Points Bibliography: Getting People into Treatment

Editor’s Note:  These entries are part of an ongoing drug-related dissertation bibliography being compiled by Jonathon Erlen. They were formerly published in the Social History of Alcohol and Drugs journal but are now periodically featured on the Points blog. For more information, contact Dr. Erlen through the link above.

A Randomized Clinical Trial of a Brief Motivational Intervention for Incarcerated Drinkers

Author: Owens, Mandy D.

Abstract: Almost half of convicted jail inmates have an alcohol use disorder and many are released to environments that put them in contact with network members and cues that make them more likely to relapse on alcohol or drugs. Given the high-risk period immediately following release, the purpose of this study was to examine the efficacy of a brief motivational intervention administered just prior to release to increase substance use treatment entry and attendance, decrease alcohol and drug use, and change social networks for inmates with alcohol use disorders. Forty adult male inmates were consented into the study and randomized to a motivational intervention or the control condition (an educational intervention), and then they were contacted to do a one-month follow-up interview (62.5% completed this interview). Results indicated that conducting these interventions was feasible and considered extremely helpful by participants. Although there were no significant group differences, effect sizes suggest possible benefits from the motivational intervention in decreasing days of alcohol and drug use and increasing abstinence, and reducing the proportion of heavy drug users or users of any kind in the social network. Future studies should replicate these findings in larger sample sizes and over longer follow-up time periods, which may have implications for programming at jails for this population. Continue reading →

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Drugs on Display in Japan: The Daiichi Sankyō Pharmaceutical Museum

by Miriam Kingsberg Kadia, Contributing Editor

Daiichi Sankyō is a pharmaceutical corporation based in Japan, with more than fifty offices around the world. In 2012, the company opened the Kusuri Myūjiamu [Pharmaceutical Museum] to showcase its century-plus history, successes, and future ambitions in drug development.
east-asiaI visited the museum one rainy Friday morning in early June 2017. The museum is located in the Daiichi Sankyō building in downtown Tokyo, with the main exhibit hall on the second floor. Admission is free. Signs posted outside suggest allocating one hour for a visit. Guests are asked to leave bags in coin lockers outside the main hall, and photographs are not permitted.

Upon arrival, the visitor is handed a large plastic button. The button is carried from station to station and placed on portals to activate auditory content. At the entry terminal, the visitor inputs some demographic information and selects a language for presentation (options include English, Japanese, and Chinese). The button subsequently activates speech in the language of choice for each subsequent display. Inasmuch as I appreciated the unique, almost futuristic design of the terminals, when a large number of patrons entered at once, the general noise level of the room rose to a point where the vocalization became almost inaudible.

The text of the exhibit is pitched at about the level of a Japanese middle-school biology course (which perhaps explains why most of the visitors I saw were schoolgirls in uniform, diligently filling out worksheets). Daiichi Sankyō emphasizes the scientific nature of its production process by inundating the viewer with chemical formulas and structures, experimental setups, and clips of researchers and pharmacists at work. The somewhat dry presentation is enlivened at points with interactive opportunities such as multiple-choice quizzes. Continue reading →

Points Bibliography: Smoking in the United States

Editor’s Note:  These entries are part of an ongoing drug-related dissertation bibliography being compiled by Jonathon Erlen. They were formerly published in the Social History of Alcohol and Drugs journal but are now periodically featured on the Points blog. For more information, contact Dr. Erlen through the link above.

Informing E-cigarette Policy: Population Effects and Tobacco Industry Incentives

Author: Cahn, Zachary

Abstract: This dissertation consists of a set of papers intended to inform practitioners and scholars of nicotine policy in general and e-cigarettes specifically. The first chapter frames the subsequent chapters and introduces some key concepts that are necessary to understand this framing. The second chapter synthesizes the research on past obstacles to cigarette innovation in order to 1) determine why cigarette innovation did not yield substantially reduced hazard for decades, and 2) gain insight into how tobacco companies are likely to behave today and in the future. Special attention will be paid to the emergence of e-cigarettes and why the industry did not enter this market sooner. The third chapter focuses on the potential for e-cigarettes to “renormalize” cigarette smoking. Looking at one specific pathway—social renormalization—this chapter seeks to estimate whether peer vaping affects the perception of peer smoking among youths. The fourth chapter examines predictors of initiation of e-cigarette use among consistent smokers and analyzes the impact of e-cigarette use on cessation among smokers in a national U.S. consumer panel. The fifth chapter puts the findings from the previous chapters into context and develops core lessons for scholars that seek to study e-cigarettes and policymakers that seek to regulate them.

Publication year: 2016

 

ISBN: 9781369330571

Advisor: Saltman, Richard B.

Committee members: Berg, Carla Michael; Haardoerfer, Regine Michael; Hockenberry, Jason Michael

University/institution: Emory University

Department: Health Services and Research Health Policy Continue reading →

Running Amok on Marijuana: Re-hashing the grain of truth in one of the world’s most persistent myths about Cannabis

by Nick Johnson, author of Grass Roots: A History of Cannabis in the American West (Oregon State University Press, 2017)

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There’s no denying that the growing nationwide acceptance of cannabis in the twenty-first century has illuminated the many benefits of this plant, long-sequestered in American society:

Hemp, the non-psychoactive variety, is a multi-faceted crop with a bevy of industrial and consumer applications.

The many inter-working compounds in marijuana are an effective medicine capable of alleviating—and possibly curing—some of our most agonizing ailments.

Widespread use of marijuana has proven to be a relatively safe activity that has never produced a lethal overdose or lived up to its opponents’ worst fears.

Cannabis advocates revel in these facts; they form the backbone of the argument for legalization. But every so often a report comes out that notches a chink in activists’ rhetorical armor. In particular, several recent incidents reflect a darker, if relatively uncommon, strain in cannabis’s long history amidst human societies: Continue reading →

The Disconnects in Indian Drug Policy: Article 47, Drug Research, and Social Policy

Editor’s Note: Today’s post is by Contributing Editor Dr. Kawal Deep Kour. 

Policymakers in India have responded to proliferating reports of substance use disorders with great concern, opening the winter session of Parliament with a discussion of drug addiction and ways and means to reverse the trend. Even formerly radical ideas are on the table: it is likely that a Private Member’s Bill calling for the legalization of medicinal opium and cannabis will be introduced this session. This measure indicates policymakers both understand there is a problem and are willing to address it from new angles. Though the government of India and its people are currently debating the issue, drug policy reformers hope this bill will create pathways for a more progressive, less punitive set of laws. That this conversation is happening at all evinces a broader trend toward flexibility among governments across the globe, particularly regarding the therapeutic use of cannabis and the costs of the international “war on drugs.”

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Prime Minister Jawaharal Nehru signing the Indian Constitution

The legal debate over legalization in India centers on Article 47 of its national constitution, ratified in 1949, which outlines one duty of the state: “to raise the level of nutrition and the standard of living and to improve public health… and, in particular, the State shall endeavour to bring about prohibition of the consumption except for medicinal purposes of intoxicating drinks and of drugs which are injurious to health.” While our knowledge of drugs and their injurious potential has increased a great deal due to social practices research, Indian drug policy discourse is dominated by medical and scientific rhetoric. Research from this perspective is often preoccupied with health problems associated with drug use. Focus on the discrete biological mechanisms or epidemiology of drug use is insufficient for understanding (or potentially influencing) behaviors related to intoxication and substance use disorders. Social scientists around the world believe there is an urgent need to incorporate more perspectives from anthropology, history, sociology, and cultural and gender studies, which remain secondary to laboratory sciences. (Regardless, most informed debate is limited to the professional academy. Public engagement by all of these disciplines should become the norm, not only to dispel myths about drugs and their use but also to perhaps help those struggling with related disorders.)

These competing frameworks result in confused approaches to drug policy. Article 47 is still invoked to justify and reinforce prohibition, but a careful reading suggests the foundation for a more progressive policy is already written in the directive. Recall that Article 47 requires the state to “raise the nutrition and the standard of living and to improve public health.” In this spirit, the National Drugs and Psychotropics Act of 1985, the foundation of Indian drug policy, was amended most recently in 2001 to allow more scientific drug research and encourage private industry to enter the international pharmaceutical opium market. One state, Uttarakhand, read even more into the legal change and recently became the first in India to legalize the production of industrial cannabis. These steps help pull us from the mess of complete prohibition, which continues to ensnare other Indian states and countries elsewhere.

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Cannabis plants in Uttarakhand (courtesy, IndiaTimes)

 

Prohibition is a flawed approach that ignores lessons from history. In 1976, the National Committee on Drug Abuse, chaired by Dr. C. Goplan, concluded that the elimination of drugs was a utopian idea and instead advocated for their “control and minimization.” Among the committee’s most significant recommendations was establishing a National Advisory Board on Drug Control featuring representation from academia, government, NGOs, and other interest groups. It called for long-term research programmes on different aspects of the problem to formulate evidence-based policies. This proposal never came to fruition, and forty years later progress has been incremental, but it is gratifying that Indian researchers so long ago envisioned a foundation for connecting scholarship to policy that continues to resonate globally as a viable model. It is this ongoing disconnect between research, policy, and practice that ails present drug policy in India and elsewhere. Existing national medical discourse masks the complexity and dynamism of drug use, but even new work among social scientists must overcome significant disciplinary barriers, public preconceptions, and policy inertia in order to make a meaningful impact regarding drug use or its potential problems.