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Illicit drug use amongst women in Zimbabwe is increasing. The most common drugs of choice are marijuana and new psychoactive substances like ecstasy, cough syrups with a high content of codeine, and other small intoxicating pills like mangemba (diazepam). The most affected population group are women between the ages of 20 to 40.

In a community engagement undertaken by Zimbabwe Civil Liberties and Drug Network in five of Zimbabwe’s provinces, socio, cultural and economic factors were identified as the drivers of increased engagement with the drug trade. The urge to be independent and the inter-related aspect of sex work were also identified as push factors accounting for the increase in illicit drug usage in the country. The community engagement showed most women use illicit drugs as a way of liberating themselves within a heavily patriarchal society and due to the traumas associated with sex work. Sex work in turn exposes women to opportunistic infections, rape, violence and sexual violence. Women perform different roles in the illicit drug economy. In their role as sellers of controlled drugs, women aimed to support their families, maximising the opportunities presented by life in illicit economies. Whilst advocacy groups are pressing for drug policy reform in Zimbabwe, interventions can be designed to help women extricate themselves from this quagmire through empowering them and having a drug policy that among other facets, strengthens communities.

We present findings from a National Institute on Drug Abuse funded study of drug use and health care. Our data indicate that stigmatization of illicit drug-users in health care settings and health care providers' diagnostic focus on the contributions of drug use to their illnesses delays treatment, lengthens hospitalizations, and increases health care costs. Our findings show that, not unlike their conventional counterparts, drug users consult their peers for advice, self-treatment, referrals to services, or simply to obtain non-judgmental counsel prior to or in lieu of seeking formal care. Such lay consultation processes influence symptom recognition, attribution, and management as well as the process of formal care seeking and its timing. Discussions with drug-using peers shape perceptions of potential problematic health care interactions. In this regard, interviewees and their lay consultants believe that to be labeled as a drug user, either through self-admission or medical diagnosis, compromises the care they receive. We conclude our chapter by discussing appropriate strategies to improve the quality of care and lower the health care costs of treating drug-using patients. Such interventions include acknowledging and supporting existing lay consultation processes, disseminating better health care information through and within drug users' networks, and encouraging health care providers to conduct more holistic evaluations of drug users' health and illnesses.

The Australian Football League (AFL) is the premier sporting competition in Australia in terms of capital outlay, breadth of industry associations, public consumption, and arguably cultural significance. The AFL competition is now a domain of specialisations and interests, which provides vast opportunity for both sporting and non-sporting institutions seeking to utilise the game to capitalise on a society of consumption, entertainment and risk. AFL officials expect high standards of their players both on and off the field. These standards are expressed in various forms of Codes and Policies. Off field player misconduct is an ongoing concern not escaping media attention, which is a resounding indication more needs to be done by the AFL to improve responsible player character development. Whether the current education programmes are sufficient to meet the AFL’s own expectations is the central issue addressed in this chapter. As it stands AFL governance is deficient on several counts. In this chapter I will focus on three governance deficiencies: firstly, the AFL Illicit Drug Policy (IDP) contains unnecessary inconsistencies relative to its primary purpose; secondly, the present measures undertaken to ensure players have appropriate education to achieve the expected character development are far from efficacious and so arguably can be vastly improved; and thirdly, the promotion of live-odds gambling during televised games is culturally problematic and inconsistent with its own demands. The ethical grounds central to this investigation are ‘fairness’ and ‘cultural influence’. In order to resolve some of its governance concerns I will explain why the AFL should be characterised as a practice-community and as such should adopt a comprehensive virtue and value-based compliance ethical education programme consistent with its own vision and conduct expectation of its players and officials. I will argue that the AFL as a practice community is much more than simply a game, given its cultural influence, commercial associations and community programmes.

In this chapter, I examine how racial disparities in punishment for nonviolent drug crimes align with significant differences in how the black and white drug problems are constructed in media, law enforcement, and academia.

By examining differences in how the black and white drug problems have been constructed over the past 70 years for the opioids (heroin, prescription painkillers), cocaine (both powder and crack), and marijuana, I illustrate how these distinct representations of the black and white drug problems accompany more punitive policies in response to black drug epidemics even as white drug epidemics are typically met with tolerance or indifference.

Historically, powerful interest groups like media and law enforcement have benefitted from circulating myths and exaggerations about the illegal drug problem that encourage punitive drug policies. By contrast, at least some academics have benefitted from taking the opposite tack and debunking many of these myths. Unfortunately, academics have been less willing to challenge myths about the black drug problem than the white drug problem. Indeed, some academics actually reinforce many of the myths about the black drug problem promoted by media and law enforcement.

This chapter builds upon a substantial academic literature that challenges myths about illegal drug use by whites. However, it goes beyond this literature to consider the paucity of similar academic research exposing media and law enforcement myths about the black drug problem.

Evaluating the prevention, intervention, and treatment programme is critical to understanding the decision-making behaviour of substance abusers. The study interweaves behavioural health economics with the extended PRECEDE–PROCEED Model and examines the effectiveness of treatment settings for substance users in New Jersey Drug and Alcohol Abuse Treatment (13,775 samples). The study also identifies the factors that are associated with substance users’ recurrence to the treatment centre. The results concluded that educational attainment, counselling services from health care providers, mental agency services, and detoxification treatments have a significant impact on preventing relapse behaviour.

This chapter explores sex work and compares legal regimes in two case study contexts of Scotland and New Zealand. It highlights parallels in policy norms and approaches towards women in sex work and women who use drugs, including stigmatisation and punishment of ‘deviant’ women or alternatively, approaches that seek to ‘rescue’ women and which frames them as victims. Different policy approaches and regulatory regimes are discussed but the chapter argues that without attention to social justice issues, the structural drivers of women’s engagement in sex work will continue to be overlooked. Participation in policy processes by those with lived experience is emphasised, both to ensure better understanding of sex work by policymakers, and also in recognition of the citizenship, voice and agency of sex workers.

Do physician perceptions of patient “deservingness” factor into the decision to prescribe opioid analgesics? Using a data set of 398 physicians randomly selected from the American College of Emergency Physicians (ACEP) membership list, we explore how a range of patient social context variables influence a physician's decision to prescribe opioids for three conditions: ankle fracture, back pain, and migraine headache. Being hurt running from the police, former and current drug or alcohol use, and frequent emergency room (ER) visits reduce the likelihood of opioid prescription. Having a reliable relationship with a primary care provider and being injured in a ladder fall or intramural collegiate basketball game increase the likelihood of opioid prescription. Factor analyses for each of the three conditions reveal two scales: socially stigmatizing characteristics and socially accepted characteristics. Discussion centers on what places people at risk for inadequate pain control. Our work contributes to the expanding literature on social conditions as a fundamental cause of illness.