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CORK Bibliography: Laws

141 citations. January 2006 to present

Prepared: January 2008

Agrawal A; Lynskey MT. Does gender contribute to heterogeneity in criteria for cannabis abuse and dependence? Results from the National Epidemiological Survey on Alcohol and Related Conditions. Drug and Alcohol Dependence 88(2-3): 300-307, 2007. (65 refs.)

Previous research has noted that a unidimensional latent construct underlies criteria for cannabis abuse and dependence. However, no study to date has explored whether gender contributes to heterogeneity in the latent abuse and dependence construct and furthermore, whether after accounting for differences in the mean scores of abuse and dependence across genders, there is any evidence for heterogeneity in the individual abuse and dependence criteria. The present study utilizes data on criteria for cannabis abuse and dependence from a large, nationally representative sample (National Epidemiology Survey on Alcohol and Related Conditions) of 8172 lifetime cannabis users to investigate whether gender contributes to heterogeneity in the underlying construct of cannabis abuse and dependence, and in each individual criterion as well. Analyses, all of which were conducted in MPlus, included factor analysis, as well as MIMIC and multiple-group models for an examination of dimensionality and gender heterogeneity, respectively. Results favor a unidimensional construct for cannabis abuse/dependence, as seen in prior research. We also identify two abuse (legal and hazard) and two dependence (quit and problems) criteria, which show significant gender heterogeneity with the abuse criteria exhibiting higher thresholds in women and the dependence criteria in men. We conclude that the criteria that serve as indicators of DSM-IV cannabis abuse and dependence do not function identically in men and women and that certain criteria (e.g. hazardous use) require further refinement.

Abrams SM; Mahoney MC; Hyland A; Cummings KM; Davis W; Song LG. Early evidence on the effectiveness of clean indoor air legislation in New York State. American Journal of Public Health 96(2): 296-298, 2006. (10 refs.)

In July 2003, New York State implemented the Clean Indoor Air Act (CIAA) to reduce exposure to environmental tobacco smoke (ETS). In this cross-sectional study, workers (n= 168) completed an interview assessing ETS exposure and provided urine for cotinine analysis. Hospitality workers recruited after implementation of the CIAA had significant reductions in ETS exposure and urine cotinine, compared with those recruited before implementation. The New York State CIAA yielded measurable reductions in ETS exposure for hospitality workers.

Alderman J; Daynard RA. Applying lessons from tobacco litigation to obesity lawsuits. (review). American Journal of Preventive Medicine 30(1): 82-88, 2006. (30 refs.)

This discussion examines the use of litigation as a strategy to protect the public health. The history of tobacco litigation provides a model to evaluate potential litigation strategies against other industries that pose a threat to public health, particularly the food industry. This paper demonstrates that although legislation would be a preferable solution, lessons from the tobacco wars suggest that effective national legislation is unlikely at the present time. Based on the differences and similarities between the tobacco and food industries, it predicts the effectiveness of particular kinds of obesity litigation and the food industry's likely response. The tobacco industry has vigorously fought individual injury lawsuits and has had remarkable success in resisting such cases. The food industry is likely to successfully employ a similar "scorched earth" litigation strategy in individual injury cases. However, the tobacco industry did agree to the Master Settlement Agreement in the lawsuits brought by the state attorneys general because they were a unique kind of litigation with a finite number of plaintiffs. Likewise, state lawsuits under consumer protection acts may be a distinct type of litigation that permits cases to focus on deceptive advertisements while avoiding complicated causation issues. Such lawsuits have the potential to be a useful tool to fight obesity and enlist the efforts of the food industry in resisting the epidemic. Understanding the lessons of tobacco can save public health advocates much time and many resources and thus allow tobacco litigation to benefit public health in new ways.

Alpert HR; Carpenter CM; Travers MJ; Connolly GN. Environmental and economic evaluation of the Massachusetts Smoke-Free Workplace Law. Journal of Community Health 32(4): 269-281, 2007. (28 refs.)

An environmental and economic evaluation of the smoke-free law in Massachusetts provides a broad appreciation of how a state-wide smoking ban affects the health of patrons and workers as well as the industries that are commonly concerned about the effects of smoking bans on business. The aim of this study is to evaluate environmental and economic effects of the statewide Massachusetts statewide Smoke-Free Workplace Law. Before and after the smoking ban, air quality testing was conducted in a sample (n = 27) of hospitality venues and state-wide economic changes were assessed. Compliance, in terms of patronage was measured by person-counts. Environmental outcomes were respirable suspended particles (RSP) less than 2.5 microns in diameter (PM2.5). Economic outcomes were meals tax collections, employment in the food services and drinking places and accommodations industries. On average, levels of respirable suspended particles (RSPs) less than 2.5 microns in diameter (PM2.5) decreased 93% in these venues after the Massachusetts Smoke-free Workplace Law went into effect. No statistically significant changes were observed among the economic indicators. This evaluation demonstrates that the state-wide Massachusetts law has effectively improved indoor air quality in a sample of Massachusetts venues and has not negatively affected several economic indicators.

Anderson D; Beckerleg S; Hailu D; Klein A. The Khat Controversy: Stimulating the Debate on Drugs. Oxford: Berg Publishers, 2007

Khat is a natural stimulant that, in the Middle East, is as common as coffee is in the West. It is popular in a number of African and Arab populations. This book examines the use of khat, its increasing availability and introduction to areas beyond those where it has been used historically. Included in this discussion is the role of globalization, ethnicity and culture. With its popularity escalating in large metropolitan areas from London to Rome, Toronto and Copenhagen, khat is fast being viewed as a problem in the West. Warning voices have been raised about its addictive properties and potential for being the next drug fad. This book is drawn from research efforts conducted by the authors to discern the trade in khat, the nature of related policy, and related policy issues. Following an introductory chapter which outlines the nature of khat use, discussion turns in Part I to khat Ethiopia and the Somaliland, the role of khat production, the role in export and foreign change. Part II turns to East Africa, with attention to Kenya, Meru and Uganda, their the khat trade, the impact of colonial controls, and campaigns against the drug. Part III reviews the global emergence of khat, the international trade, related social issues, and incorporates two case studies, the experience of control efforts in Canada and Sweden. The concluding chapter addresses the policy debates and the case for and against prohibition.

Andreeva TI; Krasovsky KS; Semenova DS. Correlates of smoking initiation among young adults in Ukraine: a cross-sectional study. BMC Public Health 7(article 106), 2007. (23 refs.)

Background: Aim: To estimate the impact of smoking restrictions in homes and schools, and tobacco advertising and information on smoking initiation by young people in Ukraine. Methods: Data of 609 young people aged 15-29 was taken from the national representative survey conducted in June 2005. Outcome measures: The reported age of cigarette initiation was used to characterize the start of smoking experimentation, and the reported age of daily smoking initiation was considered to be a characteristic of established smoking. Analysis: survival analysis Cox proportional hazard regression models were used. Results: Age of smoking initiation was reported by 87% of young men and 61% of young women, the beginning of daily smoking by 71% and 33% respectively. Being frequently exposed to second-hand smoke and having no household smoking restrictions was associated with a higher risk of earlier smoking initiation both for men and women. For women, this risk was associated with age, HR = 0.95, (95% CI 0.91-0.98), that is, younger girls were more likely to smoke their first cigarette earlier in their lifetime. Those women had a higher risk of early smoking initiation who reported to receive tobacco-related information from magazines, HR = 1.40 (1.01-1.92), and outdoor tobacco advertising, HR = 1.99 (1.45-2.75). With both men and women, the risk of establishing daily smoking was higher in those with lower levels of tobacco-related knowledge and less household smoking restrictions. For women, the risk was higher in those who live in larger cities HR = 1.77 (1.10-2.86), and who received information about tobacco smoking from colleagues or friends HR = 1.83 (1.13-2.95). Conclusion: Encouraging people to eliminate their homes of tobacco smoke and tobacco advertising bans can be effective measures in preventing the initiation of smoking among young people. Young female smoking initiation is of special concern in Ukraine, since they are more responsive to tobacco marketing and pro-smoking peer influence.

[Anon]. Cooking up solutions to a cooked up menace: Responses to methamphetamine in a federal system. Harvard Law Review 119(8): 2508-2529, 2006. (135 legal refs.)

This discussion of the response to methamphetamine takes place within the context of considering federalism and relationship of the federal and states jurisdictions, in which the federal laws provide the baseline, and state responses allow for experimentation, with successful results being folded into the federal baseline. To determine the ideal responses to methamphetamine, Part I of the note opens by tracing the nature and growth of the methamphetamine problem. Part II then examines states' recent measures to arrest use and production. The focus then turns to the federal reaction in Part III. With the initiatives of each level of government, Part IV compares their effectiveness and posits that experience suggests a model in which states supplement a baseline of federal laws. Finally, Part V considers whether this ideal federal-state balance is achievable in practice.

Asbridge M. Drugs and driving: When science and policy don't mix. (editorial). Canadian Journal of Public Health 97(4): 283-285, 2006. (40 refs.)

This commentary briefly looks at the Canadian federal government's proposed legislation to strengthen the enforcement of drug-impaired driving, placing special emphasis on cannabis. After outlining the legislation, three issues are examined. Of primary concern is at what level cannabis use impairs driving ability leading to an increased risk of motor vehicle collision. Current epidemiological evidence is reviewed. Equally important is the government's emphasis on the training and implementation of Drug Recognition Experts (DREs), specially trained police officers whose role is to detect drivers under the influence of drugs. Research on the effectiveness of DREs is discussed, along with a dialogue regarding the potential shortcomings of the DRE program. Finally, a brief surveillance of international policy literature on drugs and driving is offered, along with some sober thoughts on the potential difficulties that may emerge in the enforcement of the proposed legislation.

Ashdown GG. The blueing of America: The bridge between the war on drugs and the war on terrorism. University of Pittsburgh Law Review 67(Summer): 753-802, 2006. (342 legal refs.)

Summary. This article examines a trend toward permissive police investigatory practices and the concomitant loss in privacy rights this entails. The trend which is currently justified as important in "the war on terror" is seen as having its origin in the "war on drugs." Historically, this phenomenon has its origins in the proliferation of drug usage in the country: first marijuana, hallucinogenic drugs, and amphetamines during the counterculture years of the late '60s and '70s, and later powder and then crack cocaine. ... The definition of probable cause was diluted, and the standards on what constituted a law enforcement search or seizure were drawn narrowly. ... This "no search" casualty to privacy in the War on Drugs has tremendous potential for application to video surveillance and new surveillance devices such as weapons detectors, and facial and vehicle character recognition technology. ... Justice Stevens's majority opinion not only followed established precedent that a dog sniff was not a search for Fourth Amendment purposes, but also rejected the Illinois Supreme Court's conclusion that the use of the dog converted a lawful traffic stop into a different drug investigation not supported by reasonable suspicion. ... The major difference between the two provisions is that Title III has extensive probable cause, particularity, minimization, and termination requirements regarding the commission of federal domestic crime, whereas FISA requires only a showing of probable cause that the target is a foreign power or agent of a foreign power and, originally, certification that "the purpose" of the surveillance was the gathering of foreign intelligence information.

Bartecchi C; Alsever RN; Nevin-Woods C; Thomas WM; Estacio RO; Bartelson BB et al. Reduction in the incidence of acute myocardial infarction associated with a citywide smoking ordinance. Circulation 114(14): 1490-1496, 2006. (32 refs.)

Background-Secondhand smoke exposure increases the risk of acute myocardial infarction (AMI). One study (Helena, Mont) examined the issue and found a decrease in AMI associated with a smoke-free ordinance. We sought to determine the impact of a smoke-free ordinance on AMI admission rates in another geographically isolated community (Pueblo, Colo). Methods and Results-We assessed AMI hospitalizations in Pueblo during a 3-year period, 1.5 years before and 1.5 years after implementation of a smoke-free ordinance. We compared the AMI hospitalization rates among individuals residing within city limits, the area where the ordinance applied, versus those outside city limits. We also compared AMI rates during this time period with another geographically isolated but proximal community, El Paso County, Colo, that did not have an ordinance. A total of 855 patients were hospitalized with a diagnosis of primary AMI in Pueblo between January 1, 2002, and December 31, 2004. A reduction in AMI hospitalizations was observed in the period after the ordinance among Pueblo city limit residents (relative risk [RR]=0.73, 95% confidence interval [CI] 0.63 to 0.85). No significant changes in AMI rates were observed among residents outside city limits (RR=0.85, 95% CI 0.63 to 1.16) or in El Paso County during the same period (RR=0.97, 95% CI 0.89 to 1.06). The reduction in AMI rate within Pueblo differed significantly from changes in the external control group (El Paso County) even after adjustment for seasonal trends (P < 0.001). Conclusions-A public ordinance reducing exposure to secondhand smoke was associated with a decrease in AMI hospitalizations in Pueblo, Colo, which supports previous data from a smaller study.

Becker GS; Murphy KM; Grossman M. The market for illegal goods: The case of drugs. Journal of Political Economy 114(1): 38-60, 2006. (11 refs.)

This paper considers the costs of reducing consumption of a good by making its production illegal and punishing apprehended illegal producers. We use illegal drugs as a prominent example. We show that the more inelastic either demand for or supply of a good is, the greater the increase in social cost from further reducing its production by greater enforcement efforts. So optimal public expenditures on apprehension and conviction of illegal suppliers depend not only on the difference between the social and private values from consumption but also on these elasticities. When demand and supply are not too elastic, it does not pay to enforce any prohibition unless the social value is negative. We also show that a monetary tax could cause a greater reduction in output and increase in price than optimal enforcement against the same good would if it were illegal, even though some producers may go underground to avoid a monetary tax. When enforcement is costly, excise taxes and quantity restrictions are not equivalent.

Blecher EH. The effects of the Tobacco Products Control Amendment Act of 1999 on restaurant revenues in South Africa: A panel data approach. South African Journal of Economics 74(1): 123-130, 2006. (11 refs.)

Prior to the implementation of this legislation the restaurant industry lobbied that a full-scale ban would severely hurt business. Their lobbying resulted in a restrictive restaurant smoking policy rather than a full-scale ban. Nevertheless the industry argued that this would still severely hurt business citing international evidence in support. The objective of this paper is to investigate the change in restaurant revenues after the implementation of a public smoking ban in South Africa. We use a fixed effects panel model to explore the response of restaurant revenues to the imposition of the ban. Provincial data is used over the period 1995 to 2003 and VAT receipts are used as a proxy of restaurant turnover. We conclude that restrictive restaurant smoking policies have not had a negative effect on restaurant revenue, indicating that claims of countrywide restaurant business declines under such a policy are unwarranted.

Bonnie RJ. Judicially mandated naltrexone use by criminal offenders: A legal analysis. Journal of Substance Abuse Treatment 31(2): 121-127, 2006. (7 refs.)

The starting point for this article is the possibility of improving treatment adherence by making naltrexone therapy, particularly the recently developed depot preparation, a condition of probation or parole for nonviolent opiate-addicted offenders who voluntarily agree to these conditions. (I will characterize these arrangements as "leveraged agreements.") My assigned task is to reflect on the legal principles that would apply to these arrangements. Before addressing the legality of leveraged agreements, however, I want to consider two arrangements. First, I want to consider what I will call "no-agreement arrangements," in which a probationer or a parolee who does not want to receive naltrexone is required to do so under a threat of incarceration for noncompliance. Second, I want to consider a purely voluntary arrangement in which naltrexone treatment is not at all linked to criminal sentence. Finally, I will consider leveraged agreements.

Bos A. The history of licit cocaine in the Netherlands. De Economist 154(4): 581-586, 2006. (8 refs.)

This paper gives a description of the rise and fall of cocaine business in the Netherlands, between 1910 and 1930 when cocaine was a legal drug. When the anesthetic effects of cocaine were discovered demand for cocaine rose quickly. This made the production of coca leaves in the Dutch East Indies and the production of cocaine in the Netherlands a profitable business. However within the time span of two decades the introduction of synthetic replacements stimulated by international legislation to reduce drugs use caused the disappearance of the legal trade of coca and cocaine.

Bryan-Jones K; Chapman S. Political dynamics promoting the incremental regulation of secondhand smoke: A case study of New South Wales, Australia. BMC Public Health 6(article 192), 2006. (56 refs.)

Background: The history of governmental responses to the accumulation of scientific evidence about the harms of secondhand smoke (SHS) presents an intriguing case study of incremental public health policy development. Australia has long been considered a world-leader in progressive tobacco control policies, but in the last decade has fallen behind other jurisdictions in introducing SHS legislation that protects all workers. Bars, clubs and pubs remain the only public indoor spaces where smoking is legally permitted, despite SHS exposure in the hospitality industry being higher and affecting more people than in any other setting after domestic exposure. This paper examines the political dynamics that have shaped this incremental approach to SHS. Methods: In-depth interviews with 21 key stakeholders in the state of New South Wales ( NSW), including politicians, their advisors, health officials and tobacco control advocates, were conducted and subjected to thematic content analysis. Interviewees' comments provided insights into the dynamics surrounding the debates and outcomes of SHS legislative attempts and the current political environment, and about how to progress SHS legislation. Results: SHS restrictions have been delayed by several broad factors: the influence of industry groups successfully opposing regulation; issue wear-out; and political perceptions that there is not a salient constituency demanding that smoking be banned in bars and clubs. Interviewees also provided suggestions of strategies that advocates might utilise to best overcome the current political inertia of incremental compromises and achieve timely comprehensive smoking bans. Conclusion: Advocates concerned to shorten the duration of incremental endgames must continue to insist that governments address SHS fundamentally as a health issue rather than making political concessions to industry groups, and should broaden and amplify community voices calling on governments to finish the job. Publicity to the growing number of state and national governments that have successfully implemented total bans over the past decade is likely to make incrementalism an increasingly unattractive political option.

Butler WE. HIV/AIDS and drug misuse in Russia: Harm Reduction Programmes and the Russian Legal System. London: International Family Health, 2006. (193 refs.)

This monograph is based on a presentation made in Moscow by the author to representatives from non-governmental organizations and law enforcement agencies. Law enforcement bodies' in Russia have rather negative towards such programs. However the author suggests that the absence of a clear legal basis is the main reason why the spectrum of harm reduction services are significantly limited in Russia. (There are however harm reduction programs operating at a local level since 1997.) The research for this monograph was conducted under the auspices of the Department of the International Development of Great Britain. In analyzing the problems to be addressed to promote harm reduction programs the complexities of the laws governing HIV and drug misuse are described. There are 11 chapters plus appendices. The first chapter provides an introduction to the construct of harm reduction. The next chapters offers a brief history of legal regulation of narcotics in Russia, with particular attention to the post-Soviet era. This is followed by a chapter dealing with current patterns of narcotic use and HIV infection, as well as drug-related crime. The next six chapters consider different aspects of current legal approaches, including the enforcement agencies, narcotic laws in the criminal and civil law, and application to drug-substitution therapy. The concluding chapter examines the relationship of Russian law and United National Conventions. There is also discussion of possible policy options available under Russian law , considering how even with current legal complexities, harm reduction programs can become an integral part of Russia's response to its HIV/AIDS epidemic. Appendices include pertinent narcotics regulation, and a listing of psychotropic substances and their precursors subject to control in the Russian Federation.

Caetano R. The first pan American conference on alcohol public policies and its significance for the region. (editorial). Addiction 101(6): 765-767, 2006. (12 refs.)

Campostrini S; Holtzman D; McQueen DV; Boaretto E. Evaluating the effectiveness of health promotion policy: Changes in the law on drinking and driving in California. Health Promotion International 21(2): 130-135, 2006. (23 refs.)

The purpose of the study was to determine the utility of general population health surveillance data for evaluating broad policy changes that relate to health promotion. Data were drawn from the United States (US) Behavioral Risk Factor Surveillance System (BRFSS) for one US state, California. Because these data are collected frequently and continually, a quasi-experimental approach to the evaluation was possible using a type of interrupted time series analysis or longitudinal impact analysis. A statistically significant decrease in the number of declared episodes of drinking and driving was found after enactment of new state policy. These findings were compared and found consistent with another study in California that examined the effect of changes in the law on alcohol-related traffic accidents. Our findings suggest that data from a behavioral surveillance system, in this case the BRFSS, are useful to evaluate the effect of a health promotion intervention. Further, the study demonstrates the utility of comparing different data sources when assessing a population-wide change in health promotion policy.

Carstairs C. Jailed for Possession: Illegal Drug Use, Regulation, and Power in Canada, 1920-61. Toronto: University of Toronto, 2006. (Chapter refs.)

It is said that strict bans on non-medical use of psychoactive drugs produce fewer users, but causes more trouble and disruption among those who use drugs as a result of the prohibition. Studies of policy shifts in places in diverse places has demonstrated, and this volume demonstrates Canada in mid-20th-century Canada was no exception. Between 1908 and 1920, resentment of Chinese opium smokers, fear that drug use was spreading among young whites and a growing negatvity to all forms of intoxication was tied to hardening Canadian drug policy. By the mid-1920s, non-medical drug use was essentially criminalized. This was especially true for the small but hard core of working-class opium smokers. This forced addicts to switch from opium to morphine and heroin, from inhalation to injection, to a more expensive habit that necessitated a career of theft, dealing or prostitution, interrupted by frequent stretches in prison. The impact on different segments of the population are discussed: the police, who gained power and career opportunities; the physicians, who typically washed their hands of troublesome addicts; and social workers, left to care for those with addiction. There is an examination of old case files that provide the basis for case histories.

Carter SM; Chapman S. Smokers and non-smokers talk about regulatory options in tobacco control. Tobacco Control 15(5): 398-404, 2006. (45 refs.)

Objective: Community members are occasionally polled about tobacco control policies, but are rarely given opportunities to elaborate on their views. We examined laypeople's conversations to understand how 11 regulatory options were supported or opposed in interactions. Design: Qualitative design; purposive quota sampling; data collection via focus groups. Setting: Three locations in Sydney, Australia. Participants: 63 smokers and 75 non-smokers, men and women, from three age groups (18 - 24, 35 - 44, 55 - 64 years), recruited primarily via telephone. Measurements: Semi-structured question route; data managed in NVivo; responses compared between groups. Results: Laypeople rejected some regulatory proposals and certain arguments about taxation and the cost of cessation treatments. Protecting children and hypothecating tobacco excise for health education and care were highly acceptable. Plain packaging, banning retail displays and youth smoking prevention received qualified support. Bans on political donations from tobacco corporations were popular in principle but considered logistically fraught. Smokers asked for better cessation assistance and were curious about cigarette ingredients. Justice was an important evaluative principle. Support was often conditional and unresolved arguments frequent. We present both sides of these conflicts and the ways in which policies were legitimised or de-legitimised in conversation. Conclusions: Simple measures of agreement used in polls may obscure the complexity of community responses to tobacco policy. Support was frequently present but contested; some arguments that seem self-evident to advocates were not so to participants. The detailed understanding of laypeople's responses provided through qualitative methods may help frame proposals and arguments to meet concerns about justice, effectiveness and feasibility.

Caulkins JP; Chandler S. Long-run trends in incarceration of drug offenders in the United States. Crime & Delinquency 52(4): 619-641, 2006. (87 refs.)

Estimates are developed for the number of people incarcerated in the United States for drug law violations between 1972 and 2002, broken down by type of institution (federal prison, state prison, or jail) and, to the extent possible, by nature of drug offense (possession or use, trafficking, or other). These time series are compared to trends in drug use indicators, revealing at best weak correlations, and the absolute levels are compared to different market indicators to draw various inferences. For example, even though about 480,000 people are incarcerated for drug law violations, on average retail sellers spend less than 2 hours behind bars per sale. Still, full-time sellers might expect to spend 3 months incarcerated per year of selling, suggesting that there are roughly four active drug sellers for every one who is incarcerated.

Chen V; Forster JL. The long-term effect of local policies to restrict retail sale of tobacco to youth. Nicotine & Tobacco Research 8(3): 371-377, 2006. (35 refs.)

Many adolescent smokers rely significantly on retail tobacco sources to initiate or maintain their smoking behavior. Though promising, the results from various interventions aimed at curtailing retail tobacco access have been mixed. In the present study, 14 communities were randomly assigned to intervention and control groups in an attempt to determine the long-term effect of local youth access laws and policies on adolescent smoking. The intervention continued for 32 months. Assessments were conducted at baseline (1991) and at years 3, 5, and 7. The intervention was based on a community-organizing approach that mobilized community members to support adoption and enforcement of local ordinances to restrict minors' access to commercial sources of tobacco. The major outcome measure for the study was cross-sectional prevalence of daily tobacco use among all students in grades 8, 9, and 10 in each community, measured by a self-administered student survey. A short-term significant intervention effect was observed and reported previously. That difference between intervention and control communities was maintained through the year 5 assessment but had dissipated by the year 7 assessment, very likely related to adoption of ordinances by control communities. Restricting commercial access to tobacco through local ordinances is effective in reducing adolescent smoking both immediately after the intervention (year 3) and 2 years later (year 5). Longer-term results are still inconclusive, because control communities adopted ordinances similar to those in the intervention communities.

Chen ZL; Huang KC. Drug problems in China - Recent trends, countermeasures and challenges. International Journal of Offender Therapy and Comparative Criminology 51(1): 98-109, 2007. (26 refs.)

Drug crime in China is on an overall rising trend. Major drug crime cases are becoming more common, the types of drugs being trafficked are more diverse, and the smuggling and trafficking of drugs into the country and the smuggling of precursor chemicals out of the country have formed a bidirectional cycle. Drug crimes in China have also begun to show a conspicuous trend of internationalization. China's main countermeasures against drug crimes have been to pass new laws and regulations against drugs, to increase the efforts to eradicate cultivation, to establish and expand "drug-free communities" programs, and to strengthen international cooperation in antidrug campaigns. The existing problems demand prompt solutions, which include a shortage of funding and lack of accurate knowledge about prevalence of drug abuse and related data for scientifically studying the drug problems.

Chua SM; Lee TS. Abuse of prescription buprenorphine, regulatory controls and the role of the primary physician. Annals of Medicine (Singapore) 35(7): 492-495, 2006. (16 refs.)

Introduction: Buprenorphine is an opioid partial agonist approved in several countries for the treatment of opioid dependence. It was approved in Singapore in 2002 for this indication, and is more widely available in the primary care setting and can be prescribed by all licensed physicians who have undergone designated training. There is limited literature addressing the risk of its illicit abuse via intravenous self-ad ministration. Clinical Picture: We report 2 such cases of the abuse of prescription buprenorphine in the psychiatric consultation-liaison service of a general teaching hospital, the treatment approaches and outcomes. Conclusion: We also briefly review the indications, uses and abuses of buprenorphine in Singapore, and as reported in other countries, and the roles of primary care physicians, in order to stimulate greater awareness and understanding among specialists and general practitioners, who would encounter these patients in various settings.

Cohen J; Csete J. As strong as the weakest pillar: Harm reduction, law enforcement and human rights - Response to Small. International Journal of Drug Policy 17(2): 101-103, 2006. (19 refs.)

Cohen PJ. Medical marijuana, compassionate use, and public policy: Expert opinion or Vox populi? Hastings Center Report 36(3): 19-22, 2006. (8 refs.)

This article focuses on the reason behind the need for the approval of medical marijuana by the U.S. Food & Drug Administration. The arguments for the exemption of medical marijuana from scientific evaluation are set forth as are the rationale behind the classification of medical marijuana as a drug rather than a botanical or herbal medication. Disorders that are treated by marijuana are discussed.

Cokkinides V; Bandi P; Ward E; Jemal A; Thun M. Progress and opportunities in tobacco control. CA (Cancer Journal for Clinicians) 56(3): 135-142, 2006. (59 refs.)

Much progress has been made in reducing tobacco use in the United States. Despite the continuing challenges of tobacco control and the massive burden of illness, death, and economic costs caused by tobacco products, there are now unprecedented opportunities to prevent and treat tobacco dependence through a combination of interventions that have proven effective at both the population and individual levels. This report briefly reviews population trends in tobacco use by youth and adults, describes some of the policy measures that have proven effective in comprehensive tobacco control, and discusses the role of clinicians in the diagnosis and treatment of tobacco dependence in patients.

Collins T. Symposium: From grand slams to grand juries. Performance-enhanicng drug use in sport. Changing the Game: The Congressional response to sports doping via the anabolic steroid control Act. New England Law Review 40: 753-763, 2006. (41 legal refs.)

This article focuses on the use of anabolic steroids and steroid precursors by sports competitors and how federal legislators have responded by subjecting possessors of steroid precursor products - which were openly sold in health food stores until January 2005 - to arrest and prosecution. In the mid 1980s, reports of increasing use of anabolic steroids in organized sports came to the attention of Congress. Between 1988 and 1990, congressional hearings were held to determine whether the Controlled Substances Act should be amended to include anabolic steroids. (Significantly, medical professionals and representatives of regulatory agencies (including the Food and Drug Administration, the Drug Enforcement Administration, and the National Institute on Drug Abuse) testified against the proposed amendment to the law. The majority of witnesses at the hearings, consistent with Congress's apparent main concern, focused on the purported need for legislative action to solve an athletic "cheating" problem. Congress consequently passed the Anabolic Steroid Control Act of 1990, criminalizing the possession of anabolic steroids without a valid prescription. The law placed steroids in the same legal class as barbiturates, ketamine, LSD precursors, and narcotic painkillers such as Vicodin, the only hormones in the schedules. The 1990 law only listed twenty-seven compounds, along with their muscle-promoting salts, esters, and isomers. However, there are in theory hundreds or even thousands of anabolic steroidal compounds - many of which might enhance athletic performance - which could be created in laboratories and offered for human use. By the early part of the current decade, some of these substances were being openly marketed as performance-enhancing dietary supplements. Called "pro-hormones" or in some cases "pro-steroids," these products were frequently metabolic precursors to testosterone or other listed anabolic steroids. The Anabolic Steroid Control Act of 2004 was passed to deal with this. The new law also changes the general requisite elements of an anabolic steroid. Ironically, there is no longer any requirement for evidence that an anabolic steroid is "anabolic," i.e., that it promotes muscle growth. The ramifications for the criminal justice system are outlined. The approach to combat steroid and steroid precursor use in competitive athletics has been two-fold: the imposition of administrative penalties by the sports agencies for those who test positive for the drugs, and the imposition of sanctions to criminalize those who possess them unlawfully, regardless of sports involvement. The focus in both instances is on the drugs or substances themselves. Neither approach is free of problems. Drug testing continues to be a game of cat-and-mouse as new performance-enhancing compounds and masking techniques emerge; catching up to the cheaters can take decades. Criminal laws and sanctions may be largely irrelevant to athletic steroid use, at least at commercialized levels, based upon the lack of enforcement efforts targeting competetive athletes to date. Steroid use in sports is not so much a drug crisis as an ethics crisis. If that is the true heart of the problem, we need to look beyond drug testing and new criminal laws. We need to ask the tough questions about what drives the "winning at all costs" attitude.

Cook DM; Bero LA. Identifying carcinogens: The tobacco industry and regulatory politics in the United States. International Journal of Health Services 36(4): 747-766, 2006. (94 refs.)

The process of identifying carcinogens for purposes of health and safety regulation has been contested internationally. The U.S. government produces a "Report on Carcinogens" every two years, which lists known and likely human carcinogenic substances. In the late 1990s the tobacco industry responded to the proposed listing of secondhand smoke with a multi-part strategy. Despite industry efforts to challenge both the substance of the report and the agency procedures, environmental tobacco smoke was declared by the agency in 2000 to be a known human carcinogen. A subsequent lawsuit, launched by chemical interests but linked to the tobacco industry, failed, but it produced a particular legal precedent of judicial review that is favorable to all regulated industries. The authors argue that, in this case, tobacco industry regulation contradicts academic expectations of business regulatory victories. However, the tobacco industry's participation in the regulatory process influenced the process in favor of all regulated industry.

Davis RM; Douglas CE; Beasley JK. The Tobacco Deposition and Trial Testimony Archive (DATTA) project: Origins, aims, and methods. Tobacco Control 15(Supplement 4): 4-8, 2006. (7 refs.)

Research on previously secret tobacco industry documents has grown substantially during the past decade, since these documents first became available as the result of private and governmental litigation and investigations by the US Congress and the US Food and Drug Administration. Complementary research on tobacco litigation testimony is now being conducted through the Tobacco Deposition and Trial Testimony Archive (DATTA) project. We obtained transcripts of depositions and trial testimony, deposition and trial exhibits, expert reports, and other litigation documents from law firms, court reporter firms, individual lawyers and witnesses, tobacco company websites, and other sources. As of 3 March 2006, the publicly available collection of DATTA (http://tobaccodocuments.org/datta) contained 4850 transcripts of depositions and trial testimony, including a total of about 820 000 transcript pages. Transcripts covered testimony from 1957 to 2005 (85% were for testimony from 1990 to 2005) given by more than 1500 witnesses in a total of 232 lawsuits. Twelve research teams were established to study the transcripts, with each team covering a particular topic (for example, the health consequences of tobacco use, addiction and pharmacology, tobacco advertising and promotion, tobacco-product design and manufacture, economic impact of tobacco use, youth initiation of tobacco use, and public understanding of the risks of tobacco use and exposure to second-hand smoke). The teams used qualitative research methods to analyse the documents, and their initial findings are published throughout this journal supplement.

Deverell M; Randolph C; Albers A; Hamilton W; Siegel M. Diffusion of local restaurant smoking regulations in Massachusetts: Identifying disparities in health protection for population subgroups. Journal of Public Health Management and Practice 12(3): 262-269, 2006. (27 refs.)

Objectives: The objectives of this study were to examine the diffusion of smoke-free restaurant regulations and identify socioeconomic and racial/ethnic disparities in health protection from secondhand smoke exposure in restaurants. Methods: We examined the relationship between adoption of local smoking regulations by restaurants for each of the 351 cities and towns in Massachusetts and a number of individual variables over nine time points, starting when there were no 100% smoke-free restaurant regulations and ending with the eventual imposition of the statewide ban on smoking in restaurants and bars. Results: We found that over the 10 years before the statewide ban went into effect, only 36 percent of the total population was covered by local regulations that protected them from secondhand smoke exposure in restaurants. We also observed a substantial disparity in protection based on educational status, with up to 7 percentage points fewer nongraduates protected by local smoke-free restaurant regulations.

Ebejer KA; Winn J; Carter JF; Sleeman R; Parker J; Korber F. The difference between drug money and a "lifetime's savings"'. Forensic Science International 167(2-3): 94-101, 2007. (18 refs.)

In many countries, monies suspected of being associated with drug trafficking can be seized by the authorities. One of the ways of investigating this association is through the analysis of seized banknotes for traces of controlled drugs. We report three studies which may assist the expert in assessing whether banknotes contaminated with diamorphine are part of the general population of notes in circulation or whether they show unusual contamination patterns which require explanation. Study 1 is based on three plausible contamination scenarios as they may occur during the various stages of an illicit drug transaction and seizure. It shows that notes which have been in direct contact with visible traces of diamorphine show significantly higher contamination to those in more indirect contact with the drug. Study 2 investigates the transfer of diamorphine from one highly contaminated note to other notes in a bundle over a period of 10 weeks with and without agitation. It was found that the total amount of drug transferred was smaller than 6% and no more than 4 out of a bundle of 10 previously clean notes became lightly contaminated. Based on extensive background data, study 3 proposes a probabilistic model to assess whether an observed proportion of diamorphine bearing banknotes is likely to have been contaminated by chance. The model predicts that there is only a 0.3% chance that a bundle of 100 notes from the general banknote population contains more than six contaminated specimens. Jointly, the three studies give useful indications for the spread of contamination throughout a sample and the amounts of heroin which may be expected given plausible contamination scenarios.

Evans E; Longshore D; Prendergast M; Urada D. Evaluation of the Substance Abuse and Crime Prevention Act: Client characteristics, treatment completion and re-offending three years after implementation. Journal of Psychoactive Drugs Supplement 3: 357-367, 2006. (15 refs.)

Representing a major shift in criminal justice policy, Proposition 36 became law in November 2000 as the Substance Abuse and Crime Prevention Act (SACPA), permitting eligible offenders to receive probation with drug treatment instead of probation or incarceration. UCLA's Integrated Substance Abuse Programs was chosen by the California Department of Alcohol and Drug Programs to conduct an independent evaluation of SACPA. Analysis of the first three years of data provides information on the flow of offenders through SACPA, client and program characteristics, treatment completion rates, and effects on re-offending. Results show that most eligible offenders chose to participate in SACPA; almost two-thirds of these went on to enter treatment. Compared to other treatment clients, SACPA treatment clients included fewer women, were predominately between 26 and 45 years old, were more likely to use methamphetamine, and had been using drugs longer. Most SACPA clients were referred to outpatient drug-free treatment regardless of primary drug problem, and about one-third completed treatment. Re-offending was lowest among SACPA offenders who completed treatment. Felony and misdemeanor drug arrests were higher among SACPA-era drug offenders than in a similar group of pre-SACPA drug offenders. Future reports will cover possible SACPA cost savings, additional clients outcomes, and overall lessons learned.

Feix J; Wolber G. Intoxication and settled insanity: A finding of not guilty by reason of insanity. Journal of the American Academy of Psychiatry and the Law 35(2): 172-182, 2007. (27 refs.)

This article presents a case of first-degree murder for which the defendant was acquitted as not guilty by reason of insanity, based on a defense involving the concept of "settled insanity." The literature on settled insanity is reviewed and discussed in the context of voluntary and involuntary intoxication. Statute and case law from those jurisdictions in which settled insanity is specifically allowed as an acceptable threshold condition for the insanity defense define the concept as a permanent condition resulting from substance abuse, rather than the effects of intoxication, no matter how severe. Also discussed are potential criteria for this defense, including evidence that psychotic symptoms thought to be responsible for the crime were, in some manner, separate and apart from symptoms caused solely by voluntary acute intoxication. Other factors that may assist evaluators in differentiating settled insanity from the effects of acute intoxication are presented. It is recommended that evaluators attempt to determine the timing of the onset of psychotic symptoms in relation to substance abuse, the persistence of such symptoms beyond detoxification, and whether ongoing psychiatric treatment is necessary to ameliorate the symptoms beyond intoxication. In the case described, psychotic symptoms persisted long after acute intoxication and beyond the time when drugs or alcohol were detected in the accused's body, requiring clinical intervention for psychosis. Also, before the crime, the defendant had exhibited significant psychological difficulty. The evaluating clinician must still determine, even when a threshold condition is considered to be present, whether statutory criteria for the insanity defense (for the jurisdiction in which the crime allegedly took place) are met.

Fell JC; Voas RB. The effectiveness of reducing illegal limits for driving: Evidence for blood alcohol concentration (BAC) lowering the limit to .05 BAC. Journal of Safety Research 37(3): 233-243, 2006. (52 refs.)

Purpose: This scientific review provides a summary of the evidence regarding the benefits of reducing the illegal blood alcohol concentration (BAC) limit for driving and providing a case for enacting a .05 BAC limit. Results: Fourteen independent studies in the United States indicate that lowering the illegal BAC limit from .10 to .08 has resulted in 5-16% reductions in alcohol-related crashes, fatalities, or injuries. However, the illegal limit is .05 BAC in numerous countries around the world. Several studies indicate that lowering the illegal per se limit from .08 to .05 BAC also reduces alcohol-related fatalities. Laboratory studies indicate that impairment in critical driving functions begins at low BACs and that most subjects are significantly impaired at .05 BAC. The relative risk of being involved in a fatal crash as a driver is 4 to 10 times greater for drivers with BACs between .05 and .07 compared to drivers with .00 BACs. Summary: There is strong evidence in the literature that lowering the BAC limit from .10 to .08 is effective, that lowering the BAC limit from .08 to .05 is effective, and that lowering the BAC limit for youth to .02 or lower is effective. These law changes serve as a general deterrent to drinking and driving and ultimately save lives. Impact on Industry: This critical review supports the adoption of lower illegal BAC limits for driving.

Fentiman LC. The new "fetal protection": The wrong answer to the crisis of inadequate health care for women and children. (review). Denver University Law Review 84(2): 537-599, 2006. (244 refs.)

In 1999, Regina McKnight, a homeless, mentally retarded woman who was pregnant and addicted to cocaine, was charged with murder when her child was stillborn. The South Carolina Supreme Court affirmed her murder conviction and upheld the twenty-year sentence imposed. In 2002, a severely mentally disabled woman became pregnant after being raped by the owner of the group home where she lived. The wife of a Florida prosecutor sought to be appointed "guardian of the fetus" in order to prevent the woman from taking prescription drugs necessary to maintain her physical health and mental stability and to prevent the woman from having an abortion. Ultimately, the Florida courts rejected these efforts. In 2004, Melissa Rowland, a pregnant woman with a long history of mental illness, sought assistance at a hospital because she noticed a decrease in fetal movements. Doctors recommended a Caesarean delivery, but Rowland declined, and the hospital offered no other help. When one of the twins she was carrying was stillborn, Rowland was charged with murder, with prosecutors asserting that she had acted with depraved indifference to the value of human life. In roughly two-thirds of the states, women who write advance directives to guide their medical care should they become incompetent may have their directives rendered unenforceable if they become pregnant.

Fernando D; Fowles J; Woodward A; Christophersen A; Dickson S; Hosking M et al. Legislation reduces exposure to second-hand tobacco smoke in New Zealand bars by about 90%. Tobacco Control 16(4): 235-238, 2007. (11 refs.)

Aim: To measure exposure to second-hand smoke (SHS) in New Zealand bars before and after comprehensive smoke-free legislation enacted on 10 December 2004. Methods: Cotinine is the main specific metabolite of nicotine and a well- established biomarker for SHS exposure. We measured cotinine levels in saliva of non-smoking volunteers before and after a 3 h visit to 30 randomly selected bars in 3 cities across the country. Two measures of cotinine before the smoke-free law change during winter and spring 2004, and two follow-up measurements in the same volunteers and venues during winter and spring 2005, were included. Results: Before the smoke-free law change, in all bars and in all volunteers, exposure to SHS was evident with an average increase in saliva cotinine of 0.66 ng/ml (SE 0.03 ng/ml). Increases in cotinine correlated strongly with the volunteers' subjective observation of ventilation, air quality and counts of lit cigarettes. However, even venues that were judged to be "seemingly smoke free'' with "good ventilation'' produced discernable levels of SHS exposure. After the law change, there remained some exposure to SHS, but at much lower levels (mean saliva cotinine increase of 0.08 ng/ml, SE 0.01 ng/ml). Smoking indoors in bars was almost totally eliminated: in 2005 only one lit cigarette was observed in 30 visits. Conclusions: Comprehensive smoke-free legislation in New Zealand seems to have reduced exposure of bar patrons to SHS by about 90%. Residual exposures to SHS in bars do not result from illicit smoking indoors.

Flores ML; Barnoya J; Mejia R; Alderete E; Perez-Stable EJ. Litigation in Argentina: Challenging the tobacco industry. Tobacco Control 15(2): 90-96, 2006. (53 refs.)

Objective: To evaluate the processes and outcomes of tobacco litigation in Argentina and to analyse the strategies of the tobacco industry to oppose litigation using tobacco industry documents. Methods: A systematic search of tobacco industry documents on the internet dating from 1978 to 2002. Law library searches using Argentinean official and unofficial reports systems were combined with computerised online searches. Results: There have been at least 15 failed litigation cases in Argentina and the tobacco industry presented a concerted defence in every claim regardless of cost. We categorised 11 cases as product liability and nicotine addiction, two as health care reimbursement, and two as criminal law and secondhand smoke. Industry strategies included hiring legal consultants from prestigious international and Argentinean law firms and developing litigation prevention programmes. Industry monitored legal academic meetings, controlled the development of new product liability legislation, obtained favourable opinions from experts, and closely observed the development of litigation in Argentina. Conclusion: The strategies used by the industry have been successful in preventing recovery for tobacco injuries through litigation. Argentinean health advocates and lawyers need to be aware of the roles and strategies of the tobacco industry in order to develop effective litigation in Argentina.

Fornili K; Burda-Cohee C. Buprenorphine products for the pharmacologic management of opioid addiction: Why shouldn't advanced practice nurses prescribe? (editorial). Journal of Addictions Nursing 17(2): 139-145, 2006. (22 refs.)

This paper describes the current legislative authority that permits office-based prescribing of buprenorphine products for the pharmacological treatment of opioid addiction by physicians with certain qualifications. It outlines ways prescribers can improve the quality of care, ensure safety, prevent diversion and abuse of the medications, and improve treatment outcomes. It advances the concept of enabling advanced practice nurses with prescriptive authority (nurse practitioners) to prescribe buprenorphine products for the treatment of opioid addiction, so as to improve access to this treatment and reduce the treatment capacity gap.

Foster D; Williams R; Campbell D; Davis V; Pepperill L. Researching ourselves back to life: New ways of conducting Aboriginal alcohol research. Drug and Alcohol Review 25(3): 213-217, 2006. (7 refs.)

This paper highlights the importance -- and provides an example -- of Aboriginal control over research. It describes how Aboriginal people from Tangentyere Council conducted a survey of the attitudes of people who reside in Town Camps to a trial of liquor licensing restrictions in Alice Springs; how the results of the survey were used; and how the project led to the establishment of a permanent 'Research Hub' within Tangentyere Council. The paper provides a model of conducting research for other Aboriginal community-controlled organisations and can inform non-Aboriginal researchers about ways of working with Aboriginal community organisations to address substance misuse and other health problems.

Friedman L; Daynard R. Scottish court dismisses a historic smoker's suit. Tobacco Control 16(5): article e4, 2007. (8 refs.)

The decision in a Scottish smoker's case, McTear v. Imperial Tobacco Limited, that there was no scientific proof of causation between the plaintiff's smoking and his death from lung cancer, accepted all of the traditional arguments that the tobacco industry has made throughout the history of tobacco litigation, including that epidemiology is not an adequate branch of science to draw a conclusion of causation, that the tobacco industry has no knowledge that its products are dangerous to consumers, and that, despite this lack of knowledge, the plaintiff had sufficient information to make an informed decision about the dangers of smoking. This case relied on outmoded methods of reasoning and placed too great a faith in the tobacco industry's timeworn argument that "everybody knew, nobody knows". Further, the judge found it prejudicial that the plaintiff's expert witnesses were not paid for their services because she was indigent, believing that the lack of payment placed in doubt their credibility and claiming that the paid tobacco expert witnesses had more motive to testify independently because they had been paid, a perverse and novel line of reasoning. The McTear case contrasts unfavourably with the recent decision in United States v. Philip Morris, a United States decision that found the tobacco industry defendants to be racketeers, based both on the weight of a huge amount of internal tobacco industry documents showing that the tobacco industry knew their products were addictive and were made that way purposely to increase sales, and on the testimony of expert witnesses who, like those who testified in McTear, have made the advancement of the public health their life's work and are not "hired guns". The McTear case's reasoning seems outdated and reminiscent of early litigation in the United States. Hopefully, it will not take courts outside of the United States 40 more years to acknowledge the current scientific knowledge about smoking and health.

Gallus S; Pacifici R; Colombo P; Scarpino V; Zuccaro P; Bosetti C et al. Prevalence of smoking and attitude towards smoking regulation in Italy, 2004. European Journal of Cancer Prevention 15(1): 77-81, 2006. (31 refs.)

Aims and background: To update trends in smoking prevalence in Italy to 2004, and describe the attitudes towards forthcoming regulation of smoking. Methods: Population-based face-to-face survey conducted in March-April 2004 on a sample of 3050 individuals (1509 men and 1541 women) aged 15 or over, representative of the general adult Italian population in terms of age, sex, geographic area, habitat, education and working status. Results: Overall, 26.2% of the Italians aged 15 or over described themselves as current cigarette smokers (30.0% of men, 22.5% of women); 19.1% of men and 11.2% of women smoked 15 or more cigarettes per day. Ex-smokers were 17.9% (24.8% of men, 11.2% of women). The difference in smoking prevalence between men and women was greater in the elderly. More educated men, and those residing in northern Italy were less frequently current smokers. Conversely, women with a low level of education (19%) were less frequently current smokers than those with higher education (24%). More than 85% of Italian adult population were in favour of restrictions of smoking in public places, such as cafes and restaurants, and to ban smoking in workplaces. Conclusions: Self-reported smoking prevalence is decreasing in men but not in females. There is widespread support for smoking restriction in public areas.

Gallus S; Zuccaro P; Colombo P; Apolone G; Pacifici R; Garattini S et al. Effects of new smoking regulations in Italy. Annals of Oncology 17(2): 346-347, 2006. (9 refs.)

Background: From 10 January 2005 the Italian government banned smoking in all indoor public places. We conducted a population-based survey to provide information on attitudes towards smoking regulation and to disentangle the impact of the smoking ban on tobacco consumption. Patients and methods: We considered data from a survey on smoking, based on 3114 subjects aged 15 or over, representative of the general adult Italian population in terms of age, sex, geographic area and socioeconomic status. Results: Once smoke-free policies were introduced, support for them in the public opinion tended to increase. In Italy, smoke-free policies accounted for around 8% decrease in cigarette consumption in the short run. Moreover, tobacco bans were almost universally accepted, and the smoke-free legislation did not seem to unfavourably affect the business of restaurants or cafes. Conclusions: The results of our study on the first extensive smoking ban in a large country show the advantages of smoke-free legislations, which may have major public health implications.

Garton AJ. Casenote: Constitutional Law - Commerce Clause - Regulation of intrastate cultivation of state-authorized medical marijuana is within Congress's commercee power. Cumberland Law Review 36: 179-192, 2006. (109 legal refs.)

Summary: Gonzales v. Raich recently addressed the extent of authority the federal government possesses to regulate intrastate cultivation of medical marijuana. In Raich, residents suffering from serious medical conditions used medical marijuana in accordance with California's Compassionate Use Act and thereafter claimed that the federal government violated the Commerce Clause when Drug Enforcement Administration (DEA) agents seized and destroyed a resident's personal cannabis crops. ... In the hope of resolving ensuing federal authority disputes, the Court considered whether the AAA's regulation of production and consumption of wheat exceeded Congress's commerce power. Although Filburn's local wheat consumption "may not be regarded as commerce," the Court held that "it may still . . . be reached by Congress if it exerts a substantial economic effect on interstate commerce. ... The Court's analysis revealed its stance that Filburn's consumption of homegrown wheat reduced his need to purchase wheat in the open market and therefore indirectly "competed with wheat in commerce. ... " Thus, the Morrison holding reiterated the finding in Lopez that the regulation of purely intrastate violence that does not directly affect the "instrumentalities, channels, or goods involved in interstate commerce" is, and should remain, solely within the province of the individual states. In anticipation of future challenges to this ruling by citizens fearing excessive federal authority, the Court in Raich acknowledged alternative avenues through which residents in need of medical marijuana may obtain relief. Most importantly, the Court emphasized the ultimate power of the democratic process through which the voting public may petition Congress to authorize the reclassification of marijuana in the CSA's schedule of controlled substances. 108 Thus, even in the face of America's ever-changing interpretation of federal versus states' rights, the Court maintains a steadfast conviction that the "voices of voters" will continue to "be heard in the halls of Congress."

Gelders D; Laenen FV. 'Mr Police Officer, I thought cannabis was legal' - Introducing new policy regarding cannabis in Belgium: A story of good intentions and Babel. Drugs: Education, Prevention and Policy 14(2): 103-116, 2007. (18 refs.)

Over the last five years, the announced new policy on drugs, cannabis in particular, has been the subject of much debate within the Belgian Federal Government and between the government and the opposition parties. Unclear policies and poor public communication from the Federal Government, the competent minister and the other parties caused immense confusion about whether and when the possession of cannabis would be legal and what the criteria would be for prosecution when found possessing cannabis. This confusion has been illustrated by a survey by Gelders and Van Mierlo (2004) Legalized or not? Poor public communication causes confusion over the new cannabis policy in Belgium. Drugs: Education, Prevention and Policy, 2, 167-177. Aims: (1) to present the most relevant policy developments specifically from the last two years, and (2) to determine whether there is still confusion and to assess the knowledge of young people about current prosecution practices. Methods: (1) an analysis of policy documents and legal texts, and (2) a more up-to-date survey among 748 Belgian youngsters. Findings: only 35.1% answered the basic-knowledge questions correctly while 59.2% assessed the prosecution practice in an appropriate manner. Conclusion: there is still a lot of confusion regarding the current cannabis legislation and prosecution.

Gilbertson T. Retail point-of-scale guardianship and juvenile tobacco purchases: Assessing the prevention capabilities of undergraduate college students. Journal of Drug Education 37(1): 1-30, 2007. (14 refs.)

This randomized experiment evaluates the attitudes and behavioral intentions of 458 undergraduate college students about intervening with the intent of preventing an illegal retail purchase of tobacco products by a minor after exposure to a factorial combination of three pieces of information. MANOVA results show that none of the treatment conditions, considered alone, are correlated with increased attitudes or behavioral intentions; however, there is a significant interaction effect on attitudes when information portraying a potentially annoying situation is combined with information about the costs associated with youth tobacco use. Post-hoc t tests suggest that this effect is concentrated among non-tobacco using respondents.

Glantz SA. Commentary: Assessing the effects of the Scottish smokefree law - the placebo effect and the importance of obtaining unbiased data. (editorial). International Journal of Epidemiology 36(1): 155-156, 2007. (12 refs.)

Goel RK; Nelson MA. The effectiveness of anti-smoking legislation: A review. Journal of Economic Surveys 20(3): 325-355, 2006. (103 refs.)

This survey focuses on government efforts to curb the use of undesirable goods, notably tobacco products. We synthesize the economics literature and examine the effectiveness of government curbs on tobacco consumption through non-price controls (such as bans on cigarette advertising, health warnings, and workplace smoking bans) and price measures (or higher prices through higher taxes). This literature review is unique in that we do not merely aim to provide a summary of the literature. Rather, our main focus is to draw conclusions from the literature regarding the effectiveness of alternate policy measures across countries in checking smoking and to provide directions/suggestions for extending the scope of government intervention to other tobacco products.

Haagen PH. Symposium: From grand slams to grand juries. Performance-enhanicng drug use in sport. The players have lost that argument: Doping, drug testing, and collective bargaining. New England Law Review 40(831-849), 2006. (95 legal refs.)

This article addresses the use of performance-enhancing drugs in professional sports, and legal efforts to address doping is professional sports which can have an impact for collective bargaining in the US. This article describes several legislative efforts to address the issue. In one hearing it was made clear that Congress now regarded performance-enhancing drugs in sports as a "transcendent issue." In the face of such transcendence, a matter affecting the terms of conditions of work, drug testing, and thus a mandatory subject of collective bargaining, would not be permitted to go through the normal process of collective bargaining. The Union was informed that its obligation to protect all of its members did not extend to "cheaters." Comprehensive drug testing, including out of competition, random, unannounced testing was characterized as "not about privacy." Among the topics considered is the perceived need to control doping, and the response in Olympic and professional sports. The issue of whether drug testing works is also considered as well as the nature of penalties and due process.

Harmon AR. Methamphetamine Remediation Research Act of 2005: Just what the doctor ordered for cleaning up methfields -- or sugar pill placebo? North Carolina Journal of Law & Technology 7(Spring): 421-485, 2006. (296 legal refs.)

Methamphetamine labs can be set up anywhere. One batch of methamphetamine produces five to seven pounds of toxic byproduct. These contaminants are often dumped at the production site and, along with airborne contaminants from the cooking process, leave behind a "methfield." States have developed widely divergent standards for methfield remediation. This Comment examines the solution proposed under the Methamphetamine Remediation Research Act of 2005 ("MRRA"). Part II provides some background on methamphetamine use, production, and cleanup. Part III reviews how methfields have been addressed by state and federal agencies. Part IV evaluates the MRRA and assesses its potential contributions to the methfield remediation movement. Parts V and VI critique the MRRA, identifying potential weaknesses and outlining opportunities for improvement.

Harris LS. Exempt preparations: Historical perspectives. Drug and Alcohol Dependence 83(Supplement 1): s48-s51, 2006. (27 refs.)

This article is part of a supplemental issue of the journal devoted entirely to papers on how abuse liability of medications is affected by their formulation for medical use. This article reviews the history of the development of the concept of "exempt preparations" from its first use internationally to its current use, both nationally and internationally. The role of the WHO Expert Committee on Drug Dependence (ECDD) and the College on Problems of Drug Dependence (CDPP) is presented. Examples of exempt preparations are given and the use of the concept to permit useful therapeutic agents to be marketed with reduced regulatory control is discussed.

Hartley RD; Maddan S; Spohn CC. Prosecutorial discretion: An examination of substantial assistance departures in federal crack-cocaine and powder-cocaine cases. Justice Quarterly 24(3): 382-407, 2007. (64 refs.)

Recently there has been a call for research that explores decision-making at stages prior to sentencing in the criminal justice process. Particularly research is needed under a determinate sentencing system where judicial dispositions are usually restricted by guidelines, which increases the importance of earlier decision-making stages. As an answer to this call, and in an attempt to build on currents studies on the effects of departures as an intervening mechanism, and a source of unwarranted disparity, this study explores federal sentencing data on offenders convicted of crack-cocaine and powder-cocaine offenses. Although decision-making of all criminal justice actors generally, and prosecutors specifically, has been the subject of much research, studies have yet to resolve the nature and outcome of their "autonomous" discretion. This autonomy becomes especially salient regarding prosecutorial decisions for substantial assistance departures. In deciding who receives a substantial assistance departure, the prosecutor has carte blanche power.

Haw SJ; Gruer L; Amos A; Currie C; Fischbacher C. Fong GT et al. Legislation on smoking in enclosed public places in Scotland: How will we evaluate the impact? Journal of Public Health 28(1): 24-30, 2006. (26 refs.)

Background: From 26 March 2006, smoking will be prohibited in wholly and substantially enclosed public places in Scotland, and it will be an offence to permit smoking or to smoke in no-smoking premises. We anticipate that implementation of the smoke-free legislation will result in significant health gains associated with reductions in exposure to both environmental tobacco smoke (ETS) and personal tobacco consumption as well as other social and economic impacts. Methods: Health Scotland in conjunction with the Information Services Division (ISD) Scotland and the Scottish Executive have developed a comprehensive evaluation strategy to assess the expected short-term, intermediate and long-term outcomes. Using routine health, behavioural and economic data and commissioned research, we will assess the impact of the smoke-free legislation in eight key outcome areas - knowledge and attitudes, ETS exposure, compliance, culture, smoking prevalence and tobacco consumption, tobacco-related morbidity and mortality, economic impacts on the hospitality sector and health inequalities. Conclusion: The findings from this evaluation will make a significant contribution to the international understanding of the health effects of exposure to ETS and the broader social, cultural and economic impacts of smoke-free legislation.

Hedlund J; Shults RA; Compton R. Graduated driver licensing and teenage driver research in 2006. (review). Journal of Safety Research 37(2): 107-121, 2006. (106 refs.)

This is the third update of research on graduated driver licensing (GDL) and related teenage driver issues. It briefly summarizes research published since or not included in the 2005 update (Hedlund, J., & Compton, R. (2005). Graduated driver licensing research in 2004 and 2005. Journal of Safety Research, 36(2), 109-119.), describes research in progress of which the authors are aware, and announces plans for a symposium on teenage driving and GDL to be held in February 2007.

Henningfield J; Stolerman I; Miczek K. Nicotine psychopharmacology research: Advancing science, public health, and global policy. (editorial). Psychopharmacology 184(3-4): 263-265, 2006. (28 refs.)

Henningfield JE; Zeller M. Nicotine psychopharmacology research contributions to United States and global tobacco regulation: A look back and a look forward. (editorial). Psychopharmacology 184(3-4): 286-291, 2006. (79 refs.)

Nicotine has a long and storied history in physiology and pharmacology. Historically, it has been used as a tool to explore the nervous system, studied for its role in tobacco use, and more recently examined for its diverse potential medicinal uses. Psychopharmacology research has been pivotal in the science foundation for nicotine and tobacco product regulation.

Hernandez-Avila JE; Tirado-Ramirez E; Santos-Luna R; Reynales-Shigematsu LM. Use of Geographical Information Systems for billboards and points-of-sale surveillance in two Mexico cities. Salud Publica de Mexico 49(Supplement 2): S241-S246, 2007. (10 refs.)

Objective. To assess the degree of compliance with current legislation using Geographic Information Systems. Material and Methods. Schools and billboards advertising tobacco were geo-referenced and the distance to schools were measured. Students' access to purchasing tobacco products was observed. Results. In Cuernavaca, billboards were found within 250 meter from schools and students had access to buying cigarettes. In Culiacan, students were less exposed to tobacco advertising. Conclusions. Geographic Information Systems were useful for studying compliance with the law and could also be useful for its continuous monitoring and for suggesting changes for diminishing tobacco advertising exposure. This exposure and the ease of access to purchasing cigarettes could explain the higher prevalence of active smokers among students in Cuernavaca. This suggests that current legislation is still not enough enforced for diminishing Mexican adolescents' exposure to tobacco advertising and products.

Higuchi S; Matsushita S; Osaki Y. Drinking practices, alcohol policy and prevention programmes in Japan. International Journal of Drug Policy 17(4, Special Issue): 358-366, 2006. (38 refs.)

The purpose of this article is to outline alcohol consumption patterns and related problems, alcohol control policy and prevention programmes in Japan, which are not well-known in other countries. In Japan, per capita alcohol consumption is no longer increasing and has even started to decrease. At the same time, diversification of drinking populations has made a rapid progress. For the last several decades, alcohol consumption in non-traditional drinking populations, such as women and young people, has been on a steep rise. Consequently, in addition to traditional drinking problems observed among adult males, the magnitude of problems among these non-traditional populations has expanded. Alcohol policy and prevention programmes, however, have not developed to adequately control these problems. Availability of alcoholic beverages, including to underage populations, remains very high. Legislation related to alcohol control has not been well enforced, with the exception of the Road Traffic Law. Tax systems on alcoholic beverages are not relevant to the suppression of alcohol consumption. Moreover, there are virtually no restrictions on advertising or sponsorship and no provisions concerning an alcohol-free environment. Prevention programmes and activities to reduce harm from drinking have been carried out, especially for underage drinking, but they are insufficient to tackle the existing problems. Comprehensive discussions on alcohol policy and implementation of effective prevention programmes with participation of all sectors concerned are necessary, in parallel with actions taken by the WHO and other organisations.

Hoffman FA. The impact of pressure on drug treatment for addicted foreigners facing deportation in Germany. Journal of Ethnicity in Substance Abuse 5(1): 23-38, 2006

Qualitative findings from interviews with addictions professionals at long-term residential treatment centers are presented in an exploration of the mutual effects of alternative measures to treatment under the Narcotics Act and residence-terminating measures under the Foreigners Act on drug-treatment access and quality for addicted foreigners facing drug-related charges in Germany. Results indicate that pressure associated with contradictory drug and migration policies led to reduced access to treatment but not necessarily quality of treatment. Treatment motivation and pressures associated with the uncertainty and threats of deportation as well as inconsistent application of drug and migration laws are discussed along with recommendations for future research.

Holder HD. Alcohol and the Community: A Systems Approach to Prevention. Cambridge: Cambridge University Press, 2006

An individual's decision to use alcohol and the frequency, quantity and situation in which drinking takes place are the result of a combination of biological and social factors. Drinking is not only a personal choice, but also a matter of custom and social behaviour, and is influenced by access and economic factors including levels of disposable income and cost of alcoholic beverages. Until prevention efforts cease to focus narrowly on the individual and begin to adopt broader community perspectives on alcohol problems and strategies to reduce them, these efforts will fail. The author challenges the current implicit models used in alcohol problem prevention and demonstrates an ecological perspective of the community as a complex adaptive system composed of interacting subsystems, an appreciation and understanding of which offers a new approach to the prevention of alcohol dependence and alcohol-related problems. The book is organized into 8 chapters. following an introduction, the author begins the discussion a discussion of the patterns of consumption and influences on consumption patterns. Attention then turns to what are considered different subsystems influencing consumption, each a subject of an individual chapter. These include retail sales, and the role of alcohol availability and promotion; formal regulations, including rules, their administration and enforcement; social norms, and community values that influence drinking patterns; legal sanction that are involved in the prohbition of drinking; and the social/economic/health consequences as they are recognized by the community. The concluding chapter addresses the need for and community level approaches to alcohol problems.

Hooker C; Chapman S. Structural elements in achieving legislative tobacco control in NSW, 1955-95: Political reflections and implications. Autstralian and New Zealand Journal of Public Health 30(1): 10-15, 2006. (33 refs.)

Objective: To analyse structural factors revealed by politicians that shaped legislation on tobacco control in New South Wales, 1955-95. Methods: Parliamentary debates and other records were collected. Open-ended interviews were conducted with 17 Members of Parliament (MPs) who were significantly involved, and then analysed for structural elements. Results: Tobacco industry lobbying had a significant but limited influence on policy making, being exerted largely through social interactions with executives and based on concerns about the economic impact on third parties. MPs saw health advocates' chief functions as (1) generating community concern about the issue and support for control measures, and (2) bringing any new information to political attention, providing pro-control arguments and data through the media. Factors that delayed tobacco control policies included: the conservative stance of Premiers and major parties, commitments to unanimous federal action, and rivalry between parties. Factors that facilitated control policies included: reforms that gave the Legislative Council increased power, the use of parliamentary committees, and backbencher and grass roots support. Conclusions: Tobacco control policy and legislation has been the product of political structures that gave power to those MPs in the least powerful positions - minor parties, Members of the Legislative Council (MLCs), backbenchers, women and party rank and file - rather than to major parties and their executives. Implications: Advocates should make the most of their access points to the political process, providing information, arguments and support and demonstrating public opinion in favour of further control.

Horlings E; Scoggins A. An Ex Ante Assessment of the Economic Impacts of Economic Impacts of EU Alcohol Policies. Technical Report. Leiden, The Netherlans: RAND Corporation, 2006. (69 refs.)

This report was commissioned by the European Commission, as one of the background papers preparatory to creating a comprehensive alcohol policy for the European Union. This paper deals with an assessment of the current macroeconomic impacts of alcohol use and likely impacts of various policy options. It begins with an examination of the nature and extent of the problems posed by alcohol use. It then reviews how alcohol use is linked in macroeconomic development. The results of that analysis are used to review four policy options. The report concludes with a chapter that examines economic indicators that could be used to evaluate specific policy objectives. The report then draws conclusions and provides recommendations. For each of six policy objectives (related to drink driving, under-age drinking, hazardous and harmful drinking, families & children, violence, and economic development) each of multiple approaches are rated on a scale from 1-4 in terms of effectiveness. The same goals and means are then assessed in terms of cost-effectiveness. The report examines multiple themes in an elegant and useful fashion. There are 28 tables and 21 figures.

Houck LK. The Drug Enforcement Administration's final rule on theft and significant loss reporting: We can see more clearly now. Food and Drug Law Journal 61: 1-11, 2006. (73 legal refs.)

Summary: The pharmacist in charge of Kilgoban Pharmacy is conducting a routine inventory. To comply with federal requirements, the hypothetical pharmacist must understand DEA's rule on controlled substance theft and significant loss reporting. DEA regulations require registrants to notify the DEA field division office in their area of the "theft or significant loss of controlled substances upon discovery." This two-step notification and reporting procedure seemed simple enough when Bureau of Narcotics and Dangerous Drugs (BNDD), now DEA, promulgated the regulation in 1971. DEA regulations now require registrants to notify the DEA field division office in their area in writing of any theft or significant loss of any controlled substance within one business day of discovery. DEA addresses this issue in the final rule when, in responding to a commenter's suggestion that registrants submit a DEA-106 within thirty days of discovery, states that registrants should submit a DEA-106 "once the circumstances surrounding the theft or significant loss are clear. Part II describes the DEA regulatory scheme. Part III provides the history of DEA's reporting requirement. Part IV sets for DEA requirements. Part V describes DEA actions in response to theft and loss reporting violations, and Part VI outlines the DEA's theft or loss rule.

Jalleh G; Donovan RJ; Stewart S; Sullivan D. Is there public support for banning smoking in motor vehicles? (letter). Tobacco Control 15(1): 71-71, 2006. (10 refs.)

Johnston JB. Drugs, Dogs, and the Fourth Amendment: An Analysis of Justice Stevens' Opinion in Illinois v. Caballes. Bridgeport Law Review/Quinnipiac Law Review 24: 659-680, 2006. (166 legal refs.)

Summary: When a drug dealer delivers illegal narcotics to the American market place, he or she frequently uses our nation's roadways. ... In an opinion, authored by Justice John Paul Stevens, the Court held that Caballes did not have a reasonable expectation of privacy in transporting the discovered marijuana that was detected by the drug sniffing dog. ... While transporting narcotics can be a relatively simple task, there is a huge amount of risk should the drug trafficker get caught while engaged in his or her craft. ... If Trooper Gillette stopped Caballes unlawfully, there would have been no question as to the Court suppressing the seizure of the marijuana and reversing the conviction. ... In a matter of minutes, the Troopers were able to confirm the presence of illegal narcotics in Caballes' car thanks to the drug sniffing dog. ... For this reason, the Court found that a law enforcement investigation, like the one conducted by Trooper Gillette which does not infringe upon one's "legitimate interest in privacy," does not constitute a search pursuant to the Fourth Amendment of the United States Constitution. ... The fact of the matter is that the missteps of the past should not stop the law enforcement profession from seeking fair and effective ways to apprehend those who use America's roadways to benefit from the illegal drug trade. ... Throughout this article, the author arguesthat the long-term goals of the Fourth Amendment are two-fold. First, the most well known objective of Fourth Amendment jurisprudence is that it protects individuals from unreasonable searches and seizures by the police. Second, the United States Supreme Court generally interprets the Fourth Amendment as allowing law enforcement to lawfully apprehend the criminal element without placing unreasonable constraints in their path. Justice Stevens' opinion in Caballes provides a perfect example of the dual role of the Fourth Amendment. This article provides an analysis of Caballes and its implications for both law enforcement and the motoring public. It further examines the use of drug sniffing dogs as a tool to uncover drug trafficking strategies that involve the use of our country's roads. In addition, this article offers an in-depth review of the Court's implementation of Fourth Amendment jurisprudence in prior search and seizure cases and their effect on Justice Stevens' opinion in Caballes. Prior to commencing our discussion of Caballes, however, some background information is necessary to better understand the tensions that exist between drugs, drug sniffing police dogs, and our constitutional rights. More specifically, this information will provide background information on the tension that exists between law enforcement's duty to protect the public from drug traffickers, and its obligation to protect the public from losing its civil liberties.

Jones AS; Austin WD; Beach RH; Altman DG. Funding of North Carolina tobacco control programs through the master settlement agreement. (editorial). American Journal of Public Health 97(1): 36-44, 2007. (46 refs.)

Changing political and economic forces in 1 tobacco-dependent state, North Carolina, demonstrate how the interplay between these forces and public health priorities has shaped current allocation of Master Settlement Agreement funds. Allocation patterns demonstrate lawmakers' changing priorities in response to changes in the economic climate; some of the agreement's funds targeted to tobacco farmers appear to reflect objectives favored by tobacco manufacturers. Funds earmarked for health have underfunded youth tobacco prevention and tobacco control initiatives, and spending for tobacco farmers in North Carolina has not lived up to the rhetoric that accompanied the original agreement. We discuss the implications of these findings for future partnerships between public health advocates and workers as well as tobacco control strategies.

Julyan TE. Exempting mental health units from smoke-free laws: Nicotine can have beneficial effects. (letter). British Medical Journal 333(7567): 551-551, 2006. (2 refs.)

Kim PT. Collective and individual approaches to protecting employee privacy: The experience with workplace drug testing. Louisiana Law Review 66(Summer): 1008 - 1034, 2006. (78 legal refs.)

The latter half of the twentieth century saw a marked shift in the form of legal regulation of the workplace. At mid-century, unions were at the height of their power in terms of membership and bargaining strength. The dominant legal model for governing workplace relations was the one put into place by the Wagner Act in 1935, a model promoting collective bargaining. Since then, however, union strength has steadily eroded, and with it, collectively bargained agreements as a source of rights for workers. Paralleling this decline has been the growth of government mandates creating rights in the individual worker. This shift-from collective bargaining to individual employee rights as the primary source of legal regulation-has been both applauded and decried by observers and legal scholars. This Comment asks what difference it makes to think about workers' rights under a collective as opposed to an individual rights model in a particular context: that of protecting employee privacy. More specifically, it undertakes an examination of the range of disputes between employers and employees over workplace drug testing in the late 1980's and the 1990's, focusing on the differences between cases brought with union involvement and those brought by individual workers acting alone. In doing so, it asks how collective forms of disputing about drug testing differed from individual approaches, and whether these differences affected the ability of workers to assert and protect their interests in personal privacy. The purpose of this Comment is not to argue for or against the legality of drug testing, but rather to understand how collective approaches to contesting employer policies looked different from individual rights based claims.

Kleinig J. Thinking ethically about needle and syringe programs. Substance Use & Misuse 41(6/7): 815-825, 2006. (22 refs.)

Accepting-for the sake of argument-our current legal policies concerning heroin use and its users, what ethical questions are raised for needle and syringe program (NSPs)? Do they weaken drug laws, send the wrong message or obscure the right message, do little to eliminate the harm of drugs, detract from alternatives, and/or constitute a counsel of despair? I suggest that in the absence of established better alternatives, NSPs constitute a morally acceptable and in some cases even desirable option despite the continued criminalization of injecting drug use. Yet they must be conceived and administered in ways that do not reinforce prevailing social prejudices.

Koppelman A. Symposium. The first century. Drug policy and the liberal self. Northwestern University Law Review 100: 279-293, 2006. (69 legal refs.)

Summary. John Stuart Mill famously wrote that "the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant." The principle is very widely believed; yet our practices are inconsistent with the principle, and very few people are troubled by this. Common sense seems to dictate that we ought not to completely legalize heroin, or gambling, or prostitution, or gladiatorial fights to the death. The challenge is in finding the limits to societal intrusion and articulating a rationale. Several approaches to this are considered.

Kotani K; Osaki Y; Kurozawa Y; Kishimoto T. Insufficient smoking restrictions in restaurants around junior high schools in Japan. Tohoku Journal of Experimental Medicine 210(4): 349-353, 2006. (20 refs.)

Controls for second hand smoke (SHS) and adolescent smoking have been still sociomedical concerns in Japan. Restaurant smoking restrictions are associated with community social norms affecting adolescent smoking behavior, and the status in areas around Junior high schools (JHSs) in the community could be a sign of community practices on regulating SHS for adolescents. To examine whether restaurant smoking restrictions are seen especially in areas around JHSs in Japan, a survey using the direct inspection of a total of 16.3 restaurants (64 restaurants within and 99 outside a 1-km radius from the nearest JHSs) was conducted in May 2003 in Yonago city, Japan. We assessed smoking restriction status in each restaurant and classified them into 2 groups according to the distance from the nearest JHSs. There were only 2 (3.1%) restaurants with 100% nonsmoking and 11 (17.2%) with some partial restrictions among the restaurants within a 1-km radius of JHSs. There were 1 (1.0%) restaurant with 100% non-smoking, 3 (3.0%) with complete non-smoking sections and 17 (17.2%) with some partial restrictions among the restaurants outside a 1-km radius of JHSs. Among restaurants with some partial restrictions, restriction methods were considered insufficient. The smoking restriction status was not significantly different between the restaurant groups within and outside a 1-km radius of JHSs. These results suggest that the public awareness of and attitude toward adolescent smoking problems remains low in Japan. Further SHS control actions for adolescents are needed in Japan.

Kouvonen P; Skretting A; Rosenqvist P, eds. Drugs in the Nordic and Baltic Countries: Common Concerns, Different Realities. NAD Monograph no. 48. Helsinki, Finland: Nordic Alcohol and Drug Council, 2006. (Chapter refs.)

At a meeting in September 2003, ministers for narcotic drug policy issues from Denmark, Finland, Iceland, Norway, Sweden; from the three autonomous territories of the Faroe Islands, Greenland and �land; and from Estonia, Latvia and Lithuania expressed their concern about the escalating drug problem. They issued a letter of intent which laid down common political objectives and priorities for a long-term partnership between the Nordic and Baltic countries on narcotic drug policy issues. In this document, drug abuse and drug trafficking are identified as international problems that require international solutions. The aim is to establish a political partnership between the Nordic and Baltic countries in order to counter the problems of drug abuse and trafficking by means of subregional and regional international cooperation and by coordinated national efforts to prevent and reduce the supply and demand of illicit drugs, based on a restrictive and humanistic policy in line with UN conventions. The needs for cooperation and collaboration were highlighted in eight areas, ranging from supporting mutual knowledge and data collection to specified actions within primary prevention, law enforcement as well as treatment and rehabilitation. It was emphasised that in order to be effective, the policy must be characterised by a multidisciplinary three-pillar approach that encompasses prevention, law enforcement and treatment. This report aims to meet the above request. It describes the latest developments in drug experimenting, drug abuse and the consequences of abuse in the region consisting of the Nordic countries, the Baltic states and the St. Petersburg area, as well as the measures being taken to counteract abuse or its consequences. The report is organized into seven chapters. Following a summary chapter outlining the main findings, there is discussion of chapters that outline the prevalence and patterns of drug use; the consequences of drug use; treatment and harm reduction measures; drug use in prison; drug supply and seizures; the priorities and developments in prevention; and current national policies.

Kozelj M; Kobilica N; Flis V. Infected femoral pseudoaneurysms from intravenous drug abuse in young adults. Wiener Klinische Wochenschrift 118(9/10 (Supplement 2)): 71-75, 2006. (17 refs.)

Intravenous or parenteral drug abuse is the most common cause of infected femoral artery pseudoaneurysms (IFAP). This complication of intravenous drug abuse is not only limb threatening but can also be life threatening. The management of IFAP is difficult and controversial. Generally speaking, ligation and excision of the pseudoaneurysm without revascularization is accepted procedure in the majority of patients, with acceptable morbidity and low rate of limb loss. However, it is not an appropriate procedure for cases of acute interruption of the femoral artery flow, where a high probability of amputation is expected. We present four cases of young patients (average 19.5 years, range 17-24) with IFAP, where primary reconstruction was performed due to the absence of a Doppler signal over the pedal arteries after ligation of the common femoral artery. In two cases complications in the form of hemorrhage and repeated infection developed in the late postoperative period; in one case excision and ligation was performed, and in the last case reconstruction with a silver-impregnated dacron prosthesis. None of the patients required an amputation. Overall prognosis is uncertain because of the high incidence of postoperative drug injection despite aggressive drug rehabilitation.

Leavell NR; Muggli ME; Hurt RD; Repace J. Public health - Blowing smoke: British American Tobacco's air filtration scheme. British Medical Journal 332(7535): 227-229, 2006. (43 refs.)

As Westminster MPs prepare for a free vote on a complete smoking ban in public places, researchers question the efficacy of a technique meant to clear the air of tobacco smoke -- heavily promoted by tobacco companies as an alternative to legislation.

Leong GB; Leisenring SE; Dean MD. Commentary: Intoxication and settled insanity - Unsettled matters. (editorial). Journal of the American Academy of Psychiatry and the Law 35(2): 183-187, 2007. (10 refs.)

The role of exogenous substances in the genesis of mental symptoms has found relevance in some jurisdictions when a defense of settled insanity is raised. However, the current nosology and knowledge base reveal ambiguity and unresolved questions about the present science related to settled insanity.

Leukefeld CG; Staton M; Webster JM; McDonald HS. Treatment of persons under legal restrictions. IN: Strain EC; Stitzer ML, eds. The Treatment of Opioid Dependence. Baltimore: Johns Hopkins University Press, 2006. pp. 485-496. (49 refs.)

This chapter begins by an examining the association between drugs and crime. It also considers new models of drug abuse treatment provided in criminal justice systems, including jails and prisons. Diversion programs the combine treatment and sanctions and use community treatment are also described. A major theme is that patients in treatment due to legal pressures, while potentially viewed as a special population, in fact to not differ from non-criminal-justice-involved patients either in terms of psychosocial characteristics or demographic characteristics. Historically the criminal justice system has advocated drug-free programs for its referrals, and effectively precluded drug-substitution therapy. The rationale for this is discussed and current referral patterns are discussed along with trends in the criminal justice system referral mechanisms and practices.

Libby RT. Treating doctors as drug dealers: The Drug Enforcement Administration's war on prescription painkillers. Independent Review 10(4): 511-547, 2006. (101 refs.)

The article discusses the causes of medical undertreatment in the United States. One cause mentioned is that few doctors specialize in pain management, therefore, only few patients receive the appropriate treatment for chronic pain. Another is that a lot of physicians are being sued either for overprescribing or underprescribing painkiller drugs, as a result only few of these doctors are left to take the risks. There are many doctors prosecuted for prescribing painkillers as part of the government's effort to control narcotic drugs. The much publicized lawsuits against these doctors also contributed to the problem.

Looby A; Earleywine M; Gieringer D. Roadside sobriety tests and attitudes toward a regulated cannabis market. Harm Reduction Journal 4(article 4), 2007. (13 refs.)

Background: Many argue that prohibition creates more troubles than alternative policies, but fewer than half of American voters support a taxed and regulated market for cannabis. Some oppose a regulated market because of concerns about driving after smoking cannabis. Although a roadside sobriety test for impairment exists, few voters know about it. The widespread use of a roadside sobriety test that could detect recent cannabis use might lead some voters who currently oppose a regulated market to support it. In contrast, a question that primes respondents about the potential for driving after cannabis use might lead respondents to be less likely to support a regulated market. Methods: Phone interviews with a national sample of 1002 registered voters asked about support for a regulated cannabis market and support for such a market if a reliable roadside sobriety test were widely available. Results: In this sample of registered voters, 36% supported a regulated cannabis market. Exploratory chi-square tests revealed significantly higher support among men and Caucasians but no link to age or education. These demographic variables covaried significantly. Logistic regression revealed that gender, ethnicity, and political party were significant when all predictors were included. Support increased significantly with a reliable roadside sobriety test to 44%, but some respondents who had agreed to the regulated market no longer agreed when the sobriety test was mentioned. Logistic regression revealed that ethnicity and political affiliation were again significant predictors of support with a reliable sobriety test, but gender was no longer significant. None of these demographic variables could identify who would change their votes in response to the reliable roadside test. Conclusions: Increased awareness and use of roadside sobriety tests that detect recent cannabis use could increase support for a regulated cannabis market. Identifying concerns of voters who are not Caucasian or Democrats could help alter cannabis policy.

Luk R; Ferrence R; Gmel G. The economic impact of a smoke-free bylaw on restaurant and bar sales in Ottawa, Canada. Addiction 101(5): 738-745, 2006. (18 refs.)

Aims: On 1 August 2001, the City of Ottawa (Canada's Capital) implemented a smoke-free bylaw that completely prohibited smoking in work-places and public places, including restaurants and bars, with no exemption for separately ventilated smoking rooms. This paper evaluates the effects of this bylaw on restaurant and bar sales. Data and measures: We used retail sales tax data from March 1998 to June 2002 to construct two outcome measures: the ratio of licensed restaurant and bar sales to total retail sales and the ratio of unlicensed restaurant sales to total retail sales. Restaurant and bar sales were subtracted from total retail sales in the denominator of these measures. Design and analysis We employed an interrupted time-series design. Autoregressive integrated moving average (ARIMA) intervention analysis was used to test for three possible impacts that the bylaw might have on the sales of restaurants and bars. We repeated the analysis using regression with autoregressive moving average (ARMA) errors method to triangulate our results. Findings: Outcome measures showed declining trends at baseline before the bylaw went into effect. Results from ARIMA intervention and regression analyses did not support the hypotheses that the smoke-free bylaw had an impact that resulted in (1) abrupt permanent, (2) gradual permanent or (3) abrupt temporary changes in restaurant and bar sales. Conclusions: While a large body of research has found no significant adverse impact of smoke-free legislation on restaurant and bar sales in the United States, Australia and elsewhere, our study confirms these results in a northern region with a bilingual population, which has important implications for impending policy in Europe and other areas.

Mack AH; Lightdale HA. Forensic addiction psychiatry for the clinician, the expert, and the in-between. Addictive Disorders and their Treatment 5(2): 77-86, 2006. (49 refs.)

INTRODUCTION: Substances of abuse are commonly associated with legal issues. Both addiction psychiatrists and general psychiatrists may encounter the nexus of substances, the law, and clinical acumen. MATERIALS AND METHODS: This review addresses some generalized and some specific areas of intersection, with a focus on the role of the psychiatrist. RESULTS: We cover basics of the American legal system; the relationship between interpersonal violence and substances; and areas of criminal, civil, and administrative law in which substance use may be a factor. Finally, the review provides an overview of addiction issues in correctional psychiatry and some of the legal processes currently used to leverage treatment in jurisdictions around the nation. CONCLUSIONS: The interplay between legal issues and substances is significant and will continue to evolve in the future.

Martinez AN; Bluthenthal RN; Lorvick J; Anderson R; Flynn N; Kral AH. The impact of legalizing syringe exchange programs on arrests among injection drug users in California. Journal of Urban Health 84(3): 423-435, 2007. (41 refs.)

Legislation passed in 2000 allowed syringe exchange programs (SEPs) in California to operate legally if local jurisdictions declare a local HIV public health emergency. Nonetheless, even in locales where SEPs are legal, the possession of drug paraphernalia, including syringes, remained illegal. The objective of this paper is to examine the association between the legal status of SEPs and individual arrest or citation for drug paraphernalia among injection drug users (IDUs) in California from 2001 to 2003. Using data from three annual cross-sections (2001-03) of IDUs attending 24 SEPs in 16 California counties (N = 1,578), we found that overall, 14% of IDUs in our sample reported arrest or citation for paraphernalia in the 6 months before the interview. Further analysis found that 17% of IDUs attending a legal SEP (defined at the county level) reported arrest or citation for drug paraphernalia compared to 10% of IDUs attending an illegal SEP (p = 0.001). In multivariate analysis, the adjusted odds ratio of arrest or citation for drug paraphernalia was 1.6 [95% confidence interval (CI) = 1.2, 2.3] for IDUs attending legal SEPs compared to IDUs attending illegal SEPs, after controlling for race/ethnicity, age, homelessness, illegal income, injection of amphetamines, years of injection drug use, frequency of SEP use, and number of needles received at last visit. IDUs attending SEPs with legal status may be more visible to police, and hence, more subject to arrest or citation for paraphernalia. These findings suggest that legislative efforts to decriminalize the operation of SEPs without concurrent decriminalization of syringe possession may result in higher odds of arrest among SEP clients, with potentially deleterious implications for the health and well-being of IDUs. More comprehensive approaches to removing barriers to accessing sterile syringes are needed if our public health goals for reducing new HIV/HCV infections are to be obtained.

McColl S; Sellers EM. Research design strategies to evaluate the impact of formulations on abuse liability. Drug and Alcohol Dependence 83(Supplement 1): S52-S62, 2006. (64 refs.)

Scheduling of a chemical drug substance under the Controlled Substances Act (CSA) includes an evaluation of preclinical and clinical safety, and experimental abuse liability studies, as well as information on diversion and overdose. Formulations that mitigate abuse liability, dependence potential and public health risks (e.g., altered absorption rate and tamperability, long half-life, pro-drugs and combination products) are amenable to preclinical and clinical studies to compare their abuse potential to reference compounds. For new formulations (NF) as marketed agents, direct comparison to the immediate release (IR) formulation of the reference compound is typically needed across the full range of potential studies. While the public health advantage of formulation changes in the marketplace can be conceptualized in behavioral economic terms, generating persuasive data is challenging. Study complexity increases because of additional conditions (e.g., placebo, 2-3 doses of the IR formulation, 2-3 doses of the new formulation, and 2-3 doses of the unscheduled or negative control drug), larger sample sizes (study power driven by the comparison of the new formulation versus the IR or placebo), and associated increases in study duration. However, the use of single maximal doses of well-characterized controls can reduce the number of study arms, and using incomplete block designs can reduce study duration. Less typical experimental approaches may also be useful, such as human choice or discrimination procedures, or pre-marketing consumer studies among experienced drug tamperers. New formulations that demonstrate a substantial difference from marketed or reference products have a potential marketing advantage and should require less onerous risk management. Post-marketing epidemiological data demonstrating the lack of abuse will carry the most weight from a public health and physician perspective.

McErlean M; Triner W; Young A. Impact of outside regulatory investigation on opiate administration in the emergency department. Journal of Pain 7(12): 947-950, 2006. (15 refs.)

This study was conducted to determine whether outside regulatory investigation related to opiate prescription diversion changes the prescribing frequency of opiates in an emergency department (ED). The presence of ED administration of opiates and prescriptions for opiates on discharge were compared across a baseline period 90 days before arrest of a physician for opiate diversion, a period immediately surrounding the arrest, and a follow-up period 90 days later. At no time was there investigation of excessive opiate prescribing for patients in the ED. The likelihood of receiving opiate analgesia either in the ED or on discharge was not significantly different for patients reporting mild pain or severe pain across all three periods. Patients with moderate pain (self-reported pain scores of 4 to 6 out of 10) were less likely to receive opiates in the ED immediately after the arrest compared with the baseline period (likelihood ratio, 0.4; confidence interval, 0.2 to 0.7). Patients with moderate pain were also less likely to receive prescriptions for opiates on discharge from the ED immediately after the arrest (likelihood ratio, 0.5; confidence interval, 0.3 to 0.9). These effects had diminished by 90 days. Perspective: This study indicates that factors outside of the provider-patient relationship influence the likelihood of receiving opiates during an ED visit. Awareness of this phenomenon might serve to reduce oligoanalgesia.

McKeganey N. Street prostitution in Scotland: The views of working women. Drugs: Education, Prevention and Policy 13(2): 151-166, 2006. (25 refs.)

At the present time in Europe a range of countries are considering their prostitution laws and looking at whether these should be updated in a number of ways including the possible provision of prostitute tolerance zones. While this is an issue that is subject to heated political debate, and considerable divergence within Europe, it is not one where there has been much research evidence to date. One reason for this is the concentration in much prostitution research on sexual rather than work-related matters. This paper considers the issue of prostitute tolerance zones within the context of an ethnography of street prostitution in Scotland. In particular, the paper describes street-working women's views of their work, their reasons for working, their views as to the impact of their work on their lives, and whether it would be beneficial to provide tolerance zones to enable them to work without fear of prosecution.

McMullen JG. Underage drinking: Does current policy make sense? Lewis & Clark Law Review 10(Summer): 333-365, 2006. (215 legal refs.)

This Article examines the history of laws and policies regulating consumption of alcoholic beverages by young people in the United States, and examines youth drinking patterns that have emerged over time. Currently, all 50 states have a minimum drinking age of 21. Various rationales are offered for the 21 drinking age, such as the claim that earlier drinking hinders cognitive functions and the claim that earlier drinking increases the lifetime risk of becoming an alcoholic. While there is sufficient evidence to support the claim that it would be better for adolescents and young adults if they did not drink prior to age 21, research shows that vast numbers of underage persons consume alcoholic beverages, often in large quantities. The Article discusses the question of why underage drinking laws have not been able to effectively stop underage drinking Normally, discussions of underage drinking focus on persons under age 21 as one group. This Article breaks underage drinkers into two groups: minors (drinkers under the age of 18) and young adults (drinkers between the ages of 18 and 21). The Article goes on to separately analyze the two groups' drinking patterns and reasons for drinking. The Article concludes that prohibitions on drinking by minors could be made more effective because restrictions on activities by minors are expected and normally honored by parents, law, and society. The Article also concludes, however, that the enforcement of a drinking prohibition for young adults between the ages of 18 and 21 is doomed to remain largely ineffective because the drinking ban is wholly inconsistent with other legal policies aimed at that age group. The Article discusses three areas (health care decisions, educational decisions, and smoking) where persons over the age of 18 have virtually unfettered personal discretion, and applies the reasoning of those situations to the decision about whether to consume alcoholic beverages. The Article also compares the total drinking ban for young adults with the graduated privilege policies applied to drivers' licensing. The Article concludes that the total prohibition of alcohol consumption for young adults is inconsistent with other policies affecting young adults, and this inconsistency, coupled with harms that may come from the 21 drinking age; make the current policies ineffective and ill-advised for young adults between the ages of 18 and 21.

Measham F. The new policy mix: Alcohol, harm minimisation, and determined drunkenness in contemporary society. (editorial). International Journal of Drug Policy 17(4, Special Issue): 258-268, 2006. (88 refs.)

This paper reflects on the relationship between harm reduction, demand reduction, and supply reduction (collectively, harm minimisation) in relation to the individual, socio-economic, and legal regulation of alcohol, focusing on changing consumption patterns of youths and young adults in the UK. Firstly, harm reduction and practices of self-regulation are considered within the British context of an apparent culture of intoxication, with evidence of determined drunkenness amongst young people that builds upon a longstanding tradition of northern European drinking characterised by weekday restraint and weekend excess. Secondly, demand reduction and the predominant public health programme of recommended sensible drinking levels are discussed in relation to the credibility gap between such messages and contemporary alcohol-related attitudes and behaviours. Thirdly, looking at supply, recent legislative changes and broader developments in the alcohol industry are explored. They counterbalance economic deregulation of licensed leisure with the increased criminalisation of some drinkers. In order to produce the most effective policy mix, individualised models of harm reduction and demand reduction need to be located within broader, culturally appropriate, and context-specific policies that consider the socio-economic, political, and environmental factors influencing harm, demand, and supply.

Meyer DJ. Commentary: Legislators - How did the deciders decide? Who shall serve as their experts? (editorial). Journal of the American Academy of Psychiatry and the Law 35(3): 323-324, 2007. (1 refs.)

Weisleder presents a retrospective empirical inquiry into the decision tree of state legislators who chose the age at which minors could consent to substance abuse treatment in their respective jurisdictions. Current medical practices and the developmental research into the cognitive capacities of adolescents did not figure pro