Education to legality and doping.

When planning actions to prevent doping in the general population, public health operators may collide against the interests of criminal organizations involved in illicit trafficking of drugs. In addition to technical and professional expertise, or clinical and pharmacological skills, also a deep knowledge of legal and social issues is strongly required to face the problem and assure the effectiveness of the preventive actions. Sports competitions, athletes training or adapted physical activity may all represent conditions and environments at risk for misusing or abusing drugs and dietary supplements. A correct approach to sport and physical activity implies respect of competition rules, attention to own body limits and knowledge of risk factors. Health education campaigns and preventive actions should also consider education to legality in the different settings. The comprehension of the complex net that is available to access doping, locally or globally through online Internet sites, is essential as well as the awareness of the huge economic burden of crime interests behind the illicit trafficking of drugs. A modern whole rounded approach needs to consider doping not only as a violation of sport rules but also of the own body health, representing almost a form of addiction involving individuals and communities, and being supported by crime. Within this frame, doping is considered not just as a sport violation or a risk factor for individual's health, but as a disease of the society, in the society, against the society. A peculiar equilibrium seems to prevail between crime external pressures and resigned internal acceptance, according to the 'mafia hypothesis' model, where hosts accept parasitism to avoid retaliation. Here, main contributes and topics from the Erice 53rd Course are summarized and reviewed, providing links and references for further studies in the field. Health education and education to legality represent two sides of a same question, concerning both the general population and the health authorities. In conclusion, education to legality is a key component for prevention of doping and a priority for public health operators involved in protecting population health.

Q & A with grower Tim Cullen [interview by Mary Winter].

Tim Cullen is CEO and founder of the Colorado Harvest Company and Evergreen Apothecary, an expanding business in Denver that grows and sells marijuana. His most lucrative store averages 200 to 300 sales a day, with roughly 80 percent being for recreational purposes. The former high school biology teacher became interested in marijuana when he saw how it helped his father control the pain and nausea of Crohn's Disease, which Cullen himself developed later. He began growing marijuana in his basement in Colorado, where growing medical marijuana for personal use has been legal for 12 years. He now grows his plants in 55,000 square feet in four warehouses.

Illegal drugs laws: clearing a 50-year-old obstacle to research.

The United Nations drug control conventions of 1960 and 1971 and later additions have inadvertently resulted in perhaps the greatest restrictions of medical and life sciences research. These conventions now need to be revised to allow neuroscience to progress unimpeded and to assist in the innovation of treatments for brain disorders. In the meantime, local changes, such as the United Kingdom moving cannabis from Schedule 1 to Schedule 2, should be implemented to allow medical research to develop appropriately.

Effects of Schedule I drug laws on neuroscience research and treatment innovation.

Many psychoactive drugs are used recreationally, particularly by young people. This use and its perceived dangers have led to many different classes of drugs being banned under national laws and international conventions. Indeed, the possession of cannabis, 3,4-methylenedioxy-N-methylamphetamine (MDMA; also known as ecstasy) and psychedelics is stringently regulated. An important and unfortunate outcome of the controls placed on these and other psychoactive drugs is that they make research into their mechanisms of action and potential therapeutic uses - for example, in depression and post-traumatic stress disorder - difficult and in many cases almost impossible.

Regulating a novel drug: an evaluation of changes in use of Salvia divinorum in the first year of Florida's ban.

BACKGROUND: A plant with dissociative and psychoactive properties began to attract the attention of the media and United States policymakers following a well-publicized suicide in 2006 and reports that the plant served as a 'legal high' and substitute for cannabis. As a result, Salvia divinorum and its active ingredient, salvinorin A, were classified as Schedule I substances by the Florida Legislature on July 1, 2008. As of yet, no research has explored the efficacy of this policy or similar policies in other jurisdictions. METHODS: Three self-report studies collected from young adults both prior to and following the policy's implementation are employed to investigate the potential relationship between the policy and usage rates. In addition, law enforcement personnel from the state's most populated areas were interviewed to determine the extent to which they were encountering salvia in their work. RESULTS: It was indicated that less than two-thirds of those surveyed were aware of the drug's legal status. Lifetime prevalence of salvia use was largely unchanged. However, the rates of self-reported past year and past month use in Florida were significantly lower following the scheduling. Though use of Salvia divinorum appears to have decreased, perceptions of peer use increased markedly. Law enforcement officers and laboratories reported rarely, if ever, dealing with cases of salvia possession. CONCLUSIONS: Data suggests the classification of Salvia divinorum as a Schedule I drug was followed by a substantial reduction in recreational use. We caution that other factors may have influenced use, that the efficacy of scheduling novel substances is likely to vary by drug type, that such a reduction in reported use may only exist transiently until a sophisticated illicit market develops to replace the legitimate one, and that a state's success in regulating salvia may be related to their regulation of and enforcement of other drug prohibitions.

Anabolic-androgenic steroids and adolescents: recent developments.

Despite their classification as a Schedule III Controlled Substance, anabolic-androgenic steroids continue to be used by adolescents who seek increased muscularity as well as enhanced athletic performance. Although the potential side effects of steroids are relatively well known, problems with counterfeit substances and steroid-spiked dietary supplements have received less attention. Drawing on scholarly literature and reports from government units such as the Drug Enforcement Administration and the Food and Drug Administration, this article addresses those issues and makes recommendations for communicating with adolescents about the use of steroids.

Cannabis and its derivatives: review of medical use.

BACKGROUND: Use of cannabis is often an under-reported activity in our society. Despite legal restriction, cannabis is often used to relieve chronic and neuropathic pain, and it carries psychotropic and physical adverse effects with a propensity for addiction. This article aims to update the current knowledge and evidence of using cannabis and its derivatives with a view to the sociolegal context and perspectives for future research. METHODS: Cannabis use can be traced back to ancient cultures and still continues in our present society despite legal curtailment. The active ingredient, Δ9-tetrahydrocannabinol, accounts for both the physical and psychotropic effects of cannabis. Though clinical trials demonstrate benefits in alleviating chronic and neuropathic pain, there is also significant potential physical and psychotropic side-effects of cannabis. Recent laboratory data highlight synergistic interactions between cannabinoid and opioid receptors, with potential reduction of drug-seeking behavior and opiate sparing effects. Legal rulings also have changed in certain American states, which may lead to wider use of cannabis among eligible persons. CONCLUSIONS: Family physicians need to be cognizant of such changing landscapes with a practical knowledge on the pros and cons of medical marijuana, the legal implications of its use, and possible developments in the future.

Long-term effects of a community-based intervention: 5-year follow-up of 'Clubs against Drugs'.

AIMS: To evaluate long-term effects of a multi-component community-based club drug prevention programme. DESIGN: A pre- (2003) and post-intervention study (2004 and 2008) design. SETTING: High-risk licensed premises in central Stockholm, Sweden. PARTICIPANTS: The intervention programme, 'Clubs against Drugs', included community mobilization, drug-training for doormen and other staff, policy work, increased enforcement, environmental changes and media advocacy and public relations work. MEASUREMENT: The indicator chosen for this study was the frequency of doormen intervention towards obviously drug-intoxicated guests at licensed premises. Professional male actors (i.e. pseudopatrons) were trained to act impaired by cocaine/amphetamines while trying to enter licensed premises with doormen. An expert panel standardized the scene of drug intoxication. Each attempt was monitored by two male observers. FINDINGS: At the follow-up study in 2008 the doormen intervened in 65.5% of the attempts (n=55), a significant improvement compared to 27.0% (n=48) at the first follow-up in 2004 and to 7.5% (n=40) at baseline in 2003. CONCLUSION: The 'Clubs against Drugs' community-based intervention programme, a systems approach to prevention, appears to increase the frequency and effectiveness of club doormen's interventions regarding obviously drug-intoxicated guests.

Khat in the Horn of Africa: historical perspectives and current trends.

AIM OF THE STUDY: This article looks at the history of the expansion of khat consumption from the traditional chew regions to Western countries and assesses the implication of possible international control for its use and trade in the Horn of Africa. MATERIALS AND METHODS: Ten months of initial field work in Ethiopia, three follow up field work, archival work in Ethiopia and Europe, as well as study of available relevant literature. RESULTS: The debut of khat in the West in the 1980s was initially greeted with disdain and indifference. Authorities dismissed it on grounds that the mode of consumption, chewing the leaves for an extended period of time to extract a miniscule amount of the active ingredient, would not be appealing to Western users. Following the Mogadishu debacle of 1993, as depicted in the movie Black Hawk Down, authorities in the West began to express concern that khat was a new drug of abuse. Its trade was increasingly linked with terrorism because of its association with immigrants from the traditional khat use countries in the Horn of Africa and the Arabian Peninsula. Amid hysteria and moral panic, many Western countries classified khat as a highly potent controlled substance, rendering its possession, cultivation, and trade illegal. CONCLUSION: This article argues that more and more Western governments, out of panic rather than definitive evidence of harm, will be instituting national laws banning the leaves, but khat will not be placed under international control because the scientific evidence of harm is unlikely to rise to a critical mass that would justify its illegalization. States in the source countries would continue to tolerate khat because banning it would be disastrous from an economic and social welfare standpoint. Because of its ambiguous legal position and the unstable nature of its active ingredient, cathinone, khat would not be successfully commoditized as a global commodity or transformed into a highly concentrated illicit drug. In this situation, khat would continue to be chewed in the traditional-use areas of the Red Sea littoral marketed by local syndicates who work with a large network of petty commodity traders.

The role of drug and alcohol policy in reducing Indigenous over-representation in prison.

Australian Indigenous imprisonment rates are higher now than they were at the time of the Royal Commission into Aboriginal Deaths in Custody. The Commission attributed Indigenous imprisonment to Indigenous cultural, economic and social disadvantage. Noel Pearson has argued that Indigenous drug and alcohol use is a more important cause of Indigenous contact with the justice system than Indigenous disadvantage. In this paper I argue that the available evidence provides strong support for Pearson's view and for the proposition that future efforts to reduce Indigenous imprisonment should place more emphasis on supply-side strategies for reducing Indigenous drug and alcohol abuse.

Cannabis in Papua New Guinea.

This review covers published information on psychoactive drugs, particularly cannabis, in Papua New Guinea. Legal drugs are mentioned to place the illegal drugs into a broader public health context. Although a number of psychoactive drugs were used traditionally (and are used now), cannabis is the only illicit drug for which prevalence of use is currently not negligible. Very little epidemiology research on cannabis use and its individual and public health sequelae has been conducted, although a fuller criminology literature on the topic exists. The published cannabis use prevalence studies are limited in scope, and the most-cited one is of questionable accuracy. The complex interactions between the health of individuals and their social environments are highlighted by the destructive impacts that cannabis cultivation, trafficking and use are having in contemporary PNG.

Supreme Court denies leave to appeal in medical marijuana charter challenge.

As previously reported in this publication, in January 2002 the Ontario Court of Appeal denied Jim Wakeford's claim that Canada's laws prohibiting marijuana possession and cultivation infringe his constitutional rights to liberty and security of the person. On 22 November 2002 the Supreme Court of Canada announced that it would not hear his appeal from that decision.