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CORK Bibliography: Drug Trade and Trafficking

92 citations. January 2010 to present

Prepared: December 2011

Alonso-Canovas A; de Felipe-Mimbrera A; Gonzalez-Valcarcel J; Garcia-Barragan N; Corral I; Masjuan J. Nuerological problems at the airport. Journal of Neurology, Neurosurgery and Psychiatry 82(9): 981-985, 2011. (14 refs.)

Objectives: Neurological problems are reported to be common in air travellers. The authors aimed to study neurological problems which might be associated with air traffic in a systematic way. Methods The authors analysed a prospective registry of all the patients referred from Madrid-Barajas International Airport to the emergency department of their tertiary university hospital (Hospital Universitario Ramon y Cajal), for whom a neurological consultation was required, during a period of 21 months. Results: 77 patients with a history of air travel presented with neurological problems and were included in the analysis. Fifty-nine (76.6%) were male, and the mean age was 45.9 (range 8-89, SD 17.5). Onset of symptoms was after landing in 44 subjects (58.7%), during the flight in 31 (41.3%), and unknown in two (5.1%). Thirty-nine (50.9%) had seizures, 18 (23.4%) had a stroke, and 20 (26%) other diagnosis. Sixty-one per cent of the patients with seizures had no previous history of epilepsy. Seizures on presentation were significantly associated with the use of drugs (p=0.0008), and most of the cases with known epilepsy admitted non-adherence to treatment. Three 'body packers' were admitted with seizures secondary to intra-abdominal cocaine pack rupture. Of eight ischaemic strokes, five had high-grade carotid stenosis, and one case had economy-class stroke syndrome. Six patients with stroke were eligible and treated with intravenous thrombolysis. Conclusion: In our series of neurological problems among air travellers, drug-induced seizures and ischaemic strokes due to large-artery atherosclerosis were the commonest observed diagnoses.

Arkes J. Recessions and the participation of youth in the selling and use of illicit drugs. International Journal of Drug Policy 22(5): 335-340, 2011. (26 refs.)

Background: There has been limited research on how recessions (or more generally, the strength of the economy) affect drug use and the related outcome of drug selling. This is especially important, given the current economic crisis. This paper aims to use a conceptual framework, previous research, and new research to predict how the current economic crisis may be affecting youth drug selling and drug use. Methods: A conceptual framework to understand how a recession could affect youth drug selling and drug use is presented, along with a review of the literature on empirical investigations on how the strength of the economy affects these behaviours among teenagers. In addition, new analyses for young adults are presented. Results: The conceptual framework postulates that a recession would have direct positive effects on the prevalence of youth drug selling but ambiguous direct effects on youth drug use. The conceptual framework also postulates that drug selling and drug use are inter-connected at the individual level and the aggregate level. Thus, any effect of a recession on one would likely affect the other in the same direction. The limited empirical evidence indicates that both drug selling and drug use among youth are higher when the economy is weaker. Conclusions: The current economic crisis will likely increase both youth drug selling and drug use relative to what they would have otherwise been.

Attaran A; Bate R; Kendall M. Why and how to make an international crime of medicine counterfeiting. Journal of International Criminal Justice 9(2): 325-354, 2011. (64 refs.)

The article explores why - when the counterfeiting of medicines is so prevalent, hard to detect and quietly dangerous or fatal - it remains totally unaddressed and therefore legal in international criminal law. It is argued that criminalizing the counterfeiting of medicines on an international scale would present no legally insurmountable barriers, and would offer significant advantages over the current national-scale approaches. The authors propose a legal definition of 'counterfeit', canvass the current legal doctrines that could be arrayed to better criminalize medicine counterfeiting, including classifying the severest instances as crimes against humanity, and explain the mechanisms necessary to close the jurisdictional gaps that are currently exploited by organized criminals who trade in counterfeit medicines across borders. They suggest that a counterfeit medicine treaty should be drafted under the auspices of the World Health Organization, and illustrate the feasibility of doing so with existing and developing treaty law on another health danger, tobacco.

Attaran A; Boozary A. For peace and pain: The medical legitimisation of Afghanistan's poppy crop. Journal of Epidemiology and Community Health 65(5): 396-398, 2011. (20 refs.)

Since the overthrow of the Taliban in 2001, there has been an overall increase in illicit opium production in Afghanistan and mounting human losses. The United Nations has attributed 1 million human deaths to Afghan opiates over the past decade. As the war in Afghanistan nears a crucial mark, the NATO coalition forces and Afghan people can no longer afford the same ineffective counternarcotics strategy. This commentary proposes a strategic revision that reframes Afghanistan's poppy problem as an opportunity for global public health. Specifically, The Afghan poppy crop could be repurposed away from illicit drug production, and towards manufacturing licit opioid analgesics to address unmet needs for pain palliation, particularly for diseases such as HIV/AIDS and cancer in the developing world-that is, illegal opium could be converted into legal pain medicine, solving two problems at once. We present a supply-and-demand that illustrates how this useful exchange could be made, and discuss the political opposition that now stands in the way and perpetuates the unsatisfactory status quo in Afghanistan.

Beckerleg S. 'Idle and disorderly' khat users in Western Uganda. Drugs: Education, Prevention and Policy 17(4): 303-314, 2010. (23 refs.)

Aims: To describe and analyse patterns of khat consumption and the response of the authorities to such drug use in Western Uganda. Methods: Participant-observation and key informant interviews were carried out in Western Uganda during 2007, 2008 and 2009. Findings: Khat is legal in Uganda but its use, especially when combined with alcohol and cannabis, is linked with violent crime by many Ugandans. In Western Uganda local government authorities have attempted to crack down on khat: in Bushenyi District they have introduced a by-law; in other districts khat traders and consumers face arrest and charges of being 'idle and disorderly'. Conclusion: The authorities, by clamping down on khat, because they perceive it to be a cause of violent crime, are targeting a substance that is widely reported in the academic literature to cause apathy, not violence.

Bhattacharya IS; Watson F; Bruce M. A case of gamma-butyrolactone associated with severe withdrawal delirium and acute renal failure. European Addiction Research 17(4): 169- 171, 2011. (15 refs.)

gamma-Butyrolactone (GBL) is a popular drug of abuse which is easily available over the internet. Following a UK classification change to a class C drug in January 2010, internet supply has become difficult. Some of the effects have resulted in sourcing GBL from industrial solvents. We report a case of a 24-year-old man who was admitted for detoxification from GBL. He reported having sourced the GBL by diluting the contents of nail varnish remover pads with water. During his admission he developed a severe withdrawal delirium and acute renal failure. He required admission to the intensive care unit. Physicians and psychiatrists should be aware of toxic sources of GBL leading to renal failure and consider GBL in those presenting with agitation, psychosis or coma.

Blecher E. Commentary on Joossens et al. (2010): Eliminating the global illicit cigarette trade - what do we really know? (editorial). Addiction 105(9): 1650-1651, 2010. (6 refs.)

Bonner RC. The new cocaine cowboys how to defeat Mexico's drug cartels. Foreign Affairs 89(4): 35-47, 2010. (0 refs.)

This article considers the activity of the drug cartels in Mexico, comparing this to the activities in Columbia two decades ago. Colombia then was faced with a similar--and in many ways more daunting--struggle. In the early 1990s, many Colombians, including police officers, judges, presidential candidates, and journalists, were assassinated by the most powerful and fearsome drug-trafficking organizations the world has ever seen: the Cali and Medell�n cartels. Yet within a decade, the Colombian government defeated them, with Washington's help. The United States played a vital role in supporting the Colombian government, and it should do the same for Mexico. In the absence of activity, it is seen as highly likely that the United States will share a 2,000 mile border with a narcostate controlled by powerful transnational drug cartels, threatening the stability of Central and South America.

Bossong MG; Brunt TM; Van Dijk JP; Rigter SM; Hoek J; Goldschmidt HMJ et al. mCPP: An undesired addition to the ecstasy market. Journal of Psychopharmacology 24(9): 1395-1401, 2010. (41 refs.)

A new ecstasy-like substance, meta-chlorophenylpiperazine (mCPP), has been detected in street drugs in the Netherlands. Theoretically, mCPP possesses the potential to become a non-neurotoxic alternative for methylenedioxymethamphetamine (MDMA), the regular psychoactive substance of ecstasy. Since its introduction on the Dutch market of synthetic drugs, the percentage of mCPP-containing tablets has increased, including both tablets that contain only mCPP and tablets containing a combination of mCPP and MDMA. These tablets occur in many different colours, shapes and sizes and with various logos, making it impossible to distinguish mCPP-containing tablets from regular MDMA tablets. In addition, the reports of users concerning the effects of mCPP are predominantly negative. All these aspects together lead to the conclusion that mCPP is an undesired addition to the ecstasy market from the user's perspective.

Bretteville-Jensen AL. Illegal drug use and the economic recession: What can we learn from the existing research? International Journal of Drug Policy 22(5): 353-359, 2011. (59 refs.)

Background: Much research on the use of amphetamine, cocaine and heroin employs individual level data and analyses variations in drug use by factors like personal characteristics, socioeconomic factors, and the social environment. Less attention is given to how these individual responses inter-relate with key macroeconomic variables. From a drug policy perspective however, it is important to also understand the consequences for drug use and drug users of changes in the macroeconomic conditions. As the world is experiencing an economic recession one would like to know whether it will affect the number of drug users and/or consumption frequency and volume amongst established users. Methods: There are different channels through which a recession could influence drug consumption; here the main focus is on how an economic downturn may influence drug prices and drug users' incomes. We briefly refer to relevant economic theory before reviewing the research literature. Results: A fall in drug prices and income seem likely. Empirical studies confirm drug users' price responsiveness. Only a few studies have dealt with income elasticity amongst this group. Conclusion: As the price and the income effect may pull in opposite directions, the full effect on drug use is difficult to predict. Still, it seems likely that an economic downturn of the current magnitude could increase the use of drugs.

Bright DA; Ritter A. Australian trends in drug user and drug dealer arrest rates: 1993 to 2006-07. Psychiatry, Psychology and Law 18(2): 190-201, 2011. (21 refs.)

There is a paucity of data available in a concise, accessible form that maps trends in illicit drug crime offences for different types of drugs. The aim of the current article was to collate data on arrests for illicit drugs, examine trends for the main illicit drug types, and explore some potential explanations for emergent trends. Trends for provider-type and consumer-type offences are reviewed in terms of the number of offences per year, and the proportion of total illicit drug offences for each year for each type of drug across the period 1993 to 2006-07. The main findings are: (a) substantially more users than dealers are arrested, (b) the stability of the ratio between consumer-type and provider-type arrests suggests a longstanding law enforcement focus on targeting drug users relative to drug dealers, (c) cannabis arrests consistently account for the greatest proportion of arrests, (d) the proportion of total provider-type arrests for cannabis decreased by 30% between 1993 and 2006-07, (e) heroin arrests peaked in 1998-1999, then declined rapidly around the time of the Australian heroin shortage, and have showed a decline since that time, and (f) arrests for amphetamine-type stimulants and phenethylamines have steadily increased between the early 1990s through to 2006-07. Potential explanations for trends in drug arrests are posited, such as changes in the prevalence of use and shifts in law enforcement focus. The methodological weaknesses of the data are summarized and areas for future research are suggested.

Burgdorf JR; Kilmer B; Pacula RL. Heterogeneity in the composition of marijuana seized in California. Drug and Alcohol Dependence 117(1): 59-61, 2011. (22 refs.)

Background: Marijuana contains multiple cannabinoids. Most attention is given to delta-9-tetrahydrocannabinol (THC) which produces euphoria and in some cases anxiety and panic reactions. Research suggests that another cannabinoid, cannabidiol (CBD), may offset some of these effects. Thus, there is growing interest in the health consequences of the THC to CBD ratio for marijuana. Methods: Using data from over 5000 marijuana samples in California from 1996 to 2008, we examine changes in the median THC-level, median CBD-level, and median THC:CBD-ratio. Results: The median THC-level and median THC:CBD-ratio have dramatically increased for seizures in California, particularly north of the Mexican border. Conclusion: Research on the consequences of the THC:CBD ratio should continue, especially as more attention is devoted to thinking about how to regulate marijuana for medical and recreational use. Researchers should also consider the lack of uniformity in the chemical composition of marijuana when evaluating its health effects.

Burge M; Hunsaker JC; Davis GJ. Death of a toddler due to ingestion of sulfuric acid at a clandestine home methamphetamine laboratory. Journal of Biological Chemistry 285(2): 298-301, 2010. (20 refs.)

Exposure to strong acids such as sulfuric acid to either the skin or the gastrointestinal or respiratory mucosa will result respectively in significant -- occasionally fatal -- cutaneous chemical burns as well as devastating corrosive damage to the respiratory and gastrointestinal tracts. Most injuries are accidental, but there are reports of using acids as weapons or as a means of suicide. The primary mechanism of acid injury is coagulative necrosis of the tissues. Sulfuric acid is a chemical often used in industrial and chemical laboratories, and it is an ingredient in household products like drain cleaner. Easily accessible, over-the-counter, household drain cleaner is one of several common materials used to manufacture methamphetamine. With increasing clandestine methamphetamine laboratories in the United States, exposure to methamphetamine and the toxic chemicals used for its production is a growing problem. In many instances, children living in these laboratories qua homes are at risk for injury and death. We report the death of an unattended toddler, who ingested sulfuric acid drain cleaner in his home. The gross and histopathological autopsy findings in this case are similar to those of previously described cases of sulfuric acid injury.

Buysschaert B; Weyers P. Bodypacking. (editorial). Acta Clinica Belgica 65(3): 202-203, 2010. (2 refs.)

Carhart-Harris RL; King LA; Nutt DJ. A web-based survey on mephedrone. Drug and Alcohol Dependence 118(1): 19-22, 2011. (5 refs.)

Background: This study sought to collect information on the former legal-high 'mephedrone' using a web-based survey targeted at mephedrone users. Methods: The survey was advertised on websites frequented by drug users. Individuals were invited to complete the survey if they had taken mephedrone on at least one occasion in the past. Results: One thousand and six completed forms were received from declared users, making this the largest survey on mephedrone to date. Conclusion: Results showed that mephedrone users consider its effects to compare best with those of MDMA, and while MDMA was considered marginally safer and its effects more pleasurable, mephedrone's appeal lay in its availability, low price and reliable purity.

Caulkins JP; Nicosia N. What economics can contribute to the addiction sciences. Addiction 105(7): 1156-1163, 2010. (112 refs.)

Aims: The addiction sciences are intrinsically multi-disciplinary, and economics is among the disciplines that offer useful perspectives on the complex behaviors surrounding substance abuse. This paper summarizes contributions economics has made in the past and could make in the future towards understanding how illegal markets operate, how prices affect use, how use generates various consequences, and how policy shapes all three. Methods: Review of literature, concentrating on illegal drugs as insights concerning markets are particularly salient, although we also mention relevant studies from the alcohol and tobacco fields. Findings and Conclusions: Economics offers tools and topical expertise that usefully complement other disciplines associated traditionally with the addiction sciences. Its value goes far beyond the ability to monetize non-monetary outcomes or to calculate a cost-benefit ratio.

Cawich SO; Downes R; Martin AC; Evans NR; Mitchell DIG; Williams E. Colonic perforation: A lethal consequence of cannabis body packing. Journal of Forensic and Legal Medicine 17(5): 269-271, 2010. (31 refs.)

Body packing is one method of smuggling cannabis across international borders. The practice is prevalent in Jamaica. There has been one reported death from this practice in medical literature. We report a second fatal case of cannabis body packing, reinforcing the dangerous nature of this practice.

Chalmers J; Bradford D; Jones C. The effect of methamphetamine and heroin price on polydrug use: A behavioural economics analysis in Sydney, Australia. International Journal of Drug Policy 21(5): 381-389, 2010. (54 refs.)

Background: A key aim of supply-side drug law enforcement is to reduce drug use by increasing the retail price of drugs. Since most illicit drug users are polydrug users the effectiveness of this strategy depends on the extent to which drug users reduce their overall consumption of drugs. The literature shows that drug users do reduce their consumption of a drug when its price increases. However the extent of that decrease and the implications for the use of other drugs vary across studies. Methodology: A sample of 101 Australian methamphetamine users was surveyed using a behavioural economics approach. Participants were given a hypothetical fixed drug budget, presented with a range of drug price lists and asked how many units of each drug they would purchase. Methamphetamine and heroin prices were varied independently across trials. Results: While demand for both methamphetamine and heroin was found to be price elastic, elasticity estimates were influenced by the nature of participants' drug dependence. The group least responsive to changes in methamphetamine price were those dependent only on methamphetamine, while the group most responsive were dependent only on heroin. Similar findings emerged in relation to changes in heroin price. Cross-price elasticity analysis showed limited substitution into other drugs as the price of methamphetamine increased. In contrast, for heroin, there was significant substitution into pharmaceutical opioids and to a lesser extent, benzodiazepines and methamphetamine. However, for the most part, the decreases in methamphetamine or heroin consumption outweighed any substitution into other drugs. Conclusion: The reduction in overall drug consumption and expenditure in response to price increases in heroin and methamphetamine observed in this sample lend support to supply-side enforcement strategies that aim to increase retail drug price. Notably, this analysis highlights the importance of accounting for the nature of users' drug dependence in estimating price responsiveness.

Chang A; Osterloh J; Thomas J. Levamisole: A dangerous new cocaine adulterant. Clinical Pharmacology & Therapeutics 88(3): 408-411, 2010. (30 refs.)

Levamisole has increasingly been discovered in street cocaine as an adulterant. Recent reports have linked levamisole in street cocaine to agranulocytosis in cocaine users. It is well known that agranulocytosis is associated with therapeutic use of levamisole, and this may have led to the withdrawal of the drug from the US market. Levamisole was a US Food and Drug Administration-approved drug that has been used as an immunomodulator, a chemotherapy adjuvant, and anthelmintic medication. The purpose of adulterating street cocaine with levamisole is not known, but it has been speculated that it is added intentionally in order to potentiate the effects of cocaine. This may be supported by the recent report of metabolism of levamisole to aminorex in racehorses. Aminorex and related compounds, specifically 4-methylaminorex, or "ice," have high abuse potential because of their amphetamine-like pharmacological activity. This metabolism has not been reported in humans, and therefore the intended role of levamisole in street cocaine remains an enigma.

Chen HF; Chen SH; Lee JM; Jeng HY. Who are the potential smokers of smuggled cigarettes? Asian Economic Journal 24(3): 221-234, 2010. (22 refs.)

Although smuggled cigarettes have been a prevalent problem and a severe challenge to public health and welfare around the world, little is known about the behavior associated with smoking smuggled cigarettes and the issue is difficult to study due to data limitations. By means of a population-based tobacco survey conducted in Taiwan, the present paper applies a latent class model to identify potential smokers who are either currently or will at some point in the future be consuming smuggled cigarettes. This methodology, in contrast to the traditional discrete models, allows potential smokers who are more inclined to smoke smuggled cigarettes to be endogenously classified. The empirical results indicate that socio-demographic factors do increase the inclination to smoke smuggled cigarettes after unobserved heterogeneity has been accounted for.

Chettiar J; Shannon K; Wood E; Zhang R; Kerr T. Survival sex work involvement among street-involved youth who use drugs in a Canadian setting. Journal of Public Health 32(3): 322-327, 2010. (29 refs.)

Drug users engaged in survival sex work are at heightened risk for drug- and sexual-related harms. We examined factors associated with survival sex work among street-involved youth in Vancouver, Canada. From September 2005 to November 2007, baseline data were collected for the At-Risk Youth Study (ARYS), a prospective cohort of street-recruited youth aged 14-26 who use illicit drugs. Using multiple logistic regression, we compared youth who reported exchanging sex for money, drugs etc. with those who did not. The sample included 560 youth: median age 22; 179 (32%) female; 63 (11%) reporting recent survival sex work. Factors associated with survival sex work in multivariate analyses included non-injection crack use [adjusted odds ratio (AOR) = 3.45, 95% confidence interval (CI): 1.75-6.78], female gender (AOR = 3.02, 95% CI: 1.66-5.46), Aboriginal ethnicity (AOR = 2.35, 95% CI: 1.28-4.29) and crystal methamphetamine use (AOR = 2.02, 95% CI: 1.13-3.62). In subanalyses, the co-use of crack cocaine and methamphetamine was shown to be driving the association between methamphetamine and survival sex work. This study demonstrates a positive interactive effect of dual stimulant use in elevating the odds of survival sex work among street youth who use drugs. Novel approaches to reduce the harms associated with survival sex work among street youth who use stimulants are needed.

Clark PA; Sillup GP; Capo JA. Afghanistan, poppies, and the global pain crisis. (review). Medical Science Monitor 16(3): RA49-RA57, 2010. (20 refs.)

The World Health Organization has reported that somewhere between 30-86 million people suffer from moderate to severe pain due to cancer, HIV/AIDS, burns, wounds and other illnesses annually and do not have access to proper opiate anesthetics to control the pain. The vast majority of these people live in poor nations where medicinal opiates are either too expensive or not readily available. In this paper, it is argued that access to adequate healthcare is a human right and that adequate healthcare includes management of pain. The solution to this problem may be in Afghanistan, a country now overwhelmed with poverty and war. Afghanistan is the world's leading producer of heroin. The increase in heroin production in Afghanistan has caused the United States and the international community to begin to eradicate Afghanistan's poppy fields leading to increased poverty among poppy farmers. This paper proposed a paradigm that can be implemented in Afghanistan which would allow for Afghan farmers to continue growing their poppy crop for medicinal opiates like morphine for poor nations. The paradigm covers all parameters of medicinal opiates production including licensing, security, cultivation, harvest, and factory production of medicinal opiates. The paradigm proposed is less expensive than eradication, brings honest income to Afghan farmers and the new Afghan nation, and can eventually lead to Afghanistan acquiring a respectable role in the world community. In closing, a full ethical analysis of the paradigm is included to justify the arguments made in the paper.

Cole C; Jones L; McVeigh J; Kicman A; Syed Q; Bellis M. Adulterants in illicit drugs: A review of empirical evidence. (review). Drug Testing and Analysis 3(2): 89-96, 2011. (90 refs.)

Widespread public perception is that illicit drugs contain substances that are a serious risk to health, even though adulterants are often not considered in clinical or forensic toxicology. This review attempts to present an evidence-based overview of adulterants in illicit drugs, and their associated toxicity. Adulterants are deliberately added to increase bulk, enhance or mimic a pharmacological effect, or to facilitate drug delivery. Those present unintentionally are as a result of poor manufacturing techniques. From the reports gathered, adulterants are predominantly substances which are readily available, commonly being caffeine, procaine, paracetamol, and sugars. These are likely to have minimal impact on users' health at low dosages. Other adulterants, particularly in injectable drugs, have the potential to cause serious health issues, but the quantities reported, such as strychnine in heroin, are not life-threatening. The most commonly identified bacterial contaminants identified are Bacillus and Clostridium species. When death or serious illness due to adulteration occurs, circulation of information is particularly vital, such as in the USA regarding heroin and cocaine adulterated with fentanyl, and in Scotland recently regarding anthrax contaminated heroin. The complex interactions of supply, demand, and control of illicit drugs have a tangible impact on their adulteration. Continuing vigilance and the circulation of information is, therefore, desirable as a public health issue. As part of that strategy, analyses performed for adulterants needs to be encouraged, which are considerably limited in number and scope at the moment.

Collins M. Some new psychoactive substances: Precursor chemicals and synthesis-driven end-products. (review). Drug Testing and Analysis 3(7-8, special issue): 404-416, 2011. (59 refs.)

This paper describes some of the new classes of 'designer drugs' being encountered today by forensic scientists and law enforcement agencies in Europe, the United States, and Australia. In particular, it concentrates on new cathinone derivatives, the tryptamines, new-generation phenethylamines, and some of the synthetic cannabinoids. The synthetic approaches towards many of these designer drugs including a discussion of the chemical precursors used in the syntheses are presented. Many of today's so-called designer drugs exist as a result of legitimate research into medical conditions and the natural product chemistry. A link between synthetic approaches published in the open scientific and medical literature and the exploitation of this research by clandestine manufacture of drugs for illicit purposes is drawn.

Collins M; Salouros H; Cawley AT; Robertson J; Heagney AC; Arenas-Queralt A. The delta C-13 and delta H-2 isotope ratios in amphetamine synthesized from benzaldehyde and nitroethane. Rapid Communications in Mass Spectrometry 24(11): 1653-1658, 2010. (26 refs.)

Previous work in these laboratories and by Butzenlechner et al. and Culp et al. has demonstrated that the delta H-2 isotope value of industrial benzaldehyde produced by the catalytic oxidation of toluene is profoundly positive, usually in the range +300 parts per thousand to +500 parts per thousand. Synthetic routes leading to amphetamine, methylamphetamine or their precursors and commencing with such benzaldehyde may be expected to exhibit unusually positive delta H-2 values. Results are presented for delta C-13 and delta H-2 isotope values of 1-phenyl-2-nitropropene synthesized from an industrial source of benzaldehyde, having a positive delta H-2 isotope value, by a Knoevenagel condensation with nitroethane. Results are also presented for delta C-13 and delta H-2 isotope values for amphetamine prepared from the resulting 1-pheny1-2-nitropropene. The values obtained were compared with delta C-13 and delta H-2 isotope values obtained for an amphetamine sample prepared using a synthetic route that did not involve benzaldehyde. Finally, results are presented for samples of benzaldehyde, 1-phenyl-2-nitropropene and amphetamine that had been seized at a clandestine amphetamine laboratory.

Cunningham JK; Bojorquez I; Campollo O; Liu LM; Maxwell JC. Mexico's methamphetamine precursor chemical interventions: Impacts on drug treatment admissions. Addiction 105(11): 1973-1983, 2010. (64 refs.)

Aims: To help counter problems related to methamphetamine, Mexico has implemented interventions targeting pseudoephedrine and ephedrine, the precursor chemicals commonly used in the drug's synthesis. This study examines whether the interventions impacted methamphetamine treatment admissions -- an indicator of methamphetamine consequences. Design: Quasi-experiment: autoregressive integrated moving average (ARIMA)-based intervention time-series analysis. Interventions: precursor chemical restrictions implemented beginning November 2005; major rogue precursor chemical company closed (including possibly the largest single drug-cash seizure in history) March 2007; precursor chemicals banned from Mexico (North America's first precursor ban) August 2008. Settings: Mexico and Texas (1996-2008). Measurements: Monthly treatment admissions for methamphetamine (intervention series) and cocaine, heroin and alcohol (quasi-control series). Findings The precursor restriction was associated with temporary methamphetamine admissions decreases of 12% in Mexico and 11% in Texas. The company closure was associated with decreases of 56% in Mexico and 48% in Texas; these decreases generally remained to the end of the study period. Neither intervention was associated with significant changes in the Mexico or Texas quasi-control series. The analysis of Mexico's ban was indeterminate due largely to a short post-ban series. Conclusions: This study, one of the first quasi-experimental analyses of an illicit-drug policy in Mexico, indicates that the country's precursor interventions were associated with positive impacts domestically and in one of the Unites States' most populous states-Texas. These interventions, coupled with previous US and Canadian interventions, amount to a new, relatively cohesive level of methamphetamine precursor control across North America's largest nations, raising the possibility that the impacts found here could continue for an extended period.

Cunningham JK; Maxwell JC; Campollo O; Cunningham KI; Liu LM; Lin HL. Proximity to the US-Mexico border: A key to explaining geographic variation in US methamphetamine, cocaine and heroin purity. Addiction 105(10): 1785-1798, 2010. (69 refs.)

Aims: Although illicit drug purity is a widely discussed health risk, research explaining its geographic variation within a country is rare. This study examines whether proximity to the US-Mexico border, the United States' primary drug import portal, is associated with geographic variation in US methamphetamine, heroin and cocaine purity. Design Distances (proximity) between the US-Mexico border and locations of methamphetamine, cocaine and heroin seizures/acquisitions (n = 239 070) recorded in STRIDE (System to Retrieve Information from Drug Evidence) were calculated for the period of 1990-2004. The association of drug purity with these distances and other variables, including time and seizure/acquisition size, was examined using hierarchical multivariate linear modeling (HMLM). Setting: Coterminous United States. Findings: Methamphetamine, cocaine and heroin purity generally decreased with distance from the US-Mexico border. Heroin purity, however, after initially declining with distance, turned upwards-a U-shaped association. During 2000-04, methamphetamine purity also had a U-shaped association with distance. For each of the three drugs, temporal changes in the purity of small acquisitions (< 10 g) were typically more dynamic in areas closer to the US-Mexico border. Conclusions: Geographic variance in methamphetamine, cocaine and heroin purity throughout the coterminous United States was associated with US-Mexico border proximity. The U-shaped associations between border-distance and purity for heroin and methamphetamine may be due to imports of those drugs via the eastern United States and southeast Canada, respectively. That said, areas closer to the US-Mexico border generally had relatively high illicit drug purity, as well as more dynamic change in the purity of small ('retail level') drug amounts.

Dargan PI; Albert S; Wood DM. Mephedrone use and associated adverse effects in school and college/university students before the UK legislation change18. Quarterly Journal of Medicine 103(11): 875-879, 2010. (18 refs.)

Methods: Data was collected using a questionnaire survey in schools, colleges and universities in the Tayside area of Scotland, UK in February 2010. Results: A total of 1006 individuals completed the survey [501 (49.8%) males and 505 (50.2%) females], of whom 349 classified their educational institute as a school and 657 as a college/university. Among them 205 (20.3%) reported previous use of mephedrone; 23.4% reported using only using mephedrone on one occasion previously, although 4.4% reported daily use. A total of 56% of those who had used mephedrone, reported at least one unwanted effect associated with its use. A total of 17.6% of users reported 'addiction or dependence' symptoms associated with their mephedrone use. A total of 48.8% of users sourced mephedrone from street level dealers, 10.7% from the Internet. Conclusions: We have shown in this study that the use of mephedrone among school and college/university students is common and that users found it easy to obtain. There was a high prevalence of unwanted effects associated with its use. Further work is needed to determine the impact of the recent changes in the UK legislation relating to mephedrone and other related cathinones and whether this has been effective in reducing the prevalence of mephedrone use.

Darke S; Duflou J; Torok M. A reduction in blood morphine concentrations amongst heroin overdose fatalities associated with a sustained reduction in street heroin purity. Forensic Science International 198(1-3): 118-120, 2010. (16 refs.)

To determine the effects of a sudden and sustained reduction in heroin purity on the toxicology of heroin overdose, 959 consecutive heroin overdose cases autopsied at the NSW Department of Forensic Medicine (1/1/1998-31/12/2006) were analysed. There was a significant reduction in blood morphine concentration across the study period (beta = -0.07), declining from a median of 0.50 mg/L in the years 1998-2000 prior to 0.40 mg/L in the period 2001-2006. There was no significant change in the proportion of alcohol positive cases, but the proportion of benzodiazepine positive cases increased across time (OR 1.11), as did methadone positive cases (OR 1.12). The decline in blood morphine concentrations remained significant after controlling for these factors (beta = -0.07). In determining toxic and lethal morphine concentrations, the fact that the toxicology of overdose is responsive to changes in the opioid street market needs to be borne in mind.

Davies RB. Mandatory minimum sentencing, drug purity and overdose rates. Economic and Social Review 41(4): 429-457, 2010. (25 refs.)

As of 1987, the US's Anti-Drug Abuse Act (ADAA) has imposed mandatory minimum sentences for drug traffickers based on the quantity of the drug involved irrespective of purity. Using the STRIDE dataset and a differences-in-differences approach, I find that this led to increases in cocaine and heroin purity of 52 per cent and 27 per cent respectively. It also affected the distribution of purity around its mean. Using data on emergency room visits, I show that changes in the distribution of purity had significant impacts on such visits. These results provide insights useful when considering Ireland's drug policies which include the use of mandatory minimum sentences.

Davies S; Wood DM; Smith G; Button J; Ramsey J; Archer R et al. Purchasing 'legal highs' on the Internet-is there consistency in what you get? QJM-An International Journal of Medicine 103(7): 489-493, 2010. (15 refs.)

Background: The supply of recreational drugs has changed and users increasingly buy 'legal highs' over the Internet. Use of these is common and there is a potential for significant toxicity associated with their use. Aim: To determine the content of legal highs available for purchase in the UK and whether the content of these remains consistent. Methods: Twenty-six legal highs were purchased monthly from five different Internet sites over 6 months. These were analysed to determine the drugs in the products and whether there were any changes in their content over this time period. Results: All products were supplied initially, but there was a decline in supply of products month by month. The following drug classes were detected: piperazines, cathinones, caffeine/ephedrine or products in which no psychoactive drugs were detected. Of the products supplied on more than one occasion, 15 (75%) contained the same compounds on each occasion. In three products there was a change in the piperazine detected, with 1-benzylpiperazine being substituted for 1-methyl-4-benzylpiperazine or vice versa. In two other products there was a cathinone [4-fluorophenylpiperazine (pFPP) or 3-fluromethcathinone (3FMC)] detected in products purchased in Month 1 that was not present in the products purchased in subsequent months. Conclusions: Whilst there was no variation in the composition of most legal highs supplied over 6 month, there was significant variation in the piperazine or cathinone content of one quarter of the products. This variation could be of clinical significance as the cathinone and piperazine products can be associated with significant toxicity.

de Moura YG; Sanchez ZV; Noto AR. Diversity of contexts in drug use among street adolescents. Qualitative Health Research 20(9): 1241-1253, 2010. (32 refs.)

In this study we aimed to investigate through ethnographic methods the different contexts of drug use by street adolescents in Sao Paulo, Brazil. Participant observations and semistructured interviews were performed at 11 major points of adolescent concentration in the streets of the city and in 10 care institutions. The sample was composed of 17 adolescents between 12 and 17 years of age. Data showed diverse patterns of drug use distributed by geographic situation and street circumstances. Observations were grouped into three main contexts: (a) immersion: greater intensity of drug use associated with greater involvement in the street culture; (b) surface: less drug use associated with family closeness; and (c) alternative-migratory: greater involvement with drug trafficking and prostitution associated with less family closeness and street culture. The drug use patterns varied in accordance with the diversity of street situations. Therefore, the peculiarities of each context should be taken into consideration in the development of social/health policies.

Decorte T. The case for small-scale domestic cannabis cultivation. (editorial). International Journal of Drug Policy 21(4): 271-275, 2010. (44 refs.)

The shift to (inter)regional production, trade and domestic cultivation has become an irreversible international trend. Until now, the focus of most empirical work has been on large-scale, commercially oriented and professionally organized segments of the cannabis industry, often based on police data and on the perspective of law enforcement agencies. This paper offers a review of recent Dutch-language research that focuses on cannabis cultivation. Empirical studies were identified through literature searches using relevant search terms and Web of Science, Elin, Social Science Research Network and Elsevier ScienceDirect. The paper presents the main findings of Dutch and Belgian empirical work on the factors that stimulated the import substitution process on the cannabis market, aspects related to quality and potency issues, typologies of cannabis growers, and (unintended) effects of pursued policies. In the light of this (selective) review the author offers some commentary and analysis concerning the claims made by different stakeholders, and concludes with some reflections on future research and on policy implications. The author outlines the importance of small-scale, independent or ideologically oriented cannabis cultivation as an underresearched market segment. The author also makes a case for greater toleration of small-scale cannabis cultivation, to secure the least worst of cannabis markets.

D'Orazio JL; Curtis JA. Overdose of propafenone surreptitiously sold as "percocet". Journal of Emergency Medicine 41(2): 172-175, 2011. (12 refs.)

Background: Drug abuse is a common problem in the United States. Drugs can be acquired in many ways, and can be knowingly or mistakenly misrepresented when sold. Propafenone is an uncommonly encountered class IC antidysrhythmic that is a look-alike for the opioid, oxycodone/acetaminophen 5/325. Objective: We report a case of propafenone overdose presenting with generalized tonic-clonic seizure and a widened QRS complex, occurring after the patient had reported ingesting "Percocet (R)" (Endo Pharmaceuticals, Chadds Ford, PA). Case Report: A 17-year-old boy presented to the emergency department (ED) after a witnessed seizure lasting 2 min. The patient reported having ingested 6 "Percocet (R)" tablets that he purchased from a classmate. He noted feeling weak and dizzy approximately 3 h after the ingestion, just before the seizure. On arrival in the ED, the patient was awake and alert with a QRS length of 168 ms. A sodium bicarbonate bolus and infusion shortened the QRS length to 90 ms. The patient was discharged the following day with no further complications. The pills were identified as propafenone hydrochloride (HCI) 225-mg tablets. The classmate surreptitiously sold the pills as "Percocet (R)" due to their similar "512" imprint. Conclusions: Pharmaceutical drugs are often sold on the street, and often misrepresented. Propafenone HCI 225-mg is an uncommonly encountered pharmaceutical, but is a look-alike for oxycodone/acetaminophen 5/325. An overdose due to propafenone ingestion may present with seizures and a widened QRS complex.

Dwyer R; Moore D. Beyond neoclassical economics: Social process, agency and the maintenance of order in an Australian illicit drug marketplace. International Journal of Drug Policy 21(5): 390-398, 2010. (65 refs.)

Background: The dominant Australian approaches to understanding illicit drug marketplaces are surveillance and criminological research. These approaches rely on the elementary neoclassical economic model of the market which focuses primarily on supply and demand. In this paper, we draw on anthropological and sociological research to develop an alternative framework for understanding Australian illicit drug marketplaces that emphasises their constituent processes. Methods: The paper draws on two years of ethnographic research among heroin user/sellers of Vietnamese ethnicity in an Australian heroin marketplace. Results: Trade and barter were key modes of exchange in this marketplace. We identified active negotiation and bargaining over price on the basis of social relationships, with dealers and customers actively working to develop and maintain such ties. Dealers set price collectively and this was shaped by moral and cultural elements such as notions of a 'fair' price. Social processes and relations as well as shared cultural expectations helped to generate trust and maintain order in the marketplace. Conclusion: Our ethnographic research suggests that the dominant Australian approaches to the study of illicit drug markets, with their reliance on the elementary neoclassical economic market model, ignore the social processes and social relations through which such sites are made and remade. Nor do they adequately capture the complex character of the subjects who act within these sites. If we are to expand our understanding of illicit drug markets and marketplaces in Australia, we must look beyond the conceptions offered by surveillance and criminological approaches.

Esseiva P; Gaste L; Alvarez D; Anglada F. Illicit drug profiling, reflection on statistical comparisons. Forensic Science International 207(1-3): 27-34, 2011. (16 refs.)

This paper presents reflexions about statistical considerations on illicit drug profiling and more specifically about the calculation of threshold for determining of the seizure are linked or not. The specific case of heroin and cocaine profiling is presented with the necessary details on the target profiling variables (major alkaloids) selected and the analytical method used. Statistical approach to compare illicit drug seizures is also presented with the introduction of different scenarios dealing with different data pre-treatment or transformation of variables. The main aim consists to demonstrate the influence of data pre-treatment on the statistical outputs. A thorough study of the evolution of the true positive rate (TP) and the false positive rate (FP) in heroin and cocaine comparison is then proposed to investigate this specific topic and to demonstrate that there is no universal approach available and that the calculations have to be revaluate for each new specific application.

Evered KT. 'Poppies are democracy!' A critical geopolitics of opium eradication and reintroduction into Turkey. Geographical Review 101(3): 299-315, 2011. (60 refs.)

Historical scholarship in traditional geopolitics often relied on documents authored by states and by other influential actors. Although much work in the subfield of critical geopolitics thus far has addressed imbalances constructed in official, academic, and popular media due to a privileging of such narratives, priority might also be given to unearthing and bringing to light alternative geopolitical perspectives from otherwise marginalized populations. Utilizing the early-1970s case of the United States' first 'war on drugs,' this article examines the geopolitics of opium-poppy eradication and its consequences within Turkey. Employing not only archival and secondary sources but also oral histories from now-retired poppy farmers, this study examines the diffusion of U.S. antinarcotics policies into the Anatolian countryside and the enduring impressions that the United States and Turkish government created. In doing so, this research gives voice to those farmers targeted by eradication policies and speaks more broadly to matters of narcotics control, sentiments of anti-Americanism, and notions of democracy in Turkey and the region, past and present.

Fattore L; Fratta W. Beyond THC: The new generation of cannabinoid designer drugs. Frontiers In Behavioral Neuroscience 5: 60, 2011

Synthetic cannabinoids are functionally similar to delta9-tetrahydrocannabinol (THC), the psychoactive principle of cannabis, and bind to the same cannabinoid receptors in the brain and peripheral organs. From 2008, synthetic cannabinoids were detected in herbal smoking mixtures sold on websites and in "head shops" under the brand name of Spice Gold, Yucatan Fire, Aroma, and others. Although these products (also known as "Spice drugs" or "legal highs") do not contain tobacco or cannabis, when smoked they produce effects similar to THC. Intoxication, withdrawal, psychosis, and death have been recently reported after consumption, posing difficult social, political, and health challenges. More than 140 different Spice products have been identified to date. The ability to induce strong cannabis-like psychoactive effects, along with the fact that they are readily available on the Internet, still legal in many countries, marketed as natural safe substances, and undetectable by conventional drug screening tests, has rendered these drugs very popular and particularly appealing to young and drug-naive individuals seeking new experiences. An escalating number of compounds with cannabinoid receptor activity are currently being found as ingredients of Spice, of which almost nothing is known in terms of pharmacology, toxicology, and safety. Since legislation started to control the synthetic cannabinoids identified in these herbal mixtures, many new analogs have appeared on the market. New cannabimimetic compounds are likely to be synthesized in the near future to replace banned synthetic cannabinoids, leading to a "dog chasing its tail" situation. Spice smokers are exposed to drugs that are extremely variable in composition and potency, and are at risk of serious, if not lethal, outcomes. Social and health professionals should maintain a high degree of alertness for Spice use and its possible psychiatric effects in vulnerable people.

Ferguson KM; Bender K; Thompson S; Xie B; Pollio D. Correlates of street-survival behaviors in homeless young adults in four US cities. American Journal of Orthopsychiatry 81(3): 401-409, 2011. (49 refs.)

This study assessed the prevalence and correlates of behaviors used by homeless young people to survive on the streets. Survival behaviors include prostitution, selling blood or plasma, dealing drugs, stealing, and panhandling. One hundred ninety-six homeless young adults from 4 metropolitan areas-Los Angeles, CA (n = 50); Austin, TX (n = 50); Denver, CO (n = 50); and St. Louis, MO (n = 46)-participated in individual, semistructured, face-to-face interviews. Researchers predicted that youth transience would be related to high rates of survival behaviors. Multivariate logistic regression was used to test a model predicting relationships between survival behaviors and transience, employment, substance use, and social support. Young adults who were transient, unemployed, drug-addicted, and reliant on peers for help were more likely to use these survival behaviors. In addition, among the transient subsample, being White, more reliant on peers for help, more transient, and having been victimized were associated with high use of these survival behaviors. Identification of the environmental and demographic factors associated with survival behaviors suggests that there may be value in combining harm-reduction strategies with efforts to reduce the transience of homeless young adults.

Floyd LJ; Alexandre PK; Hedden SL; Lawson AL; Latimer WW; Giles N. Adolescent drug dealing and race/ethnicity: A population-based study of the differential impact of substance use on involvement in drug trade. American Journal of Drug and Alcohol Abuse 36(2): 87-91, 2010. (26 refs.)

Background: Among adolescents, peers are an important source of drug procurement. However, little is known about factors associated with youths' involvement in drug trade. Objectives: The aim of the study is to identify substance use behaviors and contextual factors related to drug dealing among Black and White adolescents. Methods: The sample consisted of 13,706 White and Black youths who completed the National Survey on Drug Use and Health. Separate backward logistic regression was used to identify substance use behaviors and contextual factors associated with drug dealing among Black and White youths. Results: Among White youths, drug dealing was associated with use of marijuana, hallucinogens, cocaine, prescription drug misuse, availability of cocaine, and socioeconomic status (SES). Among Black youths, marijuana use and availability of crack and marijuana were associated with drug dealing. Conclusions and Scientific Significance: For White youths, substance use seems to be more relevant to drug dealing. Consequently, preventing and treating substance abuse may reduce involvement in the illegal distribution of drugs among White youths. More research is needed to identify risk and protective factors for drug dealing among Black adolescents.

Freckelton SCI. Mental Illness, sentencing and execution: The disturbing death of an Englishman in China. (editorial). Psychiatry, Psychology and Law 17(3): 333-344, 2010. (36 refs.)

Execution is one of the indispensable means of education. Deng Xiaoping (1904-1997) Come little rabbit Come to me, Come little rabbit Let it be, Come little rabbit Come and pray, Only one people, Only one world, Only one God. Akmal Shaikh (1956-2009) [image omitted]The tragic saga of the execution of a British citizen, Akmal Shaikh, in Urumqi in northwest China in December 2009 highlights the risks of mental illnesses such as bipolar disorders and delusional disorders being discounted or inadequately taken into account in terms of their impact upon criminal responsibility and criminal culpability. The strong evidence is that Shaikh was seriously delusional and incapable of exercising reasoned judgements in his own best interests when he was found with heroin in his possession upon entering China. Yet he was not permitted to be examined by mental health professionals and was executed, after appeals, including to the Supreme People's Court of China, failed. The Shaikh case is a warning to all legal systems that a range of mental illnesses can generate symptoms causing those with them to have little insight but which, when properly evaluated, may be exculpatory or at least significantly mitigatory.

Furst RT; Curtis R; Balletto R. The transformation of drug markets and its impact on HIV outreach to injection drug users in New York City, 1987-2008. Substance Use & Misuse 46(2-3): 150-158, 2011. (25 refs.)

This oral history describes three periods of street outreach to injection drug users at risk for HIV in New York City: outreach in an era of public drug markets (1987-1993), outreach in an era of private markets (1993-2006), and network-driven outreach (2006-present). Individual interviews with administrators and supervisors of outreach workers are combined with field notes from the ethnographic research experiences of the first two authors to contextualize, compare, and contrast these distinct periods. The combination and triangulation of these sources of data allow for an analysis of both the specific and the wider social and cultural contexts in which outreach intervention efforts were situated. Through these lenses, the article examines some of the reasons why they were or were not successful and discusses prospects for the future.

Gallupe O; Bouchard M; Caulkins JP. No change is a good change? Restrictive deterrence in illegal drug markets. Journal of Criminal Justice 39(1): 81-89, 2011. (53 refs.)

Purpose: This study applies the concept of restrictive deterrence to a sample of drug market offenders. In particular, we assess the influence of behavioral changes post-arrest on time to rearrest. Methods: The sample consists of arrest data on all drug offences in South Australia from the start of 2000 to the end of 2007 (n = 26819). Cox proportional hazard models are used to conduct survival analyses. Supplementary models focus on those repeatedly arrested for cannabis cultivation to assess the influence of adjusting amounts of drugs on time to rearrest. Results: Changing behaviors is related to more rapid rearrest. Switching offense location, drug seriousness, and charge seriousness are all risk factors. However, among offenders repeatedly arrested for cannabis cultivation, changing location and increasing the number of plants they grow is related to a longer period before rearrest. Conclusions: Offenders that change their drug market behavior after being arrested appear to be placing themselves in situations in which they are more likely to fail due to the dangers of breaking into an unfamiliar market or offense pattern. Offenders with the longest post-arrest survival seem to be those that maintain their overall pattern of behavior while implementing subtle arrest avoidance techniques.

Garcia-Repetto R; Gimenez MP; Martinez MC; Soria ML. A fatally mistaken fruit juice drink: An unordinary way of cocaine intoxication. Journal of Forensic and Legal Medicine 17(8): 434-436, 2010. (15 refs.)

Cocaine is one of the drugs of abuse more frequently consumed in Spain. Furthermore, Spain due to its geographical position is used by trafficker's organizations as the port of entrance of cocaine in the European Union. We present here a case of a fatal intoxication caused by a mistake in the cocaine distribution net in our country. Cocaine was concealed in a tropical juice only sold by the Internet.

Goebel JR; Compton P; Zubkoff L; Lanto A; Asch SM; Sherbourne CD et al. Prescription sharing, alcohol use, and street drug use to manage pain among veterans. Journal of Pain and Symptom Management 41(5): 848- 858, 2011. (69 refs.)

Context. Efforts to promote awareness and management of chronic pain have been accompanied by a troubling increase in prescription medication abuse. At the same time, some patients may misuse substances in an effort to manage chronic pain. Objectives. This study examines self-reported substance misuse for pain management among veterans and identifies the contributing factors. Methods. We analyzed cross-sectional data from the Help Veterans Experience Less Pain study. Results. Of 343 veterans, 35.3% reported an aberrant pain management behavior (24% reported using alcohol, 11.7% reported using street drugs, and 16.3% reported sharing prescriptions to manage pain). Poorer mental health, younger age, substance use disorders (SUDs), number of nonpain symptoms, and greater pain severity and interference were associated with aberrant pain management behaviors. In multivariate analysis, SUDs (odds ratio [OR]: 3.9, 95% confidence interval [CI]: 2.3-6.7, P < 0.000) and poorer mental health (OR: 2.3, 95% CI: 1.3-4.3, P = 0.006) were associated with using alcohol or street drugs to manage pain; SUDs (OR: 2.4, 95% CI: 1.3-4.4, P - 0.006) and pain interference (OR: 1.1, 95% CI: 1.0-1.2, P = 0.047) were associated with prescription sharing; and SUDs (OR: 3.6, 95% CI: 2.2-6.1, P < 0.000) and number of nonpain symptoms (OR: 6.5, 95% CI: 1.2-35.4, P = 0.031) were associated with any aberrant pain management behavior. Conclusion. Veterans with a history of SUDs, greater pain interference, more nonpain symptoms, and mental health concerns should be carefully managed to deter substance misuse for pain management.

Grant P; Bell K; Stewart D; Paulson J; Rogers K. Evidence of methamphetamine exposure in children removed from clandestine methamphetamine laboratories. Pediatric Emergency Care 26(1): 10-14, 2010. (16 refs.)

Objective: To determine whether asymptomatic children removed from clandestine methamphetamine laboratories have evidence of exposure to methamphetamine. Methods: Retrospective chart review of children removed from law enforcement-certified clandestine methamphetamine laboratories in the Tulsa area of Oklahoma and Sacramento County, California. Exposure was determined by positive urine toxicology for methamphetamine. Results: One hundred four children were evaluated after removal from clandestine methamphetamine laboratories. Forty-eight children (46%) tested positive for methamphetamine. Timed urine results were known for 68 of 104, with no child testing positive after 6.5 hours from being removed from the laboratory. No child required emergency medical treatment at the time urine samples were obtained. Conclusions: Almost half of the children in this sample had evidence of exposure to methamphetamine soon after removal from methamphetamine manufacturing environments. Further research is indicated to determine the health effects of subclinical methamphetamine exposure.

Griffin N; Khoshnood K. Opium trade, insurgency, and HIV/AIDS in Afghanistan: Relationships and regional consequences. Asia-Pacific Journal of Public Health 22(Supplement 3): 159S-167S, 2010. (43 refs.)

Global health and conflict studies share key linkages that have important research and policy implications but for which data are currently lacking. This analytical review examines the ongoing conflict in Afghanistan, using it as a basis to develop a conceptual framework that integrates security and public health concepts. The analysis draws on recent peer-reviewed and gray literature to assess the interrelationship among 3 variable clusters and their impact on the emergence of the HIV epidemic in Afghanistan. The evidence suggests that there is a complex indirect relationship linking illicit opium trade, the ongoing insurgency, and forced and spontaneous migration to the emergence of an injection drug use-driven HIV epidemic in Afghanistan. These findings demonstrate a clear need for an integrated cross-disciplinary and regional approach to the emerging threat of HIV/AIDS in Afghanistan, to inform more balanced and effective policy making in this and other regions of strategic global import.

Hakkarainen P; Frank VA; Perala J; Dahl HV. Small-scale cannabis growers in Denmark and Finland. European Addiction Research 17(3): 119-128, 2011. (46 refs.)

Aims: To compare domestic cannabis cultivation in Denmark and Finland to describe national characteristics in small-scale cannabis growing. Design:: A Web survey conducted among small-scale cannabis growers in Denmark (June to November 2008) and Finland (May to June 2009). Participants: Current cannabis growers (Denmark, 401; Finland, 1,054). Measurements: Comparisons in regard to social background, growing history, practices, purposes and motives of growing, and perceptions of risks. Findings: Cannabis was cultivated primarily for own use, but sharing with friends and avoiding criminal circles also were significant motives for growing. Finnish growers prioritized indoor cultivation, whereas the Danes were more in favor of open-air plantations. Risks of getting caught by the police were observed to be greater in Finland. Growing for medical purposes was twice as prevalent in Finland as in Denmark. Conclusions: Cannabis growing is a stronger and more novel phenomenon in Finland than in Denmark, but both countries have been influenced by international trends. Finnish and Danish small-scale cannabis cultivators can be considered to be ideologically oriented lifestyle growers. Differences in the magnitude of the phenomenon may reflect differences in the availability and quality of cannabis in national drug markets. The Internet had promoted the spreading of the trend.

Heydari G; Tafti SF; Telischi F; Joossens L; Hosseini M; Masjedi M et al. Prevalence of smuggled and foreign cigarette use in Tehran, 2009. Tobacco Control 19(5): 380-382, 2010. (6 refs.)

Background: Iran is one of two main target markets for tobacco smuggling in the WHO s Eastern Mediterranean Region. The Iranian government has a local tobacco monopoly but there is high demand for international brands. Informal reports show about 20% of cigarette consumption is smuggled brands. This pack survey study is the first in Iran to gather validated information on use of smuggled cigarettes. Methods: A randomized cross sectional household survey in Tehran in 2008-2009 of 1540 smokers aged 16-90 (83% men) was performed including interviewer checking of cigarette packs. Results: In all 20 9% of cigarettes and 6 7% of domestic branded cigarettes were smuggled. A total of 60.1% of smokers preferred foreign cigarettes. There was no significant difference between consumption of illegal cigarettes by sex (Fisher exact test p=0 61). Use of smuggled cigarettes was higher among younger smokers (p=0 01). Conclusions: Use of illegal cigarettes is high. Tobacco control laws outlawing their sale are not being enforced

Hibbert DB; Blackmore D; Li JF; Ebrahimi D; Collins M; Vujic S et al. A probabilistic approach to heroin signatures. Analytical and Bioanalytical Chemistry 396(2): 765-773, 2010. (13 refs.)

The probability density functions of amount ratios of compounds (total codeine/total morphine, 6-monoacetylemorphine/total morphine, papaverine/total morphine, and noscapine/total morphine) from the analysis of seized heroin, originating from known world regions (South East Asia, South West Asia, South America, Mexico) allows calculation of likelihood ratios for 'unknown' samples. Application of Bayes Theorem with a suitable prior probability, for example the frequency of a particular region in the database, leads to the probability that a particular profile comes from a given target region. Data from 2549 seizures of heroin at Australia's border illustrates the method, and results are compared with simple HS1 ratio approaches for assigning geographical origin. The method can be implemented in a spreadsheet and gives more refined intelligence of the origins of seized drugs than simple ranges.

Huang KC; Zhang LN; Liu JH. Drug problems in contemporary China: A profile of Chinese drug users in a metropolitan area. International Journal of Drug Policy 22(2): 128- 132, 2011. (14 refs.)

Background: Drug problems are reemerging in China since the nation implemented economic reform and an "open door" policy in the early 1980s. This is causing both national and international concern. However, knowledge and understanding of the Chinese drug problem is fairly limited because of the nation's unique social and political history. In response to this shortage of information, our study presents a profile of Chinese drug users. Methods: Data were collected from a survey of drug users attending mandatory treatment centres in a large city in 2009. We present a demographic profile of the drug users, describe their patterns of drug use, their access to drugs and their history of drug treatment. Results: Chinese drug users, like those from the U.S., are likely to be unemployed and have a low level of education. However, they are more likely than those in the U.S. to use heroin, Bingdu (methamphetamine) and Maguo (a derivative of methamphetamine), and they pay less for their drugs. Conclusion: This profile of drug users is informative and valuable for drug prevention, intervention, and treatment in the Chinese setting because knowing and understanding the drug population is essential for effective control.

Ibanez M; Carlsson F. A survey-based choice experiment on coca cultivation. Journal of Development Economics 93(2): 249-263, 2010. (52 refs.)

From 1997 to 2005, an astonishing 5200 million USD was invested to reduce cocaine production in Colombia, the world's main cocaine producer. However, little is known about the effectiveness of policies targeting coca cultivation. This paper uses a survey-based experiment to evaluate the effects of the two main policies: eradication and alternative development programs. Our results support Becker's (1968) model of crime participation and in addition shed light on other non-monetary factors that affect the coca cultivation decision: religion, legitimacy, remoteness, and poverty are found to be important. We find that coca cultivation is inelastic to increases in perceived risk and relative profit so eradication and alternative development would have a rather small effect on coca cultivation. A simple simulation exercise predicts that investing additional hundred thousand dollars in eradication decreases coca cultivation in only 1.5%.

Inciardi JA; Surratt HL; Cicero TJ; Rosenblum A; Ahwah C; Bailey JE et al. Prescription drugs purchased through the internet: Who are the end users? Drug and Alcohol Dependence 110(1-2): 21-29, 2010. (34 refs.)

Although prescription drugs are readily available on the Internet, little is known about the prevalence of Internet use for the purchase of medications without a legitimate prescription, and the characteristics of those that obtain non-prescribed drugs through online sources. The scientific literature on this topic is limited to anecdotal reports or studies plagued by small sample sizes. Within this context, the focus of this paper is an examination of five national data sets from the U.S. with the purpose of estimating: (1) how common obtaining prescription medications from the Internet actually is, (2) who are the typical populations of "end users" of these non-prescribed medications, and (3) which drugs are being purchased without a prescription. Three of the data sets are drawn from the RADARS (R) (Researched Abuse Diversion and Addiction-Related Surveillance) System, a comprehensive series of studies designed to collect timely and geographically specific data on the abuse and diversion of a number of prescription stimulants and opioid analgesics. The remaining data sets include the National Survey on Drug Use and Health (NSDUH) and the Monitoring the Future (MTF) survey. Our analysis yielded uniformly low rates of prescription drug acquisition from online sources across all five data systems we examined. The consistency of this finding across very diverse populations suggests that the Internet is a relatively minor source for illicit purchases of prescription medications by the individual end-users of these drugs.

Joossens L; Merriman D; Ross H; Raw M. The impact of eliminating the global illicit cigarette trade on health and revenue. Addiction 105(9): 1640-1649, 2010. (45 refs.)

Aims: The purpose of this study was to update global estimates of the illicit cigarette trade, based on recent data, and estimate how many lives could be saved by eliminating it and how much revenue governments would gain. Data sources and methods: Our estimates of illicit market share are based on formal and informal sources. Our method for estimating the effect of eliminating the illicit trade on tobacco related deaths is based on West et al. with some minor modifications, and involves calculating the size of the illicit cigarette trade; the effect of eliminating it on the price of cigarettes and thus on consumption; the revenue governments are losing because of it; and the number of tobacco-related premature deaths that would be avoided if this illicit trade were eliminated. Results: According to available estimates, the size of the illicit trade varies between countries from 1% to about 40-50% of the market, 11.6% globally, 16.8% in low-income and 9.8% in high-income countries. The total lost revenue is about $40.5 billion a year. If this illicit trade were eliminated governments would gain at least $31.3 billion a year, and from 2030 onwards more than 164 000 premature deaths a year would be avoided, the vast majority in middle- and low-income countries. Conclusions: The burden of deaths and lost revenue caused by the illicit cigarette trade falls disproportionately on low- and middle-income countries. Eliminating this trade would avoid millions of premature deaths, and recover billions of dollars for governments.

Khajeamiri AR; Kobarfard F; Ahmadkhaniha R; Mostashari G. Profiling of ecstasy tablets seized in Iran. Iranian Journal of Pharmaceutical Research 10(2): 211-220, 2011. (9 refs.)

In this study 50 samples of ecstasy tablets seized in Iran during the period of 2007 through 2008 were examined and their physical characteristics (appearance, marking, scored/not scored, color, weight, diameter, thickness) were determined. In order to determine the chemical characteristics of these tablets, color tests (Marquis test, Simon's test, Chen's test and Gallic acid test), Thin Layer Chromatography (TLC), anion test, residual solvents, Gas Chromatography-Mass Spectrometry (GC-MS) and Liquid Chromatography-Mass Spectrometry (LC-MS) were carried out on the tablets. The range of tablets weight was 96-308 mg and the range of 3,4-methylenedioxymethamphetamine (MDMA) hydrochloride content in these tablets was 60180 mg. No good correlation was found between the tablets weight and their MDMA contents. All of the tablets containing MDMA had this compound in hydrochloride form. Ketamine, phenmetrazine and ephedrine (or pseudoephedrine) were found in some of the tablets along with MDMA. No MDMA was found in 10% of the tablets. Some of these tablets contained compounds such as caffeine or tramadol as their active ingredient.

Killias M; Isenring GL; Gillieron G; Vuille J. Do drug policies affect cannabis markets? A natural experiment in Switzerland, 2000-10. European Journal of Criminology 8(3): 171- 186, 2011. (24 refs.)

Scholars and policymakers have long debated whether drug policies have any impact on demand for, supply of and prices for illegal substances. Switzerland's recent experience with changing policies offers an opportunity to study this issue. During the 1990s, the production and sale of this substance became increasingly tolerated. As a result, visible market structures (producers as well as shops) emerged. In 2004, however, traditional repressive policies were resumed and visible structures of production and distribution of cannabis disappeared again. During these critical years, market structures were monitored by a mail survey among cannabis shops and two 'fake client' studies. The results suggest that the policy shift led to decreased availability of the substance, higher prices and lower levels of cannabis use, particularly among the youngest age groups. Despite the illegal status of cannabis, other substances are still not available from the same dealers.

Kleiman MAR; Heussler L. Crime-minimizing drug policy. Journal of Criminal Justice 39(3, special issue): 286-288, 2011. (12 refs.)

Objective: To identify changes in drug abuse control measures that would reduce non-drug crime. Method: Policy analysis. Results: Expanding current anti-drug efforts in the conventional triad of enforcement, prevention, and treatment (including drug courts) holds out little hope of reducing non-drug crime. Routine drug law enforcement risks increasing crime by raising drug prices and creating incentives for violence among dealers. Low-arrest crackdowns to break up flagrant markets promise better results. Even good prevention programs have modest effect sizes, and most prevention programs are not based on proven models. The overlap between the population. of heavy illicit drug users and the population of frequent non-drug offenders presents a problem and a policy opportunity that current programs largely fail to grasp. Drug treatment, except for opiate substitution, has difficulty recruiting and retaining clients, and weak sanctions systems render treatment mandates largely nominal. Abstinence-mandate programs such as HOPE and Sobriety 24/7 have shown superior results in reducing re-offending and incarceration. Raising alcohol taxes reduces heavy alcohol use and crime due to intoxication without generating any offsetting criminogenic effects. Conclusion: Current drug policies are not optimally designed for the control of non-drug crime. Improvements are within relatively easy reach.

Klein CA; Kandel S. www.mydrugdealer.com: Ethics and legal implications of internet-based access to substances of abuse. Journal of the American Academy of Psychiatry and The Law 39(3): 407-411, 2011. (20 refs.)

The Internet has increasingly become an intrinsic part of everyday life, offering countless possibilities for education, services, recreation, and more. In fact, an entire virtual life within the digitalized World Wide Web is possible and common among many Internet users. Today's psychiatrists must therefore incorporate this dimension of human life into clinical practice, to achieve an adequate assessment of the tools and risks available to the patient. We focus on the Internet as a portal for the trade of and access to substances of abuse. We review the legal regulations that may inform care and standards of practice and analyze the difficulties that arise in assessment and monitoring of the current situation. We consider the potential impact of Internet-based narcotics trade on addiction morbidities and the practice of clinical psychiatry, as well as on the potential legal implications that the forensic expert may face.

Knight G; Hansen S; Connor M; Poulsen H; McGovern C; Stacey J. The results of an experimental indoor hydroponic Cannabis growing study, using the 'Screen of Green' (ScrOG) method: Yield, tetrahydrocannabinol (THC) and DNA analysis. Forensic Science International 202(1-3): 36-44, 2010. (32 refs.)

The results of an indoor hydroponic Cannabis growth study are presented. It is intended that this work will be of assistance to those with an interest in determining an estimation of yield and value of Cannabis crops. Three cycles of six plants were grown over a period of 1 year in order to ascertain the potential yield of female flowering head material from such an operation. The cultivation methods used were selected to replicate typical indoor hydroponic Cannabis growing operations, such as are commonly encountered by the New Zealand Police. The plants were also tested to ascertain the percentage of the psychoactive chemical Delta-9 tetrahydrocannabinol (THC) present in the flowering head material, and were genetically profiled by STR analysis. Phenotypic observations are related to the data collected. The inexperience of the growers was evidenced by different problems encountered in each of the three cycles, each of which would be expected to negatively impact the yield and THC data obtained. These data are therefore considered to be conservative. The most successful cycle yielded an average of 881 g (31.1 oz) of dry, groomed female flowering head per plant, and over the whole study the 18 plants yielded a total of 12,360 g (436.0 oz), or an average of 687 g (24.2 oz) of dry head per plant. THC data shows significant intra-plant variation and also demonstrates inter-varietal variation. THC values for individual plants ranged from 4.3 to 25.2%. The findings of this study and a separate ESR research project illustrate that the potency of Cannabis grown in New Zealand has dramatically increased in recent years. DNA analysis distinguished distinct groups in general agreement with the phenotypic variation observed. One plant however, exhibiting a unique triallelic pattern at two of the five loci tested, while remaining phenotypically indistinguishable from three other plants within the same grow.

Kotarba JA; Fackler J; Johnson BD; Dunlap E. The melding of drug markets in Houston after Katrina: Dealer and user perspectives. Substance Use & Misuse 45(9): 1390-1405, 2010. (26 refs.)

In the aftermath of Hurricane Katrina, the majority of routine activities in New Orleans were disrupted, including the illegal drug market. The large-scale relocation of New Orleans evacuees (NOEs), including many illegal drug users and sellers, to host cities led to a need for new sources of illegal drugs. This need was quickly satisfied by two initially distinct drug markets (1) drug dealers from New Orleans who were themselves evacuees and (2) established drug dealers in the host cities. To be expected, the two markets did not operate indefinitely in parallel fashion. This paper describes the evolving, operational relationship between these two drug markets over time, with a focus on Houston. We analyze the reciprocal evolution of these two markets at two significant points in time: at the beginning of the relocation (2005) and two years later (2007). The overall trend is towards a melding of the two drug markets, as evidenced primarily by decreases in drug-related violence and the cross-fertilization of drug tastes. We describe the process by which the two drug markets are melded over time, in order to seek a better understanding of the social processes by which drug markets in general evolve.

Lee S; Kim J; In S; Choi H; Chung H; Chung KH. Detection of phentermine in hair samples from drug suspects. Forensic Science International 207(1-3): E5-E7, 2011. (13 refs.)

Phentermine (PT) has been widely used as an anti-obesity drug. This drug has to be used with caution due to its close resemblance with amphetamines in its structure and toxicity profile. Recently, PT is in distribution by illegal modes and is found to be available through sources such as the internet, thus their misuse and/or abuse is threatening to be a serious social issue. In the present study, 32 cases of drug suspects were observed for PT abuse, detected using hair samples for drug analysis. PT and other amphetamines, such as methamphetamine (MA), amphetamine (AP), 3,4-methylenedioxyamphetamine (MDMA) and 3,4-methylenedioxyamphetamine (MDA), were extracted using 1% HCl in methanol for 20 h at 38 degrees C. The extracts were derivatized with trifluoroacetic anhydride (TFAA) and analyzed using gas chromatography/mass spectrometry (GC/MS). Among the 32 cases of PT abuse, MA and its main metabolite, AP were identified in seven cases and MDMA and its main metabolite, MDA were detected in two other cases.

Li W; Yu DY; Zhang F; Sun B; Liu JY; Li MQ et al. Detection of heroin covered by skin by using robust principal components analysis. Measurement 44(1): 267-273, 2011. (13 refs.)

Nowadays, body packing has become an increasingly important approach for trafficking drugs. In this paper, robust principal component analysis (PCA) was demonstrated as a promising suitable method to detect heroin covered by skin based on the profile of energy dispersive X-ray diffraction spectrum. Firstly, some potential impact factors were investigated. Results showed that the signal was optimized when the scatter angle of 8 degrees and the count time of 1 min were chosen. Then, after being truncated, denoised and autoscaled, spectra of heroin, skin and heroin covered by skin were analyzed by robust PCA. Compared with classical counterpart, robust PCA effectively extracted principle components of samples, and successfully identified heroin covered by skin. Finally, based on Robust PCA, a method of identification was set up. This suggests that robust PCA can be employed in detecting drugs packed in body.

Loza O; Patterson TL; Rusch M; Martinez GA; Lozada R; Staines-Orozco H et al. Drug-related behaviors independently associated with syphilis infection among female sex workers in two Mexico-US border cities. Addiction 105(8): 1448-1456, 2010. (38 refs.)

Aims: To identify correlates of active syphilis infection among female sex workers (FSWs) in Tijuana and Ciudad Juarez. Design: Cross-sectional analyses of baseline interview data. Correlates of active syphilis (antibody titers > 1 : 8) were identified by logistic regression. Setting: Tijuana and Ciudad Juarez, two Mexican cities on the US border that are situated on major drug trafficking routes and where prostitution is quasi-legal. Participants: A total of 914 FSWs aged >= 18 years without known human immunodeficiency virus (HIV) infection who had had recent unprotected sex with clients. Measurement: Baseline interviews and testing for syphilis antibody using Treponema pallidum particle agglutination (TPPA) and rapid plasma reagin (RPR) tests. Findings: Median age and duration in sex work were 32 and 4 years, respectively. Overall, 18.0% had ever injected drugs, 14.2% often or always used illegal drugs before or during sex in the past month, 31.4% had clients in the last 6 months who injected drugs, and 68.6% reported having clients from the United States. Prevalence of HIV and active syphilis were 5.9% and 10.3%, respectively. Factors independently associated with active syphilis included injecting drugs (AOR: 2.39; 95% CI: 1.40, 4.08), using illegal drugs before or during sex (AOR: 2.06; 95% CI: 1.16, 3.65) and having any US clients (AOR: 2.85; 95% CI: 1.43, 5.70). Conclusions: Among female sex workers in Tijuana and Ciudad Juarez, drug-using behaviors were associated more closely with active syphilis than were sexual behaviors, suggesting the possibility of parenteral transmission of T. pallidum. Syphilis eradication programs should consider distributing sterile syringes to drug injectors and assisting FSWs with safer-sex negotiation in the context of drug use.

Maguet O; Majeed M. Implementing harm reduction for heroin users in Afghanistan, the worldwide opium supplier. (editorial). International Journal of Drug Policy 21(2, Special Issue): 119-121, 2010. (12 refs.)

Afghanistan has suffered decades of war, occupation and unrest. It is also the world's greatest producer of opium and drug production and trafficking account for a third of the total Afghan economy. Currently alongside the "War on Terrorism", the control and eradication of opium production and related trafficking is a main concern of the international community. However, this focus on supply reduction has meant scant attention has been paid to increasing drug use problems within the country; it is estimated there are up to 25,000 opium users and 20,000 heroin users in Kabul city. Drug use is often a response to war, poverty and under-development, however, street opium and heroin manufactured in the country are widely available, affordable and of high purity. This paper documents the efforts of non-governmental organisations to promote and develop harm reduction and treatment services for problem drug users in Afghanistan in this difficult context.

Mandava N; Chang RS; Wang JH; Bertocchi M; Yrad J; Allamaneni S et al. Establishment of a definitive protocol for the diagnosis and management of body packers (drug mules). Emergency Medicine Journal 28(2): 98-101, 2011. (25 refs.)

Background: 'Mules' or body packers are people who transport illegal drugs by packet ingestion into the gastrointestinal tract. These people are otherwise healthy and their management should maintain minimal morbidity. In this study, experience with body packers is presented and an algorithm for conservative and surgical management is provided. Methods: The clinical patient database for all body packer admissions at Mary Immaculate Hospital of the Caritas Health Care Inc. from 1993 to 2005 was interrogated. 56 patients (4.5%) required admission out of a total of 1250 subjects confirmed to be body packers and apprehended by United State Customs officials at JFK International Airport, New York. The retrieved patient data were analysed retrospectively. Results: 70% of the body packers were men, with a male to female ratio of 2.8 to 1. The mean age was 33 years and 52% were from Columbia. Heroin was the most common illegally transported substance (73%). 25 patients (45%) required surgical intervention, whereas 31 patients (55%) were successfully managed conservatively. Indications for intervention included: bowel obstruction, packet rupture/toxicity, and delayed progression of packet transit on conservative management. Multiple intraoperative manoeuvres were used to remove the foreign bodies: gastrotomy, enterotomy and colotomy. Wound infection was the most common complication and is associated with distal enterotomy and colotomy. Conclusions: Men were more likely to present as body packers than women. Proximal enterotomies are preferred and multiple enterotomies should be avoided. A confirmatory radiological study is needed to demonstrate complete clearance of packets. A systematic protocol for the management of body packers results in minimal morbidity and no mortality.

Mario JR. A probability-based sampling approach for the analysis of drug seizures composed of multiple containers of either cocaine, heroin, or cannabis. Forensic Science International 197(1-3): 105-113, 2010. (33 refs.)

A probability-based analytical sampling approach for seized containers of cocaine, cannabis, or heroin, to answer questions of both content weight and identity, is described. It utilizes the Student's t distribution, and, because of the lack of normality in studied populations, the power of the Central Limit Theorem with samples of size 20 to calculate the mean net weights of multiple item drug seizures. Populations studied ranged between 50 and 1200 units. Identity determination is based on chemical testing and sampling using the hypergeometric distribution fit to a program macro - created by the European Network of Forensic Science Institutes (ENFSI) Drugs Working Group. Formal random item selection is effected through use of an Excel (R)-generated list of random numbers. Included, because of their impact on actual practice, are discussions of admissibility, sufficiency of proof, method validation, and harmony with the guidelines of international standardizing bodies.

Matthew-Simmons F; Shanahan M; Ritter A. Reported value of cannabis seizures in Australian newspapers: Are they accurate? Drug and Alcohol Review 30(1): 21-25, 2011. (18 refs.)

Introduction and Aims. The news media is often touted as an important, yet inaccurate source of information about drug issues for the general public. This paper investigates the accuracy of reporting in the Australian media regarding the value of cannabis seizures made by the police. Design and Methods. A sample of Australian newspaper articles, which featured both a direct estimate of the value of a cannabis seizure and the number of plants seized, were examined. The reported values from these articles were then compared with a range of estimates made using data on cannabis plant yield and price, taken from research literature. Results. Fifteen articles were examined, referring to fourteen different seizures. The reported value of cannabis seizures in this sample of articles was highly inflated when compared with the authors' estimated value. The reported newspaper values of seizures were between 1.8 and 11.9 times higher than our middle estimate. Discussion and Conclusions. The most likely reason for the wide difference between the reported and estimated value of these seizures is the possible variability in cannabis plant yield. Whatever the reason for the discrepancy between the reported values and our estimates, greater transparency surrounding the valuations of cannabis seizures would help to better determine the true impacts of law enforcement interventions on this illicit drug supply chain.

Maurer HH. Chemistry, pharmacology, and metabolism of emerging drugs of abuse. (review). Therapeutic Drug Monitoring 32(5): 544-549, 2010. (94 refs.)

In recent years, besides the classic designer drugs of the amphetamine type, a series of new drug classes appeared on the illicit drugs market. The chemistry, pharmacology, toxicology, metabolism, and toxicokinetics is discussed of 2,5-dimethoxy amphetamines, 2,5-dimethoxy phenethylamines, beta-keto-amphetamines, phencyclidine derivatives as well as of herbal drugs, ie, Kratom. They have gained popularity and notoriety as rave drugs. The metabolic pathways, the involvement of cytochrome P450 isoenzymes in the main pathways, and their roles in hepatic clearance are also summarized.

McDermott SD; Power JD; Kavanagh P; O'Brien J. The analysis of substituted cathinones. Part 2: An investigation into the phenylacetone based isomers of 4-methylmethcathinone and N-ethylcathinone. Forensic Science International 212(1-3): 13-21, 2011. (10 refs.)

During the analysis of "seized samples'', suspected of containing 4-methylmethcathinone (mephedrone) and N-ethylcathinone (ethcathinone) additional compounds were observed in the GCMS chromatogram. These compounds were suspected to be the corresponding phenylacetone isomers of mephedrone and ethcathinone respectively. These isomers are referred to as iso-mephedrone and iso-ethcathinone, respectively. The identity of these compounds was verified by synthesising the isomers from known starting materials and comparing them with the compounds found in the seized samples. Analytical data, GCMS, NMR and IR on these compounds are provided. Possible explanations for the presence of these compounds in the seized samples are explored. Contaminated starting material is one suggestion. Rearrangement of the propiophenone based product to the phenylacetone based product is also suggested. The reaction of the alpha-bromopropiophenone with a primary amine can also lead to the phenylacetone based product. The presence of these isomeric compounds in seized samples could be used to compare different samples and attempt to establish a common origin.

McElrath K; O'Neill C. Experiences with mephedrone pre- and post-legislative controls: Perceptions of safety and sources of supply. International Journal of Drug Policy 22(2): 120- 127, 2011. (32 refs.)

Background: Drug scenes within several countries have changed in recent years to incorporate a range of licit psychoactive products, collectively known as "legal highs." Hundreds of different legal high products have been described in the literature. Many of these products contain synthetic stimulants that allegedly "mirror" the effects of some illicit drugs. In 2009-2010, growing concern by the UK and Irish governments focused on mephedrone, a synthetic stimulant that had become embedded within several drug scenes in Britain and Ireland. In April 2010, mephedrone and related cathinone derivatives were banned under the UK's Misuse of Drugs Act 1971. Setting aside "worse case scenarios" that have been portrayed by UK and Irish media, little is known about mephedrone use from the consumer's perspective. The purpose of this paper was to (1) explore respondents' experiences with mephedrone, (2) examine users' perceptions about the safety of mephedrone, and primarily to (3) examine sources of mephedrone supply during the pre- and post-ban periods. Methods: Semi-structured interviews were conducted with 23 adults who had used mephedrone during 2009-2010. Data collection occurred in May and June 2010, following the ban on mephedrone. A total of 20/23 respondents had used mephedrone during the post-ban period, and the vast majority had prior experience with ecstasy or cocaine. Respondents' ages ranged from 19 to 51, approximately half of the sample were female and the majority (19 of 23) were employed in full- or part-time work. Results: Most respondents reported positive experiences with mephedrone, and for some, the substance emerged as a drug of choice. None of the respondents reported that the once-legal status of mephedrone implied that it was safe to use. Very few respondents reported purchasing mephedrone from street-based or on-line headshops during the pre-ban period, and these decisions were guided in part by respondents' attempts to avoid "drug user" identities. Most respondents purchased or obtained mephedrone from friends or dealers, and mephedrone was widely available during the 10-week period following the ban. Respondents reported a greater reliance on dealers and a change in mephedrone packaging following the criminalisation of mephedrone. Conclusion: The findings are discussed in the context of what appears to be a rapidly changing mephedrone market. We discuss the possible implications of criminalising mephedrone, including the potential displacement effects and the development of an illicit market.

Melrose D; Ocker L; Bonnette R; Spaniol F. The internet and steroids: A less than honest relationship. Strength and Conditioning Journal 33(2): 95-99, 2011. (14 refs.)

The purpose of this article is to inform strength and conditioning professionals about potentially dishonest tactics used on the internet to sell and distribute anabolic steroids. Products purchased through this medium may have broad, diverse, and unforeseen consequences for users. By dissemination of this information, strength and conditioning professionals can use their influence to educate those individuals mostly at risk for obtaining steroids through this medium.

Moreira M; Buchanan J; Heard K. Validation of a 6-hour observation period for cocaine body stuffers. American Journal of Emergency Medicine 29(3): 299-303, 2011. (13 refs.)

Often, patients are brought in to the emergency department after ingesting large amounts of cocaine in an attempt to conceal it. This act is known as body staffing. The observation period required to recognize potential toxic adverse effects in these patients is not well described in the literature. We sought to validate a treatment algorithm for asymptomatic cocaine body stuffers using a 6-hour observation period by observing the clinical course of cocaine body stuffers over a 24-hour period. A retrospective chart review was performed on all patients evaluated for witnessed or suspected stuffing over 2 years using a standardized protocol. One hundred six patients met final inclusion criteria as adult cocaine stuffers. No patients developed life-threatening symptoms, and no patients died during observation. In our medical setting, starers could be discharged after a 6-hour observation period if there was either complete resolution or absence of clinical symptoms.

Murphy J. Drug court as both a legal and medical authority. Deviant Behavior 32(3): 257-291, 2011. (26 refs.)

This article explores how addiction is conceptualized in a drug court program. Through observations and interviews in a drug court in a large northeastern city, the author reveals how the court uses ambiguous and inconsistent medicalized language to describe addiction, extending the label of addiction to behaviors not just associated with using drugs, but with selling drugs as well. Ultimately, drug courts incorporate a medicalized notion of addiction to further their own control over drug-related issues, since they become the authority of both the client's treatment and their punishment.

Narayanan S; Vicknasingam B. Responses to the illicit drug problem: Insights from supply and demand analysis. Australian Economic Review 43(1): 88-99, 2010. (29 refs.)

This article has three objectives. First, it applies supply and demand analyses to better understand an important problem of immediate interest to young students of economics: illicit drug use. More specifically, it demonstrates how the tools of supply and demand can be used to evaluate the various approaches to achieving the commonly espoused objective of reducing drug use and the more ambitious one of achieving a 'drug-free society' that has driven the anti-drug campaigns of the United Nations (UN). Second, familiarity with the consequences of the available policy initiatives facilitates a better understanding of what an optimal policy might be and the challenge of implementing it. Finally, the principles enunciated will be used to better understand two case studies: one drawn from the Malaysian experience and the other from Australia. The author concludes that the tools of supply and demand clearly suggest the superiority of demand-reducing initiatives as compared to supply restrictions. The outcome of successful demand reduction will reduce both price and quantity used and is therefore unambiguously an improvement. In contrast, supply reduction can only hope to succeed if some special conditions exist: high price elasticity of demand and supply and a very low or negative social marginal value from drug use. These insights not withstanding, the enforcement approach has been widely embraced, not only because actions to limit supply are easier to identify and put into place but because drug supply is seen as a source of unmitigated evil and the need for authorities to be seen to be doing something about it. Yet, years of enforcement and the large amount of resources committed to stemming the inflow of drugs has yielded mixed results: some countries have shown better results than others, but none has succeeded in eradicating supply entirely . Despite the fact that the 'legalise-and-tax' approach can reproduce the price and quantity effects of a supply reduction efficiently and cheaply, the authorities are confronted with a moral dilemma because legalising the long-criminalised drug trade will unleash a powerful emotional backlash in most communities. The most workable solution appears to be an approach that retains traditional supply-side restraints but commits itself to transferring more resources to the implementation of fresh and imaginative demand reduction efforts such as harm reduction and education.

Nguyen H; Bouchard M. Patterns of youth participation in cannabis cultivation. Journal of Drug Issues 40(2): 263-293, 2010. (74 refs.)

The current study examines the patterns of youth participation in cannabis cultivation by developing a typology among a sample of young offenders (n=175) in a rural region of Quebec, Canada known for its extensive outdoor cultivation industry. A hierarchical cluster analysis approach is used to group participants on various dimensions: motivation, substance use, delinquency and type of participation in cannabis cultivation. We also explore the role that criminal networks have in structuring the nature of youth involvement in the cultivation industry. Two general categories of participants emerged: participants for which cultivation is mainly a money generating activity (Entrepreneurs and Generalists), and participants who grow for personal use and intangible rewards (Hobbyists). Further, we found another group, the "helpers", who qualify as "participants" to the cultivation industry, but not as "growers" per se. For generalists, participation to the cultivation industry is found among a portfolio of other crimes, while entrepreneurs tend to specialize in cultivation and are rewarded by achieving a higher level of success. Our results also suggest a correlation between the intensity of involvement in cultivation and the size of a youth's criminal network.

Niewiarowski S; Gogbashian A; Afaq A; Kantor R; Win Z. Abdominal X-ray signs of intra-intestinal drug smuggling. Journal of Forensic and Legal Medicine 17(4): 198-202, 2010. (13 refs.)

Introduction: "Body packers" either swallow or insert drug filled packets rectally or vaginally in order to smuggle illicit drugs. AXR is used routinely to screen suspects for the presence of intra-intestinal drug packages. AXR diagnosis can be difficult as stool or gas within the intestine may resemble ingested foreign bodies. We identify the frequency and co-existence of several signs; tic-tac sign, rosette sign, double condom sign, dense surrounding material, density and discover a new sign; parallelism, which will aid in increasing the radiological accuracy. Methods: We retrospectively reviewed 285 AXRs performed for suspicion of drug smuggling during the period of March 2006-March 2009 to identify the frequency of these signs. Results: Of the 285 AXRs performed 59 were positive, 221 negative and five were indeterminate. The tictac sign was present in 93%, double condom sign in 73%, dense surrounding wrapping material in 36% and parallelism in 27%. Sixty one percentage of drug packages were iso-dense to faeces and 39% hyperdense. Twenty percentage of the positive abdominal radiographs demonstrated one of the radiographic signs, 39% demonstrated two signs, 32% demonstrated three and 7% four. The most common radiographic sign combination was the tic-tac sign with either dense surrounding material or double condom sign. Conclusion: The most commonly encountered radiographic sign is the tic-tac sign, followed by the double condom sign and dense surrounding material. We also discover a new sign, "parallelism" which although uncommon is highly specific. Accuracy is further increased by comparing the density of packages to faeces and looking for the co-existence of multiple signs.

Nonnemaker J; Engelen M; Shive D. Are methamphetamine precursor control laws effective tools to fight the methamphetamine epidemic? Health Economics 20(5): 519-531, 2011. (27 refs.)

One of the most notable trends in illegal substance use among Americans over the past decade is the dramatic growth and spread of methamphetamine use. In response to the dramatic rise in methamphetamine use and its associated burden, a broad range of legislations has been passed to combat the problem. In this paper, we assess the impact of retail-level laws intended to restrict chemicals used to manufacture methamphetamine (methamphetamine precursor laws) in reducing indicators of domestic production, methamphetamine availability, and the consequences of methamphetamine use. Specifically, we examine trends in these indicators of methamphetamine supply and use over a period spanning the implementation of the federal Methamphetamine Anti-Proliferation Act (MAPA) (October 2000) and a more stringent state-level restriction enacted in California (January 2000). The results are mixed in terms of the effectiveness of legislative efforts to control methamphetamine production and use, depending on the strength of the legislation (California Uniform Controlled Substances Act versus federal MAPA), the specification of the comparison group, and the particular outcome of interest. Some evidence suggests that domestic production was impacted by these legislative efforts, but there is also evidence that prices fell, purities rose, and treatment episodes increased.

O'Neill TB; Rawlins JM; Rea S; Wood FM. Methamphetamine laboratory-related burns in Western Australia - Why the explosion? Burns 37(6): 1044-1048, 2011. (19 refs.)

Introduction: With increasing numbers of illicit drug users in both urban and rural communities, users and producers are becoming increasingly enterprising in their sourcing of mind altering drugs. An example of this is the 'amateur' production of methamphetamine in domestic dwellings. We describe the mechanism of burn seen in methamphetamine production, the pattern of clinical injury, and the difficulties in treating these patients. Methods: A 12 month retrospective study of five patient groups presenting to our burn service with injuries following methamphetamine laboratory explosion. Results: Out of five patient groups we have treated 9 individual patients (with one patient presenting on two different occasions) with burns following methamphetamine laboratory explosion. All patients were male and required hospital admission. The cause of the explosive injury was initially reported as barbeque or oven related, :assault, or accident in all patients. Two patients (in separate events) required intubation for associated inhalation injury. Burn size varied from 1% to 40% BSA. 7 patients required surgical debridement and skin grafting. Injury type was thermal and chemical. All patients had difficult follow-up due to low levels of clinic attendance. Conclusion: Methamphetamine laboratory explosion burns are difficult injuries from the start. Invariably the true circumstances surrounding the injury are not clear, and clinicians should be suspicious of a meth lab explosion in suspect individuals with burns plus airway injury. Patient management is complex and often requires substantial analgesic and anxiolytic medication in conjunction with clinical psychology and psychiatry as an inpatient.

Peters FT; Martinez-Ramirez JA. Analytical toxicology of emerging drugs of abuse. Therapeutic Drug Monitoring 32(5): 532-539, 2010. (75 refs.)

The emergence of ever new drugs of abuse on the illicit drug market is an ongoing challenge for analytical toxicologists. Because most of these new drugs or drug classes are not detected by established analytical methods targeting classic drugs of abuse, analytical procedures must be adapted or new procedures must be developed to cover these new compounds. This review summarizes the analytical toxicology of the following classes of emerging drugs of abuse: piperazines, phenethylamines (2Cs and FLYs), 4-substituted amphetamines, beta-keto-amphetamines, 2,5-dimethoxy-amphetamines, pyrrolidinophenones, and synthetic cannabinoids.

Roddy J; Steinmiller CL; Greenwald MK. Heroin purchasing is income and price sensitive. Psychology of Addictive Behaviors 25(2): 358-364, 2011. (31 refs.)

Semi-structured interviews were used to assess behavioral economic drug demand in heroin dependent research volunteers. Findings on drug price, competing purchases, and past 30-day income and consumption, established in a previous study, are replicated. We extended these findings by having participants indicate whether hypothetical environmental changes would alter heroin purchasing. Participants (n = 109) reported they would significantly (p < .005) decrease heroin daily purchasing amounts (DPA) from past 30-day levels (M = $60/day) if: (a) they encountered a 33% decrease in income (DPA = $34), (b) family/friends no longer paid their living expenses (DPA = $32), or (c) they faced four-fold greater likelihood of police arrest at their purchasing location (DPA = $42). Participants in higher income quartiles (who purchase more heroin) show greater DPA reductions (but would still buy more heroin) than those in lower income quartiles. For participants receiving government aid (n = 31), heroin purchasing would decrease if those subsidies were eliminated (DPA = $28). Compared to participants whose urine tested negative for cocaine (n = 31), cocaine-positive subjects (n = 32) reported more efficient heroin purchasing, that is, they live closer to their primary dealer; are more likely to have heroin delivered or walk to obtain it (and less likely to ride the bus), thus reducing purchasing time (52 vs. 31 min, respectively); and purchase more heroin per episode. These simulation results have treatment and policy implications: Daily heroin users' purchasing repertoire is very cost-effective, more so for those also using cocaine, and only potent environmental changes (income reductions or increased legal sanctions) may impact this behavior.

Schneider S; Meys F. Analysis of illicit cocaine and heroin samples seized in Luxembourg from 2005-2010. Forensic Science International 212(1-3): 242-246, 2011. (21 refs.)

This article discusses drug purity, frequency of appearance and concentration ranges of adulterants of 471 illicit cocaine and 962 illicit heroin samples seized in Luxembourg from January 2005 to December 2010. For cocaine samples the mean concentration was lowest in 2009 (43.2%) and highest in 2005 (54.7%) but no clear trend could be observed during the last 6 years. 14 different adulterants have been detected in cocaine samples, from which phenacetin has been the most abundant in terms of frequency of appearance and concentration until 2009. In 2010 the veterinary antihelminthic drug levamisole has become the most abundant adulterant detected in cocaine samples, its concentrations however remained low (1.5-4.1%). The mean heroin concentration was 26.6% in 2005, a decline has been observed in 2006 and the concentrations have been relatively stable since then (15.8-17.4%). Paracetamol and caffeine were by far the most abundant adulterants detected in heroin samples.

Schwartz RP; Kelly SM; O'Grady KE; Gandhi D; Jaffe JH. Interim methadone treatment compared to standard methadone treatment: 4-month findings. Journal of Substance Abuse Treatment 41(1): 21-29, 2011. (19 refs.)

Interim methadone (IM; with emergency counseling only) is an effective but highly restricted alternative to methadone treatment program (MTP) waiting lists. However, it is not known whether IM disadvantages patients as compared with standard methadone treatment (SM). In this clinical trial, conducted in two MTPs, 230 newly admitted patients were randomly assigned to IM, SM, and "restored" methadone treatment (SM with a counselor with a reduced caseload). Data were analyzed using generalized estimating equations and generalized linear modeling. There were no significant differences among conditions in days in treatment or of heroin or cocaine use and heroin- or cocaine-positive urine drug tests. The IM as compared to the SM group had significantly fewer self-reported days of criminal activity and lower amounts of money spent on drugs and illegal income. These findings suggest that when SM is unavailable, IM should be more widely used and less restricted.

Shook JJ; Vaughn M; Goodkind S; Johnson H. An empirical portrait of youthful offenders who sell drugs. Journal of Criminal Justice 39(3, special issue): 224-231, 2011. (25 refs.)

Purpose: This study explores the drug dealing behaviors of youthful offenders who sell drugs and examines differences between these offenders and those who do not sell drugs across a variety of measures including types of drugs sold, substance use and behaviors. Methods: The sample consists of 227 youthful offenders in two juvenile residential facilities. Chi-square and t-tests are used to assess differences between youth who sell marijuana, hard drugs, and prescription drugs and those youthful offenders who do not sell drugs across a variety of measures. Results: The majority of youthful offenders in our sample are involved in drug dealing and many are extensively involved. Drug dealing, however, is not tied solely to economic motivations but is connected to patterns of substance use. Youthful offenders who sell drugs are also engaged in patterns of delinquent and other risky behavior at higher levels but the magnitude of differences in substance use and delinquent or risky behaviors varies by type of drugs sold. Conclusions: Youthful offenders who sell drugs are embedded in patterns of substance use and delinquent behavior that differ from those who do not sell drugs and interventions for these youth need to be targeted at multiple levels.

Sloss CM; Harper GW. Legal service needs and utilization of women who trade sex. Sexuality Research and Social Policy 7(3): 229-241, 2010. (51 refs.)

Women who trade sex for money or drugs experience extensive victimization and criminalization and could benefit from legal services. In this study, 91 women currently trading sex disclosed experiences of community, intimate partner, societal, and police abuse, and a history of arrests and incarcerations. The majority of respondents indicated a need for services to help with abuse, violence, and/or legal problems, yet they reported a low perceived need and even lower use of legal services. The women revealed a higher tendency of disclosing their legal and abuse history to spiritual, mental health, and addiction service providers, than to legal service providers. The most frequently reported barrier to their legal service utilization was mistrust of the police and legal system, in part due to prior negative experiences and their own criminal status. Other barriers included fearing and protecting their perpetrators, wanting privacy, and using substances. The implications of the criminalization of sex work are discussed with regard to its impact on female sex traders' vulnerability to abuse and their use of legal services.

Sumnall HR; Evans-Brown M; McVeigh J. Social, policy, and public health perspectives on new psychoactive substances. (review). Drug Testing and Analysis 3(7-8, special issue): 515-523, 2011. (119 refs.)

New psychoactive substances pose a particular challenge to those formulating drugs policy and related public health responses. This paper outlines some of the main issues arising from their use, with a particular focus on user perspectives. Such substances are often (at least initially) produced and distributed for different reasons than controlled drugs. They emerge in users' repertoires undetected by most monitoring systems and general population drug surveys. While reasons for use by innovators and early adopters are often in the spirit of self-experimentation, such substances may rapidly diffuse to the recreational arena as a result of enthusiastic user propagation where they act as substitutes or complements to controlled drugs. The majority of substances are believed to be sourced, albeit not exclusively, from manufacturers based in China. They are retailed to consumers through the Internet and physical shops (such as 'head' and 'smart' shops), as well as traditional 'street dealers' (although data on the significance of this latter route of supply are limited). The data required for risk assessment of the harms such substances may pose, as well as information required for accurate user-derived harm reduction advice, are often limited. Moreover, some involved in the commercial supply have deliberately misbranded products, including substituting the active substance, in apparent attempts to circumvent regulatory frameworks. This leaves users susceptible to both health and criminal justice harms. Despite various attempts to restrict the supply, they often continue to be available through the illicit market, although it is not yet possible to predict whether they will join other drugs such as MDMA and LSD as mainstays of the recreational pharmacopeia.

Swahn MH; Bossarte RM; West B; Topalli V. Alcohol and drug use among gang members: Experiences of adolescents who attend school. Journal of School Health 80(7): 353-360, 2010. (38 refs.)

METHODS: Analyses were based on the Youth Violence Survey, conducted in 2004, and administered to over 80% of eligible public school students in grades 7, 9, 11, and 12 (N = 4131) in a high-risk, urban school district. The self-administered survey, completed during a class period, included measures of alcohol and drug use and related exposures. Tests of associations were determined using chi-square tests and logistic regression analyses. RESULTS: In this study, 8.8% of students reported gang membership. Students who initiated alcohol use prior to age 13 (OR = 4.90; 95% CI: 3.65-6.58), who drank alcohol 3 or more times per week (OR = 9.57; 95% CI: 6.09-15.03) and who used drugs 3 or more times per week (OR = 6.51; 95% CI: 4.59-9.25) were more likely to report gang membership than students who did not report alcohol or drug use. Boys were more likely than girls to report alcohol-related fighting and drug selling. DISCUSSION: Gang members were significantly more likely than non-gang members to have initiated alcohol early, to have reported a high prevalence of alcohol use, to have engaged in alcohol-related physical fighting, peer drinking, drug use, drug selling, peer drug selling, and having seen drug deals in their neighborhood. Schools may serve as a critically important source for intervention and prevention efforts for gang members, especially those in 7th grade, who still attend school.

Vardakou I; Pistos C; Spiliopoulou C. Drugs for youth via Internet and the example of mephedrone. (review). Toxicology Letters 201(3): 191-195, 2011. (31 refs.)

Recently a new class of "designer drugs" has emerged on the drugs abuse market, known as "legal highs". Such drugs are legal to use and possess, and legal to supply. Mephedrone, a central nervous system stimulant, is the most widely experienced "legal high". This review presents any available information about psychoactive properties, safety profile, clinical data, and legislation of the new "legal high" and emphasizes the role of Internet with mephedrone's expansion. Available data were collected by various literature search engines and World Wide Web. All valuable information about psychoactive properties, safety profile and clinical data for mephedrone and its use as "legal high" were managed to spot and summarise. Internet plays a significant role for the distribution of "legal highs", becoming one of the major "drug market". Adolescents and young adults who are curious about drugs may search on the Internet and thereby become exposed to thousands of sites that expound upon the positive effects of drugs and downplay or deny any negative effects. Use of mephedrone is mainly a youth phenomenon. The hazardous side-effects are strong desire to re-dose, uncomfortable changes in body temperature and heart rate, hallucinations and psychosis.

Vardakou I; Pistos C; Spiliopoulou C. Drugs for youth via Internet and the example of mephedrone. (review). Toxicology Letters 201(3): 191-195, 2011. (31 refs.)

Recently a new class of "designer drugs" has emerged on the drugs abuse market, known as "legal highs". Such drugs are legal to use and possess,and legal to supply. Mephedrone, a central nervous system stimulant, is the most widely experienced "legal high". This review presents any available information about psychoactive properties, safety profile, clinical data, and legislation of the new "legal high" and emphasizes the role of Internet with mephedrone's expansion. Available data were collected by various literature search engines and World Wide Web. All valuable information about psychoactive properties, safety profile and clinical data for mephedrone and its use as "legal high" were managed to spot and summarise. Internet plays a significant role for the distribution of "legal highs", becoming one of the major "drug market". Adolescents and young adults who are curious about drugs may search on the Internet and thereby become exposed to thousands of sites that expound upon the positive effects of drugs and downplay or deny any negative effects. Use of mephedrone is mainly a youth phenomenon. The hazardous side-effects are strong desire to re-dose, uncomfortable changes in body temperature and heart rate, hallucinations and psychosis.

Wilkins C; Sweetsur P. Differences in harm from legal BZP/TFMPP party pills between North Island and South Island users in New Zealand: A case of effective industry self-regulation? International Journal of Drug Policy 21(1): 86-90, 2010. (17 refs.)

Background: 'Party' pills containing benzylpiperazine (BZP)and trifluoromethylphenylpiperazine (TFMPP) were sold legally in New Zealand until early 2008. Prospective studies of hospital emergency department admissions appeared to suggest that the harm from party pills was greater among South Island than North Island users. The party pill industry association (the Social Tonics Association of New Zealand or STANZ) claimed these differences were due to the voluntary code of practice adopted by their members in the North Island. The aims of this study were to examine differences in harm from party pills between North and South Island users in New Zealand, and to investigate possible reasons for any differences in harm, including the impact of industry self-regulation. Methods: A national household survey of BZP/TFMPP party pill use was conducted in New Zealand. information on the ingredients of party pills was provided by the National Poisons Centre. Results: In a number of instances last year users of party pills from the South Island were more likely than last year users from the North Island to report harm from party pills. There were no differences between the North and South Island users with regard to the mean number of BZP/TFMPP party pills taken, mean total milligrams of BZP/TFMPP ingested or prevalence of use of other drug types in combination with party pills. A minority of users in the South Island reported using extremely high numbers of BZP/TFMPP party pills in a single session and using extremely high potency brands of party pills. Last year party pill users from the South Island were more likely than those from the North Island to be students. Conclusion: A number of factors may have contributed to the greater harm from BZP/TFMPP party pills among South Island users including a higher proportion of student users with higher consumption of alcohol and other drugs. Users from both Islands commonly exceeded the dosage of BZP/TFMPP recommended by STANZ suggesting the STANZ code of conduct was largely ineffective.

Williams CT; Liu W; Levy JA. Crossing over: Drug network characteristics and injection risk along the China-Myanmar border. AIDS and Behavior 15(5): 1011-1016, 2011. (28 refs.)

Border areas are important locations for understanding HIV transmission. This study examines individual and network correlates of border crossing and equipment sharing among methadone maintenance clients in Ruili City, a Chinese city on the Myanmar border. Data are from 298 clients enrolled in the Ruili Methadone Treatment Center. Clients were interviewed about drug use, HIV/AIDS knowledge, treatment motivation, and their social networks. Multinomial and logistic regression analysis were performed. Thirty percent of clients reported injecting in Myanmar. Compared to drug networks that usually inject in China, networks that inject equally in both places (border crossing) are more likely to share equipment. The association between HIV positive status and border-crossing was marginally significant and robust. Results indicate some added degree of risk among clients and drug networks who border-cross to use drugs. More research is needed to understand this phenomenon.

Wood E; Kerr T. Could a United Nations organisation lead to a worsening of drug-related harms? Drug and Alcohol Review 29(1): 99-100, 2010. (15 refs.)

The intimate link between illicit injection drug use and the spread of the human immunodeficiency virus (HIV) represents a global public health emergency. The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that syringe sharing among illicit injection drug users (IDU) contributes to approximately one-third of new HIV infections outside of sub-Saharan Africa. Addressing this requires collaboration between both illicit drug control and public health systems. The authors point out that there are international agencies which continue to ignore this reality, with the most worrisome being the International Narcotics Control Board. Although various international consensus documents have highlighted the value of sterile syringe distribution programs, such as needle exchange the INCB's reluctance to support this evidence-based approach to HIV prevention has been well described. It is noted that drug control conventions should not support policy decisions which can lead to worsening of the global HIV epidemic.

Yap PJ. The "dead" constitution: Crime and punishment in Singapore. Hong Kong Law Journal 40(Part 3): 577- 591, 2010. (13 refs.)

In Yong Vui Kong v Public Prosecutor, the Singapore Court of Appeal recently reaffirmed the constitutionality of the mandatory death penalty for drug trafficking offences under the Misuse of Drugs Act. Specifically, the Singapore Court held that the judicial obligation to impose a capital sentence, once guilt for the drug offence was so established, was neither a violation of the accused's constitutional right against the deprivation of his life in accordance with law nor a denial of his right to equal protection under the law. In this article, the author argues that, whilst one may be sympathetic to their Lordships for reaching the result they did, in light of the political realities underpinning Singapore's constitutional arrangement, the legal arguments advanced by the Court of Appeal for their decision unfortunately do not withstand close scrutiny.