Rhodes, T., & Hedrich, D. (2010). Harm reduction : evidence, impacts and challenges. Monographs, 10. Luxembourg: Office for Official Publications of the European Communities.
Abstract: The EMCDDA’s 10th scientific monograph, entitled Harm reduction: evidence, impacts and challenges provides a comprehensive overview of the harm reduction field. Part I of the monograph looks back at the emergence of harm reduction approaches and their diffusion, and explores the concept from different perspectives, including international organisations, academic researchers and drug users. Part II is dedicated to current evidence and impacts of harm reduction and illustrates how the concept has broadened to cover a wide range of behaviours and harms. Part III addresses the current challenges and innovations in the field. The core audience of the monograph comprises policymakers, healthcare professionals working with drug users, as well as the wider interested public.
Keywords: harm reduction; history; cooperation; research; drug user; public policy on illicit drugs; international area; Europe
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Mounteney, J., Evans-Brown, M., & Giraudon, I. (2012). Fentanyl in Europe : EMCDDA trendspotter study : report from an EMCDDA expert meeting 9 to 10 October 2012. Technical reports. Lisbon: European Monitoring Centre for Drugs and Drug Addiction, Prevalence, Consequences and Data Management Unit.
Abstract: The EMCDDA Trendspotter case study on Fentanyl in Europe was undertaken during September and October 2012. It culminated in an expert meeting in Lisbon on 9-10 October 2012. The aim of the study was to increase understanding of the availability and illicit use of fentanyl in Europe, with a specific focus on: the extent and patterns of use; illicit production and diversion; harms and deaths; and, responses to the problem. Twelve experts from 10 EU Member States (Bulgaria, Czech Republic, Germany, Estonia, Greece, Italy, Slovakia, Sweden, Finland, United Kingdom) attended the meeting, presenting their experiences and contributing to an analysis of the topic, providing insights from law enforcement, forensics, treatment, research and monitoring, and drug user perspectives.
Keywords: illicit drug; illegal drug use; fentanyl; AOD use pattern; AOD supply; AOD associated consequences; AODR mortality; public policy on AOD; treatment and maintenance; law enforcement; monitoring; statistical data; conference; international area; Europe; European Union
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European Monitoring Centre for Drugs and Drug Addiction. (2011). Drug policy profiles : Portugal. Drug policy profiles. Lisbon: Publications Office of the European Union.
Abstract: The EMCDDA Drug policy profiles aim to describe some of the main characteristics of national drug policies in Europe and beyond. The profiles do not attempt to assess these policies, but instead outline their development and main features. The objective is to help readers — from researchers to policymakers — gain a better understanding of the way in which countries control drugs and respond to drug-related security, social and health problems. This first profile describes the national drug policy of Portugal, a policy that has attracted significant attention recently in the media and in policy debates. It considers national strategies and action plans, the legal context within which they operate and the public funds spent, or committed, to resource them. It also describes the political bodies and mechanisms set up to coordinate the response to the multi-faceted problem and the systems of evaluation that may help to improve future policy.
Keywords: history; AOD public policy strategy; drug offense; law; drug legalization; evaluation; Portugal
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San, L., Camí, J., Peri, J. M., Mata, R., & Porta, M. (1990). Efficacy of clonidine, guanfacine and methadone in the rapid detoxification of heroin addicts : a controlled clinical trial. British journal of addiction, 85(1; 01/1990), 141–147.
Abstract: The efficacy of clonidine, methadone, and guanfacine in rapid detoxification of heroin inpatients was assessed in a randomized controlled clinical trial. Signs and symptoms of abstinence and of side effects were analysed in 90 heroin addicts successfully completing a 12–day inpatient trial, all patients fit DSM-III criteria for opioid dependence, the age range being 18 to 36 years. All three drugs were effective in controlling abstinence; however, the course of abstinence was different in the methadone group as compared to the adrenergic agonists, the latter showing limitations in their ability to suppress withdrawal manifestations. While mean number of withdrawal signs and symptoms was significantly tower during days 2 to 5 in the methadone group (p < 0.01), adrenergic agonists were slightly more effective at the end of the trial. Incidence of side effects was closely related to the dose administered. Hypotensive action of adrenergic agonists was more marked in orthostatic position. The present results suggest that methadone is superior to adrenergic agonists. Between these drugs clonidine appears to be less effective than guanfacine in controlling some withdrawal manifestations, and causes more side effects, mainly of cardiovascular nature.
Keywords: treatment and maintenance; inpatient care; detoxification; heroin; clonidine; guanfacine; methadone
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Siegal, H. A., Carlson, R. G., Falck, R., & Wang, J. (1994). Injection drug users' needle-cleaning practices. American journal of public health : official journal of the American Public Health Association, 84(9; 09/1994), 1523–1524.
Abstract: The effectiveness of bleach in inactivating HIV in drug users’ injection equipment is in question. In a letter to the editor published in the American Journal of Public Health, Harvey Siegal et al respond to the report by Shapshak and his colleagues that a minimum of 30 seconds in bleach is needed for sufficient cleaning of the equipment. Through their own observations of 77 intravenous drug users, Siegal et al noted a great disparity in the amount of bleaching time–from 1 to 75 seconds–as well as in the methods of cleaning of the equipment. Despite the fact that the study was conducted in project offices, the results provide some evidence of how drug users really use bleach when cleaning. It is important to clearly state disinfection techniques in prevention messages that target drug users, because a few seconds’ difference can make all the difference between becoming infected with HIV or remaining uninfected.
Keywords: letter to the editor
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Karcher, M. J. (2008). The Study of Mentoring in the Learning Environment (SMILE) : a randomized evaluation of the effectiveness of school-based mentoring. Prevention Science, 9(2; 06/2008), 99–113.
Abstract: The effect of providing youth school-based mentoring (SBM), in addition to other school-based support services, was examined with a sample of 516 predominately Latino students across 19 schools. Participants in a multi-component, school-based intervention program run by a youth development agency were randomly assigned to one of two conditions: (1) supportive services alone or (2) supportive services plus SBM. Compared to community-based mentoring, the duration of the SBM was brief (averaging eight meetings), partly because the agency experienced barriers to retaining mentors. Intent-to-treat (ITT) main effects of SBM were tested using hierarchical linear modeling (HLM) and revealed small, positive main effects of mentoring on self-reported connectedness to peers, self-esteem (global and present-oriented), and social support from friends, but not on several other measures, including grades and social skills. Three-way cross-level interactions of sex and school level (elementary, middle, and high school) revealed that elementary school boys and high school girls benefited the most from mentoring. Among elementary school boys, those in the mentoring condition reported higher social skills (empathy and cooperation), hopefulness, and connectedness both to school and to culturally different peers. Among high school girls, those mentored reported greater connectedness to culturally different peers, self-esteem, and support from friends. Findings suggest no or iatrogenic effects of mentoring for older boys and younger girls. Therefore, practitioners coordinating multi-component programs that include SBM would be wise to provide mentors to the youth most likely to benefit from SBM and bolster program practices that help to support and retain mentors.
Keywords: school; social behavior; social integration; target group; child; adolescent; United States
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Nadelmann, E. A. (1990). Global prohibition regimes : the evolution of norms in international society. International organization, 44(4; 09/1990), 479–526.
Abstract: The dynamics by which norms emerge and spread in international society have been the subject of strikingly little study. This article focuses on norms that prohibit, both in international law and in the domestic criminal laws of states, the involvement of state and nonstate actors in activities such as piracy, slavery, counterfeiting, drug trafficking, the hijacking of aircraft, and the killing of endangered animal species. It analyzes the manner in which these norms have evolved into and been institutionalized by global prohibition regimes and argues that there are two principal inducements to the formation and promotion of such regimes. The first is the inadequacy of unilateral and bilateral law enforcement measures in the face of criminal activities that transcend national borders. The second is the role of moral and emotional factors related to neither political nor economic advantage but instead involving religious beliefs, humanitarian sentiments, fears, prejudices, paternalism, faith in universalism, the individual conscience, and the compulsion to proselytize. The ultimate success or failure of an international regime in effectively suppressing a particular activity depends, however, not only on the degree of commitment to its norms or the extent of resources devoted to carrying out its goals but also on the vulnerability of the activity to its enforcement measures.
Keywords: miscellaneous; crime; crime prevention; law; criminal penalty; policy recommendations
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various. (2008). Progress on implementing the Dublin declaration on partnership to fight AIDS/HIV in Europe and Central Asia (S. Matic, J. V. Lazarus, S. Nielsen, & U. Laukamm-Josten, Eds.). Copenhagen: WHO Regional Office for Europe.
Abstract: The Dublin Declaration on Partnership to Fight HIV/AIDS in Europe and Central Asia, signed in February 2004, is a key European document on HIV/AIDS. It sets out 33 actions for governments to undertake as related to leadership, prevention, living with HIV (including treatment and care) and partnership in the 53 countries of the WHO European Region. This document, prepared under the auspices of UNAIDS, highlights the successes and shortcomings of the implementation of the Declaration, as called for in Action 33 of the Declaration itself. There are 15 thematic sections complemented by nine country reports. The report, written and reviewed by more than 50 experts in the field, is available online at www.euro.who.int/aids.
Keywords: HIV infection; hepatitis C; prevention; treatment and maintenance; drug substitution therapy; research; program evaluation; Europe; Central Asia
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Van Wormer, K. (1999). Harm induction vs. harm reduction : comparing American and British approaches to drug use. Journal of offender rehabilitation, 29(1/2), 35–48.
Abstract: The disease model, while still the predominant conceptualization guiding U.S. treatment is now being challenged by the harm reduction model, highly developed in Britain. This paper examines both positions in light of historical/cultural differences related to Puritan zealotry and argues that with regard to illegal drugs, America’s War on Drugs actually inflicts harm. The huge government expenditure, spread of AIDS, criminalization of drug users, and treatment neglect are just several of the negative consequences.
Keywords: harm reduction; government and politics; public policy on illicit drugs; HIV infection; Aids; criminalization; international differences; United Kingdom; United States
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European Monitoring Centre for Drugs and Drug Addiction. (2013). Trends in heroin use in Europe : what do treatment demand data tell us? Lisbon: Author.
Abstract: The current number of problem opioid users in Europe can be estimated atabout 1.4 million, or 0.41 % of the adult population, with heroin being by far the most widely used opioid. Heroin use has developed along different timelines; several western European countries faced increases from the 1970s onward, whereas countries in Central and Eastern Europe saw a development in heroin use in the 1990s and later. Recent analyses of multiple indicators suggest that Europe may be witnessing a longer-term decline in heroin use, although countries show varying patterns and trends.
Keywords: AOD user; AOD consumption; opioids in any form; heroin; treatment and maintenance; epidemiology; survey; statistical data; international area; Europe; European Union
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