The dissertation summarizes the drug-related death phenomenon in the UK emphasizing England and Wales and compares the figures with international development, particularly in the EU. Legal regulation, in particular the Misuse of Drugs Act of 1971 and its amendments strive for classifying drugs and label illicit drugs or their exceptional use. Moreover, legislation gives us a bundle of measures to investigate drugs misuse and especially drug-related deaths, allocating the duties of the police, coroner and judiciary.
Opiates, especially heroin, cocaine and stimulants are still the major drugs involved in the UK, which largely – with the exception of cocaine – reflects the situation on the continent. The distribution of age of death shows a tendency from the range of 20 to 30 years towards men in their forties during the last decades. Overall, the UK, Scandinavia and the Baltic states have leading numbers drug-related deaths. New Psychoactive Substances are a new challenge in Europe but the UK may be especially affected by this unfortunate wave. All authorities world-wide have to deal with this 'hydra' of new psychoactive substances (NPS) due to infinite chemical variations and unlimited supply. Nevertheless, heroin and cocaine still belong to the most noxious drugs with regard to the fatal outcome.
The problem of drug-related deaths starts with the neurobiology of addiction including cerebral reward cycles which disinhibit prefrontal control, leading to craving and drug intake, even if severe somatic damage occurred. This fatal course does not depend on a particular drug but may be concerned as the final part the fatal reward pathway. In general, noradrenalin, serotonin and dopamine are involved, although some drugs may act on specific receptors such as opiates or cannabinoids. Unfortunately, the pharmacology of the NPSs is often not well known, and this lack of information will increase the risk of drug-related deaths or delinquency in future.
Autonomy, paternalism and liberty form a field of tension in democracy, so that preventive measures must respect individual rights. Restrictive strategies alone show a limited success. It will be the concerted action of law, judiciary, police, science, educators, social work and medicine among others to strengthen future generations. We struggle hard against drugs and the sequelae but we should never give up.:Abstract 7
1 Introduction 8
2 Definitions and Epidemiology 9
3 Legal Aspects 13
4 Psychology and neurobiology of drug abuse 16
5 Toxicology and drug-effect relation 18
6 Pharmacokinetics and routes of administration 19
7 Some notes concerning drug detection 22
8 Drugs and mechanisms of action 24
9 New Psychoactive Drugs 33
10 Legal compounds for illegal use 37
11 Dying from drugs – a clinical view 39
12 Prevention strategies 40
References 42
Appendix 56
Figures and Tables
Abbreviations
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:23392 |
| Date | 11 July 2018 |
| Creators | Koch, Horst Josef |
| Publisher | Horst Josef Koch |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/draft, doc-type:report, info:eu-repo/semantics/report, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
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