scholarly journals Prison-based drug treatment in Finland: History, shifts in policy making and current status

2012 ◽  
Vol 29 (6) ◽  
pp. 575-588 ◽  
Author(s):  
Jouni Tourunen ◽  
Antti Weckroth ◽  
Teemu Kaskela
Keyword(s):  
Drug Treatment ◽  
Harm Reduction ◽  
Criminal Policy ◽  
Healthcare Services ◽  
Current Status ◽  
Individual Risk ◽  
Rehabilitative Treatment ◽  
National Drug ◽  
Free Environment ◽  
Abuse Treatment

Aim The article outlines, at the level of political discourse, changes in drug and criminal policy that may have influenced the penal system as a backdrop to the rise of prison-based drug treatment programmes (PBDT) in Finland. Methods and Data Our perspective is historical. The article is based on historical and political documents, scholarly research and white papers. Results The history of PBDT in Finland is characterised by an absence of drug treatment programmes until the 1980s, first initiatives at the end of the 1980s, enthusiastic programme development from the mid-1990s, and decreasing interest during recent years. Unlike the National Drug Strategy, the Prison Drug Strategy aimed at a drug-free environment (zero tolerance) and implemented harm-reduction measures only to a limited extent. Conclusion The development of PBDT represents the new way of performing treatment in prisons, with features of managerialism. PBDT is also affected by an organisational segregation of rehabilitation and medical treatment, which prevents integration of harm-reduction measures with rehabilitative treatment, and is in conflict with general aims of integrating substance abuse treatment to mental and healthcare services in Finland. In the spirit of a new kind of Penal Welfarism, the role of documented individual risk and needs assessment in defining an offender's sentence has increased.

scholarly journals Prior National Drug Abuse Treatment Clinical Trials Network (CTN) opioid use disorder trials as background and rationale for NIDA CTN-0100 “optimizing retention, duration and discontinuation strategies for opioid use disorder pharmacotherapy (RDD)”

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Matisyahu Shulman ◽  
Roger Weiss ◽  
John Rotrosen ◽  
Patricia Novo ◽  
Elizabeth Costello ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Extended Release ◽  
Primary Outcome ◽  
Opioid Use Disorder ◽  
Drug Abuse Treatment ◽  
Opioid Use ◽  
National Drug ◽  
Retention In Treatment ◽  
Abuse Treatment

AbstractOpioid use disorder continues to be a significant problem in the United States and worldwide. Three medications—methadone, buprenorphine, and extended-release injectable naltrexone,— are efficacious for treating opioid use disorder (OUD). However, the utility of these medications is limited, in part due to poor rates of retention in treatment. In addition, minimum recovery milestones and other factors that influence when and whether individuals can safely discontinue medications are unknown. The National Drug Abuse Treatment Clinical Trials Network (CTN) study “Optimizing Retention, Duration, and Discontinuation Strategies for Opioid Use Disorder Pharmacotherapy” (RDD; CTN-0100) will be among the largest clinical trials on treatment of OUD yet conducted, consisting of two phases, the Retention phase, and the Duration-Discontinuation phase. The Retention phase, open to patients initiating treatment, will test different doses and formulations of buprenorphine (standard dose sublingual, high dose sublingual, or extended-release injection), and a digital therapeutic app delivering contingency management and cognitive behavioral counseling on the primary outcome of retention in treatment. The Discontinuation phase, open to patients in stable remission from OUD and choosing to discontinue medication (including participants from the Retention phase or from the population of patients treated at the clinical site, referred by an outside prescriber or self-referred) will study different tapering strategies for buprenorphine (sublingual taper vs taper with injection buprenorphine), and a digital therapeutic app which provides resources to promote recovery, on the primary outcome of relapse-free discontinuation of medication. This paper describes how the RDD trial derives from two decades of research in the CTN. Initial trials (CTN-0001; CTN-0002; CTN-0003) focused on opioid detoxification, showing buprenorphine-naloxone was effective for detoxification, but that acute detoxification did not appear to be an effective treatment strategy. Trials on comparative effectiveness of medications for opioid use disorder (MOUD) (CTN-0027; CTN-0030; and CTN-0051) highlighted the problem of dropout from treatment and few trials defined retention on MOUD as the primary outcome. Long-term follow-up studies on those patient samples demonstrated the importance of long-term continuation of medication for many patients to sustain remission. Overall, these trials highlight the potential of a stable research infrastructure such as CTN to advance treatment effectiveness through a programmatic succession of large clinical trials.

scholarly journals An audit of the cervical screening programme in the National Drug Treatment Centre (NDTC)

2021 ◽  
Author(s):  
Maeve Haran ◽  
John R. Kelly ◽  
Liam Kennedy ◽  
Kieran Hennigan ◽  
Huma Farid ◽  
...  
Keyword(s):  
Drug Treatment ◽  
Screening Programme ◽  
Cervical Screening ◽  
National Drug ◽  
Treatment Centre

scholarly journals Criminal responsibility for medical malpractice in the jurisdictional practice of Serbia

2019 ◽  
Vol 147 (5-6) ◽  
pp. 380-385
Author(s):  
Vladimir Miletic
Keyword(s):  
Medical Malpractice ◽  
Criminal Responsibility ◽  
Criminal Policy ◽  
Healthcare Services ◽  
Theory And Practice ◽  
Special Importance ◽  
Medical Assistance ◽  
Public Attention ◽  
The Public ◽  
The Republic

In the field of protection and improvement of people?s health, there is a special importance of legally, efficiently, regularly, professionally, and punctually providing medical care, performing other healthcare services, or simply providing medical assistance or care. In this way, an essential social function is achieved, as well as the protection of the constitutionally proclaimed right of physical and mental integrity of the public. However, deterioration of an individual?s health who has been medically assisted is possible in the process of providing medical, or any other assistance in the field of medicine. If it is a gross medical misconduct or any other type of medical misconduct, or gross violation of a profession?s rules, because of which there is a possibility of deterioration of health of one or more individuals, then the crime of medical negligence, for which there are strict statutory offences, applies. This article addresses the aspect of theory and practice about the significance, social jeopardy, and prevalence of this crime, or criminal policy of courts in the Republic of Serbia, alongside many articles in the printed and electronic media which provoke great public attention and rough comments.

scholarly journals Psychosis and recreational use of MDMA (“Ecstasy”)

1993 ◽  
Vol 10 (3) ◽  
pp. 162-163 ◽  
Author(s):  
Eamon Keenan ◽  
Maurice Gervin ◽  
Arthur Dorman ◽  
John J O'Connor
Keyword(s):  
Drug Treatment ◽  
National Drug ◽  
Treatment Centre ◽  
Recreational Use ◽  
Paranoid Psychosis ◽  
Chronic Psychosis

AbstractA seventeen year old man attended the National Drug Treatment Centre with a paranoid psychosis following ingestion of Methylene dioxy methamphetamine (MDMA). He had been taking MDMA on a recreational basis over a five month period. Although chronic psychosis after heavy use of MDMA has been reported there are no pervious reports of psychosis following recreational use. This report highlights the psychological dangers of this drug, which has become widely misused in Dublin over the last two years.

Narcan as biomedical panic: The war on overdose and the harms of harm reduction

2020 ◽  
pp. 136248062096477
Author(s):  
Philip R Kavanaugh
Keyword(s):  
Public Health ◽  
Drug Treatment ◽  
Harm Reduction ◽  
Drug Users ◽  
Opioid Addiction ◽  
The State ◽  
Opioid Overdose ◽  
State Response ◽  
Drug Companies ◽  
The Us

As the opioid overdose crisis in the US persists, governments have coordinated with drug companies to propagate the overdose reversal drug naloxone (Narcan) as a ‘kinder/gentler’ state response, deriving from a supposedly progressive harm reduction ethos. Drawing on Derrida’s deconstruction of pharmakon, I show how Narcan is rendered paradoxical and terminal, diverting attention from the structural antecedents of opioid addiction and resources for drug treatment while reproducing corporeal suffering in those revived. I further highlight how Narcan is positioned in a wider array of regressive governing practices that legitimate the state’s punitive drug war and demonization of drug users. Narcan thus provides a useful opening between the state and contemporary biomedicine to theorize how harm reduction and public health unfurl in insidious and corrosive ways.

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