95 Summary - Crime Related to Substance Abuse This diploma thesis deals with the phenomena of drugs from the criminal law point of view. This topic represents a danger for a lot of domains, eg. criminality, therefore it is necessary to pay appropriate attention to it. The first chapter is introductory and it defines the basic terminology concerning drug problem. The next chapter looks at the drugs in international dimension. It focuses on international treaties handling narcotic drugs and psychotropic substances, which affected legislation in the Czech republic, especially by those adopted in the United Nations. I briefly mention overall situation in the Czech republic after 1989. The third chapter describes the evolution of legislation from the time of Austro- Hungarian empire until the times of new criminal code. The principal part of my diploma thesis concerns primary and secondary aspects of drug-related crime. The fourth chapter is a detailed analysis of drug crimes according to criminal code Nř 40/2009 Coll. Analysis of the individual merits follows after defining common features of these crimes. This chapter also reflects the Constitutional court decision. This decision cancels part of criminal code that enabled government to determine in its regulation the quantity of the drug which is to be treated...

No conclusive evidence exists to determine that epidural steroid injections (ESIs) provide lasting improvements in chronic pain due to herniated discs, in the Workers' Compensation population. Recently, an article by Armon et.al was published by the American Academy of Neurology, which stated that the routine use of ESIs is not recommended and that further studies are needed to elucidate this controversy (Armon, Argoff, Samuels, & Backonja, 2007). In 1998, back pain in the United States was estimated to have incurred total health-care expenditures of $90.7 billion. Medicare part B. claims in 1999 for 40.4 million individuals amounted to $49.9 million for lumbar epidural steroid injections alone. The practice of evidence based medicine will reduce health care costs and discomforts of the procedure. The objective of this study was to determine if ESIs will result in reduction of pain levels and pain medications used, and to determine the cost of treatment. In this retrospective cohort chart review study, where claimants served as their own controls, pain levels and medications used, were retrospectively assessed using documented pain scores based on the numerical pain scale, and medications prescribed, respectively. Further correlations were made with clinical and MRI findings. Costs were derived based on the amount billed by the provider to the insurance company. A randomized list of 600 charts from the insurance company's database was obtained and 120 were selected for study based on criteria. Data abstracted included gender, weight, date of injury, clinical symptoms, MRI findings, pain scores before and after ESIs, medications used before and after ESIs , date of ESIs, total amount billed for the ESIs, surgery, and total cost of the injury to date of data abstraction. The mean pain score before was 6.97 and 7.51 after ESIs The mean number of pain medication groups before was 2.41 and 3.10 after ESIs. The mean morphine equivalent dose before was 10.50mg and 22.07mg after ESIs. There was no significant correlation between amount billed for ESI and pain level. It was concluded that use of ESIs in the treatment chronic radicular pain does not reduce workers' pain levels, amount of pain medications, or narcotic consumed. These measures of discomfort remained the same, or were increased regardless of money spent.

This thesis explored the effect of cocaine use on treatment outcomes for heroin dependent individuals in Sydney, Australia. A naturalistic, longitudinal design was employed in order to examine the effects of cocaine on outcomes over a two year period. Study 1 assessed the prevalence and correlates of cocaine use among heroin dependent individuals. Cocaine use was found to be common among entrants to all three of the major treatment modalities in NSW. Heroin users who also used cocaine (CU) displayed a poorer clinical profile at baseline than non-cocaine users (NCU), reporting higher levels of drug use and dependence, and a greater prevalence of needle risk-taking and criminal behaviour. Study 2 examined outcomes three months post-study entry. CU and NCU were found to have been equally well retained in treatment. Despite significantly reduced levels of cocaine use amongst the cohort, however, CU continued to display the higher levels of drug-related harm that characterized them at baseline. In order to determine whether cocaine use itself was responsible for the greater levels of harm observed amongst CU, or whether instead CU were an inherently more dysfunctional group for whom cocaine use merely served as a marker, comparisons were made within groups on the basis of cocaine use patterns over the study period. The results of these analyses demonstrated that commencing cocaine use resulted in a clear decline in functioning, whereas cessation resulted in corresponding improvements. In Study 3 outcomes were examined twelve months post-study. Baseline cocaine use was again found to predict poorer outcome, despite a large scale reduction in cocaine use amongst the cohort. Importantly, CU were significantly less likely than NCU to be abstinent from heroin at twelve months and more likely to have been incarcerated since study entry. In addition, the effect of persistence of cocaine use was examined. Results indicated that the harms associated with cocaine use increased with increasing persistence of use. Outcomes at two years post-study entry were explored in Study 4. At this time CU and NCU recorded similar outcomes in most domains. Thus, it appeared that the harms caused by cocaine use may take a substantial period of time to diminish. Patterns of cocaine use and motivations for cessation and commencement were also examined. Responses suggested that cocaine use amongst the cohort was largely opportunistic, with participants ceasing use for a variety of reasons, including the financial and psychological problems caused by cocaine use. Past year prevalence of cocaine dependence was measured in this study, with the majority of those who had used cocaine in the past year meeting criteria for dependence. In Study 5, generalized estimating equations were used to measure the effect of baseline cocaine use on major outcome variables over the entire two year study period. Even after controlling for treatment variables, heroin use and other baseline polydrug use, the results of this study confirmed previous findings within the thesis by demonstrating the negative effect of baseline cocaine use on most outcome variables. Evidently, cocaine use among dependent heroin users has serious, long lasting, consequences. To date, however, there has been a stark lack of research examining the effect of cocaine use on treatment outcomes for heroin dependence. To that end, the results of this thesis are encouraging, suggesting that treatment for heroin dependence may also aid in reducing cocaine use among this group.

Increased demands on amphetamine dependence treatment services point to a need for effective pharmacotherapies for withdrawal symptom suppression. However, empirical data on which to base effective treatments are scarce. To address the need for an evidence base, four studies were conducted in two countries - Australia and Thailand. Firstly, the time course and severity of amphetamine withdrawal symptoms were characterised in two inpatient samples of amphetamine users. Results identified the first week of abstinence as an acute withdrawal phase characterised by increased sleeping, eating and a cluster of mood and anxiety - related symptoms. Following the acute phase, most withdrawal symptoms remained stable and at low levels for the remaining two weeks of abstinence ( the sub - acute phase ). Data from these two studies formed the basis for a new instrument, the Amphetamine Cessation Symptom Assessment scale ( ACSA ). On psychometric testing, the ACSA showed satisfactory reliability and a clear psychometric structure, delineating symptom clusters and their correlates with a three factor solution providing the best fit to the data. Using the ACSA to measure outcome, the safety and efficacy of the serotonin and noradrenaline reuptake inhibitor antidepressant mirtazapine ( 15 - 60 mg per day, n = 13 ), and the wake-promoting drug, modafinil ( 400mg per day, n = 14 ) were assessed in successive, open - label, inpatient pilot trials. Study medication was administered for up to ten days. An historical comparison group ( n = 22 ) who received treatment as usual consisting of pericyazine 2.5 - 10mg per day for control of agitation served as a comparison. Results showed that modafinil and mirtazapine were well tolerated, producing minimal positive subjective effects. There were significant group differences in withdrawal severity ( F = 18.6, df 2,219 p < 0.001 ). Post - hoc analysis showed that modafinil was more effective than mirtazapine ( p = 0.041 ), and both were more effective than treatment as usual ( both p < 0.001 ) in ameliorating withdrawal severity. Overall, these studies identified a peak in withdrawal severity during the first week of abstinence ; demonstrated the reliability and validity of the ACSA and identified modafinil as a safe and potentially effective pharmacotherapy for the treatment of amphetamine withdrawal symptoms. / Thesis (Ph.D.)--Medical School, 2005.

<p>Syftet med studien var att öka kunskapen om och förståelsen för hiv-smittade narkomaner i kriminalvård. Den övergripande frågeställningen löd; Hur beskriver ett mindre urval av hiv-smittade narkomaner i föremål för kriminalvård sina tankar och känslor kring sin sjukdom och sin livssituation? Studien var av kvalitativ design och den vetenskapliga positionen av hermeneutisk karaktär. Det empiriska materialet bestod av intervjuer med fem hiv-smittade narkomaner i kriminalvård. Tre teman var grundläggande i intervjuerna; Tankar, känslor och reaktioner kring hiv-diagnosen, Existentiella frågor, drivkraft och copingstrategier samt Bemötande i och utanför kriminalvården. Studiens teoretiska perspektiv; kristeori, existentialistisk teori, upplevelseteori och hälsoteori, valdes i syfte att nå en ökad förståelse för intervjupersonernas upplevelse av sin livssituation. Studiens resultat och analys visade att hiv-smittan fått olika konsekvenser för de intervjuade. För tre personer blev livet bättre genom sjukdomen; två av dem menade att de annars skulle varit döda. För de övriga två innebar sjukdomen i stället att döden kommit närmare och grusat alla förhoppningar om ett bättre liv. Tolkningen visade att en möjlig förklaring till de olika förhållningssätten kunde bero på skillnader i vilken inre privat betydelse sjukdomen haft för de intervjuade, samt i vilken mån de lyckats komma igenom krisen.</p>

Thesis (Ph. D.)--Memorial University of Newfoundland, 2005. / Restricted until May 2006. Includes bibliographical references (leaves 187-207).

Syftet med studien var att öka kunskapen om och förståelsen för hiv-smittade narkomaner i kriminalvård. Den övergripande frågeställningen löd; Hur beskriver ett mindre urval av hiv-smittade narkomaner i föremål för kriminalvård sina tankar och känslor kring sin sjukdom och sin livssituation? Studien var av kvalitativ design och den vetenskapliga positionen av hermeneutisk karaktär. Det empiriska materialet bestod av intervjuer med fem hiv-smittade narkomaner i kriminalvård. Tre teman var grundläggande i intervjuerna; Tankar, känslor och reaktioner kring hiv-diagnosen, Existentiella frågor, drivkraft och copingstrategier samt Bemötande i och utanför kriminalvården. Studiens teoretiska perspektiv; kristeori, existentialistisk teori, upplevelseteori och hälsoteori, valdes i syfte att nå en ökad förståelse för intervjupersonernas upplevelse av sin livssituation. Studiens resultat och analys visade att hiv-smittan fått olika konsekvenser för de intervjuade. För tre personer blev livet bättre genom sjukdomen; två av dem menade att de annars skulle varit döda. För de övriga två innebar sjukdomen i stället att döden kommit närmare och grusat alla förhoppningar om ett bättre liv. Tolkningen visade att en möjlig förklaring till de olika förhållningssätten kunde bero på skillnader i vilken inre privat betydelse sjukdomen haft för de intervjuade, samt i vilken mån de lyckats komma igenom krisen.

Thesis (M.S.W.)--University of Hong Kong, 1979.

Thesis (M.S.W.)--University of Hong Kong, 1986.

Šiame magistro darbe yra nagrinėjamos injekcinių narkotikų vartotojų socialinės ir demografinės charakteristikos bei socialinių ir medicininių paslaugų poreikiai. Darbo uždaviniai – atskleisti injekcinių narkotikų vartotojų, kaip specifinės socialinių paslaugų gavėjų grupės, socialinį bei demografinį statusą Lietuvoje; jį apibūdinančius kokybinius bei kiekybinius kriterijus; apibrėžti pagrindinius injekcinių narkotikų vartotojų socialinius bei medicininius poreikius; įvertinti socialinių paslaugų teikimo siekiant padėti injekcinių narkotikų vartotojams patenkinti socialinius ir medicininius poreikius galimybes bei problemas Lietuvoje. Rašant darbą naudoti įvairūs teoriniai (loginis, lyginimo, istorinis, sisteminis) bei empiriniai (dokumentų analizė, profesinės praktikos apibendrinimas, anketavimas) mokslinio tyrimo metodai. / This final work of postgraduate studies is committed to the analysis of socio-demographics characteristics of intravenous drug users and their needs for social and medical services. The goals of this work is to describe socio-demographics status of intravenous drug users in Lithuania; to analyze its quantitative and qualitative criterions; evaluate main social and medical needs of intravenous drugs users; to lay down concepts, forms and means which is necessary in order to organize effective social services in Lithuania which could help intravenous drugs users to satisfy their basic medical and social needs. The main scientific methods which were used to complete this work were both theoretical (logical, comparative, systemic, historical) and empiric (analysis of documents, generalization of professional experience, inquiry of intravenous drugs addicts who are registered in Lithuanian HIV center). It is necessary to mention that the main results of this work are that it describes addiction to intravenous drugs as a social problem, reveals essential social and demographics features of intravenous drugs users, analyze problems, which are related with functioning of social and medical services system for such persons. On this aspect this study also evaluates possibilities for the improvement of social and medical services in Lithuania. One part of this work describe results of practical survey (inquiry) which was carried out between 122 intravenous drug users who are... [to full text]