Substance Abuse Policy Research Articles

Model systems of treatment for alcohol abuse following traumatic brain injury

Less than 5 years ago, Rohe and DePompolo [1] published the results of an important survey, which focused on substance abuse policies among rehabilitation programmes. The authors surveyed 52 treatment programmes and obtained information regarding ongoing staff education, patient education and policies related to alcohol consumption. Less than one-third of programmes surveyed provided patient education and less than one-quarter of programmes provided staff education. Although 90% of respondents supported prohibition during hospitalization, one-half of those surveyed also routinely prescribed alcohol for patients in a variety of situations (e.g. appetite stimulation, relaxation, social facilitation). The authors concluded that consistent patient and staff education programmes were lacking and that few programmes had consistent or expressed policies regarding the use of alcohol and drugs.

Britain's “Substance Abuse Policy”: Realities and Regulation in the United Kingdom

The historical development of policy concerning drugs in Great Britain is described. A major feature of this is that it originated out of international agreement rather than being the result of a domestic need. Not until the 1960s was there an emergence of evidence of a growing number of drug users. This led to the removal of the right to prescribe drugs in treatment from doctors in general practice and the establishment of clinics for the treatment of addicts. It is noted that the policy is substantially punitive and that large numbers of people are dealt with by the courts for drug offenses. The statistical data on drugs and the current treatment practices are also discussed.

Don't ?just say no? to drug testing in the workplace: Some recommendations for developing and implementing policy

The widespread use of contraband substances by organizational members continues to present policy makers with a plethora of legal, moral, and economic issues to contend with when designing and implementing a comprehensive substance abuse policy. This article addresses methods of drug testing and their relative advantages and limitations, the legal ramifications of policy decisions, including union and nonunion concerns, and the costs and benefits associated with drug testing and screening. General guidelines for the design and implementation of a substance abuse policy are offered, and it is suggested that organizations should not summarily dismiss drug testing as a vehicle for the control and elimination of contraband substances and their use in the workplace.

Substance abuse policies and programs at U.S. medical schools.

Substance abuse policies and programs at U.S. medical schools.

Follow-up Report on AIDS Commission Recommendations Goes to President Soon

ABSTRACT SOME GROUPS are less than enthusiastic about the White House's ten-point action in response to the 597 recommendations of the Commission on the Human Immunodeficiency Virus (HIV) Epidemic (JAMA 1988;260:602).The President's response to the HIV commission's report was developed by Donald Ian Macdonald, MD, director of the Drug Abuse Policy Office. Macdonald will continue to monitor this plan and will make a follow-up report to the President later this month.In the meantime, Jean McGuire, executive director, Acquired Immuno-deficiency Syndrome (AIDS) Action Council, says: The council [which represents more than 380 community-based service organizations] is deeply disappointed that the plan falls so far short of the vision espoused by the commission.The decision that seems to have caused the most disappointment is the lack of endorsement for the commission's view that, if people are going to come forward for testing and counseling, federal antidiscrimination laws must protect those

Substance Abuse and Public Policy

This article assesses the American effort to control and eradicate substance abuse and drug trafficking. Five drug control strategies-foreign crop eradication, border interdiction, deterrence, treatment, and prevention-are evaluated. In each area, the basic programs and their effectiveness are described. The authors conclude that U.S. policy is misdirected, dominated by long-standing and insupportable beliefs about the effectiveness of supply-side interventions such as eradication and interdiction.

Opium and the People: Opiate Use in Nineteenth-Century England

An impartial observer surveying our society's response to drug abuse might be amused or appalled, but not admiring. Some dangerous drugs, such as tobacco and alcohol, are dealt with in an ambivalent manner, despite widespread acknowledgment of their devastating effects. Other dangerous drugs, such as opiates and cocaine, are strictly and harshly controlled in a manner suggestive of moralistic zeal rather than public health concern. The rationale for these differing approaches is clearly not based solely on pharmacology and has its roots in societal and historical factors. The understanding of these roots by those concerned with drug abuse treatment and policy formulation might lead to a more informed approach to these areas. This book provides such an understanding for one drug, opium. Written mainly by a historian (Berridge) aided by a psychiatrist specializing in addiction (Edwards), this volume traces the evolution of opium use in Great Britain in the 19th

Substance-abuse policies and guidelines in amateur and professional athletics

Substance-abuse policies and guidelines in amateur and professional athletic organizations are described. Amateur athletic organizations, which are governed by the U.S. Olympic Committee or the National Collegiate Athletic Association (NCAA), have developed programs that include mandatory drug testing. Drugs banned by the two organizations include psychomotor stimulants, sympathomimetic amines, narcotic analgesics, anabolic steroids, miscellaneous central nervous system stimulants, and, in the case of the NCAA, certain street drugs. Professional organizations have been somewhat slower to follow and, with the exception of tennis, do not allow mandatory drug testing. Each formal drug-screening program includes penalties for violators. The enforcement practices of the organizations representing tennis, baseball, basketball, and football are described. One aspect unique to professional sports is the employee-assistance program, which allows the impaired athlete to receive treatment while continuing to play and receive a salary. As drug-control programs become more common in athletics, opportunities may arise for pharmacists to participate in the areas of drug information and educational services.

A departmental policy addressing chemical substance abuse.

Substance abuse is a major socioeconomic problem. However, the ready availability of potent narcotic and sedative drugs probably constitutes a unique risk for anesthesiologists. Until recently, few anesthesia departments were prepared to recognize or safely manage afflicted colleagues. Because we felt it important to educate our staff and residents and to have a response mechanism established prior to the advent of a substance abuse problem, a departmental committee was formed to develop a Substance Abuse Policy. The policy has served to increase our general awareness and to direct our actions effectively when dealing with physician impairment. It is presented here in the belief that other departments might find it useful in tailoring their approach to this problem.

Federal drug abuse policy and minority group issues--reflections of a participant-observer.

(1985). Federal Drug Abuse Policy and Minority Group Issues–Reflections of a Participant-Observer. International Journal of the Addictions: Vol. 20, No. 1, pp. 203-215.

Book Review: Quantitative Explorations in Drug Abuse Policy

Book Review: Quantitative Explorations in Drug Abuse Policy

Book Reviews

Book reviewed in this article Alcohol and Old Age. Brian L. Mishara and Robert Kastenbaum. Alcoholic Korsakoff's Syndrome: An Information – Processing Approach to Amnesia. By Nelson Butters and Laird S. Cermak. Minimum Drinking – Age Laws: An Evaluation. Henry Wechsler, Editor. Quantitative Explorations in Drug Abuse Policy. Edited by Irving Leveson. Aspects of Alcohol and Drug Dependence. Edited by J. S. Madden, R. Walker and W. Kenyon. The Biochemistry of Schizophrenia and Addiction Edited by Gwynneth Hemmings. Theories of Neurosis. By Michael Gossop. Therapy and Ethics. By Norman J. Finkel. Alcoholism: The Facts By Donald W. Goodwin. Drugs: A Factual Account (3rd Edition). By Dorothy Dusek and Daniel A. Girdano. Weight Control: The Behavioural Strategies. Michael D. LeBow.

Practical aspects of school drug-abuse policy development.

(1979). Practical Aspects of School Drug-Abuse Policy Development. Journal of Psychedelic Drugs: Vol. 11, No. 4, pp. 343-345.

The Family and Federal Drug Abuse Policies. Programs: Toward Making the Invisible Family Visible

The purposes of this paper are to note why at present the family as a factor is virtually invisible in drug policy and programming and to assert that conditions now exist that demand a conscious consideration of the familv in the prevention, research, and service delivery efforts qf federal drug agencies. Data are presented which show how the parameters of drug use-abuse are changing in the United States. A tentative research and prevention agenda that integrates the family is then presented.

Discouraging Unhealthy Personal Choices: Reflections on New Directions in Substance Abuse Policy

This article depicts the incoherence of present drug, alcohol and tobacco policies and describes the emergency of a “new paternalism” which, if implemented, would push alcohol and tobacco policies toward the preventive public health and welfare model which now dominates thinking about drug abuse policy. Then drawing on the normative perspectives of law and political philosophy, the author suggests that governmental efforts to modify unhealthy personal choices can be justified and that a compelling logical case against the new paternalism will not be found in the libertarian tracts of liberal political philosophers or of the modern Supreme Court. Instead, the author contends that the case for or against restrictive policies aiming to reduce overall consumption of alcohol and tobacco and other unhealthy behaviors, will be made on the facts—how much impact, if any, will they have on consumer behavior and, ultimately, on health care and social service costs? In this connection, the author canvasses the various ways in which formal governmental action, through law, can be utilized to implement a lifestyle-modification policy. Finally, the author raises a series of residual doubts about the new paternalism; even if lifestyle-modification is a legitimate and defensible approach for improving the health of the citizenry and for reducing health care costs, it may also be a prescription for oppression.

Shifting Perspectives in Drug-Abuse Policy

Beginning with the passage of the Narcotic Addict Rehabili tation Act in 1966, federal drug abuse policy has shifted sig nificantly, in attempts to find alternatives to the traditional punitive model. NARA represented the emergence of a planned, incremental, treatment-centered model for federal offenders. With the advent of the Nixon Administration "law and order" theme, drug policy shifted to a social-control model emphasizing methadone maintenance in local govern mental units as a means of containing street crime. In 1972, Public Law 92-93 authorized a relaxation of the legislative restrictions on NARA and provided greater flexibility in the treatment of federal offenders, including probationers, parolees, and those mandatorily released. Subsequent legisla tion passed by Congress in 1972-73 reflected a desire to merge the treatment-centered model with the social-control model. This paper analyzes these policy trends and raises questions about implications for the administration of justice.

Guidelines for school-police cooperation in drug abuse policy department.

Guidelines for school-police cooperation in drug abuse policy department.