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As cannabis legalization reforms are underway, there is some concern that non-profit, ‘middle ground’ options may remain under-researched and thus less visible. This book offers an in-depth account of one of the possible ‘middle ground’ models for the supply of cannabis: the Cannabis Social Club. Cannabis Social Clubs (CSCs) are typically formal, non-profit associations of adult cannabis users who produce and distribute that substance close to or at cost price among themselves. They constitute an user-driven model for the supply of cannabis. In most jurisdictions, CSCs remain a grass roots, unregulated initiative of groups of users, but the model has been legalized in Uruguay and Malta, and it has featured recent debates and legislative proposals in other countries. This book brings together contributions from internationally respected scholars, drawing on case studies, empirical findings and policy reflections, from a range of countries (such as Belgium, Canada, New Zealand, Spain, Uruguay, USA), and a consideration of the CSC model from different disciplinary backgrounds. Part one provides detailed analysis of where and how CSCs have been operating, and a critical analysis of their key features and relationship with institutional actors. Part two discusses several policy outcomes and proposes a design of a regulatory market, as well as considering whether the CSC model might be suited for adaptation to the supply of other substances. The Cannabis Social Club is important reading for academics in the fields of drug policy analysis, criminology, economics, policy studies and anthropology. It will also be of interest to policy makers, journalists, law-enforcement personnel.
Substance and Behavioral Addictions: Concepts, Causes, and Cures presents the concepts, etiology, assessment, prevention, and cessation of substance (tobacco, alcohol, other drugs, and food) and behavioral (gambling, Internet, shopping, love, sex, exercise, and work) addictions. The text provides a novel and integrative appetitive motivation framework of addiction, while acknowledging and referencing multi-level influences on addiction, such as neurobiological, cognitive, and micro-social and macro-social/physical environmental. The book discusses concurrent and substitute addiction, and offers prevention and treatment solutions, which are presented from a more integrative perspective than traditional presentations. This is an ideal text for upper-level undergraduates and graduate students, practitioners, and researchers.
Significant changes have taken place in the policy landscape surrounding cannabis legalization, production, and use. During the past 20 years, 25 states and the District of Columbia have legalized cannabis and/or cannabidiol (a component of cannabis) for medical conditions or retail sales at the state level and 4 states have legalized both the medical and recreational use of cannabis. These landmark changes in policy have impacted cannabis use patterns and perceived levels of risk. However, despite this changing landscape, evidence regarding the short- and long-term health effects of cannabis use remains elusive. While a myriad of studies have examined cannabis use in all its various forms, often these research conclusions are not appropriately synthesized, translated for, or communicated to policy makers, health care providers, state health officials, or other stakeholders who have been charged with influencing and enacting policies, procedures, and laws related to cannabis use. Unlike other controlled substances such as alcohol or tobacco, no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively. Shifting public sentiment, conflicting and impeded scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the use of cannabis or its derivatives, and this lack of aggregated knowledge has broad public health implications. The Health Effects of Cannabis and Cannabinoids provides a comprehensive review of scientific evidence related to the health effects and potential therapeutic benefits of cannabis. This report provides a research agendaâ€"outlining gaps in current knowledge and opportunities for providing additional insight into these issuesâ€"that summarizes and prioritizes pressing research needs.
The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.
Drug trafficking and consumption are among the most pressing global issues of our time and the approaches to alleviating them are myriad and complex. With Drugs and the World,Axel Klein takes a remarkably broad approach to the issue, exploring the importance of psychoactive substances to our health and culture. To be properly understood, drugs should not be simply examined from a negative point of view, Klein argues. From their centrality in religious rituals to their part in the growth of trade among nation-states, Klein reveals the pivotal role that drugs have played in the advancement of human society. Klein then investigates the modern policies that define certain substances as drugs; the link between drugs, addiction, and crime; and the legal strategies and policies around the world that have largely failed to control global drug trafficking. The book also draws upon studies from the Caribbean, West Africa and Eastern Europe to propose solutions that could reinforce the eroded power of state institutions, law enforcement, and the democratic process in addressing drug trafficking. A timely and in-depth analysis, Drugs and the World offers an expertly written examination that will be essential for all those concerned with the role of drugs in the modern world.
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.