Study on exempted preparations.

The coming into force of the Convention on Psychotropic Substances 1971 has rekindled the interest in the technical and administrative modalities of relaxing the control measures applicable, under that convention and the Single Convention on Narcotic Drugs, 1961, to preparations of substances that are controlled by virtue of those international treaties. Therefore, an analytical review of the principles and procedures laid down in those conventions for the exemption of defined preparations from certain control measures was felt desirable as an adjunct to the ongoing discussions, especially in connection with the provisions of the 1971 Convention. The gradual emergence and development of the relevant principles and procedures embodied in the successive international control treaties since 1912 are highlighted as a background for the review of the actual treaty obligations faced by the parties to the conventions and by the international organizations concerned. Included are some suggestions for possible improvement of the system for exempting preparations under the term of the 1971 Convention.

Pharmacological approaches to the treatment of morphine-type dependence.

Of the two pharmacologically different possibilities of interfering with the processes of either tolerance or dependence of the morphine type, the so-called maintenance method commonly using methadone is predominantly a matter of tolerance, whereas the blockade with specific opiate antagonists such as cyclazocine intervenes in processes underlying dependence and withdrawal. The experimental evidence for these mechanisms is described.

Medical aspects of the chewing of khat leaves.

The khat plant (Catha edulis) is produced in certain areas of East Africa and the Arabian peninsula, and the leaves are chewed for their stimulating effect. Fresh material, which is preferred by users, contains a substance that is rapidly converted to (+)-norpseudoephedrine. As a consequence of the traditional means of consumption, intoxication with khat is self-limiting but chronic consumption can cause certain disturbances to the health of the user and may also lead to social and economic damage to the individual and the community.

Codeine and its alternates for pain and cough relief. I. Codeine, exclusive of its antitussive action.

This report-the first of a series on codeine and its alternates for pain and cough relief-presents a detailed evaluation of experimental and clinical data concerning the analgesic action of codeine (the antitussive action will be assessed separately). The authors discuss the pharmacology of the drug, including side-effects and toxicity; effects on the respiratory, circulatory, digestive and urinary systems; tolerance, dependence and liability to abuse; metabolic effects; and mechanism of action.Though codeine is generally more toxic than morphine to animals on account of its convulsant action, it is less toxic to man, possibly because it produces less respiratory depression. Again, tolerance to its analgesic effects has been demonstrated in several animal species, but dependence in man is observed far less frequently than it is with morphine, and the abstinence syndrome is less intense. From their extensive review of the evidence available, the authors conclude that codeine is a good analgesic and that little risk to public health is likely to arise from its clinical use to relieve pain.

Codeine and its alternates for pain and cough relief. 2. Alternates for pain relief.

This report-the second of a series on codeine and its alternates for pain and cough relief-contains a detailed evaluation of experimental and clinical data on newer substances having analgesic properties comparable to and in approximately the same range as those of codeine. The data are discussed under the headings: analgesic effects in animals; clinical usefulness; side-effects with particular reference to dependence and abuse liability.

Codeine and its alternates for pain and cough relief. 3. The antitussive action of codeine--mechanism, methodology and evaluation.

This report-the third of a series on codeine and its alternates for pain and cough relief-presents a detailed review of the physiology and pathophysiology of cough, the methods for the experimental and clinical measurement of the antitussive action of drugs, possible mechanisms of action of antitussive agents, and includes a compilation of experimental results and clinical experience with codeine as an antitussive.

Codeine and its alternates for pain and cough relief . 4. Potential alternates for cough relief.

In this report-the fourth of a series on codeine and its alternates for pain and cough relief-an attempt is made to evaluate, on the basis of experimental and clinical data, and wherever possible in comparison with codeine, the effectiveness of a number of antitussive substances currently in clinical use. In the discussion of the undesired side-effects particular attention is paid to the risk of dependence and abuse.

Codeine and its alternates for pain and cough relief. 5. Discussion and summary.

This chapter concludes the survey of experimental and clinical data on the analgesic and antitussive properties of codeine and its potential therapeutic alternates. From an evaluation of their effectiveness on the one hand and the side-effects, including tolerance, dependence and abuse liability on the other, it would appear that the therapeutic goals of codeine could be achieved by other substances, except perhaps where analgesia, cough relief, and sedation are required simultaneously. The use of these other substances would, however, result in no particular gain and probably no particular loss.