Suchergebnisse

This review covers the last 20 years of UK drug control policy leading up to the recent Psychoactive Substances Act. It explores policy decision made in relation to MDMA and mephedrone that not only were associated with increased drug harms overall but also had a significant detrimental effect on the UK research base. The new UK legislation on synthetic cannabinoids and other novel psychoactive substances threatens to do the same, showing that there is still much to learn from the decisions of the past. In future input from academic societies such as the BPS could help improve policy evaluation and policy development and so help avoid such problems in the future.

This book presents 13 reviews collected to present the new advances in all areas of addiction research, including knowledge gained from mapping the human genome, the improved understanding of brain pathways and functions that are stimulated by addictive drugs, experimental and clinical psychology approaches to addiction and treatment, as well as both ethical considerations and social policy. The book also includes chapters on the history of addictive substances and some personal narratives of addiction. Introduced by Sir David King, Science Advisory to the UK Government and head of the Office

Two fundamental premises I think can be accepted at the outset. First, if the Institute fulfils a useful and needed role in contributing to man's knowledge and understanding of the polar regions, and does it through bold, perceptive, and imaginative leadership, its future is secure. The second premise is that the future of the Institute itself is indisputably locked to the future of the polar regions. With these in mind let us consider briefly, by way of introduction, the founding of the Institute and the circumstances surrounding it. A question may be posed. Would the same kind of Institute be founded today as was founded in 1944. I think the answer would be no. In 1944 the Institute was founded to meet specific needs that were very real and pressing at that time. It is important to note that, as outlined in a previous chapter, the needs in Canada were quite different from those in the United States. In the United States there was in simple terms a desire to preserve for future use the knowledge and information that had been assembled by the U.S. Army Air Force's Arctic, Desert and Tropic Information Center, since it was almost taken for granted that this activity would just fade away in the rapid demobilization which could be expected at the end of World War II. In Canada, however, action stemmed from a comparatively small group of dedicated citizens who recognized the importance of the North to Canada and desired to cultivate more broadly a national concern and awareness of this. Curiously enough the common cause of World War II brought together those individuals from the United States and Canada who were then more intimately concerned with these needs and many of whom shared a common background of experience and interest in the North. Thus, at War's end a binational organization was founded to meet the differing needs of the two countries with responsibilities vested in the Board of Governors with joint Canadian and United States membership. The fundamental basis was a common desire to continue and foster this existing interest in the North, which had been brought into focus by wartime circumstances. To meet these differing needs the Institute was constituted to provide for two general areas of endeavour. The normal mission of a scientific organization to acquire and preserve knowledge was provided for and implemented initially through a grant-in-aid program, the scientific journal Arctic, the establishment of the Institute's library, and the publication of Arctic Bibliography. But in order to create a more general interest and awareness of the North and its emerging significance, an Institute Associate program was also established. This was later extended by the establishment of a class of Fellows, who are elected by the Institute's Board of Governors in recognition of their contributions to polar research and who participate in Institute affairs through election of a portion of the Institute's governing body. One must note that at this time, reflecting the need first for basic scientific knowledge of the North which had been emphasized by the military requirements of World War II, the early interest and concern of the Institute was almost exclusively within the natural sciences. As a result the people called upon in the early days of the Institute because of their experience were drawn largely from the ranks of the natural scientists. In perspective it must also be noted that at the time there were few social scientists with any interest or experience in the North except for a small group of archeologists and anthropologists. Now, twenty years later, circumstances are far different from those at the time the Institute was founded. The immediate needs which the Institute was intended to fill are now being met. The over-all importance of the polar regions to the modern world is recognized. A broad national effort in northern study has emerged in Canada with an increased recognition of the economic, social, and political significance of Canada's northern territories and a responsibility therefor. Prima facie evidence of the very basic concern for the future is demonstrated in the proposed Centennial Fund for Northern Research in Canada, in which the Arctic Institute can be said to have had the guiding hand. The United States now recognizes equally the significance of the North and additionally has mounted a vast national program of scientific endeavour in the Antarctic. Through these efforts there has been a manifold increase in polar research during the last twenty years, and a whole new generation of "polar scientists" has been trained in the process. The appropriate government agencies have recognized their mission and responsibility through the establishment and support of active programs. A number of universities in both Canada and the United States have developed programs of polar, boreal, or northern research through the interest of individual faculty members or in some cases through the establishment of special institutes. And of perhaps greatest practical importance, new funds and resources have become available to create and support these programs. Thus there would in fact be far less need today for the type of institute that was conceived in 1944. Correspondingly the Institute of today bears little resemblance to the Institute of twenty years ago. In response to the changing environment it has altered and expanded its scope of activities in directions which never could have been foreseen twenty years ago. The multiplicity of present Institute activities, all of which contribute effectively to a primary objective of increasing man's knowledge and understanding of the polar regions, has been amply covered in a previous chapter, thus little need be said here, but I do think it is important to consider the principal environmental changes that have affected the over-all field of polar research. .

Background: Psychedelic substance use in ritualistic and ceremonial settings dates back as early as 8,500 BCE. Only in recent years, from the mid-20th century, we have seen the re-emergence of psychedelics in a therapeutic setting and more specifically for the treatment of addiction. This article aims to review research over the past 40 years using classic (psilocybin, lysergic acid diethylamide [LSD], dimethyltryptamine [DMT], mescaline) and atypical (ketamine, ibogaine, 5-MeO-DMT, 3,4-methylenedioxymethamphetamine) psychedelics for the treatment of addiction. Summary: We will start with an overview of the pharmacology and physiological and psychological properties of psychedelic substances from pre-clinical and clinical research. We will then provide an overview of evidence gathered by studies conducted in controlled research environments and naturalistic and ceremonial settings, while we identify the proposed therapeutic mechanisms of each psychedelic substance. Key Messages: Classic and atypical psychedelics show promise as therapeutic alternatives for the treatment of addiction, through the improvement of psychological and physiological symptoms of dependence. A more comprehensive understanding of the ancient and present-day knowledge of the therapeutic potential of psychedelics can facilitate hope for psychedelic therapeutics in the treatment of addiction, especially for individuals who have failed other conventional treatment methods.

Alcohol use is one of the top five causes of disease and disability in almost all countries in Europe, and in the eastern part of Europe it is the number one cause. In the UK, alcohol is now the leading cause of death in men between the ages of 16–54 years, accounting for over 20% of the total. Europeans above 15 years of age in the EU on average consume alcohol at a level which is twice as high as the world average. Alcohol should therefore be a public health priority, but it is not. This paper puts forward a new approach to reduce alcohol use and harms that would have major public health and social impacts. Our approach comprises individual behaviour and policy elements. It is based on the assumption that heavy drinking is key. It is simple, so it would be easy to introduce, and because it lacks stigmatising issues such as the diagnosis of addiction and dependence, it should not be contentious.

BACKGROUND: Despite an increasing body of research highlighting their efficacy to treat a broad range of medical conditions, psychedelic drugs remain a controversial issue among the public and politicians, tainted by previous stigmatisation and perceptions of risk and danger. OBJECTIVE: This narrative review examines the evidence for potential harms of the classic psychedelics by separating anecdotes and misinformation from systematic research. METHODS: Taking a high-level perspective, we address both psychological and psychiatric risks, such as abuse liability and potential for dependence, as well as medical harms, including toxicity and overdose. We explore the evidence base for these adverse effects to elucidate which of these harms are based largely on anecdotes versus those that stand up to current scientific scrutiny. RESULTS: Our review shows that medical risks are often minimal, and that many – albeit not all – of the persistent negative perceptions of psychological risks are unsupported by the currently available scientific evidence, with the majority of reported adverse effects not being observed in a regulated and/or medical context. CONCLUSIONS: This highlights the importance for clinicians and therapists to keep to the highest safety and ethical standards. It is imperative not to be overzealous and to ensure balanced media reporting to avoid future controversies, so that much needed research can continue.

Background: Globally, non-medical heroin use is generating significant public health and social harms, and drug policy about heroin is a controversial field that encompasses many complex issues. Policy responses to illegal heroin markets have varied from militarized eradication of the opium poppy and harsh punishment of users, to more tolerant harm reduction approaches with decriminalized possession and use. Methods: This paper reports the outcomes of a multi-criteria decision analysis (MCDA) on four generic regulatory regimes of heroin: prohibition, decriminalisation, state control and free market. Invited experts on drug harms, addiction, criminology and drug policy developed a comprehensive set of 27 policy outcome criteria against which these drug policy regimes were assessed. Results: State control of heroin was identified as the preferred policy option although other policy regimes scored better on specific outcome criteria. The free market model scored better than decriminalisation, with absolute prohibition scoring worst on every criterium. The ranking of the regimes was robust to variations in the criterion-specific weights. Conclusion: The implications of these findings for the development of future policy responses to heroin and opioids generally are discussed in detail. Despite increasing overdose deaths and an opioid epidemic in North America, prohibition remains the predominant policy approach to heroin regulation at present. It is hoped that the current paper adds to the discussion of finding a valid regulatory alternative.

Nalmefene is the first drug approved for reduction of alcohol consumption. The aim of this study was to evaluate the clinical relevance of treatment with nalmefene in alcohol-dependent patients with a high drinking risk level from two randomised placebo-controlled 6-month studies (NCT00811720 and NCT00812461). Response criteria were based on alcohol consumption, Clinical Global Impression, and Short Form Health Survey mental component summary scores at month 6, analysed using logistic regression. The proportion of responders was higher in the nalmefene group than in the placebo group with odds ratios significantly in favour of nalmefene for all responder criteria; numbers-needed-to-treat ranged from 6 to 10. Significant differences from placebo in clinician-rated and patient-reported outcomes, and liver enzymes further supported the clinical relevance of the treatment effect. In conclusion, this study supports the clinical relevance of nalmefene treatment in patients with alcohol dependence. Nalmefene may help to reduce the alcohol-related burden and the large treatment gap, with currently less than 10% of alcohol-dependent patients in Europe receiving treatment.