Addiction
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To provide an overview of recent privatization/deregulation experiences in North America and other settings, in order to draw conclusions about the impacts that might be expected from such changes on rates of alcohol consumption and related problems. ⋯ The existing evaluation literature on the subject of privatization has tended to focus on examining the net short-term results in terms of alcohol consumption levels. Overall, there are too few studies employing adequate statistical methodologies to explore the underlying causes of changing alcohol consumption and alcohol-related harm. Finally, seven specific suggestions that may assist future studies are discussed.
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There has been increasing recognition of the problem of fatal opioid overdose. This review examines the pharmacological basis of respiratory depression following opioid administration. Respiration is controlled principally through medullary respiratory centres with peripheral input from chemoreceptors and other sources. ⋯ While agonist administration modifies receptor function, changes (usually in the opposite direction) also result from use of antagonists. The potential for supersensitivity to opioids following a period of administration of antagonists such as naltrexone warrants further investigation. While our understanding of the pharmacological basis of opioid-related respiratory depression has advanced, better understanding of the role of heroin metabolites, the metabolism of methadone, drug interactions and tolerance would all be of considerable value in knowing how best to respond to this problem.
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Cannabis is one of the most widely used drugs throughout the world. The psychoactive constituent of cannabis, delta 9-tetrahydrocannabinol (delta 9-THC), produces a myriad of pharmacological effects in animals and humans. For many decades, the mechanism of action of cannabinoids, compounds which are structurally similar to delta 9-THC, was unknown. ⋯ However, cannabinoid-derived drugs on the market today lack specificity and produce many unpleasant side effects, thus limiting therapeutic usefulness. The advent of highly potent analogs and a specific antagonist may make possible the development of compounds that lack undesirable side effects. The advancements in the field of cannabinoid pharmacology should facilitate our understanding of the physiological role of endogenous cannabinoids.
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The key components of a strategy to prevent tobacco-related disease are outlined. These measures aim to increase the cessation of tobacco use and reduce its uptake. ⋯ The prevention of tobacco-related disease has moved into the domain of campaigners and lobbyists at political, economic and international levels. The key target is countering the activities, especially the unethical trade practices, of the wealthy and powerful tobacco industry.