Date: April 30, 2024 Tue

Time: 3:06 am

Results for drug abuse and addiction

372 results found

Author: Rolles, Stephen Title: After the War on Drugs: Blueprint for Regulation Summary: Heroin, cocaine, ecstasy, cannabis, prescription and over-the-counter medicines, alcohol, tobacco, coffee, tea - we are all people who use drugs. Our refusal to acknowledge this comes from a deep-seated fear that 'we' might become, or be seen as, one of 'them'. What we really need to focus on is the difference between drug use and drug addiction or dependency. Global prohibitionist drug policy continues to focus efforts primarily on the substances alone. This is wrong. Of course, the harms associated with some drugs are worse than others. Sometimes these are due to the degree of addictiveness of a particular drug. But most of the harms are due to the way that a particular drug is acquired (for example, in a dark alley versus from a pharmacy), the way in which it is used (as a pill, for example, versus smoking, snorting or injecting), and, even more importantly, the way in which society treats people who use drugs. The vast majority of the horrific harms associated with drug use-crime, HIV and other blood-borne infections, violence, incarceration, death-are clearly fueled by the prohibitionist drug policies our governments pursue. The use of non-medical drugs, and more importantly the 'War on Drugs' itself, have had a profound influence on the global HIV epidemic over the past 25 years. Today, injecting drug use accounts for 30% of HIV infections worldwide outside of sub-Saharan Africa. In the Eastern Europe/Central Asia region as a whole over 60% of HIV infections are due to injecting drug use. Global normative guidance on HIV prevention, treatment, care and support for people who inject drugs emphasises the use of a comprehensive set of evidence-based interventions aimed at reducing the harms associated with drug use. This normative guidance, as endorsed by the World Health Organization, the United Nations Joint Programme on HIV/AIDS, the International AIDS Society and other organisations, is in direct contrast to global drug control policy, as set out in the three major UN drug conventions of 1961, 1971 and 1988. These call for a strict prohibitionist stance on the production, distribution and use of nonmedical drugs. It doesn't take a rocket scientist to show that criminalising drugs and drug use has directly and indirectly led to a dramatic increase in drugrelated harms, and that controlling and regulating the production and distribution of all drugs would go a long way towards reducing those harms. So long as we continue to define the drug user as 'other' and define the drug itself as the problem, we will be trapped in our misguided and harm-inducing programmes and policies. 'After the War on Drugs: Blueprint for Regulation' lays out, for the first time, a set of practical and pragmatic options for a global regulatory system for non-medical drugs. It comes at a critical time. A number of Latin American governments, including Argentina, Brazil, Ecuador, Bolivia and Mexico have moved, or are moving, towards decriminalisation of drug possession and are shifting to a public health model to prevent and treat misuse of drugs. They are no longer able to tolerate the damage done to their societies by the War on Drugs. Portugal decriminalised possession of all drugs in 2001. There are signs that the US government, under the new US 'Drug Czar' Gil Kerlikowske, is ready to review its position on the War on Drugs. Given that prohibitionist policy has been dominated by the US, and to some extent Russia, Japan and Sweden, any shifts in US policy could have dramatic effects at the global level. This is not a radical book, nor does it posit radical approaches to global drug policy. In fact, as it points out, the prohibitionist model is the radical approach, in that it is based exclusively on a moral judgment against drug use and drug users and not on an evidence based approach to reducing drug-related harms. Underscoring a century of prohibitionist policy is a deep-seated fear that moving from prohibition to a regulatory approach will lead to a 'free-for-all' situation vis-a-vis drug availability and use. 'Blueprint' outlines clearly that this fear is irrational and that reform of any kind will be vastly superior to the status quo. Details: London: Transform Drug Policy Foundation, 2009. 232p. Source: Internet Resource: Accessed April 17, 2018 at: https://www.tdpf.org.uk/sites/default/files/Blueprint.pdf Year: 2009 Country: United Kingdom URL: https://www.tdpf.org.uk/sites/default/files/Blueprint.pdf Shelf Number: 117126 Keywords: Drug Abuse and Addiction Drug Control Drug Control Policy Drug Enforcement Drug Policy Reform

Author: Hawken, Angela Title: Managing Drug Involved Probationers with Swift and Certain Sanctions: Evaluating Hawaii's HOPE Summary: This report describes an evaluation of a community supervision strategy called HOPE (Hawaii Opportunity Probation with Enforcement) for substance-abusing probationers. HOPE began as a pilot program in October 2004 and has expanded to more than 1500 participants, about one of six felony probabtioners on Oahu. Details: S.I.: s.n., 2009 Source: National Institute of Justice Year: 2009 Country: United States URL: Shelf Number: 117401 Keywords: Community Supervision Drug Abuse and Addiction Drug Offenders Probation Probation Violations Probationers Recidivism

Author: United Nations Office on Drugs and Crime. Regional Office for East Asia and the Pacific. ASEAN Title: Drug-free ASEAN 2015: Status and Recommendations Summary: At the Thirty-third ASEAN Ministerial Meeting in Bangkok in 2000, Ministers "took note of the threat from drug abuse and drug trafficking on the security and stability of the ASEAN region, particularly its relations with transnational crime" and called for a drug-free ASEAN by 2015.1 Recent documented shifts in illicit drug manufacturing and production, trafficking patterns and abuse trends make it clear that countries in the region must increase their collaborative efforts if this goal is to be realized. "Drug-Free ASEAN 2015: Status and Recommendations" serves as a timely mid-term progress report for the region and is loosely structured under three questions: 'Is the commitment achievable?' 'Is the region on track towards achieving it?' 'What can be done to accelerate progress?' In the report, national/regional overviews of the illicit drug situation since 2000 include the latest information available via data collection mechanisms established by various UNODC Regional Centre projects, official Government reports and interviews with national counterpart agencies and other drug control stakeholders from throughout the region and beyond. Based upon clearly identified response gaps, the report then proposes a series of benchmarks and recommendations for Governments to better monitor the overall progress of their drug prevention and control efforts. A final section of the report deals with emerging challenges posed by the accelerated development of trade and transportation networks in the region. To adequately address the anticipated surge of goods and persons through new and more heavily trafficked border crossings, an effective regional response will require a common strategy and coordinated actions. In October 2007, ASEAN Senior Officials on Drug Matters (ASOD) met to review "Drug-Free ASEAN 2015: Status and Recommendations". Selected recommendations from the report were then endorsed at the ASEAN Ministerial Meeting on Transnational Crime (AMMTC) in November 2007 in Brunei Darussalam. It is expected that "Drug-Free ASEAN 2015: Status and Recommendations" will serve as a key reference document in the development of an ASEAN-wide work plan by ASOD in the near future. As a collaborative undertaking, this report also highlights the growing cooperation between the ASEAN Secretariat and the United Nations Office on Drugs and Crime (UNODC) Regional Centre for East Asia and the Pacific. This not only fosters linkages between various, ongoing drug control frameworks in the region but also ensures closer collaboration between ASEAN and UNODC in the delivery of technical assistance, capacity building initiatives and expert advice. The Regional Centre looks forward to further close collaboration with the ASEAN Secretariat in the future while progressing towards a Drug-Free ASEAN 2015. Details: Bangkok, Thailand: United Nations Office on Drugs and Crime, 2008. 121p. Source: https://www.unodc.org/documents/southeastasiaandpacific/Publications/ASEAN_2015.pdf Year: 2008 Country: Asia URL: https://www.unodc.org/documents/southeastasiaandpacific/Publications/ASEAN_2015.pdf Shelf Number: 116655 Keywords: Drug Abuse and Addiction Drug Control Policy Drug Trafficking Control Illicit Drugs

Author: National Center on Addiction and Substance Abuse at Columbia University Title: Behind Bars II: Substance Abuse and America's Prison Population Summary: This new report constitutes the most exhaustive analysis ever undertaken to identify the extent to which alcohol and other drugs are implicated in the crimes and incarceration of America's prison population. This report, following more than a decade after CASA's initial analysis, finds that despite greater recognition of the problem and potential solutions, we have allowed the population of substance-involved inmates crowding our prisons and jails -- and the related costs and crimes -- to increase. Details: New York: The Center, 2010 Source: Year: 2010 Country: United States URL: Shelf Number: 117674 Keywords: Alcohol Abuse Drug Abuse and Addiction Inmates

Author: European Monitoring Centre for Drugs Title: Methamphetamine: A European Union Perspective in the Global Context Summary: This study focuses on the supply and use of methamphetamine in Europe. It provides a condensed review of key issues relevant to understanding how Europe stands vis-a-vis the global methamphetamine problem today. Details: Luxembourg: Office for Official Publications of the European Communities, 2009. 30p. Source: EMCDDA-Europol Joint Publications No. 1 Year: 2009 Country: United States URL: Shelf Number: 115669 Keywords: Drug Abuse and Addiction Methamphetamines

Author: Egli, Nicole Title: Effects of Drug Substitution Programs on Offending among Drug-Addicts Summary: Drug abusers are generally more involved in crime, in particular property crime, than people who are not drug abusers. Substitution programs have been developed in order to improve drug users' quality of life and to decrease their criminal involvement. Several evaluations, but not all, have reported crime reductions following substitution therapies based on heroin and methadone prescription. This review is aimed at gaining an overall picture on the respective effects of prescription of methadone vs. heroin and other substances. Details: Oslo: The Campbell Collaboration, 2009. 36p. Source: Campbell Systematic Review; 2009:3 Year: 2009 Country: United States URL: Shelf Number: 116316 Keywords: Drug Abuse and Addiction Drug Abuse Treatment

Author: Amon, Joe Title: Where Darkness Knows No Limits: Incarceration, Ill-treatment, and Forced Labor as Drug Rehabilitation in China Summary: This report details the abusive conditions suffered by detainees in China's drug detention centers, the failure of the Chinese government to deliver on its avowed commitment to a medical-based approach to its illicit drug use and addiction problems, and the human rights violations associated with the Anti-Drug Law. The report calls on the Chinese government to immediately close these centers and develop genuinely therapeutic, voluntary, community-based, outpatient drug dependency treatment alternatives. Details: New York: Human Rights Watch, 2010. 37p. Source: Internet Resource Year: 2010 Country: China URL: Shelf Number: 117824 Keywords: Detention Drug Abuse and Addiction Drug Offenders Drug Treatment Forced Labor Human Rights Abuses

Author: Cave, Jonathan Title: Tackling Problem Drug Use Summary: The U.K. National Audit Office (NAO) is conducting a value-for-money study on the UK Governments' 2008 drug strategy. This study focuses in particular on local delivery authorities' capacity and capability to effectively tackle proglem drug use through delivery of local services. To inform the NAO's value-for-money study, RAND performed a literature review on problem drug use and reviewed the evidence base, both literature and data, underpinning the strategy. One of the key findings is the narrower focus in the UK on most significant harms may be useful, but also carries risks and drawbacks discussed in detail in the report. Details: Cambridge, UK: RAND Europe, 2010. 66p. Source: Technical Report Year: 2010 Country: United Kingdom URL: Shelf Number: 116475 Keywords: Drug Abuse and Addiction Drug Abuse and Crime

Author: Hales, Jon Title: Longitidinal Analysis of the Offending, Crime and Justice Survey 2003-06 Summary: This report presents longitudinal analysis of self reported data on offending, drug use and anti-social behavior among young people (initially ages 10 to 25) from the U.K. Offending, Crime and Justice Survey, which was carried out annually between 2003 and 2006. The analysis identifies a small group of young people described here as prolific offenders, who accounted for a disproportionate number of offenses, including serious offences. Details: London: Home Office Research, Development and Statistics Directorate, 2009. Source: Research Report 19 Year: 2009 Country: United Kingdom URL: Shelf Number: 117354 Keywords: Antisocial Behavior Drug Abuse and Addiction Juvenile Offenders

Author: Torok, Michelle Title: Comparative Rates of Violent Crime Amongst Methamphetamine and Opioid Users: Victimisation and Offending Summary: Background There have been marked changes in methamphetamine use over the past decade as more potent forms of the drug have become increasingly available, particularly crystalline methamphetamine. A major concern of stronger potency methamphetamine is the increased potential for harm, such as psychotic symptoms and violent behaviour. Little is currently known about what effects methamphetamine use has on violent behaviour. The current research was undertaken to improve our understanding of the association between methamphetamine use and violent victimisation and offending. Comprehensive measures including prevalence, type of offence, circumstances surrounding victimisation and offending, and the predictors of violent behaviour were used to achieve a more complex understanding of the issues surrounding methamphetamine use and violence. Methodology A sample of 400 regular methamphetamine and heroin users from the greater Sydney region were interviewed face-to-face regarding their lifetime and most recent experiences of violent victimisation and offending. Participants in the study were recruited through advertisements placed in needle and syringe programs (NSPs), therapeutic communities, street press publications, and word of mouth. To be eligible for inclusion in the survey, respondents had to be at least 18 years of age, have a satisfactory understanding of English, and have used either methamphetamine or illicit opiates at least weekly over the past 12 months. The sample was categorised into three key groups based on whether they used methamphetamine or heroin most regularly: primary methamphetamine users (PM), primary heroin users (PH), and combined primary methamphetamine and heroin users (PMH). Only physical violence was measured in this study, which included assault, armed robbery, homicide, and sexual assault. Key findings Violent victimisation The lifetime risk of violent victimisation was nearly universal. Across the whole sample, 95% had ever been a victim of violence, and nearly half (46%) had experienced victimisation in the past 12 months. The overwhelming majority had been victimised on multiple occasions across a lifetime measure. Methamphetamine use was not a significant risk factor for violent victimisation. The results indicate that the major predictors of violent victimisation among illicit drug users were severity of alcohol use, a predisposition towards antisocial behaviour (i.e. a childhood history of Conduct Disorder), and drug dealing. The data indicates that being involved in illicit drug markets substantially increases the risk of victimisation and that, at some point, those who remain in these environments have a high risk of being assaulted Almost two-thirds of those who had been victimised were also under the influence of a substance at the time they were last victimised. The substances that were most commonly used prior to the most recent victimisation episode were alcohol (25%), psychostimulants (24%), and illicit opioids (24%). Nearly one-quarter of the respondents had used multiple substances prior to most recently being victimised. Violent offending The prevalence of violent offending was also high, with 82% having ever committed a violent crime, and approximately two in five having violently offended in the past 12 months. There were no group differences in the risk of lifetime offending. In the past 12 months, however, the PM group was more likely to have committed a violent crime than the PH group (51% v 35%). Nearly three-quarters (74%) of the sample had ever committed more than one violent crime. Methamphetamine use significantly increased the risk of violent offending in the past 12 months, particularly more frequent methamphetamine use. The increased risk of violent offending associated with methamphetamine use was consistent across a number of indicators, including being at greater risk for being arrested for assault and weapon offences in the preceding 12 months, and methamphetamine users being at greater risk of committing violent crime within the past month. Apart from methamphetamine use, other factors that were found to increase the risk of committing violence were heavier alcohol use, Conduct Disorder, selling drugs, and being younger. Risk perceptions of violence The majority of the sample perceived that it would be 'unlikely' or 'very unlikely' that they would be either a victim of violence (78%) or violent offender (87%) in the following 12 months, despite the high prevalence of violent victimisation and offending experienced in the previous 12 months. The majority of respondents had also witnessed high levels of victimisation and offending, and this also appears to have no impact on their own perceived risk of being exposed to violence in the future. Among those who had recently (i.e. in the last 12 months) been a victim of violence, or physically assaulted someone, the perceived risk of future victimisation and offending was higher than those who had not recently been exposed to violence. Key points: Summary of violent crime among illicit drug users - Violent victimisation was almost universal, with 95% of the sample having ever been victimised, and 46% having been a victim of violence in the past 12 months. - Violent offending was also highly prevalent, with 82% of respondents having committed a violent crime across their lifetime, and 41% having done so in the past 12 months. - Methamphetamine use did not increase the lifetime, or past 12 month, risk of violent victimisation. - Heavier methamphetamine use was associated with a significantly higher risk of violent offending in the past 12 months. - The main form of methamphetamine used did not affect risk of violent victimisation or offending. - The perceived risk of being a victim or offender of a violent crime in the following 12 months was very low, despite the high rates of victimisation, and of committing violent crime, in the past 12 months. Details: Hobart, Tasmania: National Drug Law Enforcement Research Fund, 2008. 43p. Source: Internet Resource: Monograph no. 32: Accessed April 17, 2018 at: http://www.ndlerf.gov.au/sites/default/files/publication-documents/monographs/monograph32.pdf Year: 2008 Country: Australia URL: http://www.ndlerf.gov.au/sites/default/files/publication-documents/monographs/monograph32.pdf Shelf Number: 117106 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug-Related Violence Methamphetamines Opioids Victimization Violent Crime

Author: Nicholas, Roger Title: An Environmental Scan on Alcohol and Other Drug Issues Facing Law Enforcement in Australia 2010. Summary: Environmental scanning, as with any form of predicting the future, is not a purely scientific endeavor. It involves drawing together data from a large range of sources, ranging from refereed journals to the opinions of experts in a given field, in order to try and better understand current and future trends. This document contains the key findings of an environmental scan on alcohol and other drug issues facing law enforcement in Australia. Details: Hobart, Tasmania: National Drug Law Enforcement Research Fund, 2008. 219o, Source: Year: 2008 Country: Australia URL: Shelf Number: 118167 Keywords: Alcohol Abuse Drug Abuse and Addiction Drug Enforcement Law Enforcement

Author: Hay, Gordon Title: National and Regional Estimates of the Prevalence of Opiate Use and/or Crack Cocaine Use 2005-2006: A Summary of Key Findings Summary: This report summarizes the results of the second sweep of a three-year study to estimate the prevalence of problem drug use (defined as use of opiates and/or crack cocaine) nationally (England only), regionally, and locally. An overview of national and government office region estimates are presented as comparisons with the estimates produced by the previous (2004/05) sweep of this study. Details: London: Home Office, 2007. 91p. Source: Internet Resource; Home Office Online Report; 21/07 Year: 2007 Country: United Kingdom URL: Shelf Number: 117658 Keywords: Cocaine Drug Abuse and Addiction Drug Offenders Opiates

Author: Willis, Matthew Title: Policing Substance Abuse in Indigenous Communities: Report from a Workshop held in Mildura, Victoria, 5-6 August 2008. Summary: This report documents the findings of a conference designed to disseminate findings from tne National Drug Law Enforcement Research Fund to an audience involved in implementing and managing the policing response to substance abuse in Indigenous communities. The objectives of the workshop included: establishing the key issues for police in relation to substance abuse in Indigenous communities; identifying differences in policing illicit drug use in Indigenous communities compared with other communities; and identifying where police may be able to improve their response to these issues. Details: Canberra: Australian Institute of Criminology, 2009. 29p. Source: Research in Practice; Report no. 03 Year: 2009 Country: Australia URL: Shelf Number: 115743 Keywords: -Drug Offenders Drug Abuse and Addiction Indigenous Peoples Policing (Australia) Substance Abuse, Police Response (Australia)

Author: U.S. Department of Justice. National Drug Intelligence Center Title: National Methamphetamine Threat Assessment Summary: This report presents a national-level strategic assessment of methamphetamine trafficking in the United States. This assessment addresses significant trends in methamphetamine production, transportation, distribution, and abuse. It discusses a wide range of issues, including methamphetamine production in the United States and Mexico and the impact of foreign and domestic methamphetamine production. Details: Johnstown, PA: National Drug Intelligence Center, 2009. 44p. Source: Internet Resource Year: 2009 Country: United States URL: Shelf Number: 118585 Keywords: Drug Abuse and Addiction Drug Trafficking Drugs Methamphetamines (U.S.)

Author: Rodwell, Laura Title: What Do Police Data Tell Us About Criminal Methods of Obtaining Prescription Drugs? Summary: Recent reports suggest that the illicit use of prescription medicines, particularly pharmaceutical opioids is increasing in Australia. The aim of this study was to use police data to examine: (1) whether this increase is reflected in police crime data; (b) some of the criminal methods by which these medicines are obtained; and (c) which particular medicines have been most commonly sought through these methods over time. Details: Sydney: NSW Bureau of Crime Statistics and Research, 2010. 12p. Source: Internet Resource; Crime and Justice Bulletin, No. 139 Year: 2010 Country: Australia URL: Shelf Number: 118722 Keywords: Drug Abuse and Addiction Opioids Prescription Fraud Prescription Medicines

Author: U.S. Department of Justice. Drug Enforcement Administration. National Drug Intelligence Center Title: National Prescription Drug Threat Assessment Summary: This assessment focuses primarily on domestic diversion of controlled prescription drugs (CPDs). It examines current nonmedical use of prescription-type psychotherapeutic drugs (opioid pain relievers, tranquilizers, sedatives, or stimulants) and discusses their distribution, and societal impact of CPD diversion and abuse, and Prescription Drug Monitoring Programs that have been established legislatively in many states to stem CPD diversion and abuse. This assessment also examines regional deviations from national trends. Details: Johnstown, PA: National Drug Intelligence Center, 2009. 62p. Source: Internet Resource Year: 2009 Country: United States URL: Shelf Number: 118769 Keywords: Drug Abuse and Addiction Opiods Prescription Drugs Prescription Fraud

Author: Whiting, Aimee Title: Drugs Survey Summary: This report presents the findings from an online survey of 1008 adults in Australia about using illegal drugs and people's attitudes to illegal drugs in Australian Society. Details: Crows Nest, NSW: McNair Ingenuity Research, 2010. 33p. Source: Internet Resource:Conducted for Hungry Beast, February 2010 Year: 2010 Country: Australia URL: Shelf Number: 118720 Keywords: Drug Abuse and Addiction Drug Offenses Drug Policy Public Opinion, Drugs

Author: United Nations Office on Drugs and Crime Title: Patterns and trends of Amphetamine-Type Stimulants and other Drugs in East and South-East Asia (and neighborhood regions) Summary: UNODC launcehd the Global Synthetics Monitoring: Analyses, Reporting and Trends (SMART) Programme in September 2008. The Programme seeks to enhance the capacity of Member States and authorities in priority regions, to generate, manage, analyze and report synthetic drug information, and to apply this scientific evidence-based knowledge to design the policies and programmes. The Global SMART Programme is being implemented in a gradual phased manner, with East Asia being the first focus priority region. This annual report is the first regional situation assessment for East and South-East Asia put forward under the Global SMART Programme. If forms one of the first essential key steps, in providing consolidated up-to-date analysis, based on the information shared by the members countries. This report provides an overview of the amphetamine-type stimulants in the region, and outlines several key issues and emerging threats throughout the region and their implications for the neighbouring regions. It also highlights the need for continued and joint efforts, both at the national as well as regional levels. Details: Vienna: United Nations Office on Drugs and Crime, 2009. 140p. Source: Internet Resource; Global SMART Programme Year: 2009 Country: Asia URL: Shelf Number: 117587 Keywords: Drug Abuse and Addiction Drug Control Drug Enforcement Drug Trafficking Drugs

Author: Success Works Title: Tasmania's Drug Mandated Drug Diversion Program: Evaluation Report Summary: This report evaluates the pilot Court Mandated Drug Diversion Program (CMD) in Tasmania. The goal of the program is to break the drug-crime cycle by involving offenders in treatment and rehabilitation programs and providing alternative pathways for offenders through increasing their access to drug, alcohol, or other welfare services. This evaluation considers the first two months of the pilot program. Data provided by the Tasmanian Department of Justice indicates that in its first year of operation 250 offenders were referred for screening for suitability for the program and 157 offenders commenced the program. Details: Hobart, Tasmania: Success Works, 2008. 147p. Source: Internet Resource Year: 2008 Country: Australia URL: Shelf Number: 117577 Keywords: Alternative to Incarceration Drug Abuse and Addiction Drug Abuse Treatment (Tasmania) Drug Offenders Drugs and Crime

Author: Duffy, Martin Title: Cannabis Supply and Young People: 'It's a Social Thing' Summary: The supply of drugs to young people is an emotive subject and discussion is rarely conducted with much reference to evidence. Research on young people's access to drugs is scarce in the U.K. The evidence that exists, however, shows that many young people gain access to drugs through older brothers and sisters, through friends and friends of friends - so-called social supply networks. This report offers a snapshot view of how young people in a large city and in rural villages get supplies of cannabis. Details: York, UK: Joseph Rowntree Foundation, 2008. 49p. Source: Internet Resource Year: 2008 Country: United Kingdom URL: Shelf Number: 117592 Keywords: Drug Abuse and Addiction Drugs Marijuana

Author: McManus, Rob, ed. Title: Altered States in the Palmetto State: Statistical Indicators of Illegal Drug Use Summary: This report brings together criminal justice and public health data to provide an overview of the extent and nature of illegal drug use in South Carolina. The report brings together indicators of illegal drug use such as drug arrests, drug testing results, court filings, admissions to prison and community correctional supervision, drug related emergency room discharges, drug related in-patient discharges and estimates from user surveys. Details: Blythewood, SC: South Carolina Department of Public Safety, Office of Justice Programs, Statistical Analysis Center, 2008. 227p. Source: Internet Resource Year: 2008 Country: United States URL: Shelf Number: 117596 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders Drug Offenses Drugs (South Carolina)

Author: European Monitoring Centre for Drugs and Drug Addiction Title: EMCDDA 2010 Selected Issues - Trends in Injecting Drug Use in Europe Summary: This report brings together data from a wide variety of sources as it describes Europe's current drug injecting problem and plots its trends in recent years. Responses to drug injecting and measures to reduce the harm caused by this form of drug use are also reviewed. The report finds that the available data point to a stable or declining trend of injecting in most European countries, with effective treatment and harm-reduction measures now reaching many users. Details: Luxembourg: Publications Office of the European Union, 2010. 22p. Source: Internet Resource Year: 2010 Country: Europe URL: Shelf Number: 119140 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Drug Offenders

Author: Corman, Hope Title: Effects of Welfare Reform on Illicit Drug Use of Adult Women Summary: Exploiting changes in welfare policy across states and over time and comparing relevant population subgroups within an economietric difference-in-differences framework, this study estimates the causal effects of welfare reform on adult women's illicit drug use from 1992 to 2002, the period during which welfare reform unfolded in the U.S. Details: Cambridge, MA: National Bureau of Economic Research, 2010. 52p. Source: Internet Resource; NBER Working Paper Series, Working Paper 16072 Year: 2010 Country: United States URL: Shelf Number: 119108 Keywords: Drug Abuse and Addiction Drug Offenders Drug Treatment Welfare

Author: Canty, Chris Title: Evaluation of a Community-Based Drug Law Enforcement Model for Intersectoral Harm Reduction Summary: This report presents the evaluation of four Australian pilot programs in community-based approaches to drug law enforcement. The pilot programs aimed at finding ways to ensure that drug law enforcement strategies, priorities and tactics at the local leval could be made more consistent with the official police commitment to a harm minimization philosophy. Trials were established within Fairfield in New South Wales, the Gippsland region in Victoria dn Mirrabooka and Geraldton in Western Australia. Details: Payneham, SA: Australasian Centre for Policing Research, 2001. 208p. Source: Internet Resource Year: 2001 Country: Australia URL: Shelf Number: 118695 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Drug Enforcement Drug Policy

Author: European Monitoring Centre for Drugs and Drug Addiction Title: Albania: Country Overview 2009 Summary: This country overview provides a structured synopsis of the trends and characteristics of national drug problems in Albania in 2009. It consists of a summary of the national drug situation presenting brief information in the following key areas: drug prevalence, prevention, harm reduction, drugs laws, etc. Details: Luxembourg: Publications Office of the European Union, 2009. 15p. Source: Internet Resource Year: 2009 Country: Albania URL: Shelf Number: 119128 Keywords: Drug Abuse and Addiction Drug Abuse Prevention Drug Abuse Treatment Drugs (Albania)

Author: European Monitoring Centre for Drugs and Drug Addiction Title: Montenegro: Country Overview 2009 Summary: This country overview provides a structured synopsis of the trends and characteristics of national drug problems in Montenegro for 2009. It consists of a summary of the national drug situation presenting brief information in key areas - drug prevalence, prevention, harm reduction, drug laws, etc. Details: Luxembourg: Publications Office of the European Union, 2009. 22p. Source: Internet Resource Year: 2009 Country: Europe URL: Shelf Number: 119127 Keywords: Drug Abuse and Addiction Drug Abuse Prevention Drug Abuse Treatment Drug Policy Drugs (Montenegro)

Author: European Monitoring Centre for Drugs and Drug Addiction Title: Serbia: Country Overview 2009 Summary: This country overview provides a structured synopsis of the trends and characteristics of national drug problems in Serbia in 2009. It consists of a summary of the national drug situation presenting brief information in key areas - drug prevalence, prevention, harm reduction, drug laws, etc. Details: Luxembourg: Publications Office for the European Union, 2009. 16p. Source: Internet Resource Year: 2009 Country: Serbia and Montenegro URL: Shelf Number: 119126 Keywords: Drug Abuse and Addiction Drug Policy Drug Prevention Drug Treatment Drugs (Serbia)

Author: European Monitoring Centre for Drugs and Drug Addiction Title: Bosnia and Herzegovina: County Overview 2009 Summary: This country overview provides a structured synopsis of the trends and characteristics of national drug problems in Bosnia and Herzegovina in 2009. It consists of a summary of the national drug situation presenting brief information in key areas - drug prevalence, prevention, harm reduction, drug laws, etc. Details: Luxembourg: Publications Office of the European Union, 2009. 39p. Source: Internet Resource Year: 2009 Country: Bosnia and Herzegovina URL: Shelf Number: 119125 Keywords: Drug Abuse and Addiction Drug Policy Drug Treatment Drugs

Author: European Monitoring Centre for Drugs and Drug Addiction Title: Former Yugoslav Republic of Madedonia: Country Overview 2009 Summary: This country overview provides a structured synopsis of the trends and characteristics of national drugs problems in the Former Yugoslav Republic of Macedonia in 2009. It consists of a summary of the national drug situation presenting brief information in key areas - drug prevalence, prevention, harm reduction, drugs laws, etc. Details: Luxembourg: Publications Office of the European Union, 2009. 20p. Source: Internet Resource Year: 2009 Country: Macedonia URL: Shelf Number: 119124 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Drug Policy Drugs

Author: Williams, Sarah Title: The City of Easton Weed and Seed Initiative: Evaluation 2008 Summary: This report is an evaluation and needs assessment of Easton Weed & Seed carried out between September snd November 2008. It includes background on the program and target neighborhood, a description of the Weed & Seed programs, the results of focus groups conducted with target residents and surveys of community residents. It concludes with overall impressions and recommendations. Details: Bethelmen, PA: Lehigh Valley Research Consortium, 2008. 23p. Source: Internet Resource Year: 2008 Country: United States URL: Shelf Number: 119151 Keywords: Cognitive Behavioral Therapy Correctional Education Crime Prevention Delinquency Prevention Drug Abuse and Addiction Juvenile Inmates Juvenile Offenders Juvenile Rehabilitation Weed & Seed Program

Author: Pryor, Crystal D. Title: Operation UNITE: A Qualitative Analysis Identifying Critical Factors for Implementation Summary: UNITE is an acronym meaning Unlawful Narcotics Investigations, Treatment and Education. It reflects the three-pronged, comprehensive approach deemed necessary to combating substance abuse in Kentucky Fifth Congressional District. Of Kentucky’s 120 counties, 24 of them do not have an organized regional drug task force. Fifteen of these counties with no active drug task force are represented in the Bluegrass Area Development District’s region. Current social and political perceptions across Kentucky recognize Operation UNITE efforts as largely successful. The evaluation responded to the following research questions: What factors lead to success in Kentucky’s Operation UNITE? Are these factors transferable in treating Central Kentucky’s substance abuse problems? An open-ended interview guide was used to collect data from fifteen Operation UNITE and three partnering organizations staff. The results identified 6 critical factors needed to implement Operation UNITE: a three-prong approach, financial resources, strong employee qualities, cross training, communication mediums, and checks and balances. The data collected also identified staff perceptions of internal and external success and challenges to service delivery pathways. The study’s findings are intended to assist in understanding the collaboration, coordination, and functionality of Operation UNITE. The study recommendations the findings be considered when implementing the UNITE regional drug task force model in the Bluegrass Area Development District region. Details: Lexington, KY: University of Kentucky, Martin School of Public Policy & Administration, 2007. 58p. Source: Internet Resource Year: 2007 Country: United States URL: Shelf Number: 119282 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Task Force Narcotics Substance Abuse

Author: Pacula, Rosalie Liccardo Title: Issues in Estimating the Economic Cost of Drug Abuse in Consuming Nations Summary: This report considers the current feasibility of constructing an estimate of the global cost of drug use. While national estimates exist for seven developed countries, most countries have yet to construct a comprehensive estimate. Furthermore, it is impossible to compare the existing national estimates because of differences in the construction, which may reflect varying political and social environments that influence the nature of use and its related harms. The report lays out a conceptual framework for initiating the construction of country-specific estimates in a fashion that would facilitate cross-national comparisons. It demonstrates the difficulty in trying to implement this framework using existing data, as current data available in the various countries suffer from inconsistencies in definitions, coverage, and measurement. The pitfalls and assumptions necessary to construct a comparable estimate using existing data, therefore, are quite significant. The report concludes that it is not possible at this time to develop a meaningful comparative estimate of the cost of drug use across countries. However, it points out that steps could be taken to improve the consistency of measurement in many of the indicators in future years through coordinated international efforts, not unlike that currently being undertaken by the EMCDDA for the European Community. Details: Santa Monica, CA: RAND, 2009. 47p. Source: Internet Resource; Report 3 Year: 2009 Country: International URL: Shelf Number: 117656 Keywords: Drug Abuse and Addiction Drug and Narcotic Control Economics Narcotics Substance Abuse

Author: Great Britain. National Audit Office Title: Tackling Problem Drug Use Summary: This report by the U.K. National Audit Office into government action to tackle problem drug use has concluded that there has been good progress in a number of areas, including an increasing number of problem drug users in effective treatment and an increasing number leaving treatment free from dependency. Details: London: The Stationery Office, 2010. 38p. Source: Internet Resource; HC 297 Session 2009-2010 Year: 2010 Country: United Kingdom URL: Shelf Number: 118558 Keywords: Drug Abuse and Addiction Drug Treatment

Author: European Monitoring Centre for Drugs and Drug Addiction Title: Cocaine and Crack Cocaine: A Growing Public Health Issue Summary: This report shows that, in some European countries, there has been a marked increase in recent years in the use of cocaine, in treatment demands for cocaine problems and in seizures of the drug. The potential for cocaine use to have a major impact on public health is examined and special attention given to the health consequences of cocaine use, which are often not well recognised in existing reporting systems. Also examined are the challenges to providing effective treatment for cocaine and crack cocaine dependence. Details: Luxembourg: Office for Official Publications of the European Communities, 2007. 30p. Source: Internet Resource' EMCDDA 2007 Selected Issue Year: 2007 Country: Europe URL: Shelf Number: 118622 Keywords: Cocaine Drug Abuse and Addiction Drug Treatment Drugs

Author: Lloyd, Charlie Title: Drugs Research: An Overview of Evidence and Questions for Policy Summary: In 2001 the Joseph Rowntree Foundation embarked upon a programme of research that explored the problem of illicit drugs in the UK. The research addressed many questions that were often too sensitive for the government to tackle. In many cases, these studies represented the first research on these issues. This study gives an overview of the projects in the programme. The topics covered include: The policing of drug possession; The domestic cultivation, purchasing and heavy use of cannabis; Non-problematic heroin use, heroin prescription and Drug Consumption Rooms; The impact of drugs on the family; and Drug testing in schools and in the workplace. Details: York, UK: Joseph Rowntree Foundation, 2010. 70p. Source: Internet Resource Year: 2010 Country: United Kingdom URL: Shelf Number: 119469 Keywords: Drug Abuse and Addiction Drug Testing Drug Treatment Drugs Narcotics Substance Abuse

Author: Keefer, Philip Title: Innocent Bystanders: Developing Countries and the War on Drugs Summary: Drug use and abuse is one of the most difficult challenges facing the contemporary world. If it is true that there has always been consumption of different types of drugs in different societies, although not in all of them, it is no less true that it generally took place in restricted, socially regulated realms, especially in ritualistic ceremonies. This is not the case today. Drug use has spread to all segments of society, with hedonistic motivations; although it is often not socially sanctioned, users are at times, depending on the drug, treated with leniency. It is well-established that all drugs are harmful to the health, even the legal ones, such as alcohol and tobacco, and that some drugs are more harmful, such as heroin and crack. The discussion of 'gateway drugs' is a medical issue on which there is no consensus. For the purposes of public policy design, the important thing to keep in mind is that drugs produce negative consequences for both users and societies in general, and that minimizing their consumption should be the main goal. The salient discussion, therefore, is about choosing among different strategies to achieve the same goal. Most of all, this report contributes to the debate by shedding light on the understanding of the economics and logistics of the drug market. Details: Washington, DC: The World Bank, 2010. 362p. Source: Internet Resource Year: 2010 Country: International URL: Shelf Number: 119523 Keywords: Drug Abuse and Addiction Drug Markets Drug Policy Drug Trafficking Drugs

Author: Jelsma, Martin Title: Legislative Innovation in Drug Policy Summary: This briefing summarizes good practices in legislative reforms around the world, representing steps away from a repressive zero-tolerance model towards a more evidence-based and humane drug policy. The examples provide lessons learned in practice about less punitive approaches and their impact on levels of drug use and drug related harm to the individual and society. Evidence suggests that legislation lessening criminalization combined with shifting resources from law enforcement and incarceration to prevention, treatment and harm reduction is more effective in reducing drug-related problems. Fears that softening drug laws and their enforcement would lead to sharp increases in drug use, have proven untrue. The examples cited, in spite of their differences in scope and objectives, can be regarded as improvements on an ineffective overly repressive drug control model and they indicate a direction for more substantial reform and paradigm shifts in the future. Details: Rio de Janeiro, Brazil: Latin American Initiative on Drugs and Democracy, 2009. 18p. Source: Internet Resource Year: 2009 Country: International URL: Shelf Number: 119553 Keywords: Drug Abuse and Addiction Drug Control Drug Policy

Author: Kilmer, Beau Title: Estimating the Size of the Global Drug Market: A Demand-Side Approach Summary: This report uses data on the prevalence of drug use, retail prices, and consumption patterns to generate country-level consumption and retail expenditure estimates for cannabis, heroin, cocaine, and amphetamine-type substances. Details: Santa Monica, CA: RAND, 2009. 94p. Source: Internet Resource; Accessed August 10, 2010 at: http://www.rand.org/pubs/technical_reports/2009/RAND_TR711.sum.pdf Year: 2009 Country: United States URL: http://www.rand.org/pubs/technical_reports/2009/RAND_TR711.sum.pdf Shelf Number: 117655 Keywords: Drug Abuse and Addiction Drug Markets Drug Trafficking

Author: Gutierrez, Leticia Title: Drug Treatment Courts: A Quantiative Review of Study and Treatment Quality Summary: "The effectiveness of drug courts has been debated in regards to two main factors: (1) study quality and (2) treatment quality. The current study examined these two factors. Study quality was examined using the Collaborative Outcome Data Committee Guidelines (CODC), and treatment quality was assessed by evaluating adherence to the principles of Risk-Need-Responsivity (RNR). Using the CODC Guidelines, studies were rated as: “rejected”, “weak”, “good” or “strong” based on methodological quality. These guidelines have been used in meta-analytic reviews of sex offender (Hanson, Bourgon, Helmus & Hodgson, 2009) and community supervision (Simpson, 2008) outcome evaluations. The RNR principles have been previously shown to mediate the effectiveness of offender treatment across various offender groups and a variety of criminogenic needs (e.g., substance abuse, sexual offending). In total, 96 studies were reviewed and assessed according to study and treatment quality. Results of this review found that the study quality of the literature is poor and this accounted for much of the variability found across studies. Furthermore, analyses revealed that although adherence to the RNR principles was poor, increasing adherence to RNR resulted in more effective treatment of offenders in reducing recidivism. Using only methodologically acceptable studies, the least biased estimate of the effectiveness of drug courts in reducing recidivism was found to be approximately 8%. Limitations and future research directions are discussed." Details: Ottawa: Public Safety Canada, 2009. 19p. Source: Internet Resource; Accessed August 14, 2010 at: http://www.publicsafety.gc.ca/res/cor/rep/_fl/2009-04-dtc-eng.pdf Year: 2009 Country: Canada URL: http://www.publicsafety.gc.ca/res/cor/rep/_fl/2009-04-dtc-eng.pdf Shelf Number: 117386 Keywords: Drug Abuse and Addiction Drug Courts Drug Offenders Drug Treatment

Author: World Health Organization, Europe Title: Psychoactive Substance Use in Kosovo: Rapid Assessment and Response with Youth, Injecting Drug Users and Prisoners Summary: "The report analyses the level of psychoactive substance use with youth, injecting drug users and prisoners in Kosovo. The aim of the report is to document the situation on psychoactive substance use in Kosovo and to provide recommendations which should be taken into consideration when designing evidence-based interventions and programmes at the institutional and community level." Details: Pristina, Kosovo: UNICEF, 2010. Source: Internet Resource; Accessed August 16, 2010 at:http://www.unicef.org/ceecis/RAR_psychoactive_substance_use_eng_09.pdf Year: 2010 Country: International URL: http://www.unicef.org/ceecis/RAR_psychoactive_substance_use_eng_09.pdf Shelf Number: 119608 Keywords: Drug Abuse and Addiction Drug Offenders Drug Treatment Psychoactive Drugs (Kosovo)

Author: Reuter, Peter Title: A Report on Global Illicit Drugs Markets, 1998-2007 Summary: "This document provides the key findings of a project assessing how the global market for drugs developed from 1998 to 2007 and describing drug policy around the globe during that period. To the extent data allows, the project assessed how much policy measures, at the national and sub-national levels, have influenced drug problems. The analysis is focused on policy relevant matters but it does not attempt to make recommendations to governments." Details: Brussels: European Communities, 2009p. 74p. Source: Internet Resource; Accessed August 17, 2010 at: http://ec.europa.eu/justice_home/doc_centre/drugs/studies/doc/report_short_10_03_09_en.pdf Year: 2009 Country: International URL: http://ec.europa.eu/justice_home/doc_centre/drugs/studies/doc/report_short_10_03_09_en.pdf Shelf Number: 113912 Keywords: Drug Abuse and Addiction Drug Control Drug Markets Drug Policy

Author: UK Drug Policy Commission Title: The Impact of Drugs on Different Minority Groups: Ethnicity and Drug Treatment Summary: These wide-ranging reports describe what is known about treatment and prevention within diverse communities, including LGBT groups, disabled people and BME communities. The aim of the review was to encourage greater consideration of the needs and challenges of drug problems for minority groups, by bringing together a variety of evidence in one place. The study suggests that mainstream services are not always meeting the needs of diverse communities. The reports present challenges for commissioners. The four volumes of the report are as follows; Part 1: Ethnic groups; Part 2: Lesbian, Gay, Bisexual and Transgender; Part 3: Disabled people; and Part 4: The Impact of Drugs on Different Minority Groups: Ethnicity and Drug Treatment. Details: London: UK Drug Policy Commission, 2010. 4 vols. Source: Internet Resource; Accessed August 17, 2010 at: http://www.ukdpc.org.uk/publications.shtml (website for all 4 reports) Year: 2010 Country: United States URL: http://www.ukdpc.org.uk/publications.shtml (website for all 4 reports) Shelf Number: 119625 Keywords: (U.K.) Drug Abuse and Addiction Drug Abuse Prevention (U.K.) Drug Treatment (U.K.) Minority Groups (U.K.)

Author: Machin, Juliette R. Title: Anne Arundel County Juvenile Treatment Court Outcome and Cost Evaluation Summary: Anne Arundel County Juvenile Treatment Court (JTC) was formed in 2003 after a pilot period in 2002. The program admitted its first participant in October 2003 and as of February 2009 has served 185 participants. The JTC program has three phases that can be completed by participants in a period as short as 10 months. For the 154 treatment court participants included in this study who had since exited the program, either successfully or unsuccessfully, the average number of days in the program was 316 (approximately 10 months). Graduates spent an average of 317 days in the program, whereas non-graduates spent an average of 314 days in the program. Throughout the program, participants attend treatment court hearings evaluating their progress (with a parent/guardian) and group and individual counseling sessions. The program requires that the youth submit to drug testing, attend school or another educational or occupational activity, and complete community service hours. The JTC uses incentives and sanctions to encourage positive behaviors. Youth must have been abstinent for a minimum of 60 consecutive days and complete all program requirements to graduate. Three key policy questions of interest to program practitioners, researchers, and policymakers about treatment courts were addressed in this study: 1) Does the JTC reduce substance abuse among program participants?; 2) Does the JTC program reduce recidivism in the juvenile justice system?; and 3) Does the JTC result in savings of taxpayer dollars? Details: Portland, OR: NPC Research, 2010. 51p. Source: Internet Resource: Accessed August 19, 2010 at: http://www.npcresearch.com/Files/MD%20Outcome%20Cost/AA_Co_Juv_DC_outcome-cost_0110.pdf Year: 2010 Country: United States URL: http://www.npcresearch.com/Files/MD%20Outcome%20Cost/AA_Co_Juv_DC_outcome-cost_0110.pdf Shelf Number: 119639 Keywords: Drug Abuse and Addiction Drug Offenders, Juveniles Drug Treatment Courts, Juvenile Offenders Drug Treatment, Juveniles Recidivism, Juvenile Offenders

Author: Welsh, Brandon C. Title: Effectiveness of Public Area Surveillance for Crime Prevention: Security Guards, Place Managers and Defensible Space Summary: This report presents a systematic review of the effects of surveillance of public spaces by security guards, place mangers and measures to stimulate so called defensible space. Studies were included in these systematic reviews if the surveillance measure in question (i.e., security guards, place managers, and defensible space) was the main focus of the intervention; if there was an outcome measure of crime; if the evaluation design was of high methodological quality, with the minimum design involving before-and-after measures of crime in experimental and comparable control areas; and if the total number of crimes in each area before the intervention was at least 20. The reviews revealed generally encouraging results across the three different types of public area surveillance. There is fairly strong and consistent evidence that the defensible space technique of street closures or barricades is effective in preventing crime in inner-city neighborhoods. Less conclusive statements can be made about the effectiveness of security guards and place managers. This has everything to do with the small number of high quality evaluations that have been carried out on these measures. In the case of security guards, the weight of the evidence suggests that it is a promising technique of formal surveillance when implemented in car parks and targeted at vehicle crimes. The surveillance technique of place managers appears to be of unknown effectiveness in preventing crime in public places. Implications for policy and research are explored. Details: Stockholm: Brottsforebyggande radet (Swedish National Council for Crime Prevention), 2010. 45p. Source: Internet Resource: Accessed August 25, 2010 at: http://www.bra.se/extra/measurepoint/?module_instance=4&name=Effectiviness_of_Public_Area_Surveillance_for_Crime_Prevention.pdf&url=/dynamaster/file_archive/100309/0a3ceabb221375f51f9a82824942a662/Effectiviness%255fof%255fPublic%255fArea%255fSurveillance%255ffor%255fCrime%255fPrevention.pdf Year: 2010 Country: International URL: http://www.bra.se/extra/measurepoint/?module_instance=4&name=Effectiviness_of_Public_Area_Surveillance_for_Crime_Prevention.pdf&url=/dynamaster/file_archive/100309/0a3ceabb221375f51f9a82824942a662/Effectiviness%255fof%255fPub Shelf Number: 119684 Keywords: Aggression Crime Prevention Crime Prevention through Environmental Design Drug Abuse and Addiction Drug Abuse and Crime Methamphetamine (Australia) Private Security Surveillance

Author: Burke, Cynthia Title: 2009 Juvenile Arrestee Drug Use in the San Diego Region Summary: This CJ Bulletin, “2009 Juvenile Arrestee Drug Use in the San Diego Region,” is the first in a series presenting data collected (from both juveniles and adults) in the 2009 calendar year and now includes ten years of data. As part of this study, a total of 159 youth were interviewed at Juvenile Hall during two separate months in 2009. Ninety-seven percent (97%) or 154 of these youth provided a urine sample for drug testing purposes (120 males and 34 females). This research bulletin includes the results of urinalysis trends over time, as well as information pertaining to lifetime and recent self-reported drug use, perceived risk and availability of different drugs, and characteristics of the youth that were interviewed and how these factors may be related to drug use. Details: San Diego, CA: Criminal Justice Research Division, SANDAG, 2010. 19p. Source: Internet Resource: Accessed August 28, 2010 at: http://www.sandag.org/uploads/publicationid/publicationid_1496_11514.pdf Year: 2010 Country: United States URL: http://www.sandag.org/uploads/publicationid/publicationid_1496_11514.pdf Shelf Number: 119700 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Juvenile Offenders (San Diego)

Author: Gunasekara, Sanji Title: Drug Law Reform: Lessons from the New Zealand Experience Summary: New Zealand’s existing drug laws are out of date, overly complex and poorly aligned with official drug policy. In 2007, the Government decided to entrust an independent agency, the New Zealand Law Commission, to comprehensively review the country’s drug law. The Commission will present a final report which is likely to feature a new approach to personal pos­session and use of drugs placing less emphasis on conviction and punish­ment and more on the delivery of effective treatment. This is an important departure as, in many countries, and previously in New Zealand, drug laws have been developed and implemented with little consideration of their wider impact on social policy. The Commission's final report is likely to serve as a blueprint for drug law reform. Many of the recommendations will be applicable to other countries attempting to steer a balance between enacting progressive drug law reform while complying with their international treaty obligations. Details: Amsterdam: Transnational Institute; London: International Drug Policy Consortium, 2010. 12p. Source: Internet Resource: Series on Legislative Reform of Drug Policies No. 8: Accessed September 1, 2010 at: http://www.idpc.net/sites/default/files/library/Lessons%20from%20New%20Zealand%20Experience.pdf Year: 2010 Country: New Zealand URL: http://www.idpc.net/sites/default/files/library/Lessons%20from%20New%20Zealand%20Experience.pdf Shelf Number: 119715 Keywords: Drug Abuse and Addiction Drug Policy Drug Reform

Author: National Centre for Social Research Title: ASB Family Intervention Projects: Monitoring and Evaluation Summary: Family Intervention Projects (FIPs) work with the most challenging families and tackle issues such as antisocial behaviour, youth crime, school absenteeism, drug and alcohol addiction, domestic violence, poor mental health and inter-generational disadvantage. Families are supported by a dedicated ‘key worker’ who coordinates a multi-agency package of support and works directly with family members to help them overcome their problems. The different FIP models are aimed at reducing antisocial behaviour, preventing youth crime and tackling child poverty. Family Intervention Projects (FIPs) work with the most challenging families and tackle issues such as antisocial behaviour, youth crime, school absenteeism, drug and alcohol addiction, domestic violence, poor mental health and inter-generational disadvantage. Families are supported by a dedicated ‘key worker’ who coordinates a multi-agency package of support and works directly with family members to help them overcome their problems. The different FIP models are aimed at reducing antisocial behaviour, preventing youth crime and tackling child poverty. This report provides an evaluation of the FIPs and is the first report to include information on families who have been followed up 9 to 14 months after they exited from a FIP intervention. The next monitoring report will be published in Autumn 2010 and, for the first time, will include outcomes for all types of FIPs. Details: London: Department for Children, Schools and Families, 2010. 18p. Source: Internet Resource: Accessed September 23, 2010 at: http://www.natcen.ac.uk/pzMedia/uploads/Downloadable/e3e97aca-4d52-40fd-8ccb-5c11b7bd49a8.pdf Year: 2010 Country: United Kingdom URL: http://www.natcen.ac.uk/pzMedia/uploads/Downloadable/e3e97aca-4d52-40fd-8ccb-5c11b7bd49a8.pdf Shelf Number: 119846 Keywords: Antisocial Behavior Delinquency Prevention Domestic Violence Drug Abuse and Addiction Family Interventions

Author: Rodriguez, Nancy Title: Methamphetamine Use Among Recently Booked Arrestees and Detainees in Maricopa County, Arizona Summary: Methamphetamine Use among Recently Booked Arrestees and Detainees in Maricopa County is another in a series of special topic reports for the Arizona Arrestee Reporting Information Network (AARIN). Using data collected from the core interview instrument, the report looks at the percent of adult and juvenile arrestees who use methamphetamine, their social and legal characteristics, treatment history, and other critical factors. Details: Phoenix, AZ: Center for Violence Prevention and Community Safety, Arizona State University, 2009. 14p. Source: Internet Resource: Accessed October 5, 2010 at: http://cvpcs.asu.edu/aarin/aarin-reports-1/meth-final-jan-2009.pdf/view Year: 2009 Country: United States URL: http://cvpcs.asu.edu/aarin/aarin-reports-1/meth-final-jan-2009.pdf/view Shelf Number: 119861 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders (Arizona) Methamphetamines

Author: European Monitoring Centre for Drugs and Drug Addiction Title: Polydrug Use: Patterns and Responses Summary: In this report, individual data from the surveys carried out in 2003 by the European school survey project on alcohol and other drugs (ESPAD) are used to examine the characteristics of polydrug use among over 70,000 15- to 16-year-old students from 22 European countries. Details: Luxembourg: Office for Official Publications of the European Communities, 2009. 29p. Source: Internet Resource: Accessed October 7, 2010 at: http://www.emcdda.europa.eu/attachements.cfm/att_93217_EN_EMCDDA_SI09_polydrug%20use.pdf Year: 2009 Country: Europe URL: http://www.emcdda.europa.eu/attachements.cfm/att_93217_EN_EMCDDA_SI09_polydrug%20use.pdf Shelf Number: 119886 Keywords: Alcohol Abuse Drug Abuse and Addiction Drug Offenders Narcotics

Author: Hughes, Caitlin Title: Media Reporting on Illicit Drugs in Australia: Trends and Impacts on Youth Attitudes to Illicit Drug Use Summary: This study starts to address the intersection between news media and illicit drug use. It examines two major aspects of news media: media production – as denoted by patterns and trends in Australian news media reporting on illicit drugs – and media effects – as denoted by impacts on youth attitudes to illicit drug use. The purpose of this study was fourfold: To identify the dominant media portrayals used to denote illicit drugs in Australian news media and dominant portrayals by drug type (cannabis, amphetamines, ecstasy, cocaine and heroin); To identify the extent to which media portrayals have changed over time (from 2003-2008): measured in terms of the number and type of media reports on illicit drugs; To explore the impacts of different media portrayals on youth attitudes to illicit drug use: namely their perceptions of the risks and acceptability of use and their likelihood of future use; and To determine if the media differentially affects sub-populations of youth, and if so, to identify the sub-populations of youth that are most responsive to media reporting on illicit drugs. Details: Sydney: National Drug and Alcohol Research Centre, 2010. 138p. Source: Internet Resource: Drug Policy Modelling Program, Monograph 19: Accessed October 8, 2010 at: http://www.dpmp.unsw.edu.au/DPMPWeb.nsf/resources/Monograph+16.pdf/$file/Mono+19.pdf Year: 2010 Country: Australia URL: http://www.dpmp.unsw.edu.au/DPMPWeb.nsf/resources/Monograph+16.pdf/$file/Mono+19.pdf Shelf Number: 119888 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Abuse Policy Media

Author: Sykes, Wendy Title: Perceptions of Social Harms Associated with Khat Use Summary: This is the report of research into perceptions of social harms associated with the use of khat in Somali, Yemeni and Ethiopian communities in England and Wales. Views were sought from within these key communities, from professionals and practitioners directly involved with them, from mainstream drug and alcohol service providers and from members of the wider UK population. The research was carried out in London, Sheffield and Cardiff with fieldwork conducted during May and June 2009. The research was to: explore the perceived social harms associated with khat affecting the user, his/her family and the wider community; explore differences in perceptions of harms by age group, country of origin and gender; investigate the level and type of service available to khat users and their families, and the expectations and needs of khat users from services; investigate views on the appropriate Government response to khat. Details: London: Home Office Research, Development and Statistics Directorate, 2010. 19p. Source: Internet Resource: Home Office Research Report 44: Accessed October 13, 2010 at: http://rds.homeoffice.gov.uk/rds/pdfs10/horr44c.pdf Year: 2010 Country: United Kingdom URL: http://rds.homeoffice.gov.uk/rds/pdfs10/horr44c.pdf Shelf Number: 119951 Keywords: Drug Abuse and Addiction Drugs Khat

Author: Rolles, Stephen, ed. Title: A Comparison of the Cost-effectiveness of Prohibition and Regulation of Drugs Summary: Despite the billions spent each year on proactive and reactive drug law enforcement, the punitive prohibitionist approach has consistently delivered the opposite of its stated goals. The UK Government’s own data clearly demonstrates drug supply and availability increasing; use of drugs that cause the most harm increasing; health harms increasing; massive levels of crime created at all scales leading to a crisis in the criminal justice system; and illicit drug profits enriching criminals, fuelling conflict and destabilising producer and transit countries from Mexico to Afghanistan. This is an expensive policy that, in the words of the UN Office on Drugs and Crime, has also created a raft of negative ‘unintended consequences’. The UK Government specifically claims the benefits of any move away from prohibition towards legal regulation of drug markets would be outweighed by the costs. No such cost-benefit analysis, or even a proper impact assessment of existing enforcement policy and legislation has ever been carried out here or anywhere else in the world. Yet there are clear Government guidelines that an impact assessment should be triggered by amongst other things, a policy going out to public consultation or when ‘unintended consequences’ are identified, both of which have happened with drug policy in recent years. Alternative approaches—involving established regulatory models of controlling drug production, supply and use—have not been considered or costed. The limited cost effectiveness analysis of current policy that has been undertaken has frequently been suppressed. In terms of scrutinizing major public policy and spending initiatives, current drug policy is unique in this regard. The generalisations being used to defend continuation of an expensive and systematically failing policy of drugs prohibition, and close down a mature and rational exploration of alternative approaches, are demonstrably based on un-evidenced assumptions. This paper is an attempt to begin to redress these failings by comparing the costs and benefits of the current policy of drug prohibition, with those of a proposed model for the legal regulation of drugs in the UK. We also identify areas of further research, and steps to ensure future drugs policy is genuinely based on evidence of what works. This initial analysis demonstrates that a move to legally regulated drug supply would deliver substantial benefits to the Treasury and wider community, even in the highly unlikely event of a substantial increase in use. Details: Bristol, UK: Transform Drug Policy Foundation, 2009. 50p. Source: Internet Resource: Accessed October 26, 2010 at: http://www.tdpf.org.uk/CBA%20New%202010.pdf Year: 2009 Country: United Kingdom URL: http://www.tdpf.org.uk/CBA%20New%202010.pdf Shelf Number: 120098 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Policy Drug Regulation

Author: Patel, Professor Lord Patel of Bradford Title: The Patel Report: Reducing Drug-Related Crime and Rehabilitating Offenders Summary: The report focuses on drug treatment and interventions for people in prison, people moving between prisons and the continuity of care for people on release from prison. The report outlines the evidence gathered and work carried out by the Review Group and summarises their conclusions and recommendations. Details: London: UK Department of Health, 2010. 216p. Source: Internet Resource: Accessed November 2, 2010 at: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_119850.pdf Year: 2010 Country: United Kingdom URL: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_119850.pdf Shelf Number: 120153 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders Drug Treatment Rehabilitation

Author: Haynes, R. Title: Drug Trends and Crime Tracking: Relationships Between Indices of Heroin, Amphetamine and Cannabis Use and Crime Summary: Illicit drug use is associated with a range of harms to individuals, families and the wider community, and is a contributing factor to disability and death. In addition, illicit drug use is associated with crime. In 2004–05 it is estimated that drug related crime cost the Australian community $4 billion. Due to the wide range of harms associated with illicit drug use, it is important to examine the relationships between the prevalence of illicit drug use and health-related outcomes. However, as illicit drug use is also associated with crime and criminal behaviour it is also important to consider the effects of illicit drug use and availability on crime. This research was funded by the Office of Crime Prevention as a 'Crime Futures' research project. A primary objective was to investigate the potential for drug use indicators to be identified as a planning or 'early warning' tool for changing drug use trends. It was considered that the identification of reliable indicators would assist policy makers and service organisations in the health, welfare and justice sectors to plan in advance for changes in drug use patterns. Details: Perth: Government of Western Australia, Drug and Alcohol Office, 2010. 54p. Source: Internet Resource: Drug and Alcohol Office Monograph: No. 6: Accessed December 20, 2010 at: http://www.crimeprevention.wa.gov.au/uploads/file/Drug%20Trends%20and%20Crime%20Report.pdf Year: 2010 Country: Australia URL: http://www.crimeprevention.wa.gov.au/uploads/file/Drug%20Trends%20and%20Crime%20Report.pdf Shelf Number: 120554 Keywords: Drug Abuse and Addiction Drug Abuse and Crime (Australia) Drug Abuse Policy

Author: United Nations Office on Drugs and Crime, Global SMART Programme Title: Patterns and Trends of Amphetamine-Type Stimulants and Other Drugs: Asia and the Pacific Summary: UNODC launched the Global Synthetics Monitoring: Analyses, Reporting and Trends (SMART)Programme in September 2008. The Programme seeks to enhance the capacity of Member States and authorities in priority regions, to generate, manage, analyse and report synthetic drug information, and to apply this scientic evidence-based knowledge to the design of policies and programmes. The Global SMART Programme is being implemented in a gradual phased manner, with East and Southeast Asia being the first focus region. This annual report is the second regional situation assessment for East and Southeast Asia put forward under the Global SMART Programme. It forms one of the essential key steps, in providing consolidated up-to-date analysis, based on the information shared by the member countries. It is hoped that the information on drug trends presented in this report will make a practical contribution to addressing the significant threat posed by illicit ATS manufacture, trafficking and use in the East and Southeast Asia region, and place policy-makers in a better position to evaluate the drug situation and to make informed decisions on intervention and prevention strategies. This report provides an overview of the ATS situation in the region. It outlines several key issues and emerging threats throughout the region and their implications for neighbouring regions. While the data presented points towards the increased efforts by the countries in the region to tackle the ATS problem, it also highlights the need for continued and joint efforts, both at the national as well as regional levels. It is hoped that this report and the forthcoming national and regional updates, will promote better understanding of the ATS problem and help in designing effective strategies to combat it. Details: Vienna: UNODC, 2010. 158p. Source: Internet Resource: Accessed February 3, 2011 at: http://www.unodc.org/documents/scientific/ATS_Report_2010_web.pdf Year: 2010 Country: Asia URL: http://www.unodc.org/documents/scientific/ATS_Report_2010_web.pdf Shelf Number: 120687 Keywords: Drug Abuse and Addiction Drug Control Policies Drug Trafficking Substance Abuse (Asia and the Pacific)

Author: English, Kim Title: White Paper from the Treatment Funding Working Group Summary: In 2009, the Commission on Criminal and Juvenile Justice and its Drug Policy Task Force recommended that the public policy of Colorado recognize alcoholism and substance addiction as illnesses and public health problems affecting the general welfare of the state. The Commission made a number of recommendations regarding the need to prioritize treatment for offenders with behavioral health disorders. But the members of the Commission also generally agreed that its recommendations regarding treatment require that treatment be available and accessible to the offender population. The Commission established a Treatment Funding Working Group to investigate issues related to treatment availability and treatment funding allocations. The Working Group early on agreed that the issues of treatment availability and funding cannot be considered without placing substance abuse in the larger context of co‐occurring mental health disorders (the combination of substance use disorders and mental illness is referred to as behavioral health), prevalence rates, the science of addiction, the criminal justice response to relapse, and treatment effectiveness. This report seeks to address these issues. While the report focuses on adults in the justice system, the Working Group recognizes that those in the juvenile justice system are equally important, as are efforts to prevent these problems and to intervene early. Details: Denver, CO: Colorado Department of Public SAfety, Division of Criminal Justice, 2010. 153p. Source: Internet Resource: Accessed February 24, 2011 at: http://cdpsweb.state.co.us/cccjj/PDF/Commission%20reports/Revised%202-14-11%20Treatment%20Funding%20White%20Paper.pdf Year: 2010 Country: United States URL: http://cdpsweb.state.co.us/cccjj/PDF/Commission%20reports/Revised%202-14-11%20Treatment%20Funding%20White%20Paper.pdf Shelf Number: 120867 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Drug Offenders Mental Health Treatment Substance Abuse (Colorado)

Author: United Nations Office on Drugs and Crime Title: Afghanistan Opium Survey 2010 Summary: This year’s Afghanistan Opium Survey shows that while the total area under cultivation and the number of families growing opium poppy remained the same as in 2009, opium production fell drastically to roughly half of last year’s levels. The cause of the decline in production was a naturally occurring plant disease that affected Afghanistan’s major opium poppy-growing regions this year. Like opium production, the gross export value of Afghan opiates was halved this year. This indicates that the income of Afghan traffickers from the 2010 opium season is also down. But there is cause for concern. The market responded to the steep drop in opium production with an equally dramatic jump in the market price to more than double 2009 levels. Meanwhile, the price of wheat—one of Afghanistan’s principal crop alternatives to opium—has fallen. At current prices, planting opium poppies is six times more profitable than growing wheat. The high price of opium combined with a low wheat price may encourage more farmers to cultivate opium in 2011. The 2010 Survey continues to underscore the linkage between opium poppy cultivation and security in Afghanistan. In areas where there is a government presence and the rule of law prevails, only a few hundred hectares of opium cultivation remain. Twenty provinces are already poppy-free, and with some additional effort, Afghanistan could achieve five more poppy-free provinces next year (Hirat, Kabul, Kunar, Laghman and Zabul). We encourage their governors, the central Government and donors to help these provinces become poppy-free in 2011. Badghis and Zabul have achieved significant reductions, and we encourage efforts to stop the increased cultivation in Badakhshan and Nangarhar to avoid a return to the worrying levels observed in 2007. The significant expansion of cultivation in Kandahar Province over the past two years must also be stopped, and we urge the governor and other partners to play an active role in preventing any further increase and to ensure progress is made in eradication. Further growth in poppy cultivation in Kandahar would have an adverse effect on other provinces as well. Enabling farmers to make a living and support their families by planting licit crops is the most effective way to stop opium poppy cultivation. Providing villages with agricultural assistance encourages the cultivation of licit crops. For the first time this year, we saw a correlation between provision of agricultural assistance and a drop in opium cultivation. Providing farmers with access to markets for their crops also helps keep them away from opium poppy cultivation. In villages that are close to agricultural markets, farmers plant less poppy than in villages with no access to markets. Details: Vienna: UNODC, 2010. 118p. Source: Internet Resource: Accessed march 14, 2011 at: http://www.unodc.org/documents/crop-monitoring/Afghanistan/Afghanistan_Opium_Survey_2010_web.pdf Year: 2010 Country: Afghanistan URL: http://www.unodc.org/documents/crop-monitoring/Afghanistan/Afghanistan_Opium_Survey_2010_web.pdf Shelf Number: 120925 Keywords: Drug Abuse and Addiction Narcotics Opium Abuse (Afghanistan)

Author: Lyons, Suzi Title: Close to Home: A Study on the Misuse of Drugs and Alcohol in the Midland Region Summary: The Midlands Regional Drugs Task Force (MRDTF) commissioned this study in order to establish an evidence base for drug-related issues in the Midlands region to inform the development of appropriate strategies and to respond to these issues in four selected communities. A rapid situation assessment technique was used, bringing together information from several different sources as well as interviews and focus groups with key informants in four selected communities. The key findings include the following. The MRDTF area covers four counties with a population of approximately one-quarter of a million people, and has seen a rise in its population and a change of ethnic mix over the past years. Overall it has marginally lower educational levels and housing occupancy than the national levels. One in five of the population in the MRDTF area has used an illegal drug at least once in their lifetime. Younger adults, especially men used illegal drugs, however it is shown that a proportion of women have used legal drugs. The majority of alcohol and drug use appears to start before the age of 18. The serious impact of this is clear: two out of every five drug-related deaths in the MRDTF area was a person aged 20 to 29 years of age. Alcohol use is also very prevalent among the population and was the main problem substance treated in the region (2004 – 2007). It was also implicated as an additional substance in many cases treated for polysubstance use. Alcohol (in conjunction with another drug or substance) was implicated in over onequarter of drug-related deaths in the region. Cannabis was the most commonly used drug in the general population, but the data indicated that ecstasy, cocaine and heroin was also available in the region, along with a range of other illegal and legal drugs. Cocaine use emerged as a newer trend. An opiate (mainly heroin) was the main problem drug treated in the region. Heroin and other opiates were implicated in over one-third of all deaths due to poisonings reported in the MRDTF area between 1999 and 2005. While the number of people who sought treatment for benzodiazepine addiction was very small, there was evidence that it was being abused in the MRDTF area and has been implicated in more drug-related deaths in the area than any other substance. Benzodiazepines were used by opiate and alcohol users. Polysubstance use among drug users in the region was evident. The upward trend in prosecutions for heroin in the two Garda Divisions comprising the MRDTF area indicated that the heroin market has spread to these four counties. Although the number of prosecutions for cocaine was lower it follows a similar upward trend. Details: Offaly, Ireland: Midlands Regional Drugs Task Force, 2010. 111p. Source: Internet Resource: Accessed March 17, 2011 at: http://www.drugsandalcohol.ie/13108/1/MRDTF_Report_Close_to_home.pdf Year: 2010 Country: Ireland URL: http://www.drugsandalcohol.ie/13108/1/MRDTF_Report_Close_to_home.pdf Shelf Number: 121060 Keywords: Alcohol Abuse Drug Abuse and Addiction Drug Abuse and Crime (Ireland) Drug Offenders Drug Offenses

Author: Gerra, Gilberto Title: From Coercion to Cohesion: Treating Drug Dependence Through Health Care, Not Punishment. Discussion Paper Summary: The aim of this draft discussion paper, “From coercion to cohesion: Treating drug dependence through health care, not punishment”, is to promote a health-oriented approach to drug dependence. The International Drug Control Conventions give Member States the flexibility to adopt such an approach. Treatment offered as alternative to criminal justice sanctions has to be evidence-based and in line with ethical standards. This paper outlines a model of referral from the criminal justice system to the treatment system that is more effective than compulsory treatment, which results in less restriction of liberty, is less stigmatising and offers better prospects for the future of the individual and the society. Drug dependence treatment without the consent of the patient should only be considered a short-term option of last resort in some acute emergency situations and needs to follow the same ethical and scientific standards as voluntary-based treatment. Human rights violations carried out in the name of “treatment” are not compliant with this approach. Details: Geneva: United Nations Office on Drugs and Crime, 2010. 22p. Source: Internet Resource: Accessed March 21, 2011 at: http://www.unodc.org/docs/treatment/Coercion_Ebook.pdf Year: 2010 Country: International URL: http://www.unodc.org/docs/treatment/Coercion_Ebook.pdf Shelf Number: 121088 Keywords: Drug Abuse and Addiction Health Care Substance Abuse Treatment

Author: Bewley-Taylor, David: Jelsma, Martin Title: Fifty Years of the 1961 Single Convention on Narcotic Drugs: A Reinterpretation Summary: This year marks the 50th anniversary of the United Nations Single Convention on Narcotic Drugs, signed on 30 March 1961. 73 countries were represented at the conference that took place in New York from 24 January to 25 March 1961, which sought to lay a new solid foundation for drug control in the post-war United Nations era. The aim was to replace the multiple existing multilateral treaties in the field with a single instrument as well as to reduce the number of international treaty organs concerned with the control of narcotic drugs, and to make provisions for the control of the production of raw materials of narcotic drugs. The Single Convention entered into force on 13 December 1964, having met the requirement of forty state ratifications. Couched with the lofty aim of concern for “the health and welfare of mankind,” the guiding principle of the treaty was to limit the use of drugs exclusively to medical and scientific purposes, because, as the preamble continues, “addiction to narcotic drugs constitutes a serious evil for the individual and is fraught with social and economic danger to mankind.” At the same time, the Convention recognized “that the medical use of narcotic drugs continues to be indispensable for the relief of pain and suffering and that adequate provision must be made to ensure the availability of narcotic drugs for such purposes”. Fifty years on, it is time for a critical reflection on the validity of the Single Convention today: a reinterpretation of its historical significance and an assessment of its aims, its strengths and its weaknesses. Indeed, while there is often a tendency to interpret the treaty as part of an unbroken continuum dating back to the first decade of the last century, the Single Convention must rather be seen as a significant change in way the international community approached drug control. Furthermore, it should not be forgotten that the original ambition for the ‘Single’ Convention to become the ‘convention to end all conventions’ failed when the control regime developed further with conventions in 1971 and 1988 giving rise to new inconsistencies within the current global drug control treaty system. This policy briefing analyses the origins and negotiations of the Single Convention, examines the way it broke with the previous drug control system by introducing a more prohibitive ethos, penal obligations, controls on plants and abolition of traditional uses of plants like coca, and concludes that a revision of its outdated provisions is required. Details: Amsterdam: Transnational Institute, 2011. 20p. Source: Internet Resource: Series on Legislative Reform of Drug Policies No. 12: Accessed April 8, 2011 at: http://www.druglawreform.info/images/stories/documents/dlr12.pdf Year: 2011 Country: International URL: http://www.druglawreform.info/images/stories/documents/dlr12.pdf Shelf Number: 121285 Keywords: Drug Abuse and Addiction Drug Abuse Policy Drug Control Policy

Author: Jelsma, Martin Title: Lifting the Ban on Coca Chewing: Bolivia's Proposal to Amend the 1961 Single Convention Summary: January 31, 2011, marked the close of the 18-month period during which countries could submit objections to Bolivia’s proposal to remove from the 1961 Single Convention on Narcotic Drugs the obligation to abolish the practice of coca chewing. A total of eighteen countries formally notified the UN Secretary General that they could not accept the proposed amendment: the United States, the United Kingdom, Sweden, Canada, Denmark, Germany, the Russian Federation, Japan, Singapore, Slovakia, Estonia, France, Italy, Bulgaria, Latvia, Malaysia, Mexico and Ukraine. The U.S. convened a group of ‘friends of the convention’ to rally against what they perceived to be an undermining of the ‘integrity’ of the treaty and its guiding principle to limit the trade and use of narcotic drugs exclusively to medical and scientific purposes. The UN Economic and Social Council (ECOSOC or the Council) will have to decide how to proceed, most likely during its substantive session in Geneva this July. This briefing paper analyses the reasons behind the proposed amendment and the opposing arguments that have been brought forward, and outlines the various options to be considered as the fate of Bolivia’s proposal is determined. Simply rejecting the amendment will not make the issue disappear. Details: Amsterdam: Transnational Institute, 2011. 8p. Source: Internet Resource: Series on Legislative Reform of Drug Policies No. 11: Accessed April 8, 2011 at: http://www.idpc.net/sites/default/files/library/lifting-the-ban-on-coca.pdf Year: 2011 Country: Bolivia URL: http://www.idpc.net/sites/default/files/library/lifting-the-ban-on-coca.pdf Shelf Number: 121286 Keywords: Coca Leaf Drug Abuse and Addiction Drug Control (Bolivia) Drug Policy

Author: Open Society Institute. Public Health Program Title: At What Cost? HIV and Human Rights Consequences of the Global "War on Drugs" Summary: A decade after governments worldwide pledged to achieve a "drug-free world," there is little evidence that the supply or demand of illicit drugs has been reduced. Instead, aggressive drug control policies have led to increased incarceration for minor offenses, human rights violations, and disease. This book examines the descent of the global war on drugs into a war on people who use drugs. From Puerto Rico to Phnom Penh, Manipur to Moscow, the scars of this war are carried on the bodies and minds of drug users, their families, and the health and service providers who work with them. The following topics are included in this volume: •Police Abuse of Injection Drug Users in Indonesia •Arbitrary Detention and Police Abuse of Drug Users in Cambodia •Forced Drug Testing in China •Drug Control Policies and HIV Prevention and Care Among Injection Drug Users in Imphal, India •Effects of UN and Russian Influence on Drug Policy in Central Asia •The Impacts of the Drug War in Latin America and the Caribbean •Civil Society Reflections on 10 Years of Drug Control in Myanmar, Thailand, and Vietnam •Twin Epidemics–Drug Use and HIV/AIDS in Pakistan. Details: New York: Open Society Institute, 2009. 196p. Source: Internet Resource: Accessed April 20, 2011 at: http://www.soros.org/initiatives/health/focus/ihrd/articles_publications/publications/atwhatcost_20090302 Year: 2009 Country: International URL: http://www.soros.org/initiatives/health/focus/ihrd/articles_publications/publications/atwhatcost_20090302 Shelf Number: 121408 Keywords: AIDS (Disease) Drug Abuse and Addiction Drug Abuse Policy Drug Control Drug Enforcement

Author: Gorta, Angela Title: Operation Abelia: Research and Investigations into Illegal Drug Use by Some NSW Police Officers. Volume 1: Summary Report Summary: Illegal drug use by police officers is a concern in many jurisdictions. Project Abelia combined research and investigations to develop a better understanding of the nature of the problem of illegal drug use by some NSW police officers and what can be done to minimise such illegal drug use. Volume 1 is a Summary Report which provides an outline of how Operation Abelia was undertaken and describes a selection of findings and observations made. It also provides an overview of the nine-part strategy developed from the Commission’s 64 recommendations for strengthening the NSW Police Force’s approach to minimising illegal drug use by its officers. Details: Sydney: NSW Polite Integrity Commission, 2005. 50p. Source: Internet Resource: Accessed April 21, 2011 at: http://www.pic.nsw.gov.au/files/reports/Abelia_Volume_1_%20Summary.pdf Year: 2005 Country: Australia URL: http://www.pic.nsw.gov.au/files/reports/Abelia_Volume_1_%20Summary.pdf Shelf Number: 121394 Keywords: Drug Abuse and Addiction Police Ethics Police Misconduct (Australia)

Author: Global Commission on Drug Policy Title: War On Drugs: Report of the Global Commission on Drug Policy Summary: The global war on drugs has failed. When the United Nations Single Convention on Narcotic Drugs came into being 50 years ago, and when President Nixon launched the US government’s war on drugs 40 years ago, policymakers believed that harsh law enforcement action against those involved in drug production, distribution and use would lead to an ever-diminishing market in controlled drugs such as heroin, cocaine and cannabis, and the eventual achievement of a ‘drug free world’. In practice, the global scale of illegal drug markets – largely controlled by organized crime – has grown dramatically over this period. While accurate estimates of global consumption across the entire 50-year period are not available, an analysis of the last 10 years alone shows a large and growing market. In spite of the increasing evidence that current policies are not achieving their objectives, most policymaking bodies at the national and international level have tended to avoid open scrutiny or debate on alternatives. This lack of leadership on drug policy has prompted the establishment of our Commission, and leads us to our view that the time is now right for a serious, comprehensive and wide-ranging review of strategies to respond to the drug phenomenon. The starting point for this review is the recognition of the global drug problem as a set of interlinked health and social challenges to be managed, rather than a war to be won. Commission members have agreed on four core principles that should guide national and international drug policies and strategies, and have made eleven recommendations for action. The Commission’s recommendations include: ● End the criminalization, marginalization and stigmatization of people who use drugs but who do no harm to others. ● Encourage experimentation by governments with models of legal regulation of drugs (especially cannabis) to undermine the power of organized crime and safeguard the health and security of their citizens. ● Ensure that a variety of treatment modalities are available – including not just methadone and buprenorphine treatment but also the heroin-assisted treatment programs that have proven successful in many European countries and Canada. ● Apply human rights and harm reduction principles and policies both to people who use drugs as well as those involved in the lower ends of illegal drug markets such as farmers, couriers and petty sellers. Details: Rio de Janeiro: Global Commission on Drug Policy, 2011. 20p. Source: Internet Resource: Accessed June 28, 2011 at: http://www.globalcommissionondrugs.org/Report Year: 2011 Country: International URL: http://www.globalcommissionondrugs.org/Report Shelf Number: 121881 Keywords: Drug Abuse and Addiction Drug Abuse Policy Drug Policy Drug Regulation Illegal Drug Markets

Author: Bradford, Deborah Title: Modelling Supply Rates of High-Strength Oxycodone Across New South Wales Summary: The objective of this research was to develop a statistical methodology for identifying areas with aberrantly high supply levels of 80mg oxycodone controlled-release (CR) tablets, a prescription medicine that is currently a target for illicit diversion in Australia. The intention in developing this methodology was to provide assistance to the Pharmaceutical Services unit of the New South Wales Department of Health in monitoring supply and prescribing of high-strength prescription opioids. Statistical analysis focused on modelling variations across New South Wales (from 2006 to 2009) in wholesale supply rates of 80mg oxycodone CR tablets while controlling for relevant demographic and public health characteristics of each area. This analysis identified a number of Local Government Areas with supply levels of 80mg oxycodone CR tablets that were significantly higher than that predicted by the statistical model. In contrast to analysis of raw unadjusted supply counts of this medicine, which were highest in areas with large populations, statistical modelling identified mainly regional areas as those with unexpectedly high supply rates of 80mg oxycodone CR tablets. The current findings highlight the importance of controlling for relevant population level characteristics related to indications for opioid prescribing when evaluating trends in supply of these medicines. Details: Sydney: NSW Bureau of Crime Statistics and Research, 2011. 12p. Source: Internet Resource: Contemporary Issues in Crime and Justice, No. 148: Accessed June 30, 2011 at: http://www.lawlink.nsw.gov.au/lawlink/bocsar/ll_bocsar.nsf/vwFiles/CJB148.pdf/$file/CJB148.pdf Year: 2011 Country: Australia URL: http://www.lawlink.nsw.gov.au/lawlink/bocsar/ll_bocsar.nsf/vwFiles/CJB148.pdf/$file/CJB148.pdf Shelf Number: 121929 Keywords: Drug Abuse and Addiction Opioids Prescription Drugs (Australia) Prescription Fraud

Author: Mansfield, David Title: Where Have All the Flowers Gone? Assessing the Sustainability of Current Reductions in Opium Production in Afghanistan Summary: Levels of opium poppy cultivation in Afghanistan have fallen for two consecutive years and it now appears that cultivation will be maintained at this relatively low level for another year. While this allows for progress to be declared against more short-term, area-based counter-narcotics targets, the reasons for the continued decline in cultivation are far from clear. This paper illustrates that current reductions are the result of complex economic, political and environmental processes that are both contextspecific and difficult to maintain. It argues that the coincidence of actions and events that have led to the current fall in production have set in play their own dynamic that could further destabilise parts of rural Afghanistan if not held in check. The paper is divided into three sections. Section 1 draws on detailed fieldwork in two distinct provinces as a way of exploring the different factors that lie behind the current reductions in opium production in Afghanistan. It shows how reductions in Nangarhar are largely a consequence of the concerted efforts of the current governor and the political deals he has struck with tribal leaders, local powerbrokers and to some extent the US military, whereas in Helmand the reductions in cultivation are primarily driven by shifts in the terms of trade between wheat and poppy and continuing concerns over food security. Section 2 explores the resilience of these reductions. It initially examines what opium poppy has been replaced with and highlights that reductions based on wheat are precarious and unlikely to be sustained. The section goes on to analyse the unfolding political environment in Afghanistan and how it might impact levels of opium production in the future, suggesting that the current political settlements that have been critical for reducing opium poppy in provinces such as Nangarhar and Balkh remain fragile and highly dependent on incumbent governors. The final section looks at the current policy environment for counter-narcotics. It suggests that counter-narcotics efforts and objectives have largely been relegated in Afghanistan, where counter-insurgency reigns supreme. This is not completely unwelcome because it has forced the drug control community to evaluate their interventions not simply based on the achievement of short-term, area-based targets but to consider the complex relationship between the achievement of counter-narcotics objectives and the broader goals of improving governance, security and economic growth. However, tensions still exist and this paper suggests that the trajectory of counter-narcotics policy is far from clear, particularly if production were to rise in the 2010/11 growing season. Details: Kabul, Afghanistan: Afghanistan Research and Evaluation Unit, 2010. 24p. Source: Internet Resource: Briefing Paper Series: Accessed July 2, 2011 at: http://www.hks.harvard.edu/cchrp/sbhrap/research/pdf/Wherehavealltheflowersgone.pdf Year: 2010 Country: Afghanistan URL: http://www.hks.harvard.edu/cchrp/sbhrap/research/pdf/Wherehavealltheflowersgone.pdf Shelf Number: 121955 Keywords: Drug Abuse and Addiction Drug Control Policy Opium (Afghanistan) Poppy Cultivation

Author: European Monitoring Centre for Drugs and Drug Addiction Title: Khat Use in Europe: Implications for European Policy Summary: Khat leaves are cultivated in the highlands of the Horn of Africa, Southern Arabia and along the East African coast. In many countries, chewing khat is an age-old tradition. More recently, the mass migration of people from the Horn of Africa has been associated with the spread of khat usage to neighbouring countries, Europe and the rest of the world. Exact numbers of regular khat users on a worldwide scale do not exist, however estimates range up to 20 million. This paper presents the challenges associated with the spread of khat consumption. Details: Lisbon: EMCDDA, 2011. 4p. Source: Internet Resource: Drugs in Focus No. 21: Accessed July 5, 2011 at: http://www.emcdda.europa.eu/attachements.cfm/att_137392_EN_TDAD11001ENC_WEB.pdf Year: 2011 Country: Europe URL: http://www.emcdda.europa.eu/attachements.cfm/att_137392_EN_TDAD11001ENC_WEB.pdf Shelf Number: 121963 Keywords: Drug Abuse and Addiction Drug Policy Drugs Immigrants Khat (Europe)

Author: Eisenbach-Stangl, Irmgard Title: The Vienna Drug Policy 1970 to 2005: External and Internal Views Summary: In the 60s of the last century, the international drug policy changed substantially: its focus shifted from supply control to demand control. Demand control was conceived as addiction control, and addiction was understood in psychological terms to be a problem of the individual. Accordingly, the drug policy instruments were altered and expanded. On the one hand, the “repressive, socially excluding penal measures now also aimed at individual drug users; on the other hand, new measures were introduced: “Early diagnosis, treatment, information, after-treatment, and social re-integration” are, for the first time, mentioned as drug policy measures in the Single Convention of 1961. By introducing measures of “integration” or “assimilation”, drug matters became the responsibility of not only national policy authorities but also – and this was the novelty – of regional authorities that had so far been in charge of health, social welfare, and education in Austria like in most European countries. Whether the local policy became active in drug issues and in what ways it became active and how it cooperated with the policy at national level, varied regionally. Details: Vienna: European Centre for Social Welfare Policy and Research, 2008. 9p. Source: Internet Resource: Policy Brief: Accessed July 8, 2011 at: http://www.euro.centre.org/data/1219825741_32957.pdf Year: 2008 Country: International URL: http://www.euro.centre.org/data/1219825741_32957.pdf Shelf Number: 122015 Keywords: Drug Abuse and Addiction Drug Abuse Policy

Author: Ness, Alex Title: Patterns of Mephedrone, GHB, Ketamine and Rohypnol Use Among Police Detainees: Findings from the DUMA Program Summary: In recognition of the need for ongoing monitoring of new or less common drug types, the Australian Institute of Criminology (AIC), as part of the Drug Use Monitoring in Australia (DUMA) program, interviewed 824 police detainees about their knowledge of and experience with mephedrone, GHB, Ketamine and Rohypnol. Mephedrone was the least known of the four drugs, with only 221 detainees (27%) reporting knowledge of the drug. Only six detainees (<1%) had used the drug in the previous 12 months, while 30 detainees (4%) knew of someone dealing mephedrone at the time they were interviewed. Detainees in East Perth were the most likely to have reported knowledge of mephedrone. GHB was known to more than half of all detainees interviewed (53%) and had been used in the 12 months prior to interview by 23 detainees (3%). More detainees had been offered GHB (8%), or knew of a dealer selling GHB (6%), than any of the other four drug types. Ketamine was known to 43 percent of detainees and had been used by three percent. The prevalence of Ketamine use was equal with GHB, however, knowledge of a current Ketamine dealer was lower (4%). Rohypnol was the most widely known of the four drug types (59%), however, use of the drug in the 12 months prior to interview was lower than for GHB or Ketamine (1%). Details: Canberra: Australian Institute of Criminology, 2011. 6p. Source: Internet Resource: Research in Practice, No. 16: Accessed July 11, 2011 at: http://www.aic.gov.au/documents/0/6/0/%7B0605DBE8-C4C4-46C6-807E-042F849D1826%7Drip16_003.pdf Year: 2011 Country: Australia URL: http://www.aic.gov.au/documents/0/6/0/%7B0605DBE8-C4C4-46C6-807E-042F849D1826%7Drip16_003.pdf Shelf Number: 122020 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders (Australia)

Author: Virginia Department of Health Professions and Virginia State Police Title: Prescription Monitoring Program Summary: Chapter 481 of the 2002 Acts of Assembly amended the Code of Virginia to create a prescription monitoring program as a pilot program limited to State Health Planning Region III in Southwest Virginia. The program began operations in September 2003 with prescriptions dispensed for Schedule II controlled substances being submitted by approximately 300 pharmacies and other dispensers twice a month. Currently, the database contains over 460,000 prescription records and over 1000 requests for information from the program have been processed. Review of data collected thus far appears to show that the implementation of the program has not had a “chilling” effect on the legitimate prescribing of Schedule II controlled substances. The amount of oxycodone and hydrocodone being distributed in wholesale distribution channels continued to increase throughout Virginia at a rate of 9% and 8% respectively in 2002 and 2003. Information maintained by the Department of Medical Assistance Services (DMAS) shows that after a substantial drop in claims for oxycodone containing prescriptions in the 1st and 2nd quarters of 2002, the number of claims submitted in the 1st quarter of 2004 for these products are 21% higher than they were in the 1st quarter of 2001. A survey was conducted in mid-2004 and compiled by the Survey and Evaluation Research Laboratory, Virginia Commonwealth University and sponsored by the American Cancer Society (ACS) and the South Atlantic chapter of the ACS, in collaboration with the Virginia Cancer Pain Initiative. Physicians were asked if in the past three years, they have been prescribing fewer Schedule II controlled substances. 36% of respondents reported prescribing fewer Schedule II drugs; of these, 48% cited intense media coverage and 41% cited increased law enforcement activity as the reason for prescribing fewer Schedule II prescriptions. 31% of these practitioners reported that prescribing fewer Schedule II drugs had a negative impact of helping patients manage their pain while 61% reported no impact. A concern of having a pilot program in only the southwest portion of the Commonwealth was that the illegal activity of prescription drug diversion would move to outside the program area. Data from the Drug Diversion Unit of the State Police appears to confirm that concern. Data comparing 2003 to 2004 shows complaints received by the unit increased by 26% statewide while decreasing in the program area by 47%. Arrests increased by 35% statewide versus 31% in the program area. It also appears that using the program may save substantial man-hours in performing investigations with data from the program area showing a 53% decrease in manhours spent doing pharmacy profiles between 2003 and 2004. Accidental deaths due to prescription drug abuse or misuse continues to be a significant public health concern in Virginia, especially the southwest region of the Commonwealth. Since 2000, there has been a 100% increase in drug deaths in the Western District of the Office of the Chief Medical Examiner. Statewide in 2003, there were 223 drug deaths reported in the Western District, 101 in the Tidewater District, 106 in the Central District and 108 in the Northern District. In the Western District, 44.6% of the cases identified methadone as the cause of death followed by hydrocodone, oxycodone, fentanyl and propoxyphene. The issue of prescription drug abuse is not limited to Virginia. The President’s 2004 National Drug Control Strategy highlighted the problem, reporting that the non-medical use of addictive prescription drugs has been increasing throughout the United States at alarming rates. According to the National Survey on Drug Use and Health, in 2002, an estimated 6.2 million Americans reported past-month use of prescription drugs for non-medical purposes. Nearly 14 percent of youth between the ages of 12 and 17 have used such drugs, which include pain relievers, sedatives/tranquilizers, or stimulants, for non-medical purposes at some point in their lives. To combat this problem several approaches are being developed, including education and training on appropriate pain management and opioid treatment procedures for practitioners, increasing the number of state prescription monitoring programs, and using technology to identify, investigate, and prosecute “pill mills” including internet pharmacies that provide controlled substances illegally. In May 2004, Department staff developed a list of policy issues that became evident as a result of the evaluation workplan. These policy issues were reviewed at the June and September 2004 meetings of the Advisory Committee and recommendations were made based on those issues. Details: Richmond, VA: Virginia Department of Health Professions and the Virginia State Police, 2004. 79p. Source: Internet Resource: Accessed July 14, 2011 at: http://www.dhp.virginia.gov/dhp_programs/pmp/docs/REPORT%20OF%20THE%20PMP.pdf Year: 2004 Country: United States URL: http://www.dhp.virginia.gov/dhp_programs/pmp/docs/REPORT%20OF%20THE%20PMP.pdf Shelf Number: 122060 Keywords: Drug Abuse and Addiction Illicit Drugs Prescription Drug Abuse (Virginia) Prescription Fraud

Author: Anderson, David M. Title: Khat: Social Harms and Legislation: A Literature Review Summary: This paper summarises the findings of a literature review focused on drawing together existing evidence on the reported ‘social harms’ of khat to consumers in the UK. It also provides a commentary on the legislation brought in to control and prohibit khat in other countries. The review found a general lack of robust evidence on the link between khat use and social harms. Social harms associated with khat remain a concern among the UK’s immigrant Somali, Yemeni and Ethiopian communities but there was little evidence of a clear causal relationship to support this view. There is a much stronger evidence base for the medical harm associated with khat which suggests that the dangers of khat consumption are relatively low. Details: London: Home Office, 2011. 50p. Source: Internet Resource: Occasional Paper 95: Accessed July 15, 2011 at: http://www.homeoffice.gov.uk/publications/science-research-statistics/research-statistics/crime-research/occ95?view=Binary Year: 2011 Country: United Kingdom URL: http://www.homeoffice.gov.uk/publications/science-research-statistics/research-statistics/crime-research/occ95?view=Binary Shelf Number: 122072 Keywords: Drug Abuse and Addiction Drug Policy Drugs Khat (U.K.)

Author: Kelleher, Cathy Title: An Overview of New Psychoactive Substances and the Outlets Supplying Them Summary: This report represents the outcome of a review of new psychoactive substances within the Irish context, including a review of the outlets that supply these substances. The review was commissioned by the National Advisory Committee on Drugs (NACD) in accordance with Action 14 of the National Drugs Strategy (interim) 2009–2016. Action 14 provides for the monitoring of ‘head shops’ and other outlets for the sale of psychoactive substances, under the Misuse of Drugs Act 1977 and the Misuse of Drugs (Amendment) Regulations 2007. Researchers at the Centre for Social and Educational Research (CSER) within the School of Social Sciences and Law at Dublin Institute of Technology (DIT), and at the School of Chemical and Pharmaceutical Sciences (DIT), conducted the review between May and August 2010. The proliferation of head shops and online retailers has facilitated the emergence of a range of new psychoactive substances in Ireland. Such outlets have supplied products containing powerful synthetic substances that mimic the common illegal stimulants cocaine, ecstasy and amphetamine; they have also supplied synthetic cannabinoids designed to serve as cannabis substitutes. Often these substances are ‘research chemicals’, with no medicinal value, and where there is little existing knowledge in relation to their safety or toxicity. The location of head shops in prominent areas has highlighted their existence, and has fuelled concerns relating to their unknown potential for causing harm. The ‘head shop phenomenon’ has received unprecedented attention from the general public and the media, while the dynamic nature of the phenomenon has led to demands for a swift and comprehensive response from legislators. In response to the ‘phenomenon’, the Government introduced legal measures, including the control of BZP (March 2009) and the control of mephedrone (May 2010). Also in May 2010, the Government made an Order under the Misuse of Drugs Acts 1977 and 1984 controlling a broad range of new psychoactive substances, including benzylpiperazine derivatives, synthetic cannabinoids and a number of named cathinones. In August 2010, the Criminal Justice (Psychoactive Substances) Act 2010 came into operation, making it an offence to sell, import, export or advertise psychoactive substances. This move coincided with a sharp decrease in the number of head shops which had been open for business and a significant decrease in the availability of new psychoactive substances in the few shops remaining open. This review represents the aggregation of available knowledge on new psychoactive substances within the Irish context, and empirical research aimed at providing new insights into this complex phenomenon. Specifically, the review sought to assess the availability and accessibility of new psychoactive substances in retail outlets throughout Ireland and online, and to identify and describe the products, and where possible, their specific contents. A range of new psychoactive substances was acquired and was subjected to Gas Chromatography Mass Spectrometry (GC-MS) chemical analysis in order to identify active constituents. The availability of reference standards for the analysis of new psychoactive substances was also determined. Alongside the analyses, published data in relation to new psychoactive substances and their effects were reviewed and an online survey of users of head shop products or ‘legal highs’ (as they are commonly known) was conducted in order to gain insights into patterns of use and reported effects. To further explore the use and effects of these substances, semi-structured interviews were conducted with both ‘recreational’ users and ‘problem’ drug users. Based on available information and data gathered, a number of risks associated with the use of new psychoactive substances were identified. Harm-reduction measures to minimise risk to users were considered in light of existing advice for users of cannabis and stimulant drugs. Finally, measures taken in other jurisdictions to restrict psychoactive substances were examined. Details: Dublin: National Advisory Committee on Drugs, 2011. 176p. Source: Internet Resource: Accessed July 15, 2011 at: http://www.drugsandalcohol.ie/15390/2/NACDoverview3B217396d01.pdf Year: 2011 Country: Ireland URL: http://www.drugsandalcohol.ie/15390/2/NACDoverview3B217396d01.pdf Shelf Number: 122078 Keywords: Drug Abuse and Addiction Drug Markets Drug Policy (Ireland) Psychoactive Drugs

Author: University of Kentucky Special Commission on the Study of Methamphetamine and Other Drug Use in Kentucky Title: Report on Methamphetamine and Other Drug Use in Kentucky Summary: The Commission on Methamphetamine and Other Drug Use in Kentucky spent two years listening to various experts and research about the scope of methamphetamine use and use of prescription drugs in Kentucky. While these two classes or types of drug use are not the only ones that pose a problem for the state, they are, nonetheless, ones that have been widely portrayed in the media and have received public notice. We recognize that there are other types of substance abuse that have very great impact on Kentucky. These pilot studies conducted in Kentucky and our exploration of national data applied to Kentucky populations, yield several preliminary findings that deserve attention. Overall for Kentucky  National estimates of the prevalence of drug and alcohol problems by industry type suggest that Kentucky has an estimated 54,000 workers with drug abuse and 170,000 with alcohol-related problems. Methamphetamine use and prescription drug use  Methamphetamine, while used by a relatively small percent of the population, is associated with serious health and legal problems.  Sixty percent of the primary care physicians in eastern Kentucky report that prescription opiates are among the most serious drug problems in the state.  Primary care physicians in the western part of Kentucky have more concern about the use of methamphetamine on health. Dental health  Dentists estimate that restoring dental health to individuals with “meth mouth” would cost over $5,000 per person and payer sources for their care is very uncertain. Drug exposed children  Children in homes where neglect or abuse have been investigated are more likely to have been exposed to trauma in families where methamphetamine has been used.  The cost of Out-of-Home placements of children in methamphetamine exposed homes is greater than for other Out-of-Home care for children in other neglect or abuse cases. Law enforcement and corrections  The correctional system in Kentucky has a large percentage of inmates who report having used methamphetamine before entering prison and the system is burdened by high health care costs of inmates with drug abuse histories and methamphetamine may add to those costs.  Arrest data for methamphetamine charges suggest a west-to-east trend, suggesting regional differences in the availability of methamphetamine or in local law enforcement focus. Details: Lexington, KY: University of Kentucky, 2008. 73p. Source: Internet Resource: Accessed July 19, 2011 at: http://cdar.uky.edu/Downloads/Methamphetamine%20Report%203-20-2008.pdf Year: 2008 Country: United States URL: http://cdar.uky.edu/Downloads/Methamphetamine%20Report%203-20-2008.pdf Shelf Number: 122107 Keywords: Drug Abuse and Addiction Drug Offenders Methamphetamine (Kentucky) Prescription Drug Abuse

Author: Lowe, Nathan C. Title: Reentry of Methamphetamine-Using Offenders into the Community: Identifying Key Strategies and Best Practices for Community Corrections Summary: This report discusses issues related to reentry of methamphetamine (MA) users. From 1997 to 2004, MA use increased among both state and federal prison inmates in the month before the convicting offense was committed and at the time of the convicting offense. This increase in MA use among offenders has created significant challenges for the corrections field. Specifically, correctional and treatment professionals have worked together in efforts to implement the most effective strategies to treat MA use and abuse among offenders in the community. The purpose of this report is to highlight the need for a coherent strategy for community corrections professionals to use when supervising MA-using populations in the community. This report offers the community corrections field baseline data to understand some of the obstacles and lessons learned regarding supervision of MA-using offenders. The data were gathered from a focus group and three technical assistance site visits with the underlying intention of identifying key strategies in dealing with MA-using offenders in the community. Policy and practice recommendations are also offered. These recommendations rely on the focus group, site visits, and emerging body of research literature on effective community supervision and successful substance abuse strategies. Details: Alexandria, VA: American Probation and Parole Association, 2010. 31p. Source: Internet Resource: Accessed July 28, 2011 at: http://www.appa-net.org/eweb/docs/appa/pubs/RMUOC.pdf Year: 2010 Country: United States URL: http://www.appa-net.org/eweb/docs/appa/pubs/RMUOC.pdf Shelf Number: 122114 Keywords: Community Corrections Drug Abuse and Addiction Drug Offenders Methamphetamine Reentry

Author: Organization of American States Title: Hemispheric Report: Evaluation of Progress in Drug Control: Fifth Evaluation Round Summary: The Multilateral Evaluation Mechanism (MEM) is an instrument designed to measure the progress of actions taken by all member states of the Organization of American States (OAS) to combat the global drug problem. The Inter-American Drug Abuse Control Commission (CICAD), as an OAS specialized agency, implemented this Mechanism in 1998, pursuant to a mandate from the Second Summit of the Americas held in Santiago, Chile in 1998. The MEM, as a diagnostic tool, has evolved to become an instrument which promotes cooperation to support member states in effectively addressing the drug problem. It catalyzes hemispheric cooperation, promotes dialogue among government authorities, and precisely channels assistance to areas requiring greater attention. It has become one of the primary achievements in implementing hemispheric mandates to strengthen multilateral cooperation. The country evaluation reports are based on the information provided by countries in response to a Questionnaire of Indicators. They are drafted by the Governmental Expert Group (GEG), a multi-disciplinary group composed of experts from the 33 OAS member states who have been designated by their country. Each functions independently from his/her government, and experts do not participate in the evaluation of their own countries. The GEG conducts its analysis using the information supplied by countries through their designated National Coordinating Entities (NCE), which are responsible for liaising with national organizations to gather data for completion of the questionnaire. The methodology used in the MEM process includes establishing dialogue with countries to analyze the information provided and to prepare national evaluative reports with conclusions and recommendations. Each country reviews and comments on the content of the evaluation, ensuring an open, participatory process. The MEM, therefore, allows member states to identify their strengths, weaknesses, progress, setbacks and shortcomings, and assists them in adjusting their policies and procedures in order to respond more effectively to the challenges posed by the international drug problem. The Hemispheric Report that follows provides a comprehensive review of the Fifth Evaluation Round reports, covering the period 2007-2009. The source of information is the MEM National Reports, approved by the CICAD Commissioners at the forty-eighth regular session of CICAD in Washington, D.C. in December 2010. The Hemispheric Report addresses the collective progress of the CICAD member states in confronting the drug problem from a hemispheric perspective, mirroring the structure of the Hemispheric Drug Strategy, which provides guidelines for integrated, coordinated and cooperative hemispheric action. Each chapter is based on the Fifth Evaluation Round national reports1, as well as contributions from the GEG and the Executive Secretariat of CICAD. The content of the Hemispheric Report was approved at the forty-ninth regular session of CICAD, in May 2011. Details: Washington, DC: Organization of American States, 2011. 53p. Source: Internet Resource: Accessed August 1, 2011 at: http://www.cicad.oas.org/MEM/Reports/5/Full_Eval/Informe%20Hemisferico%20-%205ta%20Ronda%20-%20ENG.pdf Year: 2011 Country: Africa URL: http://www.cicad.oas.org/MEM/Reports/5/Full_Eval/Informe%20Hemisferico%20-%205ta%20Ronda%20-%20ENG.pdf Shelf Number: 122240 Keywords: Drug Abuse and Addiction Drug Control Drug Control Policy

Author: Fox, James Alan Title: Meth Crime Rises as Budget Axe Falls: Will Congress Cut Law Enforcement and Investments that Help Get Kids on the Right Track? Summary: The more than 2,500 police chiefs, sheriffs, prosecutors, state Attorneys General, other law enforcement leaders, and violence survivors of FIGHT CRIME: INVEST IN KIDS are determined to see that dangerous criminals are put behind bars. Today, one of the toughest crime challenges facing America’s law enforcement is the methamphetamine epidemic. Like the crack epidemic of the 1980s, meth is sweeping much of the country leaving broken families, traumatized communities and an increase in crimes committed by meth addicts. The number of meth addicts has recently doubled. FIGHT CRIME: INVEST IN KIDS analyzed the best available data and research, and provides the first national estimate on crime committed by meth addicts: property and violent crimes doubled to six million crimes in 2004 compared to 2002. Despite the new laws and enforcement efforts to shut down home labs, meth addiction is spreading as new, more potent, crystal meth is moving in from Mexico. While the wave of meth abuse and meth-related crime continues to sweep eastward across the country, Congress is debating severe budget cuts to law enforcement and investments in children proven to prevent crime. America’s anti-crime arsenal contains no more powerful weapons than crime fighters on our streets and in our courts and proven prevention programs such as Head Start, pre-kindergarten, and educational child care; child abuse and neglect prevention; effective youth development activities for the after-school and summer hours; and intervention programs to help troubled kids. Details: Washington, DC: Fight Crime: Invest in Kids, 2006. 17p. Source: Internet Resource: Accessed August 3, 2011 at: http://www.jfox.neu.edu/Documents/methreport06.pdf Year: 2006 Country: United States URL: http://www.jfox.neu.edu/Documents/methreport06.pdf Shelf Number: 122293 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Abuse Prevention Methamphetamine (U.S.)

Author: European Monitoring Centre for Drugs and Drug Addiction Title: Problem Amphetamine and Methamphetamine Use in Europe Summary: Amphetamine and methamphetamine are two closely related synthetic substances that act as stimulants of the central nervous system. They can be ingested, snorted or injected, and methamphetamine, particularly in its crystalline form, can be smoked. The two substances can be so similar in their effects and appearance that often the user cannot tell them apart. Their effects include elevated mood; a sense of well-being; increased energy, wakefulness, concentration, alertness, and motor and speech activities; improved performance in physical and mental tasks; and reduced fatigue. Among other effects viewed by users as positive and rewarding are decreased social or sexual inhibitions, and the desire to lengthen social interactions or to socialise with others using the drug. This broad range of effects might explain why the use of amphetamines has been reported among many different population groups including soldiers, workers (e.g. truck or taxi drivers, hospital staff), students, sex workers, clubbers or problem heroin users. Of the main illicit drugs, the patterns and geography of amphetamines (1) use in Europe are among the most difficult to describe. There are several reasons for this. First, the prevalence of amphetamines use varies greatly between countries. The diversity of user groups is possibly one of the largest of all illicit substances found in Europe. In addition, a small number of countries have problem amphetamines use at the heart of their drug problem and, when this is the case, it has very specific socio-historical and epidemiological characteristics. The stimulant market in Europe also appears to be changing frequently, particularly in nightlife settings, with shifts in popularity between substances such as amphetamines, cocaine, ecstasy, piperazines or new stimulant drugs such as mephedrone. Finally, Europe is an important producer of amphetamines with several countries reporting illicit production facilities on their territory. The provision of care for those with amphetamines problems is another area in which differences exist between countries. In general, treatment services are more attuned to the needs of amphetamines users in the countries where problematic use of these substances is longer established, while elsewhere services are targeted to the needs of the largest group of problem drug users, mostly opioid users. Organised in two parts, this Selected issue aims to provide a comprehensive overview of the history, health effects, supply and use of amphetamines in Europe, as well as describing their problematic use and the responses to them in the European countries that are most heavily affected. The first part begins with a short history of the use of these drugs and a presentation of the laws that are used to control them. This is followed by an analysis of drug supply information, mainly from police and customs services. The next section gives an overview of the prevalence of amphetamines use in the Europe population. The last section of Part I covers the mental and physical health effects of amphetamines use, including a review of the information on infectious diseases and deaths related to these drugs. In Part 2, countries are grouped in four geographical regions and sub-regions according to their amphetamines problems, with particular attention given to those with significant levels of problem amphetamines use. Treatment responses to amphetamines problems are also described for the different countries or groups of countries. Details: Luxembourg: Publications Office of the European Union, 2010. 40p. Source: Internet Resource: Selected Issue 2010: Accessed August 16, 2011 at: http://www.emcdda.europa.eu/attachements.cfm/att_120112_EN_EMCDDA_SI10_Amphetamines.pdf Year: 2010 Country: Europe URL: http://www.emcdda.europa.eu/attachements.cfm/att_120112_EN_EMCDDA_SI10_Amphetamines.pdf Shelf Number: 122402 Keywords: Amphetamines Drug Abuse and Addiction Drug Abuse Treatment Methamphetamines Substance Use and Abuse (Europe)

Author: European Monitoring Centre for Drugs and Drug Addiction Title: Treatment and Care for Older Drug Users Summary: The world is passing through a demographic transition, one of the results of which will be an increasing number of older people in the population. With one in five Europeans above the age of 60 — a proportion that is expected to increase — Europe is the continent with the oldest population. By 2050, it is estimated that every fourth person in Europe will be older than 60. As with the general population, there is evidence to suggest that the drug using population, including those who are in treatment, is also ageing. This would bring with it specific challenges for drug treatment services and increase the burden on wider health, support and care services. The objective of the present publication is to document the ageing phenomenon linked to drug use that is now being witnessed in Europe, and particularly the ageing of problem drug users. The current publication also aims to describe the drug use, health and social characteristics of older drug users and to identify their health and social needs. Current policies, practices and the availability of health and social responses for older drug users in Europe are also presented and discussed. This Selected issue begins with a wider discussion on ageing and drug use in Europe, setting the context for the main focus of the report which is an examination of the situation and responses regarding older problem drug users in the European Union. Details: Luxembourg: Publications Office of the European Union, 2010. 36p. Source: Internet Resource: Selected Issues 2010: Accessed August 16, 2011 at: http://www.emcdda.europa.eu/attachements.cfm/att_120120_EN_EMCDDA_SI10_Ageing.pdf Year: 2010 Country: Europe URL: http://www.emcdda.europa.eu/attachements.cfm/att_120120_EN_EMCDDA_SI10_Ageing.pdf Shelf Number: 122403 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Substance Use and Abuse (Europe)

Author: Larance, Briony Title: The Diversion and Injection of the Pharmaceutical Opioids Used in Opioid Substitution Treatment: Fidings from the Australian Post-Marketing Surveillance Studies of Buprenorphine-Naloxone, 2006-2008 Summary: Opioid substitution treatment (OST) is effective in treating opioid dependence, and results in significant reductions in the negative health consequences and adverse effects on public order. In Australia, OST is highly regulated: it is available only with an individual patient authority, there is licensing of doctors, and a strong focus on supervised administration of medication. Adherence with OST is important for maximising a range of positive treatment outcomes, but is especially important in preventing injection, "leakage" of prescribed medication to the illicit market, overdose and mortality. The introduction of an opioid agonist-antagonist formulation in Australia was a new approach that was hoped to result in lower levels of injection of the medication. By deterring injection, buprenorphine-naloxone (registered as Suboxone) may reduce its attractiveness in illicit markets. Post-marketing surveillance of the diversion and injection of Suboxone was required as a condition of the product's registration in Australia. Reckitt Benckiser approached the National Drug and Alcohol Research Centre to conduct the study independently, by way of an untied educational grant. 1.1. Terminology Post-marketing surveillance studies are usually observational in design and monitor the safety of new medications being used in real-life applications. Pre-marketing (clinical) studies usually involve detailed protocol constraints and small sample sizes, and although they may suggest which medications are likely (or not likely) to be misused, they are limited in their ability to detect and quantify actual misuse. Diversion is used in this report to describe the unsanctioned supply of regulated pharmaceuticals from legal sources to the illicit drug market, or to a user for whom the drugs were not intended. Adherence is used to describe the taking of medication in accordance with prescription directions and the meeting of all the specified conditions of treatment (e.g. consumption of the dose under supervision, attendance at designated dosing times, meeting requests for urinalysis, etc). Non-adherence is, therefore, any use of a medication by the individual to whom it was prescribed where the medication was not taken exactly as directed. This includes (but is not limited to) removing all or part of a supervised dose from the dosing site for personal use or diversion to illicit markets, splitting doses, stockpiling doses, taking more or less than the prescribed dose, and injection of prescribed medication(s). This report seeks to answer the following questions: (i) Is there injection of the agonist-antagonist formulation - buprenorphine naloxone - following its large-scale introduction into treatment programs for opioid dependence? (ii) To what extent is buprenorphine-naloxone injected compared to existing OST formulations, and in particular compared to the mono-buprenorphine product, among those receiving treatment and among out-of-treatment injecting drug users (IDU)? (iii) Is diverted buprenorphine-naloxone less attractive in illicit markets? (iv) What influences the diversion and/or injection of buprenorphine-naloxone? Details: Sydney: National Drug and Alcohol Research Centre, University of New South Wales, 2009. 143p. Source: Internet Resource: Technical Report No. 302: Accessed August 22, 2011 at: http://www.med.unsw.edu.au/NDARCWeb.nsf/resources/TR+298-302/$file/TR+302.pdf Year: 2009 Country: Australia URL: http://www.med.unsw.edu.au/NDARCWeb.nsf/resources/TR+298-302/$file/TR+302.pdf Shelf Number: 122461 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Illicit Drugs Opioids Prescription Medicines

Author: Barrett, Damon, ed. Title: Children of the Drug War: Perspectives on the Impact of Drug Policies on Young People Summary: Children of the Drug War is a unique collection of original essays that investigates the impacts of the war on drugs on children, young people, and their families. With contributions from around the world, providing different perspectives and using a wide range of styles and approaches, including ethnographic studies, personal accounts, and interviews, the book asks fundamental questions of national and international drug control systems: • What have been the costs to children and young people of the war on drugs? • Is the protection of children from drugs a solid justification for current policies? • What kinds of public fears and preconceptions exist in relation to drugs and the drug trade? • How can children and young people be placed at the forefront of drug policies? Four thematic sections address: • Production and trade • Race, class, and law enforcement • Families and drug policy • Children, drug use, and dependence. Details: New York: International Debate Education Association, 2011. 241p. Source: Internet Resource: Accessed August 23, 2011 at: http://www.childrenofthedrugwar.org/ Year: 2011 Country: International URL: http://www.childrenofthedrugwar.org/ Shelf Number: 122471 Keywords: Children, Drug Use Drug Abuse and Addiction Drug Control Drug Policy

Author: United Nations Office on Drugs and Crime. Laboratory and Scientific Section Title: Amphetamines and Ecstasy: 2011 Global ATS Assessment Summary: Amphetamine-type stimulants (ATS) are firmly established on global illicit drug markets and their use continues to exceed that of opiates or cocaine. While the number of people who have used ATS at least once in the last 12 months has stabilized at the global level, increases have occurred in parts of the world that previously had only very small ATS-related problems. The widespread use of ATS is a result of their attractiveness to users: they seem to appeal to the needs of today’s societies and have become part of what is perceived to be a modern and dynamic lifestyle; in some segments of society, they continue to be used frequently for occupational purposes. It is also a result of a market potential with continuously high profits and low risks that maintain their attractiveness to criminal groups around the world. Since the last global ATS assessment was published in 2008,1 there have been several new developments. The report provides evidence for these developments since 2008, with a special focus on subregional patterns and trends, and highlights the challenges ahead. Details: Vienna: United Nations Office on Drugs and Crime, 2011. 124p. Source: Internet Resource: Global SMART Programme: Accessed September 11, 2011 at: http://www.unodc.org/documents/ATS/ATS_Global_Assessment_2011.pdf Year: 2011 Country: International URL: http://www.unodc.org/documents/ATS/ATS_Global_Assessment_2011.pdf Shelf Number: 122738 Keywords: Amphetamines Drug Abuse and Addiction Drug Markets Ecstasy Illegal Drugs

Author: Farabee, David Title: Implementation of the CYA-RSAT Programs: A Process Evaluation of the California Youth Authority’s Residential Substance Abuse Treatment (RSAT) Programs (Year 1) Summary: This report summarizes findings of a process evaluation of the Residential Substance Treatment (RSAT) Program of the California Department of the Youth Authority (CYA). Funded by the Office of Criminal Justice Planning, the CYA-RSAT program is operated at three institutional sites: (1) the Karl Holton Drug and Alcohol Abuse Treatment Center in Stockton, (2) the Heman G. Stark Youth Correctional Facility in Chino, and (3) the Ventura School in Camarillo. As a result of the RSAT funds, each of these institutions has been able to enhance the treatment components of its existing Formalized Drug Programs (FPDs). The goal of CYA-RSAT as articulated in the original proposal is to provide a safe and chemical-free environment in which participants can: · Discover the thinking errors and faulty belief systems they use to justify their chemical-dependent behavior. · Acquire the skills necessary to modify these beliefs and behaviors which will enable them to adopt a sober lifestyle. In 1943, CYA began to provide training and parole supervision to youthful offenders. In an effort to reform these offenders, CYA moved quickly to establish camps and institutions which would house and provide education and training to youths formerly detained in state reformatories, county jails, detention homes, and army camps. Camps were established throughout the state as were institutions, including those that would accommodate older youths. In 1960, the Youth Training School opened in Chino, California. Known today as the Heman G. Stark Youth Correctional Facility (YCF), this institution was named after the CYA’s longest acting director who served from 1952 to 1968. Shortly thereafter, in 1968, the Karl Holton School for Boys was opened in Stockton, California. This school was part of a general population facility which housed male offenders ages 17 to 24, but, in 1994, was converted to the Drug and Alcohol Abuse Treatment Center. Today this institution is known as the Karl Holton Drug Abuse Treatment Youth Correctional Facility, a facility devoted exclusively to the provision of substance abuse treatment. In 1970, due to declines in the number of female commitments, the Ventura School for Girls (founded in 1913 and acquired by CYA in 1942) became a coeducational facility. Thus it is now referred to as the Ventura School. Earlier, in 1964, this facility became the site of the reception clinic for all girls entering CYA, and it remains so today. The process evaluation of CYA-RSAT sought to determine the extent to which program activities and services have achieved this goal and to assess the effectiveness of each program with respect to implementation. The evaluation was conducted by the UCLA Drug Abuse Research Center (DARC) located in Los Angeles. Details: Los Angeles: UCLA Drug Abuse Research Center University of California, Los Angeles, 1998. 102p. Source: Internet Resource: Accessed September 17, 2011 at: http://www.cdcr.ca.gov/Reports_Research/docs/rsat_rep.pdf Year: 1998 Country: United States URL: http://www.cdcr.ca.gov/Reports_Research/docs/rsat_rep.pdf Shelf Number: 122772 Keywords: Drug Abuse and Addiction Drug Offenders Drug Treatment Juvenile Corrections Substance Abuse Treatment (California) Youth Adult Offenders

Author: Idaho State Police. Statistical Analysis Center Title: The Relationship Between Substance Abuse and Crime in Idaho: Estimating the Need for Treatment Alternatives Summary: The relationship between drug abuse and crime is complex. Not all individuals who use drugs become addicted, nor do they commit violent crime. Social and economic concerns, such as crime, illness, premature death, and significant loss in productivity are all affected by alcohol and drug abuse. To understand the relationship between drug abuse and crime, this report will emphasize current research as well as drug trends occurring within Idaho. First, current research regarding reasons for drug addiction and the relationship between drugs and crime will be explored. Second, substance abuse trends within Idaho’s population from various surveys will be discussed. Third, an analysis of data coming from the criminal justice system including information from adult and juvenile arrests, incarceration, drug courts, traffic crashes, numbers involved in treatment, and mortality. A final synopsis concerning what this means for Idaho will also be addressed. Details: Meridian, ID: Idaho Statistical Analysis Center, 2010. 20p. Source: Internet Resource: Accessed September 28, 2011 at: http://www.isp.idaho.gov/pgr/Research/documents/drugsandcrime.pdf Year: 2010 Country: United States URL: http://www.isp.idaho.gov/pgr/Research/documents/drugsandcrime.pdf Shelf Number: 122935 Keywords: Drug Abuse and Addiction Drug Abuse and Crime (Idaho) Drug Offenders Drug Offenses Substance Abuse

Author: Domoslawski, Artur Title: Drug Policy in Portugal: The Benefits of Decriminalizing Drug Use Summary: In 2000, the Portuguese government responded to widespread public concern over drugs by rejecting a "war on drugs" approach and instead decriminalized drug possession and use. It further rebuffed convention by placing the responsibility for decreasing drug demand as well as managing dependence under the Ministry of Health, rather than the Ministry of Justice. With this, the official response toward drug-dependent persons shifted from viewing them as criminals, to treating them as patients. Drug Policy in Portugal: The Benefits of Decriminalizing Drug Use is the second in a series of reports by the Open Society Foundations' Global Drug Policy Program that documents positive examples of drug policy reform around the world (the first being From the Mountaintops: What the World Can Learn from Drug Policy Change in Switzerland). Drug Policy in Portugal describes the process, context, ideas, and values that enabled Portugal to make the transition to a public health response to drug use and possession. Now, with a decade of experience, Portugal provides a valuable case study of how decriminalization coupled with evidence-based strategies can reduce drug consumption, dependence, recidivism, and HIV infection, and create safer communities for all. Details: Warsaw, Poland: Global Drug Policy Program, Open Society Foundations, 2011. 52p. Source: Internet Resource: Accessed October 3, 2011 at: http://www.soros.org/initiatives/drugpolicy/articles_publications/publications/drug-policy-in-portugal-20110829/drug-policy-in-portugal-20110829.pdf Year: 2011 Country: Portugal URL: http://www.soros.org/initiatives/drugpolicy/articles_publications/publications/drug-policy-in-portugal-20110829/drug-policy-in-portugal-20110829.pdf Shelf Number: 122963 Keywords: Drug Abuse and Addiction Drug Abuse Policy Drug Abuse Treatment Drug Policy (Portugal)

Author: Csete, Joanne Title: From the Mountaintops: What the World Can Learn from Drug Policy Change in Switzerland Summary: This report looks at how evidence-based services such as heroin treatment, injection rooms, and needle exchange can lower HIV infection rates, improve health outcomes, and lower crime rates. Switzerland, a country known for its solid conservatism, was shaken by seeing its cities become the point of convergence of thousands of drug users and counterculture activists, culminating in large open drug scenes in the late 1980s. The country was hit hard by HIV, which was strongly linked—both in the public mind and in reality—to growing drug injection. A confluence of events and people led Switzerland to reject more repressive policing and instead to rethink drug police practices and drug policy more broadly. Health professionals who were persuaded that the harms of drug injection could be controlled more effectively by public health programs than by policing were at the vanguard of shifting the parameters of Swiss drug policy. Details: New York: Open Society Foundations, 2010. 56p. Source: Internet Resource: Accessed October 3, 2011 at: http://www.soros.org/initiatives/drugpolicy/articles_publications/publications/csete-mountaintops-20101021/from-the-mountaintops-english-20110524.pdf Year: 2010 Country: Switzerland URL: http://www.soros.org/initiatives/drugpolicy/articles_publications/publications/csete-mountaintops-20101021/from-the-mountaintops-english-20110524.pdf Shelf Number: 122979 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Drug Policy (Switzerland) Drug Reform

Author: Wendel, Travis Title: Dynamics of Methamphetamine Markets in New York City: Final Technical Report to the National Institute of Justice Summary: Using Respondent Driven Sampling, this study piloted an innovative research design mixing qualitative and quantitative data collection methods, and social network analysis, that addresses a gap in information on retail methamphetamine markets and the role of illicit drug markets in consumption. Based on a sample of 132 methamphetamine users, buyers and sellers in New York City (NYC), findings describe a bifurcated market defined by differences in sexual identity, drug use behaviors, social network characteristics, and drug market behaviors. The larger sub-market is a closed market related to a sexual network of men who have sex with men (MSM) where methamphetamine (referred to as “tina”) is used as a sex drug. The smaller submarket is a less-closed market not denominated by sexual identity where methamphetamine (referred to as “crank,” “speed,” or “crystal meth”) overlaps with powder and crack cocaine markets. Participants in the MSM submarket viewed “tina” as very different from cocaine, due to what they characterized as the drug’s intense sexual effects, whereas participants in the smaller non-sexual-identity-denominated submarket saw “crystal meth” as a cost-effective alternative to cocaine. While majorities of participants in all subpopulations studied reported that their use of methamphetamine primarily centered on sex, almost all (91%) MSM reported this. Many MSM reported that their sexuality had become indistinguishable from their drug use. MSM had denser patterns of social network ties and many more sex partners than other subpopulations. MSM market participants reported higher prices for the drug, which may be an indication that they are accessing purer forms of methamphetamine. Participants were more willing to discuss accessing or purchasing methamphetamine than they were to discuss providing or selling the drug, although all indications are that most market participants do both. Compared with the sometimes highly organized markets that have existed for other illegal drugs (e.g., heroin, cocaine, marijuana), retail methamphetamine markets have remained, by contrast, relatively primitive in their social and technical organization, and distinct patterns of drug use emerged as an outcome of interactions between drug providers and members of their social networks. In this case, those with less structurally advantageous positions within the network must depend on better-positioned network contacts to supply them with methamphetamine. Findings from the study indicate that the most striking characteristic of the methamphetamine market in New York City is the extent of the secondary market. Study data suggests this large secondary market has developed because of “bottlenecks” in the chain of distribution, which may be the outcome of the inconsistent supply of methamphetamine available in New York City. Participants reported essentially no violence in connection with methamphetamine markets in NYC. Participants have a lifetime total of 13 methamphetamine possession arrests for the sample of 132; none has ever been arrested for methamphetamine distribution. Study findings may be useful to practitioners, policy-makers and researchers in fields including law enforcement, criminal justice, and public health and substance abuse treatment. Details: New York: John Jay College of Criminal Justice, 2011. 268p. Source: Internet Resource: Accessed October 20, 2011 at: https://www.ncjrs.gov/pdffiles1/nij/grants/236122.pdf Year: 2011 Country: United States URL: https://www.ncjrs.gov/pdffiles1/nij/grants/236122.pdf Shelf Number: 123063 Keywords: Drug Abuse and Addiction Drug Law Enforcement Drug Markets Drug Offenders Illegal Drugs Methamphetamine (New York City)

Author: Butts, Jeffrey A. Title: Organizing for Outcomes: Measuring the Effects of Reclaiming Futures in Four Communities Summary: The Robert Wood Johnson Foundation’s (RWJF) Reclaiming Futures initiative was designed to increase positive outcomes for youth involved with drugs, alcohol and crime by shifting the efforts of the juvenile justice system and the substance abuse treatment system to incorporate strategies that are more community oriented, family focused, and closely coordinated. The Foundation launched Reclaiming Futures by awarding project grants to ten communities in 2002. In four of these communities, researchers tracked the efforts of local Reclaiming Futures projects as they worked to improve the effectiveness of interventions for young offenders. The four communities included Santa Cruz County in California, Cook County (Chicago) in Illinois, a multiple-jurisdiction project in the state of New Hampshire, and King County (Seattle), Washington. The four local evaluation projects assessed the influence of Reclaiming Futures on the actual experiences of youth involved in the juvenile justice and substance abuse treatment systems. The studies examined whether youth received substance abuse screening and assessment more often and more quickly after the implementation of Reclaiming Futures. They asked whether youth participated more frequently in treatment programs and received more support services as a result of Reclaiming Futures. Finally, they examined case processing and case referral patterns to determine whether Reclaiming Futures was associated with changes in youth behavior, as measured by recidivism, or the prevalence of new contacts with law enforcement and the courts. Details: Portland, OR: Reclaiming Futures, Graduate School of Social Work, Portland State University, 2009. 42p. Source: Internet Resource: Accessed October 22, 2011 at: http://www.rwjf.org/files/research/14831reclaimingfuturesorganizingforoutcomes2009.pdf Year: 2009 Country: United States URL: http://www.rwjf.org/files/research/14831reclaimingfuturesorganizingforoutcomes2009.pdf Shelf Number: 123086 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Abuse Treatment Drug Offenders Juveniles Offenders (U.S.) Recidivism Substance Abuse Treatment

Author: Degenhardt, Louisa Title: What Do We Know About the Extent of Illicit Meth/Amphetamine Use and Dependence? Results of a Global Systematic Review Summary: Aims: Systematically review existing data on the prevalence of meth/amphetamine use and dependence. The aims of this paper are to: (1) describe the available international data on meth/amphetamine use and dependence; and (2) identify priorities for improving the quality and coverage of such estimates. Methods: Multiple search strategies: a) peer-reviewed literature searches (1990-2008) using methods recommended by the Meta-analysis of Observational Studies in Epidemiology (MOOSE) group; b) systematic searches of online databases; c) Internet searches to find any other evidence of use; d) repeated consultation and feedback from experts around the globe; e) a viral email sent to lists in the HIV and illicit drug fields. Culling and data extraction followed manualised protocols, with in-built systems of cross-checking and internal consistency. Data were extracted and graded according to predefined variables and quality scored. This paper reports the most recent and highest graded prevalence estimate for the general population and school population and reports the proportion of coverage of the world‟s population for use and dependence estimates, general population and school surveys, age and sex specific estimates, and most recent year of estimates. Results: There was some evidence of meth/amphetamine use or dependence in 181 countries/territories, comprising 99% of the world‟s population aged 15-64 years but there were no prevalence estimates in 104 of these countries. This was common in Asia, Oceania and Africa. School surveys were the most common method used (74 countries); general population surveys of meth/amphetamine use had been conducted in 48 countries. Nine countries had estimated the prevalence of dependence since 1990 (8% of the world‟s population 15-64 years). Estimates of past-year use varied extremely widely; past-year dependence estimates were all less than 1% (0.10-0.74%). Age ranges, methodologies and definitions of “amphetamines” differed widely. Conclusions: There is a global imperative to improve data on the extent of meth/amphetamine use and dependence. There were large gaps in dependence estimates even in high income countries that have the resources and infrastructure to carry out such studies. Public and policy concern about this issue has been increasing largely in the absence of any data on the extent of this “problem”. Any policies or other responses requiring some notion of “scale” are likely to be poorly targeted until this situation changes. Details: Sydney: National Drug and Alcohol Research Centre, University of New South Wales, 2010. 74p. Source: Internet Resource: Technical Report No. 310: Accessed November 23, 2011 at: http://ndarc.med.unsw.edu.au/sites/all/shared_files/ndarc/resources/TR.310.pdf Year: 2010 Country: International URL: http://ndarc.med.unsw.edu.au/sites/all/shared_files/ndarc/resources/TR.310.pdf Shelf Number: 123434 Keywords: Drug Abuse and Addiction Illegal Drugs Methamphetamines

Author: Iowa. Governor's Office of Drug Control Policy Title: Iowa’s Drug Control Strategy, 2011 Summary: The 2011 Iowa Drug Control Strategy is submitted in satisfaction of Chapter 80E.1 of the Code of Iowa which directs the Drug Policy Coordinator to monitor and coordinate all drug prevention, enforcement and treatment activities in the state. Further, it requires the Coordinator to submit an annual report to the Governor and Legislature concerning the activities and programs of the Coordinator, the Governor’s Office of Drug Control Policy and all other state departments with drug enforcement, substance abuse treatment, and prevention programs. Chapter 80E.2 establishes the Drug Policy Advisory Council (DPAC), chaired by the Coordinator, and consisting of a prosecuting attorney, substance abuse treatment specialist, law enforcement officer, prevention specialist, judge and representatives from the departments of corrections, education, public health, human services, public safety and human rights. This report and strategy was developed in consultation with the DPAC. Details: Des Moines: Governor's Office of D5ug Control Policy, 2010. 99p. Source: Internet Resource: Accessed November 23, 2011 at: http://publications.iowa.gov/10008/ Year: 2010 Country: United States URL: http://publications.iowa.gov/10008/ Shelf Number: 123445 Keywords: Drug Abuse and Addiction Drug Enforcement Drug Enforcement Policy (Iowa) Substance Abuse

Author: New York (State). Office of the Attorney General Title: Internet System for Tracking Over-Prescribing (I-STOP): A Proposal Addressing New York's Prescription Drug Abuse and Drug Diversion Epidemic Summary: Prescription drug diversion involves channeling legitimately produced controlled substances from their lawful purpose into illicit drug traffic. Abuse of diverted drugs comprises the nation’s fastest growing drug problem, and in recent years has reached epidemic proportions. It affects every sector of society, straining our healthcare and criminal justice systems, and endangering the future of our younger generations. Painkiller overdoses nationwide killed nearly 15,000 people in 2008. In New York, the number of prescriptions for all narcotic painkillers has increased from 16.6 million in 2007 to nearly 22.5 million in 2010 - prescriptions for hydrocodone have increased 16.7 percent, while those for oxycodone have increased an astonishing 82 percent. In New York City, the rate of prescription pain medication misuse among those age 12 or older increased by 40 percent from 2002 to 2009, with nearly 900,000 oxycodone prescriptions and more than 825,000 hydrocodone prescriptions filled in 2009. The roots of the problem are two-fold. First, a lack of education and communication between practitioners significantly increases the likelihood of over-prescribing and dangerous drug interaction. Second, access to an ever-increasing supply of prescription narcotics, through legal or illegal means, has grown four-fold in the past decade. Virtually all observers of prescription drug diversion agree that expanding the use of Prescription Monitoring Programs (PMPs), and enhancing the quality and availability of the data they collect, are essential to the solution. The federal Governmental Accountability Office (GAO), the Centers for Disease Control and Prevention (CDC), the insurance industry, the White House, and independent researchers all point to such an expansion as a key part of the solution to prescription drug fraud, abuse and diversion. While New York’s PMP collects critical data on prescription drugs dispensed by pharmacists, the current system is outdated with regard to how and when data is collected, who has access to it, and how it is used. New York State Attorney General Eric T. Schneiderman has introduced a program bill in the State Legislature that would exponentially enhance the effectiveness of New York’s existing PMP to increase detection of prescription fraud and drug diversion. A.8320 (Cusick)/S.5720 (Lanza) would enact the Internet System for Tracking Over-Prescribing (I-STOP) Act, to establish an on-line, real-time, controlled substance reporting system that requires prescribers and pharmacists to search for and report certain data at the time a controlled substance prescription is issued, and at the time such substance is dispensed. The legislation would: • require the Department of Health to establish and maintain an on-line, real-time controlled substance reporting system to track the prescription and dispensing of controlled substances; • require practitioners to review a patient's controlled substance prescription history on the system prior to prescribing; • require practitioners or their agents to report a prescription for such controlled substances to the system at the time of issuance; • require pharmacists to review the system to confirm the person presenting such a prescription possesses a legitimate prescription prior to dispensing such substance; • require pharmacists or their agents to report dispensation of such prescriptions at the time the drug is dispensed. I-STOP will vastly enhance the effectiveness of the present system. Its goal is to enable doctors and pharmacists to provide prescription pain medications, and other controlled substances, to patients who truly need them. At the same time, it will arm them with the necessary data to detect potentially dangerous drug interactions, identify patterns of abuse by patients, doctors and pharmacists, help those who suffer from crippling addictions and prevent potential addiction before it starts. Details: Albany, NY: New York State Office of the Attorney General, 2012. 43p. Source: Internet Resource: Accessed January 17, 2012 at: http://www.ag.ny.gov/media_center/2012/jan/ISTOP%20REPORT%20FINAL%201.10.12.pdf Year: 2012 Country: United States URL: http://www.ag.ny.gov/media_center/2012/jan/ISTOP%20REPORT%20FINAL%201.10.12.pdf Shelf Number: 123644 Keywords: Drug Abuse and Addiction Illicit Drug Markets Prescription Drug Abuse (New York State) Prescription Fraud

Author: Yearwood, Doug Title: Prescription Drug Abuse and Diversion: The Hidden Crisis Summary: This report addresses public concerns about increased misuse, abuse and illegal diversion of licit or prescription medications in North Carolina. The study indicates that prescription drug abuse and diversion is a prominent and preeminent issue facing North Carolina’s medical and law enforcement organizations and personnel. Ninety percent of the law enforcement respondents reported an increase in abuse and diversion over the past five years, with the typical agency investigating 51 prescription drug cases per year or 356 per year on a per capita basis. This case investigation rate exceeds the reported crime rates for all of the violent Part I Uniform Crime Report categories. Details: Raleigh, NC: North Carolina Governor's Crime Commission, Criminal Justice Analysis Center, 2011. 22p. Source: Internet Resource: Accessed January 20, 2012 at: http://www.ncgccd.org/pdfs/pubs/drugdiversion.pdf Year: 2011 Country: United States URL: http://www.ncgccd.org/pdfs/pubs/drugdiversion.pdf Shelf Number: 123686 Keywords: Drug Abuse and Addiction Drug Enforcement Drug Offenders Prescription Drug Abuse (North Carolina) Prescription Fraud

Author: Sweeney, Josh Title: Poly drug use among police detainees Summary: Offenders with complex drug dependencies involving two or more drug types comprise a substantial proportion of drug court and drug diversion clients, yet evaluation studies have demonstrated that these offenders often have poorer retention rates and higher post-program reoffending rates. Poly drug use also has implications for police and law enforcement agencies, as users are potentially a more diversified group whose varied patterns of use makes them more resilient to illicit drug market fluctuations. For these reasons, understanding the nature and extent of poly drug use, especially among those who come into contact with the criminal justice system, will help agencies develop more targeted programs and policing strategies that seek to minimise the impact of drug use in their communities. Using data from Australia’s most comprehensive survey of drug use among detainees, the 2009 collection of the Drug Use Monitoring in Australia (DUMA) program, it was shown that nearly a third of detainees reporting using two or more drugs in the 30 days prior to being detained. Cannabis was the primary drug used by 48 percent of detainees, followed by heroin (19%) and amphetamines (17%). Binary logistic models show that poly drug users are almost twice as likely as single drug users to self report the receipt of income from both drug dealing and other illegal sources, irrespective of any differences between frequency and type of drug used. Details: Canberra, Australia: Australian Institute of Criminology, 2011. 8p. Source: Trends & issue in crime and criminal justice, No. 425: Internet Resource: Accessed February 10, 2012 at http://www.aic.gov.au/documents/A/0/4/%7BA047429D-813B-48E5-B2DE-027A209AE899%7Dtandi425.pdf Year: 2011 Country: Australia URL: http://www.aic.gov.au/documents/A/0/4/%7BA047429D-813B-48E5-B2DE-027A209AE899%7Dtandi425.pdf Shelf Number: 124068 Keywords: Drug Abuse and Addiction Drug Offenders Drug Use (Australia) Police Custody Police Detainees (Australia)

Author: European Monitoring Centre for Drugs and Drug Addiction Title: Amphetamine: A European Union perspective in the global context Summary: This report is the third in a series of European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)–Europol joint publications dedicated to prevalent illicit drugs. It focuses on amphetamine, a substance belonging to the family often referred to as amphetamine-type stimulants (ATS), which covers two main groups of substances: the ‘amphetamines’, which includes amphetamine, methamphetamine and related substances, and the ‘ecstasy-type’ drugs, which includes methylenedioxymethamphetamine (MDMA) and its close relatives methylenedioxyamphetamine (MDA) and methylenedioxyethylamphetamine (MDEA).This study focuses on amphetamine production and markets in Europe, set in a global context. The first two EMCDDA–Europol joint publications were dedicated to methamphetamine and cocaine, while ecstasy-type substances, heroin and cannabis will be addressed in future publications. The current patterns of amphetamine use in Europe are influenced by both historical and more recent factors. The use of amphetamine has evolved over the years since it was first synthesised, in 1887. Originally an experimental substance used as a medicine to treat narcolepsy, amphetamine was used as a stimulant and performance enhancer by soldiers in the Second World War. In the late 1940s, it became a product of mass consumption, and it remained a widely prescribed medication well into the 1960s. Since the early 1970s, amphetamine has been an illicitly used and produced drug, and since the 1990s it has experienced renewed popularity in many parts of Europe, especially northern Europe. Although, worldwide, methamphetamine is probably the most widely used synthetic stimulant, in Europe it is amphetamine, mostly in the form of the sulphate salt, that has historically been, and remains, the most produced, trafficked and used synthetic stimulant. Amphetamine, therefore, may be neatly viewed as a ‘European drug’. Paradoxically, amphetamine has attracted much less attention in the European and global media, in policy circles and in academia than other drugs such as cannabis, cocaine or heroin. Even the closely related methamphetamine often seems to get more attention, although, compared with amphetamine, its production and use are much less prevalent in Europe. As a result, comparatively less information and analysis is available on amphetamine than on many other substances. Even so, EMCDDA and Europol data and analysis, as well as the literature reviewed for this report, strongly suggest that the demand and supply of amphetamine in Europe are not secondary issues but warrant careful attention. Overall, amphetamine has stabilised as the second most widely used stimulant drug in Europe today, after cocaine. And in many countries, especially in the north and east of Europe, it is the most consumed stimulant, far ahead of cocaine. In fact, in many of those countries, amphetamine is the second most widely used illicit drug after cannabis. Broadly speaking, the European amphetamine market can be characterised by two main patterns of use. The biggest group of users are generally episodic or occasional users of the drug, most of whom will be relatively well integrated socially, especially in terms of housing and employment status. Patterns of use among this group will vary from occasional experimental use (only once or twice) to regular episodic but intensive periods of use. The typical mode of administration will be nasal insufflation (snorting) or oral ingestion (swallowing). A second, more chronic, pattern of use can also be found in some countries, notably Norway, Latvia, Sweden and the United Kingdom. This pattern of use is characterised by the chronic (i.e. long-term) injection of often high-dose amphetamine. Users tend to be more socially marginalised and have more chronic health problems. In some countries, amphetamine therefore makes up a significant part of the national drug problem, with the concomitant health and social consequences, and the attendant costs to European societies, that this entails. Other consequences derive from the fact that the European amphetamine markets — 2 million Europeans are estimated to have used the drug in the last year — represent highly profitable ‘business opportunities’ for organised crime. Although some amphetamine is produced in ‘kitchen-type’ laboratories set up by chemistry students to supply a group of local friends, it is likely that the vast majority is manufactured in middling to large, sometimes ‘industrial size’, facilities. And, in this case, production and wholesale trafficking are in the hands of criminal organisations, some of which are able to operate throughout Europe, and even beyond, and which reap the corresponding profits. The decrease in the number of amphetamine production facilities dismantled in Europe in recent years does not necessarily make for comforting news, as forensic intelligence suggests that there is an increase in the production capacity of the facilities seized in key producer countries. The information available suggests that Europe is the world’s number one producer of amphetamine, with much of the production consumed within European borders. However, Europe also produces amphetamine that is usually exported to the Middle East and the Arabian Peninsula, where it is sold under the name ‘captagon’ (see p. 12). For conceptual clarity, the production and use of amphetamine in Europe needs to be distinguished from the production and export of amphetamine sold as captagon outside the European Union (EU). Patterns of use, including dose and route of administration, also are likely to differ considerably between these products. All this emphasises the need for careful monitoring of the production, trafficking and use of amphetamine in Europe today and is one of the reasons why the EMCDDA and Europol have joined efforts to publish the present report. Based on the latest statistical data, intelligence reports and original analysis, this joint publication hopes to enhance the understanding of amphetamine, an often overlooked but nevertheless key component on the European scene for stimulant drugs. -- See earlier report in DMG Gray Literature Database at #115669 -- Details: Luxembourg: Office for Official Publications of the European Communities, 2011. 50p. Source: EMCDDA-Europol Joint Publications No. 3: Internet Resource: Accessed February 21, 2012 at https://www.europol.europa.eu/sites/default/files/publications/emcdda-europol_joint_publications._amphetamine_a_european_union_perspective_in_the_global_context.pdf Year: 2011 Country: Europe URL: https://www.europol.europa.eu/sites/default/files/publications/emcdda-europol_joint_publications._amphetamine_a_european_union_perspective_in_the_global_context.pdf Shelf Number: 123592 Keywords: Amphetamines Drug Abuse and Addiction Methamphetamines Narcotics Production

Author: Kramer, Tom Title: Financing Dispossession: China's Opium Substitution Programme in Northern Burma Summary: Northern Burma’s borderlands have undergone dramatic changes in the last two decades. Three main and interconnected developments are simultaneously taking place in Shan State and Kachin State: (1) the increase in opium cultivation in Burma since 2006 after a decade of steady decline; (2) the increase at about the same time in Chinese agricultural investments in northern Burma under China’s opium substitution programme, especially in rubber; and (3) the related increase in dispossession of local communities’ land and livelihoods in Burma’s northern borderlands. The vast majority of the opium and heroin on the Chinese market originates from northern Burma. Apart from attempting to address domestic consumption problems, the Chinese government also has created a poppy substitution development programme, and has been actively promoting Chinese companies to take part, offering subsidies, tax waivers, and import quotas for Chinese companies. The main benefits of these programmes do not go to (ex-)poppy growing communities, but to Chinese businessmen and local authorities, and have further marginalised these communities. Serious concerns arise regarding the long-term economic benefits and costs of agricultural development— mostly rubber—for poor upland villagers. Economic benefits derived from rubber development are very limited. Without access to capital and land to invest in rubber concessions, upland farmers practicing swidden cultivation (many of whom are (ex-) poppy growers) are left with few alternatives but to try to get work as wage labourers on the agricultural concessions. Land tenure and other related resource management issues are vital ingredients for local communities to build licit and sustainable livelihoods. Investment-induced land dispossession has wide implications for drug production and trade, as well as border stability. Investments related to opium substitution should be carried out in a more sustainable, transparent, accountable and equitable fashion. Customary land rights and institutions should be respected. Chinese investors should use a smallholder plantation model instead of confiscating farmers land as a concession. Labourers from the local population should be hired rather than outside migrants in order to funnel economic benefits into nearby communities. China’s opium crop substitution programme has very little to do with providing mechanisms to decrease reliance on poppy cultivation or provide alternative livelihoods for ex-poppy growers. Chinese authorities need to reconsider their regional development strategies of implementation in order to avoid further border conflict and growing antagonism from Burmese society. Financing dispossession is not development. Details: Amsterdam: Transnational Institute, 2012. 92p. Source: Internet Resource: Accessed February 27, 2012 at: http://www.tni.org/sites/www.tni.org/files/download/tni-financingdispossesion-web.pdf Year: 2012 Country: Burma URL: http://www.tni.org/sites/www.tni.org/files/download/tni-financingdispossesion-web.pdf Shelf Number: 124276 Keywords: Drug Abuse and Addiction Drug Policy Opium (Burma) War on Drugs (Burma)

Author: Bouchard, Martin Title: Estimation of the Size of the Illicit Methamphetamine and MDMA Markets in Canada: A Discussion Paper on Potential Methods and Data Sources Summary: Ever since their relatively recent appearance as drugs of choice among the Canadian population, methamphetamine (meth) and 3,4-methylenedioxy-N-methylamphetamine (MDMA or ecstasy) hydrochloride have been the object of concern for public health and law enforcement agencies. The concern with meth and ecstasy are based on two main issues: (i) the highly addictive nature of these drugs paired with serious health consequences for users (especially for meth), (ii) the identification of Canadian offenders as major players in meth/ecstasy production and exportation. Although various reports suggest that both issues deserve immediate consideration from policy makers and researchers, there is a lack of data on the most basic (yet crucial) issue – the size of the markets. The purpose of this report is to re-examine the scientific and grey literature on current methods of estimating the size of illegal markets, with an emphasis on the meth/MDMA markets. The first part of this paper reviews the current data available from various surveys on the prevalence of Amphetamine-Type Stimulants (ATS) and MDMA use in Canada. The second section of the report examines recent innovations in the area, with a special emphasis on two families of methods: (i) multiplier methods, which derive an estimate of the population based on a rate of occurrence of an event in the population of interest (e.g. number of overdoses per ATS user); and (ii) capture-recapture methods, which infer the number of users, dealers or producers never arrested based on the patterns of arrests and re-arrests over a fixed time period. The third part of the paper turns to the data requirements for applying these methods to the Canadian meth and ecstasy markets, with an emphasis on estimating the scale of ATS production. Details: Ottawa: Organized Crime Division, Law Enforcement and Policy Branch, Public Safety Canada, 2010. 54p. Source: Internet Resource: Report No. 003, 2010: Accessed February 27, 2012 at: http://publications.gc.ca/collections/collection_2012/sp-ps/PS4-90-2010-eng.pdf Year: 2010 Country: Canada URL: http://publications.gc.ca/collections/collection_2012/sp-ps/PS4-90-2010-eng.pdf Shelf Number: 124279 Keywords: Drug Abuse and Addiction Drug Markets Drug Offenders Methamphetamine (Canada)

Author: Australia. Office of Crime Statistics and Research Title: Common Performance Measures for the Evaluation of Specialist Court Programs - Discussion Paper Summary: This report was produced for the ABS Boards of Management of the Statistical Units for Courts, Crime and Corrective Services. Using Australian drug court programs as the primary example, the report identifies a common set of quantitative elements that could be used for the evaluation of diversionary/specialist courts nationally. The report also includes a summary of drug court and Indigenous court program elements within each jurisdiction and the measures used to assess their effectiveness. Details: Adelaide, South Australia: Office of Crime Statistics and Research; Policy, Planning and Legislation Division, 2010. 38p. Source: Internet Resource: Accessed February 28, 2012 at http://www.ocsar.sa.gov.au/docs/research_reports/CPM-Specialist_Court_Programs_Discussion_Paper.pdf Year: 2010 Country: Australia URL: http://www.ocsar.sa.gov.au/docs/research_reports/CPM-Specialist_Court_Programs_Discussion_Paper.pdf Shelf Number: 124304 Keywords: Drug Abuse and Addiction Drug Courts (Australia) Evaluative Studies Recidivism

Author: Sweeney, Josh Title: Decrease in use of ecstasy/MDMA Summary: Recent data from the Australian Institute of Criminology’s Drug Use Monitoring in Australia program indicate a decrease in the use of ecstasy among police detainees. Specifically, only five percent of police detainees in 2010 and 2011 reported using ecstasy; 50 percent lower than in 2009 when ecstasy use peaked at 11 percent. Key findings Recent data from the Australian Institute of Criminology’s Drug Use Monitoring in Australia (DUMA) program indicate a decrease in the use of ecstasy among police detainees. Specifically, only five percent of police detainees in 2010 (n=187) and 2011 (n=170) reported using ecstasy; 50 percent lower than in 2009 (n=428) when ecstasy use peaked at 11 percent. Self-report data also indicate that ecstasy was considered by users to be lower in quality and harder to obtain in 2011 compared with earlier years. Ecstasy users also reported a decrease in the number of people selling the drug. The decline in ecstasy use coincides with a reported increase in methamphetamine use (Macgregor and Payne 2011) and the findings are consistent with data recently released by the National Drug and Alcohol Research Centre (Sindicich & Burns 2011) and in the 2010 National Drug Strategy Household Survey (NDSHS) report (AIHW 2011). Details: Canberra: Australian Institute of Criminology, 2012. 4p. Source: DUMA Research in Practice No. 26: Internet Resource: Accessed March 11, 2012 at http://www.aic.gov.au/documents/8/9/C/%7B89C0AB4B-1F28-4CA8-8483-1CE90142BC25%7Drip26.pdf Year: 2012 Country: Australia URL: http://www.aic.gov.au/documents/8/9/C/%7B89C0AB4B-1F28-4CA8-8483-1CE90142BC25%7Drip26.pdf Shelf Number: 124443 Keywords: Drug Abuse and Addiction Ecstasy Illegal Drugs Methamphetamines

Author: Douglas, Heather Title: Law Enforcement and Khat: An Analysis of Current Issues Summary: Khat is regulated in Australia through a complex regime of overlapping and differing Commonwealth, state and territory laws. In some states possession of khat is strictly prohibited and carries heavy penalties, whereas in others possession of khat appears to be legal (at least for personal use). This study drew upon focus group discussions with communities known to use khat, principally the Somali community. The researchers also interviewed police officers. The key concerns raised by police were about identifying khat and knowing of current law. Summaries of current law, along with clear photographs, are included at the back of this monograph in Appendixes 1 and 2. Many police and focus group participants were uncertain about current law relating to khat. Chapter 3 discusses current law. Some police indicated interest in knowing more about the cultural issues associated with khat. Chapter 6 discusses khat and Islam and a summary is provided in Appendix 3. Focus group participants showed a significant misunderstanding of the health issues associated with khat use. A discussion of these issues is included in Chapter 5. Focus group members were particularly concerned about the relationship between using khat and driving, in particular the question of whether khat is safe to use, or be under the influence of, while driving. This issue is discussed in Chapter 11. Details: Canberra: National Drug Law Enforcement Research Fund, 2012. 93p. Source: Internet Resource: Monograph Series No. 40: Accessed March 30, 2012 at: http://www.ndlerf.gov.au/pub/Monograph_40.pdf Year: 2012 Country: Australia URL: http://www.ndlerf.gov.au/pub/Monograph_40.pdf Shelf Number: 124770 Keywords: Drug Abuse and Addiction Drug Enforcement Khat (Australia)

Author: Merkinaite, Simona Title: A War Against Peopole Who Use Drugs: The Costs Summary: This report aims to assess whether national funding allocated for drug-related measures achieves the goals of slowing down or reversing drug epidemics and protecting society from drug-related harms. It is based on comparing costs associated with both – law enforcement activities and public health measures such as harm reduction and drug treatment. The report draws on country costs assessments done in Georgia, Kyrgyzstan, Romania and Russia as well as analysis of data from other countries of the region, including Ukraine and Tajikistan. Key findings: • Punishment for petty, non-violent drug crimes—mainly but not solely limited to criminalization of people who use drugs—results in stigma and discrimination, and creates a political climate in which human rights norms are not applied in relation to people who use drugs. • Such policies lead to police harassment, misuse of power and extortion of money from drug users and/or their relatives. • In most countries of Eastern Europe and Central Asia (EECA), governments’ unwillingness to allocate funds for harm reduction, opioid substitution therapy (OST), HIV and hepatitis C treatment is determined not by insufficiency of national funding, but by prioritization of enforcement over health approaches. • Such misguided priorities also have significant (and negative) financial consequences. For example: – The Kyrgyzstan government spends around $1.25 million per year to enforce Article 246 of the Criminal Code (regarding possession of drugs with no intent to supply). By comparison, the budget for OST programs is $500,000, and is currently covered exclusively by external donors. OST costs $500 per patient a year, while punishment costs at least $625 per each person convicted for drug possession. – In 2010 alone, the prosecution of drug offenders (for use and supply) cost at least $100 million in Russia. In comparison, under the Budget Law for 2011, HIV prevention programming is to receive less than 3% of the total $640 million to be allocated in 2012 through the Federal Budget Law for HIV, hepatitis B and C, and the government continues to prohibit internationally accepted drug treatment interventions such as OST. The government therefore will spend millions more treating people infected with HIV than it would have in protecting their health and reducing transmission. – Georgia spends around $10.5 million annually on random street drug testing and an additional $4.7 million on imprisonment of drug offenders. This not only fails to deter people from using drugs (as eventually the majority return to drug use) but also increases criminality, social isolation and stigma. Only about 10% of the estimated 40,000 people who inject drugs are currently receiving harm reduction services, yet even that small share means that up to 1,000 new HIV infections have been averted. • Despite vast investment in law enforcement interventions, neither drug use nor the HIV epidemic has been contained. Across EECA there are an estimated 3.4 million to 3.8 million people who inject drugs, which represents the highest regional prevalence of injecting drug use worldwide. One in four injectors is believed to be living with HIV in the region, accounting for 57% of all infections. • In countries where the drugs of the choice become unavailable, people are switching to other, potentially more harmful substances. Such developments indicate that punitive drug laws (prohibition of certain substances) have, at best, marginal impacts on the overall level of drug use, and have negative impacts on health. • Prosecution and incarceration for drug-related offences is one of the key reasons behind the increase in prison populations across the region. Yet maintaining prisons is expensive, and many prison systems are chronically underfunded. Among the consequences are increased HIV transmission—because drugs are easily available in most prisons, but preventive commodities such as clean needles are not—and an increase in involvement in criminal gangs as prisoners seek ways to improve their food and safety position in penitentiaries. Details: Vilnius, Lithuania: Eurasian Harm Reduction Network (EHRN), 2012. 36p. Source: Internet Resource: Accessed April 6, 2012 at: http://dl.dropbox.com/u/64663568/library/a-war-against-people-who-use-drugs-the-costs.pdf Year: 2012 Country: International URL: http://dl.dropbox.com/u/64663568/library/a-war-against-people-who-use-drugs-the-costs.pdf Shelf Number: 124881 Keywords: Drug Abuse and Addiction Drug Abuse Policy Drug Enforcement Drug Treatment War on Drugs (Europe and Asia)

Author: Barnard, Matt Title: The Drug Treatment Outcomes Research Study (DTORS): Qualitative Study Summary: The DTORS qualitative research involved in-depth interviews with both service providers and service users. Qualitative research is a key means of carrying out research in sensitive areas and is a way of collecting data that are capable of centralising the participants own experiences, being responsive to participants and remaining flexible and reflexive. Participation in the research was voluntary. Participants' were initially identified and invited to participate in the research using purposive sampling methods. In all elements of the qualitative research, this means that samples were designed to include range and diversity in all the dimensions likely to affect experiences, behaviour and attitudes, and to include all key sub-groups and constituencies. Research interviews lasted for approximately 1.5hrs and were carried out using topic guides. The data was analysed using the Framework method of analysis (Ritchie & Lewis, 2003). The qualitative research provided a rich understanding of participants' experiences and perceptions of treatment and the decisions they made about remaining in or leaving it. In the broadest terms, the research also explored: service users' pathways into treatment; service providers' experiences and views of treatment services; the factors perceived to influence service users' different pathways through treatment; and to understand the wider range of personal and social factors that may impact on different treatment outcomes for service users. Research with service providers and service users took place in 2006/07. Details: London: Home Office, 2009. 25p. Source: Internet Resource: Homes Office Research Reprot 26: Accessed April 11, 2012 at: http://www.dtors.org.uk/reports/DTORS_Qualitative_Main.pdf Year: 2009 Country: United Kingdom URL: http://www.dtors.org.uk/reports/DTORS_Qualitative_Main.pdf Shelf Number: 124933 Keywords: Drug Abuse and Addiction Drug Abuse Treatment (U.K.) Drug Offenders

Author: Davies, Linda Title: The Drug Treatment Outcomes Research Study (DTORS): Cost-effectiveness Analysis Summary: The objectives of the CBA were to: estimate the costs of treatment; descriptively compare the costs and outcomes of drug treatment overall and by treatment centre; estimate the monetary value of the outcomes measured by the DTORS and the overall net benefit of treatment. The economic evaluation used cost consequences analysis to descriptively compare the costs and outcomes of drug treatment. Cost benefit analysis was used to estimate the net benefit (cost) of drug treatment. The cost estimates included the fixed and variable costs of the treatment centres, the costs of services accessed or used by service users and families as part of treatment or as a consequence of treatment. These data were collected from a review of centre accounting and information systems, service user records (where these existed) and interviews and questionnaires completed by care and support staff and service users. The outcomes included: •Quality adjusted life years; •Engagement in drug related behaviours; •Severity of drug dependence; •Offending behaviour; •Employment. Details: London: Home Office, 2009. 21p. Source: Internet Resource: Home Office Research Report 25: Accessed April 11, 2012 at: http://www.dtors.org.uk/reports/DTORS_CostEffect_Main.pdf Year: 2009 Country: United Kingdom URL: http://www.dtors.org.uk/reports/DTORS_CostEffect_Main.pdf Shelf Number: 124934 Keywords: Cost-Benefit Analysis Drug Abuse and Addiction Drug Abuse Treatment (U.K.) Drug Offenders

Author: Great Britain. National Health Service. National Treatment Agency for Substance Misuse Title: Estimating the Crime Reduction Benefits of Drug Treatment and Recovery Summary: The Home Office estimates that drug related crime costs £13.9bn per year and that offenders who use heroin, cocaine or crack cocaine commit between a third and a half of all acquisitive crimes. As a result, reducing drug-related crime is one of the main objectives of the government’s drug strategy. This recognises that the provision of good quality drug treatment, combined with stable housing and employment, can be very effective in preventing high volume acquisitive offending. Drug addicted people often develop a tolerance through daily compulsive use, which can result in an expensive addiction. For instance, the estimated average value of drugs used in the four weeks prior to treatment among participants of the Drug Treatment Outcomes Research Study (DTORS) was £1,2964. With little income they may resort to crime to pay for their drug use. This might include acquisitive crimes such as shoplifting, burglary or robbery, or other financially motivated crimes such as soliciting and begging. Drug treatment is designed to reduce people’s need for drugs, which in turn reduces the driving force behind their drug-related offending. The National Treatment Agency for Substance Misuse (NTA) has worked closely with economists in the Home Office (HO) and the Department of Health (DH) to build a Value for Money (VFM) model in response to the National Audit Office recommendation to develop a framework for evaluating value for money in relation to the previous drug strategy. The VFM model estimates the crime prevention and health improvement benefits of treatment and recovery. This is the first time such estimates have been made at a national level. This report sets out a detailed explanation of how the estimates were calculated for the crime component of the VFM model and has been endorsed by HO. It will be followed by a publication later this year on the health improvement benefits of drug treatment, presenting our work with DH on the potential improvements to Quality Adjusted Life Years (QALYs) from drug treatment and recovery. Crime prevention and health improvement are not the only potential benefits of drug treatment. There are a variety of different harms associated with drug use and we hope to look at other potential benefits of treatment and recovery in relation to these in the future. We estimate that drug treatment and recovery systems in England may have prevented approximately 4.9m crimes in 2010-11, with an estimated saving to society of £960m in costs to the public, businesses, the criminal justice system and National Health Service (NHS). We also estimate that approximately 19.6m crimes may be prevented over the course of the Spending Review 2010 period (SR10) (2011-12 to 2014-15), with an estimated saving to society of £3.6bn. In addition we estimate that up to a further 4.1m offences may be prevented over a nine year period (from 2011-12 to 2019-2020), because we estimate that 13,702 people who left treatment in 2010-11 will go on to sustain long term recovery, with an estimated value of £700m. We also estimate that continued investment in drug treatment over the SR10 period could lead to up to an estimated 54,000 former clients sustaining long term recovery which may prevent up to 16.6m more offences with an estimated value of up to £2.6bn by 2023-24. The model also helps us to estimate the potential impact of disinvestment in adult drug treatment. We estimate that, all else being equal, for every £1m taken out of the system there could be an increase of approximately 9,860 drug-related crimes per year at an estimated cost to society of over £1.8m. These findings are based on an empirical analysis of data from the National Drug Treatment Monitoring System (NDTMS) linked to conviction records from the Police National Computer (PNC) and on self reported offences data from DTORS. Details: London: National Treatment Agency for Substance Misuse, 2012. 29p. Source: Internet Resource: Accessed May 14, 2012 at: http://www.nta.nhs.uk/uploads/vfm2012.pdf Year: 2012 Country: United Kingdom URL: http://www.nta.nhs.uk/uploads/vfm2012.pdf Shelf Number: 125256 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Abuse Treatment (U.K.) Drug Offenders

Author: Stover, H., Weilandt, C. Title: Final Report on Prevention, Treatment, and Harm Reduction Services in Prison, on Reintegration Services on Release from Prison and Methods to Monitor/Analyse Drug use among Prisoners Summary: The main objective of this work package was to analyse the status-quo of prevention, treatment and harm reduction services for people in prisons and in reintegration services for persons on release from prisons. The report is based on data on health interventions targeting imprisoned drug users as well as on relevant information included in the national action plans on social inclusion prepared by the Member States within the context of the open method of coordination on social protection and social inclusion. A key result of this work package is that there is a need for more systematic research on the effectiveness of treatment for drug users in prison, as there is hardly any high-quality research in this field, especially in the EU. Although there exist a range of interventions for drug using inmates, the implementation is often sporadic and not sufficient to meet the needs. To promote and secure health in prison, testing for infectious diseases and vaccination is a major opportunity, and does have an impact on the health of the incarcerated, the correctional employees and the communities to which the inmates return. Vaccination for Hepatitis B and A is highly recommended for prisoners. Drug testing on the other hand, in particular mandatory drug testing in prison can have adverse effects, e.g. encourage people to switch from smoking drugs like Cannabis to injecting drugs like heroin, in order to avoid detection. It has been observed that mandatory drug testing is rather expensive and can be counterproductive, due to an increasing tension in the prison. Treatment for prisoners involves the treatment for drug dependency and infectious diseases. Upon entering the prison, prisoners with AIDS should be offered treatment with highly active anti-retroviral therapy (HAART), which is an effective treatment. Hence existing HAART should not be discontinued and prisoners not yet receiving HAART should be encouraged to start HAART. Similar to AIDS, treatment for HCV is safe and feasible. Although the establishment of prison-based substitution treatment proved to be as effective in reducing mortality, crime and re-incarceration rates and HCV as in the community, the implementation of prison-based substitution treatment is still not equally well accepted and realized. Concerning harm reduction measures in prison the implementation is fragmentary and often problematic, despite existing research on the topic. Evidence for the effectiveness of prison needle exchange programmes (PNEP) has been gathered in a number of very different prison settings: PNEP reduces needle sharing very effectively, can increase uptake of drug treatment as well as the safety in the prison, and can reduce abscesses and fatal overdoses. It does not increase injecting drug use, nor has it shown any other negative effects. No research was found explicitly evaluating the distribution of sterile tattooing equipment. Still this measure should be recommended to reduce the risk of transmitting diseases, as tattooing often occurs in prison. Condoms are likely to be the most effective method for preventing sexually transmitted diseases (STDs). No serious negative effects of condom distribution in prisons have been found, and the free availability of condoms seems feasible in a wide range of prison settings. Details: Bonn, Germany: WIAD Wissenschaftliches Institut der Ärzte Deutschlands gem. e.V., 2008. 281p. Source: Internet Resource: Accessed May 14, 2012 at: http://ec.europa.eu/health/ph_determinants/life_style/drug/documents/drug_frep1.pdf Year: 2008 Country: Europe URL: http://ec.europa.eu/health/ph_determinants/life_style/drug/documents/drug_frep1.pdf Shelf Number: 113425 Keywords: Drug Abuse and Addiction Harm Reduction Programs Infectious Diseases, Prisoners Prison Health Care Prisoner Reentry, Health Services Prisoners

Author: Great Britain. National Health Service. National Treatment Agency for Substance Misuse Title: Breaking the Link: The Role of Drug Treatment in Tackling Crime Summary: The relationship between problem drug use and crime is complex. Even so, all the evidence indicates that problem drug users are responsible for a large percentage of acquisitive crime, such as shoplifting and burglary. As a direct consequence of the crime they commit, these problem drug users are highly likely to end up in the criminal justice system at some point. Some will serve community sentences, others will be sent to prison. In either case, the criminal justice system now compels them to confront their drug problems. Drug treatment for offenders in the community has improved enormously over the past decade, in terms of availability and quality. Prisons are now catching up, with the introduction of a new treatment regime – the Integrated Drug Treatment System (IDTS). The NTA is now responsible for implementing IDTS in prisons, and this report, in part, looks at the progress that has been made so far. Prisons are logical places to engage problem drug users in effective treatment. The aim is to break the link between their drug use and criminal behaviour, so that they don’t reoffend on release and have the opportunity to recover and reintegrate with society. In this way, effective treatment can liberate them, their families, and the communities that suffer as a result of drug-related crime. Drug treatment has been available in prisons for some time, but this is the first time there will be an evidence-based, individual-focused system offering consistent treatment in all prisons in England. IDTS seeks to ensure that problem drug users in prisons have access to the same quality of treatment as those in the community, and the same chance to rebuild their lives. This report is therefore about the positive impact drug treatment can have towards reducing crime, cutting the cost of drug-related harm to society, and making communities safer for everyone. Details: London: National Treatment Agency for Substance Misuse, 2004. 24p. Source: Internet Resource: Accessed May 14, 2012 at: http://www.nta.nhs.uk/uploads/nta_criminaljustice_0809.pdf Year: 2004 Country: United Kingdom URL: http://www.nta.nhs.uk/uploads/nta_criminaljustice_0809.pdf Shelf Number: 125261 Keywords: Drug Abuse and Addiction Drug Abuse and Crime (U.K.) Drug Abuse Treatment Drug Offenders

Author: United Nations Office on Drugs and Crime Title: Opiate Flows Through Northern Afghanistan and Central Asia: A Threat Assessment Summary: This report describes the illicit trade of opiates along the Northern route from northern Afghanistan to Central Asia up to the borders of the Russian Federation. It has been organized in three sections. The first section begins by addressing the dynamics of trafficking in northern Afghanistan, including the groups involved, the volumes of opiate flows and opiate consumption, as well as the share that southern Afghanistan production takes in Northern route trafficking. A second section explores trafficking dynamics through Central Asia, including the methods involved and the groups managing the trade. Lastly, the final section briefly analyzes the regional capacity to respond to the threat of Afghan opiates. For the purposes of this study, ‘northern Afghanistan’ refers to both north Afghanistan and north-east Afghanistan, following the regional grouping of provinces used in the UNODC annual Opium Poppy Survey. The north Afghanistan region consists of the provinces of Baghlan, Samangan, Faryab, Sari-pul, Jawzjan, Bamyan and Balkh, while north-east Afghanistan consists of Kunduz, Badakhshan and Takhar provinces. Details: Geneva: UNODC, 2012. 106p. Source: Internet Resource: Accessed May 15, 2012 at: http://www.unodc.org/documents/data-and-analysis/Studies/Afghanistan_northern_route_2012_web.pdf Year: 2012 Country: Asia URL: http://www.unodc.org/documents/data-and-analysis/Studies/Afghanistan_northern_route_2012_web.pdf Shelf Number: 125301 Keywords: Drug Abuse and Addiction Drug Trafficking Opiates (Asia) Opium Organized Crime

Author: Wish, Eric D. Title: The Maryland Adult Offender Population Urine Screening (OPUS) Program: Final Report Summary: In 2005, CESAR piloted an innovative cost-effective method to measure drug use trends in offenders in Maryland, using urine specimens already collected and tested for a small panel of drugs by the Division of Parole and Probation (DPP). The 2005 OPUS study sampled 299 specimens obtained from adult parolees and probationers in six counties in Maryland (Baltimore City, Baltimore, Howard, Prince George’s, Charles and Washington counties) and retested the specimens for an expanded panel of 30 drugs. The findings indicated considerable promise of the OPUS methodology for providing the state with information regarding the availability and use of drugs by offenders. The current study used the OPUS methodology to obtain 1,061 specimens from the three Maryland DPP labs that process urine specimens submitted from 55 DPP collection sites. These specimens were sent to a laboratory for testing of an extended panel of 31 drugs. As we found in the prior pilot study, the most common drugs detected were marijuana, cocaine, benzodiazepines, and morphine. Again, we found almost no evidence of methamphetamine use and that most PCP positives came from offenders in Prince George’s County. On the other hand, a larger percentage of buprenorphine positives were detected (5% vs. 13%, p<.001) than we found in 2005, suggesting greater use of this relatively newly prescribed drug in Maryland. Considerable geographic differences were found in the patterns of drugs detected across Maryland. Only 4% of the tested specimens were found to test positive solely for a drug in the expanded screen. It therefore appears that the current five drug DPP screen identifies 96% of all recent drug users. The OPUS methodology may provide states with a relatively quick and low cost method for monitoring drug trends in offenders. Details: College Park, MD: Center for Substance Abuse Research (CESAR), University of Maryland, College Park, 2009. 70p. Source: Internet Resource: Accessed July 2, 2012 at: http://www.goccp.maryland.gov/msac/documents/bjag-2005-1080.pdf Year: 2009 Country: United States URL: http://www.goccp.maryland.gov/msac/documents/bjag-2005-1080.pdf Shelf Number: 125441 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders Urine Testing

Author: McCarty, Maggie Title: Drug Testing and Crime-Related Restrictions in TANF, SNAP, and Housing Assistance Summary: Throughout the history of social assistance programs, administrators have attempted to limit access only to those families considered “worthy” of assistance. Policies about worthiness have included both judgments about need—generally tied to income, demographic characteristics, or family circumstances—and judgments about moral character, often as evidenced by behavior. Past policies evaluating moral character based on family structure have been replaced by today’s policies, which focus on criminal activity, particularly drug-related criminal activity. The existing crime and drug-related restrictions were established in the late 1980s through the mid-1990s, when crime rates, especially drug-related violent crime rates, were at peak levels. While crime rates have since declined, interest in expanding these policies has continued. The three programs examined in this report—the Temporary Assistance for Needy Families (TANF) block grant, the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps), and federal housing assistance programs (public housing and Section 8 tenant and project-based assistance)—are similar, in that they are administered at the state or local level. They are different in the forms of assistance they provide. TANF provides cash assistance and other supports to low-income parents and their children, with a specific focus on promoting work. SNAP provides food assistance to a broader set of poor households including families with children, elderly households, and persons with disabilities. The housing assistance programs offer subsidized rental housing to all types of poor families, like SNAP. All three programs feature some form of drug- and other crime-related restrictions and all three leave discretion in applying those restrictions to state and local administrators. Both TANF and SNAP are subject to the statutory “drug felon ban,” which bars states from providing assistance to persons convicted of a drug-related felony, but also gives states the ability to opt-out of or modify the ban, which most states have done. Housing assistance programs are not subject to the drug felon ban, but they are subject to a set of policies that allow local program administrators to deny or terminate assistance to persons involved in drug-related or other criminal activity. Housing law also includes mandatory restrictions related to specific crimes, including sex offenses and methamphetamine production. All three programs also have specific restrictions related to fugitive felons. Recently, the issue of drug testing in federal assistance programs has risen in prominence. In the case of TANF, states are permitted to drug-test recipients; however, state policies involving suspicionless drug testing of TANF applicants and recipients are currently being challenged in courts. SNAP law does not explicitly address drug testing, but given the way that SNAP and TANF law interact, state TANF drug testing policies may affect SNAP participants. The laws governing housing assistance programs are silent on the topic of drug testing. The current set of crime- and drug-related restrictions in federal assistance programs are not consistent across programs, meaning that similarly situated persons may have different experiences based on where they live and what assistance they are seeking. This variation may be considered important, in that it reflects a stated policy goal of local discretion. However, the variation may also be considered problematic if it leads to confusion among eligible recipients as to what assistance they are eligible for or if the variation is seen as inequitable. Proposals to modify these policies also highlight a tension that exists between the desire to use these policies as a deterrent or punishment and the desire to support the neediest families, including those that have ex-offenders in the household. Details: Washington, DC: Congressional Research Service, 2012. 32p. Source: Internet Resource: CRS Report R42394: Accessed July 2, 2012 at: http://assets.opencrs.com/rpts/R42394_20120307.pdf Year: 2012 Country: United States URL: http://assets.opencrs.com/rpts/R42394_20120307.pdf Shelf Number: 125450 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders Drug Testing (U.S.) Housing Assistance

Author: Rolles, Steve Title: The Alternative World Drug Report: Counting the Costs of the War on Drugs Summary: The Alternative World Drug Report, launched to coincide with publication of the UN Office on Drugs and Crime’s 2012 World Drug Report, exposes the failure of governments and the UN to assess the extraordinary costs of pursuing a global war on drugs, and calls for UN member states to meaningfully count these costs and explore all the alternatives. After 50 years of the current enforcement-led international drug control system, the war on drugs is coming under unparalleled scrutiny. Its goal was to create a "drug-free world". Instead, despite more than a trillion dollars spent fighting the war, according to the UNODC, illegal drugs are used by an estimated 270 million people and organised crime profits from a trade with an estimated turnover of over $330 billion a year – the world’s largest illegal commodity market. In its 2008 World Drug Report, the UNODC acknowledged that choosing an enforcement-based approach was having a range of negative "unintended consequences", including: the creation of a vast criminal market, displacement of the illegal drugs trade to new areas, diversion of funding from health, and the stigmatisation of users. It is unacceptable that neither the UN or its member governments have meaningfully assessed these unintended consequences to establish whether they outweigh the intended consequences of the current global drug control system, and that they are not documented in the UNODC’s flagship annual World Drug Report. This groundbreaking Alternative World Drug Report fills this gap in government and UN evaluations by detailing the full range of negative impacts resulting from choosing an enforcement-led approach. Details: Count the Costs.org, 2012. 111p. Source: Internet Resource: Accessed July 2, 2012 at: http://www.countthecosts.org/sites/default/files/AWDR.pdf Year: 2012 Country: International URL: http://www.countthecosts.org/sites/default/files/AWDR.pdf Shelf Number: 125458 Keywords: Costs of Crime Costs of Criminal Justice Drug Abuse and Addiction Drug Enforcement Drug Policy Illegal Drugs Organized Crime

Author: California State Task Force on Prescription Drug Misuse Title: Prescription Drugs: Misuse, Abuse and Dependency Summary: The nonmedical use of prescription drugs has emerged as a growing and serious problem in California. In response, the California Department of Alcohol and Drug Programs (ADP), under the leadership of Director Renée Zito, convened the Prescription Drug Misuse (PDM) Task Force. The Task Force was charged with studying the problem and developing recommendations to increase awareness, limit access, and reduce misuse rates. For the past year, this group has convened by teleconference. The Task Force developed information and discussed issues concerning use patterns, availability, awareness levels and problems associated with the nonmedical use of prescription drugs by diverse population sub‐groups. This report is a culmination of their efforts. Details: Sacramento: California Department of Alcohol and Drug Programs, 2009. 37p. Source: Internet Resource: Accessed July 3, 2012 at: http://www.adp.ca.gov/director/pdf/Prescription_Drug_Task_Force.pdf Year: 2009 Country: United States URL: http://www.adp.ca.gov/director/pdf/Prescription_Drug_Task_Force.pdf Shelf Number: 125462 Keywords: Drug Abuse and Addiction Drug Control Prescription Drug Abuse Prescription Drugs

Author: Gyngell, Kathy Title: The Phoney War on Drugs Summary: The Government has repeatedly declared that it is fighting a War on Drugs. But this has been a Phoney War, shows Kathy Gyngell in The Phoney War on Drugs published on Monday 18 May 2009 by the Centre for Policy Studies. For the UK now has one of the most liberal drug policies in Europe. Both Sweden and the Netherlands (despite popular misconceptions) have a more rigorous approach – and far fewer problems with drugs. Kathy Gyngell shows how the Labour Government has taken a new direction for drug policy. Its new “harm-reduction” strategy aimed to reduce the cost of problem drug use. The focus was switched from combating all illicit drug use to the problems of PDUs. Cannabis was declassified. Spending on methadone treatment increased threefold between 2003 and 2008. The aim of treatment for drug offenders was no longer abstinence but management of their addiction with the aim of reducing their reoffending. In practice, this meant prescribing methadone. But this harm-reduction approach has failed. It has entrapped 147,000 people in state-sponsored (mainly methadone) addiction. Addicts leaving government treatment programmes clean of drug use are at the same level as if there had been no treatment programme at all.   The UK now faces a widening and a deepening crisis. Over the last 10 years, Class A consumption and ‘problem drug use’ have risen dramatically, drug use has spread to rural areas and the age of children’s initiation into drugs has dropped. 41% of 15 year olds, and 11% of 11 year olds, have taken drugs. Drug death rates continue to rise and are far higher than the European average. The UK has 47.5 deaths per million population (aged 15 to 64) compared to 22.0 in Sweden and 9.6 in the Netherlands. There are over ten Problem Drug Users (PDUs) per 1,000 of the adult population, compared to 4.5 in Sweden or 3.2 in the Netherlands. Weak enforcement and prevention The UK drugs market is estimated to be worth £5 billion a year. In comparison, the Government is spending only £380 million a year – or 28% of the total drugs budget – attempting to control the supply of drugs (over £800 million is spent on treatment programmes and reducing drug-related crime). Only five boats now patrol the UK’s 7,750 mile coastline. The numbers of recorded offences for importing, supply and possession of illicit drugs have all fallen over the last 10 years. At the same time, seizures of drugs have fallen and drug prices have dropped to record low. The quantity of heroin, cocaine and cannabis that has been seized coming into the UK has fallen by 68%, 16% and 34% respectively. Both Sweden and the Netherlands have far more coherent and effective drugs policies. All illicit drug use is targeted. Treatment is clearly aimed at breaking addiction. Drug laws are clearly understood and enforced. And, unlike in the UK, the majority of the drugs budget of both countries is spent on prevention and enforcement. As Kathy Gyngell demonstrates, these principles have been lost sight of over the last 10 years in the UK. A successful UK drug policy would in contrast: bear down on the illicit use of all drugs, not the harms caused by drug use; abandon the harm reduction approach; focus treatment on abstinence and rehabilitation; include a tougher, better-funded enforcement programme to reduce the supply of drugs. Details: London: Centre for Policy Studies, 2009. 82p. Source: Internet Resource: Accessed July 10, 2012 at: http://www.cps.org.uk/files/reports/original/111026175647-thephoneywarondrugs.pdf Year: 2009 Country: United Kingdom URL: http://www.cps.org.uk/files/reports/original/111026175647-thephoneywarondrugs.pdf Shelf Number: 107669 Keywords: Drug Abuse and Addiction Drug Control Drug Enforcement Drug Policy (U.K.) Drug War

Author: Bouchard, Martin Title: Estimating the Size of the Canadian Illicit Meth and MDMA Markets: A Multi-Method Approach Summary: This study addresses the lack of reliable estimates on the scope of amphetamine-type stimulants (ATS: amphetamine, methamphetamine, ecstasy/MDMA) production in Canada. Such a study allows for a thorough assessment of Canada’s role in global ATS production and exportation. Using a multi-method approach, this research derives more accurate estimates of:  the total number of ATS users in Canada than currently exists, including an estimate of the quantity of ATS consumed domestically;  the total number of actors active on the supply side of ATS markets than currently exists;  the total production volume of ATS in Canada than currently exists, including an estimate of the number of active ATS labs; and,  the total amount of ATS exported from Canada. This report begins with a literature review of patterns in ATS use and production within and beyond Canada. Drawing from this past research, a series of methods and data sources that will allow the production of an estimate of the size of these populations for the present study are laid out. The remainder of the report presents the results from the various estimation methods that were applied to assess the size of various segments of the ATS market in Canada. The conclusion provides the main highlights and recommendations from the overall study. The review of the literature on trafficking and production found that there is too much uncertainty in regards to the existing data to truly assess the role of Canada in the global ATS trade. There are no established estimates of the size of production and the amount of ATS lab seizures remains low. While Canada ranked 6th in the world in the amount of methamphetamine seized in 2007 with 1.54 metric tons, the figure for the previous years was as low as 60kg. Finally, the review found that two methods for estimating the size of the ATS market in Canada (multiplier methods and capture-recapture methods) have shown more promise in obtaining reliable estimates of illegal populations, including drug dealers and producers. To derive these estimates, existing survey, arrest, and seizure data were used. Procedures used included multiplier methods, synthetic estimation methods, capture-recapture methods, and economic modeling methods. When possible, two methods were used to estimate a segment of the market. In most analyses, the diverse methods yielded consistent results, but much more research is required to provide further validation of this study’s results. Working with small and sparse data increases the levels of uncertainty that already exist in these estimation exercises. This report should be approached as a first step in developing standard methods that academics and policy makers can use to make systematic assessments of the ATS and other illicit drug markets in Canada and beyond. Our efforts should therefore be viewed as an exploration that lays the groundwork for a Canada-wide study with a strong emphasis on collecting fieldwork data. Assessments of the demand-side of the ATS market, based on synthetic estimation techniques, suggest that there are roughly 52,000 meth users and 270,000 ecstasy users in Canada. This estimate is based on a low count of data which combines the general population that is twelve years and older, the homeless population, and the inmate population. This total count of 320,000 likely underestimates the population of ATS consumers. Adjustments for 50% underreporting (high count) suggest a much larger total population of about 480,000 users (77,788 meth users and 402,677 ecstasy users). The assessment of the supply-side of this market relied on arrest data. The market is predominately male, but no more so than other illegal drug markets and crime settings in general. The population estimates suggest that steep increase occurred between 1999 and 2009 in Quebec, echoing what has been found through other indicators in Canada. One limit in our analysis was that we were unable to provide a valid estimate of importers, exporters, and producers. These populations are small, captured offenders have a higher likelihood of being incarcerated for longer time periods (and thus be unavailable for recapture), and simply not enough offenders get re-arrested in Quebec for these methods to be usable. The populations of meth and ecstasy dealers were estimated using both capture-recapture and multiplier estimates. Based on arrest data from Quebec, the capture-recapture estimate resulted in 3,458 meth dealers and 4,561 ecstasy dealers in Quebec. This allowed us to infer Canadian populations of 14,303 meth dealers and 16 980 ecstasy dealers. Results from the multiplier procedure for Canada that was based on a user:dealer ratio provided some validation at the higher end for meth and lower end for ecstasy—the population of meth dealers was estimated from a low of 3,457 to a high of 11,113 dealers, while the population of ecstasy dealers was estimated from a low of 17,897 to a high of 57,525 dealers. Once again, the substantial range that emerges from the multiplier procedure calls for considerable caution and additional verification with different data sources from a variety of regions. Estimates of the population of labs and producers were derived using diverse methods. The number of ATS labs was estimated using an economic model. This estimate ranged from a low of 560 labs to a high of 1,400 ATS labs in Canada. Such information was subsequently carried over to estimate the number of producers in the country. A ratio of 3.5 producers per lab was established, resulting in an estimated low of 1,960 ATS producers if 560 labs were in operation to a high of 4,900 producers if 1,400 labs were in operation in Canada. Both ATS production and consumption were estimated in order to arrive at a final estimate of how much meth could be reasonably exported from Canada. Such an analysis would lend some substance to persistent claims and debate regarding Canada’s pivotal position in the international ATS trade. Using the results from the economic model as a starting point, overall production was estimated at 2,297 kg if the lower-end 560 labs scenario was accurate and 5,743 kg if the higher-end 1,400 labs scenario was accurate. Such results must be approached with caution since the estimates are based on a single cook per lab in a given year—it may very well be the case that ATS labs produce multiple batches and will likely yield much larger quantities than we estimate. Adjusting these estimates to two ‘cooks’ per lab resulted in a low-end estimate of 4,594 kg and high-end estimate of 11,485 kg of meth in Canada. Depending on the scenario, Canadian producers would export between 38% and 75% of domestic ATS production. Using a multiplier method to derive a quantity per user ratio, meth consumption for Canada was estimated between 678 kg and 847 kg. Ecstasy consumption was estimated between 1,643 and 2,054 kg. Combining meth and ecstasy resulted in a total ATS consumption range of 2,321 to 2,902 kg in Canada. Based on mid-point estimates for consumption and seizure data, an excess of 1,733 kg to 8,624 kg of Canadian ATS was estimated for annual exportation. This would suggest that 38% (if 1733 kg of production) or 75% (if 8624 kg of production) of ATS produced in Canada is exported. Information was also added regarding the quantity of Canadian produced ATS overseas to produce an estimate of any ATS unaccounted for by Canadian users or law enforcement agencies around the world. This suggested that an excess of 288 to 7,179 kg of ATS was available for consumption overseas after domestic and international seizures and consumption were subtracted from overall production. The estimates produced for the purpose of this report suggest that Canada produces as little as 0.6% of the world’s supply or as much as 4.6%. Canada would not be considered as a major ATS producer under most standards. Based on the estimates produced in this report, Canada is no more and no less of a player today than it was five years ago. Five specific recommendations could improve these estimates over the long term:  establish a more concerted effort to monitor national trends in synthetic drug markets, especially on the supply side;  monitor trends in domestic illegal ATS precursor importation;  monitor trends in Canadian produced synthetic drugs in other countries;  adopt wastewater analysis as a method to estimate the quantity of ATS used in large Canadian cities; and  make use of capture-recapture methods for the purpose of estimating the size of illegal markets a priority for Canada as a whole. Details: Ottawa: Research and National Coordination, Organized Crime Division, Law Enforcement and Policing Branch, Public Safety Canada, 2012. 75p. Source: Internet Resource: Accessed July 19, 2012 at: http://publications.gc.ca/collections/collection_2012/sp-ps/PS4-125-2012-eng.pdf Year: 2012 Country: Canada URL: http://publications.gc.ca/collections/collection_2012/sp-ps/PS4-125-2012-eng.pdf Shelf Number: 125690 Keywords: Drug Abuse and Addiction Drug Trafficking (Canada) Drug Trafficking Control Ecstasy Methamphetamines

Author: Wisconsin State Council on Alcohol and Other Drug Abuse,Prevention Committee, Controlled Substances Workgroup Title: Reducing Wisconsin’s Prescription Drug Abuse: A Call to Action Summary: Communities around the state report that prescription narcotic abuse, such as oxycodone and hydrocodone, along with illegal narcotic substances, such as heroin, are on the rise. The Wisconsin State Council on Alcohol and Other Drug Abuse (SCAODA), in recognition that prescription drug abuse and narcotic abuse is a growing problem in Wisconsin, established a Controlled Substances Prevention Sub- Committee. The committee, known as the Controlled Substances Work Group (CSW) convened for the fi rst time in July 2010. CSW was charged with identifying prescription and non-prescription drugs that are most often abused in Wisconsin, focusing upon legal opiates (opioid analgesics) and illegal opiates, as well as other drugs of abuse with high consequences. Additionally, CSW was tasked with examining the prevalence and burden of use and to determine if an adequate surveillance system exists in Wisconsin. CSW also examined the role of community coalitions, substance abuse prevention and treatment providers, law enforcement and the judicial system, the medical community, schools, and legislative and state agencies in preventing drug abuse. CSW also identifi ed key educational messages targeting the health care community in the broad scope including; physicians, pharmacists and other key health care stakeholders, and to determine if there are preventive measures that can be employed when prescribing or dispensing drugs with a high potential for abuse. CSW examined community based education targeting the general population and specifi c subgroups (such as high risk populations) to help avoid abuse and its deadly consequences. CSW identifi ed the urgency in establishing a Prescription Drug Monitoring Program (PDMP) as well as an accessible and cost effective system for prescription drug disposal in Wisconsin. The work of CSW culminated in this report that outlines strategies and recommendations to prevent and reduce substance abuse in Wisconsin. Details: Madison, WI: State Council on Alcohol and Other Drug Abuse, 2012. 52p. Source: Internet Resource: Accessed July 20, 2012 at: http://scaoda.state.wi.us/docs/prevandspfsig/FINAL01032012CSWReport.pdf Year: 2012 Country: United States URL: http://scaoda.state.wi.us/docs/prevandspfsig/FINAL01032012CSWReport.pdf Shelf Number: 125707 Keywords: Drug Abuse and Addiction Prescription Drug Abuse (Wisconsin) Substance Abuse Prevention

Author: Kirwan, Amy Title: Licit and Illicit Quetiapine Use Among IDRS Participants Summary: Key findings • ƒQuetiapine use and associated problems have been documented overseasƒƒ • Lifetime quetiapine use was reported by 41% of the 2011 IDRS sample, and recent use was reported by 22% of the sample • Recent mental health issues and recent benzodiazepine use were prevalent among those using both licit and illicit quetiapine • Ice use was frequently reported by those reporting illicit quetiapine use • Quetiapine use among PWID warrants further research and monitoring. Details: Sydney: National Drug and Alcohol Research Centre, The University of New South Wales, 2012. 4p. Source: Internet Resource: IDRS Bulletin: Accessed August 7, 2012 at: http://ndarc.med.unsw.edu.au/sites/ndarc.cms.med.unsw.edu.au/files/ndarc/resources/IDRS%20Bulletin%20July12.pdf Year: 2012 Country: Australia URL: http://ndarc.med.unsw.edu.au/sites/ndarc.cms.med.unsw.edu.au/files/ndarc/resources/IDRS%20Bulletin%20July12.pdf Shelf Number: 125876 Keywords: Drug Abuse and Addiction Illegal Drugs (Australia)

Author: U.S. Government Accountability Office Title: Drug Control Initial Review of the National Strategy and Drug Abuse Prevention and Treatment Programs Summary: An estimated 22.6 million Americans aged 12 or older were illicit drug users in 2010, representing 8.9 percent of the population aged 12 or older, according to the National Survey on Drug Use and Health. This represents the highest overall rate of illicit drug users among this population group since 2002, when the rate was 8.3 percent. Abuse of illicit drugs results in significant social, public health, and economic consequences for the United States. For example, the economic impact of illicit drug use, including the costs of crime, health care, and lost productivity, was estimated at more than $193 billion in 2007, the most recent year for which data were available. The Office of National Drug Control Policy (ONDCP) was established by the Anti-Drug Abuse Act of 1988 to, among other things, enhance national drug control planning and coordination and represent the drug policies of the executive branch before Congress. In this role, ONDCP provides advice and governmentwide oversight of drug programs and is responsible for coordinating drug control activities, including federal drug abuse prevention and treatment programs, and related funding across the federal government. ONDCP is required annually to develop the National Drug Control Strategy (Strategy), which sets forth a plan to reduce illicit drug use through prevention, treatment, and law enforcement programs, and to develop a Drug Control Budget for implementing the Strategy. ONDCP reported that for fiscal year 2012, about $25.2 billion was provided for drug control programs across 17 federal departments and independent agencies. Further, according to ONDCP, from 2004 to 2012 this signified an increase of $5.9 billion (about 31 percent) for drug control programs, including drug abuse prevention and treatment programs. The 2010 Strategy is the inaugural strategy guiding drug policy under President Obama’s administration and, according to ONDCP officials, sought a comprehensive approach to drug policy, including an emphasis on drug abuse prevention and treatment efforts and the use of evidence-based practices—approaches to prevention or treatment that are based in theory and have undergone scientific evaluation. Drug abuse prevention includes activities focused on discouraging the first-time use of controlled substances and efforts to encourage those who have begun to use illicit drugs to cease their use. Treatment includes activities focused on assisting regular users of controlled substances to become drug free through such means as counseling services, inpatient and outpatient care, and the demonstration and provision of effective treatment methods. National Drug Control Program agencies (drug control agencies) follow a detailed process in developing their annual budget submissions for inclusion in the Drug Control Budget, which provides information on the funding that the executive branch requested for drug control to implement the Strategy. Agencies submit to ONDCP the portion of their annual budget requests dedicated to drug control, which they prepare as part of their overall budget submission to the Office of Management and Budget for inclusion in the President’s annual budget request. ONDCP reviews the budget requests of the drug control agencies to determine if the agencies have acceptable methodologies for estimating their drug control budgets, and includes those that do in the Drug Control Budget . Agencies may administer programs that include drug abuse prevention and treatment activities but do not meet ONDCP’s standards for having an acceptable budget estimation methodology. Such programs are not represented in the Drug Control Budget. Part of the 2010 Strategy is a long-term policy goal for increasing the emphasis on preventing and treating substance abuse. Multiple federal departments—and their component agencies, bureaus, divisions, and offices—and independent agencies (collectively referred to as agencies), administer drug abuse prevention and treatment programs, fund these programs, or both. The drug abuse prevention and treatment programs vary and may include grants to service providers, direct services, and education and outreach activities. For example, an agency’s grant program may award block grants to grantees, such as states or local entities, to implement their own interventions through community-based drug abuse prevention or treatment programs, while direct service programs often entail interventions directly administered by an agency to a specific population. Drug abuse prevention and treatment programs target various populations and use a wide variety of interventions, which are strategies or approaches intended to prevent an undesirable outcome, such as abuse of an illicit drug; promote a desirable outcome, such as reducing the use of alcohol among youth; or alter the course of an existing condition, such as successful treatment of drug addiction. Some programs may be either jointly funded or administered by two or more agencies. In light of the increase in the rate of illicit drug use among Americans, efforts to oversee and coordinate the implementation of the Strategy and ensure that ONDCP and federal agencies invest in the most effective drug abuse prevention and treatment programs become more important. You asked us to determine the extent to which the 2010 Strategy has been implemented, review the sources of funding for federal drug abuse prevention and treatment programs as well as federal agency efforts to coordinate their programs, and examine agencies’ efforts to evaluate drug abuse prevention and treatment programs and ensure that they are effective. Specifically, in this report we (1) provide an initial review of the extent to which the 2010 Strategy has been implemented, the extent to which ONDCP coordinates its implementation across drug control agencies, and how ONDCP assesses the effectiveness of the Strategy in preventing and reducing drug use; (2) review what agencies fund drug abuse prevention and treatment programs and how agencies coordinate their programs; and (3) provide an initial review of the extent to which federal agencies evaluate their drug abuse prevention and treatment programs and the extent to which agencies assess their programs’ effectiveness. This is the first report in response to your request that we assess the implementation of the 2010 Strategy. This report describes the implementation approach, federal agencies’ drug abuse prevention and treatment programs, and Department of Health and Human Services (HHS), Department of Justice (DOJ), and Department of Education (Education) efforts to assess the effectiveness of their drug abuse prevention and treatment programs. We will continue our work on these issues and plan to evaluate the extent to which the 2010 Strategy has been implemented and coordinated across agencies and how ONDCP assesses the effectiveness of the Strategy in preventing and reducing drug use. Details: Washington, DC: GAO, 2012. 45p. Source: Internet Resource: GAO-12-744R: Accessed August 8, 2012 at: http://www.gao.gov/products/GAO-12-744R Year: 2012 Country: United States URL: http://www.gao.gov/products/GAO-12-744R Shelf Number: 125909 Keywords: Drug Abuse and Addiction Drug Abuse Policy (U.S.) Drug Control Policy Narcotics Control

Author: Sutherland, Rachel Title: Criminal Activity Among Regular Ecstasy Users in Australia: Prevalence and Predictors Summary: The relationship between drug use and crime has been studied extensively over the past few decades, with both international and Australian studies showing that drug users are more likely to engage in crime than those who do not use drugs (AIHW 2011; Bennett et al. 2008). Indeed, a meta-analysis of studies published between 1980 and 2003 found that the odds of offending were three to four times greater for drug users than nondrug users - with the odds of offending being highest among crack users and lowest among recreational drug users (Bennett at al. 2008). In addition it has been well-established that, among those who use drugs, frequency of use is positively correlated with prevalence of crime (Nurco et al 2001; French et al 2000). There are several theories which exist to explain this relationship, however it remains unclear how much of a drug user’s offending can be attributed directly to their substance use. This question was most recently addressed by the Australian Institute of Criminology (AIC), which has been running the Drug Use Monitoring in Australia (DUMA) program for more than 13 years. Through this program the AIC found that nearly half of 1,884 police detainees across Australia attributed their current offending to alcohol or drugs. Interestingly, more detainees attributed their offending to alcohol than to all other drugs combined; however, of the illicit drugs, heroin users were the most likely to attribute their offending to drug use, while ecstasy users were among the least likely (Payne & Gaffney 2012). Whilst the above study captured the use of ecstasy, the majority of criminological research has traditionally focused on users of heroin, cocaine and methamphetamine - with relatively little attention paid to those who use ecstasy (Hendrickson & Gerstein 2005; Yacoubian et al 2004). In addition, those studies which have specifically examined the nexus between ecstasy use and crime appear to have focused on the use of ecstasy among offenders or police detainees, rather than examining the prevalence of crime among those who use ecstasy. With this in mind, this paper aims to examine criminal activity among regular ecstasy users (REU) in Australia. More specifically, this paper will: 1. Examine the prevalence of criminal activity among regular ecstasy users in Australia, from 2003- 2011. 2. Examine the extent to which drugs and/or alcohol were involved in criminal activity among REU in 2011. 3. Determine what factors were predictive of criminal activity among this population in 2011. Details: Sydney, National Drug & Alcohol Research Centre, University of New South Wales, 2012. 6p. Source: Internet Resource: Ecstasy and Related Drugs Reporting System, Drugs Trends Bulletin July 2012: Accessed August 13, 2012 at: http://ndarc.med.unsw.edu.au/sites/ndarc.cms.med.unsw.edu.au/files/ndarc/resources/EDRS%20Bulletin%20July12.pdf Year: 2012 Country: Australia URL: http://ndarc.med.unsw.edu.au/sites/ndarc.cms.med.unsw.edu.au/files/ndarc/resources/EDRS%20Bulletin%20July12.pdf Shelf Number: 125999 Keywords: Drug Abuse and Addiction Drug Abuse and Crime (Australia) Ecstasy

Author: Clark, Thomas Title: Prescription Drug Monitoring Programs: An Assessment of the Evidence for Best Practices Summary: The role of state prescription drug monitoring programs (PDMPs) in facilitating appropriate prescribing of controlled prescription drugs and helping to address the prescription drug abuse epidemic has been highlighted in recent studies and in the 2011 White House Office of National Drug Control Policy’s Prescription Drug Abuse Prevention Plan (GAO, 2002; Pradel et al., 2009; Baehren et al., 2010; Katz et al., 2010; Johnson et al., 2011; Office of National Drug Control Policy, 2011). A special concern for PDMPs is the diversion of opioid pain relievers into nonmedical use and abuse. A PDMP is a statewide electronic database that gathers information from pharmacies on dispensed prescriptions for controlled substances (most states that permit practitioners to dispense also require them to submit prescription information to the PDMP). Many PDMPs now provide secure online access to this information for authorized recipients. Prescription data (usually for the past year, and including information on date dispensed, patient, prescriber, pharmacy, medicine, and dose) are made available on request from end users, typically prescribers and pharmacists, and sometimes distributed via unsolicited reports. Recipients of PDMP data may also include practitioner licensure boards, law enforcement and drug control agencies, medical examiners, drug courts and criminal diversion programs, addiction treatment programs, public and private third-­party payers, and other public health and safety agencies. States vary widely in which categories of users are permitted to request and receive prescription history reports and under what conditions. PDMPs represent a substantially underutilized resource in efforts to improve public health outcomes and address prescription drug abuse (Katz et al., 2010). Key reasons for this underutilization include differences in the data PDMPs collect, whether and how they ensure data quality, the kinds of data analyses and reports they produce, to which users and under what conditions they make data available, and differences in an array of other procedures and practices. With respect to many of these practices, there is not widespread understanding of which constitute “best practices”; that is, which practices are associated with maximizing PDMP effectiveness. The purpose of this white paper is to describe what is known about PDMP best practices, describe and assess the evidence supporting their identification as best practices, and document the extent to which PDMPs have implemented these practices. The paper is structured as follows: • Section II provides background on the history of PDMPs and a conceptual framework for assessing their effectiveness. The contexts in which PDMPs developed have been an important influence on the range of PDMP practices and the extent of their current adoption. Practices can be organized in terms of PDMP workflow and functions (e.g., data collection, analysis, and reporting). Their effectiveness can be assessed by observing their differential impact in achieving intermediate objectives, such as increasing the utilization of PDMPs by all appropriate end users, and ultimate goals, such as improving patient health and reducing the diversion of prescription drugs into illegal use (drug diversion) and overdose. • Section III provides an overview of the paper’s methods and discusses types of evidence for effectiveness, the relative strength of the methods and evidence, and how the current evidence base for potential PDMP best practices was assessed. • Section IV describes candidate PDMP best practices, the extent to which they are implemented by PDMPs, and the evidence base for each practice, and identifies barriers to their adoption. • Section V discusses conclusions and recommendations regarding PDMP best practices. It includes a table summarizing the types of evidence that currently exist for each practice and the strength and consistency of evidence within those types. This section also outlines a research agenda, suggesting the kinds of studies needed to produce a stronger evidence base for practices we believe have the greatest potential to improve PDMP effectiveness. • Section VI provides the references we have examined in developing this white paper. These references are summarized in two tables in an appendix: one providing an overview of the peer-­reviewed, published literature on PDMP practices and effectiveness, and a second providing an overview of other literature of evaluation studies and reports, case studies, anecdotal information, and expert opinion. Details: Washington, DC: Pew Charitable Trusts, 2012. 100p. Source: Internet Resource: Accessed September 25, 2012 at: http://www.pewhealth.org/uploadedFiles/PHG/Content_Level_Pages/Reports/PDMP_Full%20and%20Final.pdf Year: 2012 Country: United States URL: http://www.pewhealth.org/uploadedFiles/PHG/Content_Level_Pages/Reports/PDMP_Full%20and%20Final.pdf Shelf Number: 126443 Keywords: Drug Abuse and Addiction Drug Abuse Prevention Prescription Drug Abuse Prescription Drug Monitoring

Author: McDougall, Kate Title: Selling Sex: A Study of Adult Women Who Exchange Sex for Money or Drugs on Toronto's Moss Park Stroll Summary: This research is a phenomenological case study on street-level sex work and the adult women who exchange sex for money or drugs in Moss Park, a particularly poor and crime-ridden neighborhood in Downtown Toronto. Hopefully, this research can be extrapolated and applied to other urban neighborhoods where street-level sex work is prevalent. The chosen methodology for this study was ten qualitative, guided one-on-one interviews in which the researcher was careful not to impose an outside conceptual framework. It is hoped that this research will help continue to cultivate a dialogue with the women engaged in this form of labor and further the ongoing discussions regarding sex work, violence, health and well-being, and the individual’s own identity and experience in street-level sex work. The information gathered from ten marginalized women who identify as being sex workers is intended to provide not only the social service organizations and advocacy groups in the community with an educational tool for understanding the nature of street-level sex work in Moss Park, but also a source of empowerment for both the women and the surrounding community to seek both change and urban social transformation around this issue. Details: Philadelphia: Eastern University, 2011. 94p. Source: Internet Resource: Thesis: Accessed September 26, 2012 at: http://www.eastern.edu/academic/ccgps/ssc/urban/pdf/McDougall_Thesis_690_5-9-2011.pdf Year: 2011 Country: Canada URL: http://www.eastern.edu/academic/ccgps/ssc/urban/pdf/McDougall_Thesis_690_5-9-2011.pdf Shelf Number: 126462 Keywords: Drug Abuse and Addiction Prostitutes Sex Workers Street Prostitution (Toronto, Canada)

Author: Lowe, Kevin Title: Sharing the Learning: The Drug and Alcohol Transitions Project for Young Adults Derby City 2009-12 Summary: The aim of this report is to tell the story of the Addaction Drug and Alcohol Transitions Project for Young Adults in Derby City. This project carried out successful, innovative work, helping young adults aged 17-24 to end, or substantially reduce, their substance misuse. The approach was highly cost effective and makes a powerful case for age-appropriate services for young adults. This report is designed for a diverse audience. It will enable practitioners, commissioners and policy-makers working in the substance misuse field to learn the lessons from the project’s work and will also be valuable for all agencies concerned about how best to meet the needs of vulnerable young adults.1 The report has been written by external consultants who interviewed the project staff and some of the young adult clients. Information has also been drawn from the project’s records. It covers: • an overview of the project • a timeline of the project’s activities • the community outreach work and individual treatment in detail • what the focus on young adults meant in practice • finance and value for money • The main messages from the project’s work. There are also several appendices which cover the project’s clients, information about the changing nature of young adulthood, and national data on the use of drugs and alcohol by young adults. The interview material provides the kind of detail that is necessary to bring the work alive. It shows what the staff actually did and contains their reflections on what worked and what was less successful. The young people also tell about what made a difference to them at a crucial stage in their lives. This report is not a formal evaluation of the outcomes of the project’s work; however, it paints a picture of a very effective project that broke new ground in work with young adults. Details: London: Addaction, 2012. 74p. Source: Internet Resource: Accessed October 15, 2012 at: http://www.addaction.org.uk/news.asp?section=408§ionTitle=Addaction+in+the+media Year: 2012 Country: United Kingdom URL: http://www.addaction.org.uk/news.asp?section=408§ionTitle=Addaction+in+the+media Shelf Number: 126730 Keywords: Alcohol Abuse Drug Abuse and Addiction Drug Abuse Prevention Youth Adults

Author: Ricklund, Peter Title: Rapid Referral Program: Spectrum Youth & Family Services: Outcome Evaluation Summary: The Rapid Referral Program is a partnership between Spectrum Youth & Family Services of Burlington, Vermont and the Chittenden County District Court. The purpose of this partnership is to increase access to mental health and substance abuse assessment services for individuals involved in the criminal justice system whose charge(s) are related to substance use. The main objective of the Program is to provide judges with a mechanism at arraignment to rapidly refer defendants to Spectrum Youth Services for substance abuse screening and treatment rather than delaying services until the case is disposed by the court. An outcome evaluation attempts to determine the effects that a program has on its participants. In the case of the Rapid Referral Program (hereafter “the Program”), the objective of this outcome evaluation was to determine the extent to which the Program impacts recidivism among Program participants. An indicator of post-Program criminal behavior that is commonly used in outcome evaluations of criminal justice programs is the number of participants who recidivate -- that is, are convicted of a crime after they complete the Program. For this study an analysis of the criminal history records of the 171 subjects who were referred and accepted into the Program from November, 2008 to September, 2011 was conducted using the Vermont criminal history record of participants as provided by the Vermont Criminal Information Center at the Department of Public Safety. The Vermont criminal history record on which the recidivism analysis was based included all charges and convictions prosecuted in a Vermont District Court that were available as of December 5, 2011. The criminal records on which the study was based do not contain Federal prosecutions, out-of-state prosecutions, or traffic tickets. MAJOR CONCLUSIONS 1. The Rapid Referral Program serves its designated target population. 2. The Rapid Referral Program serves defendants who possess a variety of risk factors generally considered to be related to recidivism. 3. The Rapid Referral Program appears to be a promising approach for positively impacting recidivism among Program participants. 4. The vast majority of Rapid Referral Program participants that recidivate are convicted of new crimes within one year of Program completion. Estimates suggest that the percentage of participants who recidivate is not likely to increase as post-Program elapsed time continues to increase for participants. 5. Generally, post-Program reconvictions for Rapid Referral Program participants involved minor types of crime. 6. The Rapid Referral Program seems to be relatively successful in reducing the number of reconvictions for alcohol and drug crimes among participants after Program completion. 7. The Rapid Referral Program recidivists tended to commit post-Program crime in Chittenden County. Details: Northfield Falls, VT: Vermont Center for Justice Research, 2012. 29p. Source: Internet Resource: Accessed October 19, 2012 at: http://www.vcjr.org/reports/reportscrimjust/downloads-2/files/Spectrum%20Report.pdf Year: 2012 Country: United States URL: http://www.vcjr.org/reports/reportscrimjust/downloads-2/files/Spectrum%20Report.pdf Shelf Number: 126747 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Abuse Treatment Mental Health Services Recidivism Substance Abuse (Vermont)

Author: Golub, Andrew Title: Monitoring Drug Epidemics and the Markets that Sustain Them Using ADAM II Final Technical Report Summary: Effective law enforcement, drug abuse and related social policies and initiatives depend on the timely availability of information and its interpretation. This study examined trends in use of five widely abused drugs among arrestees at ten geographically diverse locations from 2000 to 2010: Atlanta, Charlotte, Chicago, Denver, Indianapolis, Manhattan, Minneapolis, Portland OR, Sacramento, and Washington DC. The data came from the Arrestee Drug Abuse Monitoring Program reintroduced in 2007 (ADAM II) and its predecessor the ADAM program. ADAM data are particularly valuable because they include urinalysis results that provide an objective measure of recent drug use; they provide location specific estimates over time; and, they include sample weights that yield unbiased estimates for each location. Arrestees are often at the forefront of drug use trends. Moreover, this population is of central concern to law enforcement and related agencies. The ADAM data were analyzed according to a drug epidemics framework, which has been previously employed to understand the decline of the crack epidemic, the growth of marijuana use in the 1990s, and the persistence of heroin use. Similar to other diffusion of innovation processes, drug epidemics tend to follow a natural course passing through four distinct phases: incubation, expansion, plateau, and decline. The study also searched for changes in drug markets over the course of a drug epidemic. A variety of exploratory analyses strongly suggest that there is no simple relationship between the nature of individuals’ drug market purchases and the broader course of drug epidemics. As of 2010, the Marijuana Epidemic was in its plateau phase across the country. In contrast, by 2010 the Crack Epidemic had been in decline for some time at most locations. The timing of the decline phase varied substantially across locations. The decline started as early as 1990 in Manhattan and Washington DC and as late as 2003 in Indianapolis. As of 2010, the Crack Epidemic was still in the plateau phase in Sacramento. Powder cocaine use was only substantial at 5 of the 10 ADAM II locations. The Powder Cocaine Epidemic entered a decline early in the 2000s at two eastern locations (Charlotte and Manhattan) and closer to 2010 at two western locations (Denver and Portland OR). In Atlanta, the recent Powder Cocaine Epidemic was either still in plateau or had just entered the decline phase. Heroin use was limited to four locations and was in decline at three of the four (Chicago, Manhattan and Washington DC). Heroin use appears to be endemic to Portland OR; use is not widespread but appears to be embedded within a small population that continues to attract new young users. Methamphetamine use was substantial at two West Coast locations. Of note, the data strongly indicate that the Methamphetamine Epidemics in Portland OR and Sacramento entered the decline phase during the 2000s. The primary limitation to this analysis is that it focused exclusively on male arrestees from the 10 urban locations included in the ADAM II Program. The trends identified do not necessarily parallel the trends in the general population. Additionally, there may be variations in drug use across gender not detectable with ADAM data. The ADAM II locations provide geographic diversity but the program does not include any rural locations. Details: Final Report to the U.S. National Institute of Justice, 2012. 85p. Source: Internet Resource: Accessed November 23, 2012 at: https://www.ncjrs.gov/pdffiles1/nij/grants/239906.pdf Year: 2012 Country: United States URL: https://www.ncjrs.gov/pdffiles1/nij/grants/239906.pdf Shelf Number: 126946 Keywords: Drug Abuse and Addiction Drug Markets Drug Offenders Drugs Abuse and Crime (U.S.)

Author: Nicholas, Roger Title: Breaking the Silence: Addressing Family and Domestic Violence Problems in Alcohol and Other Drug Treatment Practice in Australia Summary: This literature review examines the relationships between alcohol and other drug (AOD) use and “family and domestic violence” (FDV) in the context of AOD treatment settings. It focuses on strategies that may be developed to enhance the responses of alcohol and other drug (AOD) treatment providers to FDV issues affecting clients and their children. Details: Adelaide, South Australia: National Centre for Education and Training on Addiction (NCETA), Flinders University, 2012. 36p. Source: Internet Resource: Accessed November 24, 2012 at: http://nceta.flinders.edu.au/files/6513/5285/7437/EN469_Nicholas_2012.pdf Year: 2012 Country: Australia URL: http://nceta.flinders.edu.au/files/6513/5285/7437/EN469_Nicholas_2012.pdf Shelf Number: 126989 Keywords: Alcohol Abuse Alcohol Treatment Programs Child Abuse and Neglect Domestic Violence Drug Abuse and Addiction Drug Treatment Family Violence (Australia)

Author: MITRE Corporation Title: Enhancing Access to Prescription Drug Monitoring Programs Using Health Information Technology: Work Group Recommendations Summary: Prescription drug misuse and overdose is one of the fastest growing health epidemics in the United States. In 2010, U.S. pharmacies dispensed enough opioid pain relievers to medicate every adult in America with a 5 mg hydrocodone every 4 hours for an entire month. As of 2010, nearly 5% of people 12 years or older in the United States stated that they used opioids nonmedically. The amount of controlled substances dispensed and used nonmedically is alarming considering that the Centers for Disease Control and Prevention (CDC) reported that in 2009, opioid drugs, including oxycodone and hydrocodone, caused more than 15,500 overdose deaths - a number that is increasing. The overdose death rates for all drugs including opioids increased in Louisiana, Mississippi, Kentucky and West Virginia from the years 1999 to 2008. In 2008, New Mexico and West Virginia reported the highest drug overdose death rates at 27 and 25.8 deaths per 100,000 population respectively. To address the prescription drug abuse problem, many states have established Prescription Drug Monitoring Programs (PDMPs). These programs collect prescription data on medications that the federal government classifies as controlled substances and other non-controlled substance drugs. Their purpose is to reduce prescription drug abuse and diversion. PDMPs are not federally operated; they are statewide electronic databases that collect, monitor, and analyze electronically transmitted prescribing and dispensing data submitted by pharmacies and dispensing physicians. PDMP information can be useful to improve decision-making when prescribing and dispensing scheduled prescription drugs, but not all states benefit equally from these programs. Although this data is made available to authorized healthcare professionals in the majority of states, access is generally optional. Details: McLean, VA: MITRE Corporation, 2012. 191p. Source: Internet Resource: Accessed December 7, 2012 at: http://www.ihealthtran.com/Enhancing-Access-to-prescription-drug-monitoring-programs-using-health-information-technology-report.pdf Year: 2012 Country: United States URL: http://www.ihealthtran.com/Enhancing-Access-to-prescription-drug-monitoring-programs-using-health-information-technology-report.pdf Shelf Number: 127134 Keywords: Drug Abuse and Addiction Drug Abuse Prevention Prescription Drug Abuse

Author: Furby, Brett Title: Evaluation of Community Offender Services Programs Drug and Alcohol Addiction and Relapse Prevention - Three Years Out Summary: Community Offender Services (COS), within Corrective Services NSW (CSNSW) is responsible for the management of offenders serving community-based sentences across 60 NSW district offices. The Drug and Alcohol Addiction Program (DAAP) and Relapse Prevention Program (RPP) were designed to be delivered by Probation and Parole Officers (PPOs) who supervise the participating offenders. These programs formed part of a drug and alcohol intervention strategy aimed to enhance the range of options that PPOs may use to assist community-based offenders under supervision in breaking the cycle of drug dependency and crime. CSNSW received funding from the NSW Drug Summit Initiative to develop, implement and evaluate these programs. The first year of the programs has previously been reported. This report details findings from the second and third years of program delivery to end September, 2008. Trends are examined on program activity data, participant characteristics and re-offending rates since program inception. At three years out, program effects remain positive with offenders showing marked improvements in levels of drug dependency, stage of change in problem resolution and legal outcomes. Details: ydney: Corporate Research, Evaluation & Statistics, NSW Department of Corrective Services, 2011. 30p. Source: Research Bulletin No. 33: Internet Resource: Accessed January 13, 2013 at http://143.119.253.176/__data/assets/pdf_file/0008/447299/RB33-Evaluation-of-Community-Offender-Services-Programs-Drug-and-Alcohol-Addiction-and-Relapse-Prevention-Three-Years-Out.pdf Year: 2011 Country: Australia URL: Shelf Number: 127279 Keywords: Alcohol Abuse Community-based Corrections Drug Abuse and Addiction Evaluative Studies Intervention Programs

Author: Advisory Council on the Misuse of Drugs (U.K.) Title: Khat: A Review of Its Potential Harms to the Individual and Communities in the UK Summary: Khat is a herbal product consisting of the leaves and shoots of the shrub Catha edulis. It is chewed to obtain a mild stimulant effect and is a less potent stimulant than other commonly used drugs, such as amphetamine or cocaine. Khat is not controlled under the Misuse of Drugs Act 1971 and is currently imported and used legally in the UK. Khat is imported into the UK from the main khat growing regions of Kenya, Ethiopia and Yemen. Generally, khat chewing is a social event which takes place within family homes, community parties and at khat cafes. Traditionally khat has been used as a medicine and was widely perceived to be a food, not a drug. There are no international comparable prevalence estimates for use of khat and no reliable published evidence as to the rates of khat use in European countries. However within Europe khat use is primarily amongst BME immigrants from the Horn of Africa countries. Rates of khat use appear high among the general populous in Somalia, Yemen and Ethiopia. However prevalence of khat use is far less among the Somali community living in the UK than in the population living in Somalia. Based on VAT data from HM Revenue and Customs there has been a reduction of importation of khat to the UK since 2005. During this period the relevant BME population in the UK has increased by 18.4%. This strongly indicates that khat use within the same UK population has decreased. Northern Ireland and Scotland do not report any figures on prevalence or treatment data of khat users engaging with the NHS. Only 6 referrals are recorded on the Welsh National Database for Substance Misuse since 2009. The NHS data for England for 2010/11 shows 112 clients began treatment for the first time citing involvement with khat at any point in their past. The ACMD is cognisant that NHS and other data may not fully represent the treatment needs of khat users due to the difficulties in engaging with all groups within communities. Anecdotal evidence reported from communities in several UK cities link khat consumption with a wide range of social harms. Research into these concerns has been undertaken but no robust evidence has been found which demonstrates a causal link between khat consumption and any of the harms indicated. Somali groups that made representations to the ACMD claimed khat use was a significant social problem within their local areas and in domestic settings. In contrast it was asserted that the Yemeni community had no problem with khat use, as it takes place within the family setting and is integrated into other social domestic events. The majority of this group use khat in an unproblematic manner. Existing legislative frameworks in health, police and council partnerships working with relevant BME Communities have shown they can successfully address anti-social behaviour concerns voiced. The comparative research undertaken in London and Minneapolis draws attention to the ongoing support upon arrival provided to those arriving in the USA, and how this enhanced employment opportunities, where employment was a key determination for social well being. There is no evidence of khat consumption being directly linked with serious or organised criminal behavior in the UK or to support the theory that khat is funding or fuelling crime. This is unsurprising given khat is not an illegal drug, is not a high value substance and therefore attracts very little profit from the UK market. In regard to international crime the ACMD has not been provided with any evidence of Al Shabaab or any other terrorist group‘s involvement in the export or sale of khat despite consultation with national and international official bodies. Evidence presented to the ACMD by researchers found no link between gang crime and khat use. Without the necessary data and robust evidence to support proportionate intervention, the ACMD does not recommend that khat be controlled under the Misuse of Drugs Act 1971. The ACMD considers that the ‗coalescence of concerns‘ around the use of khat can be addressed through the recommendations made. Details: London: Advisory Council on Misuse of Drugs, 2013. 96p. Source: Internet Resource: Accessed January 30, 2013 at: http://www.homeoffice.gov.uk/publications/agencies-public-bodies/acmd1/ACMD-khat-report-2013?view=Binary Year: 2013 Country: United Kingdom URL: http://www.homeoffice.gov.uk/publications/agencies-public-bodies/acmd1/ACMD-khat-report-2013?view=Binary Shelf Number: 127454 Keywords: Drug Abuse and Addiction Khat (U.K.)

Author: European Monitoring Centre for Drugs and Drug Addiction Title: EU Drug Markets Report: A Strategic Analysis Summary: The EU drug markets report is the first comprehensive overview of illicit drug markets in the European Union. It covers issues such as production, consumer markets, trafficking, organised crime and policy responses, along with a review of the markets for heroin, cocaine, cannabis, amphetamine, methamphetamine, ecstasy and new psychoactive substances. It concludes with concrete action points for the areas where the current EU response to the drug market and its consequent harms may be improved. An essential reference tool for law enforcement professionals, policymakers, the academic community and the general public, the report combines Europol’s strategic and operational understanding of trends and developments in organised crime with the EMCDDA’s ongoing monitoring and analysis of the drug phenomenon in Europe and beyond. Details: Luxembourg: Publications Office of the European Union, 2013. 155p. Source: Internet Resource: Accessed February 4, 2013 at: http://www.emcdda.europa.eu/publications/joint-publications/drug-markets Year: 2013 Country: Europe URL: http://www.emcdda.europa.eu/publications/joint-publications/drug-markets Shelf Number: 127467 Keywords: Drug Abuse and Addiction Drug Trafficking Drugs and Crime Illegal Drug Markets (Europe) Organized Crime

Author: Fries, Arthur Title: The Price and Purity of Illicit Drugs: 1981-2007 Summary: Through the years, policymakers and researchers have constructed estimates of the price and purity of illicit drugs as a means to monitor the status of drug markets and to gauge the effectiveness of efforts to cope with the illegal drug problem. Notwithstanding the acknowledged challenges that confront the meaningful collection, analysis, and interpretation of data on illicit drugs, it is widely recognized that price and purity affect actual drug use and consumption, and that estimates of price and purity can shed light on the workings of drug markets as well as provide insights on the utility of counter-drug policies, initiatives, and specific intervention events. This document, the Results Report, updates estimates of the price and purity of five specific illicit drugs published by the Office of National Drug Control Policy (ONDCP) in 2004: powder cocaine, crack cocaine, heroin, d-methamphetamine, and marijuana. The time period spanned by the present analyses is 1981 through 2007, adding 18 quarters to the period covered in the preceding report. All estimates were derived from records in the System To Retrieve Information from Drug Evidence (STRIDE) database maintained by the Drug Enforcement Administration (DEA), and furnished to IDA by ONDCP. STRIDE data records, totaling more than a million in number, are based on seizures and undercover purchases of illicit drugs. No other database encompasses as much spatial and temporal data on the price and purity of illicit drugs. As directed by ONDCP, the estimation methodology for generating the price and purity time series given in this current Results Report is essentially identical to the formal econometric modeling approach used in the 2004 study. We provide descriptions of that “Expected Purity Hypothesis (EPH)” modeling construct in Chapter I of this Results Report as well as in Chapter II of the accompanying Technical Report. The STRIDE database reduces down to about 163,000 records for estimating prices of our subject illicit drugs – with respective proportions being 31 percent for powder cocaine, 35 percent for crack cocaine, 20 percent for heroin, 10 percent for d-methamphetamine, and 3 percent for marijuana. Given the thousands of parameters that the EPH methodology estimates for constructing a single time line of estimates for any drug, the STRIDE data content is considered to be sparse for marijuana and d-methamphetamine, and limited for heroin (due to the inherent variability of those data). Our initial execution of the EPH modeling methods replicated the data count totals, estimates, figures, and tables presented in the 2004 ONDCP Results Report and Technical Report. We then incorporated a few modest software modifications, and executed the revised code to generate the price and purity estimates published in the present report. These updates to the previous results can be viewed as a continuation of those provided in 2004. Although the new results are not always numerically identical to past counterparts (e.g., prices for all years in this report are expressed in terms of constant 2007 dollars and zero purity observations are discarded for all drugs but marijuana), they generally are very similar and past major trends and features were reproduced. In Section A, we report national quarterly EPH estimates for each illicit drug for three or four quantity levels, and, where sufficient data exist, for sets of selected major cities. For powder cocaine, crack cocaine, heroin, and d-methamphetamine, all estimated prices reflect adjustments to account for customers’ perceptions of expected purities; i.e., we report estimated price per expected pure gram (sometimes shortened to estimated adjusted price). The lack of purity data for marijuana limits estimation to purchase prices only; i.e., we report estimated price per bulk gram. With the exception of some supplementary purity analyses that incorporate STRIDE records from seizures, all of the price and purity estimates were based exclusively on STRIDE purchase transactions. Section B follows with a discussion of the roles and utilities of specific methodological approaches for constructing price and purity time series from STRIDE data – including the EPH modeling construct (that generated the results presented in Section A) and alternative analytical techniques. Possible future methodological enhancements and research topics also are addressed. Details: Alexandria, VA: Institute for Defense Analyses, 2008. 166p. Source: Internet Resource: ICA Paper P-4369: Accessed February 22, 2013 at: http://www.whitehouse.gov/sites/default/files/ondcp/policy-and-research/bullet_1.pdf Year: 2008 Country: United States URL: http://www.whitehouse.gov/sites/default/files/ondcp/policy-and-research/bullet_1.pdf Shelf Number: 127701 Keywords: Drug Abuse and Addiction Drug Markets Illegal Drugs (U.S.)

Author: U.S. Government Accountability Office Title: Drug Control: State Approaches Taken to Control Access to Key Methamphetamine Ingredient Show Varied Impact on Domestic Drug Labs Summary: Meth can be made by anyone using easily obtainable household goods and consumer products in labs, posing significant public safety and health risks and financial burdens to local communities and states where the labs are found. Meth cooks have discovered new, easier ways to make more potent meth that require the use of precursor chemicals such as PSE. Some states have implemented electronic tracking systems that can be used to track PSE sales and determine if individuals comply with legal PSE purchase limits. Two states, along with select localities in another state, have made products containing PSE available to consumers by prescription only. GAO was asked to review issues related to meth. Thus, GAO examined, among other things, (1) the trends in domestic meth lab incidents over the last decade; (2) the impact of electronic tracking systems on meth lab incidents and limitations of this approach, if any; and (3) the impact of prescription-only laws on meth lab incidents and any implications of adopting this approach for consumers and the health care system. GAO analyzed data such as data on meth lab incidents and PSE product sales and prescriptions. GAO also reviewed studies and drug threat assessments and interviewed state and local officials from six states that had implemented these approaches. These states were selected on the basis of the type of approach chosen, length of time the approach had been in use, and the number of meth lab incidents. The observations from these states are not generalizable, but provided insights on how the approaches worked in practice. Details: Washington, DC: GAO, 2013. 70p. Source: Internet Resource:L GAO-13-204: Accessed February 22, 2013 at: http://www.gao.gov/assets/660/651709.pdf Year: 2013 Country: United States URL: http://www.gao.gov/assets/660/651709.pdf Shelf Number: 127706 Keywords: Drug Abuse and Addiction Drug Control Methamphetamine (U.S.) Methamphetamine Labs

Author: Williams, Jeremy L. Title: Meth: Resurgence in the South: A Regional Resource Summary: Methamphetamine, or meth, is a highly addictive, synthetically produced, central nervous system stimulant that, according to the U.S. Drug Enforcement Administration (DEA), is the most common synthetic drug manufactured in the United States. The recent, rapid growth of methamphetamine users in the United States largely is due to the ability to produce it using conventional, easily accessible chemicals and supplies. While other major illegal drugs, such as cocaine or heroin, are imported from South American or Asian countries, most methamphetamine consumed in the United States is produced locally with a recipe downloaded from the Internet and readily available products like pseudoephedrine and ephedrine (found in decongestants and other cold medications), iodine, rock salt, battery acid, anhydrous ammonia and some basic kitchen items like plastic bags, glass cookware, funnels and soda bottles. According to the National Institute on Drug Abuse, approximately 10 million people 12 years and older have abused methamphetamine in their lifetimes and, in 2005, about 500,000 people were current users. Other than marijuana, it is perhaps the first major drug to have vast quantities produced in rural regions of the country. This is attributable to the fact that meth production requires discrete locations, such as abandoned farms, fields, vehicles, barns and old hotel rooms. The Southern Legislative Conference (SLC) has been tracking the issue of crystal methamphetamine production, distribution and use for almost a decade. In 2001, the SLC published a report, Methamphetamine Production and Abuse in Southern States, which examined the rise in popularity of the drug from the early to mid 1980s and assessed its impacts on Southern states. It concluded that “methamphetamine has taken hold across the South and Midwest. It has become a particularly pernicious and perplexing problem in states such as Arkansas, Missouri, Oklahoma and Texas, but policymakers are confronted with a potential increase in the production and use of methamphetamine across the South.” These concerns were not unfounded. Meth has become one of the most dangerous illegal substances in Southern states, and almost every SLC state is seeing annual increases in meth laboratory seizures. According to the DEA, meth labs are, by far, the most common clandestine laboratories in the United States. Details: Atlanta, GA: Southern OFfice of the Council of State Government, 2010. 12p. Source: Internet Resource: Accessed March 1, 2013 at: http://knowledgecenter.csg.org/drupal/system/files/MethResurgence.pdf Year: 2010 Country: United States URL: http://knowledgecenter.csg.org/drupal/system/files/MethResurgence.pdf Shelf Number: 127751 Keywords: Drug Abuse and Addiction Illicit Drugs Methamphetamines (U.S.)

Author: United Nations Office on Drugs and Crime. Global SMART Programme Title: Indonesia: Situation Assessment on Amphetamine-Type Stimulants Summary: The manufacture, trafficking and use of crystalline methamphetamine is now the greatest drug threat to Indonesia. Crystal methamphetamine seizures rose 79 per cent in 2011 to 1,161 kg from the 649 kg seized in 2010, the report says, noting that while cannabis remains the most widely used illicit drug in Indonesia, crystalline methamphetamine use has expanded continually during the past several years, particularly among laborers, students and commercial sex workers. Ecstasy, popular with Indonesian young adults, continues to be the third most widely used illicit drug in Indonesia. The report, Indonesia Situation Assessment on Amphetamine-Type Stimulants (2013), highlights the latest trends and emerging concerns related to ATS in Indonesia, with the aim of gaining a more comprehensive understanding of the crystalline methamphetamine and ecstasy situation in Indonesia. Details: Vienna: UNODC, 2013. 52p. Source: Internet Resource: Accessed March 4, 2013 at: http://www.unodc.org/documents/indonesia//publication/2013/Indonesia_ATS_2013_low.pdf Year: 2013 Country: Indonesia URL: http://www.unodc.org/documents/indonesia//publication/2013/Indonesia_ATS_2013_low.pdf Shelf Number: 127822 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Illicit Drugs (Indonesia) Methamphetamines

Author: Payne, Jason Title: Prevalence and Issues Relating to Cannabis Use Among Prison Inmates: Key findings from Australian research since 2001 Summary: The nexus between drug use and crime has long been the subject of international and Australian criminological research. In particular, research has focused on the link between drug use and high volume recidivist offending, the results of which have, over the years, inspired a range of policy responses which aim to tackle the problem of drug misuse at all levels of the criminal justice system. Early intervention with young people, it is hoped, will reduce the prevalence and severity of drug use among future generations while limiting any negative consequences of their contact with the criminal justice system. For those more heavily dependent drug users, drug courts and other more intensive interventions are developed with the hopes of reducing drug dependency and thereby minimising the associated criminal consequences. In Australia, prison populations have been a key source of data for examining the nexus between drugs and crime, although in many cases the research has focused primarily on the so-called ‘harder’ drug types such as heroin, amphetamine, cocaine and ecstasy. Information about cannabis use is often collected and reported, but usually only within the broader context of other illicit drug use. For this reason, this paper provides a consolidation of research findings about cannabis from research and other data collection projects conducted within Australian prisons since 2000. Overview of key findings the vast majority of prison inmates have used cannabis at least once in their life. Self-report estimates of lifetime use are relatively consistent across studies, ranging from 81 per cent to 88 per cent the prevalence of lifetime cannabis among prisoners use varies by gender; however the differences are inconsistent. In some studies males have a higher rate than females, while in others the opposite is found although only one national study has examined the juvenile detainee population, the results suggest higher rates of lifetime cannabis use when compared with adult prisoners around one-in-three prison inmates report having used cannabis in the past 6-12 months, typically before entering prison. Estimates of recent use vary between 60 and 70 per cent the majority of prisoners who had used cannabis in the months leading up to their imprisonment did so at least once a day – often more conservative estimates suggest that approximately one-in-three prisoners reported using cannabis while in custody. Estimates vary between 30 and 50 per cent. Drug users in prison more often than not report cannabis as the first drug they used while in custody two in every five prisoners released from custody expect to use cannabis upon their release and the expectation of post-release drug use was a significant predictor of re-incarceration. Female prisoners were less likely than males to have intentions of using cannabis upon their release around half of all male prisoners released from custody report using cannabis after being released. Females were less likely than males to have used cannabis post-release. Details: Canberra: Australian Institute of Criminology, 2013. 6p. Source: Internet Resource: AIC Research into Practice Brief 7: Accessed March 8, 2013 at: http://ncpic.org.au/ncpic/publications/aic-bulletins/article/aic-research-into-practice-brief-7-prevalence-and-issues-relating-to-cannabis-use-among-prison-inmates-key-findings-from-australian-research-since-2001 Year: 2013 Country: Australia URL: http://ncpic.org.au/ncpic/publications/aic-bulletins/article/aic-research-into-practice-brief-7-prevalence-and-issues-relating-to-cannabis-use-among-prison-inmates-key-findings-from-australian-research-since-2001 Shelf Number: 127905 Keywords: Cannabis (Australia) Drug Abuse and Addiction Drug Abuse and Crime

Author: Gurung, Sundip Title: Silent Sufferers: Street Children, Drugs, and Sexual Abuse in Kathmandu, Nepal Summary: Objective: To observe socio-demographic distribution among street children in Kathmandu, and to identify associations between drug use and sexual abuse with regards to socio-demographic variables and predictive variables. Design and participants: A cross sectional study was conducted among 248 street children in Kathmandu, Nepal in 2009. Children were recruited on purposive sampling method and were asked about socio-demographic factors, drug use, sexual abuse, visits to/contact with family, gang involvement, and years spent in the streets. Results: There were significant differences among boys and girls with regard to ethnicity (p=0.002) and main source of income (p=<0.001) as well as with regard to drug use (p=<0.001), gang involvement (p=<0.001), alcohol consumption (p=<0.001), contact with family (p=<0.001), and sexual abuse (p=<0.001). After controlling the potential confounders, an association was observed between drug use and source of income among the boys [begging, OR of 4.9 CI (1.4-17), and thief/pick pocket, OR of 4.8 CI (1.1-24)]. Similarly, there was an association between drug use and alcohol consumption [Casual drinkers, OR of 3.2 CI (1.4-7.4), and regular drinkers, OR of 8.1 CI (2.0-32)]. Conclusion: The study provides important information on how distribution pattern of socio-demographic factors and predictive variables differ among boys and girls in street of Kathmandu. It also provides the information on association of drug use with regards to some of the socio-demographic factors and predictive variables. Details: Umea, Sweden: Umeå International School of Public Health, Epidemiology and Global Health, 2011. 34p. Source: Internet Resource: Thesis: Accessed March 18, 2013 at: http://www.phmed.umu.se/digitalAssets/91/91830_sundip-gurung.pdf Year: 2011 Country: Nepal URL: http://www.phmed.umu.se/digitalAssets/91/91830_sundip-gurung.pdf Shelf Number: 128009 Keywords: Begging Child Sexual Abuse Drug Abuse and Addiction Gangs Street Children (Nepal)

Author: Collins, John, ed. Title: Governing The Global Drug Wars Summary: International drug control efforts began in 1909, with the aim of eradicating the abuse of certain drugs by controlling their supply. A complex international system of enforcement grew up based on this belief in supply control. A century on, the empirical data is available and overwhelming: the system has failed. Worse, it has become increasingly clear that the human cost of pursuing many of its policies renders them unjustifiable. From mass incarceration in the United States and Asia, to the HIV/AIDS epidemic flooding Russia and the waves of violence rippling through Latin America – current global drug policies are worsening current global drug problems. This is no longer a point of controversy, but as Joseph Spillane suggests, is something which ‘no serious scholar questions’. Nevertheless, driven by a mixture of bureaucratic and ideological inertia, the international drug control system, governed through the UN and enforced by a number of core states, continues to pursue many of the same failed policies. This report asks why the system evolved in the way that it did, and explores the potential for reform. Often, those seeking to understand the complex and opaque international drug control system look to the wording of its various conventions and governing treaties – both of which are open to wide interpretation. However, as William McAllister points out, the system evolved through complex diplomatic, bureaucratic, social and interpersonal forces. It is only through an understanding of these broader forces that we can properly explain how the system was constructed and why it continues to function in the way that it does. Building on this discussion of historical complexity, David Courtwright examines the reasons why some drugs have traditionally been the subjects of ‘war,’ while others have become deeply ingrained in the mainstream economy. This is a question expanded upon by James Mill’s survey of the questionable scientific evidence underpinning cannabis’ co-option into international controls. As Joseph Spillane’s analysis shows, in order to better understand current international drug policies we should focus more attention on the considerable harms that these policies create. In particular he suggests that researchers should concentrate on the wealth of evidence available from the daily experience of contemporary drug addicts, which reveals the, often-harrowing impacts of the various drug wars. Paul Gootenberg analyses the interaction between international policies and shifting cocaine ‘commodity chains’ in Latin America over the last century, culminating in the current Mexican crisis. In so doing, he highlights a seemingly inherent tendency of international drug policy makers to create larger and more violent problems than their interdictionist policies resolve. Former Swiss President Ruth Dreifuss and her colleague Diane Steber evaluate Switzerland’s interaction with the international system, highlighting the pressure exerted on states trying to pursue policies outside the traditional supply-centric paradigm. David Bewley-Taylor then examines ‘the UNGASS decade’ between 1998 and 2008, when the international community committed itself to achieving ‘a drug free world’. He argues that the consensus that characterised this period is now fracturing as nation states are more openly pursuing alternative approaches. In the final section of this report we look towards the future of the system and highlight specific areas in need of immediate reform. Damon Barrett shows that the current system is lacking in basic human rights oversight, and as a result is permitting systematic human rights abuses. Joanne Csete focuses on the International Narcotics Control Board’s (INCB) support for unscientific policies internationally and its refusal to endorse best practice public health policies, particularly around HIV/AIDS prevention. She argues that the INCB remains ‘the most closed and least transparent of any entity supported by the United Nations.’ The machinery of international drug control has solidified around outdated modes of thinking and failed policies. Despite this, it has proved remarkably successful at restricting policy experimentation worldwide and encouraging the continuation of counterproductive approaches. Two steps need to be taken. First, there need to be immediate measures to incorporate basic human rights standards and improve the level of oversight within the system. This is particularly urgent in the areas of international funding decisions and the operation of the INCB. Second, an independent root and branch review of the approach to, and apparatus governing, international drug control needs to be conducted with a view to long-term structural reforms. Such a review must begin with a deep understanding of the historical forces that have shaped and continue to underpin the current policies and system. This report should serve as a starting point. Details: London: London School of Economics, 2012. 70p. Source: Internet Resource: LSE Ideas; Special Report SR014: : Accessed March 25, 2013 at: http://www2.lse.ac.uk/IDEAS/publications/reports/SR014.aspx Year: 2012 Country: International URL: http://www2.lse.ac.uk/IDEAS/publications/reports/SR014.aspx Shelf Number: 128121 Keywords: Drug Abuse and Addiction Drug Abuse Policy Drug Control Drug Policy Drug Regulation Drug War (International)

Author: Jovchelovitch, Sandra Title: Underground Sociabilities: Identity, Culture and Resistance in Rio de Janeiro's Favelas. Final Report Summary: Underground Sociabilities investigated pathways of exclusion and social development in Rio de Janeiro’s favelas. It examined the lived world of favela communities and the work of two local organisations AfroReggae and CUFA, to systematise and disseminate effective experiences of social development. The project comprised three studies: an investigation of the lifeworld of favela communities, a systematic study of favela organisations AfroReggae and CUFA and an investigation of elite external observers in the wider city. Our approach was psychosocial, ethnographic and multimethod: questionnaires and semi-structured interviews with 204 favela residents analysis of documents pertaining to 130 projects of social development narrative interviews with 10 AfroReggae and CUFA leaders interviews with 16 external observers and partners, with special emphasis on the police Fieldwork was conducted between October 2009 and February 2011 in Rio de Janeiro. Four communities were studied: Cantagalo, City of God, Madureira and Vigário Geral. They were selected considering location in the city and link with AfroReggae and CUFA. Cantagalo and Vigário Geral fit the accepted definition of favelas, whereas City of God was built as a planned area for relocating favela-dwellers displaced from the city centre during the 1960s. Madureira is a formal neighbourhood surrounded by favelas. Theoretical inspiration was drawn from the concepts of sociability, social representations, imagination and psychosocial cartographies. Findings enabled the development of the concept of psychosocial scaffoldings. THE CONTEXT AND RESEARCH PROBLEM Rio is an unequal city; more than 20% of its population live in favelas. Residence in a favela impacts negatively on income, education, teenage pregnancy, literacy and mortality at young age. The rooting of drug trading in the favelas during the 1970s and 80s created parallel norms and regulations in favela communities and triggered a territorial war between drug trade factions and the police. Favela-dwellers were caught in-between. Violence, lack of services and socioeconomic deprivation in the favelas created social exclusion and separation between the favelas and the asphalted areas of Rio, known in the city as the division morro/asfalto (hill/asphalt). Favelas were pushed underground and became invisible, their diverse community life shut off by geographical, economic, symbolic, behavioural and cultural barriers. Since the 1990s new actors – young, mainly black, favela dwellers – entered the public sphere to organise responses to poverty, violence and segregation challenging the traditional model of the NGO and repositioning favela populations in the Brazilian public sphere. Details: London: London School of Economics and Political Science, Institute of Social Psychology, 2012. 158p. Source: Internet Resource: Accessed March 26, 2013 at: http://www.psych.lse.ac.uk/undergroundsociabilities/pdf/Underground_Sociabilities_Final_Report.pdf Year: 2012 Country: Brazil URL: http://www.psych.lse.ac.uk/undergroundsociabilities/pdf/Underground_Sociabilities_Final_Report.pdf Shelf Number: 128141 Keywords: Cultural Activities Drug Abuse and Addiction Drug Abuse and Crime Drug Trafficking Favelas (Rio de Janeiro, Brazil) Socioeconomic Conditions and Crime Urban Communities

Author: National Advisory Council on Prescription Drug Misuse (Canada) Title: First Do No Harm: Responding to Canada’s Prescription Drug Crisis Summary: Certain prescription drugs, like opioids, sedative-hypnotics and stimulants, are associated with serious harms like addiction, overdose and death. These drugs can have a devastating impact on individuals and their families, as well as place a significant burden on our health, social services and public safety systems. In countries like Canada, where these prescription drugs are readily available, the associated harms have become a leading public health and safety concern. Canada is the world’s second largest per capita consumer of one type of these drugs, opioids (International Narcotics Control Board, 2013). Some First Nations in Canada have declared a community crisis owing to the prevalence of the harms associated with prescription drugs (Dell et al., 2012). While Canadian cost data is lacking, recent research from the United States estimates the annual cost of the non-medical use of prescription opioids to be more than $50 billion, with lost productivity and crime accounting for 94% of this amount (Hansen, Oster, Edelsberg, Woody, & Sullivan, 2011). The National Advisory Council on Prescription Drug Misuse was formed in response to the growing problem in Canada. Led by the Canadian Centre on Substance Abuse (CCSA), the Coalition on Prescription Drug Misuse (Alberta) and the Nova Scotia Department of Health and Wellness, in partnership with Health Canada’s First Nations and Inuit Health Branch’s Prescription Drug Abuse Coordinating Committee (PDACC), the Council developed First Do No Harm: Responding to Canada’s Prescription Drug Crisis (the Strategy). The Strategy represents a broad collective effort by contributors who are active participants in this work and stewards of its realization. Council members were invited to participate because of their expertise, involvement and commitment to the issue, and their ability to take on responsibility in addressing it or in implementing solutions. Members represent governments, healthcare professionals (physicians, pharmacists, coroners, dentists and nurses), patients and families, First Nations, enforcement officials, regulators, industry leaders and researchers. This membership reflects a commitment to coordinated action across multiple sectors and jurisdictions. The Council developed a strategy that addresses the harms associated with prescription drugs, while giving important consideration to their therapeutic uses. Council members were actively involved in developing the recommendations, sought input from their networks of organizations and across sectors, and focused on communication and coordination within and across jurisdictions, disciplines and communities. First Do No Harm: Responding to Canada’s Prescription Drug Crisis addresses prescription drugs that are legal and have therapeutic uses, but also have a high potential for harm. This Strategy defines the scope of the prescription drug crisis Canada faces and provides a roadmap for reducing the harms associated with these drugs. It presents 58 achievable short- and longer-term recommendations that Council members believe will address these harms and have a collective impact. The members share in the issue and will now share in addressing it through implementing the recommendations. Details: Ottawa: Canadian Centre on Substance Abuse, 2013. 88p. Source: Internet Resource: Accessed April 5, 2013 at: http://www.ccsa.ca/2013%20CCSA%20Documents/Canada-Strategy-Prescription-Drug-Misuse-Report-en.pdf Year: 2013 Country: Canada URL: http://www.ccsa.ca/2013%20CCSA%20Documents/Canada-Strategy-Prescription-Drug-Misuse-Report-en.pdf Shelf Number: 128276 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Prescription Drug Abuse (Canada)

Author: Trautmann, Franz Title: Further Insights into Aspects of the EU Illicit Drugs Market: Summaries and Key Findings Summary: • Our estimates for the EU cannabis market suggest a range of approximately €7 billion to €10 billion for 2010. These estimates are likely low as they do not account for the “consumption gap” (see below) that is created when data from general population surveys are used to measure substance use. Prior estimates of the EU cannabis market ranged from €15-35 billion. • This difference arises from two key findings of this study: o Cannabis users who use more frequently also smoke more each time they use. This is true across the seven countries studied. o Occasional users are more likely to share than are frequent users; that still further reduces the amount they consume at each session. o This picture also seems to apply to amphetamine, ecstasy and cocaine use. • Prior estimates multiplied the number of users by the average number of sessions per user and the average amount per session; this will lead to overestimates of the quantity consumed because, for example infrequent users are the vast majority of all users and they use much less per session as the result of sharing. • Our study also shows that intensive users are a small to modest fraction of cannabis users (between 5% and 25%), but are responsible for the bulk (between 55% and 77%) of the total amount of cannabis annually consumed in all countries. Infrequent users of cannabis, using less than once per month, form the largest group of past year cannabis users but account for 2 percent or less of the quantity consumed. • Another important finding is that users stating that they used in the past month and specifying the quantity used in the past month do not consume (the same amounts) each month. Multiplying their consumption by twelve to obtain an annual estimate may result in an overestimation. There are also other factors which might have led to earlier overestimations of cannabis consumption. One might be overstating the share of ‘high consumption users’ among past year. Finally, earlier studies have used higher estimates of amounts of cannabis used per unit compared to those we found in our study. • Substantial prior research finds that opioid substitution treatment (OST) such as methadone maintenance treatment (MMT) contributes substantially to a reduction of drug use related harm and to better health. Research shows that OST reduces the frequency and intensity of illicit heroin use among treatment clients. Drawing from a wider lower and upper bound range, the study calculates that the amount of pure illicit heroin consumption averted per Problem Heroin User retained in MMT each month ranges from a conservative estimate of 1.26 grams to a high estimate of 3.09 grams. This compares with estimates for the amount of pure heroin consumed when not engaged in MMT, which ranged from 1.79 to 4.5 grams. At an individual level, changes on this scale are equivalent to a 70 per cent reduction in the amount of pure heroin consumed while retained in MMT. • Extrapolating these estimates across the four case study Member States considered, we conclude that retention in MMT may reduce total pure heroin consumption by around 30 per cent. Assuming 221,452 Problem Heroin Users from a wider population of 505,173 were in receipt of MMT across these four Member States, total monthly consumption of pure heroin is estimated to have reduced by between 0.28 and 0.69 metric tons, from an estimated total of between 0.9 and 2.3 metric tons consumed. • Enforcing laws against the production and distribution of cannabis dramatically inflate their costs. The increase is largely driven by producers and traffickers requiring compensation for their risk of arrest, incarceration, seizure, and violent injury as well as by the inefficiencies associated with having to operate covertly. • Drug markets to some extent follow the same laws of economics of licit markets, as attested by our Delphi survey of European drug experts about key trends of the illicit drugs market and policy responses in the EU. The majority of experts stress the analogy of the illicit drugs market with other (licit) markets. For example, it is important to maintain working relations with suppliers and employees. A study of 33 failed transactions in the Dutch cocaine smuggling trade found that the smuggler mostly tried to understand what went wrong and work out a reasonable way of arranging compensation. However about 40% did involve either violence or its threat; how that affects behaviour within the market remains to be worked out. Details: Luxembourg: Publications Office of the European Union, 2013. 46p. Source: Internet Resource: Accessed April 5, 2013 at: http://ec.europa.eu/justice/anti-drugs/files/eu_market_summary_en.pdf Year: 2013 Country: Europe URL: http://ec.europa.eu/justice/anti-drugs/files/eu_market_summary_en.pdf Shelf Number: 128295 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Policies Illicit Drug Markets (Europe)

Author: United Nations Office on Drugs and Crime. Global SMART Programme Title: The Challenge of New Psychoactive Substances Summary: UNODC launched the Global Synthetics Monitoring: Analyses, Reporting and Trends (SMART) Programme in September 2008. The Programme seeks to enhance the capacity of Member States and authorities in priority regions, to generate, manage, analyse and report synthetic drug information, and to apply this scientific evidence-based knowledge to design the policies and programmes. The Global SMART Programme is being implemented in a gradual phased manner, with East Asia being the first focus priority region. Operations in Latin America started in 2011. This report is the first global situation assessment on new psychoactive substances put forward under the Global SMART Programme and pursuant to Commission on Narcotic Drugs Resolution 55/1 on “Promoting international cooperation in responding to the challenges posed by new psychoactive substances”, which requested the United Nations Office on Drugs and Crime to provide an update to its 2011 report entitled “Synthetic cannabinoids in herbal products”, addressing a wider range of new psychoactive substances, in addition to synthetic cannabinoids, and to take into consideration the creation of a compilation of new psychoactive substances encountered by Member States, to serve as an early warning advisory. It constitutes the first step in providing consolidated up to-date analysis, based primarily on the information shared by Member States and the International Collaborative Exercise network of drug analysis laboratories. It is hoped that the information on new psychoactive substances presented in this report will make a practical contribution to addressing the significant threat posed by the manufacture, trafficking and use of these substances throughout the world, and place policymakers in a better position to evaluate the drug situation, and to make informed decisions on intervention and prevention strategies. This report provides an overview of the situation throughout the world. It outlines the emergence of different groups of new psychoactive substances in the regions and highlights several key issues associated with these substances, including reported adverse effects associated with their use, the challenges for the identification of these substances and their subsequent control through legislation. While the information presented points towards increasing efforts by the countries to address the NPS problem, it also highlights the need for continued and joint efforts, both at the national as well as regional levels. It is hoped that this report will contribute to a better understanding of the NPS problem and in developing effective strategies to address it. Details: Vienna: Laboratory and Scientific Section United Nations Office on Drugs and Crime, 2013. 122p. Source: Internet Resource: Accessed April 16, 2013 at: http://www.unodc.org/documents/scientific/NPS_2013_SMART.pdf Year: 2013 Country: International URL: http://www.unodc.org/documents/scientific/NPS_2013_SMART.pdf Shelf Number: 128358 Keywords: Drug Abuse and Addiction Drug Control Policies Drug Markets Drug Trafficking Psychoactive Drugs

Author: Asha, Omar Title: Khat -- A Drug of Growing Abuse Summary: The National Association of Somali Women in Sweden and together with the Swedish National Association of Immigrants Against Drugs (SIMON) have taken educational mat erial. Our purpose is to stop the spread of drugs by using the force of knowledge and personal involvement. In order to create a strong public opinion against khat and to support individual khat abusers, it is necessary to have basic knowledge about khat, about its history, about the development of a drug dependence, about consequences of khat abuse for the family and the economy etc. In this booklet we write frankly about khat, about our views on drugs and about how the drug abuser is affected by his or her abuse. We approach the topic step by step with the aim of assisting group discussions founded on fact-based material. The purpose of this study material, Khat – a drug of growing abuse, is to enable discussions and thinking about the khat drug. Details: Brussels: Europe Against Drugs, 2008. 19p. Source: Internet Resource: Accessed April 16, 2013 at: http://www.eurad.net/filestore/PDF/Khatpublication.pdf Year: 2008 Country: International URL: http://www.eurad.net/filestore/PDF/Khatpublication.pdf Shelf Number: 128381 Keywords: Drug Abuse and Addiction Illegal Drugs Khat

Author: Hudson, Susan L. Title: Sex, Drugs and "Ugly Mugs": An ethnographic study of women who inject psychostimulants and engage in street-based sex work in Kings Cross, Sydney Summary: Australian and international literature provides strong evidence that intravenous use of psychostimulants increases the harms experienced by users, including heightening the risk of blood-borne virus (BBV) infection. The few Australian studies that include women who inject psychostimulants identify street-based sex work as the main method of income generation and highlight the harms that result from combining these practices. However, there has been little exploration into the way these practices are shaped by the environments in which they occur or the ways in which women manage these harms. This thesis aims to provide an in-depth exploration of the daily lives of women who inject psychostimulants and engage in street-based sex work in Kings Cross, Sydney. Over 18 months between 2005 and 2007, the author conducted ethnographic fieldwork with women who injected psychostimulants and engaged in street-based sex work in Kings Cross, Sydney. Data sources included observations recorded as fieldnotes and transcripts of in-depth interviews with 12 women. Thematic analysis of the data was employed with particular attention to the women’s shared narratives. Key findings of the thesis were that 1) the Kings Cross environment plays a prominent role in shaping the lives of women, their psychostimulant injecting and street-based sex work practices; 2) psychostimulant injecting reinforces the opportunistic nature of street-based sex work as the primary method of income generating for women, restricting the development of occupational norms; 3) synergies exist between the drug and sex markets in Kings Cross, increasing the harms associated with both injecting and street-based sex work practices; 4) public health messages relating to sharing of injecting equipment and condom use fail to account for contextually driven decision-making and risk prioritising; 5) women develop lay epidemiological understandings as they attempt to reconcile the public health messages with the lived reality. The value of these findings is in the insights they provide into the everyday lives of these women in Kings Cross that have not been documented previously and their potential for informing “bottom-up” rather than “top down” approaches to future policy, practice and research. Details: Sydney: School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, 2009. 244p. Source: Internet Resource: Dissertation: Accessed April 16, 2013 at: http://www.unsworks.unsw.edu.au/primo_library/libweb/action/dlDisplay.do?vid=UNSWORKS&docId=unsworks_8131&fromSitemap=1&afterPDS=true Year: 2009 Country: Australia URL: http://www.unsworks.unsw.edu.au/primo_library/libweb/action/dlDisplay.do?vid=UNSWORKS&docId=unsworks_8131&fromSitemap=1&afterPDS=true Shelf Number: 128386 Keywords: Drug Abuse and Addiction Prostitutes Prostitution (Australia) Sex Work Street-Based Prostitution

Author: Lynch, Shannon M. Title: Women’s Pathways to Jail: Examining Mental Health, Trauma, and Substance Use Summary: The rate of incarceration of women has increased substantially in recent decades, with a 31 percent increase between 2000 and 2011 (Minton, 2012). Female offenders appear to have different risk factors for offending than do male offenders. In particular, female offenders report greater incidence of mental health problems and serious mental illness (SMI) than do male offenders (James and Glaze, 2006; Steadman et al., 2009). Female offenders also report higher rates of substance dependence as well as greater incidence of past physical and sexual abuse (James and Glaze, 2006). Other researchers also have noted elevated rates of experiences of interpersonal trauma, substance dependence, and associated symptoms of post-traumatic stress disorder (PTSD) in female offenders (Green et al., 2005; Lynch et al., 2012). This multisite study addresses critical gaps in the literature by assessing the prevalence of SMI, PTSD, and substance use disorders (SUD) in women in jail, and the pathways to jail for women with and without SMI. Details: Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Assistance, 2013. 4p. Source: Internet Resource: BJA Policiy Brief: Accessed April 18, 2013 at: https://www.bja.gov/Publications/WomensPathwaysToJail.pdf Year: 2013 Country: United States URL: https://www.bja.gov/Publications/WomensPathwaysToJail.pdf Shelf Number: 128414 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Female Inmates Female Offenders (U.S.) Jail Inmates Mental Health Services Mentally Ill Offenders

Author: Shearer, James Title: The prison opiate dependence treatment trial Summary: The Prison Opiate Dependence Treatment Trial (the trial) examined the treatment history and treatment outcomes for 204 heroin users in NSW prisons between January 2002 and January 2004. The trial was commissioned by the New South Wales Corrections Health Service to evaluate the introduction of naltrexone, a long-acting opioid antagonist, through a controlled comparison with the two existing treatments for heroin users: methadone maintenance treatment (MMT) and drug-free counselling (AOD). The randomisation of subjects to each of the three treatment groups was not successful due to a number of factors outside the control of the researchers. Principal among these was the very poor uptake of naltrexone. Only 9 out 66 (14%) subjects assigned to naltrexone actually started naltrexone treatment and ultimately only 14 subjects out of 204 (7%) started naltrexone over the entire two year study period. An intention-to-treat analysis would be inappropriate when so few designated subjects received their experimental treatment. Secondly, the improved availability of MMT and the introduction of the mixed opioid agonist/antagonist buprenorphine meant that experimental control for methadone/buprenorphine was largely lost. Finally, the availability of heroin within NSW prisons declined in line with reduced supply in the general community (Day, Topp et al. 2003). Heroin use was a principal outcome for the study. Low levels of heroin use at baseline considerably reduced the likelihood of detecting any treatment effects. For these reasons the trial ceased recruitment in July 2003 but continued follow up until January 2004. The trial was successful in recruiting and following up subjects with a 91% follow up achieved. Subjects were assessed for suitability, randomised and interviewed regarding their drug use history, prison history and other health and psychosocial outcomes. Subjects provided hair samples to be tested for opiate use and finger prick blood samples to be tested for HIV and hepatitis C antibodies. The subjects were re-interviewed at six months and provided further hair and blood samples. At twelve months, record checks were undertaken to examine treatment retention, compliance, concomitant medications and side-effects. For analytical purposes, subjects were divided into five mutually exclusive treatment exposure groups. Subjects who received naltrexone prior to their follow up interview were categorised as the naltrexone study group (n=9). Subjects who received buprenorphine were categorised as the buprenorphine group (n=39). Subjects who received MMT only were categorised as the MMT group (n=89). Subjects who received AOD counselling only were categorised as the AOD group (n=23) and finally subjects who did not receive any of these treatment were categorised as a No Treatment group (n=26). The study found very poor induction and retention rates for oral naltrexone. Only seven percent of all subjects started naltrexone over the two year study period. Among those subjects, only seven percent were retained in treatment at six-months. Six-month retention was significantly lower in the 14 subjects who started naltrexone (7%) compared to the 12 subjects who started methadone (58%) (p=0.0007). Mean days in treatment were 59 (95% CI, 32-86) for naltrexone, 100 (95% CI, 70-130) for buprenorphine and 149 (95% CI, 117-181) for methadone. While compliance to daily doses was good when subjects were receiving naltrexone (98%), most ceased naltrexone once they were released from prison even when specific arrangements were made for community dosing at no cost to the patient. This was of particular concern as overdose risk is highest post-prison release and this may be further increased if subjects have recently ceased naltrexone. No deaths or serious adverse events were noted during the study. Few side effects were noted in those subjects who received naltrexone. Most side effects were minor, including dizziness, nausea, headache, sleep disturbance and loss of appetite which resolved or were manageable. There were no other statistically significant differences in outcomes between the study groups although results were limited by the small sample sizes of the multiple comparison groups. The experience of this study was consistent with other studies of oral naltrexone in Australia and overseas. The study did not replicate the success observed among prison parolees in the US or work release programs in Singapore. The most likely reason for this was that inmates were not subject to coercion or incentives to enter and stay on naltrexone maintenance. In the absence of such incentives, opioid dependent inmates showed a preference for agonist treatment including methadone maintenance and buprenorphine maintenance. Many inmates who achieved abstinence preferred no treatment or drug free counselling over naltrexone. The overall conclusion of the study was that poor patient acceptability and retention did not support oral naltrexone in this treatment group. The study also found relatively poor retention in subjects who started buprenorphine (n=21) due to the high proportion (20%) who were discontinued due to diversion. Diverted buprenorphine was the second most injected illicit drug (11%) after heroin (14%) at follow up. Investigation of alternate dose formulations may be warranted. Half the trial subjects did not receive any AOD counselling, mostly because they declined to attend for AOD counselling (42%) or claimed that counselling was not offered (38%). Given that subjects who received AOD counselling had improved outcomes, the underlying reasons for failure to attend or be offered AOD counselling warrant further investigation. Subjects who received no treatment of any kind had the poorest outcomes on most measures. This group was characterised by shorter sentences. New forms of depot preparations and implantable devices for both naltrexone and buprenorphine may overcome the poor treatment retention experienced in this study: however such devices remain experimental. At the conclusion of recruitment for this study, CHS withdrew funding support for oral naltrexone. We conclude from this study that treatment of heroin dependence in correctional settings using oral naltrexone is relatively ineffective because of limited attraction and poor compliance and that compliance is superior for oral methadone which is also more attractive and more effective. Details: Sydney: National Drug and Alcohol Research Centre, 2004. 46p. Source: Internet Resource: Technical Report No. 199: Accessed May 1, 2013 at: http://ndarc.med.unsw.edu.au/resource/prison-opiate-dependence-treatment-trial Year: 2004 Country: Australia URL: http://ndarc.med.unsw.edu.au/resource/prison-opiate-dependence-treatment-trial Shelf Number: 106730 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offender Treatment Drug Offenders (Australia)

Author: Roxburgh, Amanda Title: Mental Health, Drug Use and Risk among Female Street-Based Sex Workers in Greater Sydney Summary: Demographic characteristics - The mean age of the sample was 34 years and approximately one-quarter of the sample identified as being of Aboriginal and/or Torres Strait Islander (A&TSI) origin. The median years of school education completed was 9. Fourteen percent reported having no fixed address, or current homelessness and nearly half the sample reported being homeless within the past 12 months. Income apart from sex work in the past month came from several sources, and the vast majority reported sex work as their main source of income in the past month. More than half of the sample reported moving out of home before age 16. Sex work history and working conditions - The median age that participants reported starting sex work was 19, with almost one third starting before 18. Length of involvement in the sex industry ranged from four months to 39 years, and participants had worked in various other sectors of the sex industry. The majority of participants reported starting sex work because they needed the money for drugs, and this was also the main reason for remaining in the sex industry. Just under half the sample reported the money as being the most enjoyable aspect of their work, and the biggest concern for approximately one-third of the sample was the provision of a safe work environment (such as safe houses). Three-quarters of the women reported providing services on the street, two-thirds reported providing them in cars and just over half the sample reported using a safe house (in areas where safe houses were available). Two-thirds of the sample reported that they found sex work very stressful, and half stated that clients were the reason for this stress. The overwhelming majority of women reported ever having experienced violence while working, most commonly physical assault and rape. Drug use and drug treatment - Ninety four percent of the sample had ever injected any drug, and the median age of first injecting was 18, with approximately one-quarter of the sample reporting first injecting before the age of 16. There were relatively heavy patterns of heroin, cocaine and cannabis use reported among some of the women, while patterns of methamphetamine and alcohol use remained sporadic. The vast majority of the sample was heroin dependent according to the Severity of Dependence Scale (SDS) while approximately one-third was cocaine and cannabis dependent. Participants who were cocaine dependent were more likely to report sharing injecting equipment in the past month and less likely to use condoms when having penetrative sex with clients. Approximately two-thirds of the sample was in drug treatment at the time of interview. Sex work and drug use - Approximately half the sample reported injecting drugs prior to commencing sex work, and one-quarter reported commencing sex work within 3 years of injecting drug use initiation. Just over one-quarter of the sample reported starting sex work prior to injecting drug use, and approximately three-quarters reported that their drug use had increased since they started sex work. Injection-related risk behaviours - There were very few reports of borrowing used needles among the injecting drug users, while one-fifth reported lending a used needle to someone in the preceding month. Almost two-thirds of the sample reported sharing other injecting equipment in the past month. Approximately two-thirds of the sample reported testing positive for HCV. There were no reports of HIV positive results. Unwanted sexual activity - Three-quarters of the sample reported experiencing some form of child sexual abuse before the age of 16. Almost two-thirds of the sample reported that someone had sexual intercourse with them after the age of 16 when they had made it clear they did not consent. Mental health problems - Depression - Approximately half of the sample reported severe current depressive symptoms in accordance with the Beck Depression Inventory II. Depression was associated with homelessness in the past 12 months, A&TSI status, and cannabis dependence. Approximately half the sample reported ever having tried to kill themself, and approximately one-quarter had first attempted suicide by the age of 18. Borderline Personality Disorder - Approximately half the sample screened positively for a diagnosis of Borderline Personality Disorder (BPD), which was associated with a range of adverse outcomes: earlier age of injecting drug use initiation, benzodiazepine dependence, cannabis dependence, sharing injecting equipment, current severe depressive symptoms, and adult sexual assault. Post-traumatic stress disorder - All but one of the participants reported having experienced at least one traumatic event in their lifetime, with a large proportion reporting multiple traumas. Rape, physical assault, child sexual abuse and witnessing someone being badly injured or killed were the most commonly reported traumas. Approximately half of the sample met Diagnostic and Statistical Manual of Mental Disorders (DSM-IV (TR)) criteria for a lifetime diagnosis of posttraumatic stress disorder (PTSD), and one-third reported current PTSD symptoms. Approximately three-quarters of those participants who developed PTSD said they had spoken to a health professional about the associated symptoms. Those reporting current PTSD were more likely to have experienced a greater number of traumas than those who did not report current symptoms. Access to mental health services - Approximately one-quarter of the sample had ever been admitted to a psychiatric hospital, and the most common reasons for admission were depression and anxiety. Just under half of the sample reported speaking with a health professional about a mental health problem other than their drug use in the past 6 months, most commonly for depression. Crime and police contact - Just under half of the sample reported engaging in criminal activity in the month prior to the interview, and just over half of the sample had been arrested in the preceding 12 months. Over half the sample reported ever having been in prison, and a small proportion had been in prison in the preceding 12 months. There were mixed reports regarding experiences with the police. Equal proportions of participants reported experiences of police harassment, poor treatment, and assault reports not being taken seriously, as well as police assistance, respectful treatment, and police assistance after assaults. Despite the large majority of women reporting experiences of violence at work, very low proportions had reported these incidents to police. Access to information and emotional support - Participants generally had good access to information on safe sex and drug use, bloodborne virus information and legal support. Access was particularly good to information on the sex industry in general. A substantial minority of the group reported having no emotional support. Details: Sydney: National Drug and Alcohol Research Centre, 2005. 81p. Source: Internet Resource: NDARC Technical Report Number 237: Accessed May 1, 2013 at: http://ndarc.med.unsw.edu.au/resource/mental-health-drug-use-and-risk-among-female-street-based-sex-workers-greater-sydney Year: 2005 Country: Australia URL: http://ndarc.med.unsw.edu.au/resource/mental-health-drug-use-and-risk-among-female-street-based-sex-workers-greater-sydney Shelf Number: 106728 Keywords: Drug Abuse and Addiction Mental Health Services Prostitutes Prostitution (Australia) Sex Workers

Author: U.S. Government Accountability Office Title: Office of National Drug Control Policy: Office Could Better Identify Opportunities to Increase Program Coordination Summary: ONDCP is responsible for coordinating implementation of drug control policy across the federal government to address illicit drug use. ONDCP developed the 2010 Strategy, which sets forth a 5-year plan to reduce illicit drug use through programs intended to prevent or treat drug abuse or reduce the availability of drugs. GAO was asked to review Strategy implementation and drug abuse prevention and treatment programs. This report assesses, among other things, the extent to which progress has been made toward achieving Strategy goals; ONDCP has mechanisms in place to monitor progress; fragmentation, overlap, and duplication exist across prevention and treatment programs; and ONDCP and federal agencies coordinate efforts to reduce the potential for unnecessary overlap or duplication. GAO analyzed the Strategy and its updates, available data on progress toward achieving Strategy goals, and documents about ONDCP’s monitoring mechanisms. GAO also analyzed data from questionnaires sent to the 15 federal agencies that administer prevention and treatment programs that collected information on services provided and coordination efforts. What GAO Recommends GAO recommends that ONDCP assess the extent of overlap and the potential for duplication across federal programs engaged in drug abuse prevention and treatment activities and identify opportunities for increased coordination. ONDCP concurred and stated that it will work with agencies administering these programs to further enhance coordination. Details: Washington, DC: GAO, 2013. 81p. Source: Internet Resource: GAO-13-333: Accessed May 1, 2013 at: http://www.gao.gov/assets/660/653354.pdf Year: 2013 Country: United States URL: http://www.gao.gov/assets/660/653354.pdf Shelf Number: 128504 Keywords: Agency Coordination Drug Abuse and Addiction Drug Control Policy (U.S.) Drug Policy

Author: Pugh, Tracy Title: Blueprint for a Public Health and Safety Approach to Drug Policy Summary: Some of the problems with our current drug policies stem from the fact that these policies have been largely bifurcated between two different and often contradictory approaches. One treats drug use as a crime that cannot be tolerated and should be punished; the other views addiction as a chronic relapsing health or behavioral condition requiring ongoing treatment and support. Neither of these views is all encompassing—it should be recognized that there are patterns of drug use that do not result in significant harm or health problems and therefore require no intervention. The public health approach presented here takes the view that our focus should be on the harm caused by drug use and the harm caused by our policy responses to it. We have focused specifically on illicit drugs, not because they are by themselves more harmful (in fact, tobacco causes more morbidity and mortality than any illicit drug), but because it has become increasingly clear that our current policies to manage illicit drugs are failing. Drug policy in New York is further complicated by multiple actors that all play some role in preventing or responding to drug use. Without a unified framework and better coordination, they often work at cross-purposes. For instance, while New York has grown its network of innovative harm reduction, drug treatment, and alternative-to-incarceration programs, it has also been aggressive in policing and penalizing the same population that accesses these services for possession of drugs and syringes and for relapses. The result is a system that is not working well for anyone. Drug use and its associated harms continue, and our policy responses have resulted in the mass incarceration of New Yorkers, increased racial disparities, stigmatization of individuals and whole subpopulations, fragmented families, deep distrust between police and the communities they serve, and millions of dollars in costs during times of both economic prosperity and, more recently, fiscal crisis. In an era of limited resources, we simply can no longer afford to keep doing what we have been doing when our actions have shown to be largely ineffective and even detrimental: • Drug use affects New Yorkers. The New York State Office of Alcoholism and Substance Abuse Services (OASAS) estimates that one in 13 New York State residents suffers from a substance abuse condition. An estimated 447,000 people in New York State need treatment but do not get it.1 Statewide, over 1.8 million New Yorkers (1.77 million adults and 156,000 young people ages 12-17) have a substance abuse condition.2 Many more are affected by the drug use of a family member, friend, or colleague. • Incarceration has proven ineffective at reducing drug use. With one in every 100 U.S. adults now in prison and many more involved in the criminal justice system,3 incarceration is increasingly seen as an important public health issue and as a social determinant of health that exacerbates existing health disparities.4-5 In 2011, there were 104,897 adult drug arrests overall in New York City—21,149 were felony arrests and 83,748 were misdemeanors.6 That same year, the New York City Police Department made over 50,000 arrests for marijuana possession7 yet overall rates of drug use, including marijuana, have remained relatively stable.8 • Our drug policies are driving unacceptable racial disparities in our criminal justice system. Despite the relative consistency in the prevalence of drug use across races, the vast majority of those arrested and incarcerated for drug offenses are people of color. In New York City in 2011, more than 85 percent of those arrested for marijuana possession were Black and Latino, mostly young men,9 even though young white males use marijuana at comparable, if not higher, rates.10 • Illicit drug use and our current policy responses to it are costly and require a revised approach. The economic cost of illicit drug use to the U.S. is estimated to be more than $193 billion annually. 11 The average annual cost of incarceration to New York tax payers is estimated at $3.6 billion.12 As incarceration has increased substantially over the last 40 years, illicit drug use has not seen a substantial reduction. New York is poised for change. There is much momentum to move our drug policies toward a public health-based approach. At the local level, communities around the state are actively calling for a new approach. They are challenging criminal justice-dominated strategies for dealing with drug use—such as stop, question, and frisks leading to arrests for low-level marijuana possession—and mass incarceration. At the policy level, New York in 2009 became one of the first and biggest states in the country to move away from the harsh mandatory sentencing laws that characterized drug policy in the U.S. throughout much of the past four decades. The significant reform to the Rockefeller Drug Laws was advanced by a historic conference held at NYAM in January 2009. The conference, called New Directions New York: A Public Health Safety Approach to Drug Policy, helped to delineate a public health and safety approach as a clear alternative to existing policy. The conference made clear that a wide array of community, government, health, and other stakeholders agree that at the center of all our drug policies whether addressing legal or illicit drugs—should be the question, “What impact will our policies have on the public’s health and safety?” This Blueprint seeks to outline an approach that responds to this question using the best evidence available coupled with the input of hundreds of New Yorkers. Details: New York: New York Academy of Medicine, 2013. 100p. Source: Internet Resource: Accessed May 1, 2013 at: http://www.nyam.org/assets/3371_DPA_NYAM_Report_FINAL_for_WEB_v2.pdf Year: 2013 Country: United States URL: http://www.nyam.org/assets/3371_DPA_NYAM_Report_FINAL_for_WEB_v2.pdf Shelf Number: 128583 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Drug Offenders Drug Policy (New York State, U.S.)

Author: European Monitoring Centre for Drugs and Drugs Addiction (EMCDDA) Title: Drug Prevention Interventions Targeting Minority Ethnic Populations: Issues Raised by 33 Case Studies Summary: This Thematic paper contains the results of a study that examined drug prevention interventions for minority ethnic populations in 29 European countries. A total of 33 interventions were reported to the study and the issues they raise are presented and discussed in the paper. The results will inform the EMCDDA’s plans for 2013–15 in terms of monitoring drug prevention interventions particularly in three areas: data collection, design and quality, and the dissemination of knowledge. Details: Lisbon: EMCDDA, 2013. 115p. Source: Internet Resource: Accessed May 3, 2013 at: http://www.emcdda.europa.eu/attachements.cfm/att_197631_EN_TDXA13001ENN.pdf Year: 2013 Country: Europe URL: http://www.emcdda.europa.eu/attachements.cfm/att_197631_EN_TDXA13001ENN.pdf Shelf Number: 128611 Keywords: Drug Abuse and Addiction Drug Abuse Prevention Drug Abuse Treatment Drug Policy (Europe) Minority Groups Substance Abuse Treatment

Author: Care Inspectorate (Scotland) Title: A Report Into the Deaths of Looked After Children in Scotland 2009-2011 Summary: Any time a looked after child dies, local authorities must inform the Care Inspectorate, which is charged with reviewing the circumstances of the death. The report shows that 30 looked after children in Scotland died between 2009 and 2011. The report examines the causes of death, praises hospices for their care of children with life-limiting conditions and makes specific recommendations to ensure looked after children can access substance misuse treatment and local psychological services as necessary. The Care Inspectorate also recommends that all staff involved in the care of looked after children be confident in recognising and managing suicide risk factors. Details: Dundee, Scotland: Care Inspectorate, 2013. 14p. Source: Internet Resource: Accessed May 8, 2013 at: http://www.scswis.com/index.php?option=com_docman&task=doc_details&gid=940&Itemid=378 Year: 2013 Country: United Kingdom URL: http://www.scswis.com/index.php?option=com_docman&task=doc_details&gid=940&Itemid=378 Shelf Number: 128683 Keywords: Child Deaths Child Maltreatment Drug Abuse and Addiction Looked After Children (Scotland) Substance Abuse Treatmkent Suicides

Author: Caron, Anne Title: Fourth Judicial District Veterans Court – Two Year Review: July 2010 – June 2012 Summary: • The Fourth Judicial District Veterans Court began in July 2010 as a voluntary problem-solving court for veteran offenders with treatable chemical dependency and/or mental health issues. It is a hybrid of the drug court and mental health court models. • Veterans Court promotes sobriety, recovery, and stability through a coordinated response that involves the cooperation and collaboration of court and probation personnel along with the addition of the VA Medical Center, VA Benefits Administration, and volunteer veteran mentors. • In its first two years of operation, 131 individuals entered Veterans Court. Nearly all (97%) are male, two-thirds are white, the average age at entry is 44 years, and nearly half have gross misdemeanor offenses. The most common offense type is gross misdemeanor DWIs (40%), followed by misdemeanor domestic offenses (20%). Nearly half (47%) have been deployed overseas at least once, most commonly to Iraq (60%). • At the end of two years, there are seventy-three active participants (56%), forty-one graduates (31%), eight individuals terminated by the Court (6%), seven who voluntarily withdrew (5%), and two who are no longer active due to other reasons (death, transfer out of state). • This review of Veterans Court includes a pre-post analysis of participants at this point in the program. A full evaluation, with a matched comparison sample, will ensue once the number of graduates reaches 100 and those graduates have one year of street-time post Veterans Court. • Since this is a program review, all goals should be considered in progress o Goal 1: Reduce criminal recidivism  During the first six months after entry into Veterans Court, 83% of participants commit fewer offenses than during the six months just prior to entry. This pattern maintains through both years of data: 72% of participants who have at least 24 months post-entry commit fewer offenses than during the 24 months just prior to entering the Court (Table 6, page 17).  The majority of Veterans Court participants have no new offenses while in the program, and those who do commit new offenses generally do so at a non-felony level (Table 8, page 18). o Goal 2: Promote participant sobriety  Not all participants are in Veterans Court for drug or alcohol related issues: indeed only two-thirds of graduates and terminated defendants were required to take alcohol and drugs tests while in the program. Graduates test positive at a lower rate than terminated defendants do (Table 9, page 19). o Goal 3: Increase compliance with treatment and other court-ordered conditions  Between two-thirds and three-fourths of all participants are ordered to complete chemical dependency treatment and/or domestic abuse programming. No graduate or active participant has failed to complete treatment, while nearly half of the non-completers do not enter treatment before terminating from the Court.  More than half (57%) of graduates complete inpatient treatment while 39% of active participants do so (Table 10, page 21). If needed, active participants may be required to complete a more intensive level of treatment prior to their graduation. o Goal 4: Improve access to VA benefits and services  Veterans Court works closely with a VA benefits specialist and the Hennepin County Veterans Service Office to assist participants in filing claims as needed to begin receiving benefits or to increase benefits to the level to which they are entitled.  Nearly three-fourths (73%) of participants already receive benefits prior to entering the Court, while others connect while in Veterans Court (21%). A few participants (5%) are not eligible for VA benefits - for example, due to income level, dishonorable discharge status, or because they are currently active in the Guard/Reserves. o Goal 5: Improve family relationships and social support connections  The Hennepin County Veterans Court has established a mentor program, in which participants are matched with veterans in the community if they so choose in order to help them navigate the court and VA Medical Center system as well as to provide support and friendship in the community. o Goal 6: Improve life stability  More than half of graduates maintain or increase their level of employment from entry to graduation (Table 11, page 23).  Nearly three-fourths of graduates live on their own in a private residence at both entry and exit from the program, while another 15% increase their housing stability from entry to graduation (Table 12, page 23). • Overall, participants are extremely satisfied with the services they receive through Veterans Court and its partners. On the uSPEQ® survey scores can range from one (strongly disagree) to four (strongly agree), and in both the first and second years of Veterans Court the average score on all five question categories (service responsiveness, informed choice, respect, overall value, and participation) was 3.8 or higher. Although slight, scores on all five measures increased in the second year (Table 13, page 25). Details: Minneapolis: Minnesota Judicial Branch, Fourth Judicial District Research Division, 2013. 37p. Source: Internet Resource: Accessed May 15, 2013 at: http://www.mncourts.gov/Documents/4/Public/Research/Veterans_Court_Two_Year_Review.pdf Year: 2013 Country: United States URL: http://www.mncourts.gov/Documents/4/Public/Research/Veterans_Court_Two_Year_Review.pdf Shelf Number: 128726 Keywords: Drug Abuse and Addiction Mentally Ill Offenders Problem-Solving Courts Veterans Court (U.S.)

Author: Insulza, Jose Miguel Title: The Drug Problem in the Americas Summary: The Heads of State and Government of the Americas, gathered at the Sixth Summit in Cartagena, Colombia, entrusted the OAS with the task of preparing a study on the drug problem in the Americas. In keeping with the wishes of the dignitaries, that study will examine the results of current policy in the Hemisphere and explore new approaches for responding more effectively to the problem. Under the leadership of OAS Secretary General, José Miguel Insulza, this study aims to carry out a comprehensive analysis of policies applied in the Americas, and, based on the evidence found, highlight the strengths, weaknesses, and challenges in the implementation of those policies. The findings of the study will provide the basis for a scenario analysis with a view to examining new approaches. The Secretary General is coordinating with the Inter-American Development Bank (IADB), the Pan American Health Organization (PAHO), the Economic Commission for Latin America and the Caribbean (ECLAC), the CAF (Development Bank of Latin America), and the United Nations Office on Drugs and Crime (UNODC). The CICAD Executive Secretariat is providing technical and administrative support for the study. Two tracks The study consists of two separate, but interconnected reports: An analytical report will survey the current drug policy landscape by drawing on existing expertise (governments, civil society, academia or think tanks) and synthesizing lessons learned and a spectrum of policy options. A scenarios report aims to map out potential outcomes of several sets of policy options when exposed to a broad discussion of stakeholders in the drug problem in the Americas The technical secretariat will compile and analyze the information for the study, which will be divided into the following chapters consistent with the different areas of the problem targeted by the study: a.The relationship between drugs and public health; b.The relationship between drugs and economic and social development; c.The security challenges as reflected in the nexus between drugs, violence and organized crime; d.Production and supply of plant-based and synthetic drugs, pharmaceuticals, and chemical precursors; and e.The alternative legal and regulatory approaches to the drug problem. Each chapter will provide baseline analysis of the current state of play in the region, examine best practices and promising new approaches being pursued by different countries, with the point of departure being the Hemispheric Drug Strategy, and outline challenges and obstacles to improved results. Based on the findings of the Analytical Report, an exercise will be undertaken to identify diverse approaches to the problem. To that end, potential scenarios will be developed, capable of providing the Heads of State and Government of the Americas with courses of action for tackling the drug problem. Details: Washington, DC: Organization of American States, General Secretariat, 2013. 110p. Source: Internet Resource: Accessed May 21, 2013 at: http://www.oas.org/documents/eng/press/Introduction_and_Analytical_Report.pdf Year: 2013 Country: South America URL: http://www.oas.org/documents/eng/press/Introduction_and_Analytical_Report.pdf Shelf Number: 128764 Keywords: Drug Abuse and Addiction Drug Control Drug Trafficking Drugs and Crime (America)

Author: Organization of American States Title: The Drug Problem in the Americas: Studies. Legal and Regulatory Alternatives Summary: FINDINGS  Over the past two years, the hemispheric drug policy debate has become much more active and intense. Marijuana legalization initiatives in Uruguay and two western U.S. states are drawing broad attention in the hemisphere.  About a dozen OAS member states have non-criminal or reduced penalties or no penalty at all for possession of a personal amount of controlled substances, including Argentina, Brazil, and Mexico.  Decriminalization of marijuana for personal use is common in many states of the United States, in practice or by law.  The available evidence suggests that reducing penalties for possession of small quantities has little effect on the number of users.  Legalization of controlled substances, especially if commercialized, could complicate prevention efforts, decrease prices, and thus expand use and addiction, with all the negative consequences that accompany these trends.  Assuming well-functioning regulatory structures, legalization could reduce many of the negative consequences with which society is most concerned, including violence, corruption, and public disorder surrounding drug distribution; the transmission of blood-borne diseases associated with shared needles; and the incarceration of hundreds of thousands of low-level drug offenders.  There is limited evidence available to accurately measure tradeoffs, and it is difficult to predict exactly to what extent legalization would reduce violence and other harms or increase the prevalence of addiction and use. The results would vary by country, by drug, and by the nature of the legalization regime adopted. No country has legalized any of these drugs, and neither historical analogies (such as to the period when cocaine was legal in many Western countries) nor comparisons to alcohol prohibition provide much insight. Details: Washington, DC: OAS, 2013. 42p. Source: Internet Resource: Accessed May 28, 2013 at: http://www.cicad.oas.org/main/policy/informeDrogas2013/alternativasLegales_ENG.pdf Year: 2013 Country: International URL: http://www.cicad.oas.org/main/policy/informeDrogas2013/alternativasLegales_ENG.pdf Shelf Number: 128833 Keywords: Drug Abuse and Addiction Drug Control Policy Drug Legalization

Author: Chiu, Jessica Title: Punitive Drug Law and the Risk Environment for Injecting Drug Users: Understanding the Connections Summary: This paper, prepared for the Global Commission on HIV and the Law, reviews the evidence documenting the effects of punitive laws and law enforcement practices on the HIV risk environment for injecting drug users (IDUs). It then provides an overview of global drug policy, drawing on a mixture of regional reports and country case studies. Section lll summarises the adoption of harm reduction practices and policies. Finally, the paper looks at a selection of strategies that countries around the world have implemented to improve the HIV risk environment for IDUs. These include interventions to make law enforcement less harmful and more conducive to health; the integration of harm reduction and drug treatment programmes into the criminal justice system; and changes to national anti-drug laws for possession and individual use that move away from punitive anti-drug penalties. Details: Philadelphia: Temple University, School of Law, 2011. 58p. Source: Internet Resource: Working paper prepared for the Third Meeting of the Technical Advisory Group of the Global Commission on HIV and the Law, 7-9 July 2011: Accessed May 30, 2013 at: http://www.hivlawcommission.org/index.php/working-papers?task=document.viewdoc&id=98 Year: 2011 Country: International URL: http://www.hivlawcommission.org/index.php/working-papers?task=document.viewdoc&id=98 Shelf Number: 128860 Keywords: Drug Abuse and Addiction Drug Law Enforcement Drug Policy HIV (Viruses)

Author: Seddon, Toby Title: Regulating Global Drug Problems Summary: The problems associated with the global drug trade are amongst the most challenging and intractable of all those facing policy-makers. The global drug prohibition system is widely acknowledged as a costly and counterproductive failure, not only presiding over a massive expansion of the problem but also causing a range of damaging side-effects, notably fuelling organised crime. The need for new thinking has never been more evident. It is argued that current arguments for drug policy reform, whilst highly effective at critiquing prohibition, are nevertheless based on a false understanding of the nature of markets and regulation. This paper sets out an alternative constitutive conception of drug control which not only provides a better basis for challenging prohibition but also a more fruitful framework for developing an alternative approach. It is suggested that the regulation perspective outlined in this paper represents a new paradigm for addressing the challenges presented by global psychoactive commerce in the early twenty-first century. Details: Canberra: Australian National University, Regulatory Institutions Network (RegNet), 2013. 32p. Source: Internet Resource: RegNet Research Paper No. 2013/6 : Accessed June 1, 2013 at: http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2261026 Year: 2013 Country: International URL: http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2261026 Shelf Number: 128889 Keywords: Drug Abuse and Addiction Drug Control Drug Markets Drug Policy Drug Regulation

Author: Palaung Women's Organization Title: Still Imprisoned: Opium cultivation soars in Palaung areas under Burma’s new regime Summary: Almost one year after Burma’s long-awaited elections were held in November 2010, Palaung communities in northern Shan State are suffering from the effects of an even greater upsurge in opium cultivation than in previous years. Local paramilitary leaders, some now elected into Burma’s new parliament, are being allowed to cultivate and profit from drugs in return for helping the regime suppress ethnic resistance forces in Burma’s escalating civil war. As a result, drug addiction has escalated in the Palaung area, tearing apart families and communities. Burma’s drug problems are set to worsen unless there is genuine political reform that addresses the political aspirations of Burma’s ethnic minority groups. Research carried out by Palaung Women’s Organization in Namkham Township shows that: •Opium cultivation across 15 villages in Namkham Township has increased by a staggering 78.58% within two years. •12 villages in the same area, which had not previously grown opium, have started to grow opium since 2009. •A signify cant number of these villages are under the control of government paramilitary “anti-insurgency” forces, which are directly profiting from the opium trade. •The most prominent militia leader and drug-lord in the area, “Pansay” Kyaw Myint, from the military-backed Union Solidarity and Development Party, was elected as an MP for Namkham in November 2010; he promised voters that they could grow opium freely for 5 years if they voted for him. •Government troops, police and militia continue to openly tax opium farmers, and to collect bribes from drug addicts in exchange for their release from custody. •Drug addiction in Palaung communities has spiraled out of control. In one Palaung village, PWO found that 91% of males aged 15 and over were addicted to drugs. Drug addiction is causing huge problems for families, with women and children bearing the burden of increased poverty, crime and violence. Details: Mae Sot, Thailand: Palaung Women's Organization, 2011. 28p. Source: Internet Resource: Accessed June 4, 2013 at: http://www.burmapartnership.org/2011/10/still-imprisoned/ Year: 2011 Country: Thailand URL: http://www.burmapartnership.org/2011/10/still-imprisoned/ Shelf Number: 128929 Keywords: Drug Abuse and Addiction Drug-Related Violence Narcotics (Thailand) Opium

Author: Latessa, Edward J. Title: Final Report: Outcome and Process Evaluation of Juvenile Drug Courts Summary: This study adds to the existing juvenile drug court literature by providing a national multi-site outcome and process evaluation of nine juvenile drug courts from across the U.S. This study assesses the relative effect of each court, as well as their combined effectiveness in reaching the overall goal of reducing recidivism and improving youths' social functioning. It also identifies, where possible, the characteristics of youth and programs associated with successful outcomes. The goals of this research are consistent with those stated in the OJJDP-approved grant proposal. There were six original goals. One additional goal was added at the request of OJJDP. The goals of this research are: 1) To determine if there is a reduction in recidivism and substance abuse associated with participation in a juvenile drug court program, relative to comparison groups. 2) To determine if there are increases in social functioning related to participating in juvenile drug court programs relative to comparison groups. 3) To identify the characteristics of successful juvenile drug court participants. 4) To determine if juvenile drug courts are operating in a manner consistent with evidence-based approaches. 5) To identify the programmatic characteristics of effective juvenile drug courts. 6) To provide policymakers with information about the effectiveness of juvenile drug courts. 7) To determine if the 16 strategies for juvenile drug courts recommended by the National Drug Court Institute (NDCI) are effective practices (Bureau of Justice Assistance, 2003). The nine juvenile drug courts participating in this research study are located in: Ada County, Idaho; Clackamas County, Oregon; Jefferson County, Ohio; Lane County, Oregon; Lucas County, Ohio; Medina County, Ohio; Rhode Island (the state); San Diego County, California; and Santa Clara County, California. As discussed above, the study included both process and outcome evaluation components. Details: Cincinnati, OH: Center for Criminal Justice Research, University of Cincinnati, School of Criminal Justice, 2013. 421p. Source: Internet Resource: Accessed June 4, 2013 at: https://www.ncjrs.gov/pdffiles1/ojjdp/grants/241643.pdf Year: 2013 Country: United States URL: https://www.ncjrs.gov/pdffiles1/ojjdp/grants/241643.pdf Shelf Number: 128931 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders Juvenile Drug Courts Juvenile Offenders Problem-Solving Courts Recidivism

Author: Global Commission on Drug Policy Title: The Negative Impact Of The War On Drugs On Public Health: The Hidden Hepatitis C Epidemic Summary: Hepatitis C is a highly prevalent chronic viral infection which poses major public health, economic and social crises, particularly in low and middle income countries. The global hepatitis C epidemic has been described by the World Health Organization as a ‘viral time bomb’, yet continues to receive little attention. Access to preventative services is far too low, while diagnosis and treatment are prohibitively expensive and remain inaccessible for most people in need. Public awareness and political will with regard to hepatitis C are also too low, and national hepatitis surveillance is often non-existent. The hepatitis C virus is highly infectious and is easily transmitted through blood-to-blood contact. It therefore disproportionately impacts upon people who inject drugs: of the 16 million people who inject drugs around the world, an estimated 10 million are living with hepatitis C. In some of the countries with the harshest drug policies, the majority of people who inject drugs are living with hepatitis C – more than 90 percent in places such as Thailand and parts of the Russian Federation. The hepatitis C virus causes debilitating and fatal disease in around a quarter of those who are chronically infected, and is an increasing cause of premature death among people who inject drugs. Globally, most HIV-infected people who inject drugs are also living with a hepatitis C infection. Harm reduction services – such as the provision of sterile needles and syringes and opioid substitution therapy – can effectively prevent hepatitis C transmission among people who inject drugs, provided they are accessible and delivered at the required scale. EXECUTIVE SUMMARY Instead of investing in effective prevention and treatment programmes to achieve the required coverage, governments continue to waste billions of dollars each year on arresting and punishing drug users – a gross misallocation of limited resources that could be more efficiently used for public health and preventive approaches. At the same time, repressive drug policies have fuelled the stigmatisation, discrimination and mass incarceration of people who use drugs. As a result, there are very few countries that have reported significant declines in new infections of hepatitis C among this population. This failure of governments to prevent and control hepatitis disease has great significance for future costs to health and welfare budgets in many countries. In 2012 the Global Commission on Drug Policy released a report that outlined how the ‘war on drugs’ is driving the HIV epidemic among people who use drugs. The present report focuses on hepatitis C as it represents another massive and deadly epidemic for this population. It provides a brief overview of the hepatitis C virus, before exploring how the ‘war on drugs’ and repressive drug policies are failing to drive transmission down. The silence about the harms of repressive drug policies has been broken – they are ineffective, violate basic human rights, generate violence, and expose individuals and communities to unnecessary risks. Hepatitis C is one of these harms – yet it is both preventable and curable when public health is the focus of the drug response. Now is the time to reform. Details: Rio de Janeiro – RJ – Brasil: The Commission, 2013. 24p. Source: Internet Resource: Accessed June 7, 2013 at: http://www.globalcommissionondrugs.org/hepatitis/gcdp_hepatitis_english.pdf Year: 2013 Country: International URL: http://www.globalcommissionondrugs.org/hepatitis/gcdp_hepatitis_english.pdf Shelf Number: 129005 Keywords: Drug Abuse and Addiction Drug Abuse Policy Drug Abuse Treatment Hepatitis C War on Drugs

Author: Carter, Connie I. Title: Getting to Tomorrow: A Report on Canadian Drug Policy Summary: The Canadian Drug Policy Coalition is a broad coalition of non-governmental organizations and individuals committed to working with Canadians to create an approach to drug problems that will take a radical new direction—a course that will put the protection of public health and safety, social justice and equity at the forefront of Canada’s response to drugs. The primary goal of this report is to provide an overview of the state of Canadian drug policy by focusing the lens on key issues of concern to Canadians: public safety, access to services and supports for people with drug problems, national-level drug policy, and Canada’s escalating role in the international war on drugs. This report highlights the failing role that current federal drug policies play in supporting safety and health and draws attention to the acute need for an improved system of supports for people who use drugs including harm reduction. This report also highlights the patchwork of provincial policies and services that support people with drug problems. These policies, while valiant attempts to integrate and streamline services, do not always translate into meaningful changes on the front lines. This report also calls for a review of the overall use of the criminal law in responding to the use of illegal substances and drug related problems. The findings of this report, based on interviews with changemakers and service providers, and scans of important documents and research, reveals that Canada is at a crossroads when it comes to drug laws and policies. A new direction in drug policy is required. We can continue to work within the paradigm of drug prohibition or we can begin to explore alternative approaches and chart a new course that can help save lives, respect human rights and be more cost effective. The use of illegal substances is a complex issue and people use drugs for many reasons. Most people do not experience significant problems because of their drug use, some do develop drug problems, and others may experience clear benefits from illegal drug use. But despite deep public purse investments in enforcement- based approaches, lifetime use of cannabis stands at 39.4% and the non-medical use of prescription opioids is the fourth most prevalent form of substance use in Canada behind only alcohol, tobacco and cannabis. Rates of hiv and hcv associated with drug use are unacceptably high particularly among some groups. In 2010, 30.4% of new infections in women versus 13.5 % of new cases in men were attributed to injection drug use. Cases of hiv attributed to injecting drug use among First Nations, Métis and Inuit persons have gone up to more than 50 per cent in the period spanning 2001 to 2008. Deaths related to overdose of prescription opiates whether used medically or non-medically have risen sharply and are estimated to be about 50% of annual drug deaths. But like hiv and Hepatitis C infections, overdose deaths are highly preventable. This report addresses some of the urgent changes needed to support a comprehensive harm reduction and public health approach to the prevention and treatment of overdose. Despite often heroic efforts at the provincial and local levels to improve the system of supports, many people still wait unacceptably long for services. Where sound and relatively safe treatments exist, provincial governments and health authorities drag their feet because of outmoded ideas about some drugs or shortsighted concerns about finances. The Federal government remains openly hostile to evidence-based measures like key harm reduction services and has clearly taken a punitive approach to addressing drug use problems. Failure by all levels of government to fully meet the needs of people with drug problems, means that some groups are still outright denied these lifesaving services and many community-based organizations struggle to meet the basic needs of their clients. These difficulties are particularly acute for residents in rural areas, women and First Nations, Métis and Inuit citizens. Canada still relies on the criminal law to curb illegal drug use and stem the growth of illegal drug markets. These laws and policies disproportionally target already marginalized groups. Canada also spends enormous amounts of money annually to prevent the purchase, use and distribution of illegal drugs both inside Canada and beyond its borders. The federal government has allocated $527.8 million for the National Anti-Drug strategy for 2012-2017, much of it on enforcement related activities. This strategy only accounts for a portion of government spending on drug control. “Activities such as rcmp drug enforcement, drug interdiction, and the use of the military in international drug control efforts, drive up policing, military and border security budgets. Cannabis remains a key target of these policing activities—cannabis possession charges numbered 61,406 in 2011, a rate of 178 per 100,000 people in Canada. Police reported incidents of cannabis possession are far higher than any other illegal drug (21 for cocaine possession and a rate of 30 for all other illegal drugs combined.) And incidents of cannabis possession have increased 16% between 2001 and 2011. Cannabis remains a lucrative market—annual retail expenditures on this substance are estimated to be about $357 million per year in bc alone. Cannabis is a popular drug, and its harmful effects are certainly less than alcohol and tobacco, but the potential financial benefits of regulated and taxable product like cannabis are completely unavailable to federal and provincial treasuries. Rather than curbing drug markets, drug enforcement has actually been shown to escalate drug trade violence. Canada’s prisons are already overcrowded and the effects of recently introduced mandatory minimum sentences for some drug crimes are yet to be fully felt. And because of poor data collection we still do not have a full picture of the effects of the millions of dollars spent every year on enforcing Canada’s drug laws. One of the most urgent issues affecting Canadians is discrimination against people who use illegal drugs. This discrimination and the accompanying hostility towards people who use drugs can be felt in the derogatory statements that appear routinely in media reports of public debates about services. The recommendations in this report address the need for urgent change in three key areas: drug law reform, discrimination, services and supports. 1. Modernize Canada’s legislative, policy and regulatory frameworks that address psychoactive substances. We call for the replacement of the National Anti-Drug Strategy with one focused on health and human rights, the decriminalization of all drugs for personal use and the creation of a regulatory system for adult cannabis use. 2. Support and expand efforts to implement evidence- based approaches to eliminate stigma and discrimination, and social and health inequities that affect people who use drugs. 3. Support the scaling-up of comprehensive health and social services, including housing and treatment services that engage people with drug problems. Increase support for efforts to reduce the harms of substance use which includes robust educational programs about safer drug use, programs for distributing new supplies for injection and crack cocaine use, safer consumption services, opioid substitution therapies and heroin assisted treatment. Ensure these services are part of larger public health approach to substance use that respects the human rights of people who use drugs. Details: Vancouver, BC: Canadian Drug Policy Coalition, 2013. 112 p. Source: Internet Resource: Accessed June 18, 2013 at: http://drugpolicy.ca/report/CDPC2013_en.pdf Year: 2013 Country: Canada URL: http://drugpolicy.ca/report/CDPC2013_en.pdf Shelf Number: 129029 Keywords: Decriminalization Drug Abuse and Addiction Drug Policy (Canada) Illegal Drugs

Author: DrugScope Title: The Challenge of Change: Improving services for women involved in prostitution and substance use Summary: Women involved in street-based prostitution who misuse drugs and/or alcohol are one of the most marginalised and stigmatised groups in our society. However, they are rarely discussed in these terms, and too often they are absent from policy and practice addressing the needs of the most vulnerable. At a time when 'sex work' can be normalised, and even glamourised, the reality is that women involved in prostitution often use drugs and/or alcohol to cope with selling sex (and the violence and abuse in their lives) and often sell sex to support addiction. It is a vicious circle. The focus of this research study has been on policy and practice to address the drug and alcohol treatment needs of women involved in street-based prostitution. Tackling substance misuse is fundamental to reducing harm and supporting women to exit prostitution. So, what kinds of interventions work best? How widely are they available? And, critically, what do the women themselves say about their expectations and experiences of services? We found that while there are good services and positive stories, there remains a lot to be done. Many women involved in prostitution see no alternative; no other viable future for themselves; and no support for 'recovery', or prospect of ‘a normal life'. Currently, appropriate support that addresses substance misuse in the context of 'sex work' can be difficult to access. With evidence that a significant proportion of women seeking help for drug and alcohol problems (and many others who are not accessing help) have been involved in prostitution in some form, this is the 'challenge of change' identified in the report's title. Many of the women we spoke to recognise and accept this challenge on a personal level, but need more and better support from policy makers, planners and commissioners, and from services on the ground. Details: London: DrugScope, 2013. 75p. Source: Internet Resource: Accessed July 3, 2013 at: http://www.avaproject.org.uk/media/128481/challenge%20of%20change_full%20report.pdf Year: 2013 Country: United Kingdom URL: http://www.avaproject.org.uk/media/128481/challenge%20of%20change_full%20report.pdf Shelf Number: 129242 Keywords: Drug Abuse and Addiction Prostitutes (U.K.) Sex Workers Street Prostitution

Author: Legal Action Center Title: Legality of Denying Access to Medication Assisted Treatment In the Criminal Justice System Summary: This report examines the prevalence of opiate addiction in the criminal justice system, its devastating consequences, and the widespread denial of access to one of its most effective forms of treatment: medication assisted treatment (“MAT”). The report then analyzes the circumstances in which the denial of MAT violates Federal anti-discrimination laws and the United States Constitution. Details: New York: Legal Action Center, 2011. 25p. Source: Internet Resource: Accessed July 9, 2013 at: http://www.lac.org/doc_library/lac/publications/MAT_Report_FINAL_12-1-2011.pdf Year: 2011 Country: United States URL: http://www.lac.org/doc_library/lac/publications/MAT_Report_FINAL_12-1-2011.pdf Shelf Number: 129337 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Medical Care Substance Abuse Treatment

Author: Global Commission on Drug Policy Title: The War on Drugs and HIV/AIDS: How the Criminalization of Drug Use Fuels the Global Pandemic Summary: The global war on drugs is driving the HIV/AIDS pandemic among people who use drugs and their sexual partners. Throughout the world, research has consistently shown that repressive drug law enforcement practices force drug users away from public health services and into hidden environments where HIV risk becomes markedly elevated. Mass incarceration of non-violent drug offenders also plays a major role in increasing HIV risk. This is a critical public health issue in many countries, including the United States, where as many as 25 percent of Americans infected with HIV may pass through correctional facilities annually, and where disproportionate incarceration rates are among the key reasons for markedly higher HIV rates among African Americans. Aggressive law enforcement practices targeting drug users have also been proven to create barriers to HIV treatment. Despite the evidence that treatment of HIV infection dramatically reduces the risk of HIV transmission by infected individuals, the public health implications of HIV treatment disruptions resulting from drug law enforcement tactics have not been appropriately recognized as a major impediment to efforts to control the global HIV/AIDS pandemic. The war on drugs has also led to a policy distortion whereby evidence-based addiction treatment and public health measures have been downplayed or ignored. While this is a common problem internationally, a number of specific countries, including the US, Russia and Thailand, ignore scientific evidence and World Health Organization recommendations and resist the implementation of evidence-based HIV prevention programs – with devastating consequences. In Russia, for example, approximately one in one hundred adults is now infected with HIV. In contrast, countries that have adopted evidence-based addiction treatment and public health measures have seen their HIV epidemics among people who use drugs – as well as rates of injecting drug use – dramatically decline. Clear consensus guidelines exist for achieving this success, but HIV prevention tools have been under-utilized while harmful drug war policies have been slow to change. Details: Rio de Janeiro: Global Commission on Drug Policy, 2012. 24p. Source: Internet Resource: Accessed July 10, 2013 at: http://globalcommissionondrugs.org/wp-content/themes/gcdp_v1/pdf/GCDP_HIV-AIDS_2012_REFERENCE.pdf Year: 2012 Country: International URL: http://globalcommissionondrugs.org/wp-content/themes/gcdp_v1/pdf/GCDP_HIV-AIDS_2012_REFERENCE.pdf Shelf Number: 129353 Keywords: Drug Abuse and Addiction Drug Control Drug Policy HIV (Viruses) War on Drugs (International)

Author: New Jersey Commission of Investigation Title: Scenes from an Epidemic: A Report on the SCI’s Investigation of Prescription Pill and Heroin Abuse Summary: Stopping regularly in downtown Newark, the nondescript minivans drew a select clientele: homeless Medicaid recipients and drug addicts who had been told by flyers and word-of-mouth where to wait for a ride. Ten miles and 15 minutes later, they arrived at a strip mall “medical center” on Main Avenue in neighboring Passaic where a doctor licensed by the State of New Jersey quickly got down to the business of cursory examinations and bogus diagnoses. Then he wrote prescriptions for powerful painkillers, sedatives and cough syrup, which his “patients” could use themselves or sell on the street, their choice. They also left with $10 cash gift cards as thanks for coming in. The bill for it all went to government health insurance, which funneled a fortune in fraudulent Medicaid reimbursements into the bank accounts of the hidden entrepreneurs the doctor fronted for – associates of Russian organized crime. The flagrant and unbridled operation of this pill mill and others like it, the descent of sworn medical professionals into outright drug dealers, the intrusion of organized crime and other criminal elements into lucrative recesses of the health-care industry to feed an epidemic of demand for drugs: These are among the key findings of the State Commission of Investigation’s ongoing probe of illegal trafficking in and abuse of prescription painkillers and other addictive narcotics. Even as law enforcement authorities, public-health officials, social workers, treatment counselors, schools and families redouble their efforts to combat the purveyors and consequences of this predatory scourge, it continues to evolve in ways that few could have imagined when the so-called war on drugs was launched more than four decades ago. Staggering amounts of legitimate medicines manufactured by major pharmaceutical companies and intended for those needing relief from the pain of disease and injury have been diverted into criminal enterprises founded on drug abuse and addiction. What once was a menacing background narrative centered narrowly around subculture-based substances like opium, morphine and heroin has exploded into a mainstream horror story whose first chapter often begins with pill bottles in the average household medicine cabinet. Some medical management companies with names that incorporate benign terms like “pain management” and “wellness” have transformed street-corner drug-dealing into an orderly and seemingly ordinary business endeavor, except for the hidden financial backing from individuals linked to organized crime, the multiple bank accounts for money-laundering, the expert help of corrupt physicians and the shady characters who recruit and deliver customers and provide security. Meanwhile, conventional drug dealers – those tied to criminal street gangs and similar criminal enterprises – exploit legitimate businesses like used car dealerships, clothing outlets, barber shops, bars and liquor stores to cover their illicit retail commerce. They take advantage of advanced computers, communications and social networking technologies to facilitate criminal activities and thwart law enforcement. And they are finding new ways to profit from a market hungry for addictive drugs stretching well beyond New Jersey’s cities and into the outlying affluence of its suburbs and rural communities. On the demand side, witnesses told the Commission during an unprecedented public hearing that, given the shared properties of pain-numbing, high-inducing substances known as opiates and opioids, the widening abuse of prescription pills containing Oxycodone and related chemical ingredients has triggered a new and sustained rise in use of the original opiate of choice – heroin. Indeed, with high-quality heroin readily available on New Jersey streets today at roughly the same price as a pack of cigarettes – cheaper than painkilling pills of similar strength and effect – it should be no great surprise that the road to addiction has evolved fullcircle. And all too often ensnared in this harrowing, potentially lethal cycle – in many instances before they, or their families, even know it or suspect it – are adolescents, teenagers and twenty-somethings, young people on their way to becoming a new lost generation of what used to be called junkies. Also, much of what used to take place “underground” in the drug milieu is now happening in plain sight. With the advent of instantaneous communication technology and suburban demand, a handful of pills or a bag of heroin is only a text message or cell-phone call away as many dealers now deliver product to customers waiting in shopping-mall parking lots. Former suburban high school students told the Commission that the depth of their prescription pill and heroin dependency played out in full view of teachers and other adults who they said did not seem to have a clue or even care when they nodded off and fell asleep in class, day after day. During a three-week surveillance operation at several major intersections in downtown Trenton, Commission investigators observed a bustling open-air drug market daily during morning rush hour within blocks of New Jersey’s Statehouse. Law enforcement authorities are quite familiar with the spiking collateral damage from this disturbing trend: the thefts and violence, the burglaries, armed robberies, pharmacy holdups and worse. Elsewhere on the frontlines, drug treatment facilities are seeing record numbers of admissions for heroin and other opiate/opioid addictions. Details: Trenton: New Jersey Commission of Investigation, 2013. 74p. Source: Internet Resource: Accessed July 13, 2013 at: http://www.nj.gov/sci/pdf/PillsReport.pdf Year: 2013 Country: United States URL: http://www.nj.gov/sci/pdf/PillsReport.pdf Shelf Number: 129390 Keywords: Drug Abuse and Addiction Drug Markets Drug Trafficking Heroin Organized Crime Prescription Drug Abuse (New Jersey, U.S.)

Author: Kelly, Elaine Title: Policing Cannabis and Drug Related Hospital Admissions: Evidence from Administrative Records Summary: We evaluate the impact of a policing experiment that depenalized the possession of small quantities of cannabis in the London borough of Lambeth, on hospital admissions related to illicit drug use. To do so, we exploit administrative records on individual hospital admissions classied by ICD-10 diagnosis codes. These records allow the construction of a quarterly panel data set by London borough running from 1997 to 2009 to estimate the short and long run impacts of the depenalization policy unilaterally introduced in Lambeth between 2001 and 2002. We nd the depenalization of cannabis had signicant longer term impacts on hospital admissions related to the use of hard drugs, raising raising hospital admission rates for men by between 40 and 100% of their pre-policy baseline levels. Among Lambeth residents, the impacts are concentrated among men in younger age cohorts, and among those with no prior history of hospitalization related to illicit drug or alcohol use. The dynamic impacts across cohorts vary in prole with some cohorts experiencing hospitalization rates remaining above pre-intervention levels six years after the depenalization policy is introduced. We nd evidence of smaller but signicant positive spillover eects in hospitalization rates related to hard drug use among residents in boroughs neighboring Lambeth, and these are again concentrated among younger cohorts without prior histories of hospitalizations related to illicit drug or alcohol use. We combine these estimated impacts on hospitalization rates with estimates on how the policy impacted the severity of hospital admissions to provide a lower bound estimate of the public health cost of the depenalization policy. Details: Unpublished paper, 2012. 45p. Source: Internet Resource: Accessed July 17, 2013 at: http://www.homepages.ucl.ac.uk/~uctpimr/research/health.pdf Year: 2012 Country: United Kingdom URL: http://www.homepages.ucl.ac.uk/~uctpimr/research/health.pdf Shelf Number: 129420 Keywords: Decriminalization Drug Abuse and Addiction Drug Policy Hospital Admissions Illicit Drug Use Marijuana (U.K.)

Author: Ferri, Marica Title: Media Campaigns for the Prevention of Illicit Drug Use in Young People (Review) Summary: Background Substance-specific mass media campaigns which address young people are widely used to prevent illicit drug use. They aim to reduce use and raise awareness of the problem. Objectives To assess the effectiveness of mass media campaigns in preventing or reducing the use of or intention to use illicit drugs amongst young people. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2013, Issue 1), including the Cochrane Drugs and Alcohol Group’s Specialised Register; MEDLINE through PubMed (from 1966 to 29 January 2013); EMBASE (from 1974 to 30 January 2013) and ProQuest Dissertations & Theses A&I (from 1861 to 3 February 2013). Selection criteria Cluster-randomised controlled trials, prospective and retrospective cohort studies, interrupted time series and controlled before and after studies evaluating the effectiveness of mass media campaigns in influencing drug use, intention to use or the attitude of young people under the age of 26 towards illicit drugs. Data collection and analysis We used the standard methodological procedures of The Cochrane Collaboration. Main results We included 23 studies involving 188,934 young people, conducted in theUSA, Canada and Australia between 1991 and 2012. Twelve studies were randomised controlled trials (RCT), two were prospective cohort studies (PCS), one study was both a RCT and a PCS, six were interrupted time series and two were controlled before and after (CBA) studies. The RCTs had an overall low risk of bias, along with the ITS (apart from the dimension ’formal test of trend’), and the PCS had overall good quality, apart from the description of loss to follow-up by exposure. Self reported or biomarker-assessed illicit drug use was measured with an array of published and unpublished scalesmaking comparisons difficult. Pooled results of five RCTs (N = 5470) show no effect of media campaign intervention (standardised mean difference (SMD) -0.02; 95% confidence interval (CI) -0.15 to 0.12). We also pooled five ITS studies (N = 26,405) focusing specifically on methamphetamine use. Out of four pooled estimates (two endpoints measured in two age groups), there was evidence of a reduction only in past-year prevalence of methamphetamine use among 12 to 17 years old. A further five studies (designs = one RCT with PCS, two PCS, two ITS, one CBA, N = 151,508), which could not be included in meta-analyses, reported a drug use outcome with varied results including a clear iatrogenic effect in one case and reduction of use in another. Authors’ conclusions Overall the available evidence does not allow conclusions about the effect of media campaigns on illicit drug use among young people. We conclude that further studies are needed. Details: The Cochrane Collaboration, 2013. 109p. Source: Internet Resource: The Cochrane Library 2013, Issue 6: Accessed July 17, 2013 at: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009287.pub2/pdf Year: 2013 Country: International URL: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009287.pub2/pdf Shelf Number: 129428 Keywords: Drug Abuse and Addiction Drug Abuse Prevention Illicit Drug Use Media Campaigns

Author: Independent Drugs Commission for Brighton & Hove Title: Independent Drugs Commission for Brighton & Hove Report Summary: There are an estimated 60,255 people in Brighton & Hove who have used illegal drugs. This represents 36% of all adults. The figures are extrapolated from the nationwide British Crime Survey – last conducted in 2011/12 - that reports on the percentage of adults (aged 16-59). Around a quarter of these ‘lifetime users’ report using in the last year, and one eighth report using in the last month. The most popular illegal drug, as in all areas of the country, is cannabis. There is also widespread use of heroin, cocaine and amphetamines, with recent increases in the use of a wide range of new psychoactive substances, some illegal and some not controlled under the Misuse of Drugs Act. It is important to remember that alcohol remains the most widely used psychoactive substance. A study conducted in 2010 identified just over 2,000 heroin and cocaine users in the city who could be identified as problem drug users – i.e. that they were dependent on one or more drugs, or were experiencing health or social problems, or were committing crimes, related to their drug use. This figure does not include those experiencing problems with drugs other than heroin or cocaine. A total of 1,442 individuals attended treatment services in the city in the financial year 2011-12. The main problem drugs reported by this group were heroin, crack cocaine, powder cocaine, and cannabis. The age profile is spread from teenagers to people in their 50s, but in general opiate and cocaine users were an older cohort than users of other drugs. The majority of treatment clients were male (71%) and white (89%). Drug related deaths have been high in Brighton & Hove, but with signs of a recent reducing trend. 50 residents of the city died in this way in 2009, but this figure had reduced to 35 in 2010, and early indications are that this reducing trend is being continued through 2011 and 2012. There are indications that this welcome decline is arising from positive action by local services in response to recommendations in coroners’ reports. Sussex police made 760 arrests for drug offences in Brighton & Hove in the financial year 2011/12. Just over half of these were for possession offences, around 40% were for supply or importation, and 5% were for production. Details: Brighton, UK: The Commission, 2013. 23p. Source: Internet Resource: Accessed July 24, 2013 at: http://www.safeinthecity.info/sites/safeinthecity.info/files/sitc/IDC%20draft%20recommendations.pdf Year: 2013 Country: United Kingdom URL: http://www.safeinthecity.info/sites/safeinthecity.info/files/sitc/IDC%20draft%20recommendations.pdf Shelf Number: 129500 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders (U.K.)

Author: Barthe, Emmanuel P. Title: Reno, Nevada Smart Policing Initiative: Reducing Prescription Drug Abuse Summary: Prescription drugs are among the fastest growing form of drugs being abused in the United States, and Nevada ranks first among the 50 states in prevalence rates. The Reno Police Department and its research partner at the University of Nevada, Reno sought to reduce prescription drug abuse throughout the Reno community by achieving three goals: 1. Increase knowledge about the problem (Education/Prevention). 2. Reduce the number of prescription pills available for illicit use (Supply Reduction). 3. Aggressively investigate and prosecute offenders (Law Enforcement Suppression). The Bureau of Justice Assistance selected the Reno Police Department to receive funding through the Smart Policing Initiative (SPI) because their program reflected the core principles of SPI, most notably collaboration, comprehensive responses, and prevention. The foundation of the Reno SPI involves a collaborative partnership between the Reno Police Department, its research partner, and key stakeholders—including non-profit coalitions (e.g., a local substance abuse coalition called Join Together Northern Nevada), pharmacies, physicians, other healthcare professionals, school district personnel, and parents and their children. The Education/Prevention component of the Reno SPI included a school-based survey that captured prescription drug use patterns among students. Survey results helped to guide the development of an informational video that was shown to more than 1,100 students across six regional schools. The Reno SPI also included specialized training for police regarding the nature of prescription drug abuse; information on how to report prescription drug offenses more accurately; relevant criminal statutes and charging methods; and pill confiscation and identification. The SPI team also developed individualized training regarding various aspects of the prescription drug abuse problem for medical professionals (many of whom reported that they had not received such training previously), including physicians and nurses, pharmacists, and dentists. More than 530 medical professionals in the Reno area received the training. The centerpiece of the Supply Reduction component involved a series of prescription drug round-ups, in which more than 750,000 pills were collected and destroyed. The Reno SPI team also distributed 800 “MedSafe” locking medicine cabinets for home use, and distributed more than 100,000 educational stickers that pharmacies placed on prescription bags given to customers. The Law Enforcement Suppression component involved the assignment of a dedicated detective to handle all prescription drug abuse and fraud cases. The Reno SPI team also opened a phone line for the medical community to report suspicious or fraudulent behavior. Early results from the program evaluation suggest that progress has been made toward reducing the availability of prescription drugs in the Reno area. The Reno SPI highlights the importance of collaboration between law enforcement and other stakeholders to address this complex problem, most notably parents and their children, medical professionals, and the prosecutor’s office. The Reno Smart Policing Initiative has been recognized by the Center for Problem-Oriented Policing, and by the White House Office of National Drug Control Policy. Details: Alexandria, VA: CNA Analysis & Solutions, 2013. 11p. Source: Internet Resource: Accessed July 24, 2013 at: http://www.cna.org/sites/default/files/research/Reno_Program_Profile.pdf Year: 2013 Country: United States URL: http://www.cna.org/sites/default/files/research/Reno_Program_Profile.pdf Shelf Number: 129502 Keywords: Drug Abuse and Addiction Drug Abuse Prevention Drug Offenders Prescription Drug Abuse (U.S.) Problem-Oriented Policing

Author: Grund, Jean-Paul Title: Coffee Shops and Compromise: Separated Illicit Drug Markets in the Netherlands Summary: Though famous for its coffee shops, where cannabis can be purchased and consumed, the Netherlands has accomplished many enviable public health outcomes through its drug policy. These include low prevalence of HIV among people who use drugs, negligible incidence of heroin use, lower cannabis use among young people than in many stricter countries, and a citizenry that has generally been spared the burden of criminal records for low level, nonviolent drug offenses. Coffee Shops and Compromise: Separated Illicit Drug Markets in the Netherlands tells the history of the Dutch approach and describes the ongoing success of the country’s drug policy. This includes the impact of the Dutch “separation of markets,” which potentially limits people’s exposure and access to harder drugs. Though coffee shops have traditionally commanded the most media attention, the Netherlands also pioneered needle exchange and safer consumption rooms, decriminalized possession of small quantities of drugs, and introduced easy-to-access treatment services. These policies, coupled with groundbreaking harm reduction interventions, have resulted in the near-disappearance of HIV among people who inject drugs and the lowest rate of problem drug use in Europe. Details: New York: Open Society Foundations, 2013. 80p. Source: Internet Resource: Accessed August 5, 2013 at: http://www.opensocietyfoundations.org/reports/coffee-shops-and-compromise-separated-illicit-drug-markets-netherlands Year: 2013 Country: Netherlands URL: http://www.opensocietyfoundations.org/reports/coffee-shops-and-compromise-separated-illicit-drug-markets-netherlands Shelf Number: 129535 Keywords: Drug Abuse and Addiction Drug Markets Drug Policy Illicit Drugs (Netherlands) Marijuana

Author: Macgregor, Sarah Title: Synthetic Cannabis: Prevalence of use among offenders, perception of risk and negative side effects experienced Summary: Key Points -- • Of 871 police detainees surveyed through the Drug Use Monitoring in Australia (DUMA) program, 4 per cent reported recent use of synthetic cannabis. This compares to almost half (46%) who reported recent use of natural cannabis • The most common source for obtaining synthetic cannabis (aside from ‘a friend’) was from some type of shop (42%) such as a tobacconist or sex shop • At the time of interview, several synthetic compounds had been added to Schedule nine of the 2011 Commonwealth Poisons Standard by the TGA and statewide bans on the possession and distribution of synthetic cannabis products had occurred in every jurisdiction. However over half (60%) of users still believed synthetic cannabis was legal to buy at the time • The majority of detainees did not agree that synthetic cannabis is safer to use than natural cannabis, and 33 detainees reported experiencing some type of negative side effect • Most common side effects included dizziness/nausea/vomiting (26%), paranoia/panic (18%) and headaches (15%). Other symptoms included delusional behaviour/anger outbursts, hallucinations and heart palpitations/chest pains requiring emergency care • The range of negative side effects experienced by detainees from using synthetic cannabis products raises concerns for treatment providers and correctional officers who deal with drug-using offenders, given that consumers of synthetic cannabinoids could be placing themselves at risk of harm and displaying unpredictable behaviour • Evidence from overseas suggests that banning a range of specific synthetic cannabinoid compounds has led to the increased availability of more harmful compounds with more severe side effects, on the market. Details: Canberra: Australian Institute of Criminology, 2013. 10p. Source: Internet Resource: Criminal Justice Bulletin Series 11: Accessed August 19, 2013 at: http://ncpic.org.au/ncpic/publications/aic-bulletins/pdf/synthetic-cannabis-prevalence-of-use-among-offenders-perception-of-risk-and-negative-side-effects-experienced Year: 2013 Country: Australia URL: http://ncpic.org.au/ncpic/publications/aic-bulletins/pdf/synthetic-cannabis-prevalence-of-use-among-offenders-perception-of-risk-and-negative-side-effects-experienced Shelf Number: 129660 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Marijuana Synthetic Cannabis (Australia)

Author: Barrett, Damon Title: Injecting Drug Use Among Under-18s: A Snapshot of Available Data Summary: Young people who inject drugs have specific developmental, social and environmental vulnerabilities. They are less likely to use harm reduction and treatment services and are less informed about risks and their rights. Early onset of injecting, and being a new injector, have been associated with increased risks of HIV and hepatitis C transmission, while specific groups of young people, especially those that are street involved, are at considerably higher risk. The legal status of being a minor, meanwhile, raises challenges for both achieving a better understanding of the situation and for the development of targeted harm reduction interventions. This report is the first attempt to provide a global snapshot of available data on injecting drug use among children and young people under the age of 18. Based on desk research and expert questionnaires it finds that injecting among under-18s represents a data 'blind spot' impeding our ability to assess service need and to estimate budgetary implications. Available studies that have looked at injecting among this age group, however, provide important insights from every region and make a clear case for more action. Details: London: Harm Reduction International, 2013. 78p. Source: Internet Resource: Accessed January 31, 2014 at: http://www.ihra.net/files/2013/12/12/injecting_among_under_18s_snapshot_WEB1.pdf Year: 2013 Country: International URL: http://www.ihra.net/files/2013/12/12/injecting_among_under_18s_snapshot_WEB1.pdf Shelf Number: 131813 Keywords: Drug Abuse and Addiction Harm Reduction

Author: d'Abbs, Peter Title: Monitoring Trends in Prevalence of Petrol Sniffing in Selected Aboriginal Communities: An Interim Report Summary: This report presents interim findings from a study of petrol sniffing prevalence in a sample of Australian Aboriginal communities that commenced in 2011 and is scheduled for completion in 2014. The study was commissioned by the Commonwealth Department of Health and Ageing in order to contribute to monitoring the impact of an ongoing rollout of low aromatic fuel (LAF) in communities beset by petrol sniffing, and is being conducted by Menzies School of Health Research, Darwin, in partnership with Bowchung Pty Ltd, Canberra. Preparation of the report is also a response to a recommendation by the Senate Community Affairs Committee which, in a report of an inquiry into the Low Aromatic Fuel Bill tabled in 2012, stated: The committee recommends that the Government release an interim report based on the first round of data collection being undertaken by the Menzies School of Health Research. (Senate Community Affairs Legislation Committee, 2012, Recommendation 1). The report contains four sections: 1. background to attempts to date to monitor prevalence of petrol sniffing in Australian Aboriginal communities in general and, in particular, to monitor the impact of rolling out LAF; 2. methodological issues entailed in monitoring prevalence of petrol sniffing in communities; 3. the methodology adopted in the present study; and 4. interim findings of the study to date. Details: Darwin: Menzies School of Health Research, 2013. 34p. Source: Internet Resource: Accessed March 12, 2014 at: http://www.menzies.edu.au/icms_docs/176151_Final_Menzies_interim_report_May_2013.pdf Year: 2013 Country: Australia URL: http://www.menzies.edu.au/icms_docs/176151_Final_Menzies_interim_report_May_2013.pdf Shelf Number: 131861 Keywords: Aboriginals Drug Abuse and Addiction Petrol Sniffing

Author: Calafat, Amador Title: Night Life in Europe and Recreative Drug Use. SONAR 98. Summary: Young Europeans of the third millennium are the inheritors of a society defined in terms of consumption and opulence. These are young people born in the welfare society where leisure and entertainment take on a hegemonic value in social structure criteria. In contrast to the industrial order of a society orientated towards work and production, leisure time emerges as a restoration force of the individual qualities disguised or repressed by working conditions. Leisure is, therefore, defined as a success in welfare societies, as the space where individuals are liberated from the obligations imposed on them by the labour world, etiquette and routine, in order to devote time to those other activities which are freely chosen and which enable them to expand their better qualities. But leisure has also been assimilated by the market and is being defined by consumption criteria which have given rise to a very active leisure industry which is well-established and ever-expanding with an active role in creating life style criteria. Having the free time to devote to "oneself ", to "liberate oneself ", is already a criterion in the definition of the quality of life and, therefore, a necessity. But experiencing leisure does not only depend on having free time but on doing something in this time which is supposedly one's own, doing something considered creative and liberating, and taking part in the leisure industry. One of the social groups which has most appropriated the leisure space is the one comprising young people and this has led to the expansion of an industry and a market specifically engaged in promoting a supply of products, places and services, exclusively for this group. In particular, juvenile recreation is one of those sectors which has seen enormous expansion in the last twenty years, with activities closely linked to the weekends and holiday season, and which take place in specific spaces where the music, fashion and the use of legal and illegal addictive substances create the context of the entertainment. At the same time, the changes produced in this organisation of time are fundamental to understanding the dynamic of post-modern societies. Whereas the majority of activities relating to social reproduction, such as work, family life, studies, travel, etc., take place during the day, the night is the period of time devoted to rest, leisure and entertainment. During the night, although the majority of people remain in their houses, relaxing or sleeping, a part of the population, which includes a large number of young people, choose the night to go out and enjoy themselves, to take part in a ritualised meeting which may be with friends or with those people with whom they most identify themselves or with whom they can share the activities appropriate to that time. The places where the young people go are generally public spaces distributed in different areas of the city, and in each one of these places an environment has been created to suit specific activities. The environment, the dress, the type of people and the music, in particular, are the principal elements in giving these places their identity. Details: Palma de Mallorca, Spain: IREFREA and European Commission, 242p. Source: Internet Resource: Accessed March 12, 2014 at: http://www.irefrea.org/uploads/PDF/Calafat%20et%20al_1999_SONAR%2098.pdf Year: 1999 Country: Europe URL: http://www.irefrea.org/uploads/PDF/Calafat%20et%20al_1999_SONAR%2098.pdf Shelf Number: 131876 Keywords: Drug Abuse and Addiction Illegal Drugs

Author: Young, Nancy K. Title: Needs Assessment Report Summary: The purpose of this Family Drug Court Needs Assessment (FDC-NA) is to identify the training and technical assistance (TTA) needs of Family Drug Courts (FDC). The Center for Children and Families Futures (CCFF) designed and developed methods to collect and analyze data from multiple sources to identify FDC TTA needs. Primary data collection and analyses were conducted in different formats: - FDC TTA online survey-which asked FDC practitioners to rate the extent they were experiencing barriers in implementing key FDC strategies and identify specific barriers and TTA needs of their FDC - In-depth stakeholder interview with State and Federal stakeholders-to gather their input on the TTA needs of FDCs and feedback on preliminary findings of the FDC-NA Secondary analysis was conducted from three data sources: 1) Technical Assistance (TA) Tracker-which is a web-based data system used by CCFF to manage and analyze the content of previously received TTA requests 2) Post-webinar online surveys-completed by attendees from the FDC Learning Academy regarding their feedback on priority content for future webinar presentations 3) FDC Self-Assessment Surveys-administered to 16 jurisdictions regarding their level of agreement in implementing key FDC recommendations. Through this design and process of the FDC-NA, CCFF was able to draw from its prior TTA work and garner input from FDC practitioners and stakeholders in determining the current TTA needs of FDCs. The findings showed widespread interest in and the need for TTA across a broad range of topics. A synthesis of the data revealed four priority content areas and specific topics for TTA: 1) Services to Parents-Respondents cited the challenges of meeting the complex and multiple needs of parents as a result of trauma, dual-diagnosis, domestic violence and the use of medication-assisted treatment (MAT). Specific content for TTA included engagement and retention strategies, recovery supports, and serving parents in MAT. 2) Funding and Sustainability-A lack of continued funding for staff positions, treatment and a broad service array were raised as barriers to sustaining FDCs. There is a need to engage sites in active sustainability planning by exploring barriers and working towards strategic activities including cost analyses, the use of baseline measures and outcome data, and exploring refinancing and redirection strategies. 3) Cross-Systems Knowledge-A need for ongoing cross-system training to bridge the divisions between professional disciplines, agency mandates, values and practice was cited frequently by respondents. These include training in gender-specific issues, trauma, co-occurring conditions, enhancing motivation and dynamics of addiction and recovery. Details: Lake Forest, CA: Center for Children and Family Futures, 2014. 44p. Source: Internet Resource: Accessed March 17, 2014 at: http://www.cffutures.com/files/publications/OJJDP_TTA_NAR_2014.pdf Year: 2014 Country: United States URL: http://www.cffutures.com/files/publications/OJJDP_TTA_NAR_2014.pdf Shelf Number: 131940 Keywords: Drug Abuse and Addiction Drug Offenders Family Drug Courts Problem Solving Courts

Author: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) Title: Drugs and Vulnerable Groups of Young People Summary: Social policy in Europe has long identified disadvantaged populations who manifest potential for marginalisation and social exclusion. hese �vulnerable groups� are specific groups among the wider population that may be more prone to a range of problems, from ill health, substance use and poor diet, to lower educational achievement. In the area of illicit drug use, vulnerability and vulnerable groups are gaining increased attention on the European drug policy agenda, particularly as regards young people and drug use. Vulnerability as it relates to drugs is defined in this Selected issue as whether a specific group, based on sociodemographic profile and related risk factors, has an increased susceptibility to drug use and related problems. Groups identified as vulnerable � examples include �children in care institutions� or �homeless young people� � might be prone to earlier, more frequent, or more problematic drug use. They might also experience faster progression to problem drug use. As levels of both current drug use and the risks of developing drug-related problems are likely to be much higher among vulnerable groups, these groups are being given special attention in terms of demand reduction responses. Identifying these groups is important because direct assessment of drug use at the population level � for example, through large-scale screening � is often not feasible. Furthermore, selecting individuals based on individual risk factors may prove both difficult and problematic. So identifying vulnerable groups is becoming an important tool for directing or channelling policy responses at those groups or geographical areas where problem drug use is more likely to develop. This is particularly the case for those groups which might not perceive their drug use as problematic. In Europe, interventions targeted at vulnerable groups � referred to as �selective prevention� (1) � are gaining both increased policy visibility, and maturity in terms of design and evaluation. This Selected issue examines aspects of social vulnerability at the group or geographical level in Europe, focusing specifically on young people in the age-group 15�24. There is a need to find more effective ways to approach and involve vulnerable young people in demand reduction interventions, in a manner which reflects their immediate sociodemographic context. The report includes examples drawn from the EDDRA database to illustrate some of the interventions carried out in Europe. Details: Luxembourg: Office for Official Publications of the European Communities, 2008. 40p. Source: Internet Resource: Selected Issue 2008: Accessed March 20, 2014 at: http://www.emcdda.europa.eu/attachements.cfm/att_64250_EN_EMCDDA_SI08_vulnerable-young.pdf Year: 2008 Country: Europe URL: http://www.emcdda.europa.eu/attachements.cfm/att_64250_EN_EMCDDA_SI08_vulnerable-young.pdf Shelf Number: 131988 Keywords: At-Risk Youth Drug Abuse and Addiction Drug Abuse Prevention

Author: Baldwin, Simon Title: Drug Policy Advocacy in Asia: Challenges, Opportunities and Prospects Summary: This report was commissioned by the International Drug Policy Consortium (IDPC), with the support of Australian Aid, for the purpose of developing a better understanding of drug policy advocacy activity in 10 Asian countries: Cambodia, China, India, Indonesia, Lao PDR, Malaysia, Myanmar, the Philippines, Thailand, and Vietnam. It aims to achieve three goals: - Identify organisations engaged in harm reduction and drug policy advocacy - Identify gaps and challenges in harm reduction and drug policy advocacy that remain to be addressed - Develop recommendations for prioritising new activities in harm reduction and drug policy advocacy. The report does not provide an exhaustive review of drug policy content, rather it focuses on the process of drug policy making and attempts to understand the relationships between key stakeholders, including both policy makers and policy advocates, engaged in policy processes at local and regional level. The report combines data collected from published reports with key informant interviews to draw its conclusions. Details: London: International Drug Policy Consortium, 2013. 66p. Source: Internet Resource: Accessed March 20, 2014 at: http://dl.dropboxusercontent.com/u/64663568/library/IDPC-report-drug-policy-in-South-East-Asia.pdf Year: 2013 Country: Asia URL: http://dl.dropboxusercontent.com/u/64663568/library/IDPC-report-drug-policy-in-South-East-Asia.pdf Shelf Number: 131995 Keywords: Drug Abuse and Addiction Drug Control Drug Policy

Author: Van Buskirk, J. Title: Drugs and the Internet Summary: To date the availability of illicit drugs in Australia has largely been examined through interviews with people who use drugs (e.g. the Ecstasy and related Drugs Reporting System, EDRS); indicators such as drug seizures and arrests; and analyses of hospital admissions and drug-related deaths. Over the past decade there has been an increasing awareness and interest in online marketplaces as a source for discussion about and purchase of drugs (Walsh, 2011). There are now many internet sites selling substances such as prescription opioids, substances marketed as �legal� highs (e.g. herbal smoking blends) and substances that have been listed as controlled drugs (e.g. emerging psychoactive substance � EPS � such as mephedrone and synthetic cannabinoids). EPS is a general term used to refer to substances that have similar subjective effects to existing illicit psychoactive substances, and many of these are now listed as controlled drugs (i.e. they are now illicit) in Australia. The advent of the Silk Road in 2011, as an online marketplace, has broadened out the availability of EPS and other more conventional illicit substances (such as cannabis and MDMA). This bulletin is the first in a new Drug Trends series that provides analysis of trends over time in the availability and type of substances sold via the internet to Australia. The current bulletin reports for the time period September 2012 to February 2013. Key findings � The number of retailers on the Silk Road increased (from 282 at time 1 to 374 at the last time point), while the number of retailers on the surface web remained relatively stable (92 at time 1 and 101 at the last time point). The increase on the Silk Road is largely driven by international rather than domestic retailers. � On the Silk Road, cannabis and EPS were sold by the largest number of retailers consistently across all time points, followed by MDMA (3,4-methylenedioxy-Nmethylamphetamine) and pharmaceuticals (primarily benzodiazepines and sildenafil). � The type of EPS available from surface web retailers differed substantially from the EPS available from those selling on the Silk Road. EPS sold on the Silk Road more closely mirrored those most commonly used by EDRS participants (i.e. people who regularly use psychostimulants) including drugs from the 2C-x and NBOMe categories, followed by DMT (dimethyltryptamine), Mephedrone and Methylone. Average prices of methamphetamine, cocaine and ecstasy being sold on the Silk Road remained stable across the time period. Average domestic prices for common quantities of these substances were comparable to prices paid for these same quantities by 2012 EDRS participants. Average international prices for these substances were substantially lower. Details: Sydney: National Drug and Alcohol Research Centre, 2013. 11p. Source: Internet Resource: Issue 1: Accessed March 21, 2014 at: http://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/DrugsTheInternet_Newsletter%20FINAL%20with%20ISSN.pdf Year: 2013 Country: Australia URL: http://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/DrugsTheInternet_Newsletter%20FINAL%20with%20ISSN.pdf Shelf Number: 104854 Keywords: Drug Abuse and Addiction Illicit Drugs Internet Online Communications Online Transactions

Author: Khalifa, Najat Title: Harm Reduction: Evidence, Impacts and Challenges Summary: Harm reduction is now positioned as part of the mainstream policy response to drug use in Europe. However, this has not always been the case, and in reflecting on this fact we felt that the time was right to take stock of how we had arrived at this position, ask what it means for both policies and action, and begin to consider how harm reduction is likely to develop in the future. This monograph builds on other titles in the EMCDDA's Scientific monographs series, where we have taken an important and topical subject, assembled some of the best experts in the field, and allowed them to develop their ideas constrained only by the need to demonstrate scientific rigour and sound argument. Our Scientific monographs are intended to be both technically challenging and thought provoking. Unlike our other publications we take more of an editorial 'back seat' and we do not seek consensus or necessarily to produce a balanced view. Good science is best done when unconstrained, and best read with a critical eye. This volume includes a variety of perspectives on harm reduction approaches, together with an analysis of the concept's role within drug policies, both in Europe and beyond. Readers may not necessarily agree with all of the arguments made or the conclusion drawn, but we hope it is perceived as a valuable contribution to the ongoing debate on how to respond to contemporary drug problems in Europe. A number of contributors explore what harm reduction means and what policies it can encompass, as well as charting how the concept evolved. They reflect on the point we have now reached in terms of both harm reduction practice and the evidence base for its effectiveness. A major issue that many contributors touch on is the difficulty of assessing how complex interventions occurring in real world settings can be evaluated, and why conclusive evidence in such settings can be so elusive. With an eye to the future, we also asked our contributors to wrestle with the difficult issue of how harm reduction might be extended into new areas that are of particular relevance to the evolving European drug situation. Here the empirical base for grounding discussions is far less developed, and a more exploratory approach is necessary. Details: Lisbon: European Monitoring Centre for Drugs and Drug Addiction, 2010. 469p. Source: Internet Resource: EMCDDA Monographs 10: Accessed March 28, 2014 at: http://www.emcdda.europa.eu/attachements.cfm/att_101257_EN_EMCDDA-monograph10-harm%20reduction_final.pdf Year: 2010 Country: Europe URL: http://www.emcdda.europa.eu/attachements.cfm/att_101257_EN_EMCDDA-monograph10-harm%20reduction_final.pdf Shelf Number: 132020 Keywords: Drug Abuse and Addiction Drug Abuse Policy Drug Abuse Treatment Drug Policy Illicit Drugs

Author: Broadhurst, Kate Title: Consultation with Young People/Parents and Carers in Leicestershire Summary: As part of the Every Child Matters guidance, public funded bodies must now demonstrate how children and young people participate in the design, delivery and evaluation of the services they use. Leicestershire YOS commissioned Perpetuity to consult with young people and their parents/carers to understand how best to actively engage them in the planning and commissioning of substance misuse services. The YOS was also provided with key findings on service users' experience of the service they received, their awareness of services, as well as recommendations for improvement in a succinct report. Details: Leicester, UK: Perpetuity Research & Consultancy International, 2008. 48p. Source: Internet Resource: Accessed April 19, 2014 at: http://perpetuityresearch.com/778/youth-offending-service-consultation-with-young-people-parents-and-carers-in-leicestershire/ Year: 2008 Country: United Kingdom URL: http://perpetuityresearch.com/778/youth-offending-service-consultation-with-young-people-parents-and-carers-in-leicestershire/ Shelf Number: 132071 Keywords: Drug Abuse and Addiction Drug Abuse Prevention Drug Abuse Treatment

Author: DrugScope Title: State of the Sector 2013 Summary: The report, State of the Sector 2013 (1), contains the findings from a survey of nearly 170 drug and alcohol services, from across England's four Public Health England regions. It finds the drug and alcohol sector in a period of flux and facing a number of challenges: - Respondents highlighted significant problems in their ability to offer clients support to improve recovery capital, particularly employment, housing and mental and physical wellbeing; - The picture on engagement with Health and Wellbeing Boards (HWBs) and Police and Crime Commissioners (PCCs) is mixed, with positive examples, but other services reporting a lack of engagement; - 35 per cent of drug and alcohol services surveyed reported a decrease in funding, against 20 per cent reporting an increase and 33 per cent no change; - Just over half reported a large increase in caseloads in the last year, against 27 per cent reporting a decrease; - Almost half reported that they were employing fewer frontline staff and 6 out of 10 services reported an increase in the use of volunteers. The research comprised an online survey, a series of regional summits and telephone interviews with chief executives of treatment providers. It was carried out in the autumn of 2013, nearing the end of a pivotal year for drug and alcohol services in which many funding and commissioning structures were replaced with new and in some cases substantially different organisations. It is intended that further research will be carried out in 2014 to investigate how services are coping with these changes, using these findings as a baseline. Details: London: DrugScope, 2014. 96p. Source: Internet Resource: Accessed April 19, 2014 at: http://www.drugscope.org.uk/Resources/Drugscope/Documents/PDF/Policy/SOS2013_Main.pdf Year: 2013 Country: United Kingdom URL: http://www.drugscope.org.uk/Resources/Drugscope/Documents/PDF/Policy/SOS2013_Main.pdf Shelf Number: 132076 Keywords: Alcohol Abuse Drug Abuse and Addiction Drug Treatment Substance Abuse Treatment

Author: United Nations Office on Drugs and Crime (UNODC) Title: Impacts of Drug Use on Users and their Families in Afghanistan Summary: Afghanistan is the world's largest producer and cultivator of opium poppies; it produces almost three quarters of the world's illicit opium. While a significant amount of the opium produced in Afghanistan is trafficked out of the country, in 2009 it was estimated that almost 10 per cent of Afghans aged between 15 and 64 were drug users. Based on interviews with drug users, the family members of drug users, key informants and Government officials, this study aims to provide an insight into the origins, evolution and impact of drug use on users and their families across Afghanistan. While the study is not nationally representative, it seeks to enhance understanding of drug use in Afghanistan and provide information to help strengthen prevention and treatment policies. All the drug users interviewed during the study were "problem drug users", who used drugs such as opium, heroin, hashish and tranquillizers (for non-medical use) daily or several times a week. Although the use of amphetamine-type stimulants (ATS) is rising in Afghanistan, the number of ATS users remains small and that group was not interviewed for the present research study. Details: New York: UNODC, 2014. 120p. Source: Internet Resource: Accessed April 21, 2014 at: http://www.unodc.org/documents/data-and-analysis/Studies/Impacts_Study_2014_web.pdf Year: 2014 Country: Afghanistan URL: http://www.unodc.org/documents/data-and-analysis/Studies/Impacts_Study_2014_web.pdf Shelf Number: 132097 Keywords: Drug Abuse and Addiction Drug Abuse Prevention Drug Abuse Treatment Families of Drug Users

Author: Mansfield, David Title: Eyes Wide Shut: Counter-Narcotics in Transition Summary: It is now clear that the production and trade of opiates will have a significant influence on not only the economic, political and security landscape, but even the physical terrain of post-Transition Afghanistan. Levels of opium poppy cultivation are already rising; estimated cultivated area rose by 18 percent in 2012 and is likely to rise significantly over the next few years. And this trend may intensify further as politico-military actors make deals and form coalitions in response to the 2014 handover of security responsibility from the North Atlantic Treaty Organisation (NATO) to the Afghan National Security Forces (ANSF). Even while NATO forces remain, the coercive power of the Afghan state has diminished in parts of provinces previously described as "models" for counter-narcotics efforts. In provinces such as Helmand and Nangarhar, there is likely to be a return to widespread opium poppy cultivation in the more accessible and fertile areas as NATO and the ANSF cease to operate outside the areas where the state has a history of control. As security forces withdraw, the state has either relinquished control of such territory to anti-government elements (AGEs), or delegated it to local power brokers who may have little interest in reducing opium poppy cultivation, and may even encourage it. Further increases in cultivation are also likely as opium poppy returns in greater amounts to some of the provinces previously deemed "poppy free," such as Ghor, Laghman and even Balkh. Perhaps more worrying is the potential for an expansion of opium into previously uncultivated areas of desert land in the South. The adoption of new technologies-such as deep wells, herbicides and solar power-will likely aid cultivation in these areas, reducing the cost of inputs and increasing productivity. Meanwhile, ill-sequenced and poorly-targeted counter-narcotics and development efforts coupled with a continuing global demand for opiates provide additional incentives for production. Increasing levels of cultivation have wider implications for the political economy of the country. In an increasingly contested rural space, narcotics and counter-narcotics policies are both likely to be a major source of patronage and division. The Taliban have a history of actively encouraging opium poppy cultivation as part of a strategy to gain the support of the rural population and highlight the weakness of provincial administration. By provoking crop destruction as part of counter-narcotics efforts, this strategy also increases rural antipathy to the state and its international partners. The myriad different local security forces operating under the sometimes loose supervision of Afghan and international military forces are less coherent. In some areas of Kandahar and Helmand the Afghan Local Police (ALP) are pursuing an aggressive counter-narcotics effort, conscious that they may lose their salaries and patronage if they do not. In other parts of these provinces as well as in Balkh, farmers allege that members of the ALP and even the Afghan Border Police either benefit from poppy cultivation or grow it themselves. Details: Kabul, Afghanistan: Afghanistan Research And Evaluation Unit, 2013. 28p. Source: Internet Resource: Briefing Paper Series: Accessed April 23, 2014 at: http://www.areu.org.af/Uploads/EditionPdfs/Opium%20BP.pdf Year: 2013 Country: Afghanistan URL: http://www.areu.org.af/Uploads/EditionPdfs/Opium%20BP.pdf Shelf Number: 132135 Keywords: Drug Abuse and Addiction Drug Control Policy Narcotics Opium Poppy Cultivation

Author: Fishstein, Paul Title: Evolving Terrain: Opium Poppy Cultivation in Balkh and Badakhshan Provinces in 2013 Summary: It is generally assumed that there will be significant increases in the level of opium poppy cultivation after the critical year 2014, when international military combat forces will withdraw and Afghanistan will select its next president. In 2012-13, at the national level, area cultivated increased for the third consecutive year, and total opium production rose significantly. With 410 hectares (ha) of opium poppy recorded in the province, for the first time since 2007 Balkh is no longer classified as "poppy-free," while Badakhshan saw an increase of 23 percent in area cultivated, despite reported eradication of the largest area of any province. Details: Kabul: Afghanistan Research and Evaluation Unit, 2014. 64p. Source: Internet Resource: Accessed April 23, 2014 at: http://www.areu.org.af/Uploads/EditionPdfs/Poppy%20Cultivation%20in%20Balkh%20Badakhshan%20Case%20Study.pdf Year: 2014 Country: Afghanistan URL: http://www.areu.org.af/Uploads/EditionPdfs/Poppy%20Cultivation%20in%20Balkh%20Badakhshan%20Case%20Study.pdf Shelf Number: 132136 Keywords: Drug Abuse and Addiction Drug Trade Narcotics Opium Poppy Cultivation

Author: Pew Research Center Title: America's New Drug Policy Landscape: Two-Thirds Favor Treatment, Not Jail, for Use of Heroin, Cocaine Summary: The public appears ready for a truce in the long-running war on drugs. A national survey by the Pew Research Center finds that 67% of Americans say that the government should focus more on providing treatment for those who use illegal drugs such as heroin and cocaine. Just 26% think the government's focus should be on prosecuting users of such hard drugs. Support for a treatment-based approach to illegal drug use spans nearly all demographic groups. And while Republicans are less supportive of the treatment option than are Democrats or independents, about half of Republicans (51%) say the government should focus more on treatment than prosecution in dealing with illegal drug users. As a growing number of states ease penalties for drug possession, the public expresses increasingly positive views of the move away from mandatory sentences for non-violent drug crimes. By nearly two-to-one (63% to 32%), more say it is a good thing than a bad thing that some states have moved away from mandatory sentences for non-violent drug offenders. In 2001, Americans were evenly divided over the move by some states to abandon mandatory drug terms. The survey by the Pew Research Center, conducted Feb. 14-23 among 1,821 adults, finds that support for the legalization of marijuana use continues to increase. And fully 75% of the public - including majorities of those who favor and oppose the legal use of marijuana - think that the sale and use of marijuana will eventually be legal nationwide. Details: Washington, DC: Pew Research Center, 2014. 25p. Source: Internet Resource: Accessed April 23, 2014 at: http://www.people-press.org/files/legacy-pdf/04-02-14%20Drug%20Policy%20Release.pdf Year: 2014 Country: United States URL: http://www.people-press.org/files/legacy-pdf/04-02-14%20Drug%20Policy%20Release.pdf Shelf Number: 132147 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Abuse Policy Drug Enforcement Drug Offenders Drug Policy (U.S.) Drug Treatment Illegal Drugs Public Opinion

Author: United Nations Office on Drugs and Crime (UNODC) Title: Afghanistan Opium Survey 2013 Summary: Opium poppy cultivation in Afghanistan reached a sobering record high in 2013. According to the 2013 Afghanistan Opium Survey, cultivation amounted to some 209,000 hectares, outstripping the earlier record in 2007 of 193,000 hectares, and representing a 36 per cent increase over 2012. Moreover, two provinces that had previously been declared poppy-free, Faryab and Balkh in northern Afghanistan, lost this status. All in all, opium production in 2013 went up to some 5,500 tonnes, a 49 per cent increase over 2012. The hazard this situation poses to health, stability and development, and not only in Afghanistan, is well documented and has been internationally recognized frequently. At the same time, Afghanistan's counter narcotic institutions, also with the support of UNODC, have taken a significant step forward in terms of capacity and effectiveness. The Ministry of Counter Narcotics has moved quickly to advance policy and guidelines, as per its mandate. The Counter Narcotics Police of Afghanistan is still far from achieving the seizure rate witnessed in other producing countries, but police have nevertheless tripled their effectiveness over recent years to capturing well over 10 per cent of domestic production. The number of arrests, prosecutions and convictions of powerful figures remains a concern, but progress has also been witnessed with two high profile cases this year. Finally, available services in country to deal with a growing addiction problem have expanded from 30 to 90. These are tangible and hopeful signs of improvement. In order to be successful and sustainable, counter-narcotics efforts must finally break out of their insular, silo approach. If the drug problem is not taken more seriously by aid, development and security actors, the virus of opium will further reduce the resistance of its host, already suffering from dangerously low immune levels due to fragmentation, conflict, patronage, corruption and impunity. What is needed is an integrated, comprehensive response to the drug problem, embedded in a long-term security, development and institution-building agenda. Details: Vienna: UNODC, 2013. 117p. Source: Internet Resource: Accessed April 24, 2014 at: http://www.unodc.org/documents/crop-monitoring/Afghanistan/Afghan_Opium_survey_2013_web_small.pdf Year: 2013 Country: Afghanistan URL: http://www.unodc.org/documents/crop-monitoring/Afghanistan/Afghan_Opium_survey_2013_web_small.pdf Shelf Number: 132160 Keywords: Drug Abuse and Addiction Narcotics Opium Abuse (Afghanistan)

Author: United Nations Office on Drugs and Crime (UNODC) Title: Regional Programme for Southeast Asia 2014 - 2017. Promoting the Rule of Law and Health to Address Drugs and Crime in Southeast Asia Summary: The Regional Programme (RP) outlines the proposed scope and focus of UNODC's work in Southeast Asia from 2014 to 2017. It provides a framework for delivering a coherent programme of work to: (i) give clear focus to supporting Member States and regional partners in achieving priority crime and drug outcomes in the region; and (ii) increase the responsiveness, efficiency and effectiveness of UNODC's support to the region. The RP focuses primarily on regional crime and drug challenges that are best addressed through coordinated cross-border and intra-regional cooperation. UNODC Country Programs (where they exist) are linked to the Regional Programme and focus on specific national level needs and support requirements. The RP is supported by an expert team that ensures consistency of approach and the sharing of expertise between jurisdictions. The proposed programme of work has been developed in close consultation with countries of the region and other regional partners, and the situation analysis includes: A profile of UNODC's global strategy, governing bodies and mandates A brief description of the broad regional development context An overview of the key drugs and crime challenges facing the region. Particular attention is given to: (i) transnational organised crime and illicit trafficking; (ii) anti-corruption; (iii) terrorism prevention; (iv) criminal justice; and (v) drugs and health, and alternative development A profile of regional institutions and initiatives relevant to UNODC's mandates and work. Details: Bangkok: UNODC, 2014. 84p. Source: Internet Resource: Accessed April 28, 2014 at: https://www.unodc.org/documents/southeastasiaandpacific/Publications/2013/SEA_RP_masterversion_6_11_13.pdf Year: 2014 Country: Asia URL: https://www.unodc.org/documents/southeastasiaandpacific/Publications/2013/SEA_RP_masterversion_6_11_13.pdf Shelf Number: 132196 Keywords: Drug Abuse and Addiction Drug Control Drug Trafficking Drugs and Crime Organized Crime

Author: Inter-American Commission of Women Title: Women and Drugs in the Americas: A Policy Working Paper Summary: During the sixth summit of the Americas (April 2012, Cartagena), leaders of various countries of the Americas issued a mandate to the Organization of American States (OAS) to analyze current drug policies and explore new approaches, with a view to developing viable alternatives that would effectively regulate the production, trade, and consumption of drugs of illicit substances while alleviating the violence and harm associated with current approaches to this issue. Since then, the hemispheric response to the "World Drug Problem" has been a changing landscape, and many more leaders have since called for reform of international and national-level drug policies to include more effective and humane alternatives to dealing with this global crisis. Previous measures to suppress drug production and consumption have been extreme, and have often proved ineffective. Methods such as aerial fumigation to suppress cultivation or mass incarceration as a response to drug consumption and small scale trafficking, have taken governments and societies further away from their original objective of preventing drug misuse and guaranteeing universal access to health and treatment for addiction, as set out in the 1961 convention on narcotic drugs. These first UN conventions of 1961 and 1971, prepared primarily from a punitive and prohibitionist perspective, created and sustained a 'War on Drugs' mentality. The 'War on Drugs' - a rhetorical device coined under former US President Nixon's leadership - has been progressively abandoned by the majority of States in the region (including the United States), who now recognize a need for drug policy reform and a more realistic, evidence-based approach to the changing and growing phenomenon of illicit drugs and their related issues. This paradigm shift has generated a number of alternative proposals and responses to the complex issue of drugs, including the promotion of a public health approach that favours treatment instead of incarceration, the safeguarding of human rights, and the endorsement of human rights-based and harm-reduction strategies to address the violence inherent in the trafficking of illicit substances, as well as the stigma attached to their use. At the United Nations (UN) General Assembly in September 2013, Colombia, Mexico, and Guatemala, among other States, spoke of the urgent need to explore alternatives to the "War on Drugs." Uruguay presented a proposal to create the world's first national, non-medical, regulated market for cannabis. This bill has since been signed into law, the regulation for which is currently being designed and is expected to take effect later this year. Uruguay's non-punitive response to drug use comes at a time when many transit countries, including Guatemala, have experienced a gradual shift in attitudes and approaches around mitigating the harms of the drugs trade on their local communities. In transit countries, the negative effects of the illicit drugs industry on human and economic development are most keenly felt, and exacerbated by punitive policies that tend to affect vulnerable members of society who might participate in the drug trade due to financial crises and coercion at the lower level of the commercialization ladder. Claims by the media, paired with the scarce data available suggest that in the last two decades, the participation of women in the trade of illicit drugs has increased significantly. Nevertheless, while this participation is visible in the news, it has been largely absent from the research and other activities of most governmental and inter-governmental bodies. In general, we know relatively little about the people that participate in the question of illicit drugs - be they men or women. As usually happens in other areas, we understand even less about women's participation and we tend to interpret it through assumptions and stereotypes that on the one hand, complicate an adequate understanding of the social, economic, and cultural factors that determine this participation and, on the other hand, produce negative effects for women in terms of increased social stigmatization of their participation. Details: Washington, DC: Inter-American Commission of Women, 2014. 48p. Source: Internet Resource: Policy Working Paper: Accessed May 3, 2014 at: http://www.oas.org/en/cim/docs/WomenDrugsAmericas-EN.pdf Year: 2014 Country: South America URL: http://www.oas.org/en/cim/docs/WomenDrugsAmericas-EN.pdf Shelf Number: 132203 Keywords: Drug Abuse and Addiction Drug Policy Reform Female Drug Offenders Substance Abuse Treatment War on Drugs

Author: Drummond, Anne Title: Study on the Prevalence of Drug Use, Including Intravenous Drug Use, and Blood-Borne Viruses among the Irish Prisoner Population Summary: Accurate up-to-date data on the extent of drug use and the prevalence of blood-borne viruses among the prisoner population are a necessary pre-requisite for health and social service planning and policy development. The most recent national study assessing the prevalence of blood-borne viruses, along with self-reported drug use within Irish prisons (Allwright et al., 1999), was carried out over a decade ago. This study was commissioned by the National Advisory Committee on Drugs (NACD) in 2010 with the following objectives: to describe the nature, extent and pattern of consumption for different drugs among the prisoner population; to describe methods of drug use, including intravenous drug use, among the prisoner population; to estimate the prevalence of blood-borne viruses among the prisoner population and to identify associated risk behaviours; and to measure the uptake of individual drug treatment and harm reduction interventions (including hepatitis B vaccination) in prison. Methods An observational cross-sectional study, targeting all prisons and prisoners in Ireland, was carried out in early 2011. Prisoners were selected at random in proportion to the population in each prison. A detailed, validated and piloted self-completion questionnaire was administered to prisoners under the supervision of the research team. Oral fluid samples were taken for assessment of drugs of abuse and blood-borne viruses. Overall 824 prisoners participated, with a final response rate of 49.5%. Results Results reveal lifetime, last year and last month prevalence rates for drug use that greatly exceed those of the general population but which are broadly consistent with findings from prison studies internationally. For example, lifetime cannabis use among all prisoners was 87%, last year use was 69% and last month use was 43%. Likewise, lifetime heroin use was 43%, last year use was 30% and last month use was 11%. Women were significantly more likely to use drugs, including injecting drugs. Despite there being a high prevalence (26%) of ever injecting drugs among prisoners, last month injecting prevalence was low (2%). Prevalence of HIV was 2%. Prevalence rates for hepatitis C (13%) and hepatitis B (0.3%) were lower than expected. By far the most important factors associated with blood-borne viruses in this prison population were ever having used drugs IV and ever having shared IV drug equipment. Older age and having had a tattoo done in prison were associated with hepatitis C. Female prisoners were at greater risk of having hepatitis C and HIV and male-to-male sexual contact was confirmed as a risk factor for HIV. The need for drug treatment and harm reduction services was identified in different prison categories, with a pattern of very high uptake of services when they are available. Summary This study confirms that drug use, including injecting drug use, is a significant problem among prisoners in Ireland and suggests that drug-related factors are important in the acquisition of blood-borne viruses. The findings also show that prisoners who need services, such as the range of addiction services and detoxification, are very willing to use them when they are available. 'In-prison' uptake of testing and vaccination services confirms that prisons are appropriate settings for the provision of preventive, diagnostic and treatment services for drug users. It is hoped that the evidence provided in this study will facilitate service and policy development in this important area. Details: Dublin: National Advisory Committee on Drugs and Alcohol, 2014. 126p. Source: Internet Resource: Accessed May 3, 2014 at: http://www.nacd.ie/images/stories/docs/press/Full-Drug-use-among-Irish-prisoner-population.pdf Year: 2014 Country: Ireland URL: http://www.nacd.ie/images/stories/docs/press/Full-Drug-use-among-Irish-prisoner-population.pdf Shelf Number: 132207 Keywords: Drug Abuse and Addiction Drug Offenders Health Care Prisoners (Ireland) Substance Abuse Treatment

Author: Mbete, Bibi Title: HIV, Harm Reduction and Drug Policy in Kenya Summary: Kenya - like most countries - has a long tradition of punitive drug policy responses that seek to eradicate drug use and trade. This is in keeping with the prohibitionist approach that has been dominant across the world for more than 100 years, despite overwhelming evidence that this approach contributes to high levels of HIV transmission among people who inject drugs, as well as many other harms. In recent years, civil society organisations in Kenya have started to adopt programmes and practices that focus more on public health and human rights - supported mainly with funding from international donors and technical assistance from international non-governmental organisations. As part of this effort, the Kenyan Ministry of Health has recently introduced guidelines and strategies for targeted and evidence-based harm reduction interventions for people who use drugs (see Box 1), as part of its HIV response. This briefing paper aims to review the recent developments in the response to HIV and illicit drug use in Kenya, and highlights some key recommendations to address the remaining challenges and issues. Details: London: International Drug Policy Consortium, 2013. 12p. Source: Internet Resource: IDPC Briefing Paper: Accessed May 12, 2014 at: http://dl.dropboxusercontent.com/u/64663568/library/IDPC-briefing-paper_drug-policy-harm-reduction-Kenya.pdf Year: 2013 Country: Kenya URL: http://dl.dropboxusercontent.com/u/64663568/library/IDPC-briefing-paper_drug-policy-harm-reduction-Kenya.pdf Shelf Number: 132329 Keywords: Drug Abuse and Addiction Drug Policy (Kenya) Drug Reform HIV (Viruses) Illicit Drugs

Author: Youngers, Coletta A. Title: The Drug Policy Reform Agenda in the Americas. Version 2. Summary: Latin America has emerged at the vanguard of efforts to promote debate on drug policy reform. For decades, Latin American governments largely followed the drug control policies and programs of Washington's so-called war on drugs. Yet two parallel trends have resulted in a dramatic change in course: the emergence of left-wing governments that have challenged Washington's historic patterns of unilateralism and interventionism and growing frustration with the failure of the prohibitionist drug control model put forward by the US government. In recent years, the regional debate on drug policy issues �-- long dormant -- has surged as evident in media coverage, renewed interest on the part of academia, the emergence of grassroots initiatives such as the cannabis reform movement, and perhaps most importantly, calls for reconsideration of prevailing drug policies by a range of local and national officials. For the first time, sitting presidents are questioning the underlining premises of the international drug control paradigm and calling for debate on alternative approaches. Their actions have had repercussions internationally, as those presidents have successfully pushed for debate within the Organization of American States (OAS) and the United Nations (UN). At the national level, numerous countries have implemented or are debating drug policy reforms. Most significantly, two countries have boldly challenged the 1961 Single Convention on Narcotic Drugs. Bolivia is the first country to denounce and return to the convention with a reservation, in this case with regards to coca leaf use within its own territory. And the Uruguayan government has proposed creating legal, state-controlled markets for cannabis. Uruguayan officials are carefully watching the regulatory frameworks being put in place in the U.S. states of Colorado and Washington where in November 2012 voters approved cannabis legalization referendums. At the local level, officials such as Bogota Mayor Gustavo Petro are forging ahead with innovative harm reduction-oriented programs designed to provide access to health services and treatment to drug users and to reduce crime and violence. However, the obstacles to reform - at the national, regional and international levels - loom large. Efforts to rewrite drug laws in Argentina and Ecuador, for example, are floundering in the face of opposition from powerful conservative political forces and some religious sectors. More often than not, public opinion continues to support mano dura, or hardline, approaches as a result of popular perceptions and fears that more flexible drug policies will lead to increased drug use and violence. Such fears are fanned by sensationalist or biased media coverage, as well as very real problems of citizen insecurity and violence in the poor neighborhoods where illicit drug use tends to be most prevalent. Regionally, while key Latin American leaders have spoken out in favor of reform, many others have remained silent or wedded to present policy. And internationally, a key group of countries, including the United States and Canada, are vociferously opposed to taking any action outside of the confines of the existing international drug control conventions. Yet while drug policy reforms will no doubt advance slowly, major fissures are evident in the international drug control architecture so carefully crafted by the United States and other countries. Perhaps nowhere is that more evident than in Latin America. After analyzing the regional debate, national level reforms and impediments to those reforms, this report concludes with concrete policy recommendations that should be undertaken to maintain the momentum and advance drug policy debates and reforms in the region Details: London: International Drug Policy Consortium, 2013. 20p. Source: Internet Resource: IDPC Briefing Paper: Accessed May 12, 2014 at: http://dl.dropboxusercontent.com/u/64663568/library/IDPC-briefing-paper_Drug-policy-reform-in-Latin-America_V2_ENGLISH.pdf Year: 2013 Country: Latin America URL: http://dl.dropboxusercontent.com/u/64663568/library/IDPC-briefing-paper_Drug-policy-reform-in-Latin-America_V2_ENGLISH.pdf Shelf Number: 132333 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Control Policy Drug Reform (Latin America)

Author: Bagalman, Erin Title: Prescription Drug Abuse Summary: An estimated 6.8 million individuals currently abuse prescription drugs in the United States. Unlike policy on street drugs, federal policy on prescription drug abuse is complicated by the need to maintain access to prescription controlled substances (PCS) for legitimate medical use. The federal government has several roles in reducing prescription drug abuse. Coordination. The Office of National Drug Control Policy (ONDCP) coordinates and tracks prescription drug abuse reduction efforts and funding of multiple federal agencies. Regulation. The primary federal statutes governing prescription drug regulation are the Federal Food, Drug, and Cosmetic Act (FFDCA) and the Comprehensive Drug Abuse Prevention and Control Act of 1970, commonly called the Controlled Substances Act (CSA). Law Enforcement. Federal law enforcement, primarily the Drug Enforcement Administration (DEA), aims to prevent, detect, and investigate the diversion of prescription drugs while regulating the supply for legitimate medical, commercial, and scientific purposes. Health. Federal agencies and programs involved in health may address prescription drug abuse through service delivery (e.g., the Veterans Health Administration), financing (e.g., Medicare), and research (e.g., the National Institute on Drug Abuse). The federal government, state and local governments, and various private entities (e.g., pharmacies) are currently undertaking a range of approaches to reducing prescription drug abuse. Scheduling of PCS. The scheduling status of a PCS (1) affects patient access to PCS (e.g., by limiting refills); (2) affects the degree of regulatory requirements (e.g., supply chain recordkeeping); and (3) determines the degree of criminal punishment for illegal traffickers. Safe Storage and Disposal. DEA regulates storage of PCS by registered entities (e.g., pharmacies); provides registered entities with options for proper disposal of PCS; and sponsors National Prescription Drug Take-Back Days to assist citizens in safe disposal of PCS. Enhancing Law Enforcement. Federal law enforcement efforts may focus on geographic areas with higher rates of prescription drug abuse or on High Intensity Drug Trafficking Areas (HIDTA) that experience a higher volume of illicit trafficking of PCS. Using Data to Identify Risk. Most states operate prescription drug monitoring programs - databases of prescriptions filled for PCS. Other public and private entities also have data that may be analyzed to identify high-risk behavior among prescribers, dispensers, or patients. Awareness and Education. Efforts to increase awareness and education about prescription drug abuse may focus on health care providers, patients, or the general public. Treatment. Some prescription drug abuse may be avoided in treating underlying conditions (e.g., pain) or may be treated with pharmacologic or non-pharmacologic interventions. New products may improve treatment for both underlying conditions and prescription drug abuse. Details: Washington, DC: Congressional Research Service, 2014. 23p. Source: Internet Resource: R43559: Accessed June 17, 2014 at: http://www.nacds.org/ceo/2014/0529/CRS_Drug_Abuse_Report.pdf Year: 2014 Country: United States URL: http://www.nacds.org/ceo/2014/0529/CRS_Drug_Abuse_Report.pdf Shelf Number: 132480 Keywords: Drug Abuse and Addiction Drug Abuse Policy Drug Abuse Prevention Drug Enforcement Drug Regulation Prescription Drug Abuse

Author: Harwin, Judith Title: Changing Lifestyles, Keeping Children Safe: an evaluation of the first Family Drug and Alcohol Court (FDAC) in care proceedings Summary: This report presents the findings from an independent evaluation of the pilot Family Drug and Alcohol Court (FDAC). FDAC is an innovative approach to care proceedings where parental drug or alcohol misuse is a key feature of the case. The FDAC pilot began in January 2008 at the Inner London Family Proceedings Court in London. The pilot was funded by the Department for Education, the Ministry of Justice, the Home Office, the Department of Health and three inner-London local authorities (Camden, Islington, and Westminster) - the pilot local authorities. Since April 2012, when government funding came to an end, the FDAC specialist team has been funded by a consortium of five London authorities, including Southwark and Hammersmith & Fulham as well as the original three. The specialist team is provided by a partnership between the Tavistock and Portman NHS Foundation Trust and the children's charity, Coram. Parental substance misuse is a formidable social problem and a major risk factor for child maltreatment. It is a factor in up to two-thirds of care applications and parents with substance misuse problems are often involved in repeat care proceedings in relation to subsequent children. There has also been a rise in the number of care proceedings since 2008, so the scale of the problem is substantial. FDAC has been adapted to English law and practice from a model of Family Treatment Drug Courts (FTDCs) that is used widely in the USA and shows positive results. The US national evaluation of over 2,000 cases found that, compared to proceedings in the ordinary court, more FTDC parents and children were able to remain together safely, and there were swifter alternative permanent placement decisions for children if parents were unable to stop misusing, all of which meant savings on the cost of foster care during and after proceedings. The catalysts for the UK pilot were the encouraging evidence from the US evaluation and concerns about the response to parental substance misuse through ordinary care proceedings in England. These concerns were about poor child and parent outcomes; insufficient co-ordination between adult and children's services; late intervention to protect children; delay in reaching decisions; and the soaring costs of proceedings, linked to the length of proceedings and the cost of expert evidence. Details: Uxbridge, UK: Brunel University, 2014. 188p. Source: Internet Resource: Accessed June 17, 2014 at: http://www.nuffieldfoundation.org/sites/default/files/files/FDAC_May2014_FinalReport_V2.pdf Year: 2014 Country: United Kingdom URL: http://www.nuffieldfoundation.org/sites/default/files/files/FDAC_May2014_FinalReport_V2.pdf Shelf Number: 1322487 Keywords: Child Abuse and Neglect Child Maltreatment Child Protection Drug Abuse and Addiction Family Courts Problem-Solving Courts Substance Abuse

Author: Mansfield, David Title: "From Bad They Made It Worse": The concentration of opium poppy in areas of conflict in the provinces of Helmand and Nangarhar Summary: Levels of drug crop cultivation have long been seen as an indicator of the success or failure of counternarcotics efforts. However, to rely on this indicator is to misunderstand the socioeconomic and political processes that support farmers moving out of opium poppy cultivation, as well as the limited scope of many interventions currently categorized and budgeted as "counternarcotics" by the international community and the Government of the Islamic Republic of Afghanistan (GIRoA). Details: Kabul: Afghanistan Research and Evaluation Unit, 2014. 92p. Source: Internet Resource: Accessed June 26, 2014 at: http://www.areu.org.af/Uploads/EditionPdfs/NRM%20CS6%20ver%202%20(2).pdf Year: 2014 Country: Afghanistan URL: http://www.areu.org.af/Uploads/EditionPdfs/NRM%20CS6%20ver%202%20(2).pdf Shelf Number: 132549 Keywords: Drug Abuse and Addiction Drug Control Opium Poppy Cultivation Poppy Cultivation

Author: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) Title: Drug Use and Related Problems Among Very Young People (Under 15 Years Old) Summary: Evidence suggests that early experimentation with psychoactive substances, including alcohol and tobacco, is associated with an increased risk of developing drug problems later in life. In a Selected issue on 'Drug use and related problems among very young people-, the EMCDDA focuses on the prevalence and patterns of substance use among the under-15s and on available responses in terms of legislation, prevention and treatment. Details: Lisbon: European Monitoring Centre for Drugs and Drug Addiction, 2007. 28p. Source: Internet Resource: Selected Issue 2007: Accessed July 2, 2014 at: http://www.emcdda.europa.eu/attachements.cfm/att_44741_EN_TDSI07001ENC.pdf Year: 2007 Country: Europe URL: http://www.emcdda.europa.eu/attachements.cfm/att_44741_EN_TDSI07001ENC.pdf Shelf Number: 132612 Keywords: Drug Abuse and Addiction Substance Abuse

Author: DrugScope Title: It's About Time: Tackling substance misuse in older people Summary: In general, alcohol use declines with age and use of illicit drugs is less common in older people than in their younger counterparts. However, as the Royal College of Psychiatrists highlighted in its 2011 report Our invisible addicts, the number of older people with substance use problems is increasing rapidly. The European Monitoring Centre for Drugs and Drug Addiction has estimated that the number of older people with substance use problems or requiring treatment for substance misuse will more than double between 2001 and 2020. In spite of this, older people with substance use problems have historically been a marginalised group, whose particular needs have not been well met. It's about time: Tackling substance misuse in older people brings together information about older people and substance misuse - including use of alcohol, illicit drugs and prescribed and over-the-counter medications - from a range of sources, including published research and reports, service visits and a roundtable attended by academics, policy specialists, practitioners and former service users. In doing so, it aims to identify some of the key issues and problems in this area, and makes strategic and policy recommendations for change, as well as good practice recommendations for substance misuse and older people's services. Key recommendations include: - A range of interventions are needed for older people with substance use problems, from age-appropriate, non-time limited treatment and support for those who are drug and/or alcohol dependent, to brief interventions for those who are drinking at risk. Support for those with problems with prescription and/or over-the-counter medications also needs to be available. - Many of the services we visited during the research process for the briefing were delivering positive outcomes but faced a discontinuation of their funding. Independent and statutory funders and commissioners need to recognise the importance of services and interventions for older people and to consider options for sustainable funding going forward, particularly as research indicates increased prevalence and need. - Substance misuse services can implement a range of measures to help ensure the accessibility and relevance of services for older people, including specific groups or times for older people, satellite services operating out of community provision aimed specifically at older people - for instance, local support groups - and home visits. - Older people with substance misuse problems may come into contact with a number of health and social care professionals, including those working in primary care settings, older people's mental health services, residential services, and for social care providers. With particular reference to alcohol, these professionals should be trained to deliver brief interventions (IBA) and 'sensible drinking' advice to those who are not dependent, but are drinking at risk. Links with specialist support should be developed for referral of those with serious substance misuse problems. Details: London: DrugScope, 2014. 24p. Source: Internet Resource: Accessed July 3, 2014 at: http://www.drugscope.org.uk/Resources/Drugscope/Documents/PDF/Policy/ItsAboutTimeWeb.pdf Year: 2014 Country: United Kingdom URL: http://www.drugscope.org.uk/Resources/Drugscope/Documents/PDF/Policy/ItsAboutTimeWeb.pdf Shelf Number: 132620 Keywords: Alcoholism Drug Abuse and Addiction Drug Abuse Treatment Elderly Substance Abuse

Author: Morgan, Nick Title: The heroin epidemic of the 1980s and 1990s and its effect on crime trends - then and now. Research Report 79 Summary: - A variety of factors have been cited to explain the rise and fall in crime that has occurred in many nations since 1980. But as yet, no definitive explanation has been produced. In the UK context, a rise and fall in illicit drug use has not been especially prominent in this debate, perhaps due to a lack of robust data for the whole period. - This paper gathers available evidence and conducts new analysis to try to assess the effect that heroin and crack-cocaine use may have had on acquisitive crime (i.e. theft-type offences) in England and Wales since 1980. It also suggests implications for future crime trends. - Numerous sources of evidence agree that the number of heroin users increased markedly through the 1980s and early 1990s and that many also used crack as their drug-using career developed. This 'epidemic' spread from area to area but the national peak probably occurred between 1993 and 2000. Crime peaked between 1993 and 1995. - Current data, particularly from treatment providers, show that heroin/crack use has declined for at least a decade and that - as with offending - the decline has been most marked amongst younger people. This means those who began using these drugs during the epidemic still dominate the heroin/crack-using population today. - Studies agree that, in aggregate, heroin/crack users commit a large number of offences; large enough, this paper shows, to be an important driver of overall crime trends. - Studies disagree about whether it is illicit drug use that causes the criminality. This is because a sizable proportion of heroin/crack users do not resort to theft. And many were offending before taking these drugs. However, evidence suggests that, for at least some users, heroin/crack was the catalyst for offending, and for others it probably accelerated and extended their criminal career. Thus aggregate-level change in numbers of heroin/crack users is likely to affect crime trends. - An examination of the considerable regional and international variation in crime trends, particularly geographical areas where the crime drop was not marked or the peak occurred at a different time, also points to a possible causal relationship, rather than simple correlation. - Within England and Wales, the starkest example of regional variation was Merseyside, which had a recorded acquisitive crime peak five years before other police force areas. Evidence also suggests that Merseyside was one of the first areas to be hit by the heroin epidemic and the first to mount a concerted treatment response. Acquisitive (and total) recorded crime in Scotland peaked in 1991, which studies suggest is in line with the national peak in heroin/crack use. But in Edinburgh and its surrounding region (Lothian and Borders) recorded acquisitive crime peaked seven years earlier, in 1984. Data show that Lothian and Borders had a severe heroin epidemic at this time, which was not prolonged into the 1990s as in other parts of Scotland. - Like Merseyside and Edinburgh, the Republic of Ireland suffered a short, sharp heroin epidemic in the early 1980s and crime surged at this time. Northern Ireland did not have a heroin epidemic and its crime trend was much flatter over the period. - In the US all types of crime fell from 1991 but the US crime survey shows that property crime peaked over a decade earlier, in line with the US heroin epidemic. Likewise, many east European nations had a heroin epidemic about a decade after those in western Europe. Eastern Europe also had a recorded acquisitive crime peak around a decade after western Europe. - Two approaches were used in this paper to estimate the effect of heroin/crack use on crime. Both suggest that the epidemic may have had a significant impact on acquisitive crime in England and Wales. - The first approach was a police force area-level comparison of the Addicts Index and police recorded crime data from 1981 to 1996, through the crime turning point. This showed that different types of theft generally peaked together within an area. But the timing and size of these peaks varied across areas and was highly correlated with heroin use. Fixed effects regression analysis suggested that about 40 per cent of the national rise in the highest volume crime types (burglary and vehicle crime), from 1981 to the peak, can be attributed to rises in the number of heroin users. - The second approach was to model the number of heroin/crack users over time and their offending. Exploratory model results found that heroin/crack use could account for at least one-half of the rise in acquisitive crime in England and Wales to 1995 and between one-quarter and one-third of the fall to 2012, as the epidemic cohort aged, received treatment, quit illicit drug use or died. - Model results also suggested that the epidemic still affects acquisitive crime today. In the recent recession, crime in England and Wales continued to fall, which correlates with a slowly shrinking heroin/crack user population but not with economic factors. Projecting forwards, a further downward pressure on crime, of a lessening degree, might be expected as the heroin/crack cohort continues to age and get treatment. - The evidence presented shows that detecting and preventing future drug epidemics is paramount, and this requires local as well as national monitoring. Evidence also suggests that, for volume-crime reduction, it is crucial to maintain a focus on heroin/crack, despite the higher prevalence of other illicit drugs like cannabis, powder cocaine and ecstasy, and the emergence of new psychoactive substances. Specifically, it remains important to identify the minority of heroin/crack users who commit large volumes of crime during addiction periods. If that can be done, and those periods of addiction and offending can be shortened or prevented, the potential for further reductions in crime remains significant. However, many of these individuals will have been using heroin/crack intermittently for a decade or more and will have tried most current forms of treatment, so innovative approaches may be needed. Details: London: Home Office, 2014. 78 p.; Technical Report, 222p. Source: Internet Resource: Research Report 79: Accessed July 22, 2014 at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/332952/horr79.pdf Year: 2014 Country: United Kingdom URL: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/332952/horr79.pdf Shelf Number: 132733 Keywords: Cocaine Crime Rates Crime Trends Drug Abuse and Addiction Drug Abuse and Crime Heroin (U.K.)

Author: United Nations Office on Drugs and Crime Title: The Illicit Drug Trade Through South-Eastern Europe Summary: South-Eastern Europe has long served as a corridor for several drug-trafficking routes to Western and Central Europe. Owing to its geographical position between Afghanistan, the world's most important opiate-producing country, and the large and lucrative markets for opiates in Western and Central Europe, South-Eastern Europe is a crucial stage on one of the world's most important heroin trafficking routes, the "Balkan route". Diverse drug flows come from multiple directions. Externally, cocaine arrives from South America. Internally, South-Eastern Europe produces relatively large amounts of cannabis, most notably in Albania, and the region also has a recent history of producing and trafficking amphetamine-type-stimulants (ATS). Of all these drug flows, however, only heroin flows can be considered strategically significant to consumption markets in Western and Central Europe. It is important to note that South-Eastern Europe is not only a transit region, but also faces drug consumption challenges in its own right and is vulnerable to corruption. In order to place policymakers and law enforcement analysts in a better position to evaluate the drug-trafficking situation and make informed decisions regarding responses, this report analyses the major and emerging drug trends, including use, for heroin, cocaine, ATS and cannabis. Based on findings from data submitted to UNODC by countries and territories, reports from regional organizations such as SELEC and Frontex and publicly available publications and scientific literature, the report also looks at the responses of countries in the region to related challenges. With a particular focus on heroin, it analyses the Balkan route from its origin on the borders of Afghanistan, through the Islamic Republic of Iran and Turkey, into South-Eastern Europe and up to its end point in Western and Central Europe, where the four principal opiate user markets it serves (the United Kingdom, Germany, France and Italy) are located. Details: Vienna: UNODC, 2014. 142p. Source: Internet Resource: Accessed July 28, 2014 at: http://www.unodc.org/documents/data-and-analysis/Studies/Illicit_DT_through_SEE_REPORT_2014_web.pdf Year: 2014 Country: Europe URL: http://www.unodc.org/documents/data-and-analysis/Studies/Illicit_DT_through_SEE_REPORT_2014_web.pdf Shelf Number: 132793 Keywords: Drug Abuse and Addiction Drug Enforcement Drug Trafficking (Europe) Heroin

Author: Bauld, Linda Title: Problem Drug Users' Experiences of Employment and the Benefit System Summary: This study was commissioned by the Department for Work and Pensions (DWP) to examine the issues surrounding benefit uptake in England by individuals who use illicit drugs, in particular heroin and crack cocaine. Individuals who take these drugs are termed 'problem drug users' (PDUs). In addressing these issues, the study also explores the wider context of education, training and employment for drug users as well as the role of treatment. This report has two key elements: a review of the literature on drug use and benefit uptake and a qualitative component that included face-to-face semi-structured interviews with 75 drug users and ten professionals who work with drug users to explore specific issues in detail. The research was carried out by a team from the Centre for Drug Misuse Research at the University of Glasgow and the Centre for the Analysis of Social Policy in the Department of Social and Policy Sciences at the University of Bath. Details: Norwich, UK: Department for Work and Pensions, 2010. 132p. Source: Internet Resource: Research Report No. 640: Accessed July 30, 2014 at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/214409/rrep640.pdf Year: 2010 Country: United Kingdom URL: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/214409/rrep640.pdf Shelf Number: 132849 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Abuse Treatment Drug Offenders (U.K.) Employment

Author: Gomis, Benoit Title: Illicit Drugs and International Security: Towards UNGASS 2016 Summary: In spite of a decades-long 'war on drugs', the global drug trade persists as a significant problem for international security given its scale, the number of deaths related to trafficking and consumption it creates, and the organized crime and corruption it fuels. The international drug control system has been ineffective in reducing the size of the market and in preventing the emergence of new drugs and drug routes that cause and shift instability around the world. Current drug policies have been counter-productive, often causing more harm than the drugs themselves through capital punishment for offences, widespread incarceration, discrimination in law enforcement, violation of basic human rights in forced 'treatment' centres, and opportunity costs. In the last three years, the drug policy debate has evolved more than in the previous three decades. There remain a number of political obstacles to making recent developments sustainable ahead of the UN General Assembly Special Session (UNGASS) on drugs in 2016, but these should not be used as excuses for continuing with a failed status quo. Details: London: Chatham House, 2014. 16p. Source: Internet Resource: Briefing Paper: Accessed July 31, 2014 at: http://www.chathamhouse.org/sites/files/chathamhouse/home/chatham/public_html/sites/default/files/0214Drugs_BP2.pdf Year: 2014 Country: International URL: http://www.chathamhouse.org/sites/files/chathamhouse/home/chatham/public_html/sites/default/files/0214Drugs_BP2.pdf Shelf Number: 132853 Keywords: Drug Abuse and Addiction Drug Control Drug Enforcement Drug Policy Drug Trafficking Illicit Drugs Organized Crime War on Drugs

Author: Organization of American States Title: An Exploratory Study on Drugs and Violence in an Intentional Sample of Women in Twelve Countries of the Americas Summary: Purpose To analyze the similarities and differences of the individual and collective experiences of women participating in an exploratory study in 10 Spanish-speaking countries of America, Brazil and the US (English, Spanish and Portuguese-speaking Latin women), in respect to drug use, violence and sexual risk behavior. Overall goal To analyze the experiences and perceptions of women participating in the study on the use and abuse of drugs, victimization by violence and sexually risk behavior, as well as to identify and evaluate the state of self esteem, depression and psychological abuse of the same. Specific Goals - Determine the frequency of drug use, violence and sexual risk behavior among women participating in the survey. - Describe and evaluate the state of self-esteem, depression and psychological abuse, as well as the level of drug abuse, types of violence among under and over eighteen year olds and the sexual risk behavior, especially HIV/AIDS among women participating in the sample. - Identify the individual and collective experiences relating to drug use, violence and sexual risk behavior in women participating in the exploratory study sample of 10 Spanish-speaking countries of Americas, Brazil, and the US (English, Spanish and Portuguese-speaking Latin women). Design and Methodology A quantitative and qualitative approach was adopted, in which the quantitative aspect was obtained through individual interviews based on a questionnaire, and descriptive statistics were utilized to analyze the data obtained. In the qualitative aspect, focus groups with content analysis were employed. The intentional sample comprised 660 women between the ages of 18 and 60, living in lower middle class and lower class communities in the 10 Hispanic countries (Argentina, Bolivia, Chile, Colombia, Costa Rica, Ecuador, Honduras, Mexico, Peru and Venezuela), Brazil and the United States, with an average of 30 women per location. The study was conducted in the following manner: (i) In the Spanish-speaking countries, the focus groups were first organized and then on another day, individual interviews were conducted. In some of the locations in Brazil the individual interviews were conducted first, followed by the focus groups. (ii) The data obtained from the focus groups and the individual interviews were stored in a database created in each university participating in the study, prior to proceeding with the data analysis and preparation of the reports by the same universities. In countries where there was more than one participating university, one university was chosen to work with the combined data and to prepare the country report. In the case of Brazil, in particular, this stage was conducted by SENAD, which worked with five universities participating in the study. After this stage in the process, the 19 universities from Latin America and SENAD forwarded their data to the OAS/CICAD-EDRS to proceed with the analysis of the results obtained in the quantitative and qualitative components in the 12 participating countries and to prepare the final report of the exploratory study. (iii) The creation of an editorial committee with representatives from universities of Spanish-speaking Latin America , Portuguese-speaking Brazil, and the multi-lingual United States, as well as from CICAD-EDRS, SENAD/Brazil and external consultants, to assist with the preparation, revision and publication of the final report of the exploratory study. Details: Washington, DC: OAS, 2009. 168p. Source: Internet Resource: Accessed August 4, 2014 at: http://www.cicad.oas.org/reduccion_demanda/educational_development/reports/women-drugs%20ENG.pdf Year: 2009 Country: South America URL: http://www.cicad.oas.org/reduccion_demanda/educational_development/reports/women-drugs%20ENG.pdf Shelf Number: 132992 Keywords: Drug Abuse and Addiction Drug-Related Violence Female Drug Users Risk-Taking Behavior

Author: Caulkins, Jonathan P. Title: How Much Crime Is Drug-Related? History, Limitations, and Potential Improvements of Estimation Methods Summary: Drug-related crime imposes an enormous burden on society, but how big is enormous? And how do "we" as citizens, policy analysts, and policy makers develop sound intuitions for the scale of something that directly or indirectly affects hundreds of millions of people? This is the first in a series of articles (see "The Cost of Crime" by Caulkins and Kleiman, 2013, and "Drug Control and Reductions in Drug-Attributable Crime" by Caulkins, 2013) that attempt not so much to answer those questions in the sense of computing specific numerical estimates, but rather to provide guidance on how one should understand and interpret such estimates. After all, we do not lack for estimates of the annual costs of illicit drug use. The 2011 National Drug Intelligence Center report says the answer is $193 billion just for 2007 (NDIC, 2011); Henrick Harwood and his coauthors said that it was $97.7 billion just for 1992 (Harwood et al., 1998) - which would have been $135.5 billion in 2007 dollars. What is lacking is understanding of what such figures mean. Is one right, and the other wrong? Are either right? Is it possible to provide a single "right" number and, even if so, what response would the number imply, in terms of changing public policies? These figures dwarf everyday experience just as surely as do other "facts" that swirl around us. We measure computer memory in Gigabytes, where one Gigabyte is 1,073,741,824 bytes. No one can count that high. If we counted one number per second every second of every day � without pausing to sleep, eat, or go to the bathroom � it would take 34 years to count to Giga. And Giga is by no means the largest scale that informed citizens need to comprehend. After all, it is "only" a billion. Although Senator Everett Dirksen probably never said it takes several billions before one is even talking real money, it is true that the cost of drug-related crime is so enormous that no one can even hope to estimate it to the nearest billion. "A billion here, a billion there" really is just round off error when trying to grapple with the enormity of the costs of drug-related crime. Great mischief blossoms when common sense retreats in awe of such quantities. Buried behind the estimates of the National Drug Intelligence Center and Harwood and his coauthors and others like them are value judgments and crude approximations and tacit assumptions that need to be surfaced. That a calculation produces a big number, and takes two hundred pages to explain, does not imply that the resulting number is accurate. Indeed, depending on a variety of factors, the opposite may be true. To be clear, we mean no disrespect toward the authors of these enormous estimates. The analysis is daunting, having some estimates is clearly better than pure ignorance, and we could do no better. Rather, the goal in these articles is to make consumers of these figures better able to appreciate and use them effectively. Details: Pittsburgh, PA: Carnegie Mellon University; Los Angeles: University of California, Los Angeles, 2014. 44p. Source: Internet Resource: Accessed August 22, 2014 at: https://www.ncjrs.gov/pdffiles1/nij/grants/246404.pdf Year: 2014 Country: United States URL: https://www.ncjrs.gov/pdffiles1/nij/grants/246404.pdf Shelf Number: 133090 Keywords: Costs of Crime Drug Abuse and Addiction Drug Abuse and Crime (U.S.) Drug Enforcement Drug Offenders

Author: Centre for Social Justice Title: No Quick Fix: Exposing the depth of Britain's drugs and alcohol problem Summary: This report lays bare the reality of substance abuse and addiction in Britain today. This ongoing challenge affects millions of people and has huge costs. Alcohol abuse costs taxpayers $21 billion a year and drugs $15 billion. While costs matter, it is the human consequences that present the real tragedy. The abuse of substances is a pathway to poverty and can lead to family breakdown and child neglect, homelessness, crime, debt, and long-term worklessness. From its impact on children to its consequences for those in later life, addiction destroys lives, wrecks families and blights communities. The scale of the problem is shocking. 1.6 million people are dependent on alcohol in England alone. One in seven children under the age of one live with a substance-abusing parent, and more than one in five (2.6 million) live with a parent who drinks hazardously. 335,000 (one in 37) children live with a parent who is addicted to drugs. The Centre for Social Justice (CSJ) has been encouraged by some of the commitments contained within the Drug Strategy 2010 and by the efforts of some reformers within government. The move to a recovery-oriented system is an important step to ensuring that harm reduction is only the first step along a path to abstinence and full recovery. Challenges persist, however, as many vested interests remain entrenched within the treatment system. Supporters of substitute treatment remain unconvinced by the possibilities of full- and long-term recovery, and are resistant to reform. Alarmingly, some commissioners are withdrawing support for effective services. The CSJ has learned that 55 per cent of local authorities have cut funding to residential rehabilitation centres whilst harm reduction services that maintain people in their addiction have been preserved under the NHS ring-fence. These rehabilitation centres, which the Prime Minister has rightly backed in the past, have proved time and again to be an effective way of breaking the cycle of addiction and must be supported. In this report, we also highlight the system's lack of ambition to tackle alcohol abuse, despite its rising cost. While two-thirds of the 300,000 drug addicts in England get treatment, only a small minority (approximately seven per cent) alcohol dependants get similar help. Furthermore, by withdrawing its plans for a minimum unit price, the Government has missed an opportunity to tackle the increased availability of super cheap, strong alcohol. Parents and children, together with addicts and taxpayers, are calling for action. In this report we outline the challenges; in the coming year the CSJ will publish policy recommendations to help solve Britain's drug and alcohol crisis. Details: London: Centre for Social Justice, 2013. 107p. Source: Internet Resource: Breakthrough Britain II: Accessed August 23, 2014 at: http://www.centreforsocialjustice.org.uk/UserStorage/pdf/Pdf%20reports/addict.pdf Year: 2013 Country: United Kingdom URL: http://www.centreforsocialjustice.org.uk/UserStorage/pdf/Pdf%20reports/addict.pdf Shelf Number: 129896 Keywords: Alcohol Abuse Alcohol Related Crime, Disorder Alcoholism (U.K.) Drug Abuse and Addiction Drug Policy Substance Abuse

Author: Cobb, Kimberly Title: Going Beyond Compliance Monitoring of Drug/Alcohol-Involved Tribal Probationers Summary: It is no secret that alcohol and substance abuse are common problems in Indian Country. While official data on crime in Indian Country is hard to come by, anecdotal data alludes to the fact that many tribal communities face overwhelming numbers of crimes either directly related to or associated with drugs/alcohol. Alcohol abuse has been associated with numerous negative consequences including crime, domestic violence, sexual assault and rape, suicide, morbidity, and ultimately mortality (Aguirre & Watts, 2010; Kovas, McFarland, Landen, Lopez, & May, 2008). However, alcohol is far from the only substance abused on tribal land. Marijuana, methamphetamine, cocaine, heroin, and various pharmaceutical drugs are also regularly abused (NDIC, 2008). Although there has been great emphasis lately on the building or renovation of detention facilities in Indian Country, many tribal communities hold fast to the belief that they do not want to imprison their members. In fact, alternatives to incarceration, which includes probation and community supervision programs, are professed as a more "culturally compatible approach to punishment for crime" in Indian Country (Luna-Firebaugh, 2003, p. 63). Therefore, unless something tragic has occurred, those charged with drug/alcohol-related offenses will more than likely be placed on community supervision. That is where you come in as the tribal probation officer. Working with probationers is more than just identifying and controlling their risk to re-offend. As a tribal probation officer, you are "charged with ensuring public safety; holding offenders accountable for their actions; and, facilitating behavioral change in offenders" (The Century Council, 2010, pg. 8). In order to fulfill this charge, you often have to take on many roles associated with law enforcement, social work, counselor and court servant - which, at times, can have conflicting goals (Cobb, Mowatt, Matz, & Mullins, 2011). To be effective, you have to blend your duties of being an officer of the court (focused on compliance) and a probationer motivator (focused on facilitating behavior change) - both of which are necessary to fulfill the mandate of protecting public safety. In order to be effective and protect public safety over the long-term, as a tribal probation officer, you must move beyond compliance monitoring of the probation conditions ordered by the court to working with individuals on your caseload to identifying the root cause of the issues behind their drug/alcohol-related problems and intervene as necessary to put them on a better path. Details: Lexington, KY: American Probation & Parole Association, 2014. 22p. Source: Internet Resource: Accessed August 25, 2014 at: http://www.appa-net.org/eweb/docs/APPA/pubs/GBAITP.pdf Year: 2014 Country: United States URL: http://www.appa-net.org/eweb/docs/APPA/pubs/GBCMDAITP.pdf Shelf Number: 133133 Keywords: Alcohol Abuse Alternatives To Incarceration Community Based Corrections Community Supervision Drug Abuse and Addiction Drug Offenders Indians of North America Probation Officers (U.S.) Probationers Risk Assessment Substance Abuse

Author: Choate, David E. Title: Arizona Arrestee Reporting Information Network: 2013 Maricopa County Juvenile Probation Department Report. Summary: The Arizona Arrestee Reporting Information Network (AARIN) is a monitoring system that provides ongoing descriptive information about drug use, crime, victimization and other characteristics of interest among individuals arrested in Maricopa County, Arizona. Funded by the Maricopa County Board of Supervisors beginning in 2007, AARIN is modeled after the former National Institute of Justice (NIJ) national-level Arrestee Drug Abuse Monitoring Program (ADAM). In three facilities throughout the county, professionally trained interviewers conduct voluntary and confidential interviews with recently booked adult arrestees and juvenile detainees. Questions focus on a range of topics including education, employment and other demographics, patterns of drug use (lifetime and recent), substance abuse and dependence risk, criminal activity, gang affiliation, victimization, mental health, interactions with police, public health concerns, incarceration and probation, citizenship and treatment experiences. Each interviewee also provides a urine specimen that is tested for the presence of alcohol and/or drugs. Arrestees who have been in custody longer than 48 hours are ineligible for participation in AARIN, due to the 72-hour time limitation for valid testing of urine specimen. The instruments used and the reporting mechanism underwent a substantial revision in 2011. While maintaining all of the data elements from the previous core set of questions, the baseline interview expanded by more than 60%. Additionally, with the change in the core questionnaire, the project shifted its reporting strategy to focus reports to each of six key Maricopa County criminal justice agencies: Maricopa County Manager's Office, Maricopa County Sheriff's Office, Maricopa County Attorney's Office, Office of the Public Defender, Adult Probation Department and the Juvenile Probation Department. Overall, AARIN serves as a near-real time information source on the extent and nature of drug abuse and related activity in Maricopa County, AZ. This information helps to inform policy and practice among police, courts and correctional agencies to increase public safety and address the needs of individuals who find themselves in the criminal justice system. Details: Phoenix, AZ: Center for Violence Prevention & Community Safety, Arizona State University, 2013. 46p. Source: Internet Resource: Accessed August 25, 2014 at: http://cvpcs.asu.edu/sites/default/files/content/projects/AARIN%20Juvenile%20Probation%202013.pdf Year: 2013 Country: United States URL: http://cvpcs.asu.edu/sites/default/files/content/projects/AARIN%20Juvenile%20Probation%202013.pdf Shelf Number: 133138 Keywords: Drug Abuse and Addiction Drug Offenders Juvenile Offenders Juvenile Probationers Offender Profiles (Arizona)

Author: Choate, David E. Title: Arizona Arrestee Reporting Information Network: 2013 Maricopa County Adult Probation Department Report Summary: The Arizona Arrestee Reporting Information Network (AARIN) is a monitoring system that provides ongoing descriptive information about drug use, crime, victimization, and other characteristics of interest among individuals arrested in Maricopa County, Arizona. Funded by the Maricopa County Board of Supervisors beginning in 2007, AARIN is modeled after the former National Institute of Justice (NIJ) national-level Arrestee Drug Abuse Monitoring Program (ADAM). In three facilities throughout the county, professionally trained interviewers conduct voluntary and confidential interviews with recently booked adult arrestees and juvenile detainees. Questions focus on a range of topics including education, employment and other demographics, patterns of drug use (lifetime and recent), substance abuse and dependence risk, criminal activity, gang affiliation, victimization, mental health, interactions with police, public health concerns, incarceration and probation, citizenship, and treatment experiences. Each interviewee also provides a urine specimen that is tested for the presence of alcohol and/or drugs. Arrestees who have been in custody longer than 48 hours are ineligible for participation in AARIN, due to the 72-hour time limitation for valid testing of urine specimen. The instruments used and the reporting mechanism underwent a substantial revision in 2011. While maintaining all of the data elements from the previous core set of questions, the baseline interview expanded by more than 60%. Additionally, with the change in the core questionnaire, the project shifted its reporting strategy to focus reports to each of six key Maricopa County criminal justice agencies: Maricopa County Manager's Office, Maricopa County Sheriff's Office, Maricopa County Attorney's Office, Office of the Public Defender, Adult Probation Department, and the Juvenile Probation Department. Overall, AARIN serves as a near-real time information source on the extent and nature of drug abuse and related activity in Maricopa County, AZ. This information helps to inform policy and practice among police, courts and correctional agencies to increase public safety and address the needs of individuals who find themselves in the criminal justice system. Details: Phoenix, AZ: Center for Violence Prevention & Community Safety, Arizona State University, 2013. 48p. Source: Internet Resource: Accessed August 25, 2014 at: http://cvpcs.asu.edu/sites/default/files/content/projects/AARIN%20Adult%20Probation%202013.pdf Year: 2013 Country: United States URL: http://cvpcs.asu.edu/sites/default/files/content/projects/AARIN%20Adult%20Probation%202013.pdf Shelf Number: 133139 Keywords: Adult Probation (Arizona) Drug Abuse and Addiction Drug Offenders Offender Profiling Probationers

Author: Global Commission on Drug Policy Title: Taking Control: Pathways to Drug Policies that Work Summary: The upcoming United Nations General Assembly Special Session on Drugs (UNGASS) in 2016 is an unprecedented opportunity to review and re-direct national drug control policies and the future of the global drug control regime. As diplomats sit down to rethink international and domestic drug policy, they would do well to recall the mandate of the United Nations, not least to ensure security, human rights and development. Health is the thread that runs through all three of these aspirations, and the UN global drug control regime has the 'health and welfare of mankind' as its ultimate goal. But overwhelming evidence points to not just the failure of the regime to attain its stated goals but also the horrific unintended consequences of punitive and prohibitionist laws and policies. A new and improved global drug control regime is needed that better protects the health and safety of individuals and communities around the world. Harsh measures grounded in repressive ideologies must be replaced by more humane and effective policies shaped by scientific evidence, public health principles and human rights standards. This is the only way to simultaneously reduce drug-related death, disease and suffering and the violence, crime, corruption and illicit markets associated with ineffective prohibitionist policies. The fiscal implications of the policies we advocate, it must be stressed, pale in comparison to the direct costs and indirect consequences generated by the current regime. The Global Commission proposes five pathways to improve the global drug policy regime. After putting people's health and safety at the center of the picture, governments are urged to ensure access to essential medicines and pain control. The Commissioners call for an end to the criminalization and incarceration of users together with targeted prevention, harm reduction and treatment strategies for dependent users. In order to reduce drug related harms and undermine the power and profits of organized crime, the Commission recommends that governments regulate drug markets and adapt their enforcement strategies to target the most violent and disruptive criminal groups rather than punish low level players. The Global Commission's proposals are complimentary and comprehensive. They call on governments to rethink the problem, do what can and should be done immediately, and not to shy away from the transformative potential of regulation. The obstacles to drug policy reform are both daunting and diverse. Powerful and established drug control bureaucracies, both national and international, staunchly defend status quo policies. They seldom question whether their involvement and tactics in enforcing drug policy are doing more harm than good. Meanwhile, there is often a tendency to sensationalize each new "drug scare" in the media. And politicians regularly subscribe to the appealing rhetoric of "zero tolerance" and creating "drug free" societies rather than pursuing an informed approach based on evidence of what works. Popular associations of illicit drugs with ethnic and racial minorities stir fear and inspire harsh legislation. And enlightened reform advocates are routinely attacked as "soft on crime" or even "pro-drug." The good news is that change is in the air. The Global Commission is gratified that a growing number of the recommendations offered in this report are already under consideration, underway or firmly in place around the world. But we are at the beginning of the journey and governments can benefit from the accumulating experience where reforms are being pursued. Fortunately, the dated rhetoric and unrealistic goals set during the 1998 UNGASS on drugs are unlikely to be repeated in 2016. Indeed, there is growing support for more flexible interpretations and reform of the international drug control conventions aligned with human rights and harm reduction principles. Details: Rio de Janeiro - RJ - Brasil: Global Commission on Drug Policy, 2014. 45p. Source: Internet Resource: Accessed September 12, 2014 at: http://www.gcdpsummary2014.com/#foreword-from-the-chair Year: 2014 Country: International URL: http://www.gcdpsummary2014.com/#foreword-from-the-chair Shelf Number: 133289 Keywords: Drug Abuse and Addiction Drug Control Policy Drug Enforcement

Author: Ternes, Marguerite Title: An Examination of the Effectiveness of the National Substance Abuse Program Moderate Intensity (NSAP-M) on Institutional Adjustment and Post-Release Outcomes Summary: What it means The findings suggest that the National Substance Abuse Program - Moderate Intensity (NSAP-M) reduced the risks associated with substance use and criminality. The offenders with partial exposure to the program showed the poorest outcomes with respect to return to custody. The results also demonstrate the value of participating in community maintenance even with limited exposure to NSAP-M. Unfortunately, only a small percentage of offenders participated in community aftercare. What we found The occurrence of institutional misconduct was not significantly reduced by NSAP-M participation. Offenders who fully completed NSAP-M were as likely to engage in serious institutional misconduct as offenders who failed to complete all sessions of the program or offenders who had been assigned to NSAP-M but who had not enrolled in the program. Offenders who completed NSAP-M were less likely to be readmitted to prison during the 24-month follow-up period. In fact, offenders who partially completed were 25% more likely to return to prison compared to those who completed NSAP-M. The Not Enrolled group did not differ from program completers in likelihood of returning to custody. At the end of the 2 year follow-up period, 52% of both the Complete and Not Enrolled groups remained in the community, compared to 39% of the Incomplete group. When participation in the National Maintenance Substance Abuse Program delivered in the community and release type were considered, the association between NSAP-M and return to custody was no longer significant, suggesting that release type and community aftercare may be key variables in the pathway between program exposure and returning to custody. Overall, offenders who did not participate in community aftercare were 41% more likely to return to custody than those who had some exposure to the program; offenders who were released on a non-discretionary basis were 53% more likely to return to custody. Why we did this study Ensuring the safety and security of staff and offenders within the institution environment and the safe reintegration offenders into the community are key priorities of Correctional Service Canada (CSC). Correctional interventions can help address offender behavior associated with criminal activity. Given that 80% of the federal offender population has a substance use problem, it is imperative that effective substance abuse interventions are available to these offenders. The current study examined the effectiveness of NSAP-M in addressing the needs of federally incarcerated male offenders who have an identified substance abuse problem. What we did The study examined the effect of NSAP-M on institutional misconduct and return to custody. The study sample consisted of 8,121 male offenders who had accessed NSAP-M between June 2004 and December 2009. Details: Ottawa: Correctional Service of Canada, 2014. 63p. Source: Internet Resource: Research Report R-291: Accessed September 12, 2014 at: http://www.csc-scc.gc.ca/research/005008-0291-eng.shtml Year: 2014 Country: Canada URL: http://www.csc-scc.gc.ca/research/005008-0291-eng.shtml Shelf Number: 133297 Keywords: Correctional Programs Drug Abuse and Addiction Drug Offenders Inmates Prisoner Aftercare Prisoner Misconduct Substance Abuse Treatment (Canada) Treatment Programs

Author: Human Rights Watch Title: No Time to Waste: Evidence-Based Treatment for Drug Dependence at the United States Veterans Administration Summary: This briefing paper examines the response of the Veterans Administration to veterans struggling with drug and alcohol dependence, highlighting three programs that use evidence-based models to prevent overdose, treat opioid dependence and end chronic homelessness. These approaches incorporate harm reduction principles that "meet veterans where they are" - providing services along a spectrum to help veterans reduce the negative consequences of drug misuse including the harm of infectious diseases such as HIV and hepatitis. Continued support for these programs is critically important, both within the Veterans Administration, the Department of Housing and Urban Development, and in the form of essential funding from the United States Congress. Human Rights Watch research indicates: - Expanding veterans' access to naloxone is critical to saving lives from overdose; - Medication-assisted therapy is an effective treatment for opioid dependence that should be accessible to greater numbers of veterans; - Focusing on "Housing First" gives veterans a chance to stabilize and rebuild their lives. The Veterans Administration has adopted evidence-based models because they are effective. But implementing evidence-based responses to drug dependence is a matter of human rights as well as public health. These are principles that apply to all people regardless of whether they have served in the nation's military. The VA provides the three models highlighted here to veterans, but they are essential for all who are drug dependent and may be at risk of overdose, in need of treatment or without a home. By expanding and sustaining these programs the Veterans Administration can set a precedent that ultimately could be a significant contribution to protecting the right to health not only for veterans but for all Americans. Details: New York: HRW, 2014. 45p. Source: Internet Resource: Accessed September 23, 2014 at: http://www.hrw.org/sites/default/files/reports/us0614_vets_ForUpload.pdf Year: 2014 Country: United States URL: http://www.hrw.org/sites/default/files/reports/us0614_vets_ForUpload.pdf Shelf Number: 133392 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Military Veterans (U.S.) Substance Abuse Treatment

Author: Lattimore, Pamela Title: Arrestee Substance Use: Comparison of Estimates from the National Survey on Drug Use and Health and the Arrestee Drug Abuse Monitoring Program Summary: The National Survey on Drug Use and Health (NSDUH) and the Arrestee Drug Abuse Monitoring (ADAM) Program provide information on alcohol and drug use by individuals who have recently been arrested. The studies differ in their target populations (civilian, non-institutionalized individuals vs. arrestees in 39 sites recently booked into jails) and data collection methods. This study uses 2003 ADAM and 2002-2008 NSDUH data for adult males living in the 39 ADAM sites who reported a past year arrest and 2002-2008 Uniform Crime Reporting (UCR) data to examine how well NSDUH covers the arrestee population and to compare estimates of drug and alcohol use and substance abuse or dependence. In general, ADAM estimates of rates of self-reported drug use were higher. The magnitude of these differences cannot be accounted for by under-coverage in NSDUH. Other possible reasons for these differences and their implications for interpreting NSDUH and ADAM data are discussed. Details: Rockville, MD: Center for Behavioral Health Statistics and Quality, SAMHSA, 2014. 15p. Source: Internet Resource: CBHSQ Data Review: Accessed October 2, 2014 at: http://www.samhsa.gov/data/2K14/NSDUHDRADAM/NSDUH-DR-ADAM-2014.pdf Year: 2014 Country: United States URL: http://www.samhsa.gov/data/2K14/NSDUHDRADAM/NSDUH-DR-ADAM-2014.pdf Shelf Number: 133555 Keywords: Alcoholism Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders (U.S.) Substance Abuse

Author: Kachin Women's Association Thailand Title: Silent Offensive: How Burma Army strategies are fuelling the Kachin drug crisis Summary: "Silent Offensive" by the Kachin Women's Association Thailand (KWAT) reveals how the Burma Army is allowing its local militia to grow opium and produce heroin and other drugs in exchange for fighting against the KIA. As Burmese troops and their allies have progressively seized control of KIA areas, drug production has been increasing. The main opium growing areas in Kachin State are now in Chipwi and Waingmaw townships, under the control of the Burma Army and its local Border Guard Forces led by Zakhung Ting Ying, a National Assembly MP. In northern Shan State, opium is booming in areas under the Burma Army and thirteen government militia forces, four of whose leaders are MPs in the Shan State Assembly. Opium, heroin and methamphetamines are flooding from these government-controlled areas into Kachin communities, worsening existing problems of drug abuse, particularly among youth. It is estimated that about one third of students in Myitkyina and Bhamo universities are injecting drug users. The report details the harrowing impacts of the drug crisis on women, who struggle to support their families while husbands and sons sell off household property and steal to feed their addiction. Frustrated with the authorities' lack of political will to deal with the drug problem, women are taking a lead among local communities in setting up their own programs to combat drugs. KWAT critiques UNODC and other international donors for not focusing on the role of the war, and particularly the anti-insurgency policies of the government, in fuelling the drug problem in Burma. KWAT urges all stakeholders to focus on finding a just political settlement to the conflict as an urgent priority in tackling the drug crisis. Details: Chiang Mai, Thailand: Kachin Women's Association Thailand (KWAT), 2014. 50p. Source: Internet Resource: Accessed October 15, 2014 at: http://www.kachinwomen.com/images/7Oct14Report/silent_offensive_drug_report_english.pdf Year: 2014 Country: Burma URL: http://www.kachinwomen.com/images/7Oct14Report/silent_offensive_drug_report_english.pdf Shelf Number: 133914 Keywords: Drug Abuse and Addiction Heroin Illegal Drugs Narcotics (Burma) Opium

Author: Baker, Tom Title: Alcohol and other drug treatment and diversion from the Australian criminal justice system 2012-13 Summary: In the 10 years to 2012-13, the number of treatment episodes provided to clients diverted from the criminal justice system into alcohol and other drug (AOD) treatment for drug or drug-related offences more than doubled, while treatment episodes for other clients increased only marginally. This bulletin assesses the nature of diversion clients referred to AOD treatment services, how they compare with non-diversion clients receiving AOD treatment, and the treatment they receive. About 1 in 4 clients had been diverted from the criminal justice system Nationally, there were 24,069 clients who had been diverted into AOD treatment, comprising 24% of all clients. Diversion clients were younger and more likely to be male than non-diversion clients, and less likely to be Indigenous Among diversion clients: - 25% were aged 10-19 compared with 11% for non-diversion clients - 80% were male compared with 67% of non-diversion clients - 12% were Indigenous compared with 15% for non-diversion clients. Among diversion clients, about 1 in 7 also received non-diversion treatment during 2012-13 While there are client data for just 1 collection year, about 1 in 7 (3,640) diversion clients also received non-diversion episodes during 2012-13 (4% of total clients). Diversion treatment episodes were about twice as likely to involve cannabis as the principal drug of concern compared with episodes for non-diversion clients Diversion episodes were most likely to be for cannabis (43% compared with 20% for non-diversion episodes). This was followed by alcohol (21% compared with 46%), amphetamines (18% compared with 13%) and heroin (7% compared with 8%). Police diversion episodes had less intensive treatment types compared with court diversion episodes Police diversion episodes were far less likely than court diversion episodes to involve counselling (21% compared with 54%) and support and case management only (1% compared with 15%) as main treatment types, and much more likely to involve information and education only (46% compared with 20%) and assessment only (31% compared with 5%). Details: Canberra: Australian Institute of Health and Welfare, 2014. 24p. Source: Internet Resource: Bulletin 125: Accessed October 15, 2014 at: Year: 2014 Country: Australia URL: Shelf Number: 133954 Keywords: Alternatives to Incarceration Diversion Drug Abuse and Addiction Drug Offender Treatment Drug Offenders (Australia) Substance Abuse Treatment

Author: Police Executive Research Forum Title: New Challenges for Police: A Heroin Epidemic and Changing Attitudes Toward Marijuana Summary: Is the United States fundamentally shifting its approach to drugs? That's a question underlying this report. I think that in many ways, the nation still sees the harm that drugs cause to individual lives and to the fabric of our society. There is no question that drug abuse is a scourge and a tragedy. And the related issue of gang violence associated with drug trafficking is one of the biggest problems in many U.S. cities. Still, around the edges, changes are noticeable. This report details two of those changes. Surge in heroin abuse: First, we are experiencing a spreading epidemic of heroin abuse in many cities and towns across the nation. At the PERF Summit that is the center of this report, FBI Director James Comey told us he has been traveling the nation, and in every single FBI field office he has visited, people have been talking about heroin. Marijuana legalization: The other major topic of this report-the legalization of recreational marijuana in Colorado and Washington State this year-is another issue where there has been a shift in attitude. Public opinion about marijuana obviously has been changing for some time. Nearly half of the 50 states have legalized medical marijuana, going back as far as 1996. Details: Washington, DC: PERF, 2014. 64p. Source: Internet Resource: Critical Issues in Policing Series: Accessed October 20, 2014 at: http://www.policeforum.org/assets/docs/Critical_Issues_Series_2/a%20heroin%20epidemic%20and%20changing%20attitudes%20toward%20marijuana.pdf Year: 2014 Country: United States URL: http://www.policeforum.org/assets/docs/Critical_Issues_Series_2/a%20heroin%20epidemic%20and%20changing%20attitudes%20toward%20marijuana.pdf Shelf Number: 133742 Keywords: Drug Abuse and Addiction Drug Policy Heroin Marijuana (U.S.) Marijuana Legalization

Author: Great Britain. Home Office Title: Drugs: international comparators Summary: Covers approaches to drugs misuse and drug addiction in other countries: - detailing drug consumption rooms; - heroin-assisted treatment; - dissuasion commissions; - drug courts; - prison-based treatment; - prison-based harm-reduction; - new psychoactive substances; - supply-side regulation of cannabis; - decriminalising the possession of drugs for personal use Details: London: Home Office, 2014. 59p. Source: Internet Resource: Accessed November 3, 2014 at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/368489/DrugsInternationalComparators.pdf Year: 2014 Country: International URL: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/368489/DrugsInternationalComparators.pdf Shelf Number: 133934 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Abuse Treatment Drug Courts Drug Offenders Problem-Solving Courts

Author: Human Rights Watch Title: "They Treat Us Like Animals" : Mistreatment of Drug Users and "Undesirables" in Cambodia's Drug Detention Centers Summary: The Cambodian government claims its eight "drug treatment" centers provide treatment and rehabilitation for people dependent on drugs. In reality, they provide neither. At any one time, these facilities collectively hold around 1,000 men, women, and children: some are dependent upon drugs, others are homeless people, beggars, street children, sex workers, or have actual or perceived disabilities. They do not see a lawyer or a judge before or during detention, receive no formal sentence, and have no way to appeal the decision to detain them. Many are confined as part of "sweep the streets" operations ahead of high-profile international meetings, or visits by foreign dignitaries. "They Treat Us Like Animals," a follow-up to a 2010 Human Rights Watch report on the same issue, is based on interviews with 33 recent detainees of Cambodia's drug treatment centers. It finds that arbitrary detention, forced labor, and physical and sexual abuse continue with impunity. Detainees are punched and kicked by center staff, whipped with rubber water hoses, hit with sticks or branches, shocked with electric batons, and punished with physical exercises intended to cause intense physical pain and humiliation, such as having to crawl along stony ground. Former female detainees described sexual abuse by male guards. Many detainees are forced to work, such as growing vegetables or as part of work gangs on construction sites. Those who refuse are beaten. Despite the international outcry over these centers, Cambodian authorities have not released all detainees, investigated alleged torture and other abuses, or held any perpetrators accountable. Human Rights Watch calls on Cambodia's government to permanently close its drug detention centers. Authorities should also investigate credible reports of torture and other ill-treatment, and appropriately discipline or prosecute those responsible, in accordance with Cambodian and international law. Details: New York: HRW, 2014. 65p. Source: Internet Resource: Accessed November 4, 2014 at: http://www.hrw.org/sites/default/files/reports/cambodia1213_ForUpload_1.pdf Year: 2014 Country: Cambodia URL: http://www.hrw.org/sites/default/files/reports/cambodia1213_ForUpload_1.pdf Shelf Number: 133964 Keywords: Detention Centers Drug Abuse and Addiction Drug Treatment (Cambodia) Human Rights Abuses

Author: Goodhand, Jonathan Title: Drugs, (dis)order and agrarian change: the political economy of drugs and its relevance to international drug policy Summary: In May 2014 the School of Oriental and African Studies (SOAS) hosted a workshop, co-funded by NOREF and Christian Aid, designed to facilitate dialogue between scholars working on the political economy of drugs, conflict and development in Asia, Africa and Latin America. The workshop explored how political economy perspectives, derived from long-term empirical research on drugs-affected regions, can enhance understanding of, and policy responses to, drug production and trafficking. This approach, rather than seeing drugs as "exceptional" and "criminal", seeks to situate the role of illicit economies within broader processes of state formation and agrarian change. Contributions to the workshop revealed the highly differentiated and context-specific dynamics of drug economies, and how different configurations of institutions and security markets can lead to different kinds of relationships between drugs, state-building, agrarian change and development. This research does not lend itself to simple policy narratives or prescriptions, but it does suggest that there can be no universal and de-contextualised solutions to "the drug problem". Dogmatic and irreconcilable positions, adopted by both those advocating harsher prohibition and those arguing for blanket decriminalisation, fail to reflect sufficiently on the impacts such policies will have on drug-producing countries. A more grounded, comparative perspective is urgently needed in an arena where policies are often anything but evidence based and where data are patchy or politicised. Counter-narcotic (CN) strategies, based on a reification of the perceived linkages between drugs, instability and state fragility, often provide only a partial, and in some cases deeply misleading, insight into the economic and political orders that emerge around drug production. Political economy provides a corrective to these deeply entrenched biases and blind spots, by incorporating an analysis of aspects of drug economies and counter narcotics (CN) strategies that are frequently treated as residual or circumvented, including the varying levels and types of violence surrounding drug economies; the complex motives of those involved in drug production and trafficking; the linkages between licit and illicit commodities in processes of agrarian transformation; the potential developmental outcomes of drugs economies; the relationship between illicit economies and differing configurations of authority and rule; and a socially differentiated account of who gains and who loses from counter-narcotics policies. In doing so, political economy approaches provide a powerful analytical lens for developing a more contextually attuned public policy on drugs. Details: Oslo: Norwegian Peacebuilding Resource Centre (NOREF), 2014. 4p. Source: Internet Resource: Occasional Publication: Accessed November 4, 2014 at: http://www.peacebuilding.no/var/ezflow_site/storage/original/application/6ae957894148ed319a377eee7c775065.pdf Year: 2014 Country: International URL: http://www.peacebuilding.no/var/ezflow_site/storage/original/application/6ae957894148ed319a377eee7c775065.pdf Shelf Number: 133967 Keywords: Drug Abuse and Addiction Drug Policy Drug Trafficking Drug-Related Violence Illegal Drugs

Author: Open Society Foundations Title: To Protect and Serve: How Police, Sex Workers, and People Who Use Drugs Are Joining Forces to Improve Health and Human Rights Summary: Around the world, sex workers and people who use drugs report that police are often a major impediment to accessing health and social services. Common police practices- - using condoms as evidence of prostitution, harassing drug users at needle exchange points, or confiscating medications for drug treatment- fuel the HIV epidemic by driving sex workers and drug users away from life-saving services. Emerging partnerships between police, health experts, and community groups are beginning to prove that law enforcement and HIV-prevention programs can work together to save lives while reducing crime. When successfully implemented, these programs reduce the risk of HIV and drug overdose, and protect the health and human rights of these communities. Through detailed case studies from Burma, Ghana, India, Kenya, and Kyrgyzstan, this report examines how public health-centered law enforcement can reduce the risk of HIV infections among sex workers and drug users. The lessons of more than two decades of the response to HIV are clear: Police reform and community-police cooperation are as crucial to HIV prevention among criminalized groups as a condom or a clean needle, and should be supported as a central part of HIV and AIDS programming Details: New York: Open Society Foundations, 2014. 58p. Source: Internet Resource: Accessed November 25, 2014 at: http://www.opensocietyfoundations.org/sites/default/files/protect-serve-20140716.pdf Year: 2014 Country: Africa URL: http://www.opensocietyfoundations.org/sites/default/files/protect-serve-20140716.pdf Shelf Number: 134232 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Health Care Police-Community Relations Prostitutes Prostitution Sex Workers (Africa)

Author: French, Charles Title: Juvenile Justice in Oregon: An Analysis of the Performance of Oregon�s Juvenile Justice System Summary: This report is the first formal attempt to compare the performance of Oregon's juvenile justice system with other states since Oregon's system was overhauled by the legislature in 1995. The foundations of Oregon's current juvenile criminal justice policy were established through the leadership of then Oregon Attorney General Ted Kulongoski in Senate Bill 1 and passed by the legislature and signed into law by Governor Kitzhaber in 1995. This landmark legislation fundamentally restructured Oregon's juvenile system, system that are created the Oregon Youth Authority and established the concept of "early and certain intervention and sanctions" as the most effective way to hold juveniles accountable for their criminal behavior. (ORS4l 9C.00 1 ) Despite this clear legislative mandate, many of Oregon's juvenile departments have abandoned the principles of Senate Bill 1 through the influence of a large out-of-state private non-profit organization called the Annie E. Casey Foundation. As a result of the influence of the "Casey philosophy'', more than a third of all juveniles accused of criminal behavior now have their cases dismissed with no action taken by the system. It is difficult to square these practices with the clearly stated principles of Senate Bill 1, particularly when considering Oregon's poor performance in reducing juvenile property and drug crime. The writers of this report believe it is time to conduct a closer examination of how Oregon's juvenile system is actually performing in order to make it more effective and return it to the principles embodied in Senate Bill 1. Unfortunately, the most recent session of the legislature focused its attention on violent juvenile crime, an area in which Oregon has performed well. Since 1995 violent juvenile crime has dropped more than 50%o and has remained far below national juvenile crime rates. In contrast, juvenile property crime in Oregon has remained well above national averages. And, most alarmingly, drug usage and addiction by juveniles in Oregon has reached epidemic proportions, ranking second nationally. This report focuses on areas of our current system that are underperforming, property crime and drugs. Details: Oregon City, OR: Clackamas County District Attorney's Office, 2014. 141p. Source: Internet Resource: Accessed November 26, 2014 at: http://www.clackamas.us/da/documents/JuvenileJusticeinOregon20140929.pdf Year: 2014 Country: United States URL: http://www.clackamas.us/da/documents/JuvenileJusticeinOregon20140929.pdf Shelf Number: 131786 Keywords: Drug Abuse and Addiction Drug Offenses Juvenile Justice Reform Juvenile Justice Systems (Oregon) Juvenile Offenders Property Crimes

Author: English, Ebony M. Title: I Always Wanted To Be a Ho When I Grew Up. Summary: This dissertation employs a qualitative research design by exploring the narratives of female drug offenders involved in a drug-crime lifestyle. In-depth interviews were conducted to examine the subjective experiences of 26 women and their overall perception of the drug-crime lifestyle. The sample was drawn from a population of recovering addicts who frequented a rehabilitative agency in Pittsburgh, Pennsylvania. The findings provide a subjective view of female drug addicts and through an assessment of the Walters' Psychological Inventory of Criminal Thinking Styles (PICTS), the narratives of the respondents were analyzed to evaluate specifically the applicability of Walters' eight thinking styles of cognition. Based on the emerging themes of the data, the study highlighted the complexities of Walters' theoretical thinking styles of drug users and offenders' thinking styles. This study found that the narratives of the women addicts did, in fact, corroborate Walters' theoretical perspective on drug use and crime. The study recommends that more research is needed on the lines of female drug users and their intimate relationships, as well as methadone maintenance programs, victimization, child maltreatment, and the issue of drug recovery and desistance from crime. Details: Indiana, PA: Indiana University of Pennsylvania, 2011. 213p. Source: Internet Resource: Dissertation: Accessed January 22, 2015 at: https://dspace.iup.edu/bitstream/handle/2069/349/Ebony%20English%20Corrected.pdf?sequence=1 Year: 2011 Country: United States URL: https://dspace.iup.edu/bitstream/handle/2069/349/Ebony%20English%20Corrected.pdf?sequence=1 Shelf Number: 134434 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Female Drug Offenders

Author: Connolly, Johnny. Title: Crack cocaine in the Dublin Region: An evidence base for a crack cocaine strategy Summary: Crack cocaine is produced from powder cocaine using readily available chemical agents such as ammonia or baking soda. Smoking crack is a highly efficient way of getting cocaine into the brain, making its use compulsive and difficult to control in some cases. In early 2005, a number of seizures of crack cocaine were made by An Garda Siochana in Dublin's north-inner city. In addition, there were anecdotal reports of individuals using crack cocaine in Dublin. As a result, the Intersectoral Crack Cocaine Strategy Group (ISCCSG) was established in the north-inner city in March 2006. The group decided to document the nature and extent of crack use; the availability of crack; the impact of crack on the user, the family and the wider community; and current treatment and policing responses to crack use. The Alcohol and Drug Research Unit (ADRU) of the Health Research Board (HRB) was commissioned to complete the study using a rapid situation assessment method. The study involved a review of findings from relevant research, the collection and analysis of up-to-date drug-treatment and criminal justice data, and interviews and focus groups with crack users, service providers and the Garda National Drugs Unit. The study received ethical approval in August 2007. Details: Dublin: Health Research Board, 2008. 142p. Source: Internet Resource: HRB Research Series 6: Accessed February 9, 2015 at: http://www.hrb.ie/uploads/tx_hrbpublications/HRB_Research_Series_6.pdf Year: 2008 Country: Ireland URL: http://www.hrb.ie/uploads/tx_hrbpublications/HRB_Research_Series_6.pdf Shelf Number: 113022 Keywords: Crack Cocaine (Ireland) Drug Abuse and Addiction Drug Abuse and Crime Drug Abuse Treatment Drug Markets

Author: United Nations Office on Drugs and Crime (UNODC) Title: Southeast Asia Opium Survey 2014: Lao PDR, Myanmar Summary: This year's Southeast Asia Opium Survey shows that despite continued eradication efforts, opium production remains a significant challenge to sustainable development in the region. Poppy cultivation in the 'Golden Triangle' of Myanmar and Lao PDR rose in 2014 to 63,800ha, compared with 61,200ha in 2013. The estimated total amount of opium produced in the area in 2014 is approximately 762 tons, with the overwhelming majority of cultivation continuing to take place in Myanmar. The data further emphasize the urgent need to address root causes of cultivation and promote alternative development. Surveys of farmers indicate that, for many, the money made from poppy cultivation is an essential part of family income and support. Villages threatened with food insecurity and poverty need sustainable alternatives, or they will have little choice beyond growing this cash crop out of desperation. Indications of high levels of consumption of the refined form of opium - heroin - in parts of the region also represent a clear danger to health and development, underscoring the need for evidence-based, health-centred approaches to prevention and treatment. Efforts to tackle the trafficking of heroin and essential precursor chemicals by criminal groups must also be supported. Most of the heroin trafficked from Myanmar goes to neighbouring countries to meet demand in large population centres, but it is also trafficked to other parts of the region and to global markets. Meanwhile, precursors required to produce heroin are trafficked into Myanmar from neighbouring countries. This two-way trade in and out of the Golden Triangle needs to be halted. Traffickers also appear to be exploiting well-intended regional connectivity and integration plans, including the ASEAN Economic Community and supporting initiatives of international financial institutions. Efforts need to be made to strengthen the capacity and coordination of border, justice and health authorities to counter this transnational challenge. A balanced approach addressing opium production through alternative livelihood initiatives, preventing drug use and providing evidence-based treatment, while countering trafficking of heroin and related precursor chemicals, in line with the international drug control conventions and compliance with human rights standards, should be prioritized by states and international partners to safeguard and promote the region's sustainable development. Details: Bangkok: UNODC Regional Office for Southeast Asia and the Pacific, 2014. 105p. Source: Internet Resource: Accessed March 11, 2015 at: http://www.unodc.org/documents/crop-monitoring/sea/SE-ASIA-opium-poppy-2014-web.pdf Year: 2014 Country: Asia URL: http://www.unodc.org/documents/crop-monitoring/sea/SE-ASIA-opium-poppy-2014-web.pdf Shelf Number: 134897 Keywords: Drug Abuse and Addiction Drug Trafficking Heroin Opium (Asia) Organized Crime

Author: Coelho, Manuel Pinto Title: Drugs: The Portuguese Fallacy and the Absurd Medicalization of Europe Summary: Drug decriminalization in Portugal is a failure despite of various reports published all over the world pretending the opposite. There is a complete and absurd campaign of an unacceptable manipulation of Portuguese drug policy. Underestimating the readers understanding and suggesting the contrary to what facts and numbers show unequivocally, a book written by a writer/lawyer fluent in Portuguese for an American "libertarian" think-tank a long time advocating drug legalization - Cato Institute - has been carried out naively by some usually responsible national and international press all over the world, that boosting the proliferation of the Portuguese "good news" are dangerously distorting the projection of the reality. On the other hand, is very preoccupant indeed the appeal, among others, of two notorious personalities on the field of drug dependence that among others are inviting the world "to move human rights into the mainstream of drug control" and "place health at the core of drug policy". Applying in their speech the two favorite arguments the two "jewels of the crown" of the well known economic-social-political group that insistently and restlessly wishes at any cost to legalize drugs - "health" and "human rights" - those high representative officials amazingly seems they did not find the strength enough to resist the pressure and, capitulating to that lobby group are opening dangerously the door to the medicalization of drug dependency. Surprisingly the very recent 2010 EMCDDA Report, emphasizing the use of substitution drugs as main tool to tackle opioid dependence, shows clearly that Europe seems wishing to go in the same way. Details: Association for a Drug Free Portugal, 2013. 33p. Source: Internet Resource: Accessed March 18, 2015 at: http://www.drugfree.org.au/fileadmin/library/Policies__Legislation_and_law/ThePortugueseDrugFallacyReport.pdf Year: 2013 Country: Portugal URL: http://www.drugfree.org.au/fileadmin/library/Policies__Legislation_and_law/ThePortugueseDrugFallacyReport.pdf Shelf Number: 134954 Keywords: Drug Abuse and Addiction Drug Legalization Drug Policy (Portugal)

Author: Neill, Katharine A. Title: Marijuana Reform: Fears and Facts Summary: In 1972, a National Commission on Marihuana and Drug Abuse, comprising establishment figures chosen mostly by President Richard Nixon himself, issued a report that declared that "neither the marihuana user nor the drug itself can be said to constitute a danger to public safety" and recommended that Congress and state legislatures decriminalize the use and casual distribution of marijuana and seek means other than prohibition to discourage use. President Nixon ignored the report and Congress declined to consider its recommendations, but during the 40-plus years since its publication, at least 37 states have acted to refashion a crazy-quilt collection of prohibitions, nearly always in the direction favored by the commission. The specifics vary by state, but most reform legislation has followed one of three formulas: decriminalization of marijuana possession, legalization of marijuana for medical use, or legalization of marijuana for adult recreational use. In this issue brief, authors Katharine Neill and William Martin examine the facts and fears surrounding each of these options. Details: Houston, TX: Rice University, Baker Institute for Public Policy, 2015. 8p. Source: Internet Resource: Issue Brief: Accessed March 27, 2015 at: http://bakerinstitute.org/media/files/research_document/1886afae/BI-Brief-020415-MJlegalization.pdf Year: 2015 Country: United States URL: http://bakerinstitute.org/media/files/research_document/1886afae/BI-Brief-020415-MJlegalization.pdf Shelf Number: 134955 Keywords: Drug Abuse and Addiction Drug Legalization Drug Reform Policy (U.S.) Marijuana

Author: Rolles, Steve Title: Drug policy in Sweden: a repressive approach that increases harm Summary: The central aim of Swedish drug policy is to create a drug-free society. To achieve this aim, the country has adopted a punitive, enforcement-led approach to drugs. It is this approach, some have argued, that is responsible for Sweden's historically low levels of drug use. This apparent success of the Swedish model is therefore often presented as an argument against drug policy reforms such as decriminalisation and legal regulation. However, the degree to which Sweden's low prevalence of drug use can be attributed to its repressive approach is highly questionable, as research consistently shows that wider social, economic and cultural factors are the key drivers of drug prevalence - not the harshness of enforcement. Also of note is that levels of drug use in Sweden, while in relative terms still very low, are increasing. Furthermore, the Swedish model - in particular its antipathy to proven harm reduction measures - has had serious negative consequences that are almost never mentioned by its advocates. These include alarmingly high rates of hepatitis C among people who inject drugs, and a 600% increase in drug-induced deaths over the last 20 years. Details: Bristol, UK: Transform, 2015. 4p. Source: Internet Resource: Accessed March 18, 2015 at: www.tdpf.org.uk Year: 2015 Country: Sweden URL: www.tdpf.org.uk Shelf Number: 134956 Keywords: Drug Abuse and Addiction Drug Enforcement Drug Policy (Sweden) Drug Reform

Author: Murkin, George Title: Drug decriminalisation in Portugal: setting the record straight Summary: Portugal decriminalised the possession of all drugs for personal use in 2001, and there now exists a significant body of evidence on what happened following the move. Both opponents and advocates of drug policy reform are sometimes guilty of misrepresenting this evidence, with the former ignoring or incorrectly disputing the benefits of reform, and the latter tending to overstate them. The reality is that Portugal's drug situation has improved significantly in several key areas. Most notably, HIV infections and drug-related deaths have decreased, while the dramatic rise in use feared by some has failed to materialise. However, such improvements are not solely the result of the decriminalisation policy; Portugal's shift towards a more health-centred approach to drugs, as well as wider health and social policy changes, are equally, if not more, responsible for the positive changes observed. Drawing on the most up-to-date evidence, this briefing clarifies the extent of Portugal's achievement, and debunks some of the erroneous claims made about the country's innovative approach to drugs. Details: Bristol, UK: Transform, 2014. 4p. Source: Internet Resource: Accessed March 18, 2015 at: http://www.tdpf.org.uk/blog/drug-decriminalisation-portugal-setting-record-straight Year: 2014 Country: Portugal URL: http://www.tdpf.org.uk/blog/drug-decriminalisation-portugal-setting-record-straight Shelf Number: 134957 Keywords: Drug Abuse and Addiction Drug Legalization Drug Policy (Portugal) Drug Reform

Author: Dobovsek, Bojan Title: Trends and developments in drug legislation in South Eastern Europe Summary: KEY POINTS - Criminal Justice systems of South Eastern European (SEE) countries are based on different traditions and the response to the drug issue proves diversified. Deviations are wider in the area of smaller-scale violations of drug laws, while penalties envisaged for drug trafficking have more common characteristics being extremely harsh. In several countries however, regardless of the strict scope of legal provisions, the penalties actually imposed by courts are less stringent - The reaction of criminal law in cases of drug possession for personal use reveal more distinct diversifications. In general, SEE countries could be described as indecisive on issues regarding decriminalization of possession of drugs for personal use. This is an extremely crucial issue in the further development of drug policy, since this reasoning usually deeply affects the lenient or harsh treatment of the user-perpetrators within the criminal justice system. Further research and study of the current practice concerning possession for personal use, must be a priority in the future agenda of the countries of the region, in order to relieve the criminal justice and the penitentiary, system. The scientific community in SE Europe could contribute significantly in imple-menting a program to achieve this goal. - In recent years, great strides have been made to broaden harm-reduction policies and services. However, weak or non existing legislation on harm reduction, and a culture of mistrust and phobic societies, have greatly suppressed harm reduction programs and services. The shift of interest towards harm reduction is a particularly critical parameter and it will greatly influence developments in drug policy in South Eastern Europe, especially under the effect of the wider relevant European policy. - The National drug strategies an action plans have in most of the countries of South Eastern Europe never been evaluated. It is a challenge for them to assign a qualified and independent periodic evaluation. Details: Amsterdam: Transnational Institute, 2013. 16p. Source: Internet Resource: Drug Policy Dialogue in South Eastern Europe, DIOGENIS Association Pr 3, Accessed March 23, 2015 at: http://www.diogenis.info/ckfinder/userfiles/files/Briefing_paper_nr_3_Trends_and_developments_in_Drug%20_legislation_SEE_English_final.pdf Year: 2013 Country: Europe URL: http://www.diogenis.info/ckfinder/userfiles/files/Briefing_paper_nr_3_Trends_and_developments_in_Drug%20_legislation_SEE_English_final.pdf Shelf Number: 134999 Keywords: Drug Abuse and Addiction Drug Enforcement Drug Policy (Europe) Drug Reform

Author: Rosen, Liana Title: International Drug Control Policy: Background and U.S. Responses Summary: The global illegal drug trade represents a multi-dimensional challenge that has implications for U.S. national interests as well as the international community. Common illegal drugs trafficked internationally include cocaine, heroin, and methamphetamine. According to the U.S. intelligence community, international drug trafficking can undermine political and regional stability and bolster the role and capabilities of transnational criminal organizations in the drug trade. Key regions of concern include Latin America and Afghanistan, which are focal points in U.S. efforts to combat the production and transit of cocaine and heroin, respectively. Drug use and addiction have the potential to negatively affect the social fabric of communities, hinder economic development, and place an additional burden on national public health infrastructures. Details: Washington, DC: Congressional Research Service, 2015. 42p. Source: Internet Resource: CRS RL34543: Accessed March 26, 2015 at: http://fas.org/sgp/crs/row/RL34543.pdf Year: 2015 Country: United States URL: http://fas.org/sgp/crs/row/RL34543.pdf Shelf Number: 135057 Keywords: Drug Abuse and Addiction Drug Control Policy Drug Enforcement Drug Trafficking

Author: Australian Crime Commission Title: The Australian methylamphetamine market: the national picture Summary: This report aims to provide a concise understanding of the nature of organised crime involvement in the Australian methylamphetamine market. The ACC monitors all illicit drug markets through its High Risk and Emerging Drugs Special Operation. Through this work, the ACC has assessed that methylamphetamine poses the greatest threat to the Australian public of all illicit drug types. The ACC's annual Illicit Drug Data Report provides a detailed and comprehensive statistical picture of the illicit drug threat to Australia and provides an in-depth statistical analysis of the illicit drug market. The Australian Methylamphetamine Market: The National Picture is a complementary intelligence report. This report provides a brief summation of the national picture of the methylamphetamine threat. It explores the international and national dimensions of the methylamphetamine market, outlines the role of organised crime in driving the Australian market, the nature of the market, and the harms associated with methylamphetamine use. It also examines the diversion of precursor chemicals required to produce methylamphetamine in clandestine laboratories. It does this by consolidating open source information with operational and strategic intelligence collected by the ACC and Commonwealth, state and territory law enforcement agencies. The release of this report is designed to: �inform the widest possible audience, including those who are not privy to classified law enforcement intelligence; �generate discussion and dialogue about what can be done to tackle the methylamphetamine problem; �enable individuals, friends and families to understand the nature of the harms; caused by methylamphetamine and influence those around them to minimise harm �inform the national response to the methylamphetamine market. Details: Canberra: Australian Crime Commission, 2015. 24p. Source: Internet Resource: Accessed March 26, 2015 at: http://apo.org.au/files/Resource/acc_theaustralianmethylamphetaminemarket_mar_2015.pdf Year: 2015 Country: Australia URL: http://apo.org.au/files/Resource/acc_theaustralianmethylamphetaminemarket_mar_2015.pdf Shelf Number: 135060 Keywords: Drug Abuse and Addiction Drug Markets (Australia) Drug Trafficking Methamphetamine Organized Crime

Author: Victoria (AUS). Department of Premier and Cabinet Title: Ice action plan Summary: Ice use is a complex problem that demands a long-term solution, but the Ice Action Plan deals with the things that cannot wait. It�s about supporting families, treating users and making our community safer. Under the Plan, the Government will invest $4.7 million to help families identify and manage ice users and $1 million to support frontline workers who are at risk of getting attacked at work. The Government will invest $18 million to expand drug treatment and rehabilitation, so users can get the help they need, and set up a dedicated Ice Help Line that directs families and health professionals to the support they need. New measures to reduce the growing supply of ice on our streets include a $4.5 million plan to crack down on clandestine drug labs and tough laws to stop dealers and manufacturers. Community safety is our priority. The Government will invest $15 million for new drug and booze buses and provide $500,000 to help community groups tackle ice use in their local area. A stable job means a stable life, and the Andrews Labor Government is improving the prospects of young, at-risk people with the $1 billion Back to Work Plan and the $320 million TAFE Rescue Fund. The Ice Action Plan builds on the Victorian Parliament�s landmark 2014 Inquiry into the supply and use of ice, which identified a significant increase in the number of people in their 20s using ice. The work of the Premier�s Ice Action Taskforce will continue, with a long-term role to support the implementation of the Plan and advise the Government where more effort is needed. Details: Melbourne: Victorian Government, 2015. 24p. Source: Internet Resource: Accessed March 26, 2015 at: http://apo.org.au/files/Resource/ice-action-plan-final-summary-document-web-version.pdf Year: 2015 Country: Australia URL: http://apo.org.au/files/Resource/ice-action-plan-final-summary-document-web-version.pdf Shelf Number: 135061 Keywords: Drug Abuse and Addiction Drug Treatment Methamphetamine Substance Abuse Treatment

Author: Taylor, Liana R. Title: General Responsivity and Evidence-Based Treatment: Individual and Program Predictors of Treatment Outcomes During Adolescent Outpatient Substance Abuse Treatment Summary: Since it was first articulated, the Risk-Need-Responsivity model (RNR; Andrews, Bonta, & Hoge, 1990) has been extensively researched and is regarded as an empirically supported model for providing effective correctional treatment. It is comprised of three core principles: the risk principle, which provides direction for who should receive treatment; the need principle, which identifies intermediate treatment targets; and the responsivity principle, which states how treatment programs should be structured. The RNR model is purported to be relevant for all offender populations, including female offenders (Dowden & Andrews, 1999a), juvenile offenders (Dowden & Andrews, 1999b), violent offenders (Dowden & Andrews, 2000), and sexual offenders (Hanson, Bourgon, Helmus, & Hogdson, 2009). Yet, the majority of RNR research has examined the risk and need principles, and the responsivity principle remains understudied. The responsivity principle includes two sub-principles: general and specific (Andrews, & Bonta, 2010). The current research explored the general responsivity principle, which states that programs should use theoretically relevant models for individual change, specifically cognitive-behavioral and cognitive-social learning models (Andrews & Bonta, 2010). The following techniques are consistent with these models: "role-playing, modeling, repeated practice of alternative behaviors, cognitive restructuring to modify thoughts/emotions, skills building, or reinforcement" (Andrews & Bonta, 2010, p. 50). Despite empirical support, the RNR model has received minimal application to juveniles, and it has not been widely tested in the substance abuse treatment context. Additionally, it is not clear whether adherence to the RNR model is relevant for reducing substance use outcomes in youth. Adolescent substance abuse treatment programs were designed to address substance use among juveniles, and have been widely researched to determine their effectiveness; yet their effectiveness remains understudied among juvenile offenders. These studies include examinations of specific treatment interventions used, such as Multisystemic Therapy. Many of these interventions are considered to be "evidence-based treatment" (EBT), but there is a wide variety of repositories that classify interventions as "evidence-based" with varying criteria used to classify them. The juvenile drug treatment court model (JDTC) was specifically developed to address substance use and crime among juvenile offenders; however, findings from empirical studies have not demonstrated a strong treatment effect. To address these gaps in the literature, secondary analyses were conducted on data collected from 132 adolescent outpatient substance abuse treatment programs (AOPs) and 10 juvenile drug treatment courts nationwide. This research was an application of the general responsivity principle in the AOP and JDTC context to determine the impact of responsivity adherence on the odds of rearrest and substance use severity. The analyses also included an examination of evidence-based treatment (EBT) in both samples to determine the influence of EBT use scores on the odds of rearrests and substance use severity scores. To examine the AOP sample, multilevel models were used to examine the individual- and program-level impact of responsivity adherence and EBT use. To examine the JDTC sample, multivariate analyses were used to examine the individual-level impact of responsivity adherence and EBT use. Overall, responsivity adherence was not significantly associated with rearrests among AOP participants, nor was it significantly associated with substance use severity scores. Additionally, the odds of rearrest were significantly greater among individuals who received interventions with a higher EBT use score; though, there was no association between the average EBT use scores across programs and the odds of rearrest. There was no significant association between individual- and program-level EBT use scores and substance use severity. Among JDTC participants, an increase in responsivity adherence was associated with an increase in the odds of rearrest and substance use severity. A similar association emerged between EBT use scores and both outcomes, wherein increases in EBT use scores were significantly associated with an increase in the odds of rearrest and substance use severity. The results of the analyses suggest the need for further specification of both general responsivity adherence and "evidence-based" treatment for use in future research and theory; specifically, further elaboration of the general responsivity-adherent techniques and clear criteria for classifying interventions as "evidence-based treatment." The findings also imply that certain types of treatment interventions are more compatible with the JDTC model than other interventions. Additional analyses suggest the possibility that general responsivity adherence and evidence-based treatment may not be unique constructs. Future research may benefit through exploring evidence-based treatment as a criterion for adherence to the general responsivity principle. Details: Philadelphia: Temple University, 2014. 252p. Source: Internet Resource: Dissertation: Accessed April 1, 2015 at: https://www.ncjrs.gov/pdffiles1/nij/grants/248590.pdf Year: 2014 Country: United States URL: https://www.ncjrs.gov/pdffiles1/nij/grants/248590.pdf Shelf Number: 135116 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Drug Courts Drug Offenders Evidence-Based Treatment Juvenile Drug Offenders Substance Abuse Treatment

Author: Hornby Zeller Associates, Inc. Title: 2013 Prescription Monitoring Program: Survey Results Summary: The Maine Prescription Monitoring Program (PMP) is a valuable tool used by health care providers to develop comprehensive clinical backgrounds for new patients and for existing patients who request prescription refills of controlled substances. In 2012, the Maine Office of Substance Abuse and Mental Health Services (SAMHS) received a grant to improve access to complete patient prescription data through the PMP. SAMHS seeks to integrate PMP with Maine�s Health Information Exchange (HIE) and to foster interoperability with at least eight other states. Part of the improvement process will be to create access to PMP data directly from a patient�s health record in the HIE. To understand and address PMP user needs in light of these new opportunities, SAMHS invited all registered PMP users (4,127 individuals) to participate in an online survey. SAMHS contracted with Hornby Zeller Associates, Inc. (HZA) to administer the survey and analyze the results. A total of 1,282 people responded for a response rate of 31.1%. Most respondents (61.9%) were prescribers (physicians, nurse practitioners or physician assistants). Other respondents were nurses, pharmacists, clinical support, case managers, behavioral health providers and administrative support. Frequency of using PMP. Survey results indicate that most prescribers use PMP at least once a week or less than three times per month. Since survey respondents were not asked their specialty, it is not possible to conclude whether this frequency is clinically appropriate. However, for prescribers who do use PMP, most consult it just before or during a patient visit. Nearly 72% of pharmacists use PMP during the patient visit. Reasons for using PMP. The most common reasons by far for using PMP are when misuse or diversion is suspected. This is true across the board, for all types of responders no matter how frequent their use. PMP is also used periodically (49.2%) or routinely (37.6%) for patients receiving controlled substances, and periodically for patients receiving opioids (34.8%). Prompts for using PMP. Some office practices incorporate PMP as part of office procedure, policy or required protocol, and in these cases nurses most frequently access PMP. Pharmacists use PMP as part of required protocol more frequently than prescribers. Very few healthcare providers are prompted by a pop-up notice in electronic health records to consult PMP. Prescribing practices as a result of using PMP. Prescribers who alter their prescribing practices as a result of using PMP stopped (60.7%) and/or decreased (49.3%) prescribing controlled substances to the patient and/or provided patient education (44.9%). Over a third referred the patient to substance abuse treatment. A smaller number (16.5%) refused to treat the patient. (Respondents could provide more than one action, so percentages do not total 100.) For non-prescribers, the most frequent course of action after reviewing a patient�s PMP record was to notify the prescribers) of discrepancies. Barriers to using PMP. The vast majority of respondents find PMP easy to use (77.7%). While PMP users had frustrations with forgetting their passwords and with the password retrieval process, by far the greatest challenge to using PMP is the lack of real time data. Currently, data submission is required within seven days of dispensing. Pharmacists and prescribers in particular see this as a challenge to using the system to its greatest effect in prescribing and dispensing appropriate medications and in detecting misuse and diversion. Customer satisfaction. Over half (55.1%) of respondents were satisfied with PMP customer service. Responses did not vary significantly by role or by frequency of use. Details: Bangor, ME: Maine Department of Health and Human Services, Office of Substance Abuse and Mental Health Services, 2013. 22p. Source: Internet Resource: Accessed April 20, 2015 at: http://hornbyzeller.com/wp-content/uploads/2013/11/PMP-Survey-Results-FINAL-Jul-24-2013.pdf Year: 2013 Country: United States URL: http://hornbyzeller.com/wp-content/uploads/2013/11/PMP-Survey-Results-FINAL-Jul-24-2013.pdf Shelf Number: 135283 Keywords: Drug Abuse and Addiction Prescription Drug Abuse (Maine)

Author: Centre for Social Justice Title: Drugs in Prison Summary: Prisons in England and Wales have a serious drug problem - they have done for decades. There is every reason to tackle it. Prisons are straining under the violence it causes. Drug-using prisoners are suffering from physical and mental health conditions and their chances rehabilitation are slim. Society is suffering through addicted prisoners committing crime to fund their habits on release. One of the chief purposes of prison is to reduce crime. In this regard they are clearly failing. It does not have to be this way. It is very possible to change this situation and ensure prisons are a place where people battling addiction recover. Success requires a three-pronged approach: Drugs must be kept out of prisons; Demand for drugs must be reduced; Drug addicted prisoners must receive effective support into recovery. These three requirements are interdependent and failure in just one area will ultimately lead to a failure to tackle the prison drug problem. This paper sets out the Details: London: Centre for Social Justice, 2015. 86p. Source: Internet Resource: Accessed April 21, 2015 at: http://www.centreforsocialjustice.org.uk/UserStorage/pdf/Pdf%20reports/CSJJ3090_Drugs_in_Prison.pdf Year: 2015 Country: United Kingdom URL: http://www.centreforsocialjustice.org.uk/UserStorage/pdf/Pdf%20reports/CSJJ3090_Drugs_in_Prison.pdf Shelf Number: 135325 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Drug Offenders Drugs in Prison Prison Contraband (U.K.)

Author: Franquero, Oscar Pares Title: Innovation Born of Necessity: Pioneering Drug Policy in Catalonia Summary: In the 1970s, in the midst of a major political and economic transition, Spain suddenly faced unprecedented levels of heroin consumption, which soon evolved into an epidemic of fatal drug overdoses and HIV and hepatitis infections. Despite the inertia and limitations of national policies, Catalonia created a comprehensive approach to drug treatment and harm reduction. From the start, the Catalan response was motivated by families of youth who were affected by drug consumption and neighborhood movements that denounced the lack of resources. With broad political consensus, they created the Catalonian Drug Dependency Care Network that offered a multidisciplinary response to drug treatment, harm reduction, and social integration. Innovation Born of Necessity: Pioneering Drug Policy in Catalonia follows the evolution of two of the region's drug policy solutions: its health- and rights-based approach to drug treatment and harm reduction, and its model for safely legalizing the market for cannabis. Catalonia's long held values of collaborative grassroots action and political autonomy have forged many other unique social policies and mechanisms, the most well known of which is the cannabis social club. Offering a new, collective-based model for the legal growth, sale, and use of cannabis, the promise of the cannabis social club goes well beyond the significant benefits to cannabis users. After tracing their social and legal evolution, Innovation Born of Necessity shows how the cannabis social clubs reinforce civil society, protect public health, and shrink the black market while boosting the formal economy, thus contributing to a more democratic society Details: New York: Open Society Foundations, 2015. 68p. Source: Internet Resource: Lessons for Drug Policy Series, 2015: Accessed May 1, 2015 at: http://www.opensocietyfoundations.org/sites/default/files/20150428-innovation-born-necessity-pioneering-drug-policy-catalonia.pdf Year: 2015 Country: Spain URL: http://www.opensocietyfoundations.org/sites/default/files/20150428-innovation-born-necessity-pioneering-drug-policy-catalonia.pdf Shelf Number: 135447 Keywords: Drug Abuse and Addiction Drug Policy (Catalonia) Drug Reform

Author: Clark, Marilyn Title: The Gender Dimension of Non-Medical Use of Prescription Drugs (NMUPD) in Europe and the Mediterranean Region Summary: Understanding gender as it relates to drug use and drug use disorders is a critical requirement to developing effective policy and practice responses. This study aims to explore the gender dimension of non-medical use of prescription drugs (NMUPD) in Europe and the Mediterranean region and continues to build on the corpus of knowledge on the subject and also help identify gaps. Working Definitions The definition of NMUPD developed by the Lithuanian Presidency of the Council of the EU in 2013 was adopted: 'use of a prescription drug, whether obtained by prescription or otherwise, other than in the manner or for the time period prescribed, or by a person for whom the drug was not prescribed (2013:14). The term "nonmedical use," does not correspond to the definition of substance related disorders in DSM-V. For the purpose of the survey tool the 'use of prescription drugs' was defined as 'consumption with doctor's prescription and/or consumption as prescribed by a medical practitioner'. Project Purpose and Design The main aims of this study are: - To explore gender differences in NMUPD in Europe and the Mediterranean region through a documentation of secondary sources with the aim of constructing a snapshot of the current scenario with regards to gender and use and misuse of prescription drugs. - To identify gaps in the data available in the various regions in Europe and the Mediterranean. - To make recommendations for further research. - To make recommendations for policy development and practice A survey questionnaire targeted towards experts nominated by the Permanent Correspondents of the Pompidou Group Member States and former Member States and for the Mediterranean countries, experts nominated through the MedNET correspondents, constitutes the research tool. Details: Strasbourg: Council of Europe, Pompidou Group expert Working Group on the Gender Dimension of NMUPD, 2015. 152p. Source: Internet Resource: Accessed May 9, 2015 at: http://www.coe.int/t/dghl/standardsetting/equality/03themes/gender-mainstreaming/PompidouGenderDimension-V5.pdf Year: 2015 Country: Europe URL: http://www.coe.int/t/dghl/standardsetting/equality/03themes/gender-mainstreaming/PompidouGenderDimension-V5.pdf Shelf Number: 135541 Keywords: Drug Abuse and Addiction Gender Prescription Drug Abuse

Author: Wish, Eric D. Title: Community Drug Early Warning System: The CDEWS Pilot Summary: This report describes a pilot test of the Community Drug Early Warning System (CDEWS) in three jurisdictions in the Washington, DC and Richmond, VA, Metropolitan Areas. CDEWS was designed to provide rapid information about emerging drug use in local communities by sampling urine specimens already obtained and tested for a limited panel of drugs by local criminal justice agencies and retesting them for a larger panel of drugs. The anonymous specimens were sent to an independent laboratory for testing for a panel of more than 30 licit and illicit drugs including 12 synthetic cannabinoid (SC) metabolites. The results demonstrated that CDEWS could be successfully implemented in diverse criminal justice populations, including arrestees, probationers and parolees, and drug court participants. Most important, CDEWS proved its utility for uncovering emerging drugs. SCs were detected in the specimens from all participating sites in the District of Columbia, Maryland, and Virginia. Furthermore, all of the SC positive specimens contained one or two of the metabolites (UR-144 and XLR-11) recently identified and added to the federal schedule of prohibited SC metabolites after this study began. Additional analyses of the CDEWS results identified areas of Washington, DC, where the SC positive specimens were more concentrated and where future studies of its use and availability could be focused. The report concludes with research implications of the findings and next steps for implementing CDEWS in other sites. Details: Washington, DC: Executive Office of the President, 2013. 80p. Source: Internet Resource: Accessed May 16, 2015 at: https://www.whitehouse.gov/sites/default/files/finalreport_with_cover_09172013.pdf Year: 2013 Country: United States URL: https://www.whitehouse.gov/sites/default/files/finalreport_with_cover_09172013.pdf Shelf Number: 135655 Keywords: Drug Abuse and Addiction Drug Control Policy Drug Enforcement Drug Testing Illicit Drugs Urine Testing

Author: Bynum, Timothy Title: Methamphetamine in Michigan: Issues and Interventions Summary: Methamphetamine abuse and manufacture has become an increasingly serious problem across the United States in recent years. Known more commonly as "meth," the drug is a type of synthetic stimulant that affects the body's central nervous system, and is highly addictive. The consequences of methamphetamine abuse are particularly serious in that not only is the drug very addictive but chronic use can result in significant and potentially irreversible damage to the brain. Methamphetamine works by stimulating excess release of dopamine, a neurotransmitter that is instrumental in regulating feelings of pleasure in the body. Users may smoke, inhale, inject or swallow meth, depending on the form of the drug at the time of use. The effects of meth may last up to 8 hours. Users often develop a tolerance to the effects and then increase the frequency and/or dosage of the drug that is needed in order to get high. According to an ONDCP report meth users tend to be white males, with an average age of 29. Users typically come from a low or low to middle socioeconomic group and many are unemployed. Methamphetamine was originally developed for treatment of respiratory problems in the 1930s. The American Medical Association approved the use of amphetamines to treat a variety of ailments including ADD, Parkinson's, depression and narcolepsy. (Hunt, et. al, 2006) The effects on sleep and fatigue were recognized by the military and the armed forces in Japan and the United States utilized amphetamines and meth to combat fatigue. Available by prescription, more extensive civilian use commenced in the 1960s and was used by women for weight loss along with college students and truck drivers needing to stay awake for work or studying. In 1970, amphetamine and methamphetamine were classified as a Schedule II drug thus making them illegal to possess without a prescription. Until recently many of the precursors necessary to make meth were legal. In 2003 ephedrine was banned under the Ephedra Prohibition Act and in 2004 Oklahoma passed legislation restricting ephedrine/pseudoephedrine products and forced buyers to identify themselves at pharmacies where the product was now only kept behind the counter. Other states have adopted similar legislation. (Hunt et. al, 2006) Despite these new laws, meth can be manufactured rather easily in clandestine or makeshift laboratories using inexpensive and readily available ingredients, allowing large quantities to be made at more affordable prices compared to other types of stimulant narcotics. The volatility of these labs creates extremely unsafe and often toxic and explosive situations. The highly addictive nature of the drug combined with the hazards associated with the makeshift labs has garnered increased attention from law enforcement agencies and treatment providers at both national and local levels. Details: East Lansing, MI: Michigan Justice Statistics Center, School of Criminal Justice, Michigan State University, 2007. 32p. Source: Internet Resource: Accessed May 21, 2005 at: http://cj.msu.edu/assets/Methamphetamine-in-Michigan-Issues-and-Interventions.pdf Year: 2007 Country: United States URL: http://cj.msu.edu/assets/Methamphetamine-in-Michigan-Issues-and-Interventions.pdf Shelf Number: 135744 Keywords: Drug Abuse and Addiction Drug Control Policy Methamphetamine

Author: Organization of American States Title: The OAS Drug Report: 16 Months of Debates and Consensus Summary: At the Sixth Summit of the Americas, held in Cartagena de Indias, Colombia, in April 2012, our Heads of State and Government entrusted the Organization of American States with the task of preparing a Report on the drug problem in the Americas. The instructions, as communicated by the President of the Summit, Juan Manuel Santos, were clear-cut: the Report should be frank, thorough, and shed light on actions taken so far to confront the drug problem, without shying away from sensitive issues and without fear of breaking taboos in order to pave the way for new approaches to the drug phenomenon. One year later the task had been completed. In May, 2013, we delivered the Report on the Drug Problem to the same President of Colombia and, through him, to all the Heads of State and Government. It had a huge, immediate impact. Less than one month later, the OAS General Assembly met in Antigua Guatemala, for the first session ever to address this significant issue that we have lived with for several decades. Its conclusions testified to the pressing need our governments and peoples felt to revisit the policies that had predominated in the Hemisphere and yet had failed to achieve expected outcomes. In just 16 months, the Report managed to open up a discussion as frank as it was unprecedented of all the options available in the quest for more effective policies for dealing with the drug problem in the Hemisphere. The influential North American daily, The New York Times, wrote that the report "effectively breaks the taboo on considering alternatives to the current prohibitionist approach." The Colombia magazine Semana wrote that "this report opens another front in debate between the various alternatives to address the drug business in its various stages, as well as the consequences of its consumption." Details: Washington,DC: OAS, 2014. 24p. Source: Internet Resource: Accessed May 23, 2015 at: http://www.oas.org/docs/publications/LayoutPubgAGDrogas-ENG-29-9.pdf Year: 2014 Country: South America URL: http://www.oas.org/docs/publications/LayoutPubgAGDrogas-ENG-29-9.pdf Shelf Number: 135765 Keywords: Drug Abuse and Addiction Drug Control Drug Trafficking

Author: Carvalho, Ilona Szabo de Title: Citizen security rising: new approaches to addressing drugs, guns and violence in Latin America Summary: Many Latin American states are facing epidemic levels of organised and interpersonal violence. This violence is attributed to a number of risk factors, even if the illegal drugs trade and punitive responses to trafficking are widely credited with being the principle drivers. Yet while trafficking in narcotics is commonly associated with insecurity, weakening governance and underdevelopment, drugs as such are not the central problem. Rather, it is competition between criminal factions for control over the trade and a protracted "war" declared against drugs that have ratcheted up insecurity from Mexico to Brazil. The outcomes of this four-decade-long war are at best uneven, with gains in one country overshadowed by severe declines in others. More optimistically, a regional debate is under way that is challenging the status quo with a more concerted focus on prevention and demand reduction. Latin American societies are beginning to explore alternative approaches to drug control tailored to regional and national needs and priorities. There is a visible shift toward a discourse that emphasises prevention and treats consumption as a public health issue, focuses repression on the most violent criminal organisations and redirects law enforcement toward harm reduction. The hope is that this may presage a turn toward investment in policies that are animated more by evidence than ideology. Details: Oslo: Norwegian Peacebuilding Resource Centre (NOREF): 2013. 10p. Source: Internet Resource: Accessed May 26, 2015 at: http://www.peacebuilding.no/var/ezflow_site/storage/original/application/061bc30adffa795e6a5e43bf664c8666.pdf Year: 2013 Country: Latin America URL: http://www.peacebuilding.no/var/ezflow_site/storage/original/application/061bc30adffa795e6a5e43bf664c8666.pdf Shelf Number: 129717 Keywords: Drug Abuse and Addiction Drug Trafficking Drug-Related Violence Drugs and Crime Gun Violence War on Drugs

Author: Malinowska-Sempruch, Kasia Title: The Impact of Drug Policy on Women Summary: Across the globe, the failure of the war on drugs has come at an enormous cost to women. Punitive drug laws and policies pose a heavy burden on women and, in turn, on the children for whom women are often the principal caregivers. Prohibitionist policies impede access to and use of HIV and hepatitis C prevention and care services for everyone, but women and girls virtually always face a higher risk of transmission of these infections. Men suffer from unjust incarceration for minor drug offenses, but in some places women are more likely than men to face harsh sentences for minor infractions. Treatment for drug dependence is of poor quality in many places, but women are at especially high risk of undergoing inappropriate treatment or not receiving any treatment at all. All people who use drugs face stigma and discrimination, but women are often more likely than men to be severely vilified as unfit parents and "fallen" members of society. In drug policy reform debates and movements happening around the world, the rights of women should be a central concern. Less punitive laws for minor and nonviolent drug infractions are the best single means of reducing incarceration of women and thus incarceration-related abuse. Such measures will also reduce stigma and enable women to have better access to services in the community. The Impact of Drug Policy on Women elaborates on the gender dimension of drug policy and law, with attention to the burdens that ill-conceived policies and inadequate services place on women and girls. Details: Washington, DC: Open Society Foundations, 2015. 24p. Source: Internet Resource: Accessed September 2, 2015 at: http://www.opensocietyfoundations.org/sites/default/files/ungass-impact-drug-policy-women-20150507.pdf Year: 2015 Country: International URL: http://www.opensocietyfoundations.org/sites/default/files/ungass-impact-drug-policy-women-20150507.pdf Shelf Number: 135851 Keywords: Drug Abuse and Addiction Drug Policy Reform Gender-Based Programs War on Drugs

Author: Kramer, Tom Title: The Current State of Counternarcotics Policy and Drug Reform Debates in Myanmar Summary: Key Findings - Myanmar is the world's second largest producer of opium after Aghanistan. Following a decade of decline, cultivation has more than doubled since 2006. The production and use of amphetamine-type stimulants (ATS) is also rising. - Most of the opium is turned into heroin and exported via neighboring countries, especially to China. - Decades of civil war and military rule have stimulated drug production and consumption, and marginalized ethnic communities. - Myanmar has high levels of injecting drug users infected with HIV/AIDS and hepatitis C. - Drug policies in Myanmar are repressive and outdated, with an ineffective focus on arresting drug users and eradicating poppy fields. - The central government is unable to provide quality treatment for drug users. Past political repression and human rights violations by the military government caused an international boycott which prevented international donors from providing assistance. - The reform process by the new quasi-civilian government includes both a peace process to end the civil war and a review of the country's drug laws, raising hope for more effective and humane drug policies. Policy Recommendations - Myanmar's drug policies should shift focus and prioritize the provision of services for drug users and promote alternative livelihoods for opium growing communities. - Drug-related legislation should decriminalize drug use, reduce sentences for other drug-related offenses, and allow space for needle exchange programs. - The government should expand harm reduction projects and provide voluntary treatment programs for drug users. - The government should formulate a strategic plan to prioritize alternative development programs. Eradication of poppy farms should not take place unless people have sufficient access to alternative livelihoods. As such, China's opium substitution policy should not continue in its present form. - Affected communities, especially drug users and opium farmers, need to be involved in drug policy making. - More attention should be paid to ATS-related problems, which are largely overlooked by current policies. Details: Washington, DC: Brookings Institute, 2015. 14p. Source: Internet Resource: Accessed July 8, 2015 at: http://www.brookings.edu/~/media/Research/Files/Papers/2015/04/global-drug-policy/Kramer--Burma-final.pdf?la=en Year: 2015 Country: Burma URL: http://www.brookings.edu/~/media/Research/Files/Papers/2015/04/global-drug-policy/Kramer--Burma-final.pdf?la=en Shelf Number: 135926 Keywords: Drug Abuse and Addiction Drug Policy Opium

Author: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) Title: Drugs policy and the city in Europe Summary: Illicit drug problems and responses and the different forms they can take in the city environment are explored in this paper. It addresses four areas: urban spaces and drug use, responses to city-level drug problems, city-level drugs strategies, and the coordination and funding of city-level policies. This paper explores existing and emerging drug problems and responses in the city environment. It addresses four areas: urban spaces and drug use, businesses and recreational drug use, city-level drugs policies and the coordination and funding of city-level policies. The paper is based on three data sources: a review of scientific literature, grey literature, and national reports from the Reitox network of the European Monitoring Centre for Drugs and Drug Addiction. Two main categories of city-level problems related to drug use are identified: one centres on problematic forms of drug use such as use of opioids and injection, the other on recreational use of licit and illicit substances. So-called open drug scenes, where drug users congregate and high-risk drug use takes place in public spaces, were found in several cities. The open drug scenes vary by visibility, size and the type of location in which they occur. Cities differ in the level of access they provide for problem drug users to opioid substitution treatment, needle and syringe exchange programmes and low-threshold services, and in the geographical coverage of such interventions. In cities, extensive nightlife zones can be found. Concentrations of bars and clubs, and in some cases cannabis coffee shops and head shops, provide a focus for recreational drug use. Different measures have been implemented in nightlife settings to respond to drug use, including drug prevention interventions and 'pill testing' services. This study identified 10 capital cities with an active drugs strategy document. Generally, city authorities are formally responsible for the coordination of drugs policy in the municipality. A number of Europe's capital cities allocate a dedicated budget to the implementation of their drugs strategies. Details: Luxembourg: Publications Office of the European Union, 2015. 25p. Source: Internet Resource: EMCDDA Papers: Accessed July 8, 2015 at: http://www.emcdda.europa.eu/attachements.cfm/att_240226_EN_TDAU15001ENN1.pdf Year: 2015 Country: Europe URL: http://www.emcdda.europa.eu/attachements.cfm/att_240226_EN_TDAU15001ENN1.pdf Shelf Number: 135958 Keywords: Drug Abuse and Addiction Drug Enforcement Drug Policy

Author: Zhang, Sheldon X. Title: A People's War: China's Struggle to Contain its Illicit Drug Problem Summary: Key Findings - China faces a growing problem of illicit drug use. Drug addiction is considered personal failure and addicts are highly stigmatized. Drug addiction does not receive much public sympathy or priority in government funding. - The number of officially registered drug addicts totals about 2.5 million, having increased every year since the government's first annual drug enforcement report in 1998. - In recent years, synthetic drugs such as crystal methamphetamine and ketamine, have become more popular than heroin which was previously dominant. - Illegal opium cultivation no longer exist in China because of strong state control of land use and extensive domestic surveillance. - Myanmar is believed to be the single largest supplier of China's drug market. In 2013, 92.2 percent of the heroin and 95.2 percent of methamphetamine seized in China were traced to Myanmar. - Intravenous drug use significantly contributes to the spread of Hepatitis and HIV. - Drug treatment is mostly administered by the criminal justice system through enrollment in compulsory detoxification centers for first-timers and imprisonment in "education-through-labor" camps for repeat offenders. - More humane approaches are emerging. Methadone maintenance therapy (MMT) clinics have been increasing rapidly across the country and needle exchange programs are being used to prevent the spread of HIV. - The cost of delivering treatment is a key factor in developing effective substance abuse treatment. - Penalties for drug distribution and trafficking remain harsh, and include a frequent use of the death penalty. - Using an extensive network of informants, interdiction efforts focus on major drug trafficking organizations. Policy Recommendations - China should accelerate its experiment with the decriminalization of substance abuse and apply a public health approach to the treatment of addicts. - China needs to promote evidence-based treatment programs based on scientific research and rigorous evaluation. - China needs to establish a reliable drug market forecast system, which combines chemical composition analysis, reports and urine tests of arrested drug abusing offenders, and community informants on illicit drug use trends and pricing information. - China should increase the efficiency of its international collaboration and insulate its counter-narcotic programs from global politics Details: Washington, DC: Brookings Institute, 2015. 15p. Source: Internet Resource: Accessed July 8, 2015 at: http://www.brookings.edu/~/media/Research/Files/Papers/2015/04/global-drug-policy/A-Peoples-War-final.pdf?la=en Year: 2015 Country: China URL: http://www.brookings.edu/~/media/Research/Files/Papers/2015/04/global-drug-policy/A-Peoples-War-final.pdf?la=en Shelf Number: 135959 Keywords: Drug Abuse and Addiction Drug Offenders Drug Policy Illicit Drugs Opium

Author: Miraglia, Paula Title: Drugs and Drug Trafficking in Brazil: Trends and Policies Summary: Key Findings - Brazil is one of the most violent countries in the world with a national homicide rate of 27.1 per 100,000 inhabitants. A large part of this violence and criminality can be linked to arms and drug trafficking operations by organized crime groups. - Brazil's increased domestic drug consumption in recent years has affected the domestic drug market and changed the structure, profile, and modes of operation of organized crime groups. - In 2006, Brazil adopted a new drug law intended to make a clear and definitive distinction between drug users and dealers. However, a discriminatory culture in the justice system, combined with great discretion given to the authorities to classify offenses as trafficking, resulted in increased imprisonment of addicts. - Today, Brazil has the world's fourth largest imprisoned population, which points to the need for alternatives in dealing with violence and crime, particularly when related to drug consumption. - Brazil boasts innovative programs, such as the Sao Paulo de Bracos Abertos program and the Unidades de Pol�cia Pacificadora in Rio de Janeiro, but each of these faces complex challenges to their success. Policy Recommendations - Brazil needs criminal justice system reform, together with improved drug legislation that classifies offenses more precisely, to minimize the discretionary imprisonment of addicts. - Brazil should develop improved mechanisms to prevent police brutality and lethality, and should also adopt reforms to improve police efficiency and effectiveness. - Brazil should mainstream the concept of prevention in its domestic drug policy programs. Details: Washington, DC: Brookings Institution, 2015. 16p. Source: Internet Resource: Accessed July 20, 2015 at: http://www.brookings.edu/~/media/Research/Files/Papers/2015/04/global-drug-policy/Miraglia--Brazil-final.pdf?la=en Year: 2015 Country: Brazil URL: http://www.brookings.edu/~/media/Research/Files/Papers/2015/04/global-drug-policy/Miraglia--Brazil-final.pdf?la=en Shelf Number: 136103 Keywords: Drug Abuse and Addiction Drug Policy Drug Trafficking Drug-Related Violence Homicides Organized Crime

Author: Australian Crime Commission Title: 2013-14 Illicit Drug Data Report Summary: The Australian Crime Commission's Illicit Drug Data Report, now in its 12th edition, informs Australia's understanding of the illicit drug threat and focuses our collective efforts by bringing together data from a wide range of sources into the one unique report. Serious and organised criminals are at the centre of the Australian illicit drug market. Motivated by greed and power, many of these groups and individuals use the illicit drug market as their primary income stream, profiting from the misery illicit drugs inflict on the nation. Targeting illicit drug importation, production and distribution is a focus of the Australian Crime Commission and its partners. In 2013-14, law enforcement agencies recorded more than 93 000 illicit drug seizures, with a combined weight of 27 tonnes and more than 110 000 arrests. These figures are all the highest on record. While this is testament to the vigilance and achievements of law enforcement in combating the illicit drug trade, it also demonstrates the continued prevalence of drugs in our society and the need for a collective approach. All illicit drug activity is a concern for law enforcement and the wider community. But in my 38 years in law enforcement, I have never seen a substance as destructive as methylamphetamine, particularly crystal methylamphetamine (ice). Methylamphetamine is wreaking havoc in every state and territory. It is ruining lives, families and communities. We are now seeing demand for methylamphetamine in areas where the drug has not previously been a significant issue. This includes urban and rural areas and disadvantaged communities where it is having a destructive impact. Seizures in 2013-14 include a record 10 tonne seizure of benzaldehyde - a chemical used to make methylamphetamine. If not seized, this chemical could have been used to produce up to 4.5 tonnes of methylamphetamine - this equates to an estimated 45 million individual street deals, with an estimated value of $3.6 billion. More than 740 clandestine laboratories were detected this reporting period. Add that to the previous two reporting periods and that's more than 2 300 labs detected. These are dangerous, with many of the chemicals used hazardous and corrosive in nature, posing significant risk to the community and the environment. While the methylamphetamine market is the primary concern, there was also a number of records reported across other drug markets. These include a record number of national amphetamine-type stimulant seizures and arrests, a record number of national cannabis arrests, a record number of national cocaine seizures and arrests, a record number of national steroid seizures and arrests, a record number of national hallucinogen arrests and a record number of national other opioid seizures. The Illicit Drug Data Report 2013-14 provides governments, law enforcement agencies, policy makers, academia, interested stakeholders and the community with a robust statistical picture of the Australian illicit drug market. Details: Canberra: Australian Crime Commission, 2015. 228p. Source: Internet Resource: Accessed July 29, 2015 at: https://crimecommission.gov.au/sites/default/files/IDDR-201314-Complete_0.pdf Year: 2015 Country: Australia URL: https://crimecommission.gov.au/sites/default/files/IDDR-201314-Complete_0.pdf Shelf Number: 136228 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Enforcement Drug Markets Illicit Drugs Organized Crime

Author: Scott, Nick Title: How patterns of injecting drug use evolve in a cohort of people who inject drugs Summary: This paper investigates the frequency of intravenous drug use in a cohort of people who inject drugs, and the decline in use over time. It provides an important indication of the effectiveness of current interventions at reducing the consumption of illicit drugs. Comparisons are made between the injection frequency of participants on or off Opioids Substitution Therapy (OST), and according to the settings in which drugs are most frequently purchased and used (eg street, house). This research found an overall movement away from street based drug purchasing and drug use, towards more activity in private settings. This has important implications for the harms experienced by people who inject drugs. Intravenous drug use was persistent, with only slow declines observed in the frequency of the cohort's overall use. Lower injection frequency was associated with use in private rather than public locations as well as the uptake of OST. Additional work is needed to understand how this change in setting is affected by and also affects current interventions, and whether it can be used to help further reduce injecting drug use Details: Canberra: Australian Institute of Criminology, 2015. 7p. Source: Internet Resource: Trends & issues in crime and criminal justice no. 502: Accessed July 29, 2015 at: http://aic.gov.au/media_library/publications/tandi_pdf/tandi502.pdf Year: 2015 Country: Australia URL: http://aic.gov.au/media_library/publications/tandi_pdf/tandi502.pdf Shelf Number: 136231 Keywords: Drug Abuse and Addiction Drug Offenders Drug Treatment

Author: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) Title: Alternatives to punishment for drug-using offenders Summary: Based on the options provided by the international drug control legal framework, this paper considers the rehabilitative measures of treating, educating or reintegrating drug users as alternatives or additions to conviction or punishment that are established in the laws of many countries in Europe today. Distinguishing them from 'alternatives to prison', it outlines the variety of rehabilitative measures in use and sets out the main issues in their design, implementation and evaluation. The paper finds that alternatives to punishment are available across Europe to varying degrees and with inconclusive evaluations suggesting positive results. The success of these measures depends partly on the degree to which they are accurately targeted to specific objectives and specific users. The policy arguments in favour of them seem to have developed along two lines: reducing harms to the individual and society by problem drug users, and addressing structural burdens on the justice system by non-problem users. Yet the paper finds that this distinction, or prioritisation, is not always clear in the design or implementation of the different measures, which can in turn affect the few evaluations carried out. Compromises between the two different aims of the laws (to treat or to punish these offenders) can also have unintended effects on the outcomes. Clarity on these issues should assist development and implementation of more successful measures in the future. Details: Luxembourg: Publications Office of the European Union, 2015. 22p. Source: Internet Resource: EMCDDA Papers: Accessed July 29, 2015 at: http://www.emcdda.europa.eu/attachements.cfm/att_240836_EN_TDAU14007ENN.pdf Year: 2015 Country: Europe URL: http://www.emcdda.europa.eu/attachements.cfm/att_240836_EN_TDAU14007ENN.pdf Shelf Number: 136234 Keywords: Alternatives to Incarceration Decriminalization Drug Abuse and Addiction Drug Enforcement Drug Offenders

Author: Wish, Eric D. Title: Community Drug Early Warning System: The CDEWS-2 Replication Study Summary: The Community Drug Early Warning System (CDEWS) provides rapid information about emerging drug use in local communities by sampling anonymous urine specimens already collected and tested, and ready to be discarded by local criminal justice programs. CDEWS re- tests the specimens for an expanded panel of more than 75 drugs. The most dramatic finding from the first study, CDEWS-1, completed in September 2013, was the identification of specific synthetic cannabinoids (SC) used by adult arrestee and parole/probation populations in the Washington, DC and Richmond, VA Metropolitan Areas. SC metabolites were actually equally or more likely to be detected in specimens that had passed the local criminal justice system (CJS) drug tests than in those that failed, suggesting that people were using them to avoid detection by the routine CJS testing screens. This second report on CDEWS (CDEWS-2) replicates the CDEWS results for adult parolees/probationers in Washington, DC, and studies new adult and/or juvenile criminal justice populations from Washington, DC (juveniles), Denver, Colorado (drug court adults), and Tampa, Florida (juveniles). A total of 1,026 specimens from these populations were tested as part of the CDEWS-2 study. The CDEWS-2 urinalyses showed dramatic changes from the SC metabolites detected the prior year in CDEWS-1, and shows substantial differences in SC found from site to site. For the CDEWS-2 study, we interviewed toxicologists and other experts to determine the most important drugs, including new psychoactive substances (NPS), to include on our testing panel. This shows the value of interviewing experts in order to update the CDEWS test panel to include newly discovered SC metabolites. A large number of specimens tested positive for the metabolites added during CDEWS-2. About 50% of the 21-30 year old male probationers from DC who had passed the local more limited CJS screen and about 1 in 5 of all tested juveniles in DC at all ages, from 13-17, tested positive for SC. The SC metabolites detected varied by population and site; for example, all SC positive specimens from Tampa juveniles contained only one metabolite, UR-144, but only 71% of the SC positive specimens from DC juveniles and 53% of SC positives from adults in the Denver drug court contained UR-144. In fact, among DC juveniles, 8 SC metabolites were found and among Denver adults 10 SC metabolites were found. Testing for designer stimulants was suspended after all subsamples for the 4 populations tested negative for these drugs. The CDEWS-2 results attest to the value of expanded testing of specimens already collected by local CJS drug testing programs and the difficulties inherent in keeping up with the constantly evolving nature of NPS. The results suggest that many adults and juveniles in local CJS drug testing programs likely turn to SC to avoid detection. It is also likely that programs using similar protocols to test urine specimens in other contexts, such as schools, hospitals and treatment programs are missing SC use in their populations, leading to lost opportunities for diagnosis and intervention. These risks are especially dangerous for youths being exposed to new and constantly changing NPS at an early age. Future CDEWS studies of these populations might help to address these issues. Details: Washington, DC: Office of National Drug Control Policy Executive Office of the President, 2015. 100p. Source: Internet Resource: Accessed August 8, 2015 at: https://www.whitehouse.gov/sites/default/files/ondcp/policy-and-research/finalreport_4_8_15v3.pdf Year: 2015 Country: United States URL: https://www.whitehouse.gov/sites/default/files/ondcp/policy-and-research/finalreport_4_8_15v3.pdf Shelf Number: 136354 Keywords: Drug Abuse and Addiction Drug Control Policy Drug Enforcement Drug Testing Illicit Drugs Urine Testing

Author: Organization of American States Title: Trinidad and Tobago: Evaluation of Progress in Drug Control, 2007-2009 Summary: The Multilateral Evaluation Mechanism (MEM) is a diagnostic tool designed by all member states of the Organization of American States (OAS) to periodically carry out comprehensive, multilateral evaluations of the progress of actions taken by member states and by the hemisphere as a whole, in dealing with the drug problem. The Inter-American Drug Abuse Control Commission (CICAD), of the Secretariat of Multidimensional Security, an OAS specialized agency, implemented this Mechanism in 1998, pursuant to a mandate from the Second Summit of the Americas held in Santiago, Chile in 1998. The MEM is not only an evaluation instrument, but has also become a vehicle for disseminating information on the progress achieved by individual and collective efforts of OAS member state governments, catalyzing hemispheric cooperation, promoting dialogue among member state government authorities and precisely channeling assistance to areas requiring greater attention by optimizing resources. The MEM process itself is assessed by the Intergovernmental Working Group (IWG), comprised of delegations from all member states, which meets before the onset of each MEM evaluation round to review and strengthen all operational aspects of the mechanism, including the indicators of the evaluation questionnaire. National evaluation reports are drafted by experts from each member state, with experts not working on their own country's report, guaranteeing the transparent multilateral nature of the MEM. Each chapter is based on countries' responses to a questionnaire of indicators covering the main thematic areas of institution building, demand reduction, supply reduction and control measures as well as subsequent comments and updated information provided by the government-appointed coordinating entities. This report covers the full country evaluation for the MEM Fifth Round evaluation period 2007-2009. Details: Washington, DC: Inter-American Drug Abuse Control Commission (CICAD), 2010. Source: Internet Resource: Accessed August 8, 2015 at: http://www.cicad.oas.org/mem/reports/5/Full_Eval/Trin&Tobago%20-%205th%20Rd%20-%20ENG.pdf Year: 2010 Country: Trinidad and Tobago URL: http://www.cicad.oas.org/mem/reports/5/Full_Eval/Trin&Tobago%20-%205th%20Rd%20-%20ENG.pdf Shelf Number: 136358 Keywords: Drug Abuse and Addiction Drug Control Drug Enforcement Drug Policy

Author: UK Drug Policy Commission Title: Charting New Waters: Delivering drug policy at a time of radical reform and financial austerity Summary: The funding, commissioning, management and delivery structures for addressing the problems associated with illicit drugs in England are experiencing an unprecedented level of change. The government's 2010 Drug Strategy places considerable focus on improving the recovery outcomes for people with drug problems, alongside efforts to reduce the supply of drugs. It identifies the need for support from a range of different services such as employment, education and housing, and family networks to enable people to reintegrate into their communities. In contrast to the strong central oversight of previous drug strategies, it calls for far greater local control over service delivery by local areas and people accessing services. At the same time, substantial reductions in public spending are being implemented alongside wide-ranging public service reform, including structural changes to the NHS, policing and criminal justice reform and a drive to deliver the Big Society. These changes raise key questions, which our study set out to explore, about the ability of areas to achieve the ambitions of the Drug Strategy and around the future security of investment in drug interventions. With considerable additional resources for drug interventions over the last decade much has been achieved but there is a real risk that the current level of change will lead to the dilution of these gains, with negative consequences for drug users, their families, for wider communities, and indeed for the wider economy. Our study reveals a broad picture of upheaval and uncertainty and this summary sets out our study's main findings. The results will be relevant for national policy makers; commissioners and providers of drug treatment and recovery services; Directors of Public Health; those engaged in drug-related enforcement; and locally elected officials. Details: London: UKDPC, 2012. 119p. Source: Internet Resource: Accessed August 19, 2015 at: http://www.ukdpc.org.uk/wp-content/uploads/charting-new-waters-delivering-drug-policy-at-a-time-of-radical-reform-and-financial-austerity.pdf Year: 2012 Country: United Kingdom URL: http://www.ukdpc.org.uk/wp-content/uploads/charting-new-waters-delivering-drug-policy-at-a-time-of-radical-reform-and-financial-austerity.pdf Shelf Number: 136484 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Policy Drug Treatment Illegal Drugs

Author: International Centre for Science in Drug Policy Title: State of Evidence: Cannabis Use and Regulation Summary: Science in Drug Policy (ICSDP) has sought to ensure that policy responses to the many problems posed by illicit drugs are informed by the best available scientific evidence. State of the Evidence: Cannabis Use and Regulation is the ICSDP's contribution to the growing global conversation on cannabis. This report should be read in tandem with Using Evidence to Talk About Cannabis, a complementary guide to having evidence-based discussions on cannabis use and regulation. The regulation of recreational cannabis markets has become an increasingly important policy issue in a number of jurisdictions. Colorado and Washington State made headlines in 2012 when they became the first jurisdictions in the world to legalize and regulate the adult use and sale of cannabis for non-medical purposes. In 2013, Uruguay became the first country to legalize and regulate recreational cannabis markets. Momentum towards regulation continued in the United States in 2014 with successful ballot initiatives in Alaska, Oregon, and the District of Columbia. Globally, the issue of cannabis regulation is front and center in a growing number of jurisdictions, including Canada, Jamaica, Italy, Spain, several Latin American countries, and a number of additional U.S. states, including California, set to vote on legalization initiatives in 2016. Unsurprisingly, given the robust global conversation around the regulation of recreational cannabis markets, claims about the impacts of cannabis use and regulation are increasingly part of the public discourse. Unfortunately, though, these claims are often unsupported by the available scientific evidence. Another reoccurring problem in the public discourse is the selective inclusion of research studies based on their support for a predetermined narrative. The intentional exclusion of studies with contradictory findings does not allow for an objective review and analysis of all the evidence. This "cherry picking" of the evidence is a routine practice that distorts public understanding. By outlining the current state of all the scientific evidence on common cannabis claims, State of the Evidence: Cannabis Use and Regulation strives to ensure that evidence, rather than rhetoric, plays a central role in policymaking around this important issue. The harms of misrepresenting the scientific evidence on cannabis should not be overlooked. Given that policy decisions are influenced by public opinion and media reports, public discourse needs to be well informed. By addressing knowledge gaps with scientific findings, the ICSDP hopes to dispel myths about cannabis use and regulation, and ensure that the scientific evidence on these topics is accurately represented. Only then can evidence- based policy decisions be made. Readers of this report will notice three repeating themes emerge through the discussion of the scientific evidence on common cannabis claims. First, many of the claims confuse correlation and causation. Although scientific evidence may find associations between two events, this does not indicate that one necessarily caused the other. Put simply, correlation does not equal causation. This is a commonly made mistake when interpreting scientific evidence in all fields, and is unsurprisingly a recurring source of confusion in the discourse on cannabis use and regulation. Second, for several of these claims, the inability to control for a range of variables ("confounders") means that in many cases, we cannot conclude that a particular outcome was caused by cannabis use or regulation. Unless scientists can remove all other possible explanations, the evidence cannot conclusively say that one specific explanation is true. Third, many of the claims cannot be made conclusively as there is insufficient evidence to support them. Findings from a single study or a small sample cannot be generalized to entire populations. This is especially pronounced for claims related to cannabis regulation, as not enough time has passed since the regulation of recreational cannabis in Colorado, Washington State, and Uruguay to examine many of the impacts of these policy changes. These three common pitfalls are important to take into account when reading media reports and advocacy materials that suggest scientists have conclusively made some finding related to cannabis use or regulation. In many cases, due to the reasons outlined above, this will actually result in a misrepresentation of the scientific evidence. State of the Evidence: Cannabis Use and Regulation is comprised of two sections: Common Claims on Cannabis Use and Common Claims on Cannabis Regulation. Common Claims on Cannabis Use presents evidence on frequently heard claims about cannabis use, including claims on the addictive potential of cannabis, cannabis as a "gateway" drug, the potency of cannabis, and the impact of cannabis use on the lungs, heart, and brain (in terms of IQ, cognitive functioning, and risk of schizophrenia). Common Claims on Cannabis Regulation presents evidence on frequently heard claims about the impacts of cannabis regulation, including the impact of regulation on cannabis availability, impaired driving, the use of cannabis, drug crime, drug tourism, and "Big Marijuana." For each claim, the relevant available scientific evidence is presented and the strength of the scientific evidence in support of the claim is determined. Readers will notice that none of the claims are strongly supported by the scientific evidence, reinforcing the significant misrepresentation of evidence on cannabis use and regulation. Details: Toronto, ON: The Centre, 2015. 24p. Source: Internet Resource: Accessed August 28, 2015 at: https://dl.dropboxusercontent.com/u/64663568/library/State_of_the_Evidence_Cannabis_Use_and_Regulation-international-centre-for-science-in-drug-policy.pdf Year: 2015 Country: International URL: https://dl.dropboxusercontent.com/u/64663568/library/State_of_the_Evidence_Cannabis_Use_and_Regulation-international-centre-for-science-in-drug-policy.pdf Shelf Number: 136611 Keywords: Cannabis Drug Abuse and Addiction Drug Enforcement Drug Policy Drug Reform Marijuana

Author: Coghlan, Sarah Title: Drug use monitoring in Australia: 2013-14 report on drug use among police detainees Summary: Delivered by the Australian Institute of Criminology (AIC), the Drug Use Monitoring in Australia (DUMA) program supports the National Drug Strategy through its timely provision of data on changes in alcohol and other drug consumption habits among Australian police detainees and through its monitoring and reporting of fluctuations in the illicit drug market. Since 1999, 51,748 detainees have been interviewed, of whom 37,398 also provided a urine sample that was analysed to identify licit and illicit drug use. The data gathered through DUMA has informed government policy and research, and contributed to the National Drug Strategy aims of improving health, social and economic outcomes by reducing supply, demand and harm. Details: Canberra: Australian Institute of Criminology, 2015. 132p. Source: Internet Resource: AIC Monitoring Reports 27: Accessed September 5, 2015 at: http://aic.gov.au/media_library/publications/mr/mr27/mr27.pdf Year: 2015 Country: Australia URL: http://aic.gov.au/media_library/publications/mr/mr27/mr27.pdf Shelf Number: 136692 Keywords: Alcohol Abuse Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders Illicit Drugs Substance Abuse

Author: Zamudio Angles, Carlos Alberto Title: First Survey of Illegal Drug Users in Mexico City Summary: The principal motivation for implementing this survey was the lack of existing information regarding the relationship between drug users and their social networks. There is a lack of quality indicators that provide detailed information regarding the consumption of drugs, particularly when faced with the traditional dichotomy of user-addict. This dichotomy fails to see the complexity of the consumption of illegal drugs and reiterates the notion that the drug using population will inevitably move into addiction, thus ignoring the diversity of existing patterns of consumption When the socio-economic demographic of drug users was explored, it was found that more than half of all users had some university education, whether that be unfinished or graduated (54%) and more than a quarter indicated that they had some high school education (27.9). This is higher than the general Mexican population. Two out of 3 users surveyed, are engaged in full-time work (69.9%), a little less than half study (43.7%) and 1 out of 5 surveyed both work and study (22%). Only 1 out of 10 users surveyed indicated that they are currently unemployed or working without pay (9.9%). Considering almost all of those surveyed have some sort of work or daily activity (91.6%), it is recommended that society do a better job of integrating users into the formation of the public policies which affect them. The survey, which focused on the adult population of Mexico City, consisted of 350 questions and was implemented in February and March 2011. The sample size was 429 people with 310 males and 119 women and with an average age of 28.7. Details: Ciudad de Mexico, D.F., Mexico: Colectivo por una Politica Integral hacia las Drogas (CUPIDH), 2012. 9p. Source: Internet Resource: Accessed September 17, 2015 at: http://www.cupihd.org/portal/wp-content/uploads/2013/01/first-survey-of-illegal-drug-users.pdf Year: 2012 Country: Mexico URL: http://www.cupihd.org/portal/wp-content/uploads/2013/01/first-survey-of-illegal-drug-users.pdf Shelf Number: 136800 Keywords: Drug Abuse and Addiction Drug Offenders Drug Treatment

Author: Zamudio Angles, Carlos Alberto Title: Drugs DF: Illegal Drugs Markets in Mexico City Summary: In this sixth edition titled Drugs DF, CuPIHD presents a statistical, qualitative, informative and quality analysis of the dynamics and characteristics of illegal drug markets and drug users, particularly within Mexico City. Drugs DF describes the size and characteristics of the drug market in Mexico City, as well as the perceptions and relationships of drug users with their legal, economic, institutional and social environments. Using this research, we highlight the most important market dynamics within Mexico City in order to effectively deal with the issue of drugs and drug policy, not only in Mexico City, but also in all of Mexican society. We are positive that Drugs DF will be a helpful, practical tool for researchers, policy-makers and civil society that are committed to designing and implementing public policies related to illegal drugs. We hope that it will also be informative for those who have interest in going deeper in their understanding of a complex phenomenon, filled with misinformation and prejudice. We hope this publication will con- tribute to a better understanding of illegal drug markets, its dynamics and actors, in such a way that we can begin constructing alternatives to our current drug policies. Details: Ciudad de Mexico, D.F., Mexico: Colectivo por una Politica Integral hacia las Drogas (CUPIDH), 2014. 28p. Source: Internet Resource: Accessed September 17, 2015 at: http://www.cupihd.org/portal/wp-content/uploads/2014/01/Descargue-DRUGS-DF-aqui..pdf Year: 2014 Country: Mexico URL: http://www.cupihd.org/portal/wp-content/uploads/2014/01/Descargue-DRUGS-DF-aqu�..pdf Shelf Number: 136801 Keywords: Drug Abuse and Addiction Drug Markets Drug Policy

Author: Glasheen, Cristie Title: Past Year Arrest among Adults in the United States: Characteristics of and Association with Mental Illness and Substance Use Summary: Objectives. The objectives of this study are to (1) examine the characteristics of adults with a past year arrest by their mental illness and substance use status and (2) investigate the prevalence and correlates of arrests among adults with mental illness in the general U.S. population. Previous studies suggesting that the prevalence of arrest may be higher among individuals with mental illness have typically been conducted among persons in the criminal justice setting or among individuals receiving mental health treatment and may not be representative of all adults with mental illness. Also, little is known about the prevalence and correlates of arrest among adults with mental illness in the general U.S. population. Information on this link in the general population is critical for targeting programs to those most at risk for arrest. Methods. Data are from the 2008 and 2009 National Surveys on Drug Use and Health (NSDUHs). Past year arrest was defined as being arrested and booked in the past 12 months, not counting arrests for minor traffic violations. It should be noted that being arrested and booked does not necessarily translate to convictions or incarcerations. In addition to mental illness (none, low/mild, moderate, or a serious mental illness [SMI]), other hypothesized correlates of arrest included past year substance use and demographic characteristics. Descriptive statistics were used to estimate the prevalence of arrest and examine the characteristics of adults with a past year arrest. Logistic regression was used to examine the association between mental illness and arrests after controlling for substance use and demographics among all adults and among adults with any mental illness (AMI). Results. Descriptive analyses indicated that the prevalence of past year arrests was higher among adults with AMI than among adults without AMI (5.4 vs. 1.8 percent). The prevalence of past year arrest was also higher among adults with a substance use disorder (SUD) than among adults without an SUD (13.0 vs 1.5 percent). The demographic characteristics of arrestees were similar between those with and without AMI; the majority of adults who had been arrested in the past year were younger than the age of 35, male, non-Hispanic white, never married, living at or above the Federal poverty level, and had no further education beyond high school. Adult arrestees with AMI, compared with adult arrestees without AMI, were less likely to be female or non-Hispanic black and more likely to be out of the labor force. Among all adults, logistic regression models indicated that having mental illness - particularly SMI (adjusted odds ratio [OR] = 2.36) - was significantly associated with the odds of arrest, even when models controlled for demographic factors and substance use status. Among adults with AMI, the odds of arrest were higher among adults with SMI (adjusted OR = 1.48) than among adults with low/mild mental illness, but the odds of arrests among adults with moderate mental illness were not significantly different from the odds for those with low/mild mental illness. Among all adults, having an SUD was the strongest correlate of arrest (adjusted OR = 6.44), followed by not completing high school (adjusted OR = 3.53), past year illicit drug use without an SUD (adjusted OR = 2.81), and male gender (adjusted OR = 2.70). No characteristics were associated with arrest among adults with AMI that were not also associated with arrest among all adults. Conclusions. The presence of mental illness was a significant predictor of past year arrests in the U.S. general population, even in models that controlled for substance use and other correlates. However, the presence of an SUD was the strongest correlate of past year arrest among all adults and among adults with AMI or SMI. This suggests that programs may reduce arrest and recidivism by focusing on addressing the needs of people with co-occurring mental illness and SUDs. Diversion programs and mental health and drug courts may be one way to address the needs of people with mental illness and SUDs who come into contact with the criminal justice system. Introduction Studies have consistently documented high rates of mental illness among persons involved with the criminal justice system, including jail1,2,3,4,5,6 and prison populations,2,6,7,8 suggesting that the risk of arrest may be higher for individuals with a mental illness. Some research has pointed to the "criminalization of mentally disordered behavior," whereby the limited availability of mental health services has often resulted in jails becoming the placement of last resort for persons with mental illness.9,10,11,12,13 Multiple local studies have found high rates of criminal justice contact among people receiving mental health treatment in the public mental health system.14,15 In one large study linking Los Angeles County mental health treatment records to court records, 24 percent of those who received public- or Medicaid-funded mental health treatment had at least one arrest in the 10-year period covered by the study.16 The majority of these arrests (62 percent) were for nonviolent crimes, and less than half led to convictions. Similarly, a recent study found that individuals receiving mental health treatment in the Massachusetts public mental health system had 60 percent greater odds of being arrested over the 9.5 years of follow-up than did age-matched individuals in the general population.17 The rate of arrest was greater in the treatment sample than in the general population sample (32.8 vs. 23.2 percent). Studies comparing the odds of arrest among adults with a mental illness (regardless of treatment status) and adults without a mental illness in a nationally representative household sample are lacking at this time. Additionally, few nationally representative studies have looked at the sociodemographic characteristics associated with arrest among adults with mental illness. In the aforementioned studies of arrest among persons receiving mental health treatment, the factors associated with criminal justice contact included homelessness,14 younger age,16,18 male gender,16,19 African American race,16 higher levels of impairment,14,18 and type of mental illness.16 However, these studies all focused on criminal justice contact among people receiving mental health treatment in the public mental health system. This subgroup does not represent the overall population of people with mental illness because not everyone with a mental illness receives treatment,20,21,22,23 or receives it in the public sector. To our knowledge, no study has examined the characteristics associated with arrest among those with mental illness in a national, population-based sample. One of the most consistently identified risk factors for arrest in people with mental illness is having co-occurring substance use disorders (SUDs).14,15,16 Some studies have found that the overlap between mental illness and contacts with the criminal justice system is largely due to the high co-occurrence of SUDs among those with mental illness.5,24,25,26 Thus, it is important to consider the risk of arrest associated with mental illness independent of the risk associated with SUDs. Studies using data from nationally representative samples to examine these issues are lacking. This report uses data from the National Survey on Drug Use and Health (NSDUH), a nationally representative sample of persons in the civilian, noninstitutionalized U.S. population, to examine the prevalence and characteristics of past year arrest among adults with mental illness as a benchmark for evaluating future change. Thus, this report helps fill the previously described gaps in the literature on arrests among persons with mental illness in the general population. This report works toward meeting a goal within the Substance Abuse and Mental Health Services Administration's (SAMHSA's) Trauma and Justice Strategic Initiative for 2011 to 2014 to "address the needs of people with mental and substance use disorders and with histories of trauma within the criminal and juvenile justice systems." Details: Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012. 11p. Source: Internet Resource: CBHSQ State Review: Accessed September 17, 2015 at: http://archive.samhsa.gov/data/2k12/DataReview/DR008/CBHSQ-datareview-008-arrests-2012.htm Year: 2012 Country: United States URL: http://archive.samhsa.gov/data/2k12/DataReview/DR008/CBHSQ-datareview-008-arrests-2012.htm Shelf Number: 136803 Keywords: Drug Abuse and Addiction Drug Offenders Mentally Ill Offenders Recidivism Substance Abuse

Author: Coghlan, Sarah Title: Findings from the DUMA program: Methamphetamine drug market trends Summary: Methamphetamine is a drug of national concern, with the Australian Crime Commission (ACC; 2015a) assessing it to be the illicit drug posing the greatest risk to the Australian community. The Australian Institute of Health and Welfare's (AIHW) 2013 National Drug Strategy Household Survey (NDSHS) reported that approximately 400,000 Australians had used meth/amphetamines in the previous 12 months (AIHW 2014). The NDSHS reported a stable rate of meth/amphetamine use in the general community from 2010 to 2013 of 2.1 percent. However, there was a shift in the type of meth/amphetamine used, from powder to purer forms like ice or crystal methamphetamine (AIHW 2014). Specifically, powder meth/ amphetamine use among recent users decreased from 51 percent to 29 percent, while ice use more than doubled from 22 percent to 50 percent (AIHW 2014). In line with this, the frequency of methamphetamine use among injecting drug users in Melbourne remained consistent from 2008 to 2014, but users reported transitioning from powder to crystal forms of methamphetamine (Scott et al. 2015). Frequency of use of methamphetamine has also changed across the 2010 to 2013 period. In 2013, 15.5 percent of recent meth/amphetamine users reported daily or weekly use, compared with 9.3 percent in the 2010 survey (AIHW 2014). When examining use by form, approximately a quarter of users who mainly used ice reported using it at least weekly, compared with 2.2 percent of powder users who reported weekly use (AIHW 2014). Scott et al.'s (2015) study of injecting drug users in Melbourne found that those already using methamphetamine were starting to purchase the drug more frequently in 2013 compared with 2011. Details: Canberra: Australian Institute of Criminology, 2015. 8p. Source: Internet Resource: Research in Practice: Accessed September 21, 2015 at: http://aic.gov.au/media_library/publications/rip/rip43/rip43.pdf Year: 2015 Country: Australia URL: http://aic.gov.au/media_library/publications/rip/rip43/rip43.pdf Shelf Number: 136834 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Markets Methamphetamine

Author: Freeman, Patricia R. Title: Kentucky House Bill 1 Impact Evaluation Summary: In 2012, the Kentucky General Assembly passed comprehensive legislation aimed at addressing the continuing problem of prescription drug abuse and diversion. House Bill 1 (HB1), effective July 20, 2012 and outlined in Kentucky Revised Statutes (KRS) 218A.172, made sweeping changes relative to the prescribing and monitoring of controlled prescription drugs in an effort to address the prescription drug abuse problem in Kentucky. HB1 regulated pain clinics and placed new expectations on prescribers and dispensers of controlled substances (CS), including mandatory registration with the Kentucky All Schedule Prescription Electronic Reporting (KASPER) system and the requirement to query the KASPER system under particular circumstances. Additionally, HB1 required dispensers of CS to report dispensing records to KASPER within one day of dispensing. The requirements for mandatory registration and utilization of KASPER were included to assist prescribers in making appropriate treatment decisions, to identify patients potentially in need of substance abuse treatment interventions and to identify possible doctor shoppers. However, as with any policy change, there was concern over unintended consequences that impacted patients and providers due to implementation of the law. To maximize the effectiveness of HB1 and minimize unintended consequences, a comprehensive assessment of HB1�s impact on patients, prescribers, and citizens in Kentucky was needed. The goals of the HB1 Impact Evaluation were to: 1) evaluate the impact of HB1 on reducing prescription drug abuse and diversion in Kentucky; 2) identify unintended consequences associated with implementation of HB1; and 3) develop recommendations to improve effectiveness of HB1 and mitigate unintended consequences. To achieve these goals three distinct projects were conducted with the following aims. Project 1 was conducted to study changes in KASPER utilization and CS prescribing. Project 2 was a qualitative study designed to collect user perceptions of the effectiveness of KASPER and to identify potential unintended consequences of HB1. Project 3 was conducted to study changes in patient and prescriber behavior and outcomes. General Impact of HB1 As expected, the total number of CS prescriptions dispensed in Kentucky decreased for the first time since the inception of KASPER in the post-HB1 period, with the numbers of prescriptions dispensed for all Schedules of CS (CII � CV) decreasing by 4 to 8% in the post-HB1 period. While both opioid and benzodiazepine prescribing decreased, stimulant prescribing continued to increase at its previous rate. As HB1 was originally crafted by the legislature to specifically address the abuse and diversion of Schedule II opioid and Schedule III hydrocodone products, this was the desired outcome. The continued increase in stimulant prescribing is evidence that stimulant prescribing was not the focus of the legislation and argues against a blanket chilling effect of HB1 on CS prescribing. In interviews and surveys of prescribers, pharmacists and law enforcement when asked about their experience with HB1 and its implementation stated that although there was initial confusion and disruptions to workflow in their professions those have largely been resolved and, for the most part, have not negatively impacted health care professional practices. It should be noted however, that a minority of prescribers indicated they no longer prescribe CS, or prescribe fewer CS, as a result of the HB1 mandate and its burden on their practices. In the quantitative evaluation, it was found that HB1 had a significant impact on KASPER registration and utilization in these professionals� workplace. As a result of the HB1 mandate, prescriber registrants increased by 262% and the mean number of queries made annually by prescribers increased by 650%. Similarly, pharmacist registrants increased by 322% and mean number of pharmacist queries increased by 124%. The preferential impact on prescriber queries compared to pharmacists was expected, as HB1 did not mandate pharmacists to query KASPER prior to dispensing. Concurrently, in the interviews and stakeholder surveys, prescribers and pharmacists indicated utilizing more KASPER reports in their practice and discussing KASPER reports with patients and other health care providers more frequently. This observation may be a direct result of the statutory changes in HB1 that authorized providers to provide copies of reports to patients and allowed them to be shared with other health care providers and placed in medical charts. Additionally, the majority of prescriber and pharmacist respondents reported little change in prescribing and dispensing habits since implementation of HB1, although they perceived their prescribing and dispensing behaviors to be monitored more closely. Details: Lexington, KY: Institute for Pharmaceutical Outcomes and Policy, Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, 2015. 88p. Source: Internet Resource: Accessed September 25, 2015 at: http://www.chfs.ky.gov/NR/rdonlyres/8D6EBE65-D16A-448E-80FF-30BED11EBDEA/0/KentuckyHB1ImpactStudyReport03262015.pdf Year: 2015 Country: United States URL: http://www.chfs.ky.gov/NR/rdonlyres/8D6EBE65-D16A-448E-80FF-30BED11EBDEA/0/KentuckyHB1ImpactStudyReport03262015.pdf Shelf Number: 136884 Keywords: Drug Abuse and Addiction Prescription Drug Abuse Prescription Fraud

Author: Australian Institute of Health and Welfare Title: Trends in methylamphetamine availability, use and treatment, 2003-04 to 2013-14 Summary: There have been several corresponding trends in the availability, use and treatment of methylamphetamines since 2003-04. Following a decline between 2006-07 and 2009-10, there have been increases across many factors relating to methylamphetamines to 2013-14. Arrests, seizures and detections have all increased. Users are now favouring the crystal form of methylamphetamine. They are using it more frequently, and, there appear to be more new users of crystal. There are more people in treatment reporting smoking as their usual method of use for amphetamines than previously. Details: Canberra: AIHW, 2015. 40p. Source: Internet Resource: Drug treatment series no. 26: Accessed October 8, 2015 at: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129552826 Year: 2015 Country: Australia URL: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129552826 Shelf Number: 136970 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offender Treatment Drug Treatment Methamphetamine

Author: U.S. Government Accountability Office Title: Drug Control: Additional Performance Information Is Needed to Oversee the National Guard's State Counterdrug Program Summary: Since 1989 the National Guard has received hundreds of millions of dollars to help enhance the effectiveness of state-level counterdrug efforts by providing military support to assist interagency partners with their counterdrug activities. The program funds the drug interdiction priorities of each state Governor; counterdrug-related training to interagency partners at five counterdrug schools; and state-level counter-threat finance investigations, all of which are part of DOD's broader counterdrug efforts. Senate Report 113-176 included a provision for GAO to conduct an assessment of the state operations of the National Guard's counterdrug program. This report: (1) identifies the changes in funding for the program since fiscal year 2004, and (2) assesses the extent to which performance information is used to evaluate the program's activities. GAO analyzed the program's budgets and obligations data, performance measures, and program guidance, and interviewed knowledgeable officials. What GAO Recommends GAO recommends that DOD (1) identify additional information needed to evaluate the performance of state programs and oversee counterdrug schools' training; and (2) subsequently collect and use performance information to help inform funding distribution decisions to state programs and to conduct oversight of the training offered by the counterdrug schools. DOD concurred with GAO's recommendations. Details: Washington, DC: GAO, 2015. 46p. Source: Internet Resource: GAO-16-133: Accessed October 27, 2015 at: http://www.gao.gov/assets/680/673260.pdf Year: 2015 Country: United States URL: http://www.gao.gov/assets/680/673260.pdf Shelf Number: 137151 Keywords: Drug Abuse and Addiction Drug Control Drug Enforcement

Author: United Nations Office on Drugs and Crime, Country Office Pakistan Title: Female Drug Use in Pakistan: Mapping Estimates, Ethnographic Results and Behavioural Assessment Summary: This study is a part of the overall operational research which includes mapping and size estimation of female drug users, which forms the first key step in developing targeted interventions for this highly vulnerable key population. The results of this mapping study will assist in understanding the drug using scenario among female populations, which will ultimately form a baseline for service provision based on which service providing organizations will develop targeted interventions within a specific geographical setting. In addition to identification of geographical areas where these populations congregate, this study also provides valuable information on overall drug use situation in the targeted communities, economics of drug use, treatment history, criminal justice history, availability of treatment services and various religious and cultural barriers to accessing information and services among the target group. The entire approach focused around involvement of the target community individuals, peer groups and key stakeholders of the project. Although data was collected by an independent research team, the project staff including peer group was involved in the data collection process. The basic approach was largely based on a geographic mapping approach which identified key locations where key population members were found and quantified. In addition to identifying the key locations, individual drug users were contacted through peer group members and supplemented by tracing contact chains from identified drug users to reaching other drug using females in a given location. This study was conducted in all cities where subsequently a service delivery programme through the project "HIV/AIDS prevention, treatment and care for FDUs and injecting drug users", was to be placed. After distributing each target site into zone, information on drug using populations was collected through Tertiary and Secondary Key Informants in each Zone to generate a list of Spots where FDUs could be found in this phase. Various drug treatment centers and rehabilitation programs in each city were also visited to obtain contacts of FDUs in that community. Pharmacies were also visited and information was gathered about various females, who have been buying non prescription drugs regularly. In addition locations where drug users could be found including graveyards, open spaces, shrines, darbars etc., were also visited. The basic objective in Phase one was to develop an exhaustive list of all FDUs in all zones within each city, which was later validated in Phase 02, by visiting each spot and interviewing female drug users and asking for contacts of their peers involved with drug use. Once contact information for other FDUs was provided by a subject, the social mobilizers along with the field team members traced that subject, and an interview with that subject was subsequently conducted. The mapping study was followed by behavioral assessment, and the main data collection strategy involved face to face in-depth interviews of randomly selected FDUs in each site. A total number of 1,391 interviews were conducted in all 13 cities under study, and information obtained through these interviews was recorded in a pre-designed, pretested questionnaire. Data management was done by the data management team, and questionnaires after field editing were double entered in a data base designed in MS Access. Data set was thoroughly edited and cleaned, and data analysis was conducted using statistical software SPSS version 12.00. A total number of 3,538 interviews were conducted with both Secondary and Primary Key Informants. Based on the data collected during Phase I and validated in Phase II, an estimated number of 4,632 FDUs spread over 2,479 locations were estimated in the 13 cities where mapping was conducted. As expected, the highest number of FDUs was estimated to be 1,213 in Karachi, followed by Lahore and Faisalabad, where the numbers were 593 and 511 respectively. On an average 1.8 - 1.7 FDUs were reported from a single location, and 65.2% of the locations reported having a single FDU present. Unlike male drug users who congregate and use drugs with other drug users, drug use is a discreet, hidden and more of an individual activity for female drug users. Charas was the most common drug used by FDUs all over the country and 28% of the interviewed drug users reported that they used it in the last one month. Bhang was the next drug of choice reported, which was used by 14.2% of the FDUs interviewed. A fairly high proportion of females (13.6%) also reported to be using Heroin, while use of Pharmaceutical drugs was reported by 12.6% of drug users. Our study confirmed the available anecdotal information, that injecting is not a common route of drug intake among drug using females. A total of 71 female injecting drug users (FIDUs) were identified among the total estimated number of 4,632 FDUs, which calculated a prevalence of 1.5% of IDU among female drug users. Further to this, injecting drugs was reported from only 05 cities out of the 13 cities surveyed. For behavioral assessments, a total number of 1,391 interviews were conducted. The mean age of the FDUs who participated in this study was reported to be 32.8 - 9.6 yrs (median 32 yrs), while the maximum proportion (nearly 72%) of the drug users were between 21 to 40 yrs of age. Majority of the FDUs were illiterate; 66% of the FDUs interviewed did not receive any formal schooling. Nearly 60% of the interviewed females were currently married, while 15.6% reported to be never married. The remaining 24% were either widowed, or divorced/ separated from their husbands and were living separately. Ninety one % of the subjects interviewed belonged to the same city where they were interviewed and the majority was Punjabi speaking (45.3%). Charas (Hash) was the most common drug used by FDUs all over the country and 58% of the interviewed drug users reported using it ever and also in the last six months. 42% reported that they had used it in the last month as well. Pharmaceutical drugs were the next drugs of choice followed by Heroin and Bhang. The behavioral data is in agreement with the results of the mapping study conducted in phase one, which also showed similar results on drug use and injecting drug use, which was reported from only 05 cities, with very few numbers of females reported to be injecting drugs. 41.5% of the injectors reported that they had been injected daily, while another 32% informed that they have injected at least once a week in the last 6 months. Although 30% of the injectors have been injecting alone, the remaining had been injecting in groups with other IDUs. Nearly half of the subjects informed that they had been sharing syringes with other IDUs. The mean age of 1 sexual intercourse was reported to be 18.5 - 3.7 yrs. A fairly high proportion were reported to be sexually active, with high numbers of sexual partners in the last 6 months (4.9 - 16.2), suggesting they were sexually involved with a fairly large number of men. 13.5% of the FDUs reported to have sex with another male IDUs, and 25% reported selling sex for drugs or money. Only 3.7% reported that they always used a condom during the last 6 months. Approximately 44% of the FDUs interviewed had ever heard of the disease called HIV/AIDS. Knowledge of sexual intercourse as a mode of transmission of the disease was prevalent among 40% of FSWs, but only 22% knew that HIV can be transmitted by sharp instrument/needles and syringes. 19.5% knew that HIV can spread through blood transfusion, while knowledge of mother to child transmission was still lower (9.8%). While the correct knowledge of HIV transmission was fairly low, a few misconceptions about transmission of HIV were also reported. While 17% of the respondents interviewed were aware of where they could be tested for HIV, nearly half of those had been tested for HIV. Thirty one % of the FDUs interviewed knew that there are diseases which spread because of sexual intercourse. A very low proportion (13.2%) of the respondents reported that they have been treated at least once for drug use. The maximum proportion of drug users informed that they utilized private clinical facilities for treatment. This was followed by treatment services provided by NGOs and government hospitals which were 32% and 31% respectively. Nearly 11% of the FDUs interviewed that they have tried home based treatment for drug use as well. 73% of the respondent suggested that they need to be treated and showed a willingness to participate in a treatment program if offered. Only 4.3% of the respondents reported that they were arrested for reasons such as drug use (60%), drug pushing (30%), sex work (5%) and other minor petty crimes (5%) e.g., theft etc., This study addressed some of the critical issues related to women drug use, which have not been dealt adequately in previous research conducted in Pakistan. Apparently, the problem drug use in women might appear insignificant and trivial when comparing the numbers of female drug users to the enormous number of male drug using populations in the country. However, drug use occurrence among women has an impact that goes beyond the individual and affects the entire social network of families with greater negative impacts on children. Based on the conclusions of this research, an effective targeted response is necessary in order to promote safer behavior, improve access to effective health and social services, and to address the underlying structural and occupational dimensions of vulnerability. More research is warranted to gain more in depth understating of the populations, conduct more reliable size estimations and recognize the personal, environmental and social factors which lead to drug use among women. Efforts to minimize the stigma should be given high priority. Activities which involve and facilitate collective actions, such as developing associations/unions and networks, and involving the media in a positive way should be encouraged. Families of FDUs should be focused to provide support for treatment and rehabilitation. Legal assistance should be provided to FDUs to manage drug offences, petty crime and issues of violence and harassment. There is a need to broaden the focus of existing service delivery programs to address a broad and long-term perspective, and should incorporate "community based" and "women-centered" approach. The provision of Drug abuse treatment services, comprehensive harm reduction services through developing drop in centers, and providing outreach services through use of female outreach workers should be the broad focus of these services. Special emphasis should be laid on meeting the mental health needs of the target population. Depression, isolation and a feeling of being useless is a fairly commonly characteristic shared by most women. While efforts are needed to improve the mental state of the individual, family members especially spouses need to be focused to provide a supporting mechanism for the recovering FDUs. There is a need to building the right capacity within implementing organizations which equips the staff and resource personnel to deal with the issues of drug use among female using a professional and technical approach. Finally, a monitoring and evaluation framework is desired, followed by development of tools which are more user friendly and less punitive. The entire monitoring system should be managed by a management information system to provide timely and cost effective information for decision making, and effective management of the a.m., project in a systematic and timely manner. Details: Islamabad: United Nations Office on Drugs and Crime, Country Office Pakistan, 2010. 81p. Source: Internet Resource: Accessed November 17, 2015 at: https://www.unodc.org/documents/pakistan//female_drugs_use.pdf Year: 2010 Country: Pakistan URL: https://www.unodc.org/documents/pakistan//female_drugs_use.pdf Shelf Number: 137308 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Female Drug Offenders Female Offenders Geographic Analysis HIV

Author: Cockayne, James Title: What Comes After the War on Drugs - Flexibility, Fragmentation or Principled Pluralism? Summary: In April 2016, diplomats, experts and civil society actors from around the world will gather for three days at a rare Special Session of the United Nations General Assembly in New York, called to address the world drug problem (UNGASS 2016). In some quarters, particularly in the Western Hemisphere, UNGASS 2016 is seen as a moment to rethink global drug control strategies. In other regions, UNGASS 2016 is viewed somewhat differently, as a time to build upon and strengthen the current approach to drug policy, as set out in a current Plan of Action adopted in 2009. Throughout 2015, United Nations University (UNU) - a global think tank established by the UN General Assembly, and charged with contributing, through collaborative research, to collective efforts to resolve pressing global challenges - has been gathering stakeholders in a series of meetings at United Nations (UN) headquarters in New York, aimed at "Identifying Common Ground" ahead of UNGASS 2016. These meetings have addressed the relationship between contemporary global drug policy and public health, human rights, development and criminal justice. These meetings have been attended by delegates from more than 50 UN Member States, as well as representatives of 16 UN entities and 55 civil society and academic organizations. Drawing on these consultations, this Policy Report outlines how the global drug control system works, including recent trends; describes three major perspectives going into UNGASS 2016: Orthodoxy, Scepticism and Swing Voting; explores the likely outcome of UNGASS 2016; and makes recommendations for strengthening that outcome. Details: Tokyo: United Nations University, 2015. 59p. Source: Internet Resource: A Policy Report: Accessed December 1, 2015 at: http://i.unu.edu/media/unu.edu/news/72569/UNU_Drug_Policy_Online_Final.pdf Year: 2015 Country: International URL: http://i.unu.edu/media/unu.edu/news/72569/UNU_Drug_Policy_Online_Final.pdf Shelf Number: 137373 Keywords: Drug Abuse and Addiction Drug Control Drug Policy Drug Reform War on Drugs

Author: Australia. Department of the Prime Minister and Cabinet Title: Final Report of the National Ice Taskforce Summary: The Final Report of the National Ice Taskforce found that ice use in Australia is a complex problem that requires a multi-faceted response. Proportionally, Australia uses more methamphetamine than almost any other country, and the number of users continues to grow. Today, evidence suggests there are well over 200,000 users. In its Report, the Taskforce has made 38 recommendations across five areas of priority. 1. The first priority must be supporting families, workers and communities to better respond to people affected by ice. 2. Efforts to reduce demand for ice through prevention activities must be strengthened. 3. Ice users need treatment and support services that cater to their needs. 4. Efforts to disrupt supply must be more coordinated and targeted. 5. Better data, more research and regular reporting is needed to strengthen Australia's response and keep it on track. The National Ice Taskforce The National Ice Taskforce was established on 8 April 2015 to advise the Government on the impacts of ice in Australia and drive the development of a National Ice Action Strategy. The Taskforce presented its interim findings to the Council of Australian Governments on 23 July 2015, and delivered its Final Report to the Prime Minister of Australia on 9 October 2015. The Taskforce engaged extensively with people around Australia to develop this report. The Taskforce spoke to over 100 experts on research, education, prevention, treatment, law enforcement and support for users, families and Indigenous people. The Taskforce also visited nine treatment and support services, and received around 100 submissions from organisations, clinics, research bodies and academics. The Taskforce also received more than 1,200 submissions from the public. Around a quarter shared personal stories of how ice has affected them, their families and their communities. The Taskforce also held seven targeted community consultations in Mt Gambier, Broome, Darwin, Newcastle, Hobart, Townsville and Mildura. Details: Sydney: Department of the Prime Minister and Cabinet, 2015. 252p. Source: Internet Resource: Accessed January 22, 2016 at: http://www.dpmc.gov.au/pmc/publication/final-report-national-ice-taskforce Year: 2015 Country: Australia URL: http://www.dpmc.gov.au/pmc/publication/final-report-national-ice-taskforce Shelf Number: 137655 Keywords: Drug Abuse and Addiction Drug Abuse Prevention Drug Offenders Methamphetamine

Author: Coghlan, Sarah Title: Findings from the DUMA program: Impact of reduced methamphetamine supply on consumption of illicit drugs and alcohol Summary: Changes in illicit drug availability have been shown to impact users' alcohol and other drug consumption. In late 2000 and early 2001, Australia experienced a sudden and dramatic reduction in the supply of heroin which has continued to the present date. This shortage has been attributed to, at least in part, supply-side reduction strategies undertaken by law enforcement (Weatherburn et al. 2003). However, the benefits associated with this shortage were to some degree offset by the unintended consequence of displacement in illicit drug use, reflected in an increase in the use of other drugs, such as cocaine (Weatherburn et al. 2003). Research into the impact of the heroin shortage on illicit drug users has resulted in an awareness of the need to understand potential unintended outcomes of supply-side drug law enforcement strategies. Recent media articles and government inquiries have highlighted methamphetamine as a drug of particular concern in Australia, with both the purity and availability of methamphetamine currently being very high (ACC 2014; LRDCPC 2014; Scott et al. 2014). It is not clear whether law enforcement efforts could produce a substantial methamphetamine shortage, such as that seen for heroin, as the methamphetamine supply is supported by both domestic production and importation (ACC 2014; LRDCPC 2014). However, as seizure rates continue to climb, there is some evidence that government policy and policing efforts are having an impact on supply. In 2012-13, the number and weight of border detections of amphetamine type stimulants (ATS) increased and were reported by the Australian Crime Commission to be the highest on record, with the 21,056 reported seizures accounting for 24.2 percent of national illicit drug seizures, second only to cannabis (ACC 2014). Further, the number of clandestine laboratories detected in Australia was the second highest on record, having more than doubled over the last 10 years, with the majority of clandestine laboratories detected domestically producing ATS (ACC 2014). Few studies have examined the likely impact of such seizures on methamphetamine users' drug usage habits. However, a recent examination of the impact of supply-side reduction strategies on drug use and harm in New South Wales conducted by Wan et al. (2014) reported that seizures and supplier arrests for ATS were either positively associated, or were not significantly associated, with drug use and harm measures. For example, an increase in the number of large-scale ATS seizures was positively associated with an increase in the number of arrests for use or possession of ATS (Wan et al. 2014). However, no significant associations were found between the number of ATS seizures or supplier arrests and emergency department admissions (Wan et al. 2014). Although subject to number of limitations including that the study measured the associations across a relatively short temporal period (ie drug use/possession arrests were examined monthly for 4 months after seizures occurred) and that some of the drug use and harm measures may not have been sensitive enough to detect changes in consumption, the findings suggested that increases in seizures and supplier arrests for ATS may be indicative of an increased supply in the short term (Wan et al. 2014). A study by Chalmers, Bradford and Jones (2010) examined responses to hypothetical changes in the price of methamphetamine among a sample of New South Wales residents between 18 and 58 years of age (n=101) who reported using methamphetamine in the past month. As the price of methamphetamine was manipulated, users reported that they would purchase less methamphetamine at higher price levels. It was estimated that a price increase of 10 percent would result in an 18 to 19 percent decrease in the quantity of methamphetamine purchased (Chalmers, Bradford & Jones 2010). However, a number of respondents anticipated switching to using pharmaceutical opioids, cocaine and to a lesser extent, heroin, if the price of methamphetamine were to rise (Chalmers, Bradford & Jones 2010). Despite this evidence of anticipated displacement, the authors concluded that there would be an overall reduction in drug consumption, as the level of substitution for other drugs was more than offset by the decrease in the quantity of methamphetamine purchased (Chalmers, Bradford & Jones 2010). However, this study suffered from a number of limitations. First, the findings represent methamphetamine users' intentions as reported to researchers, which may or may not correspond to actual behaviour during periods of reduced methamphetamine supply. It is important to examine the actual behaviour users demonstrate in response to changes in drug markets, rather than how they believe they would behave in a hypothetical situation. Second, the assumption that supply reduction through law enforcement leads to an increase in the price of an illicit drug may not be valid or may only occur when an extreme shortage is experienced. A study conducted in the United States reported that if a drug market is well-established, the expansion of drug law enforcement may yield little return in the way of increased prices (Caulkins & Reuter 2010). Consistent with this, a 2014 review of empirical studies into the impact of increased law enforcement efforts on drug prices concluded that there was insufficient evidence to link the escalation of law enforcement activity with the raising of drug prices (Pollack & Reuter 2014). Since 1999, the Australian Institute of Criminology has monitored drug use and crime trends across Australia through the Drug Use Monitoring in Australia (DUMA) program. Each quarter, detainees held in watchhouses at various sites across Australia are asked to complete an interviewer-assisted self-report questionnaire. Twice a year, detainees are also asked to provide a voluntary urine sample, which is analysed for the presence of illicit drugs. These data allow monitoring of the availability of illicit substances, including methamphetamine, and examinations of crime and drug usage behaviours. Using DUMA data, an analysis is presented of retrospective self-reports from methamphetamine users (police detainees) on the impact that periods of reduced methamphetamine supply had on reported consumption of methamphetamine, alcohol and other illicit drugs. In order to collect more detailed data, in quarter three of 2013, detainees who had indicated methamphetamine use in the previous 12 months were presented with additional questions to assess whether they had previously experienced a period when methamphetamine was hard to get and if they had, how this had affected the quantity of methamphetamine, alcohol and other illicit drugs used at that time. The findings should be considered in the context of Australian drug markets where methamphetamine is currently readily available, with some localised differences in availability (LRDCPC 2014). Details: Canberra: Australian Institute of Criminology, 2015. 5p. Source: Internet Resource: Research in Practice No. 36: Accessed January 25, 2016 at: http://www.aic.gov.au/media_library/publications/rip/rip36/rip36.pdf Year: 2015 Country: Australia URL: http://www.aic.gov.au/media_library/publications/rip/rip36/rip36.pdf Shelf Number: 137649 Keywords: Alcohol Abuse Drug Abuse and Addiction Drug Markets Illegal Drugs Methamphetamine

Author: Nigg, Claudio R. Title: State Epidemiological Profile: Selected Youth and Adult Drug Indicators Summary: Background: The State of Hawaii Epidemiological Profile: Selected Youth and Adult Drug Indicators was developed as one of the services provided by the Alcohol and Drug Abuse Division (ADAD) Epidemiology Team. The ADAD Epidemiology Team is a partner of the Strategic Prevention Framework Partnerships for Success (SPF-PFS), which is funded through a federal grant provided by the Substance Abuse and Mental Health Services Administration (SAMHSA). The purposes of this profile are identifying Hawai'i's status of drug use by youth and adults, detecting trends of drug use, and providing information in a user-friendly format for planning and implementation of drug use prevention and treatment programs. Methods: The drug-related indicators in this profile were selected based on SAMHSA's National Outcome Measures (NOMs). In order to report those selected indicators, Hawaii Youth Risk Behavior Survey (Hawaii YRBS) and National Survey on Drug Use and Health (NSDUH) were utilized as primary data sources in this profile. Results and Findings: The overall prevalence rates of each drug-related indicator among high school students in 2013 were: 18.9% for 30-day marijuana use; 10.4% for trying marijuana before age 13 years; 6.5% for ever using cocaine; 9.2% for ever using inhalants; 8.0% for ever using ecstasy; 3.4% for ever using heroin; 4.3% for ever using methamphetamine; and 12.9% for ever using prescription drugs without a doctor's prescription. The findings indicated that there were no significant differences in drug indicators for youth (high school students or individuals aged from 12 to 17) in Hawai'i since 2007 except that rates of ever having used ecstasy were slightly but significantly higher in 2011 than 2009. Marijuana was the most prevalent illicit drug among youth with 18.9% reporting that they had used it in the past 30 days (2013). Prescription drugs and inhalants were two most common substances that were ever used by youth (12.9% and 9.2%, respectively in 2013). The least common illicit drug was heroin with 3.4% of youth reported that they had ever used it (2013). There were no sex differences for any youth drug indicator in any year from 2007 to 2013. Overall, no significant differences by grade were seen for any drug indicator except for prescription drug misuse (use without a doctor's prescription), in which 12th graders had higher rates than 9th graders in 2011 and 2013. Native Hawaiians, Caucasians, and other Pacific Islanders generally had the highest rates of youth drug use. The overall prevalence rates of each drug-related indicator among adults in 2010-2011 were: 6.9% for 30-day marijuana use; 22.1% for ever using cocaine; 10.4% for ever using inhalants; 9.4% for ever using ecstasy; 2.5% for ever using heroin; 7.1% for ever using methamphetamine; and 13.6% for ever using prescription drugs without a doctor's prescription. There were no significant differences in adult drug indicators for Hawaii since 2007. Other than marijuana use (data of ever having used marijuana is not available, but 6.9% of adults in Hawaii reported that they had used marijuana in the past 30 days in 2010-2011), rates of ever having used illicit drugs were highest for cocaine (22.1%) followed by prescription pain relievers (13.6%), and lowest for heroin (2.5%) in 2010-2011, the most current year available. Program Recommendations: Prevention efforts should be strengthened in response to the fact that the prevalence rates of illicit drugs have not changed in the past seven years. Focus should be on marijuana use and prescription drug misuse as usage rates for these substances are relatively high (prevalence - 10%) among youth and the interventions should equally target both boys and girls since there were no sex differences in any indicator. To reduce health disparities among ethnic groups in Hawaii, culturally appropriate and evidence-based programs are strongly recommended, especially for the groups with the highest rates, such as Native Hawaiians and Caucasians, and other Pacific Islanders. For the drugs with relatively lower prevalence rates such as cocaine, ecstasy, heroin, or methamphetamine, interventions that are highly targeted towards people at greatest risk are recommended. Moreover, prevention programs should be provided to middle school students in order to lower the prevalence rates in high school students. Prevention efforts for adults also should be strengthened since prevalence rates of illicit drugs have not significantly changed in the past seven years. Focus should be on marijuana, and other drugs with relatively high lifetime use rates (prevalence - 10%), such as cocaine, pain relievers, and inhalants. More young adults (aged 18 - 25) than older adults (age 26 and older) perceived no risk or slight risk of experiencing adverse health effects from marijuana use, which may indicate that young adults have an increased risk of marijuana use. Thus, it is recommended that communities have prevention interventions specifically designed for young adults and focus on risks and negative health outcomes of marijuana consumption. Details: Honolulu: Department of Public Health Sciences University of Hawaii at Manoa, 2014. 81p. Source: Internet Resource: Accessed February 8, 2016 at: http://health.hawaii.gov/substance-abuse/files/2013/05/2014State_Drug_Profile_Youth_Adults.pdf Year: 2014 Country: United States URL: http://health.hawaii.gov/substance-abuse/files/2013/05/2014State_Drug_Profile_Youth_Adults.pdf Shelf Number: 137787 Keywords: Drug Abuse and Addiction Drug Abuse Prevention Drug Offenders Substance Abuse

Author: Trust for America's Health Title: Reducing Teen Substance Misuse: What Really Works Summary: A significant number of students try alcohol, tobacco or other drugs as teenagers. More than 65 percent of students have used alcohol, more than 40 percent used illegal drugs and around one-quarter used cigarettes at some point before entering or while in high school. While the number of teens who regularly misuse or develop substance use disorders has been decreasing over time, overall levels are still too high. More than 90 percent of adults who develop a substance use disorder began using before they were 18-years-old. Substance misuse can have long-term adverse effects on physical and mental health, academic and career attainment, relationships with family and friends and establishing and being a connected part of a community. For decades, substance misuse strategies focused on individual willpower to "just say no" or intervening once a person already has a serious problem. But, the evidence shows that if the country is going to maintain a continued downward trend in substance use - it will require a greater emphasis on: 1) preventing use in the first place; 2) intervening and providing support earlier after use has started; and 3) viewing treatment and recovery as a sustained and long-term commitment. More than 40 years of research exists from the National Institutes of Health (NIH) and other experts that supports this approach, but there has been a disconnect in implementing the science into real-world practice. A prevention-oriented approach - building positive protective factors and reducing risk factors - can decrease the chances of tweens and teens initiating, regularly using or developing an addiction to alcohol and/or drugs. This approach not only lowers the chances for substance misuse, but also has a bigger impact, since similar underlying root causes have also been shown to contribute to increased likelihood of poor academic performance, bullying, depression, violence, suicide, unsafe sexual behaviors and other problems that can emerge during teenage years. Details: Washington, DC: Trust for America's Health, 2015. 100p. Source: Internet Resource: Accessed February 8, 2016 at: http://healthyamericans.org/assets/files/TFAH-2015-TeenSubstAbuse%20FINAL.pdf Year: 2015 Country: United States URL: http://healthyamericans.org/assets/files/TFAH-2015-TeenSubstAbuse%20FINAL.pdf Shelf Number: 137805 Keywords: Drug Abuse and Addiction Drug Abuse Prevention Substance Abuse Substance Abuse Prevention Substance Use

Author: Title: Drug use monitoring in Australia: an expansion into the Pilbara Summary: The link between the use of alcohol, other drugs and crime continues to be a concern in communities throughout Australia. In regional Western Australia, little is known about the patterns of substance use and crime. In an attempt to better understand a regional offending population and their alcohol and drug use, the Australian Institute of Criminology's Drug Use Monitoring in Australia (DUMA) project was utilised to collect such data in the Pilbara region of Western Australia. In South Hedland (regional Western Australia), 51 police detainees were interviewed and compared with a sample of 209 Perth (metropolitan Western Australia) detainees. The findings indicated that while illicit drug use among those interviewed in a regional setting was significantly lower across most drug types, alcohol use was higher. Of particular concern were the levels of risky drinking reported by South Hedland detainees and their assertion that alcohol contributed to their current detention. These findings are important in providing a better picture of alcohol and drug use in a regional population and will assist in shaping prevention and response strategies. Details: Canberra: Australian Institute of Criminology, 2016. 13p. Source: Internet Resource: Trends & Issues in Crime and Criminal Justice, No. 504: Accessed February 11, 2016 at: http://aic.gov.au/media_library/publications/tandi_pdf/tandi504.pdf Year: 2016 Country: Australia URL: http://aic.gov.au/media_library/publications/tandi_pdf/tandi504.pdf Shelf Number: 137843 Keywords: Alcohol Abuse Drug Abuse and Addiction Substance Abuse

Author: London School of Economics and Political Science. LSE Expert Group on the Economics of Drug Policy Title: After the Drug Wars: report of the LSE Expert Group on the Economics of Drug Policy Summary: The post-'war on drug' era has begun. Prohibitionist policies must now take a back seat to the new, comprehensive, people-centred set of universal goals and targets that we know as the Sustainable Development Goals (SDGs). Nation states and the global drug regulatory system must shift to principles of sustainable development that include: public health, harm reduction of consumption and supply, access to essential medicines, and scientific experimentation with strict legal regulation. To enable this transformation, nation states should drastically de-prioritise the prohibitionist goals of the past. They must implement new comprehensive development policies dealing with the root causes of problems associated with illicit drugs. The 'war on drugs' caused the international community to prioritise prohibitionist policies over sustainable development at a terrible socioeconomic cost. As the United Nations Development Programme highlights in the discussion paper excerpted in this report, 'evidence indicates that drug control policies often leave an indelible footprint on sustainable human development processes and outcomes... [and] have fuelled the marginalisation of people linked with illicit drug use or markets.' This report recognises that key reforms within the global regulatory system will come from changes at the national and local levels. It highlights that the UN drug control treaties recommend an approach grounded in the 'health and welfare' of mankind. Further, it emphasises that human rights obligations have absolute supremacy over drug control goals and as such there is sufficient interpretive scope within the treaties to experiment with social scientific policies that can further global health and welfare. The world can shift away from counterproductive and ineffective drug policies. The UN General Assembly Special Session in 2016 is a key platform for driving debate. However, the ultimate impetus lies with countries to reform their policies based on evidence and local realities. This report provides a framework for achieving this shift. Details: London: LSE, 2016. 140p. Source: Internet Resource: Accessed February 26, 2016 at: http://www.lse.ac.uk/IDEAS/publications/reports/pdf/LSE-IDEAS-After-the-Drug-Wars.pdf Year: 2016 Country: International URL: http://www.lse.ac.uk/IDEAS/publications/reports/pdf/LSE-IDEAS-After-the-Drug-Wars.pdf Shelf Number: 137981 Keywords: Drug Abuse and Addiction Drug Control Drug Enforcement Drug Policy War on Drugs

Author: Gannoni, Alexandra Title: Methamphetamine in Brisbane: Perspectives from DUMA police detainees Summary: Methamphetamine is of national concern (ACC 2014), but what does this statement mean to frontline police officers? In real terms it means that frontline police are required, on an increasingly frequent basis, to engage with methamphetamine users. This presents a number of challenges to police. First, methamphetamine intoxication and withdrawal can impede an individual's ability to follow police directions. Second, use is associated with behavioural and psychological disturbances, including aggression, which can increase the risk of harm for the police and members of the community. Third, the user is at increased risk of serious physical harms when in custody due to the effects of intoxication or withdrawal. Risks to the user may be exacerbated by physical exertion during interactions with police or due to use of restraint by police. Being armed with information about what methamphetamine is, the nature and extent of use of methamphetamine among Brisbane police detainees, and details of the Brisbane methamphetamine market can assist police to identify risks to themselves and others. Details: Canberra: Australian Institute of Criminology, 2015. 6p. Source: Internet Resource: Research in practice no. 45: Accessed March 2, 2016 at: http://aic.gov.au/media_library/publications/rip/rip45/rip45.pdf Year: 2015 Country: Australia URL: http://aic.gov.au/media_library/publications/rip/rip45/rip45.pdf Shelf Number: 138008 Keywords: Drug Abuse and Addiction Drug Markets Drug Offenders Methamphetamine

Author: Lenton, Simon Title: The social supply of cannabis among young people in Australia Summary: Cannabis is the most prolifically used illicit drug in Australia, however, there is a gap in our understanding concerning the social interactions and friendships formed around its supply and use. The authors recruited cannabis users aged between 18 and 30 years throughout Australia, to explore the impact of supply routes on young users and their perceived notions of drug dealing in order to provide valuable insight into the influence that reciprocal relationships have on young people�s access to cannabis. Findings reveal that the supply of cannabis revolves around pre-existing connections and relationships formed through associates known to be able to readily source cannabis. It was found that motivations for proffering cannabis in a shared environment were related more to developing social capital than to generating financial gain. Given this, often those involved in supply do not perceive that they are breaking the law or that they are 'dealers'. This social supply market appears to be built on trust and social interactions and, as such, presents several challenges to law enforcement. It is suggested that there would be benefit in providing targeted education campaigns to combat social supply dealing among young adults. Details: Canberra: Australian Institute of Criminology, December 2015. 6p. Source: Internet Resource: Trends & issues in crime and criminal justice no. 503: Accessed March 2, 2016 at: http://aic.gov.au/media_library/publications/tandi_pdf/tandi503.pdf Year: 2015 Country: Australia URL: http://aic.gov.au/media_library/publications/tandi_pdf/tandi503.pdf Shelf Number: 138010 Keywords: Cannabis Drug Abuse and Addiction Drug Dealing Drug Markets Illicit Drugs Marijuana

Author: Millsteed, Melanie Title: Recorded drug use and possession offences and offenders, 2005 - 2014 Summary: The number of recorded drug use and possession offences in Victoria has continued to increase over the past five years, while other evidence suggests that the number of people using drugs has remained stable. This exploratory study analysed trends in both the number and rate of drug use and possession offences and offenders over the past ten years, as well as the characteristics of these offenders. The research found that the rate of offences has continued to rise since 2010. The rate of offenders has also risen, but to a lesser extent. Over the past two years, the increase in both the offence and offender rates has slowed. Seventy two percent of recorded drug use and possession offenders were only recorded for one use and possession offence incident between 2005 and 2014. The majority of recorded offenders were male (81.4%) and aged under 30 at the time of their first recorded offence in the dataset (62.7%). Further research will be conducted to examine whether the observed increases over past five years were driven by offending in particular geographic regions or by offences relating to particular drug types. Details: Melbourne: Victoria Crime Statistics Agency, 2015. 13p. Source: Internet Resource: In Brief, no. 1: Accessed March 2, 2016 at: https://assets.justice.vic.gov.au//csa/resources/6d5fad02-6c3b-42c1-8a2f-0ed202896d24/20150921_copy_in+brief_paper_1.pdf Year: 2015 Country: Australia URL: https://assets.justice.vic.gov.au//csa/resources/6d5fad02-6c3b-42c1-8a2f-0ed202896d24/20150921_copy_in+brief_paper_1.pdf Shelf Number: 138025 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders

Author: Sutherland, Paul Title: Recorded drug use and possession crime in metropolitan, regional and rural Victoria, 2006-2015 Summary: This paper examines the rise in drug use and possession incidents recorded by police across Victoria over the past ten years. By exploring two separate geographical breakdowns, it is possible to see which parts of the state are making the largest contributions to the increase. The paper finds the largest increases occurred across regional urban areas, although there were also increases in metropolitan Melbourne and rural areas over the past five years. There was also a shift in the proportion of incidents that occurred in public locations, although this trend varied across Victoria. While the majority of offenders across the state were male, in metropolitan, rural and many regional areas there has been an increasing proportion of female offenders. While there has been much attention placed on the rise in drug use and possession offending in recent years, it is important to consider the findings in this report may be as much a reflection of police activity as increased prevalence of drug offending across a growing proportion of Victoria's population. Details: Melbourne: Victoria Crime Statistics Agency, 2015. 16p. Source: Internet Resource: In Brief, no. 2: Accessed March 2, 2016 at: https://assets.justice.vic.gov.au//csa/resources/518f532d-2070-417c-9a1d-7efdce501206/20151127final_in_brief2+%281%29.pdf Year: 2015 Country: Australia URL: https://assets.justice.vic.gov.au//csa/resources/518f532d-2070-417c-9a1d-7efdce501206/20151127final_in_brief2+%281%29.pdf Shelf Number: 138026 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders Rural Areas

Author: International Narcotics Control Board Title: Report of the International Narcotics Control Board for 2015 Summary: The International Narcotics Control Board is uniquely placed to contribute to current discussions on international trends and emerging threats in drug control. It will contribute the insight and experience it has accumulated over decades of monitoring the implementation of the drug control conventions and identifying achievements, challenges and weaknesses in drug control. INCB will engage in the special session and its preparation by highlighting and clarifying the approaches and principles underlying the international system of drug control and making recommendations based upon the conventions. In its annual reports, published pursuant to the treaties, INCB has been addressing, particularly in the thematic chapters, most of the relevant aspects of the global drug problem and most of the critical points in the ongoing debate on the "right way in drug policy". Equally, the release of the present annual report of the Board for 2015, the annual report on precursors and the supplementary report on the availability of internationally controlled drugs is part of our contribution to the special session and the forthcoming policy discussions. The present report of the Board for 2015 contains a thematic chapter on the health and welfare of mankind and the international drug control system. It shows that concern for health and welfare is at the core of the international drug control system. INCB emphasizes that the system in place, when fully implemented, contributes to protecting the health and welfare of people worldwide and ensures balanced national approaches that take into account local socioeconomic and sociocultural conditions. Even with the reality of the constantly shifting contours of the drug problem, the 1961, 1971 and 1988 conventions have proved their value as the cornerstone of international cooperation in drug policy. The fact that the conventions have been almost universally ratified by States underscores that the desire to counter the world's drug problem is shared globally. States have regularly reaffirmed their commitment to working within the framework of the three international drug control conventions and the political declarations. Assessing the achievements and challenges of the current drug control system, INCB believes that the control of the international licit trade in narcotic drugs, psychotropic substances and precursors has been an undeniable success, as today no noteworthy diversion of those substances from licit to illicit channels is taking place. On the other hand, the availability and accessibility of narcotic drugs and psychotropic substances for medical purposes is not at all satisfactory at the global level. Equally, the goal of a noticeable reduction in the illicit demand for and supply of drugs has not been reached. Finally, there are numerous new challenges emerging, such as new psychoactive substances. Details: Vienna: International Narcotics Control Board, 2016. 128p. Source: Internet Resource: Accessed March 8, 2016 at: https://www.incb.org/documents/Publications/AnnualReports/AR2015/English/AR_2015_E.pdf Year: 2016 Country: International URL: https://www.incb.org/documents/Publications/AnnualReports/AR2015/English/AR_2015_E.pdf Shelf Number: 138127 Keywords: Drug Abuse and Addiction Drug Control Drug Policy Illicit Drugs Narcotics

Author: Saunders, Jessica Title: A Community-Based, Focused-Deterrence Approach to Closing Overt Drug Markets: A Process and Fidelity Evaluation of Seven Sites Summary: Overt drug markets are often associated with violence and property crime, as well as lower quality of life for nearby residents. Despite the considerable strain these markets can place on communities, efforts to close them can disrupt the delicate relationship between those who live in these communities and the criminal justice agencies charged with protecting them. In 2010, the Bureau of Justice Assistance (BJA) funded Michigan State University (MSU) to train a cohort of seven jurisdictions to implement a community-based strategy that uses focused deterrence, community engagement, and incapacitation to reduce the crime and disorder associated with overt drug markets. The strategy was inspired by the High Point Drug Market Intervention and RAND was selected by the National Institute of Justice to evaluate these efforts. This process evaluation describes how well the seven sites adhered to the BJA model they were exposed to during the trainings, the barriers they encountered, and lessons learned from their experiences. Key Findings Successful Implementation Requires Strong Support from Law Enforcement and Prosecutors - Three sites did not make it to the call-in phase, with the common theme a lack of support at the highest levels of police departments or prosecutor's offices or the loss of initial support from leaders at these key agencies over time. - An initial commitment that is not sustained, or lack of strong commitment from one of these entities, may impede full implementation of the strategy. Team Members Should Have a Good Understanding of the Strategy Before Beginning the Process - A full understanding of the strategy from the outset will prevent avoidable missteps and will likely improve fidelity to the model. Team Turnover Should Be Expected and Addressed in Advance - Most of the teams experienced some turnover in the core membership, and in some cases, this put an end to the intervention. - Several team members mentioned that it was important to have multiple people from each sector familiar with the project in case someone changes positions. If Sites Plan to Track Dealers, an Action Plan Should Be Developed Prior to the Call-In - Some sites did not develop specific systems for tracking A-listers and B-listers, either from the outset or at all. This information is important for understanding the causal mechanisms underlying observed changes, keeping track of program costs, and successfully delivering on the deterrence message. - Some sites were not able to keep careful track of whether B-listers were complying with the terms of program, and some lacked specific requirements for B-lister participation. Details: Santa Monica, CA: RAND, 2016. 113p. Source: Internet Resource: Accessed march 8, 2016 at: http://www.rand.org/content/dam/rand/pubs/research_reports/RR1000/RR1001/RAND_RR1001.pdf Year: 2016 Country: United States URL: http://www.rand.org/content/dam/rand/pubs/research_reports/RR1000/RR1001/RAND_RR1001.pdf Shelf Number: 138129 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Control Drug Enforcement Drug Markets

Author: Parker, Khristy Title: Alaska Trauma Registry: Trauma Admissions Involving Alcohol or Illegal Drugs, 2014 Summary: The Alaska Trauma Registry (ATR) is an active surveillance system that collects data pertaining to hospitalizations of the most seriously injured patients in Alaska. Data collected include patient demographics, injury event, patient transport, treatment, and outcomes. Since 1991, the Alaska Trauma Registry has collected data from all 24 (22 civilian and 2 Department of Defense) acute care hospitals, with the purpose of evaluating the quality of trauma patient care, monitoring serious injury, injury prevention, and trauma system development. The ATR is a subsidiary of the Alaska Department of Health and Social Services (DHSS), Division of Public Health. This fact sheet presents data from the ATR - specifically, numbers of trauma admissions, patient demographics, and the presence of alcohol or illegal drugs in trauma admissions for 2014. Data used in this Fact Sheet were provided to the Alaska Justice Statistical Analysis Center (AJSAC) by ATR. Details: Anchorage: Alaska Statistical Analysis Center, 2016. 4p. Source: Internet Resource: Fact Sheet: Accessed March 16, 2016 at: http://justice.uaa.alaska.edu/ajsac/2016/ajsac.16-01.atr2014.pdf Year: 2016 Country: United States URL: http://justice.uaa.alaska.edu/ajsac/2016/ajsac.16-01.atr2014.pdf Shelf Number: 138266 Keywords: Alcoholism Drug Abuse and Addiction Hospitals Illegal Drug Injuries

Author: International Drug Policy Consortium Title: A Public Health Approach to Drug Use in Asia: Principles and Practices for Decriminalisation Summary: In this report, the International Drug Policy Consortium offers recommendations based on evidence and examples of good practice to inform a shift in policy responses to drug use in Asia away from criminalisation and punishment, and towards public health and harm reduction. It describes effective approaches to the decriminalisation of drug use. It also discusses approaches implemented in Asia that have proven ineffective, such as the detention of people who use drugs in compulsory centres as a form of 'rehabilitation'. The report is intended as a resource for policy makers, legislators, communities of people who use drugs and civil society organisations in Asia. The overall goal of the report is to offer guidance on steps that countries can undertake to develop drug policies that achieve better public health outcomes, by shifting away from the criminalisation and punishment of people who use drugs. It also describes legal and policy responses to drugs that are not effective, such as the detention of people who use drugs in compulsory centres for drug users, forced urine testing, compulsory registration and other punitive measures. Details: London: IDPC, 2016. 54p. Source: Internet Resource: Accessed April 4, 2016 at: https://dl.dropboxusercontent.com/u/64663568/library/Drug-decriminalisation-in-Asia_ENGLISH-FINAL.pdf Year: 2016 Country: Asia URL: https://dl.dropboxusercontent.com/u/64663568/library/Drug-decriminalisation-in-Asia_ENGLISH-FINAL.pdf Shelf Number: 138559 Keywords: Drug Abuse and Addiction Drug Legalization Drug Policy Drug Policy Reform

Author: Rolles, Steve Title: The Alternative World Drug Report. 2nd edition Summary: In April, the world will come together at the UN to discuss the future of international drug policy. It will be the first time that far-reaching drug policy reforms are meaningfully discussed at such a high level. The current enforcement-based, UN-led drug control system is coming under unparalleled scrutiny over its failure to deliver a promised "drug-free world", and for what the UN Office on Drugs and Crime (UNODC) describes as its negative "unintended consequences". It is unacceptable that despite acknowledging these negative impacts, the UNODC does not include them in its annual World Drug Report, and neither the UN nor its member states have meaningfully assessed whether these unintended consequences outweigh the intended consequences. The second edition of the Alternative World Drug Report fills this gap by detailing the full range of negative impacts caused by the drug war. It demonstrates that the current approach is creating crime, harming health, and fatally undermining all "three pillars" of the UN's work - peace and security, development, and human rights. The stark failure of the current system has meant that alternative drug policy approaches are a growing reality. This report therefore explores a range of options for reform, including decriminalisation and legal regulation, that could deliver better outcomes,. The global prohibitionist consensus has broken, and cannot be fixed. This Alternative World Drug Report is intended to help policymakers shape what succeeds it Details: London: Transform Drug Policy Foundation, 2016. 192p. Source: Internet Resource: Accessed April 6, 2016 at: http://www.countthecosts.org/sites/default/files/AWDR-2nd-edition.pdf Year: 2016 Country: International URL: http://www.countthecosts.org/sites/default/files/AWDR-2nd-edition.pdf Shelf Number: 138575 Keywords: Costs of Crime Costs of Criminal Justice Drug Abuse and Addiction Drug Enforcement Drug Policy Illegal Drugs Organized Crime

Author: Gyngell, Kathy Title: Breaking the habit: Why the state should stop dealing drugs and start doing rehab Summary: - The Coalition has inherited a failing and costly drug policy. The priority was to prescribe methadone to drug addicts in the hope that that this would replace their use of street drugs, reduce street crime and cut criminal justice costs. - This policy impeded and delayed addicts recovery from addiction. There are as many addicts today as there were in 2004/05. Fewer than 4% of addicts emerge from treatment free from dependency. Drug deaths have continued to rise. In the last three years, the number of referrals to rehabilitation units has fallen to an all-time low of 3,914. - It has been extremely expensive. The cost to the state of maintaining addicts on methadone has doubled since 2002/03 to $730 million a year. Drug users are estimated to receive L1.7 billion in benefits a year, while the welfare costs of looking after the children of drug addicts are estimated at a further L1.2 billion a year (the longer term inter-generational costs are unquantifiable but will probably be far higher). - This brings the total social and economic burden for this population to over L3.6 billion. - The Coalition has wisely recognised the scale of the problem it inherited. However, its proposed solution is flawed. - In particular its 'Drugs Recovery Payment by Results (PbR)' approach will only reinforce the status quo. - The PbR pilots will reward operators who can show that addicts have improved health and employment, who have not offended recently and who are not in treatment for drugs. - This is seriously misguided. Solving the drug problem means recognising the problem for what it is: one of addiction. The solution lies in freeing people from it, not by measuring proxy outcomes (which are easy to manipulate). - In addition, the tendering process is being managed by the National Treatment Agency - the organisation responsible for the previous policy. It clearly favours the current set-up. Independent small-scale rehabilitation operators have in effect been excluded from the PbR trials. Details: London: Centre for Policy Studies, 2011. 70p. Source: Internet Resource: Accessed April 7, 2016 at: https://www.cps.org.uk/files/reports/original/111026175000-breakingthehabit.pdf Year: 2011 Country: United Kingdom URL: https://www.cps.org.uk/files/reports/original/111026175000-breakingthehabit.pdf Shelf Number: 138601 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Drug Offenders Drug Policy Rehabilitation Programs

Author: Patterson, Eileen Title: Methamphetamine in Sydney: Perspectives from DUMA police detainees Summary: Methamphetamine is of national concern (ACC 2014), but what does this statement mean to frontline police officers? In real terms it means that frontline police are required, on an increasingly frequent basis, to engage with methamphetamine users. This presents a number of challenges to police. First, methamphetamine intoxication and withdrawal can impede an individual's ability to follow police directions. Second, use is associated with behavioural and psychological disturbances, including aggression, which can increase the risk of harm for the police and members of the community. Third, the user is at increased risk of serious physical harms when in custody due to the effects of intoxication or withdrawal. Risks to the user may be exacerbated by physical exertion during interactions with police or due to use of restraint by police. Being armed with information about what methamphetamine is, the nature and extent of use of methamphetamine among Sydney police detainees, and details of the Sydney methamphetamine market can assist police to identify risks to themselves and others. The Australian Institute of Criminology's (AIC) Drug Use Monitoring in Australia (DUMA) program interviews police detainees at selected police stations and watch houses across Australia on a quarterly basis. DUMA data collection sites in Sydney include the Bankstown and Surry Hills police stations. Detainees present at the police station during data collection are asked to complete an interviewer-assisted self-report survey on their use of alcohol and other drugs and their offending habits. Urine samples are also requested twice a year during data collections. Urine samples are subjected to urinalysis at an independent toxicology laboratory to detect the presence of a number of licit and illicit drugs, including methamphetamine. Participation in DUMA is voluntary and confidential. Since the program commenced in 1999, 53,858 detainees have been interviewed and 38,574 urine samples have been collected nationally. The data presented in this report were collected at the Bankstown police station during Quarter 4 (October) of 2014 and Quarter 2 (April) of 2015, and at Surry Hills police station in Quarter 3 (July) of 2015. From 2014 to 2015, 116 police detainees were interviewed at Bankstown police station and 55 detainees at Surry Hills police station. They were, on average, 34 years of age. The majority of detainees interviewed were male (approximately 80%), which is representative of the gender composition of the overall Australian detainee population. It should be noted that the data cannot be directly compared between sites due to differences in sample sizes. Details: Canberra: Australian Institute of Criminology, 2016. 7p. Source: Internet Resource: Research in Practice, No. 47: Accessed April 11, 2016 at: http://aic.gov.au/media_library/publications/rip/rip47/rip47.pdf Year: 2016 Country: Australia URL: http://aic.gov.au/media_library/publications/rip/rip47/rip47.pdf Shelf Number: 138631 Keywords: Drug Abuse and Addiction Drug Offenders Methamphetamine

Author: Watt, Suzie Title: Reading drug and alcohol misuse needs assessment Summary: 1.1 The Reading Borough Council (RBC) drug and alcohol misuse needs assessment quantifies the extent of misuse of alcohol and drugs in Reading; the effect this is likely to have on people and thus on health and social care and other services, and on prevention and early interventions and, the nature of current services and treatment demand for substance misuse; and what might be done to better meet identified needs. 1.2 This needs assessment is a precursor to a revised strategy for drug and alcohol services in Reading which will be developed in the near future. 1.3 Contributors to the report include key stakeholders and partners for example, Clinical Commission Group's, Source (RBC's Young Persons Drug & Alcohol Treatment Service), IRiS (Adults Drug & Alcohol Treatment service provider), RBC's Parental Substance Misuse Service, Thames Valley Police and RBC Licensing/Trading Standards Team. Client feedback and/or experience is not reflected within the paper because this is a needs assessment and not a details proposal for how service might be changed in the light of a needs assessment. 1.4 In Reading, as in many other places, there has been a greater emphasis put on the treatment of drug misuse rather than alcohol misuse. Whilst drug-related deaths rates in the local population are higher than the England average, and in comparison to other Berkshire local authorities, the numbers remain small. In contrast, the figures in the needs assessment show that the health and social care and the wider societal effects of alcohol misuse are substantially greater than those of drug misuse. Details: Reading, UK: Reading Council, 2016. 82p. Source: Internet Resource: Accessed April 14, 2014 at: http://www.reading.gov.uk/media/4501/Item-15-Appendix/pdf/Item_15_Appendix.pdf Year: 2016 Country: United Kingdom URL: http://www.reading.gov.uk/media/4501/Item-15-Appendix/pdf/Item_15_Appendix.pdf Shelf Number: 138668 Keywords: Alcoholism Drug Abuse and Addiction Substance Abuse Treatment

Author: Reed, Jack K. Title: Marijuana Legalization in Colorado: Early Findings. A Report Pursuant to Senate Bill 13-283 Summary: In 2013, following the passage of Amendment 64 which allows for the retail sale and possession of marijuana, the Colorado General Assembly enacted Senate Bill 13-283. This bill mandated the Division of Criminal Justice in the Department of Public Safety to conduct a study of the impacts of Amendment 64, particularly as these relate to law enforcement activities. This report seeks to establish and present the baseline measures for the metrics specified in S.B. 13-283, codified as C.R.S. 24-33.4-516. The majority of the information presented here should be considered pre-commercialization, baseline data because much of the information is available only through 2014, and data sources vary considerably in terms of what exists historically. Consequently, it is too early to draw any conclusions about the potential effects of marijuana legalization or commercialization on public safety, public health, or youth outcomes, and this may always be difficult due to the lack of historical data. Furthermore, the information presented here should be interpreted with caution. The decreasing social stigma regarding marijuana use could lead individuals to be more likely to report use on surveys and to health workers in emergency departments and poison control centers, making marijuana use appear to increase when perhaps it has not. Finally, law enforcement officials and prosecuting attorneys continue to struggle with enforcement of the complex and sometimes conflicting marijuana laws that remain. Thus, the lack of pre-commercialization data, the decreasing social stigma, and challenges to law enforcement combine to make it difficult to translate these early findings into definitive statements of outcomes. Details: Denver, CO: Colorado Division of Criminal Justice, Department of Public Safety, 2016. 147p. Source: Internet Resource: Accessed April 23, 2016 at: http://cdpsdocs.state.co.us/ors/docs/reports/2016-SB13-283-Rpt.pdf Year: 2016 Country: United States URL: http://cdpsdocs.state.co.us/ors/docs/reports/2016-SB13-283-Rpt.pdf Shelf Number: 138798 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Law Enforcement Drug Legalization Drug Policy Marijuana Organized Crime

Author: United Nations Office on Drugs and Crime (UNODC) Title: The Afghan Opiate Trade and Africa - A Baseline Assessment Summary: This report presents a "Baseline Assessment" of the illicit Afghan opiate trafficking situation in Africa, with a focus on heroin trafficking along the southern route out of Afghanistan into, through and from Africa. The main objective of this report is to provide an initial evidence base to support policymakers and law enforcement officials in evaluating the trafficking of Afghan opiates into and across the continent, and to allow the development of effective responses to the issue. While Africa has traditionally been perceived as a transit region for heroin and other drugs moving to destination markets in Europe, North America and Asia, drug trafficking and organized crime is increasingly posing a multifaceted challenge to health, the rule of law and development within the continent itself. Eastern Africa faces many challenges. Natural disasters and civil war, recurrent food shortages and droughts have left many of the region's 180 million people struggling under extreme poverty, and this has been exacerbated by corruption and poor governance. Eastern Africa is increasingly becoming a major landing point for heroin shipped from Afghanistan to Africa via the Indian Ocean. However, despite this increase in maritime smuggling, seizure rates of opiate within Eastern Africa remain low. In Western Africa, drug trafficking, notably via air couriers, has been going on for decades with trafficking networks making extensive use of established courier networks to move drugs, both heroin and cocaine, towards destination markets. This is one of the poorest regions in the world, and in many of the countries in this region governance and law enforcement continues to face challenges as a result of a lack of resources, making the region vulnerable to organised crime. These factors, combined with West Africa's geographic location along major and well established trafficking routes between, for example, South America and Europe, make it attractive to organized crime. Northern Africa appears to be somewhat of an outlier in this analysis of the opiate trade in the African continent, possibly due to being separate from wider drug trafficking trends seen in sub-Saharan Africa, and as a result of being mainly supplied by a sub-section of the Balkan route rather than the southern route. Heroin seizures in Northern Africa are limited and drug addiction rates are generally low. Knowledge of the current drug trafficking picture in Southern Africa is limited. A lack of heroin seizure, purity and consumption data is notable across the region, largely due to a lack of law enforcement capacity and poor data collection processes. While Mozambique and South Africa are known to be major transshipment countries for Afghan opiates, the broader picture of how this affects Southern Africa remains largely unknown. There remains a risk that traffickers will exploit limited law enforcement capacity in Southern Africa, leading to increasing drug trafficking and use, which in turn will further inhibit economic and social development within the region. Comprehensive data on the prices of opiates throughout Africa is currently unavailable. Although heroin commands a reasonably high price in parts of Africa, greater profits can generally be made in other destination markets and it is likely that prices of heroin in Africa remain significantly lower than in other international markets. There is limited data on the purity of heroin trafficked into, through and out of Africa, and there is no evidence to suggest that heroin is produced in Africa itself. Globally, Africa is estimated to be home to 11 per cent of global opiate users and of this 11 per cent of users living in Africa, more than 50 per cent live in Western and Central Africa. While cannabis remains the number one illicit drug used both on the continent and globally, and the only drug produced in Africa for export in large quantities, heroin appears to be becoming more popular in some areas, particularly in Eastern Africa. Synthetic opiates such as Tramadol are also used in Africa and use of such opiates may lead to the use of Afghan opiates, should market conditions for heroin change. Use of Afghan-sourced heroin has wider public health impacts in Africa, including on transmission rates of HIV and Hepatitis C, although data on this area remains limited. Details: Vienna: UNODC, 2016. 78p. Source: Internet Resource: Accessed April 28, 2016 at: https://www.unodc.org/documents/data-and-analysis/Afghanistan/Afghan_Opiate_trade_Africa_2016_web.pdf Year: 2016 Country: Africa URL: https://www.unodc.org/documents/data-and-analysis/Afghanistan/Afghan_Opiate_trade_Africa_2016_web.pdf Shelf Number: 138840 Keywords: Drug Abuse and Addiction Drug Smuggling Drug Trafficking Heroin Maritime Crime Opium Organized Crime

Author: Buhringer, Gerhard Title: Comparative Analysis of Research into Illicit Drugs in the European Union: Full report Summary: The study was commissioned by the European Commission's Directorate-General for Justice, Freedom and Security (Justice-Liberte-Securite; DG JLS) with the following six objectives: (1) To map the key research areas, research disciplines and recent research trends, covering both drug demand and drug supply reduction, taking into account any important interrelations with related thematic areas (i.e. mental health and addiction, licit substance abuse, etc.). (2) To map and analyse the capacity, infrastructure and model of coordination of drug-related research in the member states (MS). An analysis of the participation of the national research communities in EU programmes should also be conducted. (3) To map and analyse the capacity, infrastructure and coordination of illicit drug-related research at European and international level, taking into account the drug-related research activities of the Pompidou Group of the Council of Europe and the World Health Organisation as well as the activities of significant private or semi-private research bodies. (4) To briefly describe - for comparative purposes - the drug-related research trends, capacity, infrastructure and model of coordination in the US, Canada and Australia as well as major research collaborations in the drug field with EU partners. (5) To identify strengths and weaknesses in EU drug-related research as well as gaps in the knowledge infrastructure in this field, always bearing in mind that the focus of this study covers both supply and demand of illicit drugs. (6) To assess options for strengthening - if necessary - the drug-related research infrastructure in EU. Details: Luxembourg : Publications Office, 2009.507p. Source: Internet Resource: Accessed May 3, 2016 at: http://ec.europa.eu/justice/anti-drugs/files/drug-research-study-report_en.pdf Year: 2009 Country: Europe URL: http://ec.europa.eu/justice/anti-drugs/files/drug-research-study-report_en.pdf Shelf Number: 138902 Keywords: Drug Abuse and Addiction Drug Enforcement Drugs and Crime Illegal Drugs Illicit Drugs

Author: Open Society Foundations Title: No Health, No Help: Abuse as Drug Rehabilitation in Latin American and the Caribbean Summary: Chaining, public humiliation, abduction, and prayer. If these were treatments offered for diabetes or heart disease, we would see them as cruel and abusive. Yet these are tactics used widely in centers for the "treatment and rehabilitation" of people who use drugs in Latin America and the Caribbean. These abusive centers often operate unlawfully and without medical or governmental supervision. People are often brought to these centers against their will, by family members, by police, or by gangs of center residents. Families are not aware of the conditions in the center, or don't know where else to turn. These practices run counter to evidence-based drug treatments recommended by the World Health Organization and the United Nations Office on Drugs and Crime, and reveal how often drug dependency is treated as a moral failing rather than a medical condition. As regional governments prepare for the United Nations General Assembly Special Session (UNGASS) on drugs in April, defining what truly constitutes a "public health approach" to drug policy is increasingly important. No Health, No Help: Abuse as Drug Rehabilitation in Latin America & the Caribbean is a compilation of reports by researchers and civil society in six countries - Brazil, Colombia, the Dominican Republic, Guatemala, Mexico, and Puerto Rico. The report details the extreme human rights abuses occurring in the name of "rehabilitation," and offers recommendations for how governments can work to improve drug treatment in these countries. Details: New York: Open Society Foundations, 2016. 40p. Source: Internet Resource: Accessed May 4, 2016 at: https://www.opensocietyfoundations.org/sites/default/files/no-health-no-help-en-21060403.pdf Year: 2016 Country: Latin America URL: https://www.opensocietyfoundations.org/sites/default/files/no-health-no-help-en-21060403.pdf Shelf Number: 138911 Keywords: Drug Abuse and Addiction Drug Offenders Drug Policy Drug Treatment Substance Abuse Treatment

Author: Scaggs, Samuel Title: An Assessment of Substance Abuse Treatment Programs in Florida's Prisons Using a Random Assignment Experimental Design Summary: Prior drug involvement and dependence among incarcerated offenders is a critical issue for correctional administrators and policy makers given the financial impact of treatment costs and recidivism. While substance-addicted inmates can cause financial burdens on correctional institutions, they are also at a high risk of recidivism following their release from incarceration. Targeting inmates' substance addiction needs while in prison is intended to reduce reoffending and relapse following prison release. The exact nature of substance abuse treatment within prison systems has yet to be fully examined within the criminological literature. Specifically, while there has been extensive research on the use and effectiveness of therapeutic communities with inmates, other treatment modalities such as outpatient services have received less inquiry. This study provides an important contribution to the understanding of the role substance abuse treatment plays for inmates' in several key ways. First, we evaluate the results of a randomized experimental design study conducted by the Florida Department of Corrections (FDC) from January 2006 through December 2008 in which all inmates admitted to a Florida prison were given the opportunity to consent to participate in a study of the effectiveness of substance abuse treatment programming in prison. Second, the study assesses the impact of multiple modalities of prison−based substance abuse treatment, as well as the role that duration and recency of treatment play in the recidivism and post−prison employment outcomes of over 11,000 released inmates. Third, we use multiple statistical techniques, including logistic regression, survival analysis, Propensity Score Matching (PSM), and precision matching, to assess whether, and to what extent, evaluation outcome studies of correctional-based substance abuse treatment are impacted by the type of research design and statistical methods used. Among the major findings are that aftercare and transitional substance abuse programming has some of the largest effects of increasing employment and reducing recidivism. In addition, among inmates who complete substance abuse treatment, those who do so closer to their release from prison are less likely to recidivate. Another important finding is that some research methods produce similarities in the direction of the effect while others produce different directions in the effect of the same treatment on recidivism. Notably, the strongest design - random assignment - showed the most support for prison-based treatment's effectiveness in reducing recidivism. Due to the non-significance of the majority of results across methods, it was difficult to draw conclusions about similarities across statistical methods in this study. We conclude with a discussion of the policy implications and directions for future research on the effectiveness of prison−based substance abuse treatment. Details: Tallahassee: Florida Department of Correction; Florida State University College of Criminology and Criminal Justice, 2015. 108p. Source: Internet Resource: Accessed June 1, 2016 at: https://www.ncjrs.gov/pdffiles1/nij/grants/249843.pdf Year: 2015 Country: United States URL: https://www.ncjrs.gov/pdffiles1/nij/grants/249843.pdf Shelf Number: 139265 Keywords: Correctional Programs Drug Abuse and Addiction Drug Offenders Drug Treatment Programs Recidivism Substance Abuse Treatment

Author: Markov, Dimitar Title: Policies on drugs in Bulgarian prisons: Background report Summary: This report provides a snapshot of the situation of drug users in Bulgaria. As it is aimed to serve as a basis for comparative study on policies and practice towards drug users, particularly in prisons, in Bulgaria and Norway, it presents the country's context - general information on the country and its criminal justice system, policy and legislation on drugs explaining what are the perimeters of drug restriction and what are the national policies towards drug use. This information is illustrated with statistics on crime rates and drug crime in particular. The report also investigates how court looks upon the fact that the accused are using or addicted to narcotic substances within the criminal proceedings and specifically on the type and the term of the sentence. Finally, it looks upon the sanctions available for drug users and their situation once sentenced to imprisonment - what treatment, rehabilitation and harm reduction programmes are available in different prisons. Details: Sofia, Bulgaria: Center for the Study of Democracy, 2016. 29p. Source: Internet Resource: Accessed June 13, 2016 at: http://www.csd.bg/artShow.php?id=17594 Year: 2016 Country: Bulgaria URL: http://www.csd.bg/artShow.php?id=17594 Shelf Number: 139417 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders Drug Treatment Programs

Author: Nevendorff, Laura Title: Crystal - Meth in Indonesia: Crystal-meth use and hiv-related risk behaviour in Indonesia Summary: HIV risk behaviors among crystal-meth users might contribute to increasing HIV prevalence rates in Indonesia. Related risks can be reduced if people have access to crystal-meth related health services. Prior to the development of interventions, a comprehensive understanding of structural, social, interpersonal and personal factors related to the use of crystal-meth in Indonesia is crucial. This includes a better understanding of individual and environment factors surrounding drug use and HIV-related risk behaviors, which will allow for the designing of better interventions. This study aims to gain better knowledge on patterns of meth use and its implications on HIV risk and health seeking behavior among crystal-meth users in Indonesia, including a better understanding of on individual and environmental factors shaping drug use. A qualitative research design was developed with the aim of producing a deeper understanding of the diverse patterns of meth use and its implications for HIV risk and related health seeking behaviors. The study looked at patterns of initiation of meth use, sustained use and attempts of reducing and stopping the use of the drug, and how the drug use influenced users' behaviors, including daily activities, HIV risk behaviors, exposure to legal problems, as well as users' social and sexual networks and health seeking behaviors. It was found that patterns of meth use are dynamic and that its use is influenced by factors a personal, inter-personal and social level, occurring within a specific setting and situated within the informants' life experience. Initiation of meth use is strongly influenced by the social network during the informants' youth. Through the network information and or knowledge on the drug, its effects, and availability are provided. Moreover, various forms of assistance may also be provided by the network (e.g. borrowing of money, pawning things, pooling money, or providing drugs). Temporary cessation or relapse may also be influenced by a user's social network. The study has identified three overlapping patterns of meth use: Frequent users, who use meth on a daily basis and tend to do so independently of their social network; practical users, who use meth on a regular basis, but not as frequent as the frequent users; and casual users, who use meth on a situational basis. Users may move from one using pattern to another, depending on specific events and their life situation. Addiction is an important theme explored in this study. Most of the informants reported that the use of meth does not necessarily lead to addiction. As long as they perceived they could manage their use and were able to perform their daily routine, they did not consider themselves to be addicted. Informants tended to associate drug addiction with heroin use. This dominant perception seems to be rooted in the belief that rehabilitation or drug treatment is needed or indicated for heroin use only, and not for meth use, as meth use, according to most informants, can be controlled by the user. However, some informants stated that they were in need of psychological services to deal with depression, anxiety and stress, or required legal aid as a consequence the consequences of their meth use. Details: Jakarta: AIDS Research Center at Atma Jaya Catholic University of Indonesia, 2015. 33p. Source: Internet Resource: Accessed July 19, 2016 at: http://mainline-eng.blogbird.nl/uploads/mainline-eng/Mainlines_sober_facts_on_chrystal_meth_use_in_Indonesia.pdf Year: 2015 Country: Indonesia URL: http://mainline-eng.blogbird.nl/uploads/mainline-eng/Mainlines_sober_facts_on_chrystal_meth_use_in_Indonesia.pdf Shelf Number: 139667 Keywords: Drug Abuse and Addiction HIV Methamphetamine

Author: Canada. Task Force on Marijuana Legalization and Regulation Title: Toward the Legalization, Regulation and Restriction of Access to Marijuana - Discussion Paper Summary: In the 2015 Speech from the Throne, the Government of Canada committed to legalizing, regulating, and restricting access to marijuana. The current approach to marijuana prohibition is not working: - Youth continue to use marijuana at rates among the highest in the world. - Thousands of Canadians end up with criminal records for non-violent drug offences each year. - Organized crime reaps billions of dollars in profits from its sale. - Most Canadians no longer believe that simple marijuana possession should be subject to harsh criminal sanctions, and support the Government's commitment to legalize, tax and regulate marijuana. The Government understands the complexity of this challenge and the need to take the time to get it right. The Minister of Justice and Attorney General of Canada, supported by the Minister of Public Safety and Emergency Preparedness and the Minister of Health, has created a Task Force on Marijuana Legalization and Regulation ("the Task Force"). The Task Force is mandated to engage with provincial, territorial and municipal governments, Indigenous governments and representative organizations, youth, and experts in relevant fields, including but not limited to: public health, substance abuse, criminal justice, law enforcement, economics, and industry and those groups with expertise in production, distribution and sales. The Task Force will provide advice on the design of a new framework. The Task Force will receive submissions from interested parties, including individual Canadians, consult widely, listen and learn, and commission any necessary focussed research to support its work. It is supported by a federal secretariat and will report back to the three Ministers on behalf of the Government in November 2016, on a date to be determined by the Ministers. This Discussion Paper is designed to support consultations led by the Task Force. Its goal is to support a focussed dialogue. Details: Ottawa: Government of Canada, 2016. 27p. Source: Internet Resource: Accessed July 20, 2016 at: http://healthycanadians.gc.ca/health-system-systeme-sante/consultations/legalization-marijuana-legalisation/alt/legalization-marijuana-legalisation-eng.pdf Year: 2016 Country: Canada URL: http://healthycanadians.gc.ca/health-system-systeme-sante/consultations/legalization-marijuana-legalisation/alt/legalization-marijuana-legalisation-eng.pdf Shelf Number: 139718 Keywords: Drug Abuse and Addiction Drug Reform Policy Marijuana Marijuana Legalization

Author: McDonnell, Brian Title: Evaluation of Drug Prevention Communications Project for Young People Summary: This report on the findings of the evaluation of a drug prevention communications project for young people was commissioned by the Partnership Board of the Drugs Communication Team and conducted by researchers at the Centre for Institutional Studies at the University of East London. The research included a survey of young people's drug use and knowledge about drugs (156 young people). Twenty-eight focus groups to assess the effectiveness of the web-site (94 young people), and eight in-depth interviews with professions to obtain their views of the website were completed. Existing research on drug use and websites, and the project's monitoring data was collated and six steering group meetings attended. Details: London: Centre for Institutional Studies, University of East London, 2006. 30p. Source: Internet Resource: Accessed July 30, 2016 at: http://roar.uel.ac.uk/274/ Year: 2006 Country: United Kingdom URL: http://roar.uel.ac.uk/274/ Shelf Number: 139905 Keywords: Drug Abuse and Addiction Drug Offenders Drug Prevention Programs

Author: Kevin, Maria Title: A Process Evaluation of the Intensive Drug and Alcohol Treatment Program (IDATP). Study One: Program Establishment, Design and Appropriateness Summary: NSW 2021 Priority Action Establish dedicated metropolitan drug treatment facilities focussed on treatment, rehabilitation and keeping drugs out of prisons Foreward The CSNSW Intensive Drug and Alcohol Treatment Program (IDATP), an initiative of the current NSW government which opened in February 2012, is the largest prison -based residential drug treatment program in the southern hemisphere. While drug treatment had been available in NSW prisons for more than 20 years, the NSW government identified the need to strengthen drug treatment for prisoners and provide a new approach to rehabilitation. At the time of writing, the IDATP was an intensive nine-month program, targeted at medium to high risk male prisoners with drug abuse pr oblems and related dynamic criminogenic needs. The program aimed to prevent relapse to drug use and reoffending. It also aimed to improve the social functioning, health and well-being and post-release prospects of participants. Aside from its large capacity, what distinguished the IDATP's design from the existing programs was an intensive structure combined with a greater emphasis on the integration of a range of interventions and techniques. It operated as a modified therapeutic community, which was deli neated into three explicit program stages - Orientation, Treatment and Maintenance. These treatment stages were designed to bring about incremental degrees of psychological and social learning. The primary modalities were the community living units, therapeutic groups , education, employment, pharmacotherapy and aftercare. As of July 2014, the program had been continually operational for 30 months. More than 300 male prisoners had participated in the program and the women's program - Yallul Kaliarna had recently opened. This preliminary study endeavoured to examine program establish ment, design and appropriateness. The next phase of the evaluation will examine how well the context of the program has been implemented. Details: Sydney: Corrective Services NSW, 2015. 92p. Source: Internet Resource: Research Publication No. 54: Accessed August 1, 2016 at: http://www.correctiveservices.justice.nsw.gov.au/Documents/Related%20Links/publications-and-policies/cres/research-publications/idapt-process-study-one-report-2014.pdf Year: 2016 Country: Australia URL: http://www.correctiveservices.justice.nsw.gov.au/Documents/Related%20Links/publications-and-policies/cres/research-publications/idapt-process-study-one-report-2014.pdf Shelf Number: 139911 Keywords: Alcohol Abuse Drug Abuse and Addiction Drug Treatment Substance Abuse Substance Abuse Treatment

Author: Indiana State Epidemiology and Outcomes Workgroup Title: The Consumption and Consequences of Alcohol, Tobacco, and Drugs in Indiana: A State Epidemiological Profile 2015 Summary: This report represents the tenth official State Epidemiological Profile completed by the SEOW. As in past years, we have updated the core set of analyses to reflect the most recent data available. In order to make the report most useful for state and local policymakers and service providers, we present detailed information and descriptive analyses regarding the patterns and consequences of substance use both for the state and, whenever possible, each of Indiana's 92 counties. Prescription drug abuse remains a significant problem in Indiana, and we continue to work closely with the State Board of Pharmacy, reviewing data on dispensation of controlled substances to identify geographic patterns. Details: Indianapolis: Center for Health Policy at Indiana University-Purdue University Indianapolis (IUPUI): 2016. 228p. Source: Internet Resource: Accessed August 25, 2016 at: http://www.healthpolicy.iupui.edu/PubsPDFs/2015%20State%20Epidemiological%20Profile.pdf Year: 2016 Country: United States URL: http://www.healthpolicy.iupui.edu/PubsPDFs/2015%20State%20Epidemiological%20Profile.pdf Shelf Number: 140033 Keywords: Drug Abuse and Addiction Prescription Drug Abuse Substance Abuse

Author: Gotsis, Tom Title: Illegal Drug Use and Possession: Current Policy and Debates Summary: Government policy to address illegal drug use and possession is an ongoing topic of debate both in Australia and internationally. One part of the debate surrounding illegal drug use and possession involves the question of whether or not recreational drug use should be decriminalised, as has occurred in overseas jurisdictions such as Portugal. Another, and more immediate, part of the debate concerns the harms that have resulted from illegal drug use at music festivals. The NSW Government is reviewing the regulation of these events but has rejected options put forward by some stakeholders, including allowing pill testing and amnesty bins. The suggestion by drug law reform proponents that ice users be allowed to attend a medically supervised smoke inhalation room is also on the public agenda. An upcoming forum for discussing illegal drug use and possession is the Parliamentary Cross-Party Harm Minimisation Roundtable, to be held on 11 August at the NSW Parliament. This paper seeks to inform the current debate by discussing: - rates of illegal drug use and the harms of illegal drug use; - current Government policy and laws in relation to illegal drug use; - the use and effectiveness of harm reduction measures, such as the Medically Supervised Injecting Centre; - illegal drug use at music festivals; and - arguments for and against prohibition and decriminalisation, with examples and evidence from Australian and overseas jurisdictions Details: Sydney: NSW Parliamentary Research Service, 2016. 96p. Source: Internet Resource: Briefing Paper No. 4/2016: Accessed August 29, 2016 at: https://www.parliament.nsw.gov.au/researchpapers/Documents/Illegal%20drug%20use%20and%20possession%20current%20policy%20and%20debates.pdf Year: 2016 Country: Australia URL: https://www.parliament.nsw.gov.au/researchpapers/Documents/Illegal%20drug%20use%20and%20possession%20current%20policy%20and%20debates.pdf Shelf Number: 140076 Keywords: Drug Abuse and Addiction Drug Abuse Policy Drug Addicts Drug Offenders Illegal Drugs

Author: d'Abbs, Peter Title: Monitoring Trends in Prevalence of Petrol Sniffing in Selected Aboriginal Communities 2011-2014: Final Report Summary: This report presents the findings from a study of petrol sniffing prevalence in a sample of 53 Australian Aboriginal communities. The study was commissioned by the Commonwealth Department of the Prime Minister and Cabinet (PMC) in order to contribute to monitoring the impact of an ongoing rollout of low aromatic fuel (LAF) in communities beset by petrol sniffing, and was conducted by Menzies School of Health Research, Darwin, in partnership with Bowchung Pty Ltd, Canberra. The study commenced in 2011 and was completed in 2014. Details: Darwin: Menzies School of Health Research, 2016.83p. Source: Internet Resource: Accessed September 3, 2016 at: https://www.dpmc.gov.au/sites/default/files/publications/monitoring-trends-petrol-sniffing-2011-14.pdf Year: 2016 Country: Australia URL: https://www.dpmc.gov.au/sites/default/files/publications/monitoring-trends-petrol-sniffing-2011-14.pdf Shelf Number: 140162 Keywords: Aboriginals Drug Abuse and Addiction Petrol Sniffing

Author: Kane-Willis, Kathleen Title: Diminishing Capacity: The Heroin Crisis and Illinois Treatment in a National Perspective Summary: National Trends - This rise of heroin use has been a major focus of concern among government agencies such as the Centers for Disease Control (CDC), the Substance Abuse Mental Health Services Administration (SAMHSA), and the Office of National Drug Control Policy (ONDCP) and data verify these concerns: - In 2013, the number of individuals (681,000) reporting past year heroin use was significantly higher than in 2007 (314,000), nearly doubling over the six year period. - In 2012, those entering treatment reporting heroin as this primary substance of abuse increased to 16% of all treatment admissions, the highest level since data collection began in 1992. - Heroin overdoses (poisonings) have nearly quadrupled from 2002 to 2013, with 8,200 deaths in 2013. Illinois Trends While heroin treatment episodes are reaching historic highs nationally, in Illinois treatment admissions for heroin are significantly higher than the nation as a whole, for example: - Nationally, heroin treatment admissions comprised 16.4% of total state funded treatment in 2012, while in Illinois heroin admissions make up one-quarter of all treatment admissions for the state, and are 56% greater than the nation as a whole; - In 2012, the Chicago Metropolitan Area percentage of treatment admissions for heroin was more than double the national average (35.1% vs 16.4%). - From 2006 to 2012, heroin was the second most common reason for Illinoisans to enter state publicly funded treatment, after alcohol. In 2000, it was the 4th most common reason. Heroin use is not only rising in urban areas area but is also dramatically increasing in rural and suburban counties. - In 2007, treatment episodes for heroin comprised just 4% of total publicly funded treatment in Metro East Illinois, but by 2012, heroin made up 18% of all treatment episodes - a fourfold increase in just 5 years. - In 2007, treatment admissions in Decatur for heroin comprised just 3% of the total, spiking to 23% in 2012, representing a 6-fold increase. - In 2007, treatment admissions in Peoria-Pekin for heroin were 7% and by 2012 it was 16%, a 119% increase. - Between 2007 and 2012, treatment episodes for heroin more than doubled in Bloomington-Normal and Champaign- Urbana from 5% to 11% and 6% to 13% respectively. According to survey data heroin use is increasing especially among young people in Illinois. - In 2007, 2.5% of Illinois youth reported using heroin in the past year, while in 2013, that number increased to 3.8%, a nearly 50 percent increase in just six years. - The greatest percentage increase occurred among females - a 90% increase over that time period. Males were more likely to report using heroin - nearly six percent in 2013. The Chicago Metropolitan Area ranks in the top for both emergency department mentions for heroin and number of individuals who were arrested and tested positive for heroin. - Arrestees from Cook County tested positive for opiates (including heroin) at a rate of 18.6%, higher than any other area in the nation. - Arrestees from Cook County also self-reported using heroin more times per month than those from any other jurisdiction, (26.8 days per month). - Arrestees from Cook County reported using heroin in the last three days more than those from any other region (15.7%). - The Chicago Metropolitan area ranked first in the country for the total number of mentions for heroin (23,627) nearly double the number for New York City. - Chicago also reported the highest number of heroin mentions among African American mentions (13,178), nearly four times more than New York City (3,463) and nearly 6 times higher than Detroit (2,311). - Among whites, only Boston had more ED mentions for heroin (10,045), but Chicago was second (7,024). - Chicago ranked highest in the number of ED mentions for both women and men. Adjusting for population, Chicago ranked 2nd highest in the number of mentions overall, behind Boston. Declining Treatment Capacity: Illinois in National Perspective While heroin use is increasing in every area of the state, there has been an alarming and dramatic decrease in treatment from 2007 to 2012. - Illinois ranked first in the US for the decline in treatment capacity over this period, a loss of more than half of its treatment episodes, 52% decrease over the five year period. - In 2007, Illinois ranked 28th in state funded treatment capacity, but in 2012 Illinois ranked 44th, or 3rd worst in the nation; only Tennessee and Texas ranked lower. - In 2012, Illinois's state funded treatment rate was (265 per 100K) more than 50% lower than the US rate. - When compared to other Midwestern states, Illinois had the lowest rate of state funded treatment. Minnesota's rate was 2.7 times Illinois's rate (982.1 vs 256.6), Ohio's rate was twice as high as Illinois, Wisconsin rate was 1.8 times greater, and Indiana's rate, which was lower than that for any Midwestern state, aside from Illinois, was still 43% higher than Illinois. Illinois State funding for addiction treatment decreased significantly: - From 2007 to 2012, General Revenue Funding decreased by nearly 30% ($111M vs $79M), while Medicaid funding decreased by 4% over this time period. - These decreases in funding continue in FY 16, where the proposed budget represents a 61% decrease in state funded addiction treatment; - Including Medicaid increases from FY13 to FY16, addiction treatment funding (including Medicaid), still dropped by 28% overall ($163M in 2007 to $116M in the proposed FY16 budget) Details: Chicago: Illinois Consortium on Drug Policy, 2015. 39p. Source: Internet Resource: Accessed September 15, 2016 at: https://www.roosevelt.edu/CAS/CentersAndInstitutes/IMA/ICDP.aspx Year: 2015 Country: United States URL: https://www.roosevelt.edu/CAS/CentersAndInstitutes/IMA/ICDP.aspx Shelf Number: 147874 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Abuse Treatment Drug Offenders Heroin Addicts

Author: Kane-Willis, Kathleen Title: Hidden in Plain Sight: Heroin's Impact on Chicago's West Side Summary: The West side of Chicago may be mentioned in media reports, but in passing -- a place where suburban or increasingly rural users travel to in order to purchase heroin. However, Chicago's West side has not been spared from the health consequences of the heroin crisis, which are severe, significant and mostly silent. While the focus remains on suburban and rural users, the majority of hospitalizations for opioids (including heroin) and publicly funded treatment admissions data paint a different picture:  In 2013, 80% of the State's heroin treatment admissions occurred in the Chicago Metro Area;  Analysis of Illinois Department of Public Health Data indicate that the majority (67%) of total Illinois hospitalizations for opioids, including heroin, occurred in Chicago (2010 data) and 79% occurred in Cook County, while about 3% occurred in DuPage county (2,711) in the same period;  West side hospitalizations for opioids, including heroin, comprised nearly 1 out of 4 opioid hospitalizations for the entire State (23%);  West side hospitalizations make up 35% of the Chicago's total, compared to 7% for the North Side, and 20% for South side of Chicago;  The majority of those hospitalized for opioids on Chicago's West side were Black (83%). Diminishing Capacity Illinois publicly funded treatment capacity has declined rapidly. This decline in funding impacts those across the state but particularly those in the Chicago Metro Area, and may have a disparate impact on Black individuals - especially those in areas like the West side -- who are attempting to gain access to treatment. For example:  In just 5 years, from 2009 to 2013, the Chicago Metro Area lost 61% of its publicly funded treatment capacity compared to a state decline of 54%;  Blacks entering publicly funded treatment for heroin from the Chicago Metro Area comprised 58% of the Chicago Metro Areas treatment episodes for heroin;  The only area with a larger change in treatment episodes occurred in the Bloomington Metro area which experienced a 63% reduction in capacity from 2009 to 2013, while rural areas decreased by 39% and Peoria Metro remained stable. Mortality The image presented in news media and other forums suggests that heroin overdose is primarily a white problem, but analysis of Illinois Public Health data sets paints a different picture:  The heroin overdose mortality rate was significantly higher for African Americans (8.94 per 100,000) than for whites (5.86). Latino deaths were too low to calculate a significant rate, but both white deaths and Black deaths increased rapidly between 2013 and 2014;  Fifty-seven percent of overdoses among Blacks were due to heroin, while 37% of whites died from heroin overdoses.  Chicago had the highest rate of heroin overdose (7.42 per 100,000) significantly higher than Suburban Cook (4.73), Will (5.42), Lake (5.55), McHenry (5.53), DuPage (4.72), Kane (2.86). Arrests and Neighborhood Disparity The majority of the attention paid to the West side in regard to the heroin crisis and use is policing, arrest and incarceration rather than health based solutions for heroin use disorders. These policy and policing decisions have an impact on not only the community but on our spending for the state.  Even as arrests for heroin possession declined by 30 percent from 2010 to 2015 across the City of Chicago, the West side neighborhoods of West and East Garfield Park experienced an increase in the heroin possession arrest rate from 2010-2015;  The four Chicago neighborhoods with the highest rates of arrest for heroin possession in 2015 include West Garfield Park (2,983 arrests per 100,000), East Garfield Park (1,925 arrests per 100,000), North Lawndale (1,375.58 arrests per 100,000) and Humboldt Park (per 100,000), which all located on the West side of Chicago compared to a City rate of 141 per 100,000;  To put these arrest rates in context, the rate for heroin possession arrests in West Garfield Park (2,983 per 100,000) was more than 20 times higher than the rate for the city as a whole (141 per 100,000), East Garfield Park's was about 13 times higher than the city�s rate, North Lawndale 9 times higher and Austin (642 per 100,000) 4 times the city's rate;  West Garfield Park's rate was 2,000 times higher than Lincoln Park's arrest rate (1.56 per 100,000) and compared to Hyde Park, West Garfield Park's rate of arrest was 766 times higher than Hyde Park's rate (3.89 per 100,000).  In five areas of Chicago, no arrests for heroin possession occurred during 2015. Incarcerating individuals costs $25,000 per year, while jail time costs about $150 a day. As the state reconsiders its policies regarding both crime reduction, cost savings and reducing prison populations, it is important to recognize that providing treatment, such as methadone, returns $12 for every dollar spent. Imprisoning individuals with heroin use disorders, a health condition, is neither cost effective nor as effective as treatment in the community. Treatment in the community returns significant savings to taxpayers and societyi in public health and economic savings. POLICY RECOMMENDATIONS Increase Community Based Treatment Capacity - Particularly Medication Assisted Treatment According to analysis, Cook County has high treatment need and not enough providers for opioid use disorders, for example:  In Illinois, for everyone 1,000 residents 3.8 people has opioid use disorders than could be treated under the current system.  Currently Cook County can only treat about 15,000 individuals but the need is much higher than the system can accommodate currently. Create a Misdemeanor Classification for Small Amounts of Drugs Heroin and other opioids, no matter the amount, are currently felonies in Illinois but this is inconsistent with federal law, and many other states have created misdemeanors for personal use, for small amounts of drugs other than cannabis. Illinois policymakers have introduced legislation to reduce amounts under 1 gram from a felony to a misdemeanor.  According to polling of Illinois residents, 78% of Illinoisan believe in reclassifying small amounts of drugs from a felony to a misdemeanor.  Not only would this policy change help prevent the collateral consequences of felony convictions on those with substance use disorder, but it would yield a cost savings of $58M over three years according to a fiscal impact analysis conducted by the Sentencing Policy Advisory Council. Provide Methadone and/or Buprenorphine Maintenance in Cook County Jail and Create Linkages to Treatment Providers There exist a number of models, like the Riker's Island model in New York City, where individuals who are addicted to heroin or other opioids are provided with opioid agonist (e.g. methadone, buprenorphine) treatment in jail and then are linked to continuing methadone or buprenorphine treatment providers in the community.  These programs have demonstrated great success in both lowering crime and retaining individuals in treatment - which is one of the biggest predictor of treatment success;  Research demonstrates that methadone maintenance yielded better results than counseling alone for detainees in terms of one month and yearly relapse rates. Naloxone Dispensing in Different Environments Researchers have consistently demonstrated that more naloxone distributed in the community lowers the fatal overdose rate overall. In order to ensure that persons who are at high risk for overdose have access to naloxone (which is now covered by Medicaid as private insurance under Public Act 099‐0480), it is essential to ensure that it is more widely distributed under "standing orders," in the following settings:  In the Emergency Department, hospitals should prescribe or distribute naloxone to individuals who have experienced overdose;  In Treatment Centers and after Detox , according to the American Society of Addiction Medicine, naloxone education and distribution programs should be incorporated into the treatment system;  In Cook County Jail, Cook County Jail is now launching a pilot to ensure that individuals have access to opioid overdose education and naloxone. This program should be expanded. Increase Access to Harm Reduction Practices Harm reduction practices are an excellent way to bridge the gap to reduce the health consequences of heroin use. Harm reduction practices include the following:  Syringe exchange, including cookers, cottons and needles to stop the spread of blood borne pathogens and naloxone distribution;  Housing First initiatives, which do not require complete abstinence from substances, before being housed;  Safe use and consumption facilities, staffed with medical professionals to ensure that overdoses can be reversed as safe consumption facilities also reduce fatal overdoses in the community. Details: Chicago: Illinois Consortium on Drug Policy, 2016. 24p. Source: Internet Resource: Accessed September 15, 2016 at: https://www.roosevelt.edu/CAS/CentersAndInstitutes/IMA/ICDP.aspx Year: 2016 Country: United States URL: https://www.roosevelt.edu/CAS/CentersAndInstitutes/IMA/ICDP.aspx Shelf Number: 147875 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Drug Offenders Heroin Heroin Addicts Neighborhoods and crime

Author: Schmitz, Stephanie J. Title: A Multiple Indicator Analysis of Drug and Alcohol Use in LaPorte County: 2008-2012 Summary: Overall Drug Treatment Trends Drug treatment trends show mostly stable cocaine and methamphetamine episodes, while the increase in heroin and other opiates has increased tremendously and alcohol treatments have dropped significantly. In spite of these changes, the most common substance for which LaPorte area residents entered treatment continues to be alcohol. In both 2008 and 2011, the most recent year data was available, alcohol treatment admissions compromised the largest percentage of admissions. - The most common illicit substance for which LaPorte County residents sought treatment in 2011 was for heroin, which increased by more than 560% over a three year period. - Combined, treatment admissions for opiate pills and heroin use represented 46% of all illicit drug treatment episodes in LaPorte County in 2011. This percentage was just 29% in 2008. - Opiate pill treatment admissions increased 250%, from 16 cases in 2008 to 56 in 2011. This represents a tripling in opiate pill treatment admissions. Alcohol Indicators: Treatment and Law Enforcement Data While alcohol treatment episodes still comprise nearly half of all admissions in LaPorte County in 2011, these numbers represent a significant decline from 2008 numbers, when alcohol made up nearly threefourths of all treatment admissions. - The number of individuals admitted for alcohol use disorder decreased by 17%, from 295 cases in 2008 to 244 cases in 2011. - Individuals under aged 30 made up slightly more than 40% of all alcohol treatment episodes, and this percentage remained relatively stable over time. - The majority of people entering treatment for alcohol in LaPorte County (75%) was white in both 2008 and 2011. - The most notable change in alcohol treatment admissions occurred among women, as their admissions for alcohol treatment increased 14% from 2008 to 2011. - Treatment admissions for males decreased 28% from 2008 to 2011. - Data from the Sherriff�s Office demonstrated a 46% decrease in Operating While Intoxicated (OWI) arrests in four years, from 334 arrests in 2008 to 180 arrests in 2012. - Public drunkenness offenses also decreased by 45% during the years 2008 to 2012. - Michigan City Police also saw significant decreases in the numbers of individuals arrested for OWI offenses - nearly 60% in the four year period 2008 to 2012. - Among juvenile probationers, the number of ABC status offenses (underage alcohol use) decreased by 12%, from 196 in 2008 to 173 in 2012. - In 2012, only 5 of the 10 fatal car collisions that occurred in LaPorte County were the result of alcohol, down from 8 in 2008 and 10 in 2011. Heroin Indicators: Treatment and Law Enforcement Data Heroin treatment admissions exploded from 2008 to 2011, making heroin the most significant emergent drug threat to LaPorte County over the past several years. Treatment admissions for heroin increased by 560% in just three years, from 20 admissions in 2008 to 132 admissions in 2011. - The majority of people entering treatment for heroin -75% - were under age 30 in 2011. Age of first use is a significant concern because the trajectory of heroin use and dependency can result in considerable long-term health and financial consequences for the individual. - Heroin appears to be problem among only white individuals in LaPorte County. Of those entering treatment for heroin in 2011, all admissions excluding one multiracial individual, were for white LaPorte County residents. No African American individuals entered treatment for heroin in 2011. - Women and men were equally likely to enter treatment for heroin in 2011 (63 versus 69), invalidating the assumption that only males use �hard drugs� like heroin. Findings from the key informant interviews also verify that women are as likely to report heroin use as men. - LaPorte City Metro Operations data indicates that the largest increases in drug arrests were heroin-related offenses, which increased 290%, from 10 arrests in 2008 to 39 arrests in 2012. Marijuana Indicators: Treatment and Law Enforcement Data Marijuana treatment admissions in LaPorte County more than doubled during the 2008-2011 period. The number of LaPorte residents receiving treatment for marijuana increased by 126%, from 46 episodes in 2008 to 104 episodes in 2011. - The majority of people receiving treatment for marijuana were under age 30 in 2008 and 2011. In 2008, those under the age of 30 comprised 76% of marijuana treatment episodes, while in 2011, this number had dropped slightly to 69%. - The fastest growing treatment admissions occurred among the 30 to 39 year old age cohort. This cohort comprised only 15 percent of treatment episodes in 2008, but rose to nearly 25% in 2011. - Treatment admissions for African American individuals increased more rapidly than treatment episodes for whites during 2008-2011. However, white individuals made up the majority of treatment episodes in both 2008 and 2011. - Women made up about one-fourth of marijuana admissions in 2008, but made up about onethird of marijuana treatment admissions in 2011 - Michigan City Metro Operations data showed that marijuana arrests increased about 50%, from 142 arrests in 2008 to 192 arrests in 2012. - Among juveniles, Michigan City Metro Operations data demonstrated a 65% increase in marijuana possessions offenses, from 20 arrests in 2008 to 33 arrests in 2012. Opiate Pill Indicators: Treatment and Law Enforcement Data In addition to heroin, opiate pills such as Vicodin, oxycodone and others, represent a significant drug problem in LaPorte County. As has been noted in current research, approximately 75% of new heroin users transition to heroin following a period of opiate pill use. Once the pills become difficult or costly to acquire, it becomes easier and less expensive to use heroin. Key informants have suggested that this is happening in the LaPorte treatment population well. Therefore, the opiate pills users of today may become tomorrow�s heroin users. - Key informant interviews among hospital staff and law enforcement indicated that opiate pill use was an increasing � and serious � problem in the county. - Treatment admissions for other opiate pills increased significantly from 2008 to 2011. In just three years, these admissions rose 250%, from 16 individuals in 2008 to 56 individuals in 2011. - Patients treated for opiates tended to be significantly older than patients treated for heroin use. In 2011, about 51% of those treated for opiates, excluding heroin, were aged 30 and older. The most rapid growth in treatment episodes occurred among the 30 to 39 age cohort. Although the number of cases was small, the number of admissions among this cohort increased 700%, from 2 cases in 2008 to 16 cases in 2011 - The majority of those entering treatment for opiates other than heroin in 2011 were White, with just two cases reporting another race besides White and 6 cases unreported. No African Americans in LaPorte were admitted into treatment for opiates in 2011. - In 2011, the number of women entering treatment for opiates surpassed the number of men entering treatment for opiates (33% versus 23%). This differs from the gender profile in 2008, as males and females entered treatment for opiates at the same rate during that year. - Arrests for opioid pills reported by LaPorte City Metro Operations increased 480%, from 5 arrests in 2008 to 29 arrests in 2012. Cocaine Indicators: Treatment and Law Enforcement Data While cocaine treatment admissions increased slightly, they remained lower than treatment admissions for most other drugs except methamphetamine. The low number of cocaine treatment admissions in LaPorte County coincides with national treatment trends indicating a reduction in cocaine treatment admissions overall. As more individuals initiate to heroin and opiate use, the number of individuals seeking treatment for cocaine should continue to decrease over the next few years. - In 2011, nearly half of all individuals admitted to treatment were age 30 or older. This suggests that cocaine users in LaPorte County are an aging cohort overall, and key informant interview data with treatment providers support this hypothesis. However, there is a bimodal distribution among those admitted to treatment for cocaine in LaPorte County. The two largest cohorts were those in their 20s (12 cases) and those in their 40s (13 cases) in 2011. - Treatment admissions among white individuals increased during this time period, while treatment admissions among African American individuals remained stable. Overall, whites were much more likely to enter treatment for cocaine than were African Americans (26% versus 10%). - Females were more likely than males to be admitted to treatment for cocaine in both 2008 and 2011. Females comprised 60% of the LaPorte cocaine treatment admissions in 2008 and 2011 and males comprised 40% of the cocaine treatment admissions during those years. - LaPorte City Metro Operations data showed a dramatic 55% reduction in arrests for cocaine, from 62 arrests in 2008 to 28 arrests in 2012. - Michigan City Metro Operations data also showed a 45% decline in the number of arrests for cocaine possession, from 20 arrests in 2008 to just 11 in 2012. Methamphetamines: Treatment and Law Enforcement Data Methamphetamines are a decreasing problem in LaPorte County. Several years ago, the county was asked to prepare for the possibility of methamphetamine production and use among residents, particularly because the county does include some rural communities and these are the areas hardest hit by methamphetamine use. Since that time, the methamphetamine problem has remained very small and seemingly very contained. As of 2011, there were just 4 treatment episodes related to methamphetamine. Law enforcement indicators remain stable. We expect that methamphetamine use, arrests and production labs should continue to remain stable or decline over the next few years. Drugs and Mortality in LaPorte County Interview and data retrieved from the coroner�s office indicates that in 2012, 35 individuals died from an accidental drug overdose. Of these deaths, 57% included death from heroin alone (5 cases) or in combination with another drug (15). About 43% of deaths due to drugs in the county were unrelated to heroin use. These data suggest that heroin related mortality is a large and growing problem in LaPorte County. Further, the number of individuals who died from drug-induced causes was significantly greater than those killed by alcohol-related car collisions or from alcohol period. Details: Chicago: Roosevelt University, 2013. 128p. Source: Internet Resource: Accessed September 15, 2016 at: https://www.roosevelt.edu/CAS/CentersAndInstitutes/IMA/Publications.aspx Year: 2013 Country: United States URL: https://www.roosevelt.edu/CAS/CentersAndInstitutes/IMA/Publications.aspx Shelf Number: 147890 Keywords: Alcohol Abuse Drug Abuse and Addiction Drug Abuse Treatment Substance Abuse Substance Abuse Treatment

Author: U.S. National Heroin Task Force Title: National Heroin Task Force Final Report and Recommendations Summary: "The United States is in the grip of a national crisis - an unprecedented surge in the illicit use of prescription opioid medications and heroin. In 2014, 1.9 million people had a prescription opioid use disorder and nearly 600,000 had a heroin use disorder. The national data on overdose deaths are startling: in 2014, there were more than 27,000 overdose deaths involving prescription opioid medications and /or heroin. That is equivalent to an average of one death every 20 minutes. The opioid epidemic affects a broad cross-section of the United States population without regard to age, gender, race, ethnicity, or economic status. Living in a rural, suburban, or urban jurisdiction does not insulate an individual from the ravages of the opioid epidemic. Traditional law enforcement methods are a critical component of any counter-illicit drug strategy, but they will not resolve this crisis alone. The opioid crisis is also fundamentally a public health problem. The recommendations contained in this report are premised up on three principles: 1) public safety and public health authorities must integrate and harmonize their response to the misuse of prescription opioid medications and use of heroin; 2) policies regarding heroin use and misuse of prescription opioid medications must be grounded in a scientific understanding that substance use disorder is a chronic brain disease that can be prevented and treated; and 3) treatment and recovery services and support must be accessible and affordable. Details: Washington, DC: U.S. Department of Justice: U.S. Office of National Drug Control Policy, 2015. 35p. Source: Internet Resource: Accessed September 17, 2016 at: https://www.justice.gov/file/822231/download Year: 2015 Country: United States URL: https://www.justice.gov/file/822231/download Shelf Number: 140330 Keywords: Drug Abuse and Addiction Drug Enforcement Drug Policy Heroin Prescription drug Abuse

Author: New York State. Heroin and Opioid Task Force Title: Combatting the Heroin and Opioid Crisis Summary: Across the state the Task Force has heard from families who have loved ones addicted to heroin or other opioids, who have overdosed or have had serious health problems as a result of their addiction. Heroin overdose is now the leading cause of accidental death in the state. Between 2005 and 2014, upstate New York has seen an astonishing 222 percent increase in admissions to OASAS certified treatment programs among those 18 to 24 years of age for heroin and other opioids; Long Island has seen a 242 percent increase among the same age group for heroin and other opioids. In all, approximately 1.4 million New Yorkers suffer from a substance use disorder. Heroin and opioid addiction is now a major public health crisis in New York State. Further work must continue to fully realize the Governor's vision for a more responsive, accessible, and compassionate health care system for patients, as well as stronger education, prevention, and enforcement measures. The Task Force recommends that study and work on these issues continue as a high priority, so that New York can remain in the forefront when it comes to helping patients and their families. New York has taken important steps to address the urgent needs of those in critical condition and to prevent future generations from suffering from the disease of addiction. For the 2016 fiscal year, New York State allocated over $1.4 billion to the Office of Alcoholism and Substance Abuse Services (OASAS) to fight this battle including funding for 1,455 beds for patients in crisis; 2,221 beds for inpatient rehabilitation programs; 5,247 beds for intensive residential programs; 2,142 beds for community residential programs; 1,842 beds in supportive living programs; and 265 beds in residential rehabilitation programs for youth. Additionally, OASAS provides more than $74 million to fund prevention services through 165 providers serving communities in every county, including 1,400 schools across the state. The State has also enacted legislation to address this growing epidemic. In 2012 the State enacted the Prescription Drug Reform Act, overhauling the way prescription drugs are dispensed and tracked in New York to improve safeguards for drugs that are prone to abuse. The Act updated the Prescription Monitoring Program (PMP) Registry (also known as I-STOP) to require pharmacies to report information about dispensed controlled substances on a "real time" basis, as well as require health care practitioners to consult the PMP Registry before prescribing or dispensing certain controlled substances most prone to abuse and diversion. The Act also mandated electronic prescription of controlled substances, updated the Controlled Substances Schedules, improved education and awareness efforts for prescribers, and established a safe disposal program for prescription drugs. By the end of 2015, I-STOP had led to a 90 percent decrease in "doctor shopping" - when patients visit multiple prescribers and pharmacies to obtain prescriptions for controlled substances within a three-month time period. Earlier this year, New York State entered into an agreement with New Jersey to share PMP data both ways and prevent "doctor shopping" across state borders. In 2014, the State enacted legislation that granted Good Samaritan protections to individuals who administer an opioid antagonist like naloxone, expanded access to naloxone by allowing nonpatient-specific prescriptions, enacted insurance reforms to improve treatment options for individuals suffering from addiction, directed OASAS to create a wraparound services demonstration program to provide services to adolescents and adults for up to nine months after successful completion of a treatment program, and enhanced penalties to crack down on illegal drug distribution. Despite being on the forefront of nationally-recognized best practices, the epidemic continues to grow in New York. In response, Governor Andrew M. Cuomo convened a team of experienced healthcare providers, policy advocates, educators, parents, and New Yorkers in recovery to serve on a Heroin and Opioid Task Force and develop a comprehensive plan to bring the crisis under control. The Task Force's work was informed by two executive meetings, eight listening sessions across the state, and the 246 comments submitted through www.ny.gov/herointaskforce. This public process resulted in the following recommendations - broken into four areas: prevention, treatment, recovery, and enforcement - to continue to address the crisis. Details: Albany, NY: The Task Force, 2016. 34p. Source: Internet Resource: Accessed September 19, 2016 at; https://www.governor.ny.gov/sites/governor.ny.gov/files/atoms/files/HeroinTaskForceReport_3.pdf Year: 2016 Country: United States URL: https://www.governor.ny.gov/sites/governor.ny.gov/files/atoms/files/HeroinTaskForceReport_3.pdf Shelf Number: 140350 Keywords: Drug Abuse and Addiction Drug Enforcement Drug Treatment Heroin Illegal Drugs Opioids Prescription Drug Abuse

Author: Dempsey, Orla Title: Developing and Implementing Models for the Prevalence, Incidence and Geographic Spread of Opiate Use in Ireland Summary: The objective of this study is to further develop and implement established mathematical models for the first time to the problem of estimating the true size of the opiate epidemic and to develop and apply existing mathematical models to the problem of modelling the geographic spread of opiate use in Ireland. Estimates of the true size and spread of the opiate epidemic are difficult to obtain due to the hidden nature of opiate use however these estimates are vital for policy makers and service providers when planning for the provision of effective treatment services. In a bid to estimate the true size of the epidemic this research focuses on deriving suitable models to estimate the prevalence and incidence of opiate use in Ireland. The back calculation model from AIDS epidemiology is applied to the problem of estimating the hidden, untreated incidence of opiate use. An estimate of the hidden incidence is produced by back calculating from the known treated incidence through an estimated latency period of opiate use. The back calculation model is analytically solved and the solutions obtained are used to produce estimates of the hidden, untreated incidence of opiate use when the exact rate of progression to treatment is unknown. In a bid to produce more accurate incidence estimates data on times from first opiate use to first treatment are obtained. A model for the exact rate of progression to first treatment is determined through fitting Gamma and Weibull probability distributions to data on 5,022 times to treatment for previously untreated opiate users. The exact rate of progression to first treatment along with a range of forms of treated incidence is applied to the back calculation model which is then solved analytically for the first time. The solutions obtained are applied to the problem of estimating the true size of the hidden, untreated population of opiate users who will present for their first treatment in the future. A vast array of techniques to estimate the prevalence of drug and opiate use exist however a new approach which is not heavily data dependent would be beneficial to researchers, policy makers and service providers. An integral equation model to estimate the prevalence of opiate use is derived. The prevalence model derived is based on the models developed for the hidden incidence of opiate use. Estimates of the prevalence of opiate use are produced when the exact rate of progression to treatment is unknown and known. Whilst estimates of the true size of the epidemic are necessary, it is essential to determine where the epidemic will spread in order to determine measures to prevent further spread. A partial differential equation which uses the prevalence estimates produced, is derived to describe the geographic spread of opiate use in Ireland. Techniques to estimate model parameters for the partial differential equation are developed and the hypothetical geographic spread of opiate use from Dublin to Wexford is simulated. Models for the prevalence, incidence and geographic spread of opiate use have been developed. The models derived are not heavily data dependent and could be utilised to produce estimates of any problematic drug use in any specified location providing the necessary data is available. Details: Dublin: Trinity College, 2011. 180p. Source: Internet Resource: Thesis: Accessed September 21, 2016 at: https://www.researchgate.net/publication/249326915_Developing_and_Implementing_Models_for_the_Prevalence_Incidence_and_Geographic_Spread_of_Opiate_Use_in_Ireland Year: 2011 Country: Ireland URL: https://www.researchgate.net/publication/249326915_Developing_and_Implementing_Models_for_the_Prevalence_Incidence_and_Geographic_Spread_of_Opiate_Use_in_Ireland Shelf Number: 145575 Keywords: Drug Abuse and Addiction Drug Policy Heroin Illegal Drugs Opiates

Author: Morgan, Nick Title: New opiate and crack-cocaine users: characteristics and trends Summary: This paper uses a range of datasets and methodologies to: - obtain working estimates for the number of individuals in England who started using opiates/crack from 2005 to 2013; - examine the characteristics of these individuals. The main findings of the paper are as follows.  It is estimated that around 5,000 to 8,000 individuals started using opiates or crack-cocaine in 2013. There is a high degree of uncertainty around this figure due to the sparse data on this population, but sense-checks based on treatment and criminal justice system data suggest the true figure is unlikely to be much larger than 10,000.  Data also suggest that the number of current opiate/crack initiates involved with crime may be even lower. The number of arrestees testing positive for the first time for opiates (or for both opiates and crack-cocaine) dropped from 14,750 in 2006 to 4,281 in the first 11 months of 2013, a fall of around 70 per cent . Furthermore, of the new positive testers in 2013, only 721 were aged 18-24. Though this arrestee data will capture only a proportion of the true population, it does suggest that the number of new, young initiates involved with crime - those who have the potential to inflict most societal harm - has decreased markedly, probably just to a few thousand per year; and that this group now make up a small minority of the total number of opiate/crack-cocaine users (estimated to be 294,000 in 2011/12), most of whom are older, longer-term users.  In terms of trends in new opiate/crack-cocaine users, all available data suggest that figures have dipped by at least a fifth since 2005 and have dropped hugely since the late 1980s and early 1990s when the opiate/crack-cocaine population in the UK grew very rapidly. The current estimate works out at a rate of 0.18 per 1,000 population. During the epidemic years, published estimates of new opiate/crack-cocaine users in Manchester and Bolton show rates more than 11 times larger.  However, the findings also suggest that between 2011 and early 2014, the number of new opiate/crack-cocaine users stopped decreasing and instead stabilised at a (historically) low level. Further analysis was conducted to try and determine whether this was a precursor to a new rise in initiates. Though the data are not totally conclusive, the results suggest that a marked increase in new opiate/crack-cocaine users in the near future is unlikely. If anything, findings suggested that the downward trend may be set to resume.  Analysis also revealed some possible changes in characteristics of the new opiate/crack- cocaine initiates. There is a trend in the treatment data towards new initiates coming to treatment earlier in their drug-using careers than previous cohorts and also to have initiated use at an older age. Currently it is not possible to determine whether this is a reporting issue or a genuine shift in the age profile of new opiate/crack-cocaine users.  The report has several important policy implications. Even though numbers of new initiates involved with crime have dropped to the low thousands, putting downward pressure on crime, identification and early diversion to treatment remains paramount. Frontier Economics have estimated that the average lifetime crime cost of an injecting drug user is �445,000, so the potential for social harm - even from a small number of individuals - remains large and potentially long-lasting. This means local areas need to manage both the (relatively large) stock of current users, and the (much smaller) flow of new initiates, whose treatment needs may be different. There is no evidence of any new epidemic in this country, but given the impact of the epidemic of the 80s and early 90s on crime, ongoing monitoring of recent trends is required to spot early signs of any emerging problems. Details: London: Home Office, 2016. 45p. Source: Internet Resource: Research Report 90: Accessed October 8, 2016 at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/493524/horr90-opiate-crack-cocaine-users.pdf Year: 2016 Country: United Kingdom URL: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/493524/horr90-opiate-crack-cocaine-users.pdf Shelf Number: 145133 Keywords: Cocaine Drug Abuse and Addiction Drug Offenders Opiates

Author: LeCroy & Milligan Associates, Inc. Title: Drug Treatment Education Fund Program Evaluation Final Report Summary: Overview The Drug Treatment and Education Fund (DTEF) was established in April 1996 with the enactment of A.R.S. 13-901.01 by the Arizona Legislature. The act requires that... first and second time non-violent offenders who are convicted of personal possession or use of a controlled substance be diverted from prison and sentenced to probation and drug treatment and that a fund be created (A.R.S 13-901.02), which receives revenue from a tax on liquors, to provide substance abuse education and treatment services as mandated by the Act. The Arizona Supreme Court, Administrative Office of the Courts (AOC), administers the funds to each of the fifteen county probation departments in Arizona and provides oversight and reporting. A total of $3,297,020 was distributed to all adult probation departments (counties) in FY2006. Counties are required to screen probationers sentenced under A.R.S. 13.901.01 (mandatory cases) for substance abuse problems and refer them to appropriate treatment. Counties may also use the DTEF for "discretionary" cases, that is, for probationers who were screened and determined to need treatment but were not "mandatory" cases. LeCroy & Milligan Associates, Inc. conducted an evaluation to provide information for improvements to the DTEF programs in the fifteen county adult probation departments. The counties' practices were compared to the DTEF legislated operational code (DTEF code) and to the National Institute of Drug Abuse Principles of Drug Abuse Treatment for Criminal Justice Populations (NIDA principles). A limited and preliminary analysis of probationers' substance abuse treatment completion rates and probation outcomes was conducted. Profiles of the fifteen counties were developed to summarize the local level DTEF processes and substance abuse treatment characteristics. The results are based on these profiles. Details: Tucson, AZ: LeCroy & Milligan Associates, 2007. 112p. Source: Internet Resource: Accessed October 12, 2016 at: http://www.lecroymilligan.com/data/resources/dtef-program-evaluation-final-report-aug-9-1.pdf Year: 2007 Country: United States URL: http://www.lecroymilligan.com/data/resources/dtef-program-evaluation-final-report-aug-9-1.pdf Shelf Number: 140686 Keywords: Drug Abuse and Addiction Drug Offenders Drug Treatment Programs Probation Substance Abuse Treatment

Author: Human Rights Watch Title: Every 25 Seconds: The Human Toll of Criminalizing Drug Use in the United States Summary: Every 25 seconds someone in the United States is arrested for possessing drugs for personal use. This amounts to more than 1.25 million arrests per year and makes drug possession the single most arrested crime in the country. Black and white adults use drugs at similar rates, but a Black adult is 2.5 times more likely to be arrested for drug possession. As a result of these arrests, on any given day at least 137,000 people are behind bars. Tens of thousands more are convicted, cycle through jails and prisons, and spend extended periods on probation and parole, often burdened with crippling debt from court-imposed fines and fees. Every 25 Seconds: The Human Toll of Criminalizing Drug Use in the United States documents the devastating harms caused by enforcement of drug possession laws. This joint report by Human Rights Watch and the American Civil Liberties Union is based on extensive new analysis of federal and state-level data, and over 365 interviews conducted primarily in Louisiana, Texas, Florida, and New York. Members of the public understandably want government to take actions to prevent the potential harms of drug use. Yet criminalization is not the answer. Four decades after the declaration of the "war on drugs," rates of drug use have not significantly decreased and treatment for drug dependence is often unavailable. Instead, criminalizing drug possession has caused tremendous harm - separating families; excluding people from job opportunities, public benefits, and voting; and exposing them to discrimination. Human Rights Watch and the ACLU urge federal and state authorities to end these harms by decriminalizing personal use and possession of all drugs. The report also provides detailed recommendations authorities should follow to minimize the harmful consequences of current laws and policies, until decriminalization is achieved. Details: New York: HRW, 2016. 205p. Source: Internet Resource: Accessed October 13, 2016 at: https://www.hrw.org/sites/default/files/report_pdf/usdrug1016_web.pdf Year: 2016 Country: United States URL: https://www.hrw.org/sites/default/files/report_pdf/usdrug1016_web.pdf Shelf Number: 144931 Keywords: Decriminalization Drug Abuse and Addiction Drug Enforcement Drug Offenders Drug Policy Drug Policy Reform

Author: LeCroy & Milligan Associates, Inc. Title: Marijuana and Prescription Drug Misuse and Abuse in Arizona Summary: Recent national attention focusing on the heroin epidemic, reported increases in marijuana and prescription drug misuse and abuse among youth and recent policy shifts in our state1 have raised concerns among some policymakers and the public about the extent of the problem in Arizona and the implications for our communities. For example, data relating to Arizona high school students indicate steady increases in the percentage of 12th grade students reporting marijuana use in the past 30 days. In 2014, this percentage reached a five-year high of 23% among Arizona 12th graders, up from 18% in 2010. Nearly half (45%) of Arizona 12th grade students also reported using marijuana at least once in their lifetime, with little change occurring over the past five years. Similar trends can be seen among Arizona undergraduate students (ages 18-25), with annual increases reported in marijuana use in the past 30 days (increased from 15% in 2010 to 19% in 2014). Furthermore, Arizona has experienced steady increases in the rates of marijuana and opioid related emergency department and hospital visits. In response to these trends, the Governor's Office of Youth, Faith and Family (GOYFF) requested data from the Arizona Substance Abuse Epidemiology Work Group regarding marijuana and prescription drug misuse and abuse. The Substance Abuse Epidemiology Work Group is a formal work group of the Arizona Substance Abuse Partnership (ASAP). The purpose of the report is to provide data on the current state of marijuana and prescription drug misuse and abuse in Arizona and, where data exists, show how Arizona compares to trends at the national and regional levels. This represents a first of its kind report for Arizona. The executive summary highlights key findings from descriptive data gathered across seven areas of interest for the Epidemiology Work Group. Details: Tucson, AZ: LeCroy & Milligan Associates, 2016. 63p. Source: Internet Resource: Accessed October 14, 2016 at: http://www.lecroymilligan.com/data/resources/finalgoyff20160603-1.pdf Year: 2016 Country: United States URL: http://www.lecroymilligan.com/data/resources/finalgoyff20160603-1.pdf Shelf Number: 144805 Keywords: Drug Abuse and Addiction Marijuana Prescription Drug Abuse

Author: Macdonald, Virginia Title: Drug Control and Harm Reduction in Thailand Summary: In South East Asia, Thailand is lauded for its success in reversing an HIV epidemic in the 1990s, particularly amongst sex workers. Thailand is also known for its success in significantly reducing opium cultivation, and implementing effective alternative development programmes for opium farmers. However, other aspects of the government's response to illicit drug markets in Thailand undermine these successes and have been characterised by the exclusion and marginalisation of people who use drugs, which has fuelled on-going epidemics of HIV and hepatitis C virus (HCV) among this population. The Thai government's response to drug use continues to be one of 'zero-tolerance', focused on eradicating drug consumption and production with the imposition of harsh punishment for drug-related crimes, ranging from compulsory detention to the death penalty. This response reflects the regional commitment to achieving a 'drug-free ASEAN by 2015'. Details: London: International Drug Policy Consortium, 2013. 15p. Source: Internet Resource: IDPC Briefing Paper: Accessed October 17, 2016 at: https://dl.dropboxusercontent.com/u/566349360/library/IDPC-briefing-paper-Thailand-drug-policy-English.pdf Year: 2013 Country: Thailand URL: https://dl.dropboxusercontent.com/u/566349360/library/IDPC-briefing-paper-Thailand-drug-policy-English.pdf Shelf Number: 144866 Keywords: Drug Abuse and Addiction Drug Enforcement Drug Policy Drug Reform Opium

Author: Goldsmid, Susan Title: Methamphetamine use and acquisitive crime: Evidence of a relationship Summary: Methamphetamine use among Australian police detainees is rising; the impact of this rise on crime trends, and particularly on trends in acquisitive crime, is yet to be established. Identifying trends in and motivations for offending among methamphetamine users may assist law enforcement and policymakers to better target resources. This paper examines the engagement in acquisitive crime, and perceived motivations for methamphetaminedriven crime, of a sample of Australian police detainees recruited in 2013 through the Drug Use Monitoring in Australia program. Methamphetamine users reported deriving a significantly higher proportion of their income from crime than non-users. Logistic regression analysis reveals the use of methamphetamine, heroin and/or cannabis predicts engagement in acquisitive crime when other drug use and polydrug use is controlled for. In addition, methamphetamine users reported their use played a contributing role in their offending, most commonly through intoxication or the need for money to purchase drugs. The findings indicate recent methamphetamine use increases the risk of engagement in acquisitive offences. Details: Canberra: Australian Institute of Criminology, 2016. 14p. Source: Internet Resource: Trends & issues in crime and criminal justice no. 516: Accessed November 2, 2016 at: http://aic.gov.au/media_library/publications/tandi_pdf/tandi516.pdf Year: 2016 Country: Australia URL: http://aic.gov.au/media_library/publications/tandi_pdf/tandi516.pdf Shelf Number: 145776 Keywords: Acquisitive Crime Drug Abuse and Addiction Drug Offenders Drugs and Crime Methamphetamine Property Crimes

Author: Lader, Deborah Title: Drug Misuse: Findings from the 2015/16 Survey for England and Wales. Second edition Summary: This release examines the extent and trends in drug use among a nationally representative sample of 16 to 59 year olds resident in households in England and Wales, and is based on results from the 2015/16 Crime Survey for England and Wales (CSEW). The release covers the following topics: - extent and trends in drug use among adults, including separate analysis of young adults (16 to 24 year olds); - frequency of drug use in the last year; - drug use, by personal, household and area characteristics, and lifestyle factors; - use of new psychoactive substances (NPS); - perceived acceptability of use and ease of obtaining illegal drugs; - drug use within generations over time (a pseudo-cohort analysis). Details: London: Home Office, 2016. 51p. Source: Internet Resource: Statistical Bulletin 07/06: Accessed November 3, 2016 at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/564760/drug-misuse-1516.pdf Year: 2016 Country: United Kingdom URL: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/564760/drug-misuse-1516.pdf Shelf Number: 145003 Keywords: Drug Abuse and Addiction Drug Offenders Illegal Drugs

Author: Kruithof, Kristy Title: Study Alternatives to Coercive Sanctions as Response to Drug Law Offences and Drug-Related Crimes Final Report Summary: This study aims to map alternatives to coercive sanctions (ACS) for drug law offences and drug-related crimes that are available under the law in each EU member state and describe the use of these sanctions in practice. This was complemented by a review of international research on the effectiveness of ACS in reducing reoffending and drug use. Building upon the EU Action Plan on Drugs 2013-2016, ACS were defined as measures that had some rehabilitative element or that constituted a non-intervention (for example, deciding not to charge or prosecute), as well as those used instead of prison or other punishment (for example, a suspended sentence with drug treatment). Further details of the measures included within the definition of ACS can be found in Section 1.2. This study builds upon a report produced by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) in 2015 on alternatives to punishment for drug-using offenders, widening the scope of that study by including a broader range of sanctions and by looking at practice in each member state in more detail. Details: Luxembourg: Publications office of the European Union, 2016. 144p. Source: Internet Resource: Accessed November 3, 2016 at: https://www.rand.org/pubs/external_publications/EP66607.html Year: 2016 Country: Europe URL: https://www.rand.org/pubs/external_publications/EP66607.html Shelf Number: 144995 Keywords: Alternatives to Incarceration Drug Abuse and Addiction Drug Offenders Drug Policy Drugs and Crime Illegal Drug Trade

Author: Sperber, Kimberly Gentry Title: Factors Influencing Medication-Assisted Treatment in Ohio Halfway Houses and Community-Based Correctional Facilities Summary: Recent years have witnessed an alarming increase in the number of people dependent on opiates. Nationally, opiate overdose is the second leading cause of injury related death, surpassed only by car accidents. In Ohio, accidental overdoses has been the leading cause of death since 2007. In fact, there has been a 472% increase in drug overdose deaths from 1999 to 2013. An increase in opiate dependent people means that community corrections programs are seeing a dramatic increase in admissions of opiate dependent offenders. This is not surprising given that the link between opiate use and crime is well established. The Center for Health and Human Services Research at Talbert House completed a study based on previous National Institutes of Health studies that have examined: (1) barriers to MAT within private and public substance abuse treatment programs and (2) counselor attitudes toward MAT. This study was replicated in halfway houses and Community Based Correctional Facilities (CBCF) across Ohio and assesses attitudes of both treatment and security staff in these programs. All Ohio Department of Rehabilitation and Corrections (ODRC)-funded halfway houses and CBCFs were invited to participate in the study. All but two programs elected to participate. Data were collected through two mechanisms. The first was an in-depth structured, face-to-face interview with key staff including Program Directors, Clinical Supervisors, a representative of the medical staff, and at least two clinical/direct service staff. An interview guide was used to gather information on key independent variables within a number of domains. Examples of these domains include organizational structure, organizational resources, dominant treatment philosophy and types of services offered, availability of medical personnel, funding sources, exposure to and understanding of MAT research findings, referral source support for MAT, staff support for MAT, concerns associated with providing MAT to offenders, and client characteristics. A total of 181 staff participated in interviews for this study. The second mechanism was the administration of anonymous surveys to all staff at each facility. These surveys assessed knowledge about MAT, beliefs about the effectiveness and appropriateness of MAT for offenders, and endorsement of myths about MAT. 1876 surveys were distributed, and 910 were returned for a response rate of 49%. Interview and survey questions asked about MAT in general as well as about specific medications (e.g., methadone, buprenorphine, and naltrexone), where appropriate. Survey items were rated on a Likert scale. Major Findings A total of 49 facilities participated in the study. Interviews with the Program Directors of these facilities demonstrated that 17 of the programs did not allow any access to MAT at the time of the interview while 13 programs directly prescribed addiction medication to clients with opioid disorders, and an additional 19 programs allowed clients to access addiction medications through an external provider during their stay in the facility. Of the 13 programs providing MAT, 62% prescribed oral naltrexone, 46% prescribed injectable naltrexone, and 62% prescribed buprenorphine. No programs prescribed or allowed access to methadone. While many programs had begun to implement various forms of MAT, interview results showed that the programs faced a number of barriers to implementing comprehensive MAT services including: infrastructure, financial, workforce development, and stakeholder support.  63.3% of the facilities did not have access to medically supervised detoxification services for the clients they serve.  Response patterns indicated financial barriers to hiring medical staff.  Respondents indicated difficulties finding medical staff willing to provide services within correctional programs and with the appropriate experiences for treating a criminal justice population, particularly those with substance use disorders.  83% of the Program Directors agree that the Ohio Department of Mental Health and Addiction Services (OHMAS) is supportive of the use of medications for treating substance abuse in community corrections settings. However, less than 40% of the Program Directors agreed that OHMAS had adequately disseminated information about how to implement MAT in community corrections programs or that OHMAS had offered sufficient training opportunities about using medications to treat substance abuse.  The primary method staff use to learn about MAT is having conversations with staff of other substance abuse treatment organizations. Survey data were used to assess staff beliefs about general treatment approaches for clients with addiction disorders, beliefs about MAT for clients with addiction disorders, and beliefs about the outcomes of MAT.  Regarding overall treatment philosophy, survey responses demonstrated an overall pattern of clinical staff providing significantly higher ratings on items reflective of cognitive-behavioral and motivational enhancement approaches, and operations staff providing significantly higher ratings on items reflective of 12-step approaches and more confrontational approaches.  Regarding concerns with MAT, the consistent pattern was that operational staff were more likely to agree with a series of negative statements, such “Using medications to treat addiction is substituting one drug for another” or “Medications are drugs and you cannot be clean if you are taking drugs.”  Operations staff provided a statistically significantly lower endorsement of agreement to the item “I have received adequate information about the effects of using medication-assisted treatment for offender populations.”  Operations staff also provided significantly lower ratings of agreement than supervisory and clinical staff on items that reflected benefits of MAT, such as MAT reduces relapse, increases employment, reduces crime, reduces or blocks the effects of opioids, increases family stability, and improves birth outcomes for children born to addicted mothers. On the other hand, they provided significantly higher ratings of agreement to items indicating beliefs about negative outcomes of MAT, such as MAT rewards criminals for being drug users and interferes with the ability to drive a car. In the surveys, we also asked staff about their perceptions of the acceptability and effectiveness of four medications used to treat opioid disorders: buprenorphine, methadone, oral naltrexone, and injectable naltrexone. Since previous studies have found that lack of information about medication effectiveness serves as a barrier to its implementation, we also sought to examine the extent of knowledge diffusion regarding each medication. We operationalized diffusion as a dichotomous variable. This variable was coded based on the response to the item “Based on your knowledge and personal experience, to what extent do you consider each of the following treatment techniques to be effective?” Answering “I don’t know” was coded as a lack of diffusion, while all other ratings were considered as evidence of diffusion. Finally, we sought to identify predictors of knowledge diffusion, endorsements of acceptability, and endorsements of effectiveness. Results are summarized below:  35.1% did not know the effectiveness of buprenorphine, 37.2% did not know the effectiveness of methadone, 55.4% did not know the effectiveness of oral naltrexone, and 44% did not know the effectiveness of injectable naltrexone. This trend is consistent with the amount of time these medications have been in use within the field of community corrections in Ohio.  Staff perceived methadone and buprenorphine as less effective than both oral and injectable naltrexone, with the highest rating of effectiveness assigned to injectable naltrexone. Regarding acceptability, the results show the same trend, with staff rating methadone and buprenorphine as less acceptable than both forms of naltrexone. Again, injectable naltrexone received the highest endorsement of acceptability.  Operations staff were more likely to provide a “don’t know” response regarding the effectiveness all four medications (see Table 1.). On the other hand, staff who worked in programs that provided access to MAT (rather than directly providing MAT) were more likely to endorse an opinion about all four medications. Staff who agreed that they had received adequate information about the effects of using MAT with offender populations also had an increased likelihood of endorsing an opinion about the effectiveness of all four medications.  Staff and agency characteristics did not consistently predict perceived acceptability across the four medications (see Table 2.). Predictors that were somewhat consistent across models included staff beliefs about outcomes of MAT, whether the facility directly provided MAT, and staff concerns about MAT. Specifically, staff who demonstrated a higher level of agreement with positive statements indicating positive outcomes of MAT were significantly more likely to endorse the use of buprenorphine, oral naltrexone, and injectable naltrexone as acceptable. While direct provision of MAT served to increase the probability that staff would rate oral and injectable naltrexone as acceptable, it served to decrease the probability that staff would endorse methadone as acceptable.  The only consistent predictor of perceived effectiveness across all four medications was staff beliefs regarding the positive outcomes of MAT (see Table 3.). Higher average ratings on these beliefs resulted in statistically significant increases in the probability that staff would agree that the medication was effective. Details: Columbus, OH: Center for Health & Human Services Research, 2016. 41p. Source: Internet Resource: Accessed December 8, 2016 at: http://www.publicsafety.ohio.gov/links/MAT_CBCFs_Report.pdf Year: 2016 Country: United States URL: http://www.publicsafety.ohio.gov/links/MAT_CBCFs_Report.pdf Shelf Number: 145616 Keywords: Community-Based Corrections Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders Drug Treatment Halfway Houses Substance Abuse Treatment

Author: Sutherland, Paul Title: What drug types drove increases in drug use and possession offences in Victoria over the past decade? Summary: Previous CSA research papers have identified large increases in the number and rate of drug use and possession offences across Victoria over the past decade, which were more prominent in regional Victoria than they were in rural or metropolitan areas. To date, this work has not considered the particular types of drugs that accounted for the observed increases. This study used information recorded by Victoria Police about the type of drugs involved in use and possession offences to examine the drug types associated with the observed increases and the characteristics of alleged offenders across drug types. The study found that cannabis offences continue to account the majority of use and possession offences, but that there have been significant increases in the number of cannabis, ecstasy, methamphetamine, prescription and 'other' drug offences over the past ten years. As at end of March 2016, the rates of amphetamine, cannabis, ecstasy and methamphetamine use and possession offences are higher in regional areas than they are in rural or metropolitan areas. Details: Melbourne: Victoria Crime Statistics Agency, 2016. 25p. Source: Internet Resource: In Brief no. 5: Accessed December 19, 2016 at: https://www.crimestatistics.vic.gov.au/sites/default/files/embridge_cache/emshare/original/public/2016/07/b1/e4c026718/08072016_Inbrief5_FINAL.pdf Year: 2016 Country: Australia URL: https://www.crimestatistics.vic.gov.au/sites/default/files/embridge_cache/emshare/original/public/2016/07/b1/e4c026718/08072016_Inbrief5_FINAL.pdf Shelf Number: 147752 Keywords: Crime Statistics Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders

Author: High Intensity Drug Trafficking Program Title: Marijuana's Impact on California. California High Intensity Drug Trafficking Report Summary: A growing number of California residents are interested in removing barriers to recreational marijuana use, and this paper will outline the current state of marijuana policy in California and the potential impacts of further legalizing marijuana use. Section One, The Science on Marijuana Marijuana is the most abused illicit drug in the world, but the gap between the science on marijuana and the common perception of marijuana has never been greater. Section Two, California Youth Marijuana Use In 2013, California was ranked 20th in current use among youth, and by 2014 California was ranked 11th in the country. The state's largest average increase in youth past 30-day use of marijuana coincided with the proliferation of marijuana dispensaries in the state; at that time, California’s youth use rate was already 29% higher than the national average. Section Three, California Schools Due to a new program, school expulsion rates in California have greatly decreased, even though the number of students who are caught with drugs has not declined. Section Four, California Marijuana Use Ages 18-25 In 2012 and 2013, adult marijuana use for California adults aged 18-25 years was 22% compared to the national average of 19%. Section Five, Marijuana-Related Emergency Department Visits and Hospital Admissions From 2010 to 2014, after marijuana dispensaries began to proliferate, there was a 116% increase in Emergency Department visits and admissions for any related marijuana use. Marijuana-related exposures for young children (0-5 years old) also increased 513% between 2005 and 2015. During the same time there was a 139% increase among children 6-19 years old. Section Six, Treatment From 2005 to 2015, the rate of admissions to drug treatment programs for marijuana abuse remained steady – so did the fact that teens and young adults make up the largest proportion of people admitted for treatment. Section Seven, California Impaired Driving From 2005 to 2014, total statewide traffic fatalities decreased 29% in California, but fatalities involving drivers testing positive for marijuana increased 17%. Section Eight, Diversion More interdiction events, including those by the United States Postal Service (USPS) Inspection Service, resulted in seized marijuana originating from California than from any other state. Details: s.l.: California High Intensity Drug Trafficking Program, 2016. 65p. Source: Internet Resource: Accessed December 20, 2016 at: https://learnaboutsam.org/wp-content/uploads/2016/10/CA-MJ-IMPACT-REPORT-FINAL1.pdf Year: 2016 Country: United States URL: https://learnaboutsam.org/wp-content/uploads/2016/10/CA-MJ-IMPACT-REPORT-FINAL1.pdf Shelf Number: 147299 Keywords: Driving Under the Influence Drug Abuse and Addiction Drug Trafficking Drug Treatment Drugged Driving Marijuana

Author: Police Executive Research Forum Title: Building Successful Partnerships between Law Enforcement and Public Health Agencies to Address Opioid Use Summary: In 2014, deaths caused by opioids—including prescription drugs, heroin, and synthetic opioids such as fentanyl—reached record-breaking levels in the United States. With an estimated 78 Americans dying from opioid overdoses each day, In many places, the opioid epidemic has contributed to a shift in how law enforcement agencies fight opioid abuse in their communities. Historically, many of the law enforcement efforts to curb opioid abuse have focused on using enforcement actions (including arrests and incarceration) to target drug use and distribution. However, as opioid-related deaths continue to rise and as more is understood about the nature of opioid addiction, many law enforcement officials are realizing that a more comprehensive approach is needed. "Targeting the 'supply' side of the drug markets, which is what we've been doing for the last 50 or 60 years, is important work," said Leonard Campanello, Chief of Police for the Gloucester (Massachusetts) Police Department. "But this approach alone hasn’t solved the problem. We still have more people addicted. We have more people dying. As police, we need to start looking at the problem from a public health perspective. When our communities are suffering such great losses, it is critical that we find new ways to help." For decades, many law enforcement agencies have supported comprehensive approaches in which police provide enforcement while public health agencies, educational organizations, court systems, and others provide drug treatment and drug abuse prevention work. What is new is the extent to which the opioid epidemic has caused many law enforcement agencies to increase their own involvement in "demand-side" efforts. Today, police officers in many agencies are themselves administering naloxone to save the lives of opioid users who are in an overdose crisis and connecting people to treatment services. And some law enforcement agencies are facilitating "syringe services" programs and other harm reduction efforts and using public health data to drive policy decisions. These strategies, which focus on reducing opioid-related deaths and mitigating the harms caused by opioid abuse, rely on building strong—and often unprecedented—partnerships between the public health and public safety sectors. Details: Washington, DC: Office of Community Oriented Policing Services, 2016. 110p. Source: Internet Resource: COPS Office Emerging Issues Forums: Accessed December 21, 2016 at: https://ric-zai-inc.com/Publications/cops-p356-pub.pdf Year: 2016 Country: United States URL: https://ric-zai-inc.com/Publications/cops-p356-pub.pdf Shelf Number: 147792 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Drug-Related Deaths Partnerships

Author: Harwin, Judith Title: After FDAC: Outcomes 5 Years Later Summary: This report presents the findings from a continuation study of outcomes of cases heard in the first Family Drug and Alcohol Court (FDAC) in England. It builds on earlier findings reported in 20142 . It provides information on child and maternal outcomes at the end of the care proceedings using a larger number of FDAC cases than before. It also has a longer followup period, reporting on outcomes up to five years after the end of proceedings. This is the first report in which the longer term outcomes of non-reunified FDAC mothers and their children five years on are also presented. The FDAC evaluation team has been following up the same cohort of cases that entered the London FDAC between 2008 and 2012 and similar cases entering ordinary care proceedings in the same court over the same period (140 FDAC and 100 comparison). It provides a unique opportunity to track cases with the aim of finding out whether the FDAC approach achieved better substance misuse and family reunification outcomes than ordinary court and service delivery. Details: Bailrigg, Lancaster, UK: Lancaster University, 2016. 89p. Source: Internet Resource: Accessed January 25, 2017 at: http://wp.lancs.ac.uk/cfj-fdac/files/2016/12/FDAC_FINAL_REPORT_2016.pdf Year: 2016 Country: United Kingdom URL: http://wp.lancs.ac.uk/cfj-fdac/files/2016/12/FDAC_FINAL_REPORT_2016.pdf Shelf Number: 145423 Keywords: Child Abuse and Neglect Child Maltreatment Child Protection Drug Abuse and Addiction Family Courts Problem-Solving Courts Substance Abuse

Author: Alpert, Abby Title: Supply-Side Drug Policy in the Presence of Substitutes: Evidence from the Introduction of Abuse-Deterrent Opioids Summary: Overdose deaths from prescription opioid pain relievers nearly quadrupled between 1999 and 2010, making this the worst drug overdose epidemic in U.S. history. In response, numerous supply-side interventions have aimed to limit access to opioids. However, these supply disruptions may have the unintended consequence of increasing the use of substitute drugs, including heroin. We study the consequences of one of the largest supply disruptions to date to abusable opioids – the introduction of an abuse-deterrent version of OxyContin in 2010. Our analysis exploits across state variation in exposure to the OxyContin reformulation. Using data from the National Survey on Drug Use and Health (NSDUH), we show that states with higher pre-2010 rates of OxyContin misuse experienced larger reductions in OxyContin misuse, permitting us to isolate consumer substitution responses. We estimate large differential increases in heroin deaths immediately after reformulation in states with the highest initial rates of OxyContin misuse. We find less evidence of differential reductions in overall opioid-related deaths, potentially due to substitution towards other opioids, including more harmful synthetic opioids such as fentanyl. Our results imply that a substantial share of the dramatic increase in heroin deaths since 2010 can be attributed to the reformulation of OxyContin. Details: Cambridge, MA: National Bureau of Economic Research, 2017. 59p. Source: Internet Resource: NBER Working Paper Series: Working paper 23031: Accessed January 26, 2017 at: http://www.nber.org/papers/w23031.pdf Year: 2017 Country: United States URL: http://www.nber.org/papers/w23031.pdf Shelf Number: 145428 Keywords: Drug Abuse and Addiction Drug Abuse Policy Opioids Opioids Epidemic OxyContin Prescription Drugs

Author: Clarke, Ann Title: Review of Drug and Alcohol Treatment Services for Adult Offenders in Prison and in the Community Summary: (i) Introduction Executive Summary In 2015, the Probation Service and Irish Prisons Service (IPS) sought an independent review of alcohol and drug treatment services for adult offenders in the community and in prison. The review explores current provision and provides recommendations based on the evidence collected. It sets out a model of effective practice for the treatment of adult offenders which facilitates a continuum of care from prison to the community. A multi-method approach was used to meet the terms of reference. This included a literature review, consultations with key personnel in the Probation Service, IPS, service providers, the National Drugs Rehabilitation Implementation Committee (NDRIC), and the Health Service Executive (HSE), as well as site visits to Cork and Mountjoy Prisons, five community-based organisations and five Local Drugs and Alcohol Task Force projects (LDATFs). (ii) Model of Effective Practice The model of effective practice is presented in the main report. This is based on a review of international literature, the NDRIC framework, consultations with community-based organisations1 and prison-based health teams and addiction counsellors. It recognises that recovery from addiction is a long-term process that frequently requires multiple episodes of treatment and/or interventions. It acknowledges that no one treatment option fits all individuals and a broad range of options is required. It highlights the importance of good communication and co-ordination both within systems (e.g. prison) and between systems (e.g. prison and community). The principles underpinning the model include equity of access, choice, person centred provision that uses evidenced-based treatment and intervention options, co-ordinated approaches with clear treatment pathways into and out of different settings, using time in prison as an opportunity to address addiction and having a focus on outcomes. The core components of the model are interlinked rather than linear. These components are pre-work and preparation, referral, assessment, care planning, case management, treatment and recovery management. The model will work in both the community setting and prison setting. (iii) Strengths of the Current System of Provision Addiction is a major contributory factor in criminality. The Probation Service’s Drugs and Alcohol Survey (2011) found that the majority of alcohol and drug misusing offenders had their misuse linked to their offending. Martyn (2012) found that 89% of adult offenders on probation supervision had misused drugs or alcohol and Freeman and Allen (2015) found that 60% of prisoners in Cork prison had a documented history of substance abuse and addiction. Both the Probation Service and the IPS recognise the role drugs and alcohol play in criminality and recidivism and both have invested heavily in developing a system of provision to address drug and alcohol addictions. The prison environment provides a unique opportunity to support individuals to address addiction and it is appropriate that a range of treatment and intervention options is provided in the prison estate. Excluding direct staff and GP costs, the IPS and Probation Service have combined expenditure of €3.33m on the provision of addiction services for adult offenders. Expenditure by the Probation Service has remained stable in recent years, while spending by the IPS has reduced in line with the decline in prisoner numbers. However, those in prison are now more likely to be the most challenging and chaotic. This includes those with a dual diagnosis of addiction and mental health issues. Health teams are present in every prison and some staff have specialist qualifications in the treatment of addiction. Clinicians have an interest in addiction and are familiar with the care pathways within the prison estate, thus increasing their effectiveness. The development of joint strategies between the Probation Service and the IPS has supported the development of a more integrated and co-ordinated approach to dealing with offenders, including those with addictions. The current model of provision is a mixed methods layered approach incorporating residential treatment provided in the community using a number of treatment regimes. This includes detoxification within prison, methadone treatment, one to one and group addiction counselling, specialist treatment methodologies (e.g. Cognitive Behaviour Therapy, Therapeutic Communities, 12 Step Programmes), harm reduction and relapse prevention. This mixed methods way of working fits with international best practice and is appropriate. The NDRIC framework is an important national development that the Probation Service and the IPS have aligned with. There are opportunities to further strengthen this alignment with NDRIC, most notably in the areas of care planning, enhanced communication and protocols with the HSE, better internal and external co-ordination. While small in number and primarily Dublin-based, community prison link workers are a valuable resource which provides a link for offenders between prison and the community. Greater integration of these workers in the system of provision, including links with the work of Probation Officers and Integrated Sentence Managers (ISMs), would be supported by the development of a formal joint Service Level Agreement between the Probation Service and the IPS and organisations providing community prison link workers. From the limited outcomes data that is available, positive outcomes are evident. Overall we can expect between 70% and 100% of those who enter a detox programme to complete it, and between 60% and 80% of those who commence treatment to complete it. Of those who complete treatment we can expect around half to return to training, education or employment. Around one-third will achieve total recovery, another one-third will manage their addiction safely and around one-third will relapse. (iv) Gaps in Provision The system of provision is evolving to address needs as they arise. Areas that pose particular challenges at present and that require attention and further development are:  Treatment services for women offenders. Women, especially women with children, have specific needs that a comprehensive system of provision should cater for. While women with addiction are catered for within prison and within the community, the options available are relatively limited. The Probation Service and the IPS are aiming to address these challenges through a joint strategy for women offenders.  There is a strong focus on drug addiction within the current system of provision. However, alcohol abuse is just as important a contributor to criminality as is drug addiction and abuse. Because of the non-availability of alcohol within the prison estate, prisoners with an alcohol addiction effectively have no choice other than to detox, with or without medication. Programmes that place more attention on the underlying reasons for alcohol addiction and how to prevent these triggers in the future as well as harm reduction strategies require further development across the prison estate.  Within drug addiction, many of the treatment regimes are focused on opiate based drugs. However, in recent years the trends in usage have been away from opiates towards other drugs such as benzodiazepines and novel psychoactive substances, which are more difficult to detect. Treatment regimes are playing catch up to these developments, both in the community and within the prison estate.  There are a growing number of offenders presenting with co-morbidities, e.g. alcohol and/or drug abuse combined with mental health issues. Best practice advocates a system of integrated dual treatment and many of the existing suites of community-based service providers and the system of provision within the prison estate does not adequately cater for co-morbidities. (iii) Strengths of the Current System of Provision Addiction is a major contributory factor in criminality. The Probation Service’s Drugs and Alcohol Survey (2011) found that the majority of alcohol and drug misusing offenders had their misuse linked to their offending. Martyn (2012) found that 89% of adult offenders on probation supervision had misused drugs or alcohol and Freeman and Allen (2015) found that 60% of prisoners in Cork prison had a documented history of substance abuse and addiction. Both the Probation Service and the IPS recognise the role drugs and alcohol play in criminality and recidivism and both have invested heavily in developing a system of provision to address drug and alcohol addictions. The prison environment provides a unique opportunity to support individuals to address addiction and it is appropriate that a range of treatment and intervention options is provided in the prison estate. Excluding direct staff and GP costs, the IPS and Probation Service have combined expenditure of €3.33m on the provision of addiction services for adult offenders. Expenditure by the Probation Service has remained stable in recent years, while spending by the IPS has reduced in line with the decline in prisoner numbers. However, those in prison are now more likely to be the most challenging and chaotic. This includes those with a dual diagnosis of addiction and mental health issues. Health teams are present in every prison and some staff have specialist qualifications in the treatment of addiction. Clinicians have an interest in addiction and are familiar with the care pathways within the prison estate, thus increasing their effectiveness. The development of joint strategies between the Probation Service and the IPS has supported the development of a more integrated and co-ordinated approach to dealing with offenders, including those with addictions. The current model of provision is a mixed methods layered approach incorporating residential treatment provided in the community using a number of treatment regimes. This includes detoxification within prison, methadone treatment, one to one and group addiction counselling, specialist treatment methodologies (e.g. Cognitive Behaviour Therapy, Therapeutic Communities, 12 Step Programmes), harm reduction and relapse prevention. This mixed methods way of working fits with international best practice and is appropriate. The NDRIC framework is an important national development that the Probation Service and the IPS have aligned with. There are opportunities to further strengthen this alignment with NDRIC, most notably in the areas of care planning, enhanced communication and protocols with the HSE, better internal and external co-ordination. While small in number and primarily Dublin-based, community prison link workers are a valuable resource which provides a link for offenders between prison and the community. Greater integration of these workers in the system of provision, including links with the work of Probation Officers and Integrated Sentence Managers (ISMs), would be supported by the development of a formal joint Service Level Agreement between the Probation Service and the IPS and organisations providing community prison link workers. From the limited outcomes data that is available, positive outcomes are evident. Overall we can expect between 70% and 100% of those who enter a detox programme to complete it, and between 60% and 80% of those who commence treatment to complete it. Of those who complete treatment we can expect around half to return to training, education or employment. Around one-third will achieve total recovery, another one-third will manage their addiction safely and around one-third will relapse. (iv) Gaps in Provision The system of provision is evolving to address needs as they arise. Areas that pose particular challenges at present and that require attention and further development are:  Treatment services for women offenders. Women, especially women with children, have specific needs that a comprehensive system of provision should cater for. While women with addiction are catered for within prison and within the community, the options available are relatively limited. The Probation Service and the IPS are aiming to address these challenges through a joint strategy for women offenders.  There is a strong focus on drug addiction within the current system of provision. However, alcohol abuse is just as important a contributor to criminality as is drug addiction and abuse. Because of the non-availability of alcohol within the prison estate, prisoners with an alcohol addiction effectively have no choice other than to detox, with or without medication. Programmes that place more attention on the underlying reasons for alcohol addiction and how to prevent these triggers in the future as well as harm reduction strategies require further development across the prison estate.  Within drug addiction, many of the treatment regimes are focused on opiate based drugs. However, in recent years the trends in usage have been away from opiates towards other drugs such as benzodiazepines and novel psychoactive substances, which are more difficult to detect. Treatment regimes are playing catch up to these developments, both in the community and within the prison estate.  There are a growing number of offenders presenting with co-morbidities, e.g. alcohol and/or drug abuse combined with mental health issues. Best practice advocates a system of integrated dual treatment and many of the existing suites of community-based service providers and the system of provision within the prison estate does not adequately cater for co-morbidities.  The absence of a peer-led positive drugs free environment, within the prison estate, for offenders who have come off drugs or alcohol needs to be addressed. (v) Development Needs In terms of actual work on the ground, certain aspects of the model of effective practice (see Figure 1 above for a summary and chapter five of the main report for the full model) require further development as follows: NDRIC is an important national framework that the Probation Service and the IPS should align further with wherever possible. This will help ensure continuity of care between different settings and optimal use of resources. As highlighted above, a more broadly based system of provision that caters for the specific needs of women offenders, treatments and interventions for alcohol abuse, treatments and interventions that accommodate the changing nature of drug abuse and co-morbidities is desirable. Within the prison estate, more focus on the development of alcohol treatment programmes would be beneficial as well as relevant screening and treatment regimes for nonopiate based drug addiction. This latter point also requires development within the community setting. With regard to co-morbidities, commissioning of service providers with expertise in mental health and treatment of addiction is one option. Another possibility is to develop protocols with the HSE on access to psychiatric and psychological services. Equity of access and treatment irrespective of location is a key principle that underpins the service provision model. This means that the current system of a broad base of community based organisations should be continued. However, as noted above, this could be strengthened by having more specialist services for women, services capable of addressing co-morbidities and services willing and able to deal with sex offenders or those with a history of violence. Within the prison estate, a minimum standard of provision should be present in every prison, with specialist programmes developed in Mountjoy. This is with a view to disseminating these throughout the prison estate once proven – in other words a hub and spoke model rather than a centralised model. Care planning the whole way through, from an offender being in the community (e.g. receiving treatment in the community through the HSE) to being in prison (where they might receive addiction counselling or participate in detox or continue with methadone maintenance) to discharge from prison back into the community, is an area that requires further work. Use of common assessment, screening tools and care plan templates can support a more co-ordinated care planning process. Currently, when an offender moves from the community into prison, there is a break in the care planning process. Similar breaks can occur on discharge, although the Integrated Sentence Management process has gone a considerable way to minimising this. Within the prison estate, clear responsibility for case management should be assigned and known. Information sharing, communication and co-ordination are requirements for effective through-care planning. At present, care plans do not follow the offender from one setting to another and at each stage the prison health staff, prison-based addiction counsellors, community-based treatment staff, Probation Officers, ISMs and community prison link workers are relying on the offender to inform them of what treatment or interventions they have engaged in before. Working with NDRIC, to develop a basic care plan that can be shared electronically, will support better co-ordination and effective provision of services. National protocols around referral, drop-out from treatment/interventions and information sharing require development to ensure a co-ordinated collaborative approach that supports effective case management and care planning between and within different settings. Better preparation of offenders who are moving to a residential treatment centre is an important success determinant in reducing drop-out rates, particularly in respect of offenders coming from a prison setting. Within the prison estate, a system of waiting time recording and management is a necessary step in order to support effective deployment of resources and efficient management of demand for services, particularly for addiction counselling. Harm reduction is an important component of the treatment toolkit (e.g. providing information and education on the risks of taking different types of drugs). Not every offender in treatment will successfully detox or remain drugs or alcohol free. Within the prison estate, a harm reduction programme should be developed and incorporated into the treatment regime. The Mountjoy Medical Unit operates the Drugs Treatment Programme (DTP). This could be improved through the development of a universal curriculum, better co-ordination of the service providers contracted to deliver different aspects of the curriculum and tracking of outcomes achieved. It has potential to be disseminated to other prisons once its effectiveness has been proven. For offenders remaining in prison, who have successfully detoxed, access to a peer-led positive drugs free environment will support their recovery. However, it must be remembered that within a community setting, drugs are readily available. This suggests that the primary focus should be on supporting offenders to build their own internal resilience and capacity to resist a return to addictive behaviours and be supported to build an alternative set of behaviours that support their good health and well-being. Considerable progress has been made in the management of release planning from prisons, e.g. the introduction of ISMs. However, there are still a number of areas where release of offenders with an addiction can be problematic, e.g. those who are homeless, or who are still chaotic drug users, or who are on remand, or who are released on bail by the courts, or who are on temporary release or post custody supervision. Managing these complex cases jointly and developing shared protocols would support more effective communication and coordination of such cases. The IPS needs to develop a national system of clinical governance for treatment within the prison estate that ensures consistency across prisons in the approach to treating offenders with addictions. Service Level Agreements (SLAs) are a fundamental tool in the overall governance (both financial and operational) of external service providers/CBOs contracted to provide addiction related services either in the community or within prisons. The SLAs that currently are in place have too much variability in their requirements for each service provider and there are inconsistencies between those of the Probation Service and the IPS. A standardised SLA template should be used by the Probation Service and the IPS for contracting of CBOs. One group of workers who currently provide services within the prison system have no SLA or oversight by either the Probation Service or the IPS, i.e. community prison link workers. This needs to be addressed, given that funding for their work is channelled through the Department of Justice and Equality. All Service Level Agreements should incorporate an agreed set of outcomes. For treatment services we would recommend a small number of performance indicators that focus on participation and treatment outcomes. These indicators should apply to community based services and treatment programmes within the prison estate. Joint training between community based organisations, the Probation Service and the IPS would facilitate useful networking and sharing of good practice and learning. This would also support working across the silos that are within the control of the Probation Service and the IPS. Finally, funding levels by the Probation Service should be maintained while those of the IPS should be restored to 2011 levels in order to address the gaps identified above. Multi-annual SLAs (covering up to a three-year period) should be considered for all service providers. Detailed recommendations are provided in chapter fifteen. Details: Dublin: Irish Probation Service and Irish Prison Service, 2016. 112p. Source: Internet Resource: Accessed January 27, 2017 at: http://www.justice.ie/en/JELR/PS_IPS_Probation_Review_of_treatment_for_offenders.pdf/Files/PS_IPS_Probation_Review_of_treatment_for_offenders.pdf Year: 2016 Country: Ireland URL: http://www.justice.ie/en/JELR/PS_IPS_Probation_Review_of_treatment_for_offenders.pdf/Files/PS_IPS_Probation_Review_of_treatment_for_offenders.pdf Shelf Number: 144929 Keywords: Alcoholism Drug Abuse and Addiction Drug Offenders Drug Treatment Programs Substance Abuse Treatment

Author: Public Health England Title: An evidence review of the outcomes that can be expected of drug misuse treatment in England Summary: This review gives policy makers and local areas an objective assessment of what drug treatment outcomes are achievable, and compares outcomes in England to the evidence and to other drug treatment systems It reviews the impact of housing problems, unemployment and social deprivation on treatment engagement and outcomes. The review also considers how drug treatment will need to be configured to meet future need and recommends an appropriate set of measures or indicator for treatment evaluation. Details: London: Public Health England, 2017. 158p., app. Source: Internet Resource: Accessed February 3, 2017 at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/586111/PHE_Evidence_review_of_drug_treatment_outcomes.pdf Year: 2017 Country: United Kingdom URL: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/586111/PHE_Evidence_review_of_drug_treatment_outcomes.pdf Shelf Number: 140804 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Abuse Treatment Drug Offenders

Author: European Parliament. Directorate-General for Internal Policies. Policy Department C Citizens' Rights and Constitutional Affairs Title: A Review and Assessment of EU Drug Policy Summary: EXECUTIVE SUMMARY The challenges facing Europe in the field of drugs are still significant and have increased in complexity in recent years. In addition to the key issue of mortality and morbidity as a result of opioid use, new and emerging problems are being experienced across the EU. These include the creation of new psychoactive substances and the increasing dynamism of illicit drug markets. This study aims to provide evidence on international and EU approaches to drug policy, including these challenges and focusing on several case study countries. This evidence has been used to identify and develop policy proposals. Drug policy at the UN and EU levels The main tenets of the UN's approach to drugs are the 1961 UN Single Convention on Narcotic Drugs, the 1971 UN Convention on Psychotropic Substances and the 1988 UN Convention against illicit traffic in Narcotic Drugs and Psychotropic Substances. A key UN policy document is the 2009 'Political Declaration and Plan of Action on International Cooperation towards an Integrated and Balanced Strategy to Counter the World Drug Problem'. This document details a set of goals to be achieved by 2019, including significant and measurable progress in eliminating the illicit cultivation of opium poppy, coca bush and cannabis plant, as well as actions to be implemented by countries across three main pillars. In April 2016, the UNGASS on the World Drug Problem was convened; a UN General Assembly special session seen as an important milestone in achieving the goals set out in the 2009 policy document. The UNGASS resulted in the adoption of the outcome document 'Our joint commitment to effectively addressing and countering the world drug problem. This document provided a range of operational recommendations and broadened the original pillar structure to 7 pillars (see chapter 2). Several new themes were added including drugs and health, drugs and human rights, new drug related challenges such as NPS and use of the internet, and international and development related cooperation. At the EU level, although the primary onus for developing drug policy and legislation remains with the Member States, there are a several legal bases for EU action, as stipulated in the Treaty of Lisbon. These cover the context of adopting minimum rules on the definition of criminal offences and sanctions on serious organised crime (Article 83 TFEU), public health (Article 168 TFEU), the internal market (Article 114 TFEU) and judicial cooperation in criminal matters (Articles 82-86 TFEU). In terms of EU policy, the most prominent current instrument is the EU Drugs Strategy 2013-2020. The Strategy provides the overarching political framework and priorities for EU drug policy. The EU Drugs Strategy has 5 main objectives, namely to reduce demand and harm, disrupt the drugs market, discourse and analysis, cooperation, and research and monitoring. The implementation of the Strategy's long-term objectives have been operationalised in 4- year Action Plans. In November 2015, the Commission adopted a report on the progress of the implementation of the EU Drugs Strategy and Action Plan. The mid-term evaluation of the first Action Plan (2013-2016) is due to be completed by the end of 2016 or, at the latest, early 2017. The findings from the mid-term evaluation and the Public Consultation, which was launched by the European Commission in March 2016, will inform the Commission's decision to propose a new Action Plan for 2017-2020. Recent EU legislative developments relate to a package of two proposals regarding new psychoactive substances. These proposals were put forward by the European Commission is 2013. As Member States expressed doubts in the Council concerning the choice of Article 114 TFEU as the legal basis for the proposed Regulation, inter-institutional negotiations of this legislative package were ongoing for more than two years. As a result, the Commission withdrew its proposal on 29 August 2016 and tabled a proposal amending the founding Regulation of the EMCDDA (Regulation (EC) No 1920/2006 on the EMCDDA). Under this proposal, deadlines for decision-making on NPS will be significantly reduced and Europol will take on a more active role in the risk assessment procedure and the Early Warning System (EWS), with a view to quicker identification and assessment of the involvement of criminal groups. The new proposal was welcomed by all Member States and was backed by the European Parliament's LIBE Committee on 17 November 2016. Details: Brussels: European Parliament, 2016. 224p. Source: Internet Resource: Accessed February 8, 2017 at: http://www.europarl.europa.eu/RegData/etudes/STUD/2016/571400/IPOL_STU(2016)571400_EN.pdf Year: 2016 Country: Europe URL: http://www.europarl.europa.eu/RegData/etudes/STUD/2016/571400/IPOL_STU(2016)571400_EN.pdf Shelf Number: 144946 Keywords: Drug Abuse and Addiction Drug Control Policy Drug Enforcement Drug markets Drug Policy Illicit Drugs Organized Crime

Author: McBride, George Title: High Stakes: An Inquiry into the Drugs Crisis in English Prisons Summary: Prisons are in crisis with record levels of suicides, violence and self-harm. Traditional drugs have been replaced by a family of drugs called synthetic cannabinoid receptor agonists, generically referred to as 'black mamba' or 'spice.' The government has failed to recognise the important policy implications of these new drugs, and the lack of intelligent drug policy in the new white paper risks undermining the entirety of the proposed prison reforms. This report is the first of its kind bringing together experts in drug and prison policy to examine the implications of the radical shift in prison drug markets and propose pragmatic solutions to reduce drug-related harms and improve prison safety and security. The report reviews the rise to near ubiquity of spice in men's prisons in England. These diverse and multitudinous substances have risen to prominence globally in response to international prohibition of popular illicit substances, in particular cannabis. These new substances have relatively unknown risk profiles and many induce paranoia, behavioural disturbances, violence, seizures and convulsions. They are particularly popular in prisons due to their low cost, difficulty to detect, and "bird [prison sentence] killing" effects. Too little is being done to fight drug demand within prisons. Prisoners are often left unoccupied in their cells for 23 hours a day. Many prisoners are developing drug problems during their incarceration. Overall 8% of men in prison in England and Wales report developing a drug problem since they have been in prison. In prisons with the worst regimes this is as high as 14-16%. This is increasing drug use and the frequency of dangerous incidents, which are a substantial drain on prison staff resources. This feeds a vicious cycle, further draining resources, and is leaving prisoners increasingly unoccupied and under supervised. As staff capacity is reduced this further decreases the ability of prisons to perform essential functions in disrupting the supply of drugs into prisons leaving criminal organisations able to push drugs with impunity. The supply reduction methods proposed in the White Paper are expensive distractions from the real work needed to disrupt criminal supply chains. Proposed extensions to the mandatory drug testing regime will be impracticable with the available resources, only identify a limited range of the drugs in circulation, and fail to assist in identifying those supplying drugs. New sniffer dogs will quickly become obsolete due to the rate of chemical innovation of new substances. We are currently monitoring drug use in prisons through mandatory drug testing and records of seizures. These methods give very little assistance in terms of understanding who is supplying drugs, who is using drugs, what drugs are in circulation, how drugs are getting into prisons, or the level and nature of harm associated with drug use in a given prison. Recommendations: Risk management not zero tolerance – a chasm exists between the prevailing rhetoric and policy reality. In order to manage prisons effectively efforts need to focus on disrupting supply chains, reducing demand for drugs, and improving intelligence-gathering. Reducing drug-related harms makes prisons safer places in which rehabilitation is more effective. Helping addicted drug-users who are willing to change to turn their lives around is proven to reduce re-offending rates. Reduce demand through purposeful activity – There needs to be an acceptance that supply reduction measures are there to disrupt supply, they are not there to eradicate it. A shift of emphasis towards demand reduction is required to make prisons more effective places at tackling problem drug habits and rehabilitating offenders. There is a clear link between a lack of purposeful activity and the uptake of drug use. Busy prison regimes and treatment are more effective than security measures in managing the drug problem in our prisons. The long-held emphasis on supply reduction over demand reduction creates an increased burden on staff, logistical and management difficulties, and associated difficulties in implementing new policies, supporting work, training, education and treatment schemes. These costs too often go uncounted. Overhaul monitoring of drug use – An essential part of effective management is using appropriate, reliable metrics for measuring success and failure. The Ministry of Justice’s recommendations to monitor prisons’ drug policy outcomes via drug testing prisoners on arrival and exit from prison will not provide reliable or useful data. Instead, a system should be implemented to monitor the nature and scale of the drug market and drug-related harms. Regular anonymous audits of drug use and the drug market could provide valuable information from treatment staff, prison officers, current and ex-prisoners. Overhaul monitoring of drug supply and security – Current supply-reduction and security measures are not grounded in evidence. New proposed measures focus on drones and visitors when there is no evidence that these are the primary sources of supply. There is evidence suggesting corrupt staff may be a major source of supply. Evidence gathering is needed on drug seizures to assist in determining their providence, as well as a new regional task force within the Prison Service to oversee periodic spot checks and searches of staff. Improve staff to prisoner ratio – Overseeing busy prison routines and effective treatment is a labour-intensive endeavour with no quick-fix technological solutions. In order to bring about this reform we need a better staff to prisoner ratio. To do so means that we need to either substantially reduce the prison population or substantially increase prison funding. Reducing the prison population likely has both fiscal and outcome benefits by reducing the use of a costly and ineffective intervention. Details: London: Volteface, 2016. 44p. Source: Internet Resource: Accessed February 11, 2017 at: http://volteface.me/app/uploads/2017/01/High-Stakes-A4-Printed-Booklet-Final-Version-1.pdf Year: 2016 Country: United Kingdom URL: http://volteface.me/app/uploads/2017/01/High-Stakes-A4-Printed-Booklet-Final-Version-1.pdf Shelf Number: 144834 Keywords: Drug Abuse and Addiction Drug Control Drug Control Policy Drug Offenders Drug Use in Prison Prison Contraband Prison Policy Prison Violence

Author: Global Commission on Drug Policy Title: Advancing Drug Policy Reform: A New Approach to Decriminalization Summary: Every year, hundreds of millions of people around the world use illicit drugs. Many do so for enjoyment, some to relieve pain, while others use for traditional, cultural or religious reasons. Despite the fact that drug use is both widespread and non-violent, the predominant approach of governments around the world is to criminalize those who use and/or possess drugs. Such policies are enacted with the false hope that, combined with efforts targeting the production and supply of drugs, the drug market and use can be eliminated. The harms created through implementing punitive drug laws cannot be overstated when it comes to both their severity and scope. On a daily basis, human rights abuses - from the death penalty and extrajudicial killings, to inhuman and coerced drug treatment - are committed around the world in the name of drug control, while strict drug laws have escalated public health crises in the form of HIV and hepatitis C epidemics. Furthermore, in a number of countries drug laws have caused severe prison overcrowding. These extensive damages wrought by a punitive approach to drugs and drug use fundamentally undermine the principle of human dignity and the rule of law, fracturing the relationship between States and their populations. In order to begin mitigating these widespread harms, governments must as a matter of urgency decriminalize the possession of drugs for personal use. Decriminalization is typically understood as the removal of a criminal record for drug possession for personal use offenses, with the optional imposition of civil penalties such as fines or administrative sanctions, or no penalty at all. Though some governments have already taken this approach, only a small number have implemented policies that have brought about positive outcomes for people who use drugs and society as a whole. What's more, these governments typically rely on penalizing people with civil sanctions. This approach does not go far enough. The Commission believes that for the principle of human dignity and the rule of law to be firmly upheld, there must be no penalty whatsoever imposed for low-level possession and/or consumption offenses. Beyond decriminalizing the possession of drugs for personal use, governments must implement alternatives to punishment for many low-level actors in the drug trade, including those who engage in social supply, drug couriers, and cultivators of illicit crops. Many of these people engage in the trade non-violently and may do so to alleviate their severe socio-economic marginalization. Punishing these groups is unjust and only serves to heighten their vulnerability. Ultimately, no longer criminalizing people who use drugs and addressing low-level actors with proportionate responses should be considered as a step toward bringing illicit drug markets under control through sensible regulation. Only then can the societal destruction caused by drug prohibition be properly mitigated. Drug use is, and always has been, a reality in all of our societies. For too long governments have waged a misguided war against the drug market and people who use drugs, handing down sanctions that are disproportionate, unjust and wholly unnecessary. The evidence of just how harmful punitive drug laws are is irrefutable. Governments can no longer ignore the need for a new approach. Details: Geneva, SWIT: The Commission, 2016. 44p. Source: Internet Resource: Accessed February 13, 2017 at: http://www.globalcommissionondrugs.org/wp-content/uploads/2016/11/GCDP-Report-2016-ENGLISH.pdf Year: 2016 Country: International URL: http://www.globalcommissionondrugs.org/wp-content/uploads/2016/11/GCDP-Report-2016-ENGLISH.pdf Shelf Number: 145125 Keywords: Drug Abuse and Addiction Drug Decriminalization Drug Enforcement Drug Reform Policy Illicit Drugs

Author: Smart Approaches to Marijuana (SAM) Title: Lessons Learned After 4 Years of Marijuana Legalization Summary: In the wake of multimillion-dollar political campaigns funded with out-of-state money, Colorado and Washington voted to legalize marijuana in November 2012. Though it would take more than a year to set up retail stores, personal use (in Colorado and Washington) and home cultivation (in Colorado, which includes giving away of up to six plants) were almost immediately legalized after the vote. Using marijuana in public, which remains illegal under these new laws, has increased conspicuously in both states. Also, a brand-new marijuana industry selling candies, cookies, waxes, sodas, and other marijuana items has exploded—and with it a powerful lobby to fight any sensible regulation. Though it is still early—the full effects on mental health and educational outcomes, for example, will take many more years to fully develop—these “experiments” in legalization and commercialization are not succeeding by any measure. Colorado now leads the country in past-month marijuana use by youth, with Washington not much further behind. Other states that have since legalized marijuana occupy 4th place (District of Columbia) and 5th place (Oregon). States with lax “medical marijuana” laws occupy 2nd and 3rd place (Vermont and Rhode Island, respectively). Additionally, as explained in greater detail below, the laws have had significant negative impacts on public health and safety, such as: • Rising rates of pot use by minors • Increasing arrest rates of minors, especially black and Hispanic children • Higher rates of traffic deaths from driving while high • More marijuana-related poisonings and hospitalizations • A persistent black market that may now involve increased Mexican cartel activity in Colorado The federal government, through the Department of Justice (DOJ), announced it would initially take a hands-off approach to state implementation of legalization, instead promising to track eight specific consequences—from youth marijuana use to use on public lands—and determine action later. So far, however, neither the federal nor state authorities have implemented a robust public tracking system for these criteria. This failure led the U.S. Government Accountability Office (GAO) to criticize DOJ in 2016 for not appropriately monitoring and documenting legalization outcomes. As of the date of this publication, there has been no word from the Department of Justice about state marijuana program compliance with any of the eight criteria it identified. Quietly, however, state agencies such as the Colorado Department of Public Safety, have released very negative updates on marijuana data and other indicators. In the meantime, the promises of tax revenue windfalls and decreased crime have not materialized. Pot tax revenue comprises a tiny fraction of the Colorado state budget— less than one percent—and after costs of enforcement are subtracted, the remaining revenue is very limited. Some Colorado school districts, such as Denver's, have not seen a single dollar of new funding from state pot taxes. And in Washington, half of the marijuana tax money legalization advocates promised for prevention and schools has been siphoned off into the state's general fund. Details: Alexandria, VA: SAM, 2016. 30p. Source: Internet Resource: Accessed February 13, 2017 at: https://learnaboutsam.org/wp-content/uploads/2016/11/SAM-report-on-CO-and-WA-issued-31-Oct-2016.pdf Year: 2016 Country: United States URL: https://learnaboutsam.org/wp-content/uploads/2016/11/SAM-report-on-CO-and-WA-issued-31-Oct-2016.pdf Shelf Number: 145017 Keywords: Drug Abuse and Addiction Drug Abuse Policy Drug Legalization Marijuana Marijuana Legalization

Author: Sindicich, Natasha Title: Patient Motivations, Perceptions and Experiences of Opioid Substitution Therapy in Prison Summary: People with opioid dependence are overrepresented in correctional settings (AIHW, 2013; Indig et al., 2010). Opioid substitution therapy (OST) is an effective treatment for opioid dependence, reducing illicit opioid use (Mattick, Breen, Kimber, & Davoli, 2009, 2014) and mortality (Degenhardt et al., 2011). OST is provided in correctional settings in many jurisdictions around the world (HRI, 2014), but there has been limited examination of the patient experience of opioid substitution therapy (OST) in correctional settings. Unexplored issues include reasons for entering (or not entering) treatment; patient perceptions of advantages and disadvantages of OST in prison; and preferences to cease or remain in treatment on release from prison. This latter issue is of particular importance, as clinicians report that patients often wish to cease OST prior to release, even when informed of the risk of overdose and benefits of remaining in treatment. This qualitative study aimed to examine patient motivations for, and perceptions and experiences of, OST in prisons in New South Wales (NSW), Australia. Forty-seven participants were recruited from seven correctional centres across NSW between September 2012 and October 2013. All participants had a recorded history of opioid use and/or dependence. To ensure a broad range of perspectives were obtained, participants were selected on the basis of specific exposures to OST: Exposure group A (n=7): New inductions to OST. These individuals were within 28 days of commencing OST at the time of interview. They may have been in OST previously, in community or custodial settings; Exposure group B (n=11): Continuing OST from the community. This group of patients had been in OST prior to custody, and were in treatment in custody for at least 28 days before interview (i.e. had some familiarity with the opioid treatment program in prison). Exposure group C (n=10): Commenced OST in custody. These participants were in treatment for at least 28 days before interview (i.e. had some familiarity with the opioid treatment program in prison). Exposure group D (n=9): Voluntarily ceased OST in custody. Exposure group E (n=10): Patients who reported heroin use on reception to prison, but have not entered OST or have declined to be placed on the OST waiting list during this custodial sentence. The sample was predominantly male (n=32; 68%), and 18 participants (38%) identified as Aboriginal and/or Torres Strait Islander. The average age of participants was 35 years. Three-quarters (n=35, 75%) of the sample were sentenced, 11 were on remand, and one participant was unsure of sentencing status. The majority (n=42; 89%) reported a previous incarceration history. Twenty-eight participants were currently prescribed OST (methadone n=27, 57%; buprenorphine-naloxone-naloxone n=1, 2%). Findings by exposure group Among new OST inductions (Group A, n=7), reasons for commencing OST included wanting to abstain from drug use in prison and in the community upon release, as well as to aid with opioid withdrawal. Some participants noted the role of OST in the management of chronic pain. Benefits of OST identified by this group included elimination of opioid cravings, and the financial advantages of not buying drugs in prison. Criticisms of the opioid treatment program reported by this group included the waiting period to enter the program, with over half reporting drug use during this period in order to manage withdrawal symptoms. All participants in this group reported a willingness to stay in OST post-release, with two participants noting that they would prefer to be switched from methadone to buprenorphine formulations due to the lower frequency of administration (every second day) and higher number of ‘take-away’ doses available, which was deemed more practical for meeting employment commitments. Almost all (10/11) Group B patients (continuing OST from the community) were satisfied to remain in OST. Most (7/11) were willing to continue with OST post-release, so as to avoid drug relapse. As in Group A, two participants reported a preference to switch from methadone to buprenorphine-naloxone formulations post-release. For those who were wanting to cease treatment prior to release, reasons for this included pressure from family members and friends, the stigma attached to OST, the long-term nature of OST, and the perceived side-effects of poor dental health and appearing "stoned". Group C (n=10) were current OST patients who had commenced OST during this custodial period. Participants in this group reported drug use and unsafe injecting practices while in prison before commencing treatment. Most (6/10) reported that they would remain in OST post-release, at least until they felt they were stable and had a daily routine in the community. Those who wanted to cease treatment prior to release reported that they were primarily on OST for the management of their chronic pain and that on their release, they would seek other medication, often the preferred opioid analgesic they were prescribed prior to custody. Group D (n=9) had ceased OST during their current incarceration period. Around half (4/9) of participants in this group expressed interest in re-starting OST. Motivations for restarting OST included wanting to cease drug use in prison, and prevention of opioid withdrawal. Again, it was reported that drug use and unsafe injecting practices occurred during waiting periods to enrol in treatment. Reasons for ceasing OST related to release from prison and a reluctance to continue in OST due to the long-term nature of treatment, daily stressors of obtaining methadone in the community, and previous unsuccessful attempts OST episodes in the community. Group E (n=10) were people with a history of opioid use and/or dependence who had not entered OST in this period of incarceration. Seven participants in this group reported prior OST in the community or during previous incarcerations. Six of the ten participants in this group reported that they would like to be in OST, preferably prescribed a buprenorphine-naloxone formulation. Recurrent themes across groups Perceptions of opioid treatment program operation Participants were critical of the time taken to be assessed for OST and commenced on treatment. Participants perceived that this process was expedited if they reported drug use in prison to health centre staff; however, drug use is not a high priority indication for treatment entry per se (unlike pregnancy or HIV seropositivity, for example), so it is unclear if this perception was valid. Once treatment had commenced, participants perceived that there was a lack of monitoring and limited discussion of long-term treatment plans, particularly in relation to ceasing OST. Some participants questioned the motivations of other OST patients; for example, people with no recent history of opioid use who requested assessment for the opioid treatment program, or patients who deliberately requested higher doses of medicine than necessary in order to feel intoxicated. Intentions to cease OST prior to or on release Around one-third of current OST patients reported an intention to cease OST prior to or on release from prison. Participants identified aspects of OST in the community that they perceived as restrictive (e.g. daily dosing; difficulties in travelling to clinics within opening hours; difficulties going away from home). Some participants expressed concern that attending an OST clinic would result in drug use and/or crime as a result of exposure to past associates. Participants also expressed concern about the long-term nature of OST, with the perception that OST was replacing one addiction for another and in conflict with the goal of being "drug free". Participants also identified the stigma attached to OST as a reason for ceasing treatment prior to release. For some participants, this issue was framed in terms of where best to withdraw from OST, specifically methadone – in custody, or in the community. These participants identified the prison setting as a more fitting environment for managing withdrawal. Drug use in prison, including buprenorphine-naloxone diversion Across groups there was consensus that drugs including cannabis, heroin, methamphetamine, and buprenorphine-naloxone diverted from the opioid treatment program. Availability and pricing of drugs varied by prison. Drugs were injected and smoked. Awareness of the risk of blood borne virus transmission via sharing of needles and syringes was high, with specific mentions of risk of hepatitis C virus (HCV) and HIV transmission. Participants reported use of needles and syringes by multiple people despite these risks. The issue of buprenorphine-naloxone diversion from the opioid treatment program was mentioned by 18 participants. Diversion appeared to occur largely in the context of patients being "stood over"; that is, being forced to give their buprenorphine-naloxone to someone else. Participants reported that people engaged in stand over behaviour to obtain buprenorphine-naloxone for their own use (medicating withdrawal symptoms, or getting intoxicated) or to sell for profit. Use of OST for chronic pain Five participants were prescribed methadone for the treatment of chronic pain. Participants generally stated a preference for other analgesic medicines. Methadone was, however, perceived as more effective for pain relief than other options available in the prison setting (e.g. ibuprofen). Naltrexone for the treatment of opioid dependence Over half of participants (27/47) had heard of naltrexone (either oral or implant formulation). There was some scepticism regarding the utility of naltrexone treatment for opioid dependence in the prison settings, primarily because participants believed that those prescribed naltrexone would continue to use, or commence using, non-opioid drugs. Discussion and conclusions Treatment seeking was often precipitated by drug use and injecting in prison. OST was also sought to medicate opioid withdrawal symptoms. Keeping prison-based OST numbers within a range that results in safe management both in custody and upon release to the community has led to delays in accessing OST for those patients seeking to commence treatment in prison, and patients clearly have strong negative views about this approach. Among some participants, the waiting list appeared to act as a barrier to initiating the process of commencing OST. Balancing the needs of opioid dependent patients against operational and capacity issues, and safety and security concerns, are ongoing challenges for clinical staff. With some exceptions, benefits of OST in prison were largely framed in terms of avoiding negative experiences or outcomes, rather than as direct positive benefits of treatment. These findings highlight that although OST is perceived as preventing negative outcomes, it is not necessarily seen as producing positive outcomes for the individual, such as better health or quality of life. This is line with previous research that has reported the considerable ambivalence that many opioid dependent persons have towards OST (Harris & Rhodes, 2013). Diversion of buprenorphine-naloxone from the opioid treatment program appeared to most commonly occur in the context of patients being "stood over" for their medicine, although there may also be patients who voluntarily engage in diversion. The potential for diversion of buprenorphine products used for OST in correctional settings has been previously identified (Gordon et al., 2014; Kinlock, Gordon, Schwartz, & Fitzgerald, 2010; Magura et al., 2009), and the combination buprenorphine-naloxone film was introduced into NSW correctional centres specifically in response to concerns regarding diversion of the mono-buprenorphine formulation (administered sublingually). Policies and procedures for reducing the incidence of diversion and for responding to identified cases of diversion are in place in correctional health centres in NSW. Despite the identified benefits of OST in prison, there was considerable ambivalence among patients regarding continuation of OST once released. Balancing the preference of many patients to cease OST prior to release against patient safety post-release is a substantial challenge for correctional health care providers. The weeks immediately after release from prison are associated with an elevated risk of drug-related death (compared to other time at liberty) (Merrall et al., 2010), and exposure to OST during this period is highly protective against mortality (Degenhardt et al., 2014). As such, correctional health care providers in NSW are trained to advise patients to remain in OST through their transition to the community, and are reluctant to assent to patient requests to cease OST prior to release. This tension between patient preference and evidence-informed clinical practice appears to be perceived by patients as a lack of consultation and/or poor treatment planning. Further work is needed examining provider perspectives of OST in prison, and determining models of care to enhance post-release engagement in OST. Participants reported that injecting drug use occurred in prisons. Awareness of the potential for HCV or HIV transmission through the sharing of injecting equipment was high; nonetheless, participants reported that sharing of needles and syringes was common. Participants perceived a needle and syringe program as feasible for the prevention of re-use of injecting equipment. This study has generated unique data on patient perspectives of OST in correctional settings. We have described patient perspectives on entry to, experiences of, and retention in, OST in prison and post-release. Our findings have highlighted the challenges facing opioid treatment providers in prison in addressing patient ambivalence towards OST and preferences to cease OST prior to release, and can inform the development of policies and clinical practices that are mindful of patient perspectives and concerns. These results are suggestive of the need for further work examining how best to attract and retain opioid dependent prisoners in treatment, including provider perspectives; evaluation of programs designed to increase post-release retention in OST (and other care), and quantitative analyses of retention in OST in prison and post-release. Details: Sydney: NATIONAL DRUG AND ALCOHOL RESEARCH CENTRE, UNIVERSITY OF NEW SOUTH WALES, 2016. 43p. Source: Internet Resource: Technical Report Number 332: Accessed February 24, 2017 at: https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Technical%20Report%20Number%20332.pdf Year: 2016 Country: Australia URL: https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Technical%20Report%20Number%20332.pdf Shelf Number: 141212 Keywords: Correctional Programs Drug Abuse and Addiction Drug Abuse Treatment Drug Offenders Opioids Substance Abuse Treatment

Author: Gau, Jacinta M. Title: Non-Medical Use of Prescription Drugs: Policy Change, Law Enforcement Activity, and Diversion Tactics Summary: The crisis in prescription-opioid addiction began long before it was finally brought out into the open (Inciardi et al., 2009). Southern states experienced the most notable rates of addiction and overdose. This finding was attributed to this group’s high level of involvement in manuallabor occupations and tendency to be uninsured and live in areas with few or no medical resources (Young, Havens, & Leukefeld, 2012). Many people's opioid addiction begins when they are prescribed these pills for legitimate pain. The State of Florida emerged as the epicenter of the national opioid epidemic. In 2010, the Florida Medical Examiners Commission's (FMEC) annual report revealed startling rates of deaths due to or related to oxycodone, hydrocodone, and other prescription opioids; in fact, more people died from opioids than from cocaine. The report found that, excluding alcohol, prescription drugs were 81% of all drug-related or drug-caused deaths (FMEC, 2011). In 2011, this rose to 83% (FMEC, 2012). The Florida legislature’s first contribution to the fight against prescription pill abuse was the authorization of the creation of a prescription drug monitoring program (PDMP) in 2009 (also known as E-FORSE; FS 893.055). The PDMP became operational in 2011. Law enforcement officers may become certified to access the PDMP directly; those who are not certified can gain access only via a certified officer or the Florida Department of Health (FDOH). The second major step occurred in 2010 with the official creation of the term "pain management clinic" (PMC) and requirement that certain medical establishments register with the FDOH as pain clinics under the law (FS 458.3265 (applicable to medical practices) and FS 459.0137 (applicable to osteopathic practice). There are two triggers which would require a medical office to register as a pain clinic: (a) if the clinic advertises in any medium that it offers pain management services; or (b) if in any month a majority of the clinic's patients are prescribed opioids, benzodiazepines, barbiturates, or carisoprodol for the treatment of chronic, nonmalignant pain. The third meaningful piece of legislation was House Bill (HB) 7095. Dubbed the "pill mill law," HB 7095 was signed into law on June 3, 2011 (and went into effect on July 1, 2011) and established several new regulations pertaining to the physical facilities of pain clinics and the acceptable minimum extent of medical examinations and follow-ups physicians must perform on patients before and after prescribing them opioids for the treatment of chronic, nonmalignant pain. HB 7095 was intended to compel physicians and clinics currently operating in a subpar manner to either improve or go out of business, while at the same time adding no burden to physicians already delivering high-quality, ethical care. This law also contained a dispensing ban, which prohibits PMCs from operating on-site pharmacies. Now, patients receiving prescriptions from PMCs must fill those prescriptions at independently operated community pharmacies (CPs). The present project is an overview of trends in PMCs occurring in the three years following the important changes to Florida law and policy that occurred primarily in 2011 (though changes began in 2009). Quantitative and qualitative data were collected. The first source of quantitative data is the FDOH, which is charged with receiving and approving applications, inspecting facilities, handling disciplinary allegations and hearings, and forcibly closing clinics found to be in persistent violation of regulatory standards. Second are three police departments serving large cities across the state, from which geocoded crime-incident data were obtained. Finally, qualitative data from in-depth interviews with law-enforcement officers around the state allow for a detailed look into the challenges law enforcement face in attempting to hold pain-management clinic physicians criminally liable. Details: Orlando, FL: Department of Criminal Justice University of Central Florida, 2017. 22p. Source: Internet Resource: Accessed March 21, 2017 at: https://www.ncjrs.gov/pdffiles1/nij/grants/250603.pdf Year: 2017 Country: United States URL: https://www.ncjrs.gov/pdffiles1/nij/grants/250603.pdf Shelf Number: 144536 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Addiction Drug Control Policy Prescription Drug Abuse Prescription Drugs

Author: Persuaduraan Korban Napza Indonesia (PKNI) Title: Women speak out: Understanding women who inject drugs in Indonesia Summary: The needs of women who inject drugs have largely been ignored by existing programmes and policies in Indonesia. The Indonesian Drug Users Network supported the implementation of the Perempuan Bersuara study to explore health needs, sexual and injecting risk behaviours, gender-based violence, contact with law enforcement, and harm reduction service accessibility among more than 700 women who inject drugs across multiple sites in West Java, Greater Jakarta, and Banten province. As people who use and inject drugs and direct beneficiaries of Indonesia's harm reduction and HIV response, we feel that the complex needs of women in our community have been neglected for far too long. There is an urgent need to develop gender-sensitive, low-threshold programmes and evidence-based drug policies that accommodate and respond to the specific needs of this group. Details: s.l.: Indonesian Drug Users Network, 2016. 28p. Source: Internet Resource: Accessed March 27, 2017 at: https://dl.dropboxusercontent.com/u/566349360/library/WomenSpeakOut_English_Web.pdf Year: 2016 Country: Indonesia URL: https://dl.dropboxusercontent.com/u/566349360/library/WomenSpeakOut_English_Web.pdf Shelf Number: 144592 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug-Related Violence Female Drug Users Gender-Specific Programs

Author: Corda, Alejandro Title: Cannabis in Latin America and the Caribbean: From punishment to regulation Summary: Cannabis (or marihuana) is one of the most widely consumed psychoactive substances in the world. According to the United Nations World Drug Report, 183 million people, or 3.8% of the world's population, used cannabis in 2014. Its cultivation was also reported by 129 countries. Cannabis is subject to the United Nations System for International Control of Narcotic Drugs and Psychotropic Substances (hereafter "drugs") and is the most widely consumed of all the drugs. According to that control system, cannabis is among the substances with the strictest legal status; they are the most prohibited, supposedly because of the harm they cause and their lack of medical usefulness. Nevertheless, its medicinal, spiritual and social use has been recorded in different places and times in human history, without serious associated consequences. Its prohibition began in the early 20th century, even though there were - and are - no records of overdose deaths, and public health risks are relatively low, even compared to other psychoactive substances with less strict legal status, such as alcohol and tobacco. Unlike other substances subject to control, which are produced in only certain regions of the world, cannabis is cultivated, produced and consumed worldwide. Some countries, however, have historically been regional producers or have a longer history or closer ties with the plant. On the American continent, this is true of Mexico in North America, Jamaica in the Caribbean, and Paraguay and Colombia in South America. Proposals for regulation of the cannabis market have been on the table for a number of years. The movement of users and growers has placed the issue on the social, political and media agenda, and there have been some reforms. One example is Uruguay, where the decision was made to regulate the market for cannabis for any kind of use. In other countries, however, reforms have been limited to regulating systems of access to cannabis for medicinal or therapeutic use. Although the international drug control system considers the possibility of "medical and scientific" use of cannabis, prejudices about the substance have hampered the development of regulations and acceptance by Western medicine. In fact, many "reforms" related to medicinal cannabis required only modification of low-level regulations. This means that a proposal being presented as novel is actually something that should always have existed. Key points The prohibitionist approach imposed on cannabis by the international drug control system still persists in nearly all of the Latin American and Caribbean countries examined. In almost all of them, possession falls under criminal law. Some countries' legislation establishes thresholds below which cannabis possession should not be considered a crime. Only in Uruguay does the law include regulation of the entire chain. Although cannabis organizations and other groups have managed to place the issue on the agenda, in most countries reforms are still pending or have been inadequate. The inclusion of relatives and users of cannabis for medicinal and therapeutic purposes has helped give impetus to the movement and to raise awareness among both political stakeholders and the public. Many of the reforms under way do not recognize the need to regulate the recreational and cultural use of cannabis and run the risk of perpetuating the current consequences, with the persistent impact on health, security, institutionality and human rights that the prohibition of cannabis and the lack of state regulation allow and encourage. The countries of Latin America and the Caribbean should prepare for future reform scenarios, instead of considering temporary measures that will perpetuate the same harmful consequences. Limiting reform solely to medicinal cannabis is only a partial, inadequate and temporary solution. If change is truly sought, it is necessary to move toward models of state regulation of cannabis for all purposes. Details: Amsterdam: Transnational Institute, 2016. 32p. Source: Internet Resource: Drug policy Briefing no. 48: Accessed April 6, 2017 at: https://www.tni.org/files/publication-downloads/dpb_48_eng_web_def.pdf Year: 2016 Country: Latin America URL: https://www.tni.org/files/publication-downloads/dpb_48_eng_web_def.pdf Shelf Number: 144729 Keywords: Cannabis Drug Abuse and Addiction Drug Offenders Drug Policy Drug Prohibition Drug Reform Marijuana

Author: Blickman, Tom Title: Morocco and Cannabis: Reduction, containment or acceptance Summary: This policy briefing discusses whether or not the aim of reducing cannabis cultivation is realistic or beneficial for Morocco, what it would actually mean for the major production area the Rif - one of the poorest, most densely populated and environmentally fragile regions in the country - and what that could imply for meaningful sustainable development. The briefing will give some historical background, discuss developments in the cannabis market, and highlight environmental and social consequences as well as the recent debate about regulation in Morocco and about European policies. KEY POINTS - Morocco continues to be the world's largest producer of cannabis resin (hashish). Over the past 50 years, the Moroccan cannabis growers shown a remarkable resilience to government attempts to eradicate or reduce cannabis cultivation as well as a noteworthy ability to adapt to changing international market conditions. - Since Morocco's independence the government has practiced a policy of containment regarding cannabis cultivation, allowing no new areas but tacitly allowing those already in production to be maintained. - The rapid increase in illicit cannabis cultivation in the Rif during the last decades, as well as poor soil conservation practices, have taken a heavy toll on the Rif's already threatened forests and fragile ecosystems. - The unregulated cannabis market in Morocco has negative social consequences. Some 48,000 growers have arrest warrants hanging over their heads, which is a source of corruption and repression. An amnesty and decriminalization could be effective measures to diminish negative social consequences and open the debate about regulation. - Cannabis farmers in Morocco should have access to emerging legally regulated cannabis markets that are gaining ground worldwide. The challenge is to find a sustainable development model that includes cannabis cultivation in Morocco, instead of excluding cannabis and ignoring the realities of more than 50 years of failed attempts to eradicate the only viable economic option in the region. Details: Amsterdam: Transnational Institute, 2017. 28p. Source: Internet Resource: Drug Policy Briefing, no. 49: Accessed April 6, 2017 at: https://www.tni.org/files/publication-downloads/dpb_49_eng_web.pdf Year: 2017 Country: Morocco URL: https://www.tni.org/files/publication-downloads/dpb_49_eng_web.pdf Shelf Number: 144730 Keywords: Cannabis Drug Abuse and Addiction Drug Markets Drug Offenders Drug Policy Drug Reform Marijuana

Author: Putri, Dania Title: Cannabis in Indonesia: Patterns in consumption, production, and policies Summary: Key Points - Traditional use of cannabis in Indonesia has mainly been found in the northern part of Sumatra, particularly in the Aceh region. Restrictions in production, use and distribution of cannabis were initiated by the Dutch colonial government in the 1920s following international actions on cannabis control. - Cannabis is the most widely used illicit substance in Indonesia, with approximately two million users in 2014. Under the current narcotics law cannabis is included in the mostrestrictive Schedule I list, along with substances such as heroin, and crystal meth or shabu. Penalties for cannabis-related offences are comparable to shabu- or heroin-related offences, in spite of the common perception that cannabis is less harmful. - The ambiguous nature of the narcotics law often triggers the victimisation of cannabis users who are either falsely accused as dealers, or have limited or no access to legal support during legal proceedings. Entrapment and extortion by law enforcement and security officers are widespread. - Government attempts to alleviate prison overcrowding by sending users to rehabilitation centres have triggered many criticisms, mainly due to their problematic methods (such as forced urine tests and breaches of patient confidentiality) and the questionable effectiveness of mandatory rehabilitation programmes, especially as the majority of cannabis users do not develop problematic use. - Decriminalizing use, possession for personal use and small-scale cannabis cultivation for personal use may help resolve various issues ranging from prison overcrowding to extortion of users by law enforcement officers, and may also free up human and financial resources to tackle problematic use. Details: Amsterdam: Transnational Institute, 2016. 24p. Source: Internet Resource: Drug Policy Briefing no. 44: Accessed April 12, 2017 at: https://www.tni.org/files/publication-downloads/dpb_44_13012016_map_web.pdf Year: 2016 Country: Indonesia URL: https://www.tni.org/files/publication-downloads/dpb_44_13012016_map_web.pdf Shelf Number: 144819 Keywords: Cannabis Drug Abuse and Addiction Drug Offenders Drug Policy Illicit Drugs Marijuana

Author: Crawford, Catherine Title: United Kingdom Drug Situation: Focal Point Annual Report 2016 Summary: Executive summary - Overall drug prevalence in the general population is lower now than ten years ago, with cannabis being the main driver of that reduction. However, there has been little change in recent years. - The order of drugs most commonly reported by respondents has not changed much over this time, with cannabis most prevalent (6.5%) followed by powder cocaine (2.2%) and ecstasy/MDMA (1.5%), according to the most recent Crime Survey for England and Wales. - Seizures data suggests that herbal cannabis has come to dominate the market. While resin was involved in around two-thirds of cannabis seizures in 2000, it was involved in only five per cent in 2015/16. - On 26 May 2016, the Psychoactive Substances Act 2016 came into force in the UK, prohibiting the production, supply, import/export and possession on prison grounds of psychoactive substances, other than those exempted by the legislation. This act was brought in to tackle the trade in new psychoactive substances (NPS) which has steadily grown in recent years. Over 350 premises in the UK trading in NPS have either closed or stopped selling substances covered by the legislation. - In addition, synthetic cannabinoid receptor agonists (SCRAs), a class of NPS whose use among the prison population and vulnerable people has caused concern, became controlled under the Misuse of Drugs Act 1971 as Class B substances in December 2016. - Temporary class drug orders on methylphenidate-related compounds (including ethylphenidate) and methiopropamine have been remade for another 12 months. - Using the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) definition, which refers to deaths caused directly by the consumption of at least one illicit drug, the total number of drug-related deaths (DRDs) in the UK during 2014 was 2,655; a five per cent increase from 2013 and the highest number reported to date. - Due to substantial delays being typical between occurrence and registration of DRDs in England and Wales, UK-wide DRD figures are not yet available covering deaths occurring beyond 2014. However, published statistics for DRDs occurring in Scotland during 2015 showed a 15% increase on 2014. - Deaths registered in 2015 in England and Wales were notably higher than deaths registered in 2014. It is therefore likely that DRD figures for 2015 will set a new record. - Across the UK there were 2,304 deaths reported which featured an opioid (87% of UK cases). As in previous years, the substance with the largest number of associated deaths was heroin. In contrast to the UK as a whole, tramadol was the most commonly mentioned opioid drug in Northern Ireland. - The proportion of deaths involving cocaine has risen; however, many of these deaths are believed to be heroin users who also use crack cocaine. - The number of MDMA-associated deaths in England and Wales rose to 57 cases, returning to levels seen prior to the decrease in availability of MDMA in the late 2000s. - Over the last decade the average age of death has increased from 37.6 years in 2004 to 41.6 in 2014, with males being younger than females (40.3 years and 44.6 years respectively). The largest proportion of deaths in the UK in 2014 was in the 40-44 years age group. - There were 124,234 treatment presentations in the UK in 2015. This total includes for the first time, data from individuals presenting to treatment services in prisons in England. - Fifty per cent of all treatment presentations in the UK were for primary opioid use, with 26% of all service users presenting for treatment of cannabis use. However, among those who had never previously been in treatment, just under half (48%) of clients had a primary substance of cannabis, compared to 21% who presented for treatment of heroin. The proportions of users presenting for treatment of these substances appear to have stabilised over the past two years. - The primary drugs cited by those presenting to specialist substance misuse treatment services varied notably between each of the four countries of the UK. While almost half of treatment entrants cited heroin in England, Scotland and Wales, less than 10% did in Northern Ireland. - Benzodiazepines were cited as a primary problem substance in far greater proportion of cases in Scotland and Northern Ireland than in England or Wales, whereas Wales had a far higher proportion of clients citing amphetamines/methamphetamines than in any of the other countries. - Treatment data from prisons showed that 27,836 individuals presented to treatment services in English prisons in 2015, with 564 presenting in prison in Northern Ireland; approximately one-quarter of the treatment clients from each country. Heroin was the most common primary substance among clients in England, whereas cannabis was the most common substance in Northern Ireland. - The use of NPS, and SCRAs in particular, remains a growing concern in prisons in the UK. Surveys carried out in England, Wales and Scotland found that around 10% of prisoners reported use of SCRAs while in prison, behind cannabis with a prevalence at around 15%. - The Prisons and Probation Ombudsman has found 64 deaths that occurred in prisons in England and Wales between June 2013 and April 2016 that were associated with NPS. NPS use has also been associated with self-harm incidents, intimidation and violence. - National Take-Home Naloxone programmes continue to supply naloxone to those exiting prison in Scotland and Wales: there were 932 kits issued by NHS staff in prisons in Scotland, and 146 in Wales, in 2015/16. - Prevalence of HIV among people who inject drugs (PWID) participating in the Unlinked Anonymous Monitoring (UAM) survey in England, Wales and Northern Ireland in 2015 was one per cent (a similar level to recent years). HIV prevalence among 'recent initiates' to injecting substantially increased in 2015 to 2.6%, the highest level seen in the last ten years. However, this likely represents an increase in prevalence among men who have sex with men rather than among the wider population who inject drugs. - There were 50 new diagnoses of HIV among PWID reported from Scotland, compared with 17 in 2014. This increase was due to an outbreak of HIV in PWID in Glasgow. - Around 90% of the hepatitis C infections diagnosed in the UK are acquired through injecting drug use. The prevalence of hepatitis C among PWID has remained fairly stable over the last ten years, and was 50% in the UAM survey of PWID in 2015. - Hepatitis B prevalence rates have also remained stable for 2015 at 13%. This is half the level seen ten years ago, with the decrease likely to be due to the increased uptake of the hepatitis B vaccination among the PWID population. - The level of direct sharing of needles and syringes reported by participants in the UAM Survey of PWID has declined over the last decade from 28% in 2005 to 16% in 2015. However, levels of concern have increased around the harms associated with people who inject NPS such as mephedrone. One-third of participants in the UAM survey of PWID who were currently injecting mephedrone reported they had shared needles or syringes previously used by someone else. - An Independent review into the impact on employment outcomes of drug or alcohol addiction, and obesity was published in December 2016 and made a number of recommendations to promote employment of those with addictions, including that those making a claim should be required to attend a structured discussion with a healthcare professional on the impact of their health condition on their ability to work. - The Association for Young People's Health, in conjunction with Public Health England, published A public health approach to promoting young people's resilience, to aid policy makers and commissioners. Similarly, Mentor-ADEPIS published a briefing paper aimed at teachers and practitioners on how building resilience can prevent substance abuse. - The numbers of recorded incidents of possession and supply offences across the UK, and arrests for drug offences in England and Wales, have fallen in 2015/16, continuing the trends seen over the past five years. In 2015/16, 31,342 supply/trafficking offences and 157,271 possession offences were recorded in the UK. - Heroin purity has continued to rise since the low level seen in the early 2010s, and in 2015 was 44%, more than twice the purity seen in 2011 and 2012 when it reached its nadir. Similarly, cocaine purity, which was at its lowest in 2010, has risen since that time, and in 2015 was also 44%. - Street level price data from law enforcement agencies suggests that most recorded drug prices have remained stable in recent years. - The number of cannabis seizures in all forms in England and Wales in 2015/16 decreased, continuing the downwards trend seen in recent years. Cocaine, ecstasy and heroin seizure numbers all remained stable, while the number of crack seizures increased in 2015/16. Details: London: United Kingdom Focal Point at Public Health England, 2017. 180p. Source: Internet Resource: Accessed April 17, 2017 at: http://www.nta.nhs.uk/uploads/2905931ukdrugsituation2016webaccessible.pdf Year: 2017 Country: United Kingdom URL: http://www.nta.nhs.uk/uploads/2905931ukdrugsituation2016webaccessible.pdf Shelf Number: 144988 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Enforcement Drug Offenders Drug Treatment Illegal Drug Use

Author: Castiglioni, Sara, ed. Title: Assessing illicit drugs in wastewater: Advances in wastewater-based drug epidemiology Summary: Assessing illicit drugs in wastewater: advances in wastewater-based drug epidemiology reviews a new approach to estimating drug use in populations, based on the detection and quantification of drugs and their metabolic products in community wastewater. Strengths of the wastewater-based approach include avoiding the problems associated with questionnaire-based research, better identification of the drugs being used and being able to provide near-real-time results, with the power to identify trends in drug use patterns, over time and geographically. Novel uses of the approach are explored, such as the early detection of new psychoactive substances on the drug market. The report also looks at the limitations to the approach and how these can be overcome for this new tool to take its place in the drug epidemiologist�s toolkit. Details: Lisbon: European Monitoring Centre for Drugs and Drug Addiction, 2016. 82p. Source: Internet Resource: Accessed May 6, 2017 at: http://www.emcdda.europa.eu/system/files/publications/2273/TDXD16022ENC_4.pdf Year: 2016 Country: Europe URL: http://www.emcdda.europa.eu/system/files/publications/2273/TDXD16022ENC_4.pdf Shelf Number: 145326 Keywords: Drug Abuse and Addiction Environmental crime Illicit Drugs Offenses against the Environment Pollution Wastewater

Author: Camacho, Adriana Title: Drug Consumption in Colombia Summary: This paper examines the evolution of drug use in Colombia over the past years. Our analysis, based on surveys from the Direccion Nacional de Estupefacientes, shows that drug consumption grew substantially between 1996 and 2013. The growth occurred for both genders, all ages, socioeconomic strata and types of occupation. The results also suggest that men of high socioeconomic strata who regularly consume alcohol and cigarettes and who are between 18 and 24 years of age are more likely to use drugs. Finally, the paper presents some indirect evidence that contradicts the alleged effects of the judgment of the Constitutional Court (Sentencia C-221 of May 1994) that decriminalized the personal dose on the consumption of drugs in Colombia. Details: Bogota: Universidad de los Andes, Colombia - Department of Economics, 2016. 32p. Source: Internet Resource: Documento CEDE No. 2016-36: Accessed May 9,. 2017 at: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2877199 Year: 2016 Country: Colombia URL: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2877199 Shelf Number: 145363 Keywords: Drug Abuse and Addiction Drug Legalization Drug Policy

Author: Australian Institute of Health and Welfare Title: Alcohol and other drug treatment services in Australia 2015-16 Summary: In 2015-16, about 796 alcohol and other drug treatment services provided just over 206,600 treatment episodes to an estimated 134,000 clients. The top 4 drugs that led clients to seek treatment were alcohol (32% of treatment episodes), cannabis (23%), amphetamines (23%), and heroin (6%). The proportion of episodes where clients were receiving treatment for amphetamines has continued to rise over the 5 years to 2015-16, from 12% of treatment episodes in 2011-12 to 23% in 2015-16. The median age of clients in AOD treatment services is rising, from 31 in 2006-07 to 33 in 2015-16. Details: Canberra: AIHW, 2017. 85p. Source: Internet Resource: Drug Treatment Series No. 29: Accessed July 5, 2017 at: http://www.aihw.gov.au/publication-detail/?id=60129559769 Year: 2017 Country: Australia URL: http://www.aihw.gov.au/publication-detail/?id=60129559769 Shelf Number: 146509 Keywords: Alcohol Treatment Drug Abuse and Addiction Drug Treatment Substance Abuse Treatment

Author: Bronson, Jennifer Title: Drug Use, Dependence, and Abuse Among State Prisoners and Jail Inmates, 2007-2009 Summary: Presents prevalence estimates of drug use, drug use disorders, and participation in drug treatment programs among state prisoners and sentenced jail inmates, including trends in drug use over time by demographics and most serious offense, drug use at the time of offense and whether an inmate committed the offense to obtain drugs, and comparisons to the general population. Data are from BJS's National Inmate Survey, conducted in 2007 and 2008-09. Comparisons to the general population are based on the Substance Abuse and Mental Health Services Administrations National Survey on Drug Use and Health, conducted in 2007, 2008, and 2009. Highlights: During 2007-09, an estimated 58% of state prisoners and 63% of sentenced jail inmates met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for drug dependence or abuse. Among prisoners and jail inmates, prevalence estimates for those who met the criteria for dependence were two to three times higher than for abuse. The percentage of inmates who met the DSM-IV criteria was higher for those held for property offenses than those held for violent or other public order offenses. Lifetime drug use among the incarcerated populations was unchanged from 2002 to 2009. During 2007-09, prisoners (77%) and jail inmates (78%) reported having ever used marijuana/hashish, more than any other drug. Details: Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, 2017. 27p. Source: Internet Resource: Accessed September 11, 2017 at: https://www.bjs.gov/content/pub/pdf/dudaspji0709.pdf Year: 2017 Country: United States URL: https://www.bjs.gov/content/pub/pdf/dudaspji0709.pdf Shelf Number: 147212 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders Jail Inmates Prisoners

Author: Camera, Gabriele Title: Nonmedical Prescription Drug Use: Theory and Policy Implications Summary: The illicit nonmedical use of prescription drugs is studied in a model where individuals with imperfectly observable health conditions seek prescription drugs for either medical or nonmedical reasons. The equilibrium number of medical and nonmedical users is endogenous and depends on economic and non-economic barriers to drugs consumption, such as pricing, health care costs, refill policies, monitoring programs, and the medical community's prescription standards. The results show policies centered around raising economic barriers reduces nonmedical use but inhibits medical use due to imperfect screening. Alternatively, the results suggest a national drug registry may be more effective at preventing nonmedical use. Details: Worcester, MA: Department of Economics, College of the Holy Cross, 2014. 30p. Source: Internet Resource: FACULTY RESEARCH SERIES, PAPER NO. 14-02: Accessed September 18, 2017 at: http://web.holycross.edu/RePEc/hcx/HC1402-Engelhardt-Camera_PrescriptionDrugs.pdf Year: 2014 Country: United States URL: http://web.holycross.edu/RePEc/hcx/HC1402-Engelhardt-Camera_PrescriptionDrugs.pdf Shelf Number: 147369 Keywords: Drug Abuse and Addiction Illegal Drugs Prescription Drug Abuse

Author: Curtin University. National Drug Research Institute Title: The Social Costs of Methamphetamine in Australia 2013/14 Summary: Australia has one of the highest documented rates of methamphetamine use in the world, with about 2.1% of the population aged 14 years and over reporting they have used methamphetamine in the past year. Recent changes in the purity and form of methamphetamine have resulted in a significant rise in public concern and media interest in the harms associated with the consumption of methamphetamine. As documented in this report, methamphetamine consumption is associated with a diverse range of harms and costs to individual drug users, their families and wider society. The objective of this project was to estimate the cost of methamphetamine use to Australia for a specific year (2013/14) rather than the future costs arising from use in that year, due to limitations in the available data and the level of uncertainly concerning future outcomes. Thus, other than years of life lost due to premature mortality, the costs do not include costs for treating chronic health conditions or lower levels of productivity over the lifespan. The harms and costs of drug use are substantially increased for dependent drug users compared with other users(Moore, 2007). We based our analyses on an estimated 160,000 dependent methamphetamine users and 108,000 regular nondependent users (Degenhardt et al., 2016a). There are also estimated to be 240,995 people in Australia who use methamphetamine occasionally (Australian Institute of Health and Welfare, 2014a). Finally, we excluded the private costs incurred by non-dependent methamphetamine users. However, the private costs or the "internalities" of dependent drug use were quantified but not added to the overall total. The report identified a range of prevention, supply reduction, harm reduction and treatment initiatives targeting the use of methamphetamine. In 2013/14 school based programs were the major prevention approach, with no substantial general population programs being identified in that year. Supply reduction programs were evident at the local level, through jurisdiction level policing or initiatives such as ProjectStop, which aims to limit access to precursor chemicals through the purchase of some over-the-counter medicines. Nationally, there were initiatives to regulate the commercial supply of chemicals and products that could be used in clandestine laboratories. The major harm reduction initiatives were existing programs that aim to reduce harms from injecting drug use (e.g. needle and syringe programs) that also involve some users of methamphetamine. However, treatment programs, such as withdrawal management, counselling services and residential rehabilitation, were the largest cost items in this area. Chapter 4 provides costing for these items. Details: Perth, Western Australia: The Research Institute, 2016. 200p. Source: Internet Resource: Accessed October 27, 2017 at: https://ndri.curtin.edu.au/local/docs/pdf/publications/T246.pdf Year: 2016 Country: Australia URL: https://ndri.curtin.edu.au/local/docs/pdf/publications/T246.pdf Shelf Number: 147843 Keywords: Costs of Drug Abuse Drug Abuse and Addiction Drug Abuse Treatment Methamphetamine Substance Abuse

Author: Dow, Martha Title: A Response to Illicit Drug Overdoses: Naloxone Administration in Surrey and Vancouver, British Columbia Summary: The administration of naloxone by fire first responders was initiated in Vancouver and Surrey in response to increasing opioid related overdose incidents along with the inability of first responders' to administer an antidote treatment. The naloxone administration protocol was implemented in February 2016 and this study discusses the experiences to date in both cities. Overall, the initial training and subsequent follow-up was favourably received by members and prepared them for administering naloxone in overdose situations. This study examines, within the current context, lessons learned and opportunities for future engagement with members to support, at the highest level possible, proactive approaches to pre-hospital patient care. Given the current context, fire first responders represent a crucial aspect in any opioid overdose response. Prior to the opioid crisis, fire first responders were restricted to basic paramedical protocols for life-saving interventions such as oxygen administration, auto defibrillators, and cardiopulmonary resuscitation (CPR). In an effort to address the provincial opioid crisis, British Columbia Emergency Health Services (BCEHS) trained fire first responders in Surrey and Vancouver to administer the opioid overdose reversing drug "Naloxone" via intramuscular injection. This study reviewed the training process and efficacy of fire first responders utilizing intramuscular injection protocols to administer life-saving overdose drugs. The evidence for this study was gathered through quantitative and qualitative approaches. Naloxone administration training was well-received and fire first responders easily adapted to the new paramedical protocol of administering intramuscular injections. Fire first responders in Surrey and Vancouver successfully reversed over 240 opioid overdoses in 2016. Details: Abbotsford, BC: University of the Fraser Valley, Centre for Social Research, 2017. 21p. Source: Internet Resource: Accessed November 6, 2017 at: https://www.ufv.ca/media/assets/centre-for-social-research/Naloxone-study-(UFV-research-note)-March-2017.pdf Year: 2017 Country: Canada URL: https://www.ufv.ca/media/assets/centre-for-social-research/Naloxone-study-(UFV-research-note)-March-2017.pdf Shelf Number: 148043 Keywords: Drug Abuse and Addiction Illicit Drugs Opioids

Author: McLean, Rachel Title: The WINDOW Study: Release from Jail: Moment of Crisis or Window of Opportunity for Female Detainees in Baltimore City? Summary: The numbers of women in prisons and jails has increased substantially in the past decade. The rate at which women are incarcerated increases each year. Female prisoners face different challenges than male prisoners. Incarcerated women are more likely than incarcerated men to have suffered from sexual abuse, be HIV positive, have a history of substance use and/or mental health issues, to be mothers, and to be unemployed at the time of arrest. Women are most often arrested for non-violent offenses such as drug possession, theft and prostitution, which stem from drug use and poverty. Women's needs upon reentry to the community differ as well, with an emphasis on family reunification, housing, drug treatment and childcare often superseding employment. Just as women differ from men in terms of their needs in prison and upon release, so do women exiting short periods of detention in jails differ from those exiting prisons. Women in jail are less likely to have had the time to make use of in-house programming than women in prison or to have post-release supervision through parole. For this reason, community based resources are needed to provide services to women exiting jails to stabilize women's lives and prevent their re-arrest. Particular attention is needed for communities in Baltimore City to which a large number of prisoners and detainees return that lack the capacity to provide jobs, housing and social support. Little is known about the needs unique to women exiting jails. The Window Study sought to identify the needs unique to women detained in the Baltimore City Women's Detention Center. One hundred forty eight female detainees at WDC were anonymously interviewed by public health graduate students from the Johns Hopkins University Bloomberg School of Public Health between January and March of 2005. The Window Study found high rates of mental illness, recent daily heroin and cocaine use, and commercial sex work among participants. Most women did not have insurance, and chronic diseases such as asthma, high blood pressure and diabetes were common. Five percent of female detainees interviewed reported being infected with HIV, and four percent reported being pregnant. Three quarters desired drug treatment upon release, and over half reported having been unable to afford drug treatment. Nearly half of detainees had no legal income prior to arrest, lacked a GED or high school diploma, and had no stable housing awaiting them upon release. An additional one fifth reported making less than $400/month. One quarter of women reported difficulties with literacy. Two-thirds did not have anyone to meet them at the moment of release. Thirty percent planned to walk or did not have a mode of transportation upon release. Eleven percent of women reported that there would be people using drugs or on probation at the place where they would be staying. Of the 80% of women with children, 58% had custody of at least one child. Women with strong family ties, insurance, and who lived in safe neighborhoods were more likely to have stable housing awaiting them upon release. Women with a history of sex work, and those who identified as bisexual or lesbian were less likely to have a place to stay upon release. The WINDOW Study identified a need for developing a continuum of care that addresses the immediate needs of women exiting pretrial detention, principally transportation, affordable housing, drug treatment, economic opportunity, assistance with entitlements and family reunification. Particular attention is needed for women struggling with addiction, lesbian and bisexual women, and those engaging in commercial sex work. Details: Baltimore, MD: Power Inside, 2005. 29p. Source: Internet Resource: Accessed November 7, 2017 at: http://www.realcostofprisons.org/pdfs/WINDOW%20ReportFinal.pdf Year: 2005 Country: United States URL: http://www.realcostofprisons.org/pdfs/WINDOW%20ReportFinal.pdf Shelf Number: 148060 Keywords: Drug Abuse and Addiction Female Inmates Female Offenders Female Prisoners Jail Inmates Sex Workers

Author: Wish, Eric D. Title: Community Drug Early Warning System (CDEWS-3): Maryland - Site 4 of 4 Summary: The Community Drug Early Warning System (CDEWS) provides timely information about emerging drug use in criminal justice populations in local communities by collecting and re-testing urine specimens already obtained and tested for a limited panel of drugs by local criminal justice testing programs. CDEWS or local staff sample specimens that are ready to be discarded and send them to an independent laboratory for testing for an expanded panel of over 150 drugs. By using already collected de-identified urine specimens, CDEWS is able to provide a relatively quick and inexpensive snapshot of the types of drugs recently used by participating populations. The CDEWS methodology has now been piloted in twelve jurisdictions and the results are provided in five reports already released by the Office of National Drug Control Policy (ONDCP). This report presents findings from adult parolees and probationers in a single jurisdiction -- Maryland -- as part 4 of 4 sites for the third CDEWS Study, called CDEWS-3. This study was conducted somewhat differently from prior CDEWS studies. This is because we wanted to replicate the findings from a study we had conducted in Maryland in 2008. And second, because of the opioid epidemic in Maryland, the State asked us to collect and analyze a separate large sample of specimens statewide that had tested positive for opiates by the laboratory used by the Maryland Division of Parole and Probation (DPP). With the strong support of the DPP, we collected two samples of specimens: the Maryland Regional Sample (N=288) and the Opiate Positive (Opiate+) Sample (N=202 statewide). Specimens were classified as CJS+ (tested positive for any drug) or CJS- (tested negative for all drugs) according to the results from the DPP laboratory's 4-drug screen. The findings from the Maryland Regional Sample indicated that most of the persons who had tested positive for one of the drugs in the CDEWS larger test panel had also tested positive for one of the four drugs in the DPP drug screen. However, approximately one in ten CJS+ specimens also contained antidepressants, synthetic cannabinoids (SC), methadone and/or other licit pharmaceutical opioids, drugs not tested for by the limited DPP screen. The additional drugs the CDEWS lab detected may not have practical significance for the DPP, given that most of these specimens did test positive for a drug in the DPP's limited screen. It is not possible to tell from the urinalyses if the persons taking the licit drugs were doing so legally under a physician's supervision. In contrast, 15% of the specimens that the DPP screen indicated did not contain a drug (CJS-) contained an opioid. Methadone and buprenorphine were among the opioids most found in CJS specimens and it is possible that these persons were receiving treatment with these drugs. Antidepressants were identified in as many CJS- specimens as CJS+ specimens (9%). SC was found in CJS- specimens but these metabolites were less common than in CJS+ specimens. These results suggest that in this population, persons were unlikely to be using SC to avoid detection by the standard DPP tests. The comparisons of probationers/parolees in this study and our earlier study in 2008 show considerable agreement in the drugs detected. The primary changes were a decline in cocaine (36% to 17%) and buprenorphine (15% to 7%) and an increase in codeine (3% to 13%) among CJS+ specimens. The increase in codeine positives may be the result of the increased sensitivity of the tests used in the current study. The results from the Opiate+ Sample strongly indicated that probationers/parolees who had tested positive for opiates by the DPP screen were likely to be using a variety of legal and illegal opioids in addition to non-opioid drugs. About one in three also used cocaine, one fifth used marijuana and/or benzodiazepines and about one quarter used a prescription opioid other than morphine or codeine. These results therefore have important implications for the testing used by physicians and diagnosticians who need to know if patients are using other drugs. Use of multiple opioids at the same time may lead to serious health complications and even death. We also conducted special analyses of the combined specimens found in either sample to be positive for fentanyl, synthetic cannabinoids, or codeine. Perhaps some of the most meaningful results in this study were those showing the large number of opioid and non-opioid drugs found in the fentanyl+ specimens. The 21 specimens positive for fentanyl each contained an average of 5 different drugs, most prominently morphine, codeine, 6-MAM (heroin), cocaine, and/or hydromorphone. The findings for fentanyl+ specimens were similar to those described above for the entire sample of Opiate+ specimens and our recent study of 136 persons who died of a fentanyl related overdose in New Hampshire. It is clear that probationers/parolees in Maryland who screen positive for any opioids are likely to be using a variety of other opioid and non-opioid drugs. These findings suggest that treatment will be more effective if one identifies and focuses on the totality of drugs the person may be using. Our analysis of the combined sample of all specimens positive for SC supported the findings from our previous CDEWS studies that found multiple SC metabolites in specimens. Surprisingly, specimens from the current study often contained both new and older generation SC metabolites. Given the unpredictable composition of synthetic cannabinoids (also known as Spice or K2) being marketed, it is not possible for users to know what chemicals they are consuming and to predict the effects. SC was less likely to be found in the Maryland samples compared to other CDEWS study samples, and few persons who tested CJS- in the Maryland Regional Sample were found to test positive for SC. Probationers in Maryland may therefore be less likely than other populations CDEWS has studied to use SC to avoid screening positive by the CJS test screens, which do not typically test for SC. We also found that 70% of the Opiate+ specimens contained codeine and that codeine was found across the state. In addition, codeine was detected in 81% of fentanyl+ specimens from the combined Opiate+ and Maryland Regional samples. Acetylcodeine, which metabolizes into codeine, is often produced as an impurity of illicit heroin synthesis, which may explain the large percentage of specimens positive for codeine given that almost all of the specimens also contained morphine. It is also possible that some of the codeine positives were the result of the direct use of codeine. We suspected that some of the codeine detected might have been caused by the use of "Purple Drank", a mixture of codeine syrup and promethazine typically sold as a cough suppressant, that has been reported in Maryland. However, only 4% of the codeine positive specimens contained promethazine. Given that the half-life of promethazine is longer than that of codeine, one would expect to have detected promethazine in these specimens had "Purple Drank" been the source of the codeine. It is also possible that the codeine may have resulted from codeine extracted from pills containing the drug. Additional research is needed to learn more about the codeine that was detected in 60% or more of probationers across all regions of Maryland and how the use of codeine may relate to the State's current opioid epidemic. Details: Washington, DC: Office of National Drug Control Policy Executive Office of the President, 2017. 57p. Source: Internet Resource: Accessed November 29, 2017 at: https://ndews.umd.edu/sites/ndews.umd.edu/files/finalreport_cdews3_mdapproved.pdf Year: 2017 Country: United States URL: https://ndews.umd.edu/sites/ndews.umd.edu/files/finalreport_cdews3_mdapproved.pdf Shelf Number: 148578 Keywords: Drug Abuse and Addiction Drug Control Policy Drug Enforcement Drug Offenders Drug Testing Illicit Drugs Parolees Probationers Urine Testing

Author: Wish, Eric D. Title: Community Drug Early Warning System (CDEWS-3): Honolulu, Hawaii - Site 1 of 4 Summary: The Community Drug Early Warning System (CDEWS) provides timely information about emerging drug use in criminal justice populations in local communities by collecting and re‐testing urine specimens already obtained and tested for a limited panel of drugs by local criminal justice testing programs. CDEWS or local staff sample specimens that are ready to be discarded and send them to an independent laboratory for testing for an expanded panel of drugs. By using already collected de‐identified urine specimens, CDEWS can provide a relatively quick and inexpensive snapshot of the types of drugs recently used by participating populations. The CDEWS methodology has been implemented in five jurisdictions and the results are contained in two reports already released by the Office of National Drug Control Policy (Wish et al., 2013, 2015). We introduce here a new report format that contains the findings from a single jurisdiction - the Hawaii's Opportunity Probation with Enforcement (HOPE) and General Supervision (GS) probationer populations in Honolulu, Hawaii - as part 1 of 4 sites for the third CDEWS Study, called CDEWS‐3. In 2004, Judge Steven Alm launched the HOPE program in Hawaii. HOPE enrolls higher risk felony probationers with serious criminal histories and extensive substance abuse histories in a program that includes frequent urine drug monitoring coupled with brief jail sanctions for drug violations (The Institute for Behavior and Health, Inc., 2015). With Judge Alm's strong support, local staff were able to provide anonymous urine specimens previously collected from a sample of adult male probationers from the HOPE program (n=194) and the neighboring GS probation program (n=143), which were then sent to the CDEWS independent laboratory for expanded testing. While the onsite screens used by the HOPE and GS probation programs only tests for 6 drugs, the CDEWS independent laboratory tested for over 150 legal and illegal drugs. The expanded testing showed that the current onsite test screens used by these programs had identified most of the drug users in the HOPE and GS probationer programs. The most common drugs found were methamphetamine and amphetamine. Any additional legal and illegal drugs detected by the CDEWS independent laboratory were primarily detected in specimens that had previously tested positive for at least one of the drugs in the standard local onsite screens. The major exception was methamphetamine, which was detected in a minority of the specimens that had tested negative for all drugs, including methamphetamine, by the onsite criminal justice system (CJS) drug screens. Subsequent analyses suggested that this under‐detection was because the onsite screens for methamphetamine were less sensitive than the tests utilized by the CDEWS independent laboratory. We had hypothesized that the HOPE probationers might be more likely than GS probationers to turn to synthetic cannabinoids (SCs) to evade detection, because of the HOPE program's focus on sanctioning people for "dirty" urines. While SCs were found only in specimens that had tested negative by the CJS onsite drug screens, few specimens (2% or less) from HOPE or GS probationers tested positive for SC. However, the SC metabolites that were detected were later generation SC metabolites recently added to the CDEWS‐3 laboratory test panel. None of these later generation metabolites could have been detected by either the onsite or laboratory SC screens used by the GS and HOPE probation programs at the time of the study. This finding attests to the need for jurisdictions to routinely update their test panels for synthetic drugs, whose formulations tend to change rapidly. Although SC use was found in some probationers in this jurisdiction in Hawaii, SCs may not be as large a problem as was found in some prior CDEWS studies. Nevertheless, the Hawaii HOPE and GS programs may want to consider expanding their SC test panel to include the newer SC metabolites (AB‐PINACA, 5F‐AB‐PINACA, AB‐CHMINACA (metab 4), 5F‐AMB) that were detected in their populations. Details: Washington, DC: Office of National Drug Control Policy, Executive Office of the President, 2016 37p. Source: Internet Resource: Accessed November 29, 2017 at: https://obamawhitehouse.archives.gov/sites/default/files/ondcp/policy-and-research/cdews3_hawaii_final.pdf Year: 2016 Country: United States URL: https://obamawhitehouse.archives.gov/sites/default/files/ondcp/policy-and-research/cdews3_hawaii_final.pdf Shelf Number: 148580 Keywords: Drug Abuse and Addiction Drug Control Policy Drug Enforcement Drug Offenders Drug Testing Urine Testing

Author: Great Britain. HM Inspectorate of Probation Title: New Psychoactive Substances: the response by probation and substance misuse services in the community in England Summary: The prevalence of NPS is hard to quantify for several reasons. Synthetic drug manufacture is not geographically constrained and this prevents an estimation of the volume of such drugs being manufactured worldwide. Users of NPS often don't know what they are taking, and in some cases they have been misled, with NPS passed off as more conventional drugs such as ecstasy. In addition, GPs, accident and emergency departments, probation services and the police do not specifically record NPS use. While the overall size of the NPS market is small in comparison with other drugs, an increasing number of countries are reporting seizures of NPS. There is also growing recognition of the harm associated with NPS use - often the result of crude manufacturing techniques and unpredictable dosage levels. As a result, they can be more lethal than other drugs. Concern is also rising about their use among marginalised populations such as prisoners and street homeless, attracted by the availability and low cost of NPS. Treatment options are more limited than with other substances, for example opioids, where substitutes are available. In most cases, treatment involves psychosocial interventions to help people consider the health risks and the costs of using NPS, and to help them make behavioural changes to reduce harm and moderate their drug use. We came across two areas using clinical detoxification to help manage withdrawal from NPS use. Overall, inspected areas did not have a good enough understanding of the prevalence of NPS use at a local level or what may work for those using NPS. While the UK government has issued advice and guidance for commissioners and substance misuse services, in the main, strategies have focused on crisis management to address emergencies. While local management relationships between substance misuse services and probation providers were good, probation engagement at a strategic level was less consistent. Where the strategic response was appropriately coordinated, for example in Newcastle, it included longer-term actions for agencies to work together and address NPS-related concerns locally. They were also more likely to be collecting NPSspecific data. Partnership working was strongest in probation teams that worked in collaboration with other agencies, such as Integrated Offender Management, and in cases where service users had court-imposed or licence conditions to engage with substance misuse services. In other cases, work was often being done in isolation. We found the assessments and plans completed by substance misuse services sufficient overall. In line with Public Health England guidance, substance misuse services worked with the individual symptoms and not specifically on the drug that the individual used. We were told that this national guidance that NPS users should be treated the same as other drug users was the reason that NPS-specific training had not been rolled out to all keyworkers - we found that this had led to a significant gap. Without specific training, keyworkers relied on their more experienced colleagues and their own research to increase their knowledge and understanding. The most skilled practitioners had developed NPS toolkits, which were then used in individual work with service users. Where these were being used, we found that there was more awareness of the risks and effects of using NPS. However, many NPS users were not accessing available services. All the cases we inspected were known either to have used or be currently using NPS, yet probation assessments lacked sufficient information to explore the pattern, level and funding of NPS use. Many users experienced problems with housing, mental health, relationships and finances. Some had lost placements in hostels or housing tenancies for reasons that were often related to their NPS use, but responsible officers rarely identified this. In the process, those who lost their accommodation ended up on the streets, sleeping rough in an environment where NPS were easy to obtain and frequently used. Worryingly, probation providers did not routinely consider the risks associated with NPS use to groups such as children, staff, prisoners or the wider community, despite there being enough known about the unpredictable behaviour that could be displayed by those using the drugs. Two Community Rehabilitation Companies had developed short-duration substance misuse interventions. NPS use was only covered to a basic standard, with many attendees being better informed than responsible officers. We found no evidence that the Building Skills for Recovery accredited programme, which is designed to reduce offending behaviour and problematic substance misuse, was used for NPS users by either the National Probation Service or Community Rehabilitation Companies. Responsible officers were rarely able to talk to NPS users about their symptoms and consolidate work undertaken by substance misuse services. While probation providers were making appropriate referrals to substance misuse services, these were not always responded to in a timely fashion. Service user engagement was often sporadic and responsible officers did not do enough to support NPS users to re-engage. We found poor-quality information-sharing. Prisoners were being released into the community often with no information shared about their NPS use in prison, and release plans did not meet the needs of the prisoner in relation to their substance misuse. We found good recording of information by substance misuse keyworkers who had access to probation IT systems. In many cases, however, we found that substance misuse services held information that would have improved the quality of probation assessments and plans but was not being shared. NPS users were disengaged from services, insufficient progress had been made to address NPS use and in many cases no other work was taking place either. NPS users lacked trust in the help and support available, and many turned to using NPS to forget their problems. Confidence, knowledge and awareness were the key areas that affected the quality of work for both probation and substance misuse services. While some training had been provided, this was often not sufficient for practitioners and was no longer up to date. As a result, responsible officers and many substance misuse keyworkers were not confident enough to undertake harm minimisation work with NPS users. While clinical guidance is available, not enough has been provided to inform professionals working with NPS users on community orders in the criminal justice system. Details: Manchester, UK: Her Majesty's Inspectorate of Probation, 2017. 59p. Source: Internet Resource: Accessed November 30, 2017 at: http://www.justiceinspectorates.gov.uk/cjji/wp-content/uploads/sites/2/2017/11/New-Psychoactive-Substances-report.pdf Year: 2017 Country: United Kingdom URL: http://www.justiceinspectorates.gov.uk/cjji/wp-content/uploads/sites/2/2017/11/New-Psychoactive-Substances-report.pdf Shelf Number: 148589 Keywords: Drug Abuse and Addiction Drug Offenders Drug Treatment Probation Officers Probationers Substance Abuse Substance Abuse Treatment Synthetic Drugs

Author: Henzel, Paula Ditton Title: Behavioral Health Needs of Jail Inmates in Washington State Summary: THIS REPORT DESCRIBES the characteristics of 123,240 individuals booked into jail in 2013 who were recent or former clients of the Washington State Department of Social and Health Services (DSHS) or the Health Care Authority (HCA). We compare mental health and substance use disorder treatment needs among the 44,805 Medicaid enrollees booked into jail and the general Medicaid population. To identify behavioral health treatment needs among Medicaid recipients booked into jail, we matched statewide jail booking records with mental health and substance use disorder indicators in the DSHS Integrated Client Database (ICDB). Mental health treatment needs were identified by receipt of publicly funded mental health treatment services, prescriptions for psychotropic medications, and mental health-related medical service encounters, hospitalizations and diagnoses during the jail booking year or the year prior. Substance use disorder treatment needs were identified using a comprehensive set of indicators including diagnoses, procedures, prescriptions, treatment or arrests that reflect a possible substance use disorder. Details: Olympia, WA: Washington State Department of Social and Health Services, 2016. 10p. Source: Internet Resource: RDA Report 11.226: Accessed December 6, 2017 at: https://www.ofm.wa.gov/sites/default/files/public/legacy/sac/pdf/research-11-226a.pdf Year: 2016 Country: United States URL: https://www.ofm.wa.gov/sites/default/files/public/legacy/sac/pdf/research-11-226a.pdf Shelf Number: 148739 Keywords: Drug Abuse and Addiction Jail Inmates Jails Mental Health Services Mentally Ill Inmates Substance Abuse Treatment

Author: Wish, Eric D. Title: Community Drug Early Warning System (CDEWS-3): Ohio -- Site 2 of 4 Summary: The Community Drug Early Warning System (CDEWS) provides timely information about emerging drug use in criminal justice populations in local communities by collecting and re‐testing urine specimens already obtained and tested for a limited panel of drugs by criminal justice testing programs. CDEWS or local staff sample specimens that are ready to be discarded and send them de‐ identified to an independent laboratory for testing for an expanded panel of drugs. The CDEWS methodology has been implemented previously in five jurisdictions with non‐prison populations (Wish et al., 2013; Wish et al., 2015). This report describes the first CDEWS study of prison inmates, conducted in the Belmont and Ross Correctional Institutions for adult males in Ohio. This report is the second of 4 reports that are part of the third CDEWS Study, CDEWS‐3. Urine drug testing is conducted in these facilities on the basis of the inmate's assignment to one of three test groups: Random, For Cause, and treatment Program testing. Specimens are tested by the correctional institution for a panel of 8 drugs. Specimens that had tested positive (CJS+) or negative (CJS‐) for any drug by the prison drug screen were selected from each of the test groups for inclusion in the study. A total of 108 usable specimens were obtained from Belmont and 85 specimens from Ross. The most dramatic findings from this study involved the detection of two types of prescription drugs in both institutions, buprenorphine, a prescribed opioid used to treat substance use disorder for opioids, and antidepressants. Buprenorphine is not prescribed for treatment in these institutions and it is not clear how much of the antidepressants detected were prescribed by the physicians at the prison. While marijuana use was detected in these institutions, it is noteworthy that not a single specimen tested positive for a synthetic cannabinoid. In contrast to other criminal populations studied by CDEWS in other locations, there was no evidence of synthetic cannabinoid use to avoid detection by the prison's drug testing program. This study demonstrated that the CDEWS methodology could be adapted for prison settings. While the use of buprenorphine and marijuana was already being detected by these institutions' testing programs, the extensive use of antidepressants uncovered may be a new finding. Details: Washington, DC: Office of National Drug Control Policy Executive Office of the President, 2016. 36p. Source: Internet Resource: Accessed December 6, 2017 at: https://ndews.umd.edu/sites/ndews.umd.edu/files/pubs/finalreport-cdews3-oh-v31-final-for-distribution.pdf Year: 2016 Country: United States URL: https://ndews.umd.edu/sites/ndews.umd.edu/files/pubs/finalreport-cdews3-oh-v31-final-for-distribution.pdf Shelf Number: 148740 Keywords: Drug Abuse and Addiction Drug Control Policy Drug Enforcement Drug Testing Illicit Drugs Urine Testing

Author: Ghandnoosh, Nazgol Title: Opioids: Treating and Illness, Ending a War Summary: More people died from opioid-related deaths in 2015 than in any previous year. This record number quadrupled the level of such deaths in 1999. Unlike the heroin and crack crises of the past, the current opioid emergency has disproportionately affected white Americans-poor and rural, but also middle class or affluent and suburban. This association has boosted support for preventative and treatment-based policy solutions. But the pace of the response has been slow, critical components of the solution-such as health insurance coverage expansion and improved access to medication-assisted treatment- face resistance, and there are growing efforts to revamp the failed and costly War on Drugs. This report examines the sources of the opioid crisis, surveys health and justice policy responses at the federal and state levels, and draws on lessons from past drug crises to provide guidance on how to proceed. The War on Drugs did not play a major role in ebbing past cycles of drug use, as revealed by extensive research and the reflections of police chiefs. In 2014, the National Research Council concluded: The best empirical evidence suggests that the successive iterations of the war on drugs- through a substantial public policy effort-are unlikely to have markedly or clearly reduced drug crime over the past three decades. Growing public awareness of the limited impact and devastating toll of the War on Drugs has encouraged many policymakers and criminal justice practitioners to begin its winding down. The number of people imprisoned nationwide for a drug offense skyrocketed from 24,000 in 1980 to a peak of 369,000 in 2007. It has since declined by nearly one-quarter, reaching approximately 287,000 people in the most recent count. The lessons from past drug crises and the evidence base supporting a public health approach can guide policymakers as they seek an end to the current opioid crisis. Details: Washington, DC: The Sentencing Project, 2017. 35p. Source: Internet Resource: Accessed January 31, 2018 at: https://www.sentencingproject.org/wp-content/uploads/2017/12/Opioids-Treating-an-Illness-Ending-a-War.pdf Year: 2017 Country: United States URL: https://www.sentencingproject.org/wp-content/uploads/2017/12/Opioids-Treating-an-Illness-Ending-a-War.pdf Shelf Number: 148950 Keywords: Drug Abuse and Addiction Drug Abuse Treatment Drug Treatment Opioids War on Drugs

Author: Child Protection Centers and Services (CPCS) NGO Nepal Title: The Street Children of Kathmandu: Study, approaches and comments on the daily life of street-based children of the Nepalese capital Summary: They are called Raju, Dinesh, Sunita, Bikram, or Akash. In the company of many others they spend their childhood and adolescence living on the streets of Kathmandu. In turn, they warm their frozen hands on the hot coals of a furnace, in turn they sing alone in the dark deserted streets scavenging for any profitable waste, in turn they hassle a passer-by to beg a couple of rupees, in turn they are happy when they fill their empty stomachs with a hot meal, in turn they are sad for having lost a precious trinket, in turn they laugh at the new pleasures that city life has to offer them, in turn they cry remembering the villages they left behind, in turn protector, in turn raped, in turn a player, in turn beaten, in turn a good prince, in turn hunted, in turn living and in turn dead - but in each step, each dream, they remain children and free. Who are these children? Where do they come from? How can they live without parents at such a young age? Are they tempted by soft or hard drugs? What dangers will their lives encounter? In what type of social context do they grow up? Are they surrounded by an education system? These are seven questions that this book will try to illuminate. Other than answers, in this book you will find a new approach to these various questions, mixed with emotions and life experience, as there exists neither theory nor formula to try to understand the magical, tragic and worrying lives that defines the street and the micro-society which the children establish. The service and street workers of CPCS estimate that the number of children living on the street is between 800 to 1100, for Kathmandu alone and its valley. This information has been confirmed by most of the major organisations and other research. This study focuses on these children in particular, as we remain convinced that caution should be used with regards to the multiple "categories" that illustrate the link between the children and the street. The contextual and situational differences between "street children, children in the street, street-working children, street-living children, children with a street-relationship, urban children at risks, etc" appear in effect to be more pertinent in detailed expert analysis than actual reality. This book is based on a survey carried-out with 430 children, 430 lives. In particular, it is the result of an unfinished common working platform between more than 40 people and more than a dozen Nepalese and international experts. The hope is that this book will convey helpful new elements, clues and suggestions that will prove useful not only to NGOs and social workers but also to the general public, as our aim is to reach as many audiences as possible. We remain convinced that it is through a society as a whole, and not only just organisations or governments, that we can bring about an improvement to the condition of these lives and ultimately the social rehabilitation of these children. With this in mind, we have attempted to base ourselves less on the statistics and analysis of data, but rather concentrate our research on children's interviews, illustrations and photos, and in particular on the advice of recognised Nepalese social workers and international experts. At first sight, they may appear to be a certain confusion as the reader is taken on a journey through scientific analysis, essays, witness accounts, and documents. Nevertheless, this confusion permits us to understand the complexity of the situation and the diverse analyses possible. Details: Dillibazaar, Kathmandu: CPCS Nepal, 2007. 194p. Source: Internet Resource: Accessed February 13, 2018 at: http://cpcs.international/wordpress/wp-content/uploads/2014/12/the-street-children-of-kathmandu_en_2007.pdf Year: 2007 Country: Nepal URL: http://cpcs.international/wordpress/wp-content/uploads/2014/12/the-street-children-of-kathmandu_en_2007.pdf Shelf Number: 149114 Keywords: Begging Child Sexual Abuse Drug Abuse and Addiction Gangs Street Children (Nepal) Street Workers

Author: MacDonald, Shanna Farrell Title: Women Offenders, Substance Use, and Behaviour Summary: About four-in-five women offenders in Canada have substance use problems, and recent evidence suggests that substance use is more important in understanding women's offending than it is in men's. However, little research has focused on the differences in substance use behaviours among women and their relationship to correctional outcomes. Considering that substance use variability has been shown to inform treatment success in the community, this study examined the relationships of both substance use severity and type of user with institutional and post-release behaviour. Participants were 962 women newly admitted to a federal women's institution from February 2010 to February 2014 who completed a computerized assessment of their substance use problems. Women were categorized both based on the severity of their substance use issue and on the type of substance that was most problematic for them (none, alcohol, drugs, or alcohol and drugs). Women in each category were contrasted in terms of their demographic and offence information, their substance use behaviours, their institutional adjustment (institutional offences and segregation placements), and their post-release outcomes. Both substance use severity and type of user were found to be associated with the women's offence, risk, and substance use characteristics. As severity increased, so did the proportion of women who had committed a violent index offence and who had served a previous federal sentence. Not surprisingly, severity of problem was also associated with a more extensive history of substance use, as well as use of a wider variety of drugs. In terms of type of substance user, women in the alcohol and drug group were more likely than those in the other groups to have been convicted of a violent offence or served a previous federal sentence and had more elevated risk. The breadth of the alcohol and drug users' substance use history was also more extensive. As well, both substance use severity and type of user were associated with institutional behaviour and post-release outcome. Women with more severe substance use problems and who had used drugs (either as their sole problematic substance or together with alcohol) were more likely to be found guilty of disciplinary offences, to be placed in segregation, and to be returned to custody after their release, even after accounting for possible covariates. Overall, results emphasized the importance of considering differences in substance use among women offenders. This finding, together with the prevalence of substance use problems among women, underscores the importance of interventions in this area. The Correctional Service of Canada offers women offenders correctional programs that address the problematic behaviours directly or indirectly linked to their crime - which may include substance use. The programs aim to help women understand the impact of problematic behaviours and to enhance their ability to live balanced and crime-free lives. Conforming to this principle, at CSC, women offenders participating in correctional program create individual self-management and healing plans focused on the behaviours they identify as problematic in their own lives and offence cycles, including substance use. Details: Ottawa: Correctional Service Canada, 2015. 34p. Source: Internet Resource: Research Report 2015 No. R-358: Accessed February 20, 2018 at: http://publications.gc.ca/collections/collection_2017/scc-csc/PS83-3-358-eng.pdf Year: 2015 Country: Canada URL: http://publications.gc.ca/collections/collection_2017/scc-csc/PS83-3-358-eng.pdf Shelf Number: 149189 Keywords: Correctional Programs Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders Female Offenders Gender-Specific Programs Substance Abuse Offenders Women Offenders

Author: Matthew, Dayna Bowen Title: Un-burying the Lead: Public health tools are the key to beating the opioid epidemic Summary: On November 1st, the President's Commission on Combating Drug Addiction and the Opioid Crisis, chaired by Governor Chris Christie, released its report and recommendations for fighting "the worst drug overdose epidemic in U.S. history." The Report repeatedly underscores the scope and urgency of the nation's opioid epidemic that is ravaging families and communities in all 50 states. It claims 175 lives daily. In addition to these deaths, other tragic and costly health consequences of this epidemic include unprecedented increases in the incidence and prevalence of addiction, increased hospitalizations and emergency room visits, and a dramatic increase in the number of babies born with neonatal abstinence syndrome. There is much in the Report to praise. For example, the Commission recommended that the president declare the opioid crisis a national public health emergency and the president adopted this recommendation. The declaration of a public health emergency will eventually allow states to apply for and Congress to fund long-term interventions to prevent and treat drug abuse. Moreover, the Commission's recommendations that emphasize treatment and harm reduction admirably include systemic changes that would have long-term impact, such as:  Development of new quality measures to incentivize early screening and treatment referrals;  Waiver of Institutions for Mental Diseases (IMD) exclusions within Medicaid to expand capacity for in-patient treatment;  Broad expansion of federal drug courts to divert individuals away from prison and into treatment programs; and  Insurer regulations and penalties for mental health parity violations. However, this report argues that it is the Commission's final six recommendations - buried in the back of the report--that offer the most far-reaching and promising opportunities for state and federal leaders to strike at the root causes of the opioid crisis. These final recommendations, listed on the left side of Table 1 below, signal that our government may be willing to seriously address the opioid crisis as the public health emergency that it is. They aim at changing the fundamental social and environmental conditions that are risk factors for the populations among which addiction and death rates are soaring. As such, they have the greatest potential for impact because they reach the broadest segments of the community where addictions flourish. But even they do not go far enough. These good ideas need to be accompanied by action steps to implement them with the immediacy that this crisis warrants. This report suggests the logical "next steps" that should accompany the Commission's recommendations. They are listed on the right side of Table 1 below. This report proceeds in three parts. It first calls attention to the Commission's final six recommendations. It argues that these proposals, which focus on reforming housing, employment, family, criminal justice and educational determinants of opioid addiction, are the most important. interventions of all. Second, this report places the current opioid epidemic into historic context; America has seen terrible spikes in opioid and other drug related deaths in this country during two prior periods. The public health lessons from earlier epidemics provide strong support for the Commission's final six recommendations, and counsel a comprehensive approach to the social and economic risk factors associated with opioid addiction. Finally, this report asserts that the Commission's recommendations will have limited impact unless they are implemented with immediate action steps to ensure, and even expand, their concrete impact. Therefore, for each one of the Commission's final six recommendations, this report proposes a related action step for housing9 and employment,10 community engagement, and criminal justice interventions12 that are essential to defeating the worsening opioid crisis in this country. Moreover, this section urges the Administration to reach back 50 years in America's self-proclaimed drug "war" and extend the public health framework it has now adopted toward opioid addiction to the victims of America's earlier opioid crisis, and to those who became addicted to successor drugs. These victims of America's earlier opioid crises tragically were subjected to a criminal justice rather than public health approach to their disease. This report argues it is not too late to correct that error, by applying the public health framework to all populations affected by the disease of addiction. In conclusion, this report outlines a comprehensive and equitable strategy that federal, state, and local governments, as well as affected communities can take to effectively address the social determinants of opioid addiction. Details: Washington, DC: USC-Brookings Schaeffer Initiative for Health Policy , 2018. 18p. Source: Internet Resource: Accessed February 22, 2018 at: https://www.brookings.edu/wp-content/uploads/2018/01/es_20180123_un-burying-the-lead-final.pdf Year: 2018 Country: United States URL: https://www.brookings.edu/wp-content/uploads/2018/01/es_20180123_un-burying-the-lead-final.pdf Shelf Number: 149227 Keywords: Drug Abuse and Addiction Drug Policy Drug Treatment Opioid Epidemic Opioids Public Health

Author: Ali, Farihah Title: Synthetic Cannabinoid Use in Correctional Populations - An Emerging Challenge for Offender Health and Safety? A Brief Review Summary: Synthetic cannabinoids (SCs) have become increasingly popular among various user populations, and have arisen as common alternatives to organic cannabis products. SCs are an emerging category of drugs under the umbrella of New Psychoactive Substances (NPS). They belong to a continually evolving series of synthetic psychoactive product groups, based on successive structural modifications, commonly marketed as herbal mixtures which mimic cannabis' psychoactive effects, and are classified as 'legal highs'. SCs, however, have been associated with a variety of distinct adverse health outcomes (especially acute), some of which are considered more severe than those which result from the use of natural cannabis products. Compared to natural cannabis products, SCs pose threats to users' health, including: elevated levels of cardio-vascular problems, kidney problems, seizures, acute hallucinations, psychosis and anxiety, among others. Various jurisdictions have reported high numbers of presentations to emergency departments, as well as cases of mortality, directly related to the use of SCs. While all forms of SCs are banned in correctional institutions, existing evidence suggests that they have become increasingly popular among offenders, and as such, pose distinct novel challenges for correctional administrations charged with the responsibility for offender health and safety. SC use results in potentially powerful stimulant effects which may make them attractive for use by offenders, but may also result in adverse outcomes which come with potentially undesirable or hazardous consequences for offender behaviour and safety. Moreover, SCs evade major routine drug interdiction and drug testing systems in operation in correctional systems, and hence are attractive for illicit use, trade, and import in correctional settings. To better understand SC use, and the possible health and safety consequences for offenders, this report reviewed pertinent national and international literature on SC use, availability, and related health outcomes among general and correctional populations. Research data on SCs in the context of Canadian correctional systems are currently limited, and are thus urgently required. Educating offenders and correctional staff on the risks of SC use is imperative, and correctional systems should prepare for the potential health and safety consequences of increased SC use while awaiting the results and guidance offered by future research. Details: Ottawa: Correctional Service of Canada, 2017. 24p. Source: Internet Resource: 2017 No.R-397: Accessed March 13, 2018 at: http://publications.gc.ca/collections/collection_2017/scc-csc/PS83-3-397-eng.pdf Year: 2017 Country: Canada URL: http://publications.gc.ca/collections/collection_2017/scc-csc/PS83-3-397-eng.pdf Shelf Number: 149456 Keywords: Correctional Institutions Drug Abuse and Addiction Drug Offenders Health Care Prisoners Psychoactive Substances

Author: Singer, Jeffrey A. Title: Abuse-Deterrent Opioids and the Law of Unintended Consequences Summary: The United States has seen a surge in deaths from overdoses of opioids, including both prescription drugs and illegal opioids such as heroin. Nonmedical users and abusers often obtain prescription opioids diverted from the legal to the illegal market. In the hope of reducing opioid use, abuse, and overdoses, policymakers have focused on developing and promoting tamper-resistant or abuse-deterrent formulations (ADFs) that render diverted opioids unusable if individuals attempt to use them for nonmedical (i.e., recreational) purposes. Although the benefits of ADFs seem to be nonexistent, these formulations have led to real harms. ADFs have encouraged users to switch to more dangerous opioids, including illegal heroin. In at least one instance, the reformulation of a prescription opioid led to a human immunodeficiency virus (HIV) outbreak. Along the way, ADFs unnecessarily increase drug prices, imposing unnecessary costs on health insurance purchasers, taxpayers, and particularly patients suffering from chronic pain. Like the federal government's promotion of abuse-deterrent alcohol a century ago, these efforts are producing unintended consequences, such as making legal pain relief unaffordable for many patients and possibly increasing morbidity and mortality. Government at all levels should stop promoting ADF opioids. Congress should end or limit the ability of pharmaceutical manufacturers to impose higher costs on pain patients by using ADFs to "evergreen" their opioid patents (evergreening is a practice by which pharmaceutical manufacturers extend or renew the patent protection before the current patent expires by tweaking the formula slightly or repurposing the product). The FDA should end its policy of encouraging ADF opioids and particularly its goal of eliminating non-ADF opioids. Lawmakers should abandon efforts to require consumers to purchase coverage for costlier ADF opioids and should instead allow insurers to steer medical users of these products toward cheaper, non-ADF generic formulations. Details: Washington, DC: Cato Institute, 2018. 9p. Source: Internet Resource: Policy Analysis No. 832: Accessed April 4, 2018 at: https://www.cato.org/publications/policy-analysis/abuse-deterrent-opioids-law-unintended-consequences Year: 2018 Country: United States URL: https://www.cato.org/publications/policy-analysis/abuse-deterrent-opioids-law-unintended-consequences Shelf Number: 149664 Keywords: Drug Abuse and Addiction Illegal Drugs Opioid Epidemic Opioids Prescription Drugs

Author: Pew Charitable Trusts Title: More Imprisonment Does Not Reduce State Drug Problems: Data show no relationship between prison terms and drug misuse Summary: Nearly 300,000 people are held in state and federal prisons in the United States for drug-law violations, up from less than 25,000 in 1980.1 These offenders served more time than in the past: Those who left state prisons in 2009 had been behind bars an average of 2.2 years, a 36 percent increase over 1990,2 while prison terms for federal drug offenders jumped 153 percent between 1988 and 2012, from about two to roughly five years.3 As the U.S. confronts a growing epidemic of opioid misuse, policymakers and public health officials need a clear understanding of whether, how, and to what degree imprisonment for drug offenses affects the nature and extent of the nation's drug problems. To explore this question, The Pew Charitable Trusts examined publicly available 2014 data from federal and state law enforcement, corrections, and health agencies.4 The analysis found no statistically significant relationship between state drug imprisonment rates and three indicators of state drug problems: self-reported drug use, drug overdose deaths, and drug arrests. The findings-which Pew sent to the President's Commission on Combating Drug Addiction and the Opioid Crisis in a letter dated June 19, 2017-reinforce a large body of prior research that cast doubt on the theory that stiffer prison terms deter drug misuse, distribution, and other drug-law violations. The evidence strongly suggests that policymakers should pursue alternative strategies that research shows work better and cost less. Details: Philadelphia: Pew Charitable Trusts, 2018. 19p. Source: Internet Resource: Accessed April 4, 2018 at: http://www.pewtrusts.org/~/media/assets/2018/03/pspp_more_imprisonment_does_not_reduce_state_drug_problems.pdf Year: 2018 Country: United States URL: http://www.pewtrusts.org/~/media/assets/2018/03/pspp_more_imprisonment_does_not_reduce_state_drug_problems.pdf Shelf Number: 149676 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders Mass Incarceration

Author: Police Executive Research Forum Title: The Unprecedented Opioid Epidemic: As Overdoses Become a Leading Cause of Death, Police, Sheriffs, and Health Agencies Must Step Up Their Response Summary: Consider the following pieces of information: - In Philadelphia, 35 people died of heroin overdoses in less than a week last December. - In New York City, fatal drug overdoses, which numbered 1,374 in 2016, are four times more common than homicides. The police are moving mountains to analyze overdose cases quickly, in order to stop the fatalities when an extremely powerful batch of heroin or fentanyl hits the streets. - In Louisville, Kentucky, police had 52 overdose calls over a 32-hour period last February. On average, police save someone's live with naloxone about twice a day, and one person dies from an overdose every day. - In Cabell County, West Virginia, officials reported 26 drug overdoses in a five-hour period, due to a batch of heroin containing fentanyl. The county reported the highest overdose death rate in the state, with 132 deaths among a population of less than 100,000. - In Ohio, the state with the most overdose deaths, an average of 11 people died every 24 hours in 2016, and coroners report that the numbers for 2017 are even higher. In Akron, 16 drug dealers have been sentenced to long prison terms because their product was linked to fatal overdoses, but the police chief doesn't think those prosecutions have "sent a message" to other dealers or slowed down the heroin trafficking. - In Cook County, Illinois, where Chicago and some of its suburbs are located, fentanyl took hold with a vengeance in 2016, causing more than 560 fatal overdoses. When Chicago's opioid overdoses are laid out on a map of the city, it correlates closely with the locations of shootings, prompting one police official to note that "our violent crime problem is our drug problem." - In New Jersey, crime labs have backlogs, but they find a way to turn heroin analyses around in a matter of hours if fatalities are involved. - In Baltimore, where 694 people suffered fatal overdoses in 2016, the Health Department is very concerned about the high likelihood that prescription opioid pills will lead to more cases of heroin addiction. So it is taking action. The Health Department is asking doctors to provide a prescription for naloxone along with every prescription they write for opioid pain pills. The idea is that doctors will think twice about prescribing oxycodone if they have to tell their patients, "Here's a prescription for your shoulder pain. And this other prescription is in case you end up having a heroin overdose." These are a few of the stories that you will find in the report you are holding. This is PERF's third major report about the epidemic of overdoses by persons addicted to opioid drugs. In 2014 and again in 2016, we held national conferences and released reports about the crisis, focusing on what local police and other agencies were doing to reduce the carnage. This new report summarizes what we learned at a third national PERF conference, held at the New York City Police Department's headquarters in April 2017. The reason PERF continues to focus on the opioids crisis is that despite the groundbreaking work that police and other agencies are doing, the epidemic is continuing to worsen. The latest numbers, released by the Centers for Disease Control and Prevention (CDC) in August 2017, are horrible. Drug overdose deaths in 2016 totaled 64,070, a 21-percent increase over the year before. And approximately three-fourths of all drug overdose deaths are caused by opioid drugs. Let's put those numbers in context: - The 64,070 drug fatalities in 2016 outnumber the 35,092 motor vehicle fatalities in 2015. - Drug fatalities in 2016 outnumber American fatalities in the entire course of the Vietnam War, which totaled 58,200. - Drug fatalities in 2016 outnumber AIDS-related deaths in the worst year of the HIV epidemic, when 50,628 people died in 1995. - Drug fatalities in 2016 outnumber the peak year of homicides in the United States, when 24,703 people were murdered in 1991. - Drug fatalities in 2016 outnumber suicides, which have been increasing for nearly 30 years and which totaled 44,193 in 2015. Furthermore, the new CDC statistics confirm what police chiefs have been telling us-Fentanyl is driving the sharp increases in opioid-related fatalities. CDC identified 15,466 fatalities in 2016 resulting from heroin overdoses, but 20,145 fatalities caused by fentanyl or other synthetic opioids. So it is clear that police and other criminal justice agencies, along with public health departments, drug treatment and social service providers, elected officials, and others, must step up their efforts to prevent new cases of opioid addiction, while helping addicted persons through the long and difficult process of getting free of opioid drugs. Details: Washington, DC: PERF, 2017. 92p. Source: Internet Resource: Accessed April 12, 2018 at: http://www.policeforum.org/assets/opioids2017.pdf Year: 2017 Country: United States URL: http://www.policeforum.org/assets/opioids2017.pdf Shelf Number: 149796 Keywords: Drug Abuse and Addiction Drug-Related Deaths Opioid Epidemic Opioids Prescription Drug Abuse

Author: United Nations Office on Drugs and Crime (UNODC) Title: Opioid overdose: preventing and reducing opioid overdose mortality Summary: Although data are limited, an estimated 70,000-100,000 people die from opioid overdose each year. Opioid overdose was the main cause of the estimated 99,000- 253,000 deaths worldwide related to illicit drug use in 2010. Opioid overdose is both preventable and, if witnessed, treatable (reversible). In its resolution 55/7 on promoting measures to prevent drug overdose, in particular opioid overdose, the Commission on Narcotic Drugs called upon Member States to include effective measures to prevent and treat drug overdose in national drug policies. In that resolution, the Commission requested the United Nations Office on Drugs and Crime (UNODC), in collaboration with the World Health Organization (WHO), to collect and circulate available best practices on the prevention and treatment of and emergency response to drug overdose, in particular opioid overdose, including on the use and availability of opioid receptor antagonists such as naloxone and other measures based on scientific evidence. This discussion paper outlines the facts about opioid overdose, the actions that can be taken to prevent and treat (reverse) opioid overdose and areas requiring further investigation. Opioids, which can be chemically synthesized or derived from the opium poppy plant, are a group of compounds that activate the brain's opioid receptors, a class of receptors that influence perceptions of pain and euphoria and are involved in the regulation of breathing. Some of the more commonly known and used opioids are morphine, heroin, methadone, buprenorphine, codeine, tramado, oxycodone and hydrocodone. They are used as medicines to treat pain and opioid dependence. If used in excess or without proper medical supervision, opioids can cause fatal respiratory depression. In cases of fatal overdose, the victim's breathing slows to the point where oxygen levels in the blood fall below the level needed to transfer oxygen to the vital organs. As oxygen saturation (normally greater than 97 per cent) falls below 86 per cent, the brain struggles to function. Typically, the individual becomes unresponsive, blood pressure progressively decreases and the heart rate slows, ultimately leading to cardiac arrest. Death can occur within minutes of opioid ingestion. But often, prior to death there is a longer period of unresponsiveness lasting up to several hours. This period is sometimes associated with loud snoring, leading to the term "unrousable snorers". Worldwide, overdose is the leading cause of avoidable death among people who inject drugs. However, it is difficult to accurately estimate the number of fatal opioid overdoses because of the poor quality or limited nature of mortality data available. According to UNODC estimates, drug-related deaths account for between 0.5 percent and 1.3 percent of all-cause mortality at the global level among persons aged 15-64. In that regard, the recent Global Burden of Diseases, Injuries, and Risk Factors Study, 2010 found that there were an estimated 43,000 deaths in 2010 due to opioid dependence and 180,000 deaths due to drug poisoning, resulting in more than 2 million years of life lost. In the United States of America alone, there were an estimated 38,329 drug poisoning deaths in 2010, including 16,651 fatal opioid overdoses related to prescription opioid analgesics in 2010, with the remainder of those deaths largely involving heroin and/or cocaine. Opioid overdose accounts for nearly half of all deaths among heroin injectors, exceeding HIV and other disease-related deaths. Overdose was reported more frequently than were other causes in the 58�cohort studies examined in a 2011 meta-analysis. That meta-analysis also indicated that overdose represented the most common specific cause of death, at 6.5 deaths per 1,000 person-years. Among the 10 per cent of people living with HIV in the United States who also inject drugs, overdose is a common cause of non-AIDS related death. A recent meta-analysis showed that HIV sero-positivity is associated with an increased risk of overdose: people who use drugs have a 74 percent greater risk of overdose if they are HIV-positive compared with their HIV-negative counterparts. In the Russian Federation, overdose is the second leading cause of death for people with HIV after tuberculosis. Nationally reported mortality data in both low-income and high-income countries are often insufficient to estimate overdose deaths. Current data on overdose mortality derive mostly from prospective cohort studies and national reporting systems, largely from high-income countries. To address these challenges, some countries have now adopted a standard case definition, contributing to an improved capacity for reliable overdose data. However, in a significant number of countries, data on overdose are limited, with the result that alternative data sources, often combined with expert opinion, are required to estimate rates. Consequently, overdose mortality generally tends to be underestimated, and nationally reported statistics in that regard are likely to be conservative. For example, against the backdrop of negligible numbers of fatal overdoses reported by national authorities of Central Asian countries, 25.1 percent of injecting drug users surveyed in Kazakhstan, Kyrgyzstan and Tajikistan in 2010 reported having witnessed someone die from an overdose in the previous 12 months. It is likely that people who use opioids also experience a high rate of non-fatal overdose. For instance, 59 percent of known heroin injectors in a study conducted in 16 Russian cities reported having had at least one non-fatal overdose in their lifetime. The proportion of heroin injectors reporting lifetime non-fatal overdose is similarly high in several other cities: 41 percent in Baltimore, 42 percent in New York City, 68�percent in Sydney, 38 percent in London, 30 percent in Bangkok, and 83�percent in Bac Ninh, Viet Nam. Non-fatal overdose can significantly contribute to morbidity, including cerebral hypoxia, pulmonary oedema, pneumonia and cardiac arrhythmia, that may result in prolonged hospitalizations and brain damage. Details: Vienna: UNODC, 2013. 28p. Source: Internet Resource: Discussion paper, UNODC/WHO: Accessed April 18, 2018 at: https://www.unodc.org/docs/treatment/overdose.pdf Year: 2013 Country: International URL: https://www.unodc.org/docs/treatment/overdose.pdf Shelf Number: 149846 Keywords: Drug Abuse and Addiction Drug Overdoses Drug-Related Deaths Narcotics Opioid Crisis Opioid Epidemic Opioids Prescriptions Drugs

Author: Patterson, Eileen Title: Drug use monitoring in Australia: 2015 and 2016 report on drug use among police detainees Summary: Established in 1999, the Drug Use Monitoring in Australia (DUMA) program is funded by the Australian Government and is the nation's largest and longest-running ongoing survey of police detainees across the country. DUMA currently operates at five data collection sites and comprises two core components: a self-report survey including a range of criminal justice, demographic, drug use and drug market participation information; and voluntary urinalysis, which provides an objective measure for corroborating reported recent drug use (within 48 hours of arrest). This biennial report is part of the Australian Institute of Criminology's (AIC) Statistical Report series and aims to describe the DUMA data collected between January 2015 and December 2016 (herein referred to as 2015-16) at five sites: Adelaide (South Australia), Brisbane (Queensland), Perth (Western Australia) and Sydney (Bankstown and Surry Hills, New South Wales). Details: Canberra: Australian Institute of Criminology, 2018. 98p. Source: Internet Resource: Statistical Report 04: Accessed April 24, 2018 at: https://aic.gov.au/publications/sr/sr4 Year: 2018 Country: Australia URL: https://aic.gov.au/publications/sr/sr4 Shelf Number: 149873 Keywords: Alcohol Abuse Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders Illicit Drugs Substance Abuse

Author: Hardy, Steven Title: Street involved drug use, social dynamics and interactions with police in Ottawa Summary: Homeless populations are frequently associated with drug consumption. Drug use by homeless people is more visible leading to the assumption that homeless or street involved populations use drugs more frequently or differently than other segments of the population. In this paper, I challenge this idea and consider how homeless and street involved populations consume drugs and how they understand their drug consumption. In 15 semi-structured, open-ended interviews I explored how homeless and street involved men consume drugs and how they view their drug use. Their drug use is within the broader societal context that impacts their understandings and views of drug consumption. Using Peta Malins' definition of the "junkie", I explore the impact of this idea on how drugs are consumed by homeless and street involved populations. Drawing on the idea of subjectivities, this paper looks at how these individuals understand what it means to be a "junkie" and how they understand their own drug consumption in response. Police have an impact on the daily lives of street involved drug users. This paper explores how police interact with street involved drug users and how street involved drug users understand these interactions. Finally, I consider how the "junkie" subjectivity impacts interactions between street involved users and police. Details: Ottawa: Carleton University, 2017. 139p. Source: Internet Resource: Thesis: Accessed April 26, 2018 at: https://curve.carleton.ca/system/files/etd/24a686ce-eeb5-491c-a514-93574703aabb/etd_pdf/7a795ab822b8c41077f62cb17b54ddc3/hardy-streetinvolveddrugusesocialdynamicsandinteractions.pdf Year: 2017 Country: Canada URL: https://curve.carleton.ca/system/files/etd/24a686ce-eeb5-491c-a514-93574703aabb/etd_pdf/7a795ab822b8c41077f62cb17b54ddc3/hardy-streetinvolveddrugusesocialdynamicsandinteractions.pdf Shelf Number: 149900 Keywords: Drug Abuse and Addiction Drug Offenders Homeless Persons Police-Citizen Interactions

Author: Disney, Lynn Title: Illicit Drug Use and Criminal Behavior: A Literature Review Summary: Speculation and case histories about the role of illegal drug use and crime abounds. Turf wars between rival gangs, desperate users seeking resources to supply their habits, injuries resulting from a person high on PCP-are all examples of crimes that occurred as a result of illegal drug use. Look at almost any newspaper and you will find articles discussing these crimes in detail. These accounts rarely apply an empirical framework, and in reality, estimating the proportion of crime attributable to illegal drug use is an area of research where little agreement exists. The purpose of this literature review is to examine evidence-based approaches that have been tested in research and then determine whether defensible methodologies exist for calculating a drug use-attributable fraction for crimes committed in the United States. ANALYTICAL CONSIDERATIONS The precise nature and relationship of these factors is complex. Drugs can produce a variety of symptoms and side effects, depending on the individual. Do mental health problems precede or are they caused by the drug use? Does the criminal behavior occur because the individual is taking drugs or is it a cause of substance use? The answers to these questions differ based on who is taking the drug, the drug being taken, and the environment in which it is taken. A person with schizophrenia may abuse drugs to quell the symptoms of the disease. A woman may abuse drugs to alleviate feelings of inadequacy caused by spousal abuse. A teenager may engage in risky sexual behaviors due to lowered inhibitions caused by using drugs. A heroin addict may commit a burglary to obtain the funds to support his habit. In some cases, the crime would not occur but for the drug use. This paper attempts to tease out the causal relationship between illicit drug use and other forms of criminal behavior. Complicating any examination of the link between illicit drug use and criminal behavior is the tendency to include tobacco use and alcohol in this equation. While these products all may involve some significant risk of criminal behavior, they are outside the scope of this report. To the extent possible, numbers attributed to the use and abuse of tobacco and alcohol will be removed from the analysis. The abuse of prescription drugs as a cause of criminal behavior was not excluded but few studies focused solely on this exposure. Details: Washington, DC; Office of National Drug Control Policy, 2010. 84p. Source: Internet Resource: Accessed May 4, 2018 at: https://obamawhitehouse.archives.gov/sites/default/files/ondcp/policy-and-research/illicit_drug_use_and_criminal_behavior_literature_review_2010.pdf Year: 2010 Country: International URL: https://obamawhitehouse.archives.gov/sites/default/files/ondcp/policy-and-research/illicit_drug_use_and_criminal_behavior_literature_review_2010.pdf Shelf Number: 150048 Keywords: Drug Abuse and Addiction Drug-Related Violence Drugs and Crime Illicit Drugs

Author: King County Heroin and Prescription Opiate Addiction Task Force Final Report and Recommendations Title: Heroin and Prescription Opiate Addiction Task Force: Final Report and Recommendations Summary: Heroin and opioid use are at crisis levels in King County. In 2015, 229 individuals died from heroin and prescription opioid overdose in King County alone. To confront this crisis, in March 2016, King County Executive Dow Constantine, Seattle Mayor Ed Murray, Renton Mayor Denis Law and Auburn Mayor Nancy Backus convened the Heroin and Prescription Opiate Addiction Task Force. The Task Force, co-chaired by the King County Department of Community and Human Services and Public Health - Seattle & King County, was charged with developing both short and long-term strategies to prevent opioid use disorder, prevent overdose, and improve access to treatment and other supportive services for individuals experiencing opioid use disorder. The Heroin and Prescription Opiate Addiction Task Force met over a six month period from March to September 2016 to review 1) current local, state and federal initiatives and activities related to prevention, treatment and health services for individuals experiencing opioid use disorder; 2) promising strategies being developed and implemented in other communities; and 3) evidence-based practice in the areas of prevention, treatment and health services. The Task Force strived to avoid redundancy with other related activities and to leverage existing partnerships and activities where appropriate. Additionally, the Task Force applied an equity and social justice lens to the work to ensure that recommendations do not exacerbate, but rather lessen, inequities experienced by communities of color as a direct result of the "War on Drugs." This report provides a summary of the group's recommendations to both prevent opioid addiction and improve opioid use disorder outcomes in King County. Details: Seattle: The Task Force, 2016. 101p. Source: Internet Resource: Accessed May 4, 2018 at: https://www.kingcounty.gov/~/media/depts/community-human-services/behavioral-health/documents/herointf/Final-Heroin-Opiate-Addiction-Task-_Force-Report.ashx Year: 2016 Country: United States URL: https://www.kingcounty.gov/~/media/depts/community-human-services/behavioral-health/documents/herointf/Final-Heroin-Opiate-Addiction-Task-_Force-Report.ashx Shelf Number: 150055 Keywords: Drug Abuse and Addiction Drug Treatment Opiates Prescription Drug Abuse Substance Abuse Treatment

Author: Efrat, Asif Title: Governing Guns, Opposing Opium: A Theory of Internationally Regulated Goods Summary: The paper examines a significant phenomenon overlooked by the trade literature: internationally regulated goods. Contrary to the general trend of trade liberalization, specific goods, such as drugs, small arms, and antiquities, have come under increasing international control in recent decades through a set of global regulatory agreements. I argue that these goods are unique in that they involve transnational negative externalities. Whereas certain countries benefit from the trade in these goods, the trade inflicts negative effects on other countries. Examples of such negative externalities include fatalities and refugee flows resulting from rampant gun violence, high crime rates associated with widespread drug abuse, and archaeological destruction caused by antiquities looting. The paper develops a theory that first explains why national regulation is insufficient and why international regulation is necessary for curbing these negative externalities. The theory then analyzes why certain governments are strongly in favor of international regulation while others wish to maintain the trade uncontrolled. My analysis locates the sources of governments' conflicting preferences in the domestic political arena and considers how exporters, consumers, and civil society shape governments' views. The final part of the theory examines how the distribution of state power affects the establishment of the regulatory agreements. The paper makes several theoretical contributions by bridging rationalist and non-rationalist accounts of international law and by focusing on international cooperation in the absence of shared interest. Details: Ithaca, NY: Cornell Law School, 2008. 71p. Source: Internet Resource: Cornell Law Faculty Working Papers: Accessed May 4, 2018 at: https://scholarship.law.cornell.edu/clsops_papers/41/ Year: 2008 Country: International URL: https://scholarship.law.cornell.edu/clsops_papers/41/ Shelf Number: 150060 Keywords: Drug Abuse and Addiction Gun Violence International Trade Trade Regulation

Author: McGuffog, Ingrid Title: Drug Use and Drug Control Policy: Evaluating the Impact of Precursor Regulation on Drug Use Behaviour Summary: Controlling the availability of illicit drugs and their use is an exemplar of a wicked problem. Reducing the scale of the illicit drugs market through suppressing supply has proven extremely difficult. A recent systematic review of studies by Cunningham and colleagues who have produced a series of research papers examining the impact of precursor regulations on various methamphetamine outcomes in North America, argue this research represents the most compelling evidence to date that 'precursor regulations, or indeed any supply control strategy, can have significant impacts on the retail market for illicit drugs'. The review of this work concludes that the question for future research is 'not so much whether precursor regulations work, but which regulations work best and in what context'; this is the starting point for my research. The market for methamphetamine is entrenched, broad and dynamic and represents an important criminological and public health problem in Australia. Within Australia the production of methamphetamine has been concentrated in Queensland and that state government has responded by developing a coercive regulatory framework which co-opts pharmacies into a partnership with drug law enforcement that is aimed at preventing the diversion of licit precursor chemicals to the illicit market for manufacture into methamphetamine. In 2005, the Queensland Pharmacy Guild in partnership with the Queensland Police Service developed an electronic medication recording system Project STOP, - which is a real-time web based database used by police to track and apprehend 'pseudo runners' - to facilitate adherence to the compulsory requirements of recording and reporting sales of pseudoephedrine placed upon them by both health regulations and the criminal law. In my thesis, I refer to the family of innovations (legislative, policy and technological interventions) underpinning the police-pharmacy partnership as Third Party Policing (TPP). Details: Brisbane: Griffith University, School of Criminology and Criminal Justice, 2012. 270p. Source: Internet Resource: Dissertation: Accessed May 7, 2018 at: https://research-repository.griffith.edu.au/bitstream/handle/10072/366750/McGuffog_2013_02Thesis.pdf?sequence=1 Year: 2012 Country: Australia URL: https://research-repository.griffith.edu.au/bitstream/handle/10072/366750/McGuffog_2013_02Thesis.pdf?sequence=1 Shelf Number: 150096 Keywords: Drug Abuse and Addiction Drug Control Policy Drug Markets Illicit Drugs Methamphetamines

Author: Doleac, Jennifer L. Title: The Moral Hazard of Lifesaving Innovations: Naloxone Access, Opioid Abuse, and Crime Summary: The United States is experiencing an epidemic of opioid abuse. In response, many states have increased access to naloxone, a drug that can save lives when administered during an overdose. However, naloxone access may unintentionally increase opioid abuse through two channels: (1) reducing the risk of death per use, thereby making riskier opioid use more appealing, and (2) saving the lives of active drug users, who survive to continue abusing opioids. By increasing the number of opioid abusers who need to fund their drug purchases, naloxone access laws may also increase theft. We exploit the staggered timing of naloxone access laws to estimate the total effects of these laws.We find that broadening naloxone access led to more opioid-related emergency room visits and more opioid-related theft, with no reduction in opioid-related mortality. These effects are driven by urban areas and vary by region. We find the most detrimental effects in the Midwest, including a 14% increase in opioid-related mortality in that region. We also find suggestive evidence that broadening naloxone access increased the use of fentanyl, a particularly potent opioid. While naloxone has great potential as a harm-reduction strategy, our analysis is consistent with the hypothesis that broadening access to naloxone encourages riskier behaviors with respect to opioid abuse. Details: Bonn: IZA Institute of Labor Economics, 2018. 77p. Source: Internet Resource; IZA Discussion Paper No. 11489: Accessed May 9, 2018 at: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3170278 Year: 2018 Country: United States URL: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3170278 Shelf Number: 150120 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Naloxone Opioid Epidemic

Author: Malatras, Jim Title: By the Numbers: Opioid Deaths Continue to Surge in New York State Summary: The opioid epidemic continues to ravage the nation. The sad fact is no matter the region of the country, there are people struggling with opioid addiction. Not only is every region touched, no group - rich or poor, rural or urban, black or white, men or women - is immune from the epidemic's devastating effects. But, as we will describe below, some groups are disproportionately affected. In April 2017, the Rockefeller Institute of Government released a report finding a 71 percent increase in drug deaths in New York State (NYS) from 2010-15. In later reports and using online interactive maps to track drug overdoses and deaths, we found that use of deadly drugs, like heroin and fentany, were rapidly growing. For example, using provisional New York State Department of Health data, we found a 54 percent increase in heroin deaths and a 50 percent increase in emergency room visits due to heroin overdoses, and a 45 percent increase in the use of life-saving overdose medication, like Naloxone, in one year alone (2014-15). Policymakers across the nation have grappled with how to address the epidemic. The solutions have varied from the president of the United States declaring the problem a national public health emergency to once unthinkable solutions in many communities, like safe injection sites. But given all the policies implemented and funding provided to battle the opioid epidemic, could the tide be turning? Recent reports suggest that some county officials are forecasting a decrease in the number of drug deaths in the coming months. It is too early to tell if that is a larger trend. Given this potential change, using the most recent Centers for Disease Control and Prevention data from 2016, we have updated our findings from April 2017 and found that opioid deaths continue to mount. In fact, from 2015 to 2016, New York saw the single greatest annual increase in drug-related deaths in six years. Details: Albany, NY: Rockefeller Institute of Government, 2018. 16p. Source: Internet Resource: accessed May 18, 2018 at: http://rockinst.org/wp-content/uploads/2018/03/2018-03-21-By-The-Numbers-Opioid-Deaths.pdf Year: 2018 Country: United States URL: http://rockinst.org/wp-content/uploads/2018/03/2018-03-21-By-The-Numbers-Opioid-Deaths.pdf Shelf Number: 150266 Keywords: Drug Abuse and Addiction Drug-Related Deaths Opioid Epidemic

Author: Wartell, Julie Title: Prescription Drug Fraud and Misuse. 2nd edition Summary: This guide describes the problem of prescription drug fraud and misuse and reviews some of the factors that increase their risks. It then identifies a series of questions to help you analyze your local problem. Finally, it reviews responses to the problem, and what is known about them from evaluative research and police practice, For the purposes of this guide, prescription drug fraud, which falls under the broader heading of pharmaceutical diversion, is defined as the illegal acquisition of prescription drugs for personal use or profit. This definition excludes theft, burglary, backdoor pharmacies, and illegal importation or distribution of prescription drugs. This guide also discusses common forms of prescription drug diversion, as not all cases of diversion are fraudulent. For example, sharing medication and taking medication without permission are not acts categorized as fraudulent yet still warrant police attention. The related issue of prescription misuse and addiction is also covered, as many offenders become addicted and begin more widespread use through illegally obtaining prescription drugs from family and friends. "Backdoor pharmacies" are businesses not licensed/authorized to distribute pharmaceutical drugs. Prescription drug fraud and misuse is but one aspect of the larger set of problems related to the unlawful use of controlled substances. This guide is limited to addressing the particular harms created by prescription fraud and misuse. Details: Washington, DC: U.S. Department of Justice, Office of Community Oriented Policing Services, 2013. 72p. Source: Internet Resource: Problem-Specific Guides Series Problem-Oriented Guides for Police, no. 24: Accessed May 23, 2018 at: https://ric-zai-inc.com/Publications/cops-p257-pub.pdf Year: 2013 Country: United States URL: https://ric-zai-inc.com/Publications/cops-p257-pub.pdf Shelf Number: 130303 Keywords: Drug Abuse and Addiction Opioid Crisis Opioids Prescription Drug Fraud Prescription Drugs

Author: Sacco, Lisa N. Title: Prescription Drug Monitoring Programs Summary: In the midst of national concern over the opioid epidemic, federal and state officials are paying greater attention to the manner in which opioids are prescribed. Nearly all prescription drugs involved in overdoses are originally prescribed by a physician (rather than, for example, being stolen from pharmacies). Thus, attention has been directed toward better understanding how opioids are being prescribed and preventing the diversion of prescription drugs after the prescriptions are dispensed. Prescription drug monitoring programs (PDMPs) maintain statewide electronic databases of prescriptions dispensed for controlled substances (i.e., prescription drugs with a potential for abuse that are subject to stricter government regulation). Information collected by PDMPs may be used to educate and inform prescribers, pharmacists, and the public; identify or prevent drug abuse and diversion; facilitate the identification of prescription drug-addicted individuals and enable intervention and treatment; outline drug use and abuse trends to inform public health initiatives; or educate individuals about prescription drug use, abuse, diversion, and PDMPs themselves. As of February 2018, 50 states, the District of Columbia, and two territories (Guam and Puerto Rico) had operational PDMPs within their borders. How PDMPs are organized and operated varies among states. Each state determines which agency houses the PDMP; which controlled substances must be reported; which types of dispensers (e.g., pharmacies) are required to submit data; how often data are collected; who may access information in the PDMP database (e.g., prescribers, dispensers, or law enforcement); the circumstances under which the information may (or must) be accessed; and what enforcement mechanisms are in place for noncompliance. PDMP costs may vary widely, with startup costs that can range as high as $450,000 to over $1.5 million and annual operating costs ranging from $125,000 to nearly $1.0 million. States finance PDMPs using monies from a variety of sources including the state general fund, prescriber and pharmacy licensing fees, state controlled substance registration fees, health insurers' fees, directsupport organizations, state grants, and/or federal grants. The federal government supports state PDMPs through programs at the Departments of Justice (DOJ) and Health and Human Services (HHS). Since FY2002, DOJ has administered the Harold Rogers Prescription Drug Monitoring Program, and in FY2017, DOJ incorporated this grant program into the new Comprehensive Opioid Abuse Program. HHS programs include National All Schedules Prescription Electronic Reporting (NASPER), State Demonstration Grants for Comprehensive Opioid Abuse Response, Opioid Prevention in States grants, State Targeted Response to the Opioid Crisis Grants, and various pilots and initiatives under the Office of the National Coordinator for Health Information Technology (ONC). Of note, NASPER last received appropriations (of $2.0 million) in FY2010. State PDMPs vary with respect to whether or how information contained in the database is shared with other states. Federal policymakers have repeatedly emphasized the importance of enhancing interstate information sharing and the interoperability of state PDMPs. In 2011, the Obama Administration included efforts to increase interstate data sharing in its action plan to counter prescription drug abuse. In 2017, a presidential commission recommended, among other things, that the Trump Administration support legislation to require DOJ to fund a "data-sharing hub" and require states receiving federal grant funds to share PDMP data. Details: Washington, DC: Congressional Research Service, 2018. 34p. Source: Internet Resource: R42593: Accessed May 25, 2018 at: https://fas.org/sgp/crs/misc/R42593.pdf Year: 2018 Country: United States URL: https://fas.org/sgp/crs/misc/R42593.pdf Shelf Number: 150372 Keywords: Drug Abuse and Addiction Drug Abuse Policy Drug Abuse Prevention Drug Regulation Opioid Epidemic Opioids Prescription Drug Abuse

Author: Reichert, Jessica Title: Opioid Prescribing in Illinois: Examining Prescription Drug Monitoring Program Data Summary: Almost three times as many opioids are prescribed in the United States today as compared to 1999. Health care practitioners wrote 259 million prescriptions for opioid pain medication in 2012, which is enough to provide a full bottle of pills for almost every adult in the country. An estimated one in five patients with pain symptoms who go to their doctor's office receive an opioid prescription. In a 2015 national survey, 13 percent of adults who report taking prescription opioids also reported misuse (defined as non-medical use). Of those, 41 percent obtained opioids for free from friends or relatives. Illinois opioid prescribing is relatively low compared to other states. According to the Centers for Disease Control and Prevention, Illinois ranked 41st out of 50 states and District of Columbia on opioid prescription totals. However, prescription rates vary greatly by county, city, and medical practitioner. This article describes Illinois opioid prescription practices using Illinois Prescription Monitoring Program (ILPMP) data, focusing on trends and prescribing variations by county. A review of available research on the association between opioid prescribing, opioid misuse, and opioid use disorders also is summarized. Policy and practice implications also are included. Details: Chicago: Illinois Criminal Justice Information Authority, 2018. 21p. Source: Internet Resource: Accessed July 2, 2018 at: http://www.icjia.state.il.us/assets/articles/PMP_Article_050918.pdf Year: 2018 Country: United States URL: http://www.icjia.state.il.us/assets/articles/PMP_Article_050918.pdf Shelf Number: 150756 Keywords: Drug Abuse and Addiction Opioid Epidemic Opioids Prescription Drug Abuse Prescription Drug Monitoring

Author: Sullivan, Riley Title: The Fiscal Impact of the Opioid Epidemic in the New England States Summary: The rise in the abuse of-and addiction to-opioids and the rapid increase in the number of fatal overdoses in recent years have made the opioid epidemic a priority for local, state, and federal policymakers. Understanding the epidemic's direct fiscal impact is key to acknowledging its scope and magnitude. While opioid abuse has many direct and indirect fiscal costs, few studies quantify them. This report assembles available data on the impact of opioid epidemic on criminal justice, treatment, and related health expenditures in the New England states. The research finds that state governments in the region spend a higher percentage on total opioid-related costs and more per capita than the national averages. Across the region, treating opioid-use disorder-on both an emergency and a long-term basis-accounts for the majority of the costs. Estimates for medical treatment expenditures associated with opioid abuse reach as high as $340 million annually in Massachusetts alone. While providing new insight the author acknowledges that the costs considered in this policy report are incomplete. It's plausible that the opioid epidemic's impact on state revenues is also significant and could affect regional fiscal health. For example, individuals incarcerated for drug crimes or in residential treatment programs are not earning wages. Evidence also suggests that non-institutionalized individuals abusing opioids are more likely out of work than employed, likewise resulting in lost revenue (Krueger 2017). The author plans to conduct further research on opioid abuse's impact on employment and labor force participation, which should contribute to a fuller understanding of the epidemic's fiscal cost to the region. However, beyond the fiscal cost is the toll opioid abuse has taken on individuals, families, and communities. The costs analyzed in this report are just a small part of the greater damage inflicted across the region and the country. Details: Boston: New England Public Policy Center; Federal Reserve Bank of Boston: 2018. 28p. Source: Internet Resource: Policy Report 18-1: Accessed July 9, 2018 at: https://www.bostonfed.org/publications/new-england-public-policy-center-policy-report/2018/the-fiscal-impact-of-the-opioid-epidemic-in-the-new-england-states.aspx#collapse2 Year: 2018 Country: United States URL: https://www.bostonfed.org/publications/new-england-public-policy-center-policy-report/2018/the-fiscal-impact-of-the-opioid-epidemic-in-the-new-england-states.aspx#collapse2 Shelf Number: 150778 Keywords: Cost Analysis Costs of Criminal Justice Drug Abuse and Addiction Drug Abuse Treatment Opioid Crisis Opioid Epidemic Opioids Prescription Drug Abuse

Author: Scandinavian Research Council for Criminology Title: Drugs: What Is the Problem and How Do We Perceive It? Policies on Drugs in Nordic Countries Summary: Drug policies in Nordic countries seem to be at the brink of change. Perhaps it has always been seen like this, as drug policy is one rather exceptional part of the criminal policy characterized by disagreements and controversies, in contrast to many other parts of the criminal policy that prevail calm, more dominated by consensus. The drug policy has never settled down. Nonetheless, this impression of imminent change was the background of our initiative to arrange a workshop on Nordic drug policies, to map out: What are the topics of the debate; and what are the positions among social researchers in the Nordic countries at the end of 2014. Looking for participants we soon discovered that drug policy is a theme of interest of scholars beyond the social sciences, working in different fields and specialties. The eventual working group of ten participants included criminologists and sociologists, a medical professional, historian, lawyer and an economist. In a way this is not surprising, but in accordance with one theme of the discussions: Drug use and drug problems are not just about drugs. May be this concentration on drugs leaves us helpless in order to make relevant answers to the variations of problems and poverties that appear together with drug use and drug problems? The contributions from the workshop can be read in this report. They may be seen as struggles to extend the scope of impacts of the control line to drug users, and toward control systems; and to carry forward fundamental values as most relevant also toward drug users. The contributions direct their attention toward policies of control and sanctions against drugs in the Nordic countries. Some are discussing the volume and character of drug use as well as the control and sanctions applied, and costs paid by those who experience the control policies. One text looks for ideological and political conditions contributing to demonize drugs. How to develop the Nordic drugs policies in the future in relation to changes in policies in recent years in USA, Latin America, and Portugal as well as harm-reduction movements? The peculiar position of drugs as a huge threat that has to be eradicated, has given police exceptional conditions in applying highly unusual investigation methods within the realm of civil penal law. Another peculiarity is how the drug policies seem immune when it comes to facts and arguments about its contradictions, paradoxes and unwanted consequences. These features make the drug policies strange, irregular and dangerous toward many of those affected by its consequences. Even in a political context their highly contradictive elements appear as unusual. Also researchers� interference in the field needs to be investigated. After 50 years these features still keep drug policies as an important field for investigations. Details: Aarhus, Danmark: Aarhus University, 2015. 115p. Source: Internet Resource: Accessed August 2, 2018 at: http://www.nsfk.org/Portals/0/Archive/1_NSfK%20Working%20Group%20Report%20Drugs.pdf Year: 2015 Country: Denmark URL: http://www.nsfk.org/Portals/0/Archive/1_NSfK%20Working%20Group%20Report%20Drugs.pdf Shelf Number: 151013 Keywords: Drug Abuse and Addiction Drug Control Drug Policy (Nordic Countries) Poverty

Author: National Center on Addiction and Substance Abuse at Columbia University Title: Childhood Poisoning: Safeguarding Young Children from Addictive Substances Summary: As a result of America's current addiction epidemic, babies and pre-school age children are being accidentally exposed at unacceptably high rates to toxic, addictive substances including nicotine, alcohol, caffeine, prescription drugs, marijuana and illicit drugs. Fortunately, there are steps parents, health care professionals, policymakers, industry and researchers can take to prevent such occurrences and protect children from the potentially life-threatening effects of these substances. METHODS This report summarizes the available research on the nature, extent, and consequences of young children's exposure to a range of addictive substances based on data collected by the American Association of Poison Control Centers (AAPCC), as well as other research reports and data sources. It explains why and how such exposures occur, and what the barriers are to preventing them. Finally, it provides a comprehensive approach to addressing the problem of childhood exposures and poisonings. RESULTS In 2016 alone, there were more than 30,500 reports to poison control centers of young children exposed to addictive substances. The number of children aged five and younger who have been exposed to the toxic effects of nicotine, alcohol, caffeine, marijuana, certain opioids and methamphetamine have increased over the past decade, as have the number of children who experience serious consequences from these events. Additional key findings include: Exposures to marijuana increased by 148 percent over a seven-year period. Exposures to prescription opioid pain relievers increased 93 percent each year over a nine-year period, corresponding to the opioid epidemic's progression. Calls to poison control centers about e-cigarettes increased more than 1,400 percent in just three years. The number of young children exposed to alcoholic beverages has increased every year since 2012. RECOMMENDATIONS AND CONCLUSIONS This report offers concrete recommendations for parents and other caregivers, health care professionals, policymakers, industry and researchers to ensure that the growing availability of addictive products is met with an effective response that will protect the youngest victims of substance use and addiction Details: New York: The Center, 2018. 154p. Source: Internet Resource: Accessed September 17, 2018 at: https://www.centeronaddiction.org/addiction-research/reports/childhood-poisoning-safeguarding-young-children-addictive-substances Year: 2018 Country: United States URL: https://www.centeronaddiction.org/addiction-research/reports/childhood-poisoning-safeguarding-young-children-addictive-substances Shelf Number: 151555 Keywords: Child Protection Drug Abuse and Addiction Opioid Epidemic Poisoning Substance Abuse

Author: Fealk, Rebecca Title: Drug Sentencing in Arizona: A Prescription for Failure Summary: Across the nation, there is growing awareness of the increased use of opioids, and a related rise in the spread of blood-borne disease, accidental overdoses, and deaths. From Indiana to Alaska, state officials have implemented emergency ordinances to address this devastating epidemic. With an increasing number of people (particularly white, middle-/upper-class people) affected by this crisis, the rhetoric of those in power has moved away from portraying addiction as a moral failure to be criminalized, to recognizing it as a disease that should be treated. This shift has allowed for minor changes in a handful of communities around the U.S. Yet in Arizona and at the federal level, policies overwhelmingly have remained mired in the outdated and ineffective "tough-on-crime" approach to address drug use. This is despite multiple studies that show incarceration does not reduce addiction nor does it increase public safety. In Arizona's largest county, for instance, drug-related activities are the No. 2 reason for arrest, and represent the majority of all charges filed. Yet once there, less than two percent of people with significant substance abuse histories receive addiction treatment. The dismal result is that Arizona has the fifth highest incarceration rate in the country, and a recidivism rate of 50 percent. AFSC has worked for over 20 years in Arizona to reform the criminal justice system. These efforts have been hampered by the fact that the state does not collect any aggregate data on how criminal sentencing laws are actually being applied. There was no way to know how many people were arrested or sentenced under a given criminal law, what sentence they received, or how much it cost. The result: Our report "Drug Sentencing in Arizona: A Prescription for Failure" offers a first-of-its-kind data analysis that takes a critical look at drug-sentencing laws and how they are applied at all stages of the criminal justice system. The results demonstrate the ineffectiveness of Arizona's "hardline" approach to drug offenses and shine a light on glaring disparities in how the state treats people of color: Of the 10 most charged offenses in Maricopa County (Phoenix) in 2015, eight were drug-related. And all were for possession, use, or paraphernalia, not for sales or trafficking offenses. Drug crimes make up the largest category of offense for which people are incarcerated in the Arizona state prison system, with more than one-fifth being in for drugs as their highest charge. One-third of women are incarcerated solely for drugs. African Americans are more likely to go to prison for a drug offense (even possession) and receive sentences that are 24 percent longer than white people convicted of drug crimes. The state spends over half a million dollars per day to incarcerate people whose most serious charge is a drug offense. Our new report shows that Arizona needs a more effective, equitable, and humane approach to dealing with drug addiction. Details: Tucson: American Friends Service Committee -- Arizona, 2017. 32p. Source: Internet Resource: Accessed September 26, 2018 at: https://afscarizona.files.wordpress.com/2017/07/drug-sentencing-in-arizona-prescription-for-failure.pdf Year: 2017 Country: United States URL: https://afscarizona.files.wordpress.com/2017/07/drug-sentencing-in-arizona-prescription-for-failure.pdf Shelf Number: 141693 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Drug Offenders Drug-Related Crime Mass Incarceration Racial Disparities Sentencing

Author: Shiner, Michael Title: The Colour of Injustice: 'Race', drugs and law enforcement in England and Wales Summary: Stop and search focuses on low-level drug offences - Use of stop and search has fallen sharply, dropping by 75 per cent from 2010/11 to 2016/17. - Stop and search has become increasingly concentrated on suspected drug offences, most of which involve low-level possession. Half of all stop-searches were targeted at drugs in 2010/11, rising to almost two-thirds by 2016/17. - The intensity of the focus on drugs varies sharply between forces: 82 per cent of stop-searches during 2016/17 were for drugs in Merseyside compared with 46 per cent in Durham. - Substantial variations are evident between forces with similar crime-relevant profiles, suggesting they are largely a function of differences in police policy and decision-making. - Police forces are making operational decisions to target low-level drug possession offences over other, more serious, offences. Stop and search is more disproportionate than ever - The number of stop and searches has fallen sharply for all ethnic groups, but has fallen most sharply for white people even though they had relatively modest rates of exposure at the outset. - Disproportionality has increased as the use of stop and search has fallen, indicating that residual use of the powers is more heavily concentrated on black and minority ethnic groups. - Black people were stopped and searched at more than eight times the rate of white people in 2016/17. Asian people and those in the 'mixed' group were stopped and searched at more than twice the rate of white people. - Black people were stopped and searched for drugs at almost nine times the rate of white people, while Asian people and those in the 'mixed' group were stop-searched for drugs at almost three times the rate of white people. - The 'find' rate for drugs is lower for black than white people, suggesting that such searches are carried out on the basis of weaker 'grounds' for black people. Variations across forces point to discrimination - Forces vary sharply in their overall use of stop and search as well as their rates of disproportionality. Such differences are evident between forces with similar crime-relevant profiles, suggesting they are largely a function of police policy and decision-making. - High rates of stop and search in London are an important driver of ethnic disproportionality because a large proportion of the black and minority ethnic population live in the capital - Black people were stopped and searched at a higher rate than white people by every force in England and Wales during 2016/17. Disproportionality ratios varied from 1.7 in Durham to 20.4 in Dorset for all stop-searches; and from 1.7 in Cleveland to 26.5 in Dorset for drug searches. - Some forces have substantially reduced their use of stop and search without seeing a corresponding increase in disproportionality. Other forces have combined much more modest reductions in stop and search with high, and increasing, rates of disproportionality. London data point to patterns of geographic and individual profiling - Overall rates of stop and search are higher among inner than outer London boroughs. - Variations between boroughs are strongly linked to levels of deprivation. Overall rates of stop and search are highest in more deprived boroughs with considerable inequality. - Rates of stop and search appear to be more sensitive to deprivation and inequality than crime. The concentration of stop and search in deprived boroughs cannot be explained by patterns of drug use, including cannabis use. - The concentration of stop and search in boroughs with high levels of deprivation and inequality fuels disproportionality because people from black and some other minority ethnic groups tend to live in such areas in relatively large numbers. - 'Race' complicates and confounds the general relationship between stop and search and deprivation. Rates of stop and search for black people do not vary with levels of deprivation. - Disproportionality is highest in relatively wealthy and affluent boroughs. White people are subject to very low rates of stop and search in such locations, while black people continue to experience heightened rates of intervention. This pattern is consistent with ethnic profiling because it indicates that black people are being singled out for suspicion. Arrests and out of court disposals exacerbate ethnic disparities - Stop and search was responsible for 39 per cent of all arrests for drugs in 2016/17 compared with 3 per cent of arrests for other offences. - The rate at which stop and search identifies stolen or prohibited items is similar for all ethnic groups, though the 'find rate' for drug searches is lower for black than white people. - The rate at which further action is taken, leading to a criminal justice outcome, is similar for all ethnic groups, but there are marked differences in the type of action taken. - Black people are more likely to be arrested as a result of stop and search than white people, but less likely to be given an out of court disposal. This means black people are more likely to be prosecuted. - Penalty notices for disorder (PNDs) or 'on the street- fines are the only out of court disposal that black people receive at higher rate than white people. Unlike other out of court disposals, PNDs do not require an admission of guilt. - The number of arrests from stop and search has fallen much more sharply for white than black people. Arrests from drug searches halved for white people between 2010/11 and 2016/17, but remained stable for black people. - Stop and search accounts for a much larger proportion of arrests of black than white people: 17 per cent compared with 5 per cent for all offences; and 57 per cent compared with 31 per cent for drug offences. Such disparities suggest that the disproportionate application of stop and search is largely a function of police policy and decision-making rather than crime. Sentencing decisions perpetuating injustice - Ethnic disparities introduced by stop and search and other forms of police activity follow through to prosecution, conviction and sentencing. - Black people were prosecuted for drug offences at more than eight times the rate of white people in 2017. This compared with almost four times the rate for all indictable offences. - More black people were prosecuted for cannabis possession than supply of Class A or B substances combined. The balance was reversed for white people. - Black and Asian people were convicted of cannabis possession at 11.8 and 2.4 times the rate white people despite their lower rates of self-reported use, providing prima facie evidence of discrimination. - Black people made up a quarter of those convicted of cannabis possession even though they comprise less than 4 per cent of the population. - Black people were sentenced to immediate custody for drug offences at 9.1 times the rate of white people, but given suspended sentences at 5.6 times the rate of white people. Details: London: StopWatch, Release, International Drug Policy Unit, 86p. Source: Internet Resource: Accessed November 2, 2018 at: https://www.release.org.uk/sites/default/files/pdf/publications/The%20Colour%20of%20Injustice.pdf Year: 2018 Country: United Kingdom URL: https://www.release.org.uk/sites/default/files/pdf/publications/The%20Colour%20of%20Injustice.pdf Shelf Number: 153151 Keywords: Drug Abuse and Addiction Drug Enforcement Drug Offenders Racial Disparities Racial Profiling in Law Enforcement Stop and Search

Author: Australian Institute of Health and Welfare Title: Opioid harm in Australia: and comparisons between Australia and Canada Summary: Locally and internationally, the rising use of opioids is a cause of concern. All opioids-including codeine-can be addictive and their use can result in dependence, accidental overdose, hospitalisation or death. This report brings together information from a range of data sources to tell the national story of opioid use and its harmful effects. It is the first time that the AIHW has produced such a comprehensive report that presents current national data and trends on opioid use and harms in Australia. The report also presents findings from a collaboration between the AIHW and the Canadian Institute for Health Information (CIHI). This includes comparisons between ED presentations and hospitalisations in Australia and Canada, where possible, and discussion of the benefits and challenges of international collaboration. In Australia in 2016-17, 3.1 million people had 1 or more prescriptions dispensed for opioids (most commonly for oxycodone); about 40,000 people used Heroin; and about 715,000 people used Pain-killers/analgesics and pharmaceutical opioids for illicit or non-medical purposes. Opioid deaths and poisoning hospitalisations have increased in the last 10 years Legal or pharmaceutical opioids (including codeine and oxycodone) are responsible for far more deaths and poisoning hospitalisations than illegal opioids (such as heroin). Every day in Australia, nearly 150 hospitalisations and 14 emergency department (ED) presentations involve opioid harm, and 3 people die from drug-induced deaths involving opioid use. In 2016, the number of opioid deaths (1,119) was the highest number since the peak in 1999 (1,245 deaths). After 1999, the number of deaths fell to a low of 439 in 2006, then began to climb again. In 2016, opioid deaths accounted for 62% of all drug-induced deaths. From 2007 to 2016, after adjusting for differences in the age structure of the population, the rate of opioid deaths increased by 62%, from 2.9 to 4.7 deaths per 100,000 population. The increase was driven by an increase in accidental opioid deaths and in pharmaceutical opioid deaths. Similarly, from 2007-08 to 2016-17, after adjusting for age, the rate of hospitalisations per 100,000 population with a principal diagnosis (main reason for hospitalisation) of opioid poisoning increased by 25%, while the rate of hospitalisations with any diagnosis (all reasons for hospitalisation) of opioid poisoning increased by 38%. Pharmaceutical opioids are responsible for more opioid deaths and poisoning hospitalisations than heroin In 2016, the most commonly mentioned opioid in opioid deaths was Naturally derived opioids (for example, oxycodone, codeine and morphine), which was mentioned in 49% of opioid deaths. Similarly, in 2016-17, hospitalisations with a principal diagnosis of opioid poisoning were more likely to involve pharmaceutical opioids than heroin or opium. The rate per 100,000 for those by Naturally derived opioids was more than twice as high as for those by Heroin. More opioid prescriptions were dispensed but on average prescriptions were for lower doses and/or quantities In 2016-17, 15.4 million opioid prescriptions were dispensed under the Pharmaceutical Benefits Scheme (PBS) to 3.1 million people. The oral morphine equivalent (OME) is a measure of opioid use that adjusts for the difference in potency between different opioids. It converts the amount of each opioid dispensed to the amount of oral morphine that would be required to produce the same pain-relieving effect. After adjusting for differences in the age structure of the population, from 2012-13 to 2016-17, although there was a rise in the rate of prescriptions dispensed per 100,000 population and the number of people per 100,000 population receiving them (9% and 4% respectively), the OME stayed the same over the same period (989 to 987 OME mg per 1,000 population per day)-on average, the prescriptions dispensed were for lower doses and/or quantities. Oxycodone and codeine most commonly dispensed opioids -- Oxycodone was the most commonly dispensed prescription opioid in 2016-17, with 5.7 million prescriptions dispensed to 1.3 million people, followed by codeine (3.7 million prescriptions to 1.7 million people) and tramadol (2.7 million prescriptions to 600,000 people). Similar to the results for all opioid prescriptions dispensed, on average prescriptions dispensed for oxycodone were for lower doses and/or quantities. After adjusting for differences in the age structure of the population over time, from 2012-13 to 2016-17 there was approximately a 30% rise in both the number of oxycodone prescriptions dispensed per 100,000 population and the number of people receiving them per 100,000 population, but the OME over the same period remained the same (338 to 340 OME mg for oxycodone per 1,000 population per day). Higher rates of OME for opioids dispensed in Inner regional and Outer regional areas -- After adjusting for differences in the age structure of the population, the total number of prescriptions dispensed per 100,000 population was highest for Inner regional areas (74,000 per 100,000 population) and lowest for Very remote areas (38,000 per 100,000 population). The rate of OME was also highest for Inner regional areas (1,374 OME mg per 1,000 population per day), followed closely by Outer regional areas (1,362 OME mg per 1,000 population per day). These rates of OMEs are 2 times higher than in Very remote areas, which at 645 OME mg per 1,000 population per day was the lowest of all areas. 1 in 10 Australians have ever used any type of opioid for illicit or non-medical purposes In 2016, around 1 in 10 (11%) of Australians aged 14 and over had ever used at least 1 type of opioid for illicit or non-medical purposes; recent use (that is, use in the last 12 months) was much lower, at 3.7%. Most had used pharmaceutical opioids rather than illegal opioids, with 9.7% having ever used Pain-killers/analgesics and pharmaceutical opioids, compared with 1.3% who had ever used Heroin. Of people who reported non-medical use of Pain-killers/analgesics and pharmaceutical opioids, 75% had used Over-the-counter codeine products, 40% had used Prescription codeine products and 17% had used Oxycodone. Opioid use varies between Australia and Canada -- Both Australia and Canada have government-funded pharmaceuticals. Overall, there was a downward trend in both countries in the total average opioid dosage (the defined daily dose or DDD) per 1,000 people, per day prescribed in the 5 years to 2016-17. However there were slight differences in the types of opioids prescribed, with the DDD rate for hydromorphone substantially higher in Canada, and the DDD rate for tramadol and buprenorphine higher in Australia. Both countries had a similar DDD rate for fentanyl. Illicit use of fentanyl is more common in Canada than it is in Australia, while heroin use is comparatively higher in Australia than in Canada. The impact of this difference is that people using these different drugs-while they are all opioids-have different trajectories and contact with the acute care system. Fentanyl is more potent than heroin and has a greater potential to be lethal, meaning many users die before they can receive acute care. Side effects from opioid use are responsible for the greatest number of hospitalisations in both Canada and Australia Despite differences in the rates of hospital care in Australia and Canada for opioid harms-due in part to differences in systems and infrastructure for health services-there are similarities in the profiles of people most likely to receive hospital care for opioid harm. In both Australia and Canada, the greatest volume of harm treated in hospitals came from side effects from opioid use. The age distribution for people hospitalised for this reason was similar in Australia and Canada, with rates of hospitalisation increasing with increasing age, reflecting the rates of prescription opioids in both countries. Details: Canberra: AIHW, 2018. 130p. Source: Internet Resource: Accessed November 14, 2018 at: https://www.aihw.gov.au/getmedia/605a6cf8-6e53-488e-ac6e-925e9086df33/aihw-hse-210.pdf.aspx?inline=true Year: 2018 Country: Australia URL: https://www.aihw.gov.au/getmedia/605a6cf8-6e53-488e-ac6e-925e9086df33/aihw-hse-210.pdf.aspx?inline=true Shelf Number: 153417 Keywords: Drug Abuse and Addiction Illicit Drugs Opioid Crisis Opioid Deaths Opioids Prescription Drug Abuse Prescription Drugs

Author: U.S. Department of Justice. Drug Enforcement Administration Title: 2018 National Drug Threat Assessment Summary: The 2018 National Drug Threat Assessment (NDTA)1 is a comprehensive strategic assessment of the threat posed to the United States by domestic and international drug trafficking and the abuse of illicit drugs. The report combines federal, state, local, and tribal law enforcement reporting; public health data; open source reporting; and intelligence from other government agencies to determine which substances and criminal organizations represent the greatest threat to the United States. Illicit drugs, as well as the transnational and domestic criminal organizations who traffic them, continue to represent significant threats to public health, law enforcement, and national security in the United States. Drug poisoning deaths are the leading cause of injury death in the United States; they are currently at their highest ever recorded level and, every year since 2011, have outnumbered deaths by firearms, motor vehicle crashes, suicide, and homicide. In 2016, approximately 174 people died every day from drug poisoning (see Figure 1). The opioid threat (controlled prescription drugs, synthetic opioids, and heroin) has reached epidemic levels and currently shows no signs of abating, affecting large portions of the United States. Meanwhile, as the ongoing opioid crisis justly receives national attention, the methamphetamine threat remains prevalent; the cocaine threat has rebounded; new psychoactive substances (NPS) are still challenging; and the domestic marijuana situation continues to evolve. Controlled Prescription Drugs (CPDs): CPDs are still responsible for the most drug-involved overdose deaths and are the second most commonly abused substance in the United States. As CPD abuse has increased significantly, traffickers are now disguising other opioids as CPDs in attempts to gain access to new users. Most individuals who report misuse of prescription pain relievers cite physical pain as the most common reason for abuse; these misused pain relievers are most frequently obtained from a friend or relative. Heroin: Heroin use and availability continue to increase in the United States. The occurrence of heroin mixed with fentanyl is also increasing. Mexico remains the primary source of heroin available in the United States according to all available sources of intelligence, including law enforcement investigations and scientific data. Further, significant increases in opium poppy cultivation and heroin production in Mexico allow Mexican TCOs to supply high-purity, low-cost heroin, even as U.S. demand has continued to increase. Fentanyl and Other Synthetic Opioids: Illicit fentanyl and other synthetic opioids - primarily sourced from China and Mexico - are now the most lethal category of opioids used in the United States. Traffickers- wittingly or unwittingly- are increasingly selling fentanyl to users without mixing it with any other controlled substances and are also increasingly selling fentanyl in the form of counterfeit prescription pills. Fentanyl suppliers will continue to experiment with new fentanyl-related substances and adjust supplies in attempts to circumvent new regulations imposed by the United States, China, and Mexico. Cocaine: Cocaine availability and use in the United States have rebounded, in large part due to the significant increases in coca cultivation and cocaine production in Colombia. As a result, past-year cocaine initiates and cocaine-involved overdose deaths are exceeding 2007 benchmark levels. Simultaneously, the increasing presence of fentanyl in the cocaine supply, likely related to the ongoing opioid crisis, is exacerbating the re-merging cocaine threat. Methamphetamine: Methamphetamine remains prevalent and widely available, with most of the methamphetamine available in the United States being produced in Mexico and smuggled across the Southwest Border (SWB). Domestic production occurs at much lower levels than in Mexico, and seizures of domestic methamphetamine laboratories have declined steadily for many years. Marijuana: Marijuana remains the most commonly used illicit drug in the United States. The overall landscape continues to evolve; although still illegal under Federal law, more states have passed legislation regarding the possession, use, and cultivation of marijuana and its associated products. Although seizure amounts coming across the SWB have decreased in recent years, Mexico remains the most significant foreign source for marijuana available in the United States. Domestic marijuana production continues to increase, as does the availability and production of marijuana-related products. New Psychoactive Substances (NPS): The number of new NPS continues to increase worldwide, but remains a limited threat in the United States compared to other widely available illicit drugs. China remains the primary source for the synthetic cannabinoids and synthetic cathinones that are trafficked into the United States. The availability and popularity of specific NPS in the United States continues to change every year, as traffickers experiment with new and unregulated substances. Mexican Transnational Criminal Organizations (TCOs): Mexican TCOs remain the greatest criminal drug threat to the United States; no other group is currently positioned to challenge them. The Sinaloa Cartel maintains the most expansive footprint in the United States, while Cartel Jalisco Nueva Generacion's (CJNG) domestic presence has significantly expanded in the past few years. Although 2017 drug-related murders in Mexico surpassed previous levels of violence, U.S.-based Mexican TCO members generally refrain from extending inter-cartel conflicts domestically. Colombian TCOs: Colombian TCOs' majority control over the production and supply of cocaine to Mexican TCOs allows Colombian TCOs to maintain an indirect influence on U.S. drug markets. Smaller Colombian TCOs still directly supply wholesale quantities of cocaine and heroin to Northeast and East Coast drug markets. Dominican TCOs: Dominican TCOs dominate the mid-level distribution of cocaine and white powder heroin in major drug markets throughout the Northeast, and predominate at the highest levels of the heroin and fentanyl trade in certain areas of the region. They also engage in some street-level sales. Dominican TCOs work in collaboration with foreign suppliers to have cocaine and heroin shipped directly to the continental United States and its territories from Mexico, Colombia, Venezuela, and the Dominican Republic. Family members and friends of Dominican nationality or American citizens of Dominican descent comprise the majority of Dominican TCOs, insulating them from outside threats. Asian TCOs: Asian TCOs specialize in international money laundering by transferring funds to and from China and Hong Kong through the use of front companies and other money laundering methods. Asian TCOs continue to operate indoor marijuana grow houses in states with legal personal-use marijuana laws and also remain the 3,4-Methylenedioxymethamphetamine (MDMA, commonly known as Ecstasy) source of supply in U.S. markets by trafficking MDMA from clandestine laboratories in Canada into the United States. Gangs: National and neighborhood-based street gangs and prison gangs continue to dominate the market for the street-sales and distribution of illicit drugs in their respective territories throughout the country. Struggle for control of these lucrative drug trafficking territories continues to be the largest factor fueling the street-gang violence facing local communities. Meanwhile, some street gangs are working in conjunction with rival gangs in order to increase their drug revenues, while individual members of assorted street gangs have profited by forming relationships with friends and family associated with Mexican cartels. Illicit Finance: TCOs' primary methods for laundering illicit proceeds have largely remained the same over the past several years. However, the amount of bulk cash seized has been steadily decreasing. This is a possible indication of TCOs' increasing reliance on innovative money laundering methods. Virtual currencies, such as Bitcoin, are becoming increasingly mainstream and offer traffickers a relatively secure method for moving illicit proceeds around the world with much less risk compared to traditional methods. Details: Washington, DC: DEA, 2018. 164p. Source: Internet Resource: Accessed November 14, 2018 at: https://www.dea.gov/sites/default/files/2018-11/DIR-032-18%202018%20NDTA%20final%20low%20resolution.pdf Year: 2018 Country: United States URL: https://www.dea.gov/sites/default/files/2018-11/DIR-032-18%202018%20NDTA%20final%20low%20resolution.pdf Shelf Number: 153464 Keywords: Drug Abuse and Addiction Drug Cartels Drug Enforcement Drug Trafficking Gangs Illicit Drugs Opioid Crisis Organized Crime

Author: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) Title: Captagon: understanding today's illicit market Summary: Originally, Captagon was the main brand name for a medicinal product containing fenetylline as its active ingredient. It is no longer produced today or used for therapeutic purposes. Nevertheless, many countries in the Middle East regularly report seizures of a drug known as 'captagon' as part of their reporting obligations to international organisations. Captagon is also reported to be a commonly used stimulant in the Middle East and, to a lesser extent, some countries bordering the European Union, while some indicators suggest that European countries may be a source of the captagon consumed in these countries. In addition, some recent media reports have linked this drug to perpetrators of terrorist acts in Europe or terrorist groups based in areas of conflict in the Middle East. This has led to heightened interest in and concern about this drug, although only limited information is available on what the substance reported as captagon actually is and where it comes from. This report therefore aims to provide an overview of what is known about the captagon phenomenon, and how it may concern Europe, to assist those working in the illicit drugs field who may need to respond to the issue. It reviews how the drug known as captagon has evolved from the medicinal product Captagon into illicitly produced and marketed tablets, which generally appear to contain other substances, most commonly amphetamine, despite bearing the logo that was used on the original Captagon tablets. It also reviews what is known about the current production, supply and use of captagon. Finally, it highlights how the often sensationalist media reports of special links between captagon use and terrorist activity in Europe are not supported by evidence, although there may be some opportunistic links between drug use and supply in general and terrorism. Details: Luxembourg: Publications Office of the European Union, 2018. 21p. Source: Internet Resource: EMCDDA Papers: Accessed November 16, 2018 at: http://www.emcdda.europa.eu/system/files/publications/9783/20184976_TDAU18002ENN_PDF.PDF Year: 2018 Country: Europe URL: http://www.emcdda.europa.eu/system/files/publications/9783/20184976_TDAU18002ENN_PDF.PDF Shelf Number: 153501 Keywords: Captagon Drug Abuse and Addiction Illegal Drugs Illicit Drugs

Author: Colorado Department of Public Health and Environment Title: Monitoring Health Concerns Related to Marijuana in Colorado: 2016 Summary: The state's Retail Marijuana Public Health Advisory Committee has released its second set of findings from the committee's review of the scientific literature currently available on the health effects of marijuana use. The report, "Monitoring Health Concerns Related to Marijuana in Colorado: 2016," also provides survey data about marijuana use in Colorado and data from hospitals and the poison center on potential marijuana-related health effects. Senate Bill 13-283 requires the committee to monitor the emerging science and medical information about marijuana use and report its findings. "Just as with tobacco and alcohol, continued monitoring of marijuana use and potential health effects help guide our work to protect the health of Colorado's citizens," said Dr. Larry Wolk, executive director and chief medical officer at the Colorado Department of Public Health and Environment. "We want to base policy decisions and educational campaigns on sound science." The report recommends continued monitoring of several trends, including: About 6 percent of pregnant women choose to use marijuana while pregnant. This percentage is higher among those with unintended pregnancies as well as younger mothers or those with less education. Using marijuana during pregnancy is associated with negative effects on exposed children, including decreased cognitive function and ability to maintain attention on task. Effects may not appear until adolescence. At least 14,000 children in Colorado are at risk of accidentally eating marijuana products that are not safely stored, and at least 16,000 are at risk of being exposed to secondhand marijuana smoke in the home. The committee found strong evidence such accidental exposures can lead to significant clinical effects that, in some cases, require hospitalization. More than 5 percent of high school students use marijuana daily or nearly daily. This has been the case since at least 2005. The report finds weekly marijuana use by adolescents is associated with impaired learning, memory, math and reading, for as long as 28 days after last use. Weekly use also is associated with failure to graduate from high school. In addition, adolescent marijuana users are more likely to develop cannabis use disorder or be addicted to alcohol, tobacco or illicit drugs in adulthood. In Colorado, one in four adults ages 18-25 reported past-month marijuana use and one in eight use daily or nearly daily. These numbers have been consistent since marijuana's legalization. There are indications that policy and education efforts about the potential health effects of marijuana are working. For example, marijuana exposure calls to the Rocky Mountain Poison and Drug Center have decreased since 2015. This includes calls about accidental exposures in children under 9 years old. In addition, the overall rate of marijuana-related emergency department visits dropped 27 percent from 2014 to 2015. (2016 data is not available yet.) The report also cited these trends: Past-month marijuana use among adults and adolescents has not changed since legalization either in terms of the number of people using or the frequency of use. Based on the most comprehensive data available, past-month marijuana use among Colorado adolescents is nearly identical to the national average. Daily or near-daily use of marijuana among adults in Colorado is much lower than daily or near-daily use of alcohol or tobacco. Based on its findings, the committee also recommends continuing to use survey, poison center and hospital data to monitor trends in marijuana use and health effects; state support of research to fill important gaps in public health knowledge; and continued public education about the potential risks of marijuana use. Details: Denver: The Department, 2017. 304p. Source: Internet Resource: Accessed November 21, 2018 at: https://drive.google.com/file/d/0B0tmPQ67k3NVQlFnY3VzZGVmdFk/view Year: 2017 Country: United States URL: https://drive.google.com/file/d/0B0tmPQ67k3NVQlFnY3VzZGVmdFk/view Shelf Number: 153528 Keywords: Drug Abuse and Addiction Drug Policy Marijuana Marijuana Legalization Public Health

Author: Kilmer, Beau Title: Considering Heroin-Assisted Treatment and Supervised Drug Consumption Sites in the United States Summary: Current levels of opioid-related morbidity and mortality in the United States are staggering. Data for 2017 indicate that there were more than 47,000 opioid-involved overdose deaths, and one in eight adults now reports having had a family member or close friend die from opioids. Increasing the availability and reducing the costs of approved medications for those with an opioid use disorder (OUD) is imperative; however, jurisdictions addressing OUDs and overdose may wish to consider additional interventions. Two interventions that are implemented in some other countries but not in the United States are heroin-assisted treatment (HAT; sometimes referred to as supervised injectable heroin treatment) and supervised consumption sites (SCSs; sometimes referred to as overdose prevention sites). Given the severity of the opioid crisis, there is urgency to evaluate tools that might reduce its impact and save lives. In this mixed-methods report, the authors assess evidence on and arguments made about HAT and SCSs and examine some of the issues associated with implementing them in the United States. Key Findings -- Evidence from randomized controlled trials of HAT in Canada and Europe indicates that supervised injectable HAT - with optional oral methadone - can offer benefits over oral methadone alone for treating OUD among individuals who have tried traditional treatment modalities, including methadone, multiple times but are still injecting heroin. Although heroin cannot be prescribed in the United States because it is a Schedule I drug, it would be legal to conduct a human research trial on HAT. The literature on treating OUD with hydromorphone (e.g., Dilaudid) is less extensive than the literature on HAT; however, the existing results are encouraging. Hydromorphone trials in the United States would face fewer barriers than HAT trials. The scientific evidence about the effectiveness of SCSs is limited in quality and the number of locations evaluated. Many SCSs have been around for 15 to 30 years. Persistence does not imply effectiveness, but it seems unlikely that these SCSs - which were initially controversial in many places - would have such longevity if they had serious adverse consequences for their clients or communities. For drug consumption that is supervised, SCSs reduce the risk of a fatal overdose, disease transmission, and harms associated with unhygienic drug use practices; however, there is uncertainty about the size of the population-level effects of SCSs. There are significant legal issues surrounding the implementation of SCSs in the United States.. Both HAT and SCSs, as currently implemented, serve only a small share of people who use heroin. It is important to have a sense of potential scale limitations and costs when discussing HAT and SCSs. It might be constructive to view HAT and SCSs as exemplars of broader strategies, not as the only option within their class. Recommendations -- Given (1) the increased mortality associated with fentanyl, (2) the fact that some people who use heroin may not respond well to existing medications for OUD, (3) HAT's successful implementation abroad, and (4) questions concerning whether the success would carry over to the United States, HAT trials should be conducted in some of the U.S. jurisdictions that already provide a spectrum of social services and good accessibility to medication treatments for OUD. Conducting trials with HAT and hydromorphone are not mutually exclusive, and it may make sense to include both in the same study, as was done in Canada. Assessing the impact of injectable hydromorphone via clinical trials (with or without a HAT arm) would inform future regulatory decisions about using it as a medication treatment for OUD. Some researchers and advocates believe that, during an emergency like the present opioid crisis, the absence of a large downside risk for an intervention that has strong face validity (e.g., SCSs) may be sufficient for some decisionmakers to proceed, rather than waiting for further evidence. Nevertheless, if attempts to implement SCSs in the United States are successful, a strong research component should be incorporated into these efforts. Details: Santa Monica, CA: RAND, 2018. 93p. Source: Internet Resource: Accessed Dec. 6, 2018 at: https://www.rand.org/pubs/research_reports/RR2693.html?utm_source=WhatCountsEmail&utm_medium=Drug%20Policy%20Research%20Center%20(DPRC)+AEM:%20%20Email%20Address%20NOT%20LIKE%20DOTMIL&utm_campaign=AEM:363632650 Year: 2018 Country: United States URL: https://www.rand.org/pubs/research_reports/RR2693.html?utm_source=WhatCountsEmail&utm_medium=Drug%20Policy%20Research%20Center%20(DPRC)+AEM:%20%20Email%20Address%20NOT%20LIKE%20DOTMIL&utm_campaign=AEM:363632650 Shelf Number: 153920 Keywords: Drug Abuse and Addiction Drug Consumption Facilities Drug-Related Deaths Fentanyl Opioid Epidemic Opioids Prescription Drug Abuse Substance Abuse Treatment

Author: Stone, Katie Title: The Global State of Harm Reduction 2018 Summary: In 2008, Harm Reduction International (HRI) released the first Global State of Harm Reduction, a report that mapped responses to drug-related HIV, viral hepatitis and tuberculosis (TB) around the world for the first time. The data gathered for the report provided a critical baseline against which progress could be measured in terms of the international, regional and national recognition of harm reduction in policy and practice. Since 2008, the biennial report has become a key publication for researchers, policymakers, civil society organisations, UN agencies and advocates, mapping harm reduction policy adoption and programme implementation globally. Over the last decade, reports of injecting drug use and the harm reduction response have increased; harm reduction programmes are currently operating at some level in almost half of the 179 countries in the world where injecting drug use has been documented. With patterns of drug use globally continuing to evolve, Harm Reduction International reached out in 2017 to civil society networks across the world to ask what they wanted to see in this report. The 2018 Global State of Harm Reduction report has a broader scope, containing information on: - The number of people who inject drugs and the number of people imprisoned for drug use (where data is available). - Needle and syringe programmes (NSP), opioid substitution therapy (OST), HIV and hepatitis C and TB testing and treatment for people who use drugs, in both the community and in prisons. - The harm reduction response for people who use amphetamine-type stimulants, cocaine and its derivatives, and new psychoactive substances. - Drug-checking in nightlife settings. - Harm reduction for women who use drugs. - Drug consumption rooms. - Drug-related mortality and morbidity and the overdose response, as well as naloxone peer distribution in the community and naloxone provision in prisons. - Developments and regressions in funding for harm reduction. This report and other Global State of Harm Reduction resources can be found at www.hri.global. Details: London: Harm Reduction International, 2018. 176p. Source: Internet Resource: Accessed December 18, 2018 at: https://www.hri.global/files/2018/12/11/global-state-harm-reduction-2018.pdf Year: 2018 Country: International URL: https://www.hri.global/files/2018/12/11/global-state-harm-reduction-2018.pdf Shelf Number: 154070 Keywords: Cocaine Drug Abuse and Addiction Drug Consumption Facilities Drug Use Harm Reduction HIV Methamphetamine Naloxone Substance Abuse

Author: Ghandnoosh, Nazgol Title: Opioids: Treating an Illness, Ending a War Summary: More people died from opioid-related deaths in 2015 than in any previous year. This record number quadrupled the level of such deaths in 1999. Unlike the heroin and crack crises of the past, the current opioid emergency has disproportionately affected white Americans-poor and rural, but also middle class or affluent and suburban. This association has boosted support for preventative and treatment-based policy solutions. But the pace of the response has been slow, critical components of the solution-such as health insurance coverage expansion and improved access to medication-assisted treatment-face resistance, and there are growing efforts to revamp the failed and costly War on Drugs. Details: Washington, DC: The Sentencing Project, 2018. 32p. Source: Internet Resource: Accessed January 24, 2019 at: https://www.sentencingproject.org/publications/opioids-treating-illness-ending-war/ Year: 2018 Country: United States URL: https://www.sentencingproject.org/publications/opioids-treating-illness-ending-war/ Shelf Number: 154399 Keywords: Drug Abuse and Addiction Drug Abuse and Crime Opioid Epidemic Opioids Prescription Drugs

Author: Minhee, Christine Title: The Cure for America's Opioid Crisis? End the War on Drugs Summary: The War on Drugs. What began as a battle waged on morals has in fact created multiple public health crises, and no recent phenomenon illustrates this in more macabre detail than America's opioid disaster. Last year alone amassed a higher death toll than the totality of American military casualties in the Vietnam, Iraq, and Afghanistan wars combined. With this wave of mortalities came an accompanying tidal crash of parens patriae lawsuits filed by states, counties, and cities on the theory that jurisdictions are entitled to recompense for the costs of addiction ostensibly created by Big Pharma. To those attuned to the failures of the Iron Law of Prohibition, this litigation-fueled blame game functions merely as a Band-Aid over a deeply infected wound. This Article synthesizes empirical economic impact data to paint a clearer picture of the role that drug prohibition has played in the devastation of American communities, exposes parens patriae litigation as a misguided attempt at retribution rather than deterrence, and calls for the legal and political decriminalization of opiates. We reveal that America's fear of decriminalization has at its root the "chemical hook" fallacy-a holdover from Nancy Reagan-era drug policy that has been debunked by far less wealthy countries like Switzerland and Portugal, whose economies have already benefited from discarding the War on Drugs as an irrational and expensive approach to public health. We argue that the legal and political acceptance of addiction as a public health issue-not the view that addiction is a moral failure to scourge-is the only rational, fiscally responsible option left to a country that badly needs both a prophylactic against future waves of heavy opioid casualties, and restored faith in its own criminal justice system. Details: Seattle: University of Washington School of Law, 2018. 70p. Source: Internet Resource: University of Washington School of Law Research Paper No. 2018-11: Accessed February 20, 2019 at: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3245489 Year: 2018 Country: United States URL: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3245489 Shelf Number: 154675 Keywords: Drug Abuse and Addiction Drug Enforcement Drug Policy Opioid Epidemic Opioids Prescription Drugs War on Drugs

Author: International Drug Policy Consortium Title: 10 Years of Drug Policy in Asia: How Far Have We Come? A Civil Society Shadow Report Summary: Countries in Asia implement some of the harshest drug policies in the world. As United Nations (UN) member states are set to meet in March 2019 to take stock of progress made since 2009 and delineate the next phase for global drug policy, '10 Years of Drug Policy in Asia: How Far Have We Come?' evaluates the impacts of drug policies in Asia over the past decade from a civil society perspective. The critical role of civil society in the design, implementation, monitoring and evaluation of drug policies is acknowledged in the 2009 Political Declaration and Plan of Action, as well as in the Outcome Document of the 2016 United Nations General Assembly Special Session (UNGASS) on drugs. Using data from the UN, academic literature and contributions from civil society, this report aims to provide a critical assessment of drug policy failures and successes across the region, with the aim of informing high-level discussions on the next decade of drug policy. Details: London: IDPC, 2019. 66p. Source: Internet Resource: Accessed march 5, 2019 at: https://idhdp.com/media/532117/10-year-review_asia.pdf Year: 2019 Country: Armenia URL: https://idhdp.com/media/532117/10-year-review_asia.pdf Shelf Number: 154811 Keywords: Drug Abuse and Addiction Drug Enforcement Drug Policy War on Drugs

Author: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) Title: Wastewater Analysis and Drugs: A European multi-city study Summary: The findings of the largest European project to date in the emerging science of wastewater analysis are taken up in this 'Perspective on drugs'. The project in question analysed wastewater in around 60 European cities and towns (hereinafter referred to as 'cities') to explore the drug-taking habits of those who live in them. The results provide a valuable snapshot of the drug flow through the cities involved, revealing marked geographical variations. Details: Lisbon: EMCDDA, 2018. 12p. Source: Internet Resource: Perspectives on Drugs: Accessed March 5, 2019 at: http://www.emcdda.europa.eu/publications/pods/waste-water-analysis_en Year: 2018 Country: Europe URL: http://www.emcdda.europa.eu/publications/pods/waste-water-analysis_en Shelf Number: 154817 Keywords: Drug Abuse and Addiction Drug Enforcement Illicit Drugs Wastewater Analysis

Author: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) Title: Drug treatment systems in the Western Balkans. Outcomes of a joint EMCDDA-UNODC survey of drug treatment facilities Summary: This report presents a summary of the key findings from drug treatment facility surveys carried out in 2017 in Albania, Bosnia and Herzegovina, Serbia and the territory of Kosovo. The results provide insight into the characteristics and capacity of the treatment systems, as well as the availability and provision of treatment interventions. The report also considers the implications for practice and policy. Details: Luxembourg: Publications Office of the European Union, 2019. 40p. Source: Internet Resource: Accessed March 6, 2019 at: http://www.emcdda.europa.eu/system/files/publications/10368/20186097_TD0618248ENN_PDF.pdf Year: 2019 Country: Europe URL: http://www.emcdda.europa.eu/system/files/publications/10368/20186097_TD0618248ENN_PDF.pdf Shelf Number: 154831 Keywords: Drug Abuse and Addiction Drug Treatment Substance Abuse Treatment

Author: Disley, Emma Title: Development of a framework to estimate the cost of opioid dependence Summary: Opioid dependence imposes a range of costs on individuals, families, communities and society, and understanding these costs is important to inform policy and decision making in this area, especially when budgets for services to address challenges such as substance misuse are under pressure. This report sets out the findings of a targeted review of the harms of opioid dependence, and an assessment of existing estimates of the costs of opioid dependence. A proposed framework for developing new, more comprehensive estimates of the costs of opioid dependence is outlined. Details: Santa Monica, CA: RAND, 2013. 91p. Source: Internet Resource: Accessed march 12, 2019 at: https://www.rand.org/pubs/research_reports/RR406.html Year: 2013 Country: United States URL: https://www.rand.org/pubs/research_reports/RR406.html Shelf Number: 154910 Keywords: Drug Abuse and Addiction Illegal Drugs Opioids Prescription Drug Abuse

Author: Stein, Bradley D. Title: Policies to Support a Better Treatment for Heroin and Prescription Opioid Abuse Unlike Methadone, Buprenorphine Can Be Taken at Home, but Greater Access is Key Summary: Abuse of heroin and prescription opiates (such as oxycodone and hydrocodone) has spiked in the past decade, with an estimated 2 million people having used in the past year. Although methadone clinics offer effective treatment, only a fraction of those trying to quit opiates enter a clinic's doors. Unlike methadone, the prescription drug buprenorphine can be taken outside a methadone clinic, which greatly increases treatment options for people unable or unwilling to receive a daily dose of methadone at a clinic. However, access to buprenorphine is somewhat limited; the only physicians who can prescribe it are those who complete an approved course or have board certifications in addiction medicine or addiction psychiatry and receive a special U.S. Drug Enforcement Administration number indicating that they are waivered from the special registration requirements in the Controlled Substances Act. In addition, the number of patients they can treat is restricted because of concerns that buprenorphine would be diverted to illicit use. Policymakers are examining ways to improve access, including increasing the number of patients a waivered physician can treat and allowing nonphysicians who receive waivers to prescribe it as well. Key Findings Access to buprenorphine increased dramatically in 2006, when physicians who were permitted (waivered) to prescribe the drug were allowed to prescribe it for 100 patients at a time rather than 30. Waivered physicians are more plentiful in states where Medicaid or another state-provided benefit covers buprenorphine treatment and in states with specific guidance on both the use of buprenorphine and the distribution of clinical guidelines for buprenorphine treatment. While some policies opened the door to greater access, others may limit utilization once patients have started treatment. For example, requiring patients to attend drug counseling, charging copayments, and requiring prior authorization for a prescription may have the effect of decreasing or limiting use of buprenorphine. Details: Santa Monica, CA: RAND, 2015. 4p. Source: Internet Resource: Research Brief: Accessed March 12, 2019 at: https://www.rand.org/pubs/research_briefs/RB9871.html Year: 2015 Country: United States URL: https://www.rand.org/pubs/research_briefs/RB9871.html Shelf Number: 154916 Keywords: Drug Abuse and Addiction Opioids Prescription Drug Abuse Substance Abuse Treatment

Author: Critchley, Karen Title: Criminal Justice Project: Drug Interventions Programme - Sefton Drug Testing Profile (2014 to 2017) Summary: The Drug Interventions Programme (DIP) process generally begins with the police drug testing individuals in the custody suite following an arrest. If offenders test positive for Class A drugs (opiates and/or cocaine), they are served with a Required Assessment (RA) by the police. This a compulsory legal sanction which requires the individual to attend up to two appointments (initial/follow-up RA) with a drugs worker. During these assessments the drugs worker will assess the individual's drug use and offending behaviour and, if necessary, encourage them to engage with drug treatment services (Home Office, 2010). In 2016/17, 57% of those accessing DIP in Merseyside presented via the RA route, while in Sefton 60% presented through RAs (Collins et al., 2017a). For this reason, the police play an important role in the early stages of the DIP process. Merseyside Police introduced targeted drug testing in 2015. This involves a set list of questions around drug use that should be considered by the police before a decision is made on whether the arrestee is drug tested. The main aim of targeted testing is to reduce the number of negative drug tests carried out in the custody suite setting, thus save police time and money, while ensuring offenders who use drugs continue to be drug tested and referred to treatment services through the RA process. This Drug Testing Profile for Sefton presents information on drug tests carried out at Sefton's custody suites and on Sefton residents across the Merseyside area between January 2014 and December 2017, with a particular focus given to the most recent year (2017). This profile contextualises Merseyside Police drug testing data by providing numbers and trends of offenders who use drugs identified through this route into the DIP system and a demographic overview of the individuals. Comparisons to overall Merseyside figures have been made, where possible, with tables in Appendix A and B showing comparisons across each area (custody suite area and area of residence). This profile also provides recommendations for all stakeholders involved with DIP, in terms of the efficient use of resources and effective services locally and across Merseyside. Details: Liverpool: Public Health Institute, Liverpool John Moores University, 2018. 19p. Source: Internet Resource: Accessed March 13, 2019 at: http://researchonline.ljmu.ac.uk/8552/1/SeftonDrugTestingProfile%282014-17%29.pdf Year: 2018 Country: United Kingdom URL: http://researchonline.ljmu.ac.uk/8552/1/SeftonDrugTestingProfile%282014-17%29.pdf Shelf Number: 154938 Keywords: Drug Abuse and Addiction Drug Offenders Drug Testing Program Drug Treatment Programs Substance Abuse Treatment

Author: United Nations Office on Drugs and Crime. Independent Evaluation Unit Title: Final Independent project evaluation of the "Promoting Alternatives to Incarceration for Convicted Drug Users, including Rehabilitation and Probation� (Forming part of the Sub-Programme 5 on Drugs and HIV of the Indonesia Country Programme 2012-2016) Summary: Drug abuse remains a major problem in Indonesia. At the same time, the national policy response to drugs remains predominantly focused on law enforcement measures, which contributes to the overcrowding of Indonesia's prison. The new Narcotics Law #35/2009 introduces mechanisms for diverting people who use drugs away from prison and towards rehabilitation. However, significant challenges remain in the execution of the law. As of March 2014, several Indonesian government agencies, including the National Narcotics Board (In Indonesia: Badan Narkotika Nasional/BNN), the Indonesian National Police (INP), Supreme Court, Attorney General's Office (AGO), Ministry of Health (MoH), Ministry of Law and Human Rights (MoLHR), and Ministry of Social Affairs (MoSA), signed a Memorandum of Understanding (MOU) to promote this legislative framework. The MoU further launched the joint Inter-ministerial regulation to operationalize this legislation by establishing the Integrated Assessment Team (IAT). As a valued partner of the Government of Indonesia (GOI), the United Nations Office on Drugs and Crime (UNODC) has been asked to provide technical assistance on the implementation of this regulation. Therefore, UNODC has been implementing the "Promoting Alternatives to Incarceration for Convicted Drug Users, including Rehabilitation and Probation" (INDA06) project. The INDA06 is funded by the Government of the United States of America through the U.S. Department of State's Bureau of International Narcotics and Law Enforcement Affairs (USA-INL). The original duration of the project was 24 months - January 2015 - December 2016. However, a no-cost extension was approved which extended it to June 2017. The project was implemented in two cities, Jakarta and Makassar, Indonesia. The project's main objective is to improve Indonesia's criminal justice reform agenda through alternatives to imprisonment for convicted drug users. The project outcome is to support the implementation of the national joint regulation on the placement of people with drug dependence and victims of drug abuse into rehabilitation institutions. The activities include providing capacity building to Law Enforcement Agencies (LEA), service providers and civil society, strengthening the Integrated Assessment Team (IAT), and introducing international best practices (i.e. the Drug Court Treatment). The Evaluation -- The purpose of this evaluation is to document key achievements, challenges, lessons learned and good practices for future programming and decision-making. It aims to: 1) Assess the Organisation for Economic Co-operation and Development - Development Assistance Committee (OECD DAC) criteria for: Relevance, efficiency, effectiveness, impact, sustainability, as well as partnership and cooperation, human rights and gender; 2) Identify gaps, limitations and/or challenges; 3) Derive lessons learned and best practices; and 4) Generate actionable recommendations that help in promoting the model of alternatives to imprisonment for convicted drug users. This evaluation was conducted from early April through the end of June 2017. The evaluation reviewed all project activities implemented from January 2015 until the end of the field mission in early June 2017. The field missions took place in two cities in Indonesia: Jakarta and Makassar. The evaluation had three phases - (1) the inception phase, with desk review and preparation of the inception report; (2) the data collection phase, which involves a "mixed methods approach" to combining quantitative (i.e. on-line survey) and qualitative methods (i.e. interviews and focus group discussions (FGDs)) to obtain deeper insight into what the project has been able to achieve, including a proper diversification of data sources; and (3) the analysis/synthesis/reporting phase, with drafting and finalization of the report. Details: Vienna: UNODC, 2017. 84p. Source: Internet Resource: Accessed March 13, 2019 at: https://www.unodc.org/documents/evaluation/Independent_Project_Evaluations/2017/INDA06_Final_Independent_Project_Evaluation_final_report_October_2017.pdf Year: 2017 Country: Indonesia URL: https://www.unodc.org/documents/evaluation/Independent_Project_Evaluations/2017/INDA06_Final_Independent_Project_Evaluation_final_report_October_2017.pdf Shelf Number: 154944 Keywords: Alternatives to Incarceration Diversion Programs Drug Abuse and Addiction Drug Offenders Offender Rehabilitation Programs Probation

Author: McKendy, Laura Title: Overdose Incidents in Federal Custody, 2012/2013 - 2016/2017 Summary: The rise of drug overdose incidents, specifically those involving opioids, is a growing concern for Canadian society (British Columbia Coroners Service Death Review Panel, 2018; Special Advisory Committee on the Epidemic of Opioid Overdoses, 2018; Health Canada, 2017). While numerous reports have documented trends in the community, limited detailed data is available on trends in overdose incidents among custodial populations. This report furthers knowledge on this topic by examining all overdose incidents in federal custody over a five-year period (2012/2013 - 2016/2017), identifying the prevalence and nature of overdose incidents, the circumstances under which overdose incidents occur, the characteristics of offenders who experience overdose incidents, and patterns in the nature of staff and medical responses. Over the five-year period under examination, 330 incidents were identified for analysis. Most of these overdose incidents were unintentional and non-fatal. More specifically, over three-quarters of cases (77%) were identified as unintentional non-fatal overdose incidents, 15% were intentional non-fatal overdose incidents, and 7% were identified as fatal overdose incidents, either intentional or non-intentional. Overdose incidents have seen a notable increase in the Prairie region; in 2016/2017, 48% (42) of all overdose incidents occurred in this region, compared to 20% (8) in 2012/2013. In terms of the substances involved in overdose incidents, differences were observed across incident types. Opioids were most common in fatal overdoses and unintentional non-fatal overdose incidents, accounting for 91% and 57% of incidents respectively. Contrastingly, intentional nonfatal overdose incidents seldom involved opioids and most often involved prescription medications (e.g., anticonvulsants, antidepressants, cardiovascular medications), identified in 85% of cases. Over the five-year period examined, overdose incidents involving opioids increased in raw numbers (from 19 in 2012/2013 to 50 in 2016/2017), with a moderate increase as a percentage of all overdose incidents (from 48% to 57%). Notably, the percentage of those involving fentanyl increased from 3% (1) in 2012/2013, to 26% (23) in 2016/2017. At the same time, the percentage of overdose incidents involving heroin decreased from 25% (10) in 2012/2013, to 13% (11) in 2016/2017. When it came to fatal overdose incidents, fentanyl was the most common substance found, noted in 36% (8) of cases across the five-year period. While variation exists, certain characteristics were common among offenders who overdosed. They tended to be male (92%), Caucasian (58%) or Indigenous (36%), aged 25-34 (39%), classified as medium security (72%), serving relatively short (under 4 year) sentences (41%), with a major index offence of robbery (31%). Offenders typically had institutional histories riddled with security and discipline incidents, particularly incidents involving drugs, other contraband (excluding tobacco), and disobedience. Indigenous offenders were involved in 119 (36%) of overdose incidents over the five-year period examined. Indigenous representation was highest in the Pacific region (46%) and was higher The rise of drug overdose incidents, specifically those involving opioids, is a growing concern for Canadian society (British Columbia Coroners Service Death Review Panel, 2018; Special Advisory Committee on the Epidemic of Opioid Overdoses, 2018; Health Canada, 2017). While numerous reports have documented trends in the community, limited detailed data is available on trends in overdose incidents among custodial populations. This report furthers knowledge on this topic by examining all overdose incidents in federal custody over a five-year period (2012/2013 - 2016/2017), identifying the prevalence and nature of overdose incidents, the circumstances under which overdose incidents occur, the characteristics of offenders who experience overdose incidents, and patterns in the nature of staff and medical responses. Over the five-year period under examination, 330 incidents were identified for analysis. Most of these overdose incidents were unintentional and non-fatal. More specifically, over three-quarters of cases (77%) were identified as unintentional non-fatal overdose incidents, 15% were intentional non-fatal overdose incidents, and 7% were identified as fatal overdose incidents, either intentional or non-intentional. Overdose incidents have seen a notable increase in the Prairie region; in 2016/2017, 48% (42) of all overdose incidents occurred in this region, compared to 20% (8) in 2012/2013. In terms of the substances involved in overdose incidents, differences were observed across incident types. Opioids were most common in fatal overdoses and unintentional non-fatal overdose incidents, accounting for 91% and 57% of incidents respectively. Contrastingly, intentional nonfatal overdose incidents seldom involved opioids and most often involved prescription medications (e.g., anticonvulsants, antidepressants, cardiovascular medications), identified in 85% of cases. Over the five-year period examined, overdose incidents involving opioids increased in raw numbers (from 19 in 2012/2013 to 50 in 2016/2017), with a moderate increase as a percentage of all overdose incidents (from 48% to 57%). Notably, the percentage of those involving fentanyl increased from 3% (1) in 2012/2013, to 26% (23) in 2016/2017. At the same time, the percentage of overdose incidents involving heroin decreased from 25% (10) in 2012/2013, to 13% (11) in 2016/2017. When it came to fatal overdose incidents, fentanyl was the most common substance found, noted in 36% (8) of cases across the five-year period. While variation exists, certain characteristics were common among offenders who overdosed. They tended to be male (92%), Caucasian (58%) or Indigenous (36%), aged 25-34 (39%), classified as medium security (72%), serving relatively short (under 4 year) sentences (41%), with a major index offence of robbery (31%). Offenders typically had institutional histories riddled with security and discipline incidents, particularly incidents involving drugs, other contraband (excluding tobacco), and disobedience. Indigenous offenders were involved in 119 (36%) of overdose incidents over the five-year period examined. Indigenous representation was highest in the Pacific region (46%) and was higher The rise of drug overdose incidents, specifically those involving opioids, is a growing concern for Canadian society (British Columbia Coroners Service Death Review Panel, 2018; Special Advisory Committee on the Epidemic of Opioid Overdoses, 2018; Health Canada, 2017). While numerous reports have documented trends in the community, limited detailed data is available on trends in overdose incidents among custodial populations. This report furthers knowledge on this topic by examining all overdose incidents in federal custody over a five-year period (2012/2013 - 2016/2017), identifying the prevalence and nature of overdose incidents, the circumstances under which overdose incidents occur, the characteristics of offenders who experience overdose incidents, and patterns in the nature of staff and medical responses. Over the five-year period under examination, 330 incidents were identified for analysis. Most of these overdose incidents were unintentional and non-fatal. More specifically, over three-quarters of cases (77%) were identified as unintentional non-fatal overdose incidents, 15% were intentional non-fatal overdose incidents, and 7% were identified as fatal overdose incidents, either intentional or non-intentional. Overdose incidents have seen a notable increase in the Prairie region; in 2016/2017, 48% (42) of all overdose incidents occurred in this region, compared to 20% (8) in 2012/2013. In terms of the substances involved in overdose incidents, differences were observed across incident types. Opioids were most common in fatal overdoses and unintentional non-fatal overdose incidents, accounting for 91% and 57% of incidents respectively. Contrastingly, intentional nonfatal overdose incidents seldom involved opioids and most often involved prescription medications (e.g., anticonvulsants, antidepressants, cardiovascular medications), identified in 85% of cases. Over the five-year period examined, overdose incidents involving opioids increased in raw numbers (from 19 in 2012/2013 to 50 in 2016/2017), with a moderate increase as a percentage of all overdose incidents (from 48% to 57%). Notably, the percentage of those involving fentanyl increased from 3% (1) in 2012/2013, to 26% (23) in 2016/2017. At the same time, the percentage of overdose incidents involving heroin decreased from 25% (10) in 2012/2013, to 13% (11) in 2016/2017. When it came to fatal overdose incidents, fentanyl was the most common substance found, noted in 36% (8) of cases across the five-year period. While variation exists, certain characteristics were common among offenders who overdosed. They tended to be male (92%), Caucasian (58%) or Indigenous (36%), aged 25-34 (39%), classified as medium security (72%), serving relatively short (under 4 year) sentences (41%), with a major index offence of robbery (31%). Offenders typically had institutional histories riddled with security and discipline incidents, particularly incidents involving drugs, other contraband (excluding tobacco), and disobedience. Indigenous offenders were involved in 119 (36%) of overdose incidents over the five-year period examined. Indigenous representation was highest in the Pacific region (46%) and was higher The rise of drug overdose incidents, specifically those involving opioids, is a growing concern for Canadian society (British Columbia Coroners Service Death Review Panel, 2018; Special Advisory Committee on the Epidemic of Opioid Overdoses, 2018; Health Canada, 2017). While numerous reports have documented trends in the community, limited detailed data is available on trends in overdose incidents among custodial populations. This report furthers knowledge on this topic by examining all overdose incidents in federal custody over a five-year period (2012/2013 - 2016/2017), identifying the prevalence and nature of overdose incidents, the circumstances under which overdose incidents occur, the characteristics of offenders who experience overdose incidents, and patterns in the nature of staff and medical responses. Over the five-year period under examination, 330 incidents were identified for analysis. Most of these overdose incidents were unintentional and non-fatal. More specifically, over three-quarters of cases (77%) were identified as unintentional non-fatal overdose incidents, 15% were intentional non-fatal overdose incidents, and 7% were identified as fatal overdose incidents, either intentional or non-intentional. Overdose incidents have seen a notable increase in the Prairie region; in 2016/2017, 48% (42) of all overdose incidents occurred in this region, compared to 20% (8) in 2012/2013. In terms of the substances involved in overdose incidents, differences were observed across incident types. Opioids were most common in fatal overdoses and unintentional non-fatal overdose incidents, accounting for 91% and 57% of incidents respectively. Contrastingly, intentional nonfatal overdose incidents seldom involved opioids and most often involved prescription medications (e.g., anticonvulsants, antidepressants, cardiovascular medications), identified in 85% of cases. Over the five-year period examined, overdose incidents involving opioids increased in raw numbers (from 19 in 2012/2013 to 50 in 2016/2017), with a moderate increase as a percentage of all overdose incidents (from 48% to 57%). Notably, the percentage of those involving fentanyl increased from 3% (1) in 2012/2013, to 26% (23) in 2016/2017. At the same time, the percentage of overdose incidents involving heroin decreased from 25% (10) in 2012/2013, to 13% (11) in 2016/2017. When it came to fatal overdose incidents, fentanyl was the most common substance found, noted in 36% (8) of cases across the five-year period. While variation exists, certain characteristics were common among offenders who overdosed. They tended to be male (92%), Caucasian (58%) or Indigenous (36%), aged 25-34 (39%), classified as medium security (72%), serving relatively short (under 4 year) sentences (41%), with a major index offence of robbery (31%). Offenders typically had institutional histories riddled with security and discipline incidents, particularly incidents involving drugs, other contraband (excluding tobacco), and disobedience. Indigenous offenders were involved in 119 (36%) of overdose incidents over the five-year period examined. Indigenous representation was highest in the Pacific region (46%) and was higher among women (52%) relative to men (35%). Overdose incidents involving Indigenous offenders were somewhat less likely to involve opioids compared to incidents involving non-Indigenous offenders (45% versus 56%). Over the five-year period examined, 21 overdose incidents occurred involving women; all were non-fatal and most (71%) were unintentional. Overdose incidents involving women typically involved prescription medications (86%), while none involved opioids. Overdose incidents involving women were most common in the Ontario and Pacific regions; nine incidents (43% of all cases) occurred in both of these regions. All women involved in overdose incidents had an identified mental health disorder, while 95% (20) had histories of substance abuse. Overall, overdose incidents tended to occur when offenders were well into their sentence. At the time of incident, offenders had served, on average, 41% of their current sentence, or an average of 4.9 years. The average length of time between the most recent admission date and incident date was 3.2 years. However, variation was observed across incident type; those involved in fatal incidents had served more time (7.8 years) and had been out of the community longer (4.5 years) compared to those involved in non-fatal incidents. In terms of potential risk factors, offenders involved in overdose incidents often had histories of substance misuse and mental illness. More specifically, 95% of offenders had issues related to drugs, while 54% had issues with alcohol. In 81% of cases, substance misuse was identified as a factor linked to criminal offending. Mental illness was particularly common among those involved in intentional non-fatal overdose incidents; 92% had at least one mental health disorder identified, while 89% had histories of self-injurious/suicidal behaviour. A disproportionate number of incidents occurred at a single medium security men's institution in the Prairie region, Drumheller Institution. An institutional-level analysis suggests that the experience of Drumheller is more closely tied to the opioid crisis in the community; over threequarters (77%) of overdose incidents at Drumheller Institution involved opioids, compared to 47% at all other institutions. Fentanyl was identified in 34% of overdose incidents at Drumheller, compared to 8% at all other institutions. Overall, the number of overdose incidents at Drumheller increased from five incidents in 2012/2013, to 25 in 2016/2017. Despite a higher number of overdose incidents, Drumheller had a smaller percentage of deaths (i.e. 2%) and much higher usage of naloxone. The medication, which can temporarily reverse an opioid overdose, was used in 91% of cases at Drumheller, compared to 34% at all other institutions. The findings outlined in this report suggest that the community opioid crisis may be paralleled in custodial settings. As this crisis continues to affect the federal offender population, CSC remains committed to efforts to curb prison drug use and reduce the likelihood of overdose incidents. The widespread availability of naloxone in institutions, as well as CSC's take-home naloxone kit program, Opioid Substitution Treatment (OST) program, substance misuse programs, and the Prison Needle Exchange Program (PNEP), constitute efforts to reduce the potential harms associated with drug use and improve offender health outcomes. This report will further assist in CSC's goal of achieving safe custodial environments by contributing to knowledge on recent trends surrounding fatal and non-fatal drug overdose incidents in custody. Details: Ottawa: Correctional Service of Canada, 2018. 62p. Source: Internet Resource: No. SR-28-02: Accessed April 2, 2019 at: https://www.csc-scc.gc.ca/research/092/sr-18-02-en.pdf Year: 2019 Country: Canada URL: https://www.csc-scc.gc.ca/research/092/sr-18-02-en.pdf Shelf Number: 155268 Keywords: Drug Abuse and Addiction Drug Offenders Drug Overdose Drug-Related Deaths In-Custody Deaths Opioid Epidemic Opioids Prison Deaths

Author: Jelsma, Martin Title: Human Rights, Illicit Cultivation and Alternative Development: Connecting the Dots... Summary: The three UN drug control conventions (1961, 1971 and 1988) and subsequent UN Political Declarations and Action Plans (1998, 2009, 2016) have served as a basis for supply reduction measures towards the cultivation of crops used for the illicit production of narcotic drugs. Frequently, forced eradication operations have led to violent confrontations with small-scale farmers of coca, cannabis and opium poppy, and to numerous human rights violations. Alternative development (AD) programmes have been at the core of efforts to find a more humane balance between drug control obligations, supply reduction policy objectives, and the protection of the rights of people dependent on illicit cultivation for basic subsistence. The development of the AD discourse, its funding support and its troubled relationship with ongoing�and better resourced-parallel law enforcement and eradication operations, have encountered serious challenges. For many, �the difficult balancing between short-term objectives of illicit cultivation reduction and the longer-term approaches based on sustained development efforts has called into question the relevance and even the legitimacy of alternative development policies.�2 Human rights arguments have thus far not played an important role in this discussion and bringing economic, social and cultural rights more firmly to the table could change the terms of the debate. Over the past decade, policymakers, civil society groups and UN agencies have dedicated increasing attention to human rights violations associated with the criminalisation of people who use drugs, the transmission of HIV and hepatitis, forced treatment and drug detention centres, mass incarceration of low-level drug offenders, the death penalty for drug offences, extrajudicial killings, and the lack of access to controlled medicines in the developing world. Much less attention, however, has been paid to human rights protection for rural communities (small farmers, sharecroppers and day labourers) involved in the cultivation, harvesting, processing and trading of drug-linked crops. The only explicit mention of human rights in any of the three UN drug control treaties can be found in the 1988 Convention Against Trafficking of Narcotic Drugs and Psychotropic Substances and deals specifically with "measures to eradicate illicit cultivation of narcotic plants". Article 14.2 specifies that such measures "shall respect fundamental human rights and shall take due account of traditional licit uses, where there is historic evidence of such use, as well as the protection of the environment". ... Details: Amsterdam: Transnational Institute (tni), 2018. 39p. Source: Internet Resource: Discussion Paper: Accessed June 7, 2019 at: https://www.ohchr.org/Documents/HRBodies/HRCouncil/DrugProblem/HRC39/TransnationalInstitute.pdf Year: 2018 Country: International URL: https://www.ohchr.org/Documents/HRBodies/HRCouncil/DrugProblem/HRC39/TransnationalInstitute.pdf Shelf Number: 156318 Keywords: Crop-Substitution Programs Drug Abuse and Addiction Drug Control Policy Human Rights Abuses Illegal Drugs Illicit Drugs Narcotics Supply Reduction