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Recreational drug use is widespread. It is argued that it has reached a phase of ‘normalisation’ among youth and has become a part of mainstream culture. While there is a substantive body of literature addressing substance use in club settings, the world of music festivals is underexplored. The research aims to fill this gap by analysing patterns of drug use and implementation of harm reduction measures among Polish and Hungarian women at music festivals. This explorative inquiry used an online questionnaire, which was shared via social media channels. The data collection lasted for one month during the summer of 2017.

The study found that over 95% (N=510) of women use psychoactive substances at festivals. The most popular drugs are alcohol and cannabis, and the least popular cocaine and psilocybin. The majority of women declare moderate use of alcohol and light to moderate use of cannabis. One-fifth of the respondents report a moderately heavy use of 3,4-methylenedioxymethamphetamine and 8% heavy use of amphetamine. There are numerous positive weak relationships between the intensity of use of various substances. Increased use of drugs is also related to increased frequency of combining them. Low prevalence of illicit drugs testing is observed. There seems to be a negative correlation between the intensity of substance use and the adoption of harm reduction measures. The results have high practical relevance primarily for harm reduction and medical services. Especially cases of moderately heavy and heavy use should be of interest, even more so given that combining substances seems to be prevalent. The data suggest that we can distinguish between two groups: one aware and implementing various measures of harm reduction and second not adopting any of them. There is a need for more widespread drug education and harm reduction promotion, which should be implemented in a favourable legal and policy environment.

The opioid epidemic in the USA, the new psychoactive substances emerging on the market and the recent increase in cocaine treatment demands in Western Europe, all emphasise the importance of monitoring the use and harms of drugs over time. To be informed about new consumption patterns, this study aims to study the trends among people entering treatment for substance use in Belgium.

Belgian data from the Treatment Demand Indicator collected between 2015 and 2019 were used. A reference group of treatment units was selected to allow for comparisons between the different years. Trend analysis was performed by using a joinpoint regression among different regions and groups of clients.

The drugs of choice that were most frequently mentioned among the 23,000 analysed treatment episodes were alcohol and cannabis. Both remained relatively stable over time. Heroin seemed to be decreasing significantly at the national level, but increased in Brussels. Benzodiazepines decreased significantly in Flanders and Brussels, but not in Wallonia. On the other hand, reports of crack cocaine increased significantly in the three regions with a more pronounced trend in Wallonia and Brussels. Substances such as fentanyl, methamphetamine, ketamine or volatile inhalants have been mentioned significantly more by people entering treatment in 2019, although their contribution to the total number is still limited.

To the best of the authors’ knowledge, this study is the first to evaluate trends for all drugs of choice at a national and regional level. These results might not only benefit national policymakers but also other countries with similar alcohol or drug use patterns.

The relationships between tourist resorts and transnational crime are rarely analyzed systematically. This paper begins to fill this gap by examining how organized crime groups and individuals linked to them can take advantage of tourist resorts to commit crimes.

The purpose of this paper is to analyse the association between drug consumption and unemployment. This paper also studies the differential association between these variables in both the pre- and current-crisis periods. The results are compared in an attempt to verify that the population of users is more vulnerable in terms of how likely they are to get and hold down a job in the labour market.

Matching methods and microdata from the Survey on Alcohol and Drugs in Spain, EDADES are used. The use of these methods on the estimates carried out prove to be particularly effective in reducing treatment-selection bias. The authors’ interest is also to analyse the differential association between the interest variables in both the pre- and current-crisis periods. For this purpose, the authors also use the differences-in-differences (DID) estimation method between the two periods to check if the impact of drug use on unemployment depends on the economic context. The estimations are compared in an attempt to verify that the population of users is less likely to attain and hold down a job in the labour market than non-drug users.

The results obtained in the current study are consistent with the hypothesis that drug use decreases an individual’s capacity and availability when he or she is trying to enter the labour market. In both 2007 and 2013, drug users were more likely to be unemployed, regardless of the type of drug. Differences in the probability of being unemployed intensify during an economic crisis. In light of these results, it is possible to conclude that the negative effect of drug consumption on an individual’s employability is increased during periods of economic recession.

The study presented here has some limitations. Firstly, cross-sectional data were used to examine the causal relationship between consumption and employment. In this sense, the results are susceptible to bias. The unavailability of longitudinal data on the same individual made it impossible for the researchers to consider periods of abstinence, the duration of periods of consumption and how this consumption affected an individual’s productivity and his or her working situation. Another limitation is that certain relevant unemployment variables may have been omitted. Among the variables that affect an individual’s labour participation is the existence of sources of income as an alternative to market salaries. With state subsidies, income from illegal activities and money sent by family or friends, an individual may decide not to work. This problem could be mitigated if omitted variables operate in a similar way throughout both of the periods examined.

Given the results obtained in this paper, the authors believe that public policy conclusions should be mainly concerned with the importance of implementing proactive employment policies, along with family support programmes and a greater role for primary care among the people with the highest risks of exclusion. Health treatment should go jointly with measures that make it easier for individuals to enter the workforce. These steps would only be possible with an improved level of education and more complete professional profiles, to increase motivation when individuals seek employment.

This study could make various contributions to the existing body of evidence. In the authors’ knowledge, this is the first attempt to document the effect of the economic crisis on the employability of the drug-using population in contrast with the general population. Moreover, a methodology is presented that provides an alternative to those used in earlier studies, in terms of reducing treatment-selection bias. At the same time, the use of a DID estimation method between pre- and current-crisis periods allow us to check if the impact of drugs consumption on unemployment depends on the economic context.

Several studies reported high rates of psychiatric commorbidity among methadone patients. We examined the relationships of measures of psychopathology to outcomes of screening urine tests for cocaine, opiates, and benzodiazepines in a sample of 56 methadone patients. They also completed the Symptom Check List-90-Revised (SCL-90-R). The highest scales in the SCL-90-R profile of our patients were those indicating somatic discomfort, anger, phobic anxiety, paranoid ideation, and also obsessive-compulsive disorder symptoms (scores above the 39th per centile). The only significant correlations between urine tests and SCL-90-R psychopathology were those involving benzodiazepines: patients with urine tests positive for benzodiazepines had lower social self-confidence (r=0.48), were more obsessive-compulsive (r=0.44), reported a higher level of anger (r=0.41), of phobic tendencies (r=40), of anxiety (r=0.39), and of paranoid tendencies (r=0.38), and also reported more frequent psychotic symptoms (r=0.43).

Although we have achieved a greater understanding of cryptomarket specifics, evidence on the consumer side of cryptomarkets is still needed – not only regarding the role of cryptomarkets on individual drug-using careers but also on the motives for buying illicit drugs from cryptomarkets. Moreover, research has indicated that national differences exist regarding different variables relating to cryptomarket use and prevalence, as well as to why users are drawn to these markets. In this chapter, the author presents the results of a Belgian case study focusing on drug cryptomarket buyers. Using an online quantitative survey (N = 99) and semi-structured interviews (N = 10), we gain exploratory insight into the motives of Belgian buyers sourcing illicit drugs from cryptomarkets and how they believe these cryptomarkets affect their drug-using careers. Results indicate that most of the respondents had bought drugs offline before buying them from cryptomarkets and that the frequency of their drug use did not change once cryptomarkets were accessed. Almost 60% of our respondents, however, consumed different drugs or a wider range of drugs following their cryptomarket use. Furthermore, most of the respondents purchased from cryptomarkets for their personal consumption, and some of them also shared their supply with friends, that is, social supply. The alternative drug offer was the principal reason why they were using cryptomarkets, followed by curiosity and the price and the quality of the drugs. Although the respondents in this study were well aware of different risks related to market vendors, market administrators, and law enforcement, these risks were considered to be minimal and part of the cryptomarket environment. The results of this case study are informative and highlight areas requiring further research.

This paper aims to explore how the Celtic Tiger economic boom and Great Recession influenced drug and alcohol use in one Irish city.

Semi-structured interviews were conducted with 48 people, living in Cork City, who had previously used drugs and/or alcohol problematically. All participants had engaged with services for their problematic use and had at least one year of abstinence at time of interview.

Some participants reported that their drug and/or alcohol consumption increased during the economic boom; others, who were already in (self-defined) active addiction, reported how full employment lessened some of the harms of their problematic use. For others, problematic use struck once the economy entered a downturn and, heavy drink and drug use became a means of soothing the strains of economic recession.

The paper provides two key contributions. Methodologically, it demonstrates how large-scale national quantitative data can mask local idiosyncratic tendencies, suggesting the need for mixed-method approaches for understanding drug market trends. The paper also provides insights into the impact of global and local economic conditions on drug and alcohol consumption in Ireland.

Although first rank symptoms focus on positive symptoms of psychosis they are shared by a number of psychiatric conditions. The difficulty in differentiating bipolar disorder from schizophrenia with affective features has led to a third category of patients often loosely labeled as schizoaffective. Research in schizophrenia has attempted to render the presence or absence of negative symptoms and their relation to etiology and prognosis more explicit. A dichotomous population is a recurring theme in experimental paradigms. Thus, schizophrenia is defined as process or reactive, deficit or non-deficit and by the presence or absence of affective symptoms. Laboratory tests confirm the clinical impression showing conflicting responses to dexamethasone suppression and clearly defined differences in autonomic responsiveness, but their patho-physiological significance eludes mainstream theory. Added to this is the difficulty in agreeing to what exactly constitutes useful clinical features differentiating, for example, negative symptoms of a true deficit syndrome from features of depression. Two recent papers proposed that the general and specific cognitive features of schizophrenia and major depression result from a monoamine-cholinergic imbalance, the former due to a relative muscarinic receptor hypofunction and the latter, in contrast, to a muscarinic hypersensitivity exacerbated by monoamine depletion. Further development of these ideas will provide pharmacological principles for what is currently an incomplete and largely, descriptive nosology of psychosis. It will propose a dimensional view of affective and negative symptoms based on relative muscarinic integrity and is supported by several exciting intracellular signaling and gene expression studies. Bipolar disorder manifests both muscarinic and dopaminergic hypersensitivity. The greater the imbalance between these two receptor signaling systems, the more the clinical picture will resemble schizophrenia with bizarre, incongruent delusions and increasingly disorganized thought. The capacity for affective expression, by definition a non-deficit syndrome, will remain contingent on the degree of preservation of muscarinic signaling, which itself may be unstable and vary between trait and state examinations. At the extreme end of muscarinic impairment, a deficit schizophrenia subpopulation is proposed with a primary and fixed muscarinic receptor hypofunction.

The genomic profile of bipolar disorder and schizophrenia overlap and both have a common dopaminergic intracellular signaling which is hypersensitive to various stressors. It is proposed that the concomitant muscarinic receptor upregulation differentiates the syndromes, being marked in bipolar disorder and rather less so in schizophrenia. From a behavioral point of view non-deficit syndromes and bipolar disorder appear most proximate and could be reclassified as a spectrum of affective psychosis or schizoaffective disorders. Because of a profound malfunction of the muscarinic receptor, the deficit subgroup cannot express a comparable stress response. None -theless, a convergent principle of psychotic features across psychiatric disorders is a relative monoaminergic-muscarinic imbalance in signal transduction.

This chapter explores the norms and assumptions that frame and sustain international drug policy and the international drug control regime. Drug policy is conceptualised as a ‘policy fiasco’ that persists despite extensive evidence of goal failure. The absence of effective monitoring and evaluation, impact assessment, stakeholder participation and mainstreaming of rights-based approaches, conflict sensitivity and gender sensitivity is emphasised, substantiating the argument that drug policy is a case study of ‘institutional path dependence’. Drug policy has repeatedly missed targets for achievement of a ‘drug free world’. This is explained through reference to the counterproductive and ‘unintended consequences’ of a drug policy approach of criminalisation. The impacts of drug policy enforcement are shown to be negative, pernicious and disproportionately born by the poor, by vulnerable communities and those subject to discrimination on account of race, gender and class.