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This chapter explores the historical context of drug control in the United States, the ongoing regulation of the cannabis market at the State level and the role of the United States in the international negotiations related to the United Nations General Assembly Special Sessions (UNGASS) on drugs in 1998 and 2016. We continue by analysing the position, allies and activities of the United States before and during UNGASS 2016 to provide an understanding of possible scenarios related to the 2009 Political Declaration and Plan of Action review to take place via a High-level Ministerial Segment within the 2019 Commission on Narcotic Drugs meeting. While US drug policy is not expected to positively shift in the next few years, State-level regulation of cannabis is expected to continue and create pressure from below.

Clinical outcome in patients with ischemic heart disease can be significantly improved with the implementation of targeted drug delivery into the ischemic myocardium. The purpose of this paper is to review the data of recent literature and present original findings relevant to the problem of therapeutic heart targeting with use of nanoparticles.

For literature review, a public‐domain database (Medline) was searched using a web‐based search engine (PubMed) and the following key words: “nanoparticles”, “nanocarriers”, and “targeted drug delivery”. Experimental approaches included fabrication of carbon and silica nanoparticles, their characterization and surface modification. The acute hemodynamic effects of nanoparticle formulation as well as nanoparticle biodistribution were studied on male Wistar rats.

Carbon and silica nanoparticles are biocompatible materials that can be used as carriers for heart‐targeted drug delivery. Concepts of passive and active targeting can be applied to the development of targeted drug delivery to the ischemic myocardial cells.

The present paper is believed to be the first on ligand‐directed targeted drug delivery into the damaged myocardium.

The aim of the present study was to assess the prescribing pattern of general practitioners (GPs) in Kerman province of Iran.

A total of 45,384 prescriptions issued in one year (2002) by GPs in ten cities of Kerman province were investigated for the number of drugs/prescription, drug name, drug category and route of administration. The mean number of drugs/prescription was 3.43.

Overall most of the drugs (97.2 per cent) were prescribed by generic name. The most frequently prescribed drugs were antibiotics (33.95 per cent), sedative/hypnotics (19.56 per cent), non‐steroidal anti‐inflammatory drugs (NSAIDs) (19.2 per cent) and corticosteroids (11.2 per cent). About 42.4 per cent of the patients received an injectable drug.

The results of this study showed inappropriate prescription of antibiotics, NSAIDs, corticosteroids and injectable drugs. So intervention methods should be chosen to change physicians' prescribing behavior, through education of rational drug prescription, to improve the quality of prescribing practice of GPs.

This paper aims to explore the cessation of injecting amongst male drug users when in prison in England and uncovers what influenced this behaviour and why.

Qualitative interviews were conducted with 30 male drug users on release from prison to explore what happened to their injecting drug use in prison. The research was conducted from a pragmatic harm reduction approach using grounded theory.

Not injecting in prison was identified as a pertinent finding and nine overarching themes accounted for this decline. The themes often overlapped with one another, highlighting how the decision not to inject when last in prison was multi‐factorial. Running throughout the themes were participants' concerns regarding the health and social risks attributed to injecting in prison, alongside an appreciation of some of the rehabilitative measures and opportunities offered to injecting drug users when in prison.

This qualitative research offers an updated perspective on illicit drug injecting in prison in England from the view of drug users since health and prison policy changes in prescribing and practice. It contributes to evidence suggesting that prisons can be used as a time of reprieve and recovery from injecting drug use.

The dynamics of drug use and trafficking in Poland have changed dramatically since the early 1990s. These changes include legal definitions of drug use, the actors involved in trafficking, and the types of drugs traversing the country. The Polish police force experienced two significant reforms in the 1990s and drug‐related legislation underwent significant reconstruction in 1997 and 2000, while drug trafficking operations continue to persist by organized criminal groups. The purpose of this study is to qualitatively investigate these police reforms and drug legislation developments since 1990, and empirically analyze the interaction effects of these reforms with drug trafficking arrests in Poland.

Officially reported annual data were tested using multivariate regression analyses.

The findings observed from this exploratory study suggest that both the police reforms and changes in drug‐related legislation positively affected the number of arrests for drug trafficking. Additionally, this study found support for an increase in efficiency of the policing model despite the recent decline in the strength of the police force. Interestingly, the number of police officers in the country had no effect on any of the variables.

Quantitatively, the small number of observations poses limitations on the interpretation of the multivariate regression results. In addition, future research should include additional explanatory variables to achieve a greater comprehensive summary of the interaction effects of policing reforms and drug‐related legislation with drug trafficking arrests.

This paper illustrates the need for accurate and timely national‐level, systematically collected data on drug‐ and police‐related indicators that will allow for more inclusive and comprehensive analyses.

This study is one of the first to empirically examine potential interaction effects of police reform and drug‐related legislation on drug trafficking arrests in Poland.

This paper seeks to understand whether some Lean Six Sigma tools are useful to reduce safety and health risks to nurses and physicians who manage cancer drugs. An additional objective is to analyze economic improvements reached by the means of lean six sigma.

An improvement project inside the pharmacy department of an Italian hospital was observed and studied. The project was conducted through the define‐measure‐analyze‐improve‐control (DMAIC) pattern typical of Lean Six Sigma.

The FMEA risk analysis shows an improved situation concerning health and safety for nurses and physicians. Furthermore, the centralization and the use of other tools such as value stream mapping (VSM) have led to an interesting saving due to the reduction of immobilized capital inside the stockrooms of the departments. Other unexpected improvements in terms of motion and transportation reduction have occurred.

It is difficult to generalize the developed theory from one case study to other public health care organizations. Academics and practitioners could investigate the subject in more detail by the means of other case studies or a quantitative inquiry.

The paper suggests an interesting and practical way to reduce risks for health and safety and costs inside pharmacy departments.

Lean Six Sigma and its tools have been used for the first time for reducing health and safety risks due to cancer drugs.

Medication management is a complex process, at high risk of error with life threatening consequences. The focus should be on devising strategies to avoid errors and make the process self-reliable by ensuring prevention of errors and/or error detection at subsequent stages. The purpose of this paper is to use failure mode effect analysis (FMEA), a systematic proactive tool, to identify the likelihood and the causes for the process to fail at various steps and prioritise them to devise risk reduction strategies to improve patient safety.

The study was designed as an observational analytical study of medication management process in the inpatient area of a multi-speciality hospital in Gurgaon, Haryana, India. A team was made to study the complex process of medication management in the hospital. FMEA tool was used. Corrective actions were developed based on the prioritised failure modes which were implemented and monitored.

The percentage distribution of medication errors as per the observation made by the team was found to be maximum of transcription errors (37 per cent) followed by administration errors (29 per cent) indicating the need to identify the causes and effects of their occurrence. In all, 11 failure modes were identified out of which major five were prioritised based on the risk priority number (RPN). The process was repeated after corrective actions were taken which resulted in about 40 per cent (average) and around 60 per cent reduction in the RPN of prioritised failure modes.

FMEA is a time consuming process and requires a multidisciplinary team which has good understanding of the process being analysed. FMEA only helps in identifying the possibilities of a process to fail, it does not eliminate them, additional efforts are required to develop action plans and implement them. Frank discussion and agreement among the team members is required not only for successfully conducing FMEA but also for implementing the corrective actions.

FMEA is an effective proactive risk-assessment tool and is a continuous process which can be continued in phases. The corrective actions taken resulted in reduction in RPN, subjected to further evaluation and usage by others depending on the facility type.

The application of the tool helped the hospital in identifying failures in medication management process, thereby prioritising and correcting them leading to improvement.

Bibliometric traits were used to describe the development and clinical use of levodopa as an antiparkinsonian agent. Yearly percent compositions of a complete collection of 2,335 papers, published from 1960 through 1974, which reported the administration of levodopa to humans, were obtained for: single‐author, non‐regular‐journal, DOPA‐word in title, short, O reference, English language, and contemporary papers. From this basic description a hypothesis was erected, according to which these bibliometric traits can be used for predicting the future of a developing drug. A successful drug (a drug of choice) will have a development peak and a clinical‐use peak on a graph plotting the annual slopes of the percent composition of the trait against the year, for ‘bursts’ of 3–6 years. The main premonitory event (predictor) is the switch in polarity of the slope. Single‐author papers were judged to be the best bibliometric trait for predictive use.

The purpose of this paper is to explore how injecting opiate users on a methadone treatment programme experience stigma as drug addicts, and as service users in health care and pharmacy settings. In particular the paper explores the rationale for injecting drugs, which the paper is argued to create the conditions for experiencing shame at the micro interactional level, influenced by macro institutional factors. The paper links this issue of being an injecting drug user in treatment to question whether the definition of recovery as “drug free” in the Scottish drug policy document The Road to Recovery (2008) creates the potential for stigma of service users receiving methadone maintenance treatment.

In all, 14 participants, all of whom identified themselves as problem intravenous users of drugs, were recruited from three voluntary sector (third sector) treatment agencies in Scotland. Participants took part in semi-structured interviews; these were recorded, transcribed and qualitatively analysed thematically.

Participants describe feelings of stigma in relation to their drug taking as problem users. Their experiences as recovering opiate injectors raises further challenges in distancing themselves from stigmatised addict identities.

Reasons for injecting rather than smoking heroin were principally financially challenging a widely held belief that users inject primarily for pleasure, which is argued as increasing the potential for stigma. Shame and perceived discrimination was documented before and during drug treatment.

Presents information on the Drug abuse resistance education (DARE) program, a set of 17 lessons on drug resistance given by police officers to sixth grade children. Measures attitudes toward drug use and degree of reported use. Indicates that DARE is successful in providing information but that the levels of reported behavior do not show significant improvement in self‐reported drug use compared to two control groups. Urges caution in expanding the program, since positive results are limited at present.