Eliseu Labigalini Jr, Lucio Ribeiro Rodrigues, Dartiu Xavier Da Silveira
01 October 1999
This study ensued from clinical observations based on spontaneous accounts by crack abusers undergoing their first psychiatric assessment, where they reported using cannabis in an attempt to ease their own withdrawal symptoms.
In the city of São Paulo, the culture of crack use has undergone considerable changes over these 11 years since it was first described. The sociodemographic profile of the users is practically the same and most use is still compulsive, with significant physical, moral and social impairment among them. Sole use of crack has overwhelmingly been replaced by associations between crack and other drugs, thus characterizing users in the city of São Paulo as multiple drug users.
An ethnographic study of women and drug use in inner city neighborhoods in Kingston, Jamaica, revealed that cannabis is commonly used in conjunction with crack cocaine to minimize the undesirable effects of crack pipe smoking, specifically paranoia and weight loss.
The cocaine base, or “pasta”, may be seen as a type of South American crack. Its obligatory method of administration is smoking. A primary condition of the “pasta” smoker is compulsive drug-search behavior and addiction to cocaine base destroys emotional and mental balance. Socio-economic maladjustment is the norm amongst “pasta” addicts. Since 1984 I have recommended the chewing of the coca leaf, between 100 to 200 grams of coca leaf per week for the treatment of cocaine dependence.
Eberhard Schatz, Katrin Schiffer, John Peter Kools
15 January 2011
This paper, written in collaboration with the Correlation Network, briefly describes the history and the basic elements of the Dutch drug dependence treatment policy, including recent trends in drug use and the current drug treatment system implemented in the four largest cities in the Netherlands. Building on more than 30 years’ experience, the Dutch approach focuses on an integrated treatment system, which provides comprehensive support and services to the most vulnerable groups, including homeless people, problematic drug users and chronic psychiatric patients. At the same time, a strong emphasis is given to public order and crime reduction.
Mascha Nuijten, Peter Blanken, Wim van den Brink, Vincent Hendriks
18 August 2011
Cocaine, particularly in its base form ('crack'), has become one of the drugs of most concern in the Netherlands, being associated with a wide range of medical, psychiatric and social problems for the individual, and with significant public order consequences for society. Available treatment options for cocaine dependent users are limited, and a substantial part of the cocaine dependent population is not reached by the addiction treatment system.
James Shearer, John Sherman, Alex Wodak, Ingrid van Beek
31 May 2002
The illicit use of amphetamines continues to be a growing problem in many countries around the world, yet treatment responses remain in need of further development. This is particularly true with regards to pharmacotherapy for amphetamine dependence. In this Harm Reduction Digest four authors who bring together considerable research and clinical experience in this area describe the nature of amphetamine-related problems and consider the role of amphetamine agonists in substitution therapy for amphetamine dependence.
There is a growing body of evidence to support the use of medical cannabis as an adjunct to or substitute for prescription opiates in the treatment of chronic pain. When used in conjunction with opiates, cannabinoids lead to a greater cumulative relief of pain, resulting in a reduction in the use of opiates (and associated side-effects) by patients in a clinical setting. Additionally, cannabinoids can prevent the development of tolerance to and withdrawal from opiates, and can even rekindle opiate analgesia after a prior dosage has become ineffective.
Philippe Lucas, Amanda Reiman, Mitch Earleywine, Stephanie K. McGowan, Megan Oleson, Michael P. Coward, Brian Thomas
19 November 2012
This article examines the subjective impact of medical cannabis on the use of both licit and illicit substances via self-report from 404 medical cannabis patients recruited from four dispensaries in British Columbia, Canada. The aim of this study is to examine a phenomenon called substitution effect, in which the use of one product or substance is influenced by the use or availability of another.
Coca tea has been used for the treatment of cocaine dependence. Two previous reports found that treatment that includes coca tea can be successful in controlling relapse to cocaine dependence. In the current study, coca tea plus counseling was used to treat cocaine dependence in 23 cocaine-addicted coca paste smokers seeking treatment at an outpatient clinic in Lima, Peru.
European Monitoring Centre for Drugs, Drug Addiction (EMCDDA)
01 August 2000
Treatment for drug addiction was seen as a measure to reduce drug abuse as early as 1961 when the UN Single Convention was signed. However, the only recognised concept of drug treatment mentioned by the Convention concerned the detoxification of the individual through ‘drug-free treatment’. Therapeutic measures aimed at treating drug addictions through maintenance and related distributions of alternative substances are not expressly mentioned by the UN Conventions of 1961, 1971 and 1988.
Marie Longo, Wendy Wickes, Matthew Smout, Sonia Harrison, Sharon Cahill, Jason M. White
18 June 2009
This study tested the impact of a long-acting form of amphetamine as medication to help control dependent use of the closely allied stimulant, methamphetamine. Prescribed usually for the treatment of pathological sleepiness or attention deficit/hyperactivity disorder, effects of the amphetamine tablets prescribed in the study take several hours longer to emerge than normal amphetamine and last three to six hours longer, giving it a 'smoothing' profile similar to methadone for heroin users; non-rapid onset make it less intensely pleasurable, and longer duration suits it to once-daily administration.
In a confidential and authoritative memorandum to the INCB, UNODC legal experts argue that most harm reduction measures are in fact acceptable under the conventions. According to the Legal Affairs Section "it could easily be argued that the Guiding Principles of Drug Demand Reduction provide a clear mandate for the institution of harm reduction policies that, respecting cultural and gender differences, provide for a more supportive environment for drug users."