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1 – 10 of 283

Abstract

Details

Clinical Governance: An International Journal, vol. 15 no. 3
Type: Research Article
ISSN: 1477-7274

Article
Publication date: 12 July 2018

Donald F. Vitaliano

The purpose of this paper is to estimate the demand and supply of opiates in the USA during the period 1870–1914 when the market was virtually unregulated.

Abstract

Purpose

The purpose of this paper is to estimate the demand and supply of opiates in the USA during the period 1870–1914 when the market was virtually unregulated.

Design/methodology/approach

The price and quantity of opiates is econometrically estimated using a data set constructed primarily from pharmaceutical trade journals.

Findings

Per capita opiate consumption varies in inverse proportion to its price, a price elasticity of demand of unity. The supply of opiates to the USA is perfectly elastic, a horizontal line, implying the USA was a “price-taker” in the world market for opium. The number of medical schools, a proxy for the state of medical science, significantly effects opiate consumption, as does the import tariff on opium.

Research limitations/implications

Opiate use, both medicinal and addictive, is highly responsive to purely the economic forces of price and income. The influential role of the medical profession in shaping the pattern of consumption is confirmed. Data limitations prevent making substantive statements about usage of the various sub-categories of opium, requiring all opium to be treated as equivalent units of morphine sulfate.

Practical implications

Decriminalized access to opiates and other addictive substances is likely to result in a significant increase in usage, which could be controlled by taxation.

Originality/value

Prior studies of unregulated opiate demand and supply have covered Indonesia and Taiwan under colonial government monopoly, not a major western country user like the USA. Also, this paper uses a newly created consistent set of inflation-adjusted opiate prices covering a long period (1870–1914).

Details

Drugs and Alcohol Today, vol. 18 no. 4
Type: Research Article
ISSN: 1745-9265

Keywords

Article
Publication date: 5 April 2011

Steven A. Blackwell, David K. Baugh, Melissa A. Montgomery, Gary M. Ciborowski and Jesse M. Levy

The purpose of this paper is to identify the probability of the occurrence of an analgesic medication injury when controlling for potential risk factors, as well as gain a better…

Abstract

Purpose

The purpose of this paper is to identify the probability of the occurrence of an analgesic medication injury when controlling for potential risk factors, as well as gain a better understanding of which risk factors appear more problematic.

Design/methodology/approach

Cross‐sectional retrospective review of 2004 Centers for Medicare and Medicaid Service Medicaid Pharmacy claims data. Logistic regression analysis performed to examine the risk of injury‐related emergency room (ER) visits following the use of analgesics controlling for potential risk factors.

Findings

Methadone, an agent to treat severe pain, and propoxyphene, an agent to treat non‐severe pain, are problematic opioids in the elderly. White origin, male gender, and increased disease burden are potential risk factors influencing injury‐related ER visits for elderly analgesic recipients. Increased age in the elderly is a potential risk factor for severe pain analgesics; decreased age for non‐severe pain analgesics.

Research limitations/implications

The study uses administrative data which, by its nature, makes conducting outcomes research on inappropriate medication use problematic. A number of confounders are present.

Practical implications

Appropriate drug therapy in an elderly patient is complicated by age‐related changes in pharmacokinetics as well as chronic disorders that affect drug response. Knowing of additional risk factors that may place the patient at greater odds of having an adverse outcome should improve prescribing practices.

Originality/value

The findings add to the literature by identifying problematic risk factors associated with injury among elderly recipients of analgesics.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 5 no. 1
Type: Research Article
ISSN: 1750-6123

Keywords

Article
Publication date: 7 July 2020

Rowdy Yates

As the clamour within the drug treatment field in the UK – and throughout much of Europe – increases, leading agencies are arguing for a review of the current legislation and a…

Abstract

Purpose

As the clamour within the drug treatment field in the UK – and throughout much of Europe – increases, leading agencies are arguing for a review of the current legislation and a change in focus away from criminal justice and towards a more public health understanding of addiction. Therapeutic communities have found themselves united with many drug users-led campaigns to argue for a wholesale restructuring of the legislative, policy and funding arrangements which recognises the role of recovery-oriented interventions within the mix. Given these on-going debates, it is perhaps useful to understand how the current arrangements were established [1].

Design/methodology/approach

In 1850s, the sale of opium – like alcohol – was largely unregulated. It was widely used, in a variety of preparations, by all classes for medical and non-medical purposes. A pennyworth of opium was as likely (perhaps more likely) as a pound of potatoes to find its way into the weekly shopping basket.

Findings

By the 1920s, the Fu Manchu novels of Sax Rohmer – with their tales of innocent English virgins being seduced into crime and sexual perversion by an evil Chinese genius who lurked within the opium dens of Edwardian Britain – had redefined opium as a drug of the outside, the deadly, an agent in the enslavement of innocence.

Originality/value

This dramatic change was largely brought about by the introduction of an array of new medications and a move away from traditional “herbal” remedies. This change was accelerated by the experiences of the First World War and underpinned by the print media and laid the foundations of the legislation and policy of the present day.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 41 no. 2
Type: Research Article
ISSN: 0964-1866

Keywords

Article
Publication date: 10 July 2020

Sabir Zaman, Shahid Irfan, Basharat Hussain, Muhammad Tahir Nawaz and Shazia Khalid

There is increased social discussion of the emerging issues of opioid use, health and well-being of young adults within contemporary Asian society. The purpose of this study is to…

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Abstract

Purpose

There is increased social discussion of the emerging issues of opioid use, health and well-being of young adults within contemporary Asian society. The purpose of this study is to contribute new knowledge of opioid-using young adults through ethnographic perspectives of the five main cultures of Pakistan. Furthermore, it tried to explore the values of opioid users.

Design/methodology/approach

It is a qualitative study. Semi-structured interview and observation techniques were used to gain the participants’ information, in a non-judgmental environment. Observation and life focus history interview methodology were used for data collection. The sample consisted of 18 male opioid users (approximately three from each area including: Punjab, Khyber Pakhtoon Khah, Balochistan, Sindh, Gilgit Baltistan and Azad Jammu and Kashmir). An interview script was used in interviews after written informed consent. After the detailed interview and observation of non-verbal behaviours, the researchers analysed the data by using the content analysis of qualitative method.

Findings

The result showed that poor relationships, conflicts over property, lack of social support and family problems increased with the use of opioids by individuals. The individual’s mental health, such as hopelessness, curiosity, mistrust and lack of interest in social activities, was the major cause of opioid addiction. Moreover, peer influences and friends may also have played contributing roles in opioids use among men.

Research limitations/implications

The current study added to the understanding of the relationship of different environmental, behavioural and social factors involved in developing opioid use among young individuals. The homogeneity of the sample may have weakened the generalisability of the findings of the study as all participants in the study were male.

Practical implications

Clinicians and allied professionals have shown a great interest in early intervention with opioid users. At the same time, there is a lack of qualitative studies exploring the lived experiences of young opioid users. That is why this study was done, to empower counsellors.

Social implications

Opioids, including heroin, have strong addictive tendencies. They are easily available, particularly in unplanned urban areas of Pakistan. The present study tried to understand the lived experiences and beliefs of opioid users belonging to different cultures of Pakistan.

Originality/value

At the same time, there is a lack of qualitative studies exploring the lived experiences of adult opioid users. Therefore, this study presented 18 interview-based facts from the opioid users belonging to different areas of Pakistan residing in capital of Pakistan. The content of these vignettes was examined in the context of an ethnographic perspective, as it has a strong connection and contribution to drug abuse.

Book part
Publication date: 25 May 2017

Jeanette Covington

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…

Abstract

Purpose

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.

Methodology/approach

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.

Findings

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.

Originality/value

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.

Article
Publication date: 1 April 1986

Diana Brahams

The last 60 years have seen unprecedented advances in medical treatment. Patients' expectations for a successful outcome are now higher than at any previous time. More and more…

Abstract

The last 60 years have seen unprecedented advances in medical treatment. Patients' expectations for a successful outcome are now higher than at any previous time. More and more patients are ready to sue for damages if the result is disappointing, since there is less readiness to accept that failure may not be the result of medical negligence.

Details

Journal of Management in Medicine, vol. 1 no. 4
Type: Research Article
ISSN: 0268-9235

Article
Publication date: 1 March 1998

Mark Simmonds and Mrs Peggy Edwards

For this study 334 patients during their stay in the recovery room were assigned to the following groups: ‘comfortable’, in ‘pain’ and in ‘severe pain’. Fourteen per cent of…

Abstract

For this study 334 patients during their stay in the recovery room were assigned to the following groups: ‘comfortable’, in ‘pain’ and in ‘severe pain’. Fourteen per cent of patients awoke from anaesthesia in ‘pain’ and 10% were discharged to the ward in ‘pain’. Thirty‐seven per cent of patients using patient‐controlled analgesia (PCA) in the recovery room were discharged in ‘pain’; 63% of these patients had neither been prescribed nor given a ‘loading dose’ in the recovery room. Forty‐eight per cent of patients receiving sole intramuscular opioid analgesia were discharged in ‘pain’. Ninety per cent who received nurse‐administered ‘prn’ intravenous bolus opioids were discharged ‘comfortable’. An algorithm was therefore developed for the administration of loading doses of intravenous opioids in the recovery unit to be used by recovery nursing staff prior to PCA or other analgesic methods. An early re‐audit established that the algorithm became widely adopted by anaesthetists, was safe and produced comparable discharge pain scores.

Details

Journal of Clinical Effectiveness, vol. 3 no. 3
Type: Research Article
ISSN: 1361-5874

Book part
Publication date: 9 October 2012

Nancy D. Campbell

Purpose – The chapter examines the historical pattern of interconnections between drug policy, research, and treatment in light of recent theoretical developments in the…

Abstract

Purpose – The chapter examines the historical pattern of interconnections between drug policy, research, and treatment in light of recent theoretical developments in the medicalization thesis advanced in the sociology of medicine.

Methodology/approach – The chapter uses interpretive methods to examine how the social construction of addiction as a “chronic, relapsing brain disorder” converges with or diverges from the conceptual framework offered by sociological theorists of medicalization and biomedicalization.

Findings – The approach adopted shows how the meanings of the bio/medicalization of addiction shifted and circulated within and beyond the institutions developed to respond to drug addiction as a hybrid social, medical, and biomedical condition during the 20th century.

Social implications – Bio/medical frameworks for addiction are the outcome of historical attempts to influence public attitudes and develop effective methods to treat and prevent this “disease” in ways that would positively affect the quality of life of people living with addictions.

Originality/value – This original contribution addresses both strengths and limitations of bio/medical models, assessing how their influence has changed over time.

Details

Critical Perspectives on Addiction
Type: Book
ISBN: 978-1-78052-930-1

Keywords

Article
Publication date: 30 August 2023

Maria-Goretti Ane

This paper aims to explore the role of tramadol in pain management and the impact of regulatory measures on supply and medical access in Ghana and other African countries.

Abstract

Purpose

This paper aims to explore the role of tramadol in pain management and the impact of regulatory measures on supply and medical access in Ghana and other African countries.

Design/methodology/approach

The study adopted an exploratory design and qualitative methods to explore the perspectives of different actors, including officials of regulatory agencies, law enforcement agents, health-care providers and non-medical tramadol users. Data were collected through individual and group interviews, and transcripts were subjected to thematic analysis.

Findings

Findings show that tramadol fills a critical gap in treating pain across Ghana in areas with an acute shortage of opioid analgesics due to scheduling-related barriers. This was partly due to porous borders allowing for an influx of tramadol into the countries. The study further found that most tramadol purchases in Ghana and other West African countries were made from market traders rather than from health-care settings and were mainly generic medicines categorised as “substandard/spurious/falsely-labelled/falsified/counterfeit medical products” within the World Health Organization standards.

Research limitations/implications

Although the findings are instructive, there were some limitations worth noting. The study encountered several limitations, especially with the non-medical users, because the environment is highly criminalised, People who use drugs were unwilling to avail themselves for fear of law enforcement officers’ harassment. Obtaining ethical clearance had its own bureaucracy – challenges that delayed the study time frame.

Practical implications

Placing tramadol under the list of internationally controlled substances would create barriers to access to effective pain medications, particularly by the poor, and encourage victimisation of users by law enforcement authorities.

Originality/value

The study is based on empirical research on tramadol use and regulation in African countries, contributing to knowledge in an under-researched subject area on the continent. The comparative approach further adds value to the research.

Details

Drugs, Habits and Social Policy, vol. 24 no. 4
Type: Research Article
ISSN: 2752-6739

Keywords

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