This extended review of Stimson and Oppenheimer’s classic book Heroin Addiction aims to highlight its contribution to the literature and consider its contemporary relevance for…
Abstract
Purpose
This extended review of Stimson and Oppenheimer’s classic book Heroin Addiction aims to highlight its contribution to the literature and consider its contemporary relevance for research, policy and practice.
Design/methodology/approach
The review examines the core themes of the longitudinal study that the book presents by bringing it in to dialogue with a recent “living history” project on John Marks’ radical heroin prescribing in the 1980s and 1990s.
Findings
The three core themes explored are treatment as containment; the balance between therapy and social control; and the benefits of heroin versus methadone.
Originality/value
The book is a “timeless classic” that still resonates with contemporary concerns and has much to tell us about heroin addiction and its treatment.
Details
Keywords
The purpose of this paper is to re-appraise the Misuse of Drugs Act 1971 in order to develop alternative and new ideas for drug law reform.
Abstract
Purpose
The purpose of this paper is to re-appraise the Misuse of Drugs Act 1971 in order to develop alternative and new ideas for drug law reform.
Design/methodology/approach
The approach is to analyse the Act from historical and socio-legal perspectives, drawing on the inter-disciplinary field of regulation studies.
Findings
The Act has its roots in radical counter-cultural reform activism in the 1960s. Its innovative legal structure has enabled a diverse range of policy approaches to be possible over the last 50 years. Future drug law reform efforts need to broaden out from a narrow focus on law and also to engage more seriously with the politics of drug law and policy.
Originality/value
Drawing on the inter-disciplinary field of regulation studies leads to novel insights about the politics and practice of drug law reform.
Details
Keywords
The concept of ‘drugs’, as we understand it today, is a regulatory construct that was invented at the beginning of the 20th century as part of the creation of the international…
Abstract
The concept of ‘drugs’, as we understand it today, is a regulatory construct that was invented at the beginning of the 20th century as part of the creation of the international prohibition regime. Substances that come under this banner share little in common except how they are regulated. It follows that if we wish to contest prohibition, we will also need to contest, and perhaps eventually abandon, the idea of ‘drugs’. Some of the complexities in developing alternative terminology and concepts are briefly discussed.
Details
Keywords
The purpose of this paper is to review the literature on the connections between illegal drugs and the informal economy and consider this in the light of the increasing levels of…
Abstract
Purpose
The purpose of this paper is to review the literature on the connections between illegal drugs and the informal economy and consider this in the light of the increasing levels of global interconnectedness in recent decades.
Design/methodology/approach
This is a review of the empirical drugs literature with a primary focus on British‐based research and analysis of the impact of different aspects of globalization.
Findings
Patterns of heroin and crack‐cocaine use need to be understood in their social, economic and cultural context, particularly in relation to their location in the informal economy. Globalizing processes have profoundly shaped local drug problems over the last 30 years.
Practical implications
The governance of the drug problem needs to be reframed to take account of its social economic nature and global character. New ways of thinking are required to advance future research and policy.
Originality/value
The focus on the impact of globalizing processes is original and leads to some important new insights for future research and policy.
Details
Keywords
The purpose of this paper is to review the research evidence on recent British trends in the use of heroin and/or crack‐cocaine by young people in order to appraise the scale and…
Abstract
Purpose
The purpose of this paper is to review the research evidence on recent British trends in the use of heroin and/or crack‐cocaine by young people in order to appraise the scale and nature of the contemporary health problem they pose.
Design/methodology/approach
The approach consists of a narrative review of the main current data sources on young people's drug use.
Findings
Use of heroin or crack‐cocaine is rare in Britain in the general population of young people and is concentrated more amongst young adults than adolescents. There is some evidence for associations between use of these drugs and socio‐economic disadvantages, although the links are complex. There may be fruitful connections to be made between drug policy and public health strategies for tackling health inequalities.
Practical implications
Embedding responses to young people's heroin/crack use within mainstream strategies to tackle health inequalities may be mutually beneficial to both policy agendas.
Originality/value
Situating in its proper evidential context the emotive issue of young people's use of what are believed to be the most dangerous illicit drugs, and appraising these data from a public health perspective, may lead to a more realistic and appropriate research and policy response.
Paul Gray and Toby Seddon
To report on findings from the evaluation of two innovative community‐based prevention projects in the UK targeted at children disaffected from school, one involving football the…
Abstract
Purpose
To report on findings from the evaluation of two innovative community‐based prevention projects in the UK targeted at children disaffected from school, one involving football the other horticulture.
Design/methodology/approach
Qualitative inquiry focusing on three areas: “theories of change” underpinning the projects; referral and operational processes; inter‐agency partnerships. Main methods were: an interactive event for 50 practitioners; semi‐structured interviews with project staff, project participants and other stakeholders; review of project documentation; observations.
Findings
Both the projects evaluated had clear and plausible “theories of change”. Referral processes were effective. Strong variations in “dosage” and length of project involvement appeared to be linked to differences in the effectiveness of the two projects.
Research limitations/implications
The principal limitation to the research was the lack of case monitoring and outcome data that prevented any quantitative assessment of the projects. Further research is needed to establish the long‐term impact of this kind of targeted prevention work.
Practical implications
Prevention work targeted at children disaffected from school needs to be underpinned by clear “theories of change”. Effective work requires good relationships with referring schools, the delivery of multi‐faceted interventions and interventions to be of an adequate length.
Originality/value
The focus on “theories of change” or mechanisms is an original contribution to the prevention literature. The paper will be valuable for those working in drug action teams and local authorities in planning prevention work for young people. The two projects were highly innovative in involving pupils in two very different activities – football and horticulture.
Details
Keywords
The purpose of this paper is to introduce the five papers comprising this special issue on post‐millennium trends in young people's substance use in the UK. The positions taken by…
Abstract
Purpose
The purpose of this paper is to introduce the five papers comprising this special issue on post‐millennium trends in young people's substance use in the UK. The positions taken by the authors of each of the papers in the issue are compared with respect to their conclusions on how best to reduce harmful outcomes for young people in relation to their substance use, and what role exists for health education in this process.
Design/methodology/approach
The approach takes the form of a narrative review of the papers in the issue.
Findings
Across substances (alcohol, tobacco and illicit drugs), the authors identify slight downward trends in population prevalence of use by adolescents and young adults since 2000. This downward trend follows some fairly steep rises during the 1990s, resulting in levels of use remaining historically relatively high. The importance of global and demographic changes is identified as being important in understanding the (arguably somewhat limited) scope for changing youthful behaviour. The different recommendations for how to reduce harmful outcomes for young people are discussed: modifying the context/environment of use (for alcohol and tobacco), drugs treatment (for drug‐using offenders), tackling inequality and disadvantage (for heroin and crack cocaine).
Practical implications
Two key roles for health educators are identified: first, supporting mechanisms already known to be effective in reducing use/harmful use such as smoke‐free environments; second, providing an “expert” source of information used by the vast majority of young people who both want and require this on their lifelong health and drug “journeys”. Health education should have a harm reduction role; measuring success in terms of reducing population prevalence of substance use may be inappropriate and unrealistic.
Originality/value
Important insights are gained into substance use trends by young people when UK trends are set alongside international trends, and when all the psychoactive substances consumed are considered together.
Details
Keywords
This article considers the recent public debate in the UK on drug classification and the role of the Advisory Council of the Misuse of Drugs, particularly following David Nutt's…
Abstract
This article considers the recent public debate in the UK on drug classification and the role of the Advisory Council of the Misuse of Drugs, particularly following David Nutt's departure as Chair of the ACMD. It suggests that there have been flaws in the arguments on both sides, and considers some of the implications for wider debate on regulation and control.