an overarching approach to drug policy remains controversial. This cross-national analysis considers how the problem of drugs was constructed and represented in two key reports on the place of ‘recovery’ in drug policy, critically examining how the problem of drugs (and the people who use them) are constituted in recovery discourse, and how these problematisations are shaped and disseminated. Bacchi's poststructuralist approach is applied to two documents (one in Britain and one in Australia) to analyse how the ‘problem of drugs’ and the people who use them are constituted: as problematic users, constraining alternative understandings of the shifting nature of drug use; as responsibilised individuals (in Britain) and as patients (in Australia); as worthy of citizenship in the context of treatment and recovery, silencing the assumption of unworthiness and the loss of rights for those who continue to use drugs in ‘problematic’ ways. The position of the organisations which produced the reports is considered, with the authority of both organisations resting on their status as independent, apolitical bodies providing ‘evidence-based’ advice. There is a need to carefully weigh up the desirable and undesirable political effects of these constructions. The meaning of ‘recovery’ and how it could be realised in policy and practice is still being negotiated. By comparatively analysing how the problem of drugs was produced in ‘recovery’ discourse in two jurisdictions, at two specific points in the policy debate, we are reminded that ways of thinking about ‘problems’ reflect specific contexts, and how we are invoked to think about policy responses will be dependent upon these conditions. As ‘recovery’ continues to evolve, opening up spaces to discuss its contested meanings and effects will be an ongoing endeavour. [ABSTRACT FROM AUTHOR]

Based on documentary analyses and interviews with twenty key informants in 2012, this paper analyses the shift in British drugs policy towards 'recovery' from the perspectives of major stakeholders. The processes involved in reopening the debate surrounding the role of substitution treatment and its re-emergence on to the policy agenda are examined. Drawing on Kingdon's work on agenda-setting, the ways in which methadone maintenance was challenged and defended by key stakeholders in the initial phase of policy development and the negotiation of a 'recovery' focus as the organizing concept for British drugs policy are explored. Study limitations are noted. [ABSTRACT FROM AUTHOR]

During the last 5 years, there has been an important shift in the policy discourse around drugs issues. This article reviews the key changes and continuities in British drugs policy since the mid 1990s. It examines the crime reduction focus of the previous Labour government and the processes by which the recovery discourse came to dominate the current policy framework under the coalition government in 2010. The shifts in policy and practice will be explored in relation to how the drugs problem was framed and reframed over time and how shifts within the wider social, political, and economic contexts have impacted these developments. It is argued that although the moves toward a recovery-based policy represent significant changes, there are powerful continuities and remnants of previous policies and structures, which have endured and set the parameters for the current policy framework, particularly in relation to crime reduction priorities. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Decisions on whether and how to 'schedule' drugs (i.e. to determine their legal status and penalties to be applied for sale or possession) are often heavily criticized. We sought to assess more comprehensively the results of such decisions for newly emerging drugs. Methods Through analysis of legislation and secondary sources, we identified 63 substances that have emerged since 1971, including all that have been added to the most restrictive schedule by the United Nations, United States, United Kingdom, Canada, Australia and/or New Zealand. Measurements For each jurisdiction we recorded whether, when, and how the substance was scheduled and note what decisions engendered substantial criticism or controversy within the international treaties' framework of balancing medical benefits with risk of abuse. Findings (i) The rate of emergence of new drugs has been fairly steady. (ii) There is broad cross-national agreement on what should be scheduled. (iii) The United States often acts first. (iv) Temporary bans that delay final decisions by 12-18 months can sometimes allow final decisions to be grounded on a substantially expanded research base. (v) It appears that no more than seven of the decisions reached by the United States with respect to the 63 substances are candidates for being considered errors, and arguably the United States has committed at most one serious Type I and one serious Type II error. Results for other countries are broadly similar. Conclusions The process for determining the legal status of new psychoactive substances appears to function reasonably well, within the framework of international treaty obligations. Most criticisms relate to one or a few substances (e.g. 3,4-methylenedioxymethamphetamine) and/or complaints that the decisions discount benefits that are not recognized by the treaties (e.g. recreational or religious use). [ABSTRACT FROM AUTHOR]

In this paper we discuss the relative physical, psychological and social harms of the two most frequently used intoxicant drugs in the UK, namely cannabis and alcohol. Over the past 40 years, the use of both drugs has risen significantly with differential consequences. It is argued that increased policing of cannabis use under the current drug classification system will lead to increased criminalization of young people, but is unlikely to significantly reduce the rates of schizophrenia and psychosis. In comparison, increases in alcohol drinking are related to significant increases in liver cirrhosis hospital admissions and mortality, at a time when mortality rates from other major causes are on the decline. A recent expert-led comparison of the health and social harms to the user and to others caused by the most commonly used drugs in the UK showed alcohol to be more than twice as harmful as cannabis to users, and five times as harmful as cannabis to others. The findings underline the need for a coherent, evidence-based drugs policy that enables individuals to make informed decisions about the consequences of their drug use. [ABSTRACT FROM PUBLISHER]

In 1997 New Labour came to power with a landslide victory. This period also marked a watershed for illicit drug use which had become so widespread across the UK that it was regarded as a mainstream adolescent experience. However, broadly speaking there were two groups of drug users: one group of young people who selectively used drugs on a recreational and largely non-problematic basis; while another group (usually unemployed and socially excluded),who used whatever drugs they could find in a chaotic and problematic manner. Drug taking had become a nor- malized activity and criminalization of these drugs seemed unenforceable, out of touch and inappropriate. Inheriting an unworkable 1971 Misuse of Drugs Act 1997 seemed an opportune time for the New Labour government to deliver on its 'promise of change' and introduce drug legislation fit for the new millennium. This article reflects upon some of the key policy and legal changes introduced by the New Labour government (1997-2010) to manage drug use and misuse. [ABSTRACT FROM AUTHOR]

Abstract: One of the challenges for drug policy research is being able to compare policy options and outcomes. The development of indexes, such as the UK Drug Harm Index or the UNODC Illicit Drug Index is a way to systematically enable such comparisons. An Index is a single common metric that represents the diverse outcomes or consequences of drug use. An Index may be used for performance monitoring within one country/region over time; to establish societal benefit of drug policies as expressed in social costs saved; to compare countries or regions; or for comparative policy analysis. Clarity of purpose is important in how an Index is used. The consequences or outcomes that can be combined into a single Index include health consequences, crime consequences, public amenity, pain and suffering, labour market outcomes, and drug manufacture and trafficking activity. The choice of outcomes for inclusion is driven by the purpose but also often by practical considerations, such as data availability. The weighting of the consequences is an important consideration in translating the outcomes into a common metric. A monetary unit has a number of advantages: it is a unit that can be measured across diverse impacts; it gives implicit “weighting” of harms; and it is intuitive for policy makers and community. On the other hand, it represents an economic perspective. No one Index will be regarded as suitable and appropriate by every stakeholder and ongoing research effort on Indexes is an important foundational research activity to advance illicit drug policy. [Copyright &y& Elsevier]

A typology of drug smuggling 'technologies' is developed based on interviews with 110 inmates incarcerated in UK prisons for importing illegal drugs. Approximately three-quarters were involved in courier-based operations. The other 30 collectively accounted for substantially greater smuggling throughput capacity and fell into five groups: operations employing 'bent' lorry drivers; shipping drugs intermingled with legitimate commerce; transporting drugs on commercial airlines with assistance from corrupt officials; mailing drugs into the UK; and smuggling via boats landing between ports of entry. A Pareto Law seems to apply, with a minority of respondents being responsible for the majority of the smuggling. Most participated in smuggling to make money, but more than a few couriers reported being coerced and/or tricked into carrying drugs. Perhaps not coincidentally, rough calculations suggest that, when balancing profits against prison risk, crime does not pay for couriers but can for organizations employing bent lorry drivers. [ABSTRACT FROM AUTHOR]

The fundamental activity of most drug dealers is buying drugs from a supplier and selling them on, usually in smaller lot sizes to multiple customers at a lower market level. Data on such 'cycles' of purchase and resale are derived from interviews with 65 dealers incarcerated in UK prisons. A power function relationship between price and transaction size is confirmed. Analyses reveal great consistency in proportional price markups across drugs and time, high cycle frequencies (typically weekly or more often) and importers who vertically integrate into the highest level of domestic distribution, so that an important share of their net revenues effectively derives from domestic distribution inside the UK, as opposed to importation per se. [ABSTRACT FROM AUTHOR]

The article discusses which evaluated the basis of drugs policy in Great Britain. In this study, social and medical sciences, official documents, and websites have been reviewed to re-evaluate drugs policy. Results of study showed the need to clearly define drugs problem and that the misinformation about illegal drugs has created public fear and questionable basis for public policy. Opinion on drugs/crime relationship is also cited.

The introduction of concept-based therapeutic communities, based upon the model pioneered by Charles Dederich with the Synanon community in California, was a significant development in the evolution of drug treatment provision in the UK. For a short period in the 1970s, these communities enjoyed unparalleled influence in the development and direction of treatment approaches across the whole spectrum of services. This article considers the developments in psychiatry and social care that prepared the ground for that phenomenon. In addition, the article considers the subsequent demise in the importance of therapeutic communities to the direction of drug policy and the implications that this might have for future development of residential treatment services. [ABSTRACT FROM AUTHOR]

Abstract This article presents a review of evaluations of community-backed initiatives for drug users in the UK. Community-backed responses have taken a number of approaches. Despite accessing over 250 publications relating to initiatives in the course of this study, a paucity of published evaluative evidence on ‘what works?’ and ‘why does it work?’ was apparent. The readily accessible literature is examined under five broad types of initiative: self-help groups, parents’ groups, residents’ groups, community development groups and diversionary activity groups. In a further commentary on evaluation issues for such drug initiatives, it is argued that they are under-evaluated, partly because they are on the margins of drug services and partly because of a lacuna of support in evaluation skills. [ABSTRACT FROM AUTHOR]

The 2019 novel coronavirus (COVID-19) pandemic has placed a significant strain on hepatitis programs and interventions (screening, diagnosis, and treatment) at a critical moment in the context of hepatitis C virus (HCV) elimination. We sought to quantify changes in Direct Acting Antiviral (DAA) utilization among different countries during the pandemic. We conducted a cross-sectional time series analysis between 1 September 2018 and 31 August 2020, using the IQVIA MIDAS database, which contains DAA purchase data for 54 countries. We examined the percent change in DAA units dispensed (e.g., pills and capsules) from March to August 2019 to the same period of time in 2020 across the 54 countries. Interrupted time-series analysis was used to examine the impact of COVID-19 on monthly rates of DAA utilization across each of the major developed economies (G7 nations). Overall, 46 of 54 (85%) jurisdictions experienced a decline in DAA utilization during the pandemic, with an average of -43% (range: -1% in Finland to -93% in Brazil). All high HCV prevalence (HCV prevalence > 2%) countries in the database experienced a decline in utilization, average -49% (range: -17% in Kazakhstan to -90% in Egypt). Across the G7 nations, we also observed a decreased trend in DAA utilization during the early months of the pandemic, with significant declines ( p < 0.01) for Canada, Germany, the United Kingdom, and the United States of America. The global response to COVID-19 led to a large decrease in DAA utilization globally. Deliberate efforts to counteract the impact of COVID-19 on treatment delivery are needed to support the goal of HCV elimination.

Background: There is evidence to suggest that medically supervised drug consumption rooms (DCRs) may form part of responses to reduce drug-related harm. Although DCRs have been established globally, they are perceived by some to be a controversial approach in the UK, and Government has repeatedly rejected proposals to establish one in Glasgow, Scotland. As public support is an important component of policy development and enactment, we sought to investigate the effects of different types of message framing on public support for DCR., Methods: We undertook a cross-sectional online study with a randomised design, conducted with a nationally representative sample. Participants were randomised to one of six message conditions comprising combinations of four components. All conditions included i) a basic description of a DCR, and conditions included combinations of ii) factual information; iii) pre-emptive refutation of common public concerns about DCR; and/or iv) a sympathetic narrative describing a mother whose son died from a heroin overdose. After reading each message, participants completed a bespoke measure assessing support for DCR. Data were analysed using ANCOVA., Results: Complete data were obtained from 1591 participants (50.3% Female; mean age 44.9 ± 16.1 years). Compared to reading a basic description of DCR alone, there was greater support for DCR in participants receiving the refutation (p < .001); sympathetic + factual (p < .05); and sympathetic + factual + refutation (p < .001) message conditions. Presenting factual or sympathetic messages alone were not associated with increased support., Conclusion: Our findings suggest that public support for DCRs is not improved through communication of factual statements outlining potential benefits of the intervention alone. Advocates seeking to foster public support, and thus influence policy making, should also consider communication campaigns that address common concerns that the public might have about DCRs, and present the intervention in relation to potential benefits that they hold for people indirectly affected by drug-related harm., Competing Interests: Declaration of Competing Interest None, (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: The decision by the UK government to leave the European Union comes at a time when parts of the UK are experiencing a marked rise in reported gun and knife crimes. The health effects of Brexit will have serious consequences as to how the UK tackles this upsurge in drug-related crime., Health Policy Processes: The UK's future participation with the EU's specialised agencies will depend on the detail of any agreement reached on future collaboration with the EU and its drug agency, the EMCDDA., Context: The EMCDDA provides the EU and its Member States with a factual overview of European drug problems and a solid evidence base to support debates on drugs policies. It also supports early warning initiatives and coordinates measures at national and supranational levels with Europol and supranational enforcement agencies., Expected Outcomes: While these arrangements might continue throughout any transition period, those working within the sector require guidance and assurances from the British government about its long-term intentions after any transition., Conclusions: The scale of collaboration between the UK and European institutions is extensive. It is not clear how this might be replicated after Brexit. Yet an alternative framework of collaboration between the UK and the EU is clearly needed to facilitate shared and agreed approaches to data sharing and drug surveillance after Brexit., (Copyright © 2019 The Author(s). Published by Elsevier B.V. All rights reserved.)

In this article the author discusses the requirements for effective performance contracting to enhance the effectiveness of substance use treatment. He says that the desired result of such move should be observable, valuable to the purchaser, and as a result of behaviors by the treatment program. He emphasizes that the desired result should be associated in time to a reward that is large enough to change the contingent behavior. He stresses that both requirements are often ignored.

In this article the author enumerates the Implicit Rules of Evidence-Based Drug Policy identified in the article of J. Mcleod and M. Hickman on how Great Britain has reclassified cannabis. Also investigated is the possibility that rescheduling cannabis is sending a wrong message that encourages more use by implying a lack of firm resolve. He states that both authors can offer casual assessment of drug policy after caefully documenting the uncertainties behind cannabis-schizophrenia association.

Background: Recent decades have seen substantial changes in the UK cannabis landscape, including increased domestic production, the ascendancy of stronger strains (namely 'skunk') and the drug's reclassification under the 1971 Misuse of Drugs Act. Resultantly, cannabis retains significance in the consciousness, priorities and policy agendas of communities, drug services and criminal justice agencies., Methods: This paper presents an empirical study, which examined both perceptions and impacts of cannabis cultivation and its control within a North-West English borough. It draws on qualitative research with samples of professionals, practitioners, resident groups, cannabis users, cannabis users' families and cannabis cultivators themselves., Findings: The findings suggest that cannabis cultivation was not a uniformly familiar concept to respondents, who had limited knowledge and experience of its production. Across all participant groups, the transmission of accurate information was lacking, with individuals instead drawing on the reductionist drug discourse (Taylor, 2016) to fill knowledge deficits. Consequently, some participants conflated cannabis cultivation with wider prohibitionist constructions of drug markets, resulting in the diffusion of misinformation and an amplification of anxieties. In contrast, other participants construed cultivation as making economic sense during austerity, justifying such tolerance through inverse adherence to the same narrow socio-cultural construction of drugs i.e. that cultivation carried comparatively less harms than real drug markets. Enforcement mechanisms also drew on generic prohibitionist conceptions, assuming cultivators to be unconstrained, autonomous actors in need of punishment; a belief which lacked nuanced understanding of the local terrain where vulnerable individuals cultivating under duress played a key role in the supply chain., Conclusion: The paper concludes with a call for the provision of accessible information/education; the need to challenge and reconceptualise the assumed autonomy and resultant punity directed at all cannabis cultivators; and a subsequent need to reassess established forms of legal (and increasingly social) enforcement., (Copyright © 2017 Elsevier B.V. All rights reserved.)

In this article the author presents his views regarding the commentary of H. Kalant about the drugs classification of Great Britain along with science and politics. He agrees that the drug classification is neither science nor politics, in which unregulated drug and alcohol use produce greater harms and problems against the principles of regulating human behavior. He critically marks that science can be the prime mediator of drug policy if only if the harms caused by the drugs are minimized.

Objective: Analysis of the policy response by Australia's National Drugs and Poisons Schedule Committee (NDPSC) and comparison with recommendations by expert advisory committees in New Zealand and the United Kingdom., Methods: Analysis of public policy documents of relevant regulatory authorities was conducted. Data were extracted regarding changes to over-the-counter (OTC) codeine analgesic scheduling, indications, maximum unit dose, maximum daily dose, maximum pack size, warning labels, consumer medicine information and advertising. Where available, public submissions and other issues considered by the committees and rationale for their recommendations were recorded and thematically analysed., Results: Expert advisory committees in Australia, NZ and the UK defined the policy problem of OTC codeine misuse and harm as small relative to total use and responded by restricting availability. Pharmacist supervision was required at the point-of-sale and pack sizes were reduced to short-term use., Conclusions: Comparison with recommendations by expert advisory committees in NZ and the UK suggests the NDPSC's actions in response to OTC codeine misuse were appropriate given the available evidence of misuse and harm, but highlights opportunities to utilise additional regulatory levers., Implications: Framing policy problems as matters of public health in the context of limited evidence may support decision makers to implement cautionary incremental policy change., (© 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.)