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The purpose of this paper is to review the evidence of alcohol use disorders within the different stages of the criminal justice system in the UK. Furthermore it reviewed the worldwide evidence of alcohol brief interventions in the various stages of the criminal justice system.

A rapid systematic review of publications was conducted from the year 2000 to 2014 regarding the prevalence of alcohol use disorders in the various stages of the criminal justice system. The second part of the work was a rapid review of effectiveness studies of interventions for alcohol brief interventions. Studies were included if they had a comparison group. Worldwide evidence was included that consisted of up to three hours of face-to-face brief intervention either in one session or numerous sessions.

This review found that 64-88 per cent of adults in the police custody setting; 95 per cent in the magistrate court setting; 53-69 per cent in the probation setting and 5,913-863 per cent in the prison system and 64 per cent of young people in the criminal justice system in the UK scored positive for an alcohol use disorder. There is very little evidence of effectiveness of brief interventions in the various stages of the criminal justice system mainly due to the lack of follow-up data.

Brief alcohol interventions have a large and robust evidence base for reducing alcohol use in risky drinkers, particularly in primary care settings. However, there is little evidence of effect upon drinking levels in criminal justice settings. Whilst the approach shows promise with some effects being shown on alcohol-related harm as well as with young people in the USA, more robust research is needed to ascertain effectiveness of alcohol brief interventions in this setting.

This paper provides evidence of alcohol use disorders in the different stages of the criminal justice system in the UK using a validated tool as well as reviewing the worldwide evidence for short ( < three hours) alcohol brief intervention in this setting.

President Cyril Ramaphosa, in his 2018 State of the Nation Address, stated that “Thieves who are stealing public funds should be arrested and prosecuted”, and called for lifestyle audits of public-sector employees. The gross misuse of COVID-19 relief funds by public officials indicated the urgent need to execute these audits as an anti-corruption measure. This paper aims to provide a review of the existing state of affairs with regard to the application of lifestyle audits in South Africa.

This paper critically analyses the literature available on the current position of South Africa concerning lifestyle audits in the public sector, based on the mandates of some of the anti-corruption agencies that could be responsible for the conducting and processing of such audits.

South Africa has only recently seen a framework for applying lifestyle audits, developed by the Department of Public Service and Administration. Although these first steps in developing a standard practice are laudable, the practical process of dealing with misconduct and/or criminal matters remains to be seen. It is recommended that South Africa consider a legislative approach to dealing with unlawfully obtained wealth by either criminalising the act of illicit enrichment (per the United Nations Convention Against Corruption) or creating an Unexplained Wealth Order, as seen, for example, in the UK.

South Africa is in dire need of addressing corruption in the public sector. Despite lifestyle audits being called for, the lack of proper implementation is negating any positive outcomes. Therefore, alternative solutions should be investigated.

Global evidence indicates that multiple structural, biological, and behavioural mechanisms link gender-based violence (GBV), HIV/HCV, and substance misuse among women and adolescent girls. The aim of this chapter is to briefly summarise and synthesise recent literature that examines the complex and bi-directional relationships among these epidemics in different populations of adolescent girls and women around the world. To inform this chapter, a selective search strategy was conducted, prioritising use of meta-analytic epidemiological studies and research on interventions and policies that address different aspects of the syndemic among women and girls who use drugs worldwide. The search targeted publications from 2015 to 2019 using PubMed, MEDLINE, and Google Scholar. The chapter highlights methodological and geographic gaps in existing policy, intervention, and implementation research and makes recommendations for strategies to tackle these gaps. It also identifies a continuum of multilevel evidence-based interventions that target the risk environments and key syndemic mechanisms linking these intersecting epidemics that have been found to be effective in reducing intimate partner violence and other forms of GBV, substance use, and HIV/HCV risks. This chapter also assesses inclusiveness of existing research and interventions for underserved and disproportionately affected populations, affecting adolescent girls, sexual minority women, and racial/ethnic minority women and identifies strategies to target gaps or disparities for these key affected populations. Finally, this chapter describes the gaps and opportunities that harm reduction programmes, medical settings, and other community organisations experience in implementing gender-responsive programmes and policies to redress these intersecting epidemics.

This chapter discusses how ‘hidden’ populations of women who use drugs (WWUD) in coastal Kenya became ‘visible’ through accessing health, harm reduction and rights services. This effort was facilitated by the Muslim Education and Welfare Association (MEWA) and their work with community leaders. Mapping undertaken by MEWA outreach workers identified women who use opioids and other substances in isolated drug use settings. MEWA introduced daily meals in identified sites, needle and syringe services and residential rehabilitation services for opioid withdrawal. The introduction of residential adherence services for HIV and tuberculosis and the provision of methadone enabled compliance with the 90-90-90 UN HIV cascade. These services achieved sustained HIV viral load suppression at 83% and a 100% cure rate for tuberculosis among WWUD. In addition, disclosure and partner risk tracing was established in the ‘drug dens’ for women who test positive for STIs. The introduction of women-only hours once per week at the drop-in centre contributed to a better understanding of drug dependency among outreach workers and clinicians. Policies on gender-based violence were also refined, leading to an increase in reported cases. Programmes targeting families were introduced to promote effective communication and improve parenting skills. Access barriers to social security programmes were tackled by a network of paralegal officers in partnership with Kenyan authorities. Finally, entrepreneurship training and mentorship programmes were implemented to build resilience among WWUD.

Parallel with trends in the wider East Africa region, there has been an increase in the number of women involved in drug use, trafficking and drug-related crime in Kenya (Beckerleg, Telfer, & Hundt, 2005 ). Vulnerable populations, such as domestic labourers, ethnic minorities, those living in slums, bar attendants, sex workers and refugees, are recruited into criminal organisations and assigned roles that expose them to negative health outcomes, human rights violations and incarceration (NACADA, 2016 ). In cases where women do not directly participate in drug use or the drug trade, they often are responsible for mitigating the risks arising from drug use by family members and the community. This reflects their triple burden of care and support when family and social life deteriorates (Mburu, Limmer, & Holland 2019).

The Kenya Narcotic Drugs and Psychotropic Substances Control Act of 1994, criminalises possession and trafficking of illicit drugs. The enforcement of this legislation has led to an increase in the number of women incarcerated in Kenya for drug, but also (and mainly) alcohol offences. This goes against the recommendation of the UN Commission on Narcotic Drugs in 2005 that States should adopt innovative measures and policies that prioritise treatment and rehabilitation as opposed to incarceration. In Kenya, prisons have adopted the Mandela and Bangkok Rules, enabling a paradigm shift in the provision of correctional services for women offenders, including remote parenting, family open days and linkages to aftercare services. However, these policies need to be anchored in the legal framework, with adequate resources to hasten the realisation of goals for the care and treatment of female drug and criminal offenders.

Eastern Europe and Central Asia (EECA) is home to 21% of the world’s population of people who inject drugs and it is the region with the fastest-growing HIV epidemic. HIV prevalence among women who inject drugs is significantly higher than among men in EECA. Even in places with high coverage of needle syringe programmes and HIV testing and treatment, women’s access to opioid substitution treatment is lower than men, and women’s sexual and reproductive health needs remain unaddressed. EECA has a unique system of drug registries that store the personal data of people who use drugs. Registration lowers the chances of employment and access to education and for women and increases the risk of losing custody of their children. The system of drug registries contributes to drug-related stigma. Breaches of confidentiality of drug registry data lead to the further marginalisation of women who use drugs. Criminalisation, past experience of police violence and poverty contribute to healthcare access barriers for women. There is a need for legislative changes to improve personal data protection, decriminalise drug use and reduce police violence. The positive effects of these changes would only be seen in the long term. In the interim, women need special access programmes that are designed specifically to address their needs, that provide free-of-charge services and that ensure the safety and confidentiality of personal data.

Cannabis as a recreational drug is prohibited in Nigeria. Consequently, the open use of cannabis attracts both formal and informal sanctions. As such, there is much stigma on users' faces across social spaces. This has led to innovations in drug use. Recently, non-medical use of tramadol has been rising across each of the gender categories. This study aims to understand (1) tramadol use prompts, (2) the sudden surge in gendered recreational use of tramadol and (3) the gendered challenges of recreational tramadol use among Nigerian university students.

Data were collected between December 2021 and October 2022. The researcher conducted 20 semi-structured interviews, with participants chosen purposefully from acquaintances and others selected through chain referral. The selection criteria included knowledge of a particular tramadol tablet and willingness to participate. This study got ethical approval from the Anambra State Ministry of Health (Ref: MH/AWK/M/321/354) and oral consent was obtained before the interviews. The participants were assured of confidentiality. The interviews were conducted in English (the formal Nigerian language) and lasted between 30 and 65 min. The data collected were transcribed and coded manually, and themes generated.

Findings suggest that peer pressures accounted for entry-level drug use. However, cannabis-related stigma is attributed to the surge in tramadol use across gender categories. Furthermore, academic pressure and sexuality are major reasons for tramadol use. The challenges associated with tramadol use include headaches and addiction.

This study, to the best of the author’s knowledge, presents alternative data on the surge in tramadol use among Nigerian university students.