The debate surrounding marijuana legalization has increased its popularity in recent years, as the state of California seriously considers the complete legalization of the substance for those ages 21 and over. This would make California the first government in recorded history to regulate the cultivation and sale of marijuana on a commercial level. Advocates back the economic positives concerning high tax revenues, but those opposed argue that the dangers associated with public health greatly outweigh any monetary gain. The present study attempts to reveal the possible public health concerns, even potential benefits, caused by marijuana use and its distribution. Specifically, measures of California’s Medical Marijuana Program will be assessed on the total number of drug treatment admissions in each county, taking into account treatment type and which type of drug is primarily responsible for said admissions. Findings reveal influences by both gateway and substitution effects, creating both positive and negative correlations throughout the field of public health. The influences of intangible variables, like that of the black market, make the results difficult to generalize. However, significant correlations can be found among specific health factors, like Heroin use, Crack/Cocaine use, and Residential Treatment.

Aims: To examine how patients with experience of being involuntarily discharged from medication-assisted treatment with methadone or buprenorphine have coped with the consequences following the discharge. The study also aim to examine how the patients cope with the stigma related to their abuse of heroin and how they manage to cope with the rules regarding themedication-assisted treatment. Method: Three patients with experience of involuntary discharge from medication-assisted treatment have been interviewed. All were heroin abusing men living in Stockholm. The interviewees were recruited through the Swedish Drug Users Union and through a shelter for homeless people with drug problems. Results: All the discharged patients experienced a hard time after the discharge. One went back to abuse heroin and the other two began to buy methadone or burprenorphine on the black market. All of them also experienced it difficult to cope with the stigma and considered that there were many obstacles in their life caused by the treatment rules. Conclusion: The discharge led to harsh consequences for all the patients. Heroin addicts need to deal with a lot of stigma related both to their drug abuse and the medical assisted treatment and find it difficult to manage that.

published_or_final_version / Social Work and Social Administration / Master / Master of Social Sciences

For over a century the international community has widely accepted a policy of universal drug prohibition. However, an increasing number of countries have been willing to experiment with progressive drug policies as the shortcomings of strict prohibition become more clear. This thesis is a study of the structures of drug laws in four countries – the Netherlands, Portugal, the United States, and Mexico – and their economic, public health, and human rights outcomes. The policies range in restrictiveness from the decriminalization of all drugs in Portugal to complete criminalization in Mexico. This thesis focuses on cannabis and heroin, two drugs which differ markedly in their risk for addiction and acute harm. A wide range of sources in the drug policy literature was analyzed. Evidence suggests that progressive policies in Portugal and the Netherlands have not significantly increased drug use and have led to numerous favorable public health outcomes. States in America that have legalized marijuana face many legal and economic challenges, and they should be observed closely as their policies develop further. Strict supply-control enforcement in Mexico has, on the other hand, led to an extreme upsurge in violent crime. These results suggest that in the future policymakers should drastically reallocate resources from ineffective supply-side strategies and pursue proven policies centered on public health and the protection of human rights.

This is an ethnographic account of peer learning among a group of heroin 'addicts' in Delhi, India. This study responds to the limited attention given to 'naturalistic' or 'informal' peer learning patterns in the educational literature, and the lack of explicit exploration of the phenomenon among drug user populations. The study involved seven and a half months of fieldwork with the predominant use of participant observation and semi-structured interviews to generate data. Analysis was inductive and interpretive with the use of situated learning theory to 'tease out' patterns in the data. The participants were using and non-using addicts affiliated to SHARAN, a non-governmental organization (NGO) in the religious marketplace of Yamuna Bazaar. The group included approximately 300-500 members, 20 of whom were main informants. Analysis of the group organization revealed community-based and masculinity-based characteristics that enabled the group to manage stigma, promote 'positive' ideals, and co-construct nonhegemonic masculinities. Peer-based outreach was identified as a form of 'institutional' peer learning in which peer educators performed the roles of 'doctor', 'role model', and 'counsellor' during interactions with 'clients' that had the effect of disempowering clients in many cases. The practice of poetry in which peers created couplets in alternating exchanges was identified as one form of naturalistic peer learning that entailed processes of legitimate peripheral participation, meaning negotiation, and reflective learning. Street 'doctory' in which peers provided medical care in the form of procedures, illness discussions, and health consultancy was identified as another naturalistic peer learning pattern involving processes of legitimate peripheral participation, meaning negotiation, and learning through teaching. These findings suggest that naturalistic peer learning involved co-participatory processes that manifested in a diversity of everyday practices. It is recommended that engaging these processes and practices would be useful for interventions, while further research should explore such patterns in other contexts.

This thesis investigates the behavioural and interactive elements of heroin importation behaviour. Almost all heroin consumed in Australia is imported. Thus the people who conduct the importing and their behavioural characteristics are an important point of focus. The thesis argues too little is known of illegal drug importation and higher level drug deal offending beyond stereotypes and that the lack of publicly available, independent research means there is ill-informed public and political debate and a very narrow evidence-base on which policy and strategy can be based. Review of available literature led to identification of a number of gaps in knowledge about heroin imporation offending and these provided a framework for the focus of investigations. The thesis uses data triangulation to increase the validity of the findings. The findings are based on agency data and semi-structured interviews with informants in Australia, Thailand and Hong Kong. The characteristics of offenders detected importing heavy weights of heroin are contrasted with those importing lighter weights. A number of understandings arise from the findings including some that are supported by other research. As well there are a number of new findings which challenge current concepts and stereotypes and have implications for policy and strategy aimed at supply reduction. (For complete abstract open the document)

Opioid drug related death is the topic of this thesis. Each of the published works submitted in this volume has investigated an aspect of opioid drug related death. The publications have been grouped into three sub-themes: i. Characteristics of opioid drug related deaths ii. Methadone-related deaths in and out of treatment iii. Improving the quality of treatment for opioid drug dependence: a focus on injectable opioid treatment The introduction and background (Chapter1) will briefly review-the-relevant literature on opioid drug death predating my own contribution to the field. The next chapter of the thesis, 'Publications' (Chapter 2), will comprise the body of published work being submitted for the degree of Doctor of Medicine. Each article is accompanied by text on the preceding page outlining my individual contribution to that research study. The thesis will conclude with a discussion of the published works (Discussion, Chapter 3) which summarises the chief findings and reflects on the international significance and impact of the work. Finally, the Conclusion (Chapter 4) will submit suggestions for areas of future research into opioid drug related death.

Thesis (Ph.D.)--University of Melbourne, Dept. of Medicine, Western Hospital, 2007. / Typescript. Includes bibliographical references (leaves 145-181).

Thesis (M.A. (Health Social Sciences))--Mahidol University, 2004.

Thesis (Ph.D.)--Ohio University, November, 2004. / Includes bibliographical references (p. 163-171)