The International journal on drug policy
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Int. J. Drug Policy · Jan 2016
Misuse of non-prescription codeine containing products: Recommendations for detection and reduction of risk in community pharmacies.
Misuse of opioid analgesics is an emergent global public health concern. Codeine has an identified abuse liability, given its effect and development of tolerance within a short timeframe on regular or excessive use. Estimation and management of misuse of over the counter (OTC) codeine containing products are hampered by widespread and easy availability and the heterogeneous and hidden nature of misuse. ⋯ Limited up scheduling that still enables purchase of codeine products without a prescription, and varied measures of pharmacist intervention at point of sale have not succeeded in curtailing therapeutic and non-therapeutic forms of misuse. This commentary broadly discusses the concepts of medication misuse, codeine's potential for misuse and dependence, characteristics of codeine misuse in general, harms from OTC codeine products in particular, 'unique issues' with OTC codeine products, the problems with scheduling solutions and pharmacy based interventions targeting users, along with the supports needed for these interventions. The recent introduction of new OTC combinations of non-opioid agents which provide greater analgesic efficacy than OTC codeine combination analgesics with no risk of opioid dependence provides a satisfactory alternative to these widely misused products.
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Int. J. Drug Policy · Dec 2015
Regulating the sale of tobacco in New Zealand: A qualitative analysis of retailers' views and implications for advocacy.
In contrast to the sale of alcohol and other psychoactive substances, the retail availability of tobacco in New Zealand (NZ) is relatively unregulated. Tobacco is almost universally available, and the absence of a licensing scheme for tobacco retailers makes enforcement of retail-level legislation challenging. As a key stakeholder group, the views of tobacco retailers are likely to influence the tobacco retail policies that gain political support. We explored NZ tobacco retailers' views towards mandatory licensing of tobacco retailers, and how they perceived policies that would reduce tobacco availability. ⋯ In contrast to claims made by industry-related organisations, a proposed licensing policy is unlikely to be met with blanket opposition from tobacco retailers. Advocacy efforts may garner more support for tobacco retail policies if the purpose of policies was framed in terms of protecting young people from smoking.
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Int. J. Drug Policy · Dec 2015
Methods and predictors of tampering with a tamper-resistant controlled-release oxycodone formulation.
In April 2014, a tamper-resistant controlled-release oxycodone formulation was introduced into the Australian market. This study aimed to identify the level and methods of tampering with reformulated oxycodone, demographic and clinical characteristics of those who reported tampering with reformulated oxycodone, and perceived attractiveness of original and reformulated oxycodone for misuse (via tampering). ⋯ Current findings suggest that the introduction of the tamper-resistant product has been successful at reducing, although not necessarily eliminating, tampering with the controlled-release oxycodone formulation, with lower attractiveness for misuse. Appropriate, effective treatment options must be available with increasing availability of abuse-deterrent products, given the reduction of oxycodone tampering and use amongst a group with high rates of pharmaceutical opioid dependence.
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Chemsex is a colloquial term used by gay men in some parts of the UK to describe the use of psychoactive substances (typically mephedrone, GHB/GBL or crystal methamphetamine) during sex. Use of these drugs by gay men in London appears to have risen sharply from relatively low levels and, as yet, there is little data to inform appropriate harm reduction services. This study sought to understand the personal and social context of chemsex and the nature of harm reduction need. ⋯ Findings from this study indicate a substantial degree of harm in the usage of relatively new psychoactive substances in highly sexual circumstances. Generic drug services, typically designed to address the needs of opiate users, may not be sufficiently resourced to address the specific and acute needs of gay men engaging in chemsex.
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Int. J. Drug Policy · Aug 2015
Motivations for prescription drug misuse among young men who have sex with men (YMSM) in Philadelphia.
Prescription drug misuse (i.e. opioids, tranquilizers and stimulants) has become the fastest growing area of substance abuse among young adults. Limited studies focus on prescription drug misuse among young men who have sex with men (YMSM, aged 18-29 years). Furthermore, little is known about YMSM's motivations for misuse. The purpose of this study was to explore personal motivations for prescription drug misuse among YMSM, including the possible connection between misuse and sexual behaviors. ⋯ Our findings offer insights into YMSM's motivations for prescription drug misuse, and point to the importance of recognizing and addressing them. While substance use is likely related to various psychosocial issues impacting YMSM, it also may lead to significant health consequences. Results support the need to include prescription drugs and polysubstance use in harm reduction messages and treatment approaches aimed at substance using YMSM.