Abstract: Dans les rares pays où ils existent, les programmes de prescription d’héroïne consistent en des traitements individualisés dans le cadre d’une approche médico-psychosociale. Dans cette optique, une nouvelle avancée est aujourd’hui expérimentée : la diacétylmorphine (DAM) par voie orale, pour les usagers-dépendants. Le point sur ce dispositif, et notamment les protocoles menés en Suisse.

Abstract: Akzeptanzorientierung bezeichnet eine in den 1980er Jahren als Gegenentwurf zur abstinenzdogmatisch-repressiven Drogenpolitik damaliger Bundesregierungen entstandene Drogenhilfemethode. Der Begriff der Niedrigschwelligkeit definiert wiederum die Ausprägung von Zugangsschwellen. Primärziel ist die Gesundheits- und Überlebenssicherung der Konsumenten sowie deren möglichst voraussetzungsfreie Unterstützung. Allerdings bestehen Einschränkungen durch eine heterogene Gesetzeslage und ordnungspolitische Aufgaben. Vielfältige ethische Problemstellungen und Dilemmata resultieren daraus, da zugleich eine Verpflichtung dem abhängigen Individuum gegenüber besteht. Die Doppelmandatierung der darin involvierten Sozialen Arbeit ist manifest. Zudem ist die deutsche Drogenpolitik weiterhin primär prohibitiv ausgerichtet. Eine eindeutige Lösung existiert nicht. The term “acceptance-oriented drug work” (AODW) describes a drug-help method which arose during the 1980s as an alternative concept to both the repressive and dogmatic abstinence-oriented drug policies of the German Government followed at that time. On the other hand, “low thresholdness” solely describes a specific level of entry requirements laid down by drug-help facilities. The main goal of AODW is to protect health and to facilitate survival of drug-consuming persons, as well as to offer support on low- to lowest-demand conditions. However, confinements are generated by the heterogeneous legal framework and regulatory duties. Various ethical problems and quandaries result thereof, since acceptance-oriented drug work adheres to an ethical obligation towards the drug-addicted individual. The Janus face of social work involved therein is apparent. Furthermore, the German Government’s drug policies remain slanted towards prohibition. There is no clear and definite solution to changing the current situation.

Abstract: Background: The effect of alcohol portrayals and advertising on the drinking behaviour of young people is a matter of much debate. We evaluated the relationship between exposure to alcohol advertising, marketing and portrayal on subsequent drinking behaviour in young people by systematic review of cohort (longitudinal) studies. Methods: studies were identified in October 2006 by searches of electronic databases, with no date restriction, supplemented with hand searches of reference lists of retrieved articles. Cohort studies that evaluated exposure to advertising or marketing or alcohol portrayals and drinking at baseline and assessed drinking behaviour at follow-up in young people were selected and reviewed. Results: seven cohort studies that followed up more than 13,000 young people aged 10 to 26 years old were reviewed. The studies evaluated a range of different alcohol advertisement and marketing exposures including print and broadcast media. Two studies measured the hours of TV and music video viewing. All measured drinking behaviour using a variety of outcome measures. Two studies evaluated drinkers and non-drinkers separately. Baseline non-drinkers were significantly more likely to have become a drinker at follow-up with greater exposure to alcohol advertisements. There was little difference in drinking frequency at follow-up in baseline drinkers. In studies that included drinkers and non-drinkers, increased exposure at baseline led to significant increased risk of drinking at follow-up. The strength of the relationship varied between studies but effect sizes were generally modest. All studies controlled for age and gender, however potential confounding factors adjusted for in analyses varied from study to study. Important risk factors such as peer drinking and parental attitudes and behaviour were not adequately accounted for in some studies. Conclusion: data from prospective cohort studies suggest there is an association between exposure to alcohol advertising or promotional activity and subsequent alcohol consumption in young people. Inferences about the modest effect sizes found are limited by the potential influence of residual or unmeasured confounding.

Abstract: Recent advances in prevention science provide evidence that adolescent health and behavior problems can be prevented by high-quality prevention services. However, many communities continue to use prevention strategies that have not been shown to be effective. Studying processes for promoting the dissemination and high-quality implementation of prevention strategies found to be effective in controlled research trials has become an important focus for prevention science. The Communities That Care prevention operating system provides manuals, tools, training, and technical assistance to activate communities to use advances in prevention science to plan and implement community prevention services to reduce adolescent substance use, delinquency, and related health and behavior problems. This paper describes the rationale, aims, intervention, and design of the Community Youth Development Study, a randomized controlled community trial of the Communities That Care system, and investigates the baseline comparability of the 12 intervention and 12 control communities in the study. Results indicate baseline similarity of the intervention and control communities in levels of adolescent drug use and antisocial behavior prior to the Communities That Care intervention. Strengths and limitations of the study’s design are discussed.