Search

Povodom donošenja regulative o kanabisu u Kanadi (oktobar 2018), ovaj članak ukratko podseća na velike istorijske momente osporavanja zakona o drogama. Zapravo, druga polovina XX veka predstavljala je period delovanja tri Komisije koje su preporučile ublažavanje zakona vezanih za korišćenje kanabisa. Sa druge strane, ovaj članak predstavlja sažet prikaz regulative koja je trenutno na snazi. I na kraju, u njemu se pominju i kratkoročne posledice regulative o kanabisu u Kanadi. Mi ćemo se najviše fokusirati na kriminalitet, na cenu kanabisa i na rasprostranjenost konzumiranja.

This study identifid the most prominent risk factors associated with driving after cannabis use (DACU). 1,126 Canadian drivers (17–35 years old) who have used cannabis in the past 12 months completed an online questionnaire about sociodemographic information, substance use habits, cannabis effect expectancies, driving behaviours and peers’ behaviours and attitudes concerning DACU. A hierarchical logistic regression allowed identifying variables that were associated with DACU. Income (CA$30,000–CA$69,000), weekly-to-daily cannabis use, higher level of cannabis-related problems, expectation that cannabis facilitates social interactions, drunk driving, belief that DACU is safe, general risky driving behaviours, having a few friends who had DACU and injunctive norms predicted past 12-month DACU. Older age, holding negative expectations concerning cannabis, driving aggressively and perceived accessibility of public transportation decreased the probability of DACU. With restricted resources, programmes will be more efficient by targeting Canadian young adults most inclined to DACU by focussing on these risk factors.

Young adults that drive after cannabis use (DACU) may not share all the same characteristics. This study aimed to iden-tify typologies of Canadians who engage in DACU. About 910 cannabis users with a driver's license (17–35years old) who have engaged in DACU completed an online question-naire. Two-step cluster analysis identified four subgroups, based on driving-related behaviors, cannabis use and related problems, and psychological distress. Complementary comparative analysis among the identified subgroups was performed as external validation. The identified subgroups were: (1) frequent cannabis users who regularly DACU; (2) individuals with generalized deviance with diverse risky road behaviors and high levels of psychological distress; (3) alco-hol and drug-impaired drivers who were also heavy frequent drinkers; and (4) well-adjusted youths with mild depres-sive-anxious symptoms. Individuals who engaged in DACU were not a homogenous group. When required, prevention and treatment need to be tailored according to the different profiles.

The debate on recreational use of cannabis, recently relaunched by the election of the Liberal Party of Canada that intends to legalize and regulate its use and access, implies a better understanding of social control mechanisms that are in place, and their influence on users' behaviors.This study addresses the issue of formal and informal controls by providing, first, a theoretical perspective of this concept, and, second, by illustrating its operation from the users' perspective.Semi-structured interviews were conducted with 164 regular, adult cannabis users recruited in four large Canadian cities (Vancouver, Toronto, Montreal, and Halifax). An initial qualitative analysis based on the principles of grounded theory was conducted. The main categories identified were then used to find and re-code relevant material on the respondents' experience with formal and informal control (secondary analysis).The users' perspective shows that mechanisms of informal control play an important role in defining the social context of their use (when, where, and with whom cannabis is consumed). In contrast, formal control had no deterrent impact on the cessation or reduction of use, but affected their behavior by influencing them to change the context of their practices to avoid criminal legal consequences and stigmatization. Conclusions/Importance: The regulatory controls based in public health that the Canadian government plans to implement (replacing criminal ones), should be based on a better understanding of current practices and patterns of cannabis users, and in accordance with informal controls already in place. Legislative formal controls, in a regulatory model, that are better defined and consistent with social practices, will be more accepted and respected by the user population and thus likely to be more effective in reducing harm.

Issues Despite a growing trend towards considering addiction as a chronic disease, the development of intervention models addressing the chronicity of substance use disorder is relatively new, and no literature review on this topic is available. The aim of this systematic review is to evaluate the efficacy of intervention models designed within the perspective of addiction as a chronic disease and those tailored to persons with substance use disorder who revolve in and out of treatment. Approach Electronic databases were searched to identify articles published between 2000 and 2015 reporting an empirical study of an intervention model with data on its effectiveness. Study selection, data extraction and quality appraisal were performed independently by two reviewers. Key Findings The selection process yielded 16 studies meeting all the inclusion criteria. The intervention models were classified into four groups according to the duration, frequency and components of the interventions. In general, the models showed potential therapeutic effects. The outcomes tended to be positive immediately after the end of the treatment. However, months after, the benefits obtained during treatment did not persist. Implications and Conclusion. The review highlights that models designed specifically for persons with multiple treatment re-entries are scarce, but promising. Further research is needed to determine the best match between the clinical profile of persons with substance use disorder and a model's components, intensity and duration. [Simoneau H, Kamgang E, Tremblay J, Bertrand K, Brochu S, FleuryM-J. Efficacy of extensive interventionmodels for substance use disorders: A systematic review. Drug Alcohol Rev 2017;00:000-000]

This study aimed to identify and compare major areas of met and unmet needs reported by 455 homeless or recently housed individuals recruited from emergency shelters, temporary housing, and permanent housing in Quebec (Canada). Mixed methods, guided by the Maslow framework, were used. Basic needs were the strongest needs category identified, followed by health and social services (an emergent category), and safety; very few participants expressed needs in the higher-order categories of love and belonging, self-esteem, and self-actualization. The only significant differences between the three housing groups occurred in basic needs met, which favored permanent housing residents. Safety was the only category where individuals reported more unmet than met needs. The study results suggested that increased overall access to and continuity of care with family physicians, MD or SUD clinicians and community organizations for social integration should be provided to help better these individuals. Case management, stigma prevention, supported employment programs, peer support and day centers should particularly be more widely implemented as interventions that may promote a higher incidence of met needs in specific needs categories.

When drug-using and lawbreaking women are mothers, their competence as mothers is often questioned because good mothers are not supposed to do such things. Consequently, they are often labeled as unfit mothers. This qualitative study seeks to examine the experience of motherhood in substance-using and lawbreaking mothers. Interviews with 38 substance-using women who had broken the law were conducted. Women in our study embrace two models of motherhood: one is an idealized view of motherhood as worthwhile, gratifying, and true to social expectations, and the other a model of the “deviant good mother,” which conforms more closely to their deviant lifestyle. Both of these models influence the way that these mothers perceive their substance use, their criminal behavior, and the possibility of being a good mother. The “deviant good mother” model also allowed them to build (or rebuild) a positive and fulfilling maternal identity.

This qualitative study aimed to comprehend how mothers experienced and built their maternal identity throughout their lives. Thirty-eight semi-structured interviews were conducted with drug-using and law-breaking mothers. Results showed that three events were significant for participants: pregnancies, loss of custody, and incarceration. As each event challenged their maternal identity, they questioned their substance use and their criminal involvement. Our results suggest that these events represent key moments to encourage their growing awareness and to foster changes in their deviant lifestyle. We conclude this article by discussing interventions possible for each of these important moments in these mothers’ lives.