Afghanistan has a sizeable problem with opioid use

In 2010, opioid use and dependence made the largest contribution to morbidity and mortality from illicit drug use, contributing to premature death from drug overdose and suicide, and in those who inject these drugs, infection with HIV and other blood-borne viruses. Dependence also produced considerable disability.1 Afghanistan has a tradition of opium smoking, and has long been a major source of illegal opiates for eastern and western Europe. In the past decade, Afghans have also reportedly begun to inject heroin and use pharmaceutical opioids

Trends and characteristics of accidental and intentional codeine overdose deaths in Australia

Examines trends in codeine-related mortality rates in Australia, and the clinical and toxicological characteristics of codeine-related deaths. Abstract Objectives: To examine trends in codeine-related mortality rates in Australia, and the clinical and toxicological characteristics of codeine-related deaths. Design and setting: Analysis of prospectively collected data from the National Coronial Information System on deaths where codeine toxicity was determined to be an underlying or contributory cause of death. The study period was 2000–2013. Main outcome measures: Population-adjusted numbers (per million persons) of (1) codeine-related deaths, classified by intent (accidental or intentional); and (2) heroin- and Schedule 8 opioid-related deaths (as a comparator). Results: The overall rate of codeine-related deaths increased from 3.5 per million in 2000 to 8.7 per million in 2009. Deaths attributed to accidental overdoses were more common (48.8%) than intentional deaths (34.7%), and their proportion increased during the study period. High rates of prior comorbid mental health (53.6%), substance use (36.1%) and chronic pain (35.8%) problems were recorded for these deaths. For every two Schedule 8 opioid-related deaths in 2009, there was one codeine-related death. Most codeine-related deaths (83.7%) were the result of multiple drug toxicity. Conclusions: Codeine-related deaths (with and without other drug toxicity) are increasing as the consumption of codeine-based products increases. Educational messages are needed to better inform the public about the potential harms of chronic codeine use, especially in the context of polypharmacy

The "lessons" of the Australian "heroin shortage"

Heroin use causes considerable harm to individual users including dependence, fatal and nonfatal overdose, mental health problems, and blood borne virus transmission. It also adversely affects the community through drug dealing, property crime and reduced public amenity. During the mid to late 1990s in Australia the prevalence of heroin use increased as reflected in steeply rising overdose deaths. In January 2001, there were reports of an unpredicted and unprecedented reduction in heroin supply with an abrupt onset in all Australian jurisdictions. The shortage was most marked in New South Wales, the State with the largest heroin market, which saw increases in price, dramatic decreases in purity at the street level, and reductions in the ease with which injecting drug users reported being able to obtain the drug. The abrupt onset of the shortage and a subsequent dramatic reduction in overdose deaths prompted national debate about the causes of the shortage and later international debate about the policy significance of what has come to be called the "Australian heroin shortage". In this paper we summarise insights from four years' research into the causes, consequences and policy implications of the "heroin shortage"

La política antidrogas: nuevos horizontes de cambio en el control de la oferta y la demanda

96 p.De acuerdo con la Organización Mundial de la Salud (OMS, 1994) una sustancia o droga psicoactiva es aquella que, al ingerirse, afecta procesos mentales, como la cognición o la memoria. El término es asemejado generalmente con el de psicotrópico y ambas expresiones refieren al grupo de sustancias, legales e ilegales, de interés para la política en materia de drogas. En general, la literatura refiere con el término psicotrópico, a medicamentos utilizados principalmente en el tratamiento de los trastornos mentales, como los ansiolíticos, sedantes, antidepresivos, anti maníacos y neurolépticos. Bajo la categoría de sustancias psicotrópicas se encuentran los estupefacientes, acepción utilizada para referirse a sustancias cuya acción sedante, analgésica, narcótica y euforizante puede conducir al acostumbramiento y a la toxicomanía, por lo cual tienen un elevado potencial de abuso y / o dependencia psíquica/física. Entre ellos, se cuentan los estimulantes -cocaína, cafeína, nicotina-, los alucinógenos -Peyote y Psilocybes, los opiáceos -morfina, heroína-, y los sedantes/hipnóticos -alcohol- (OMS, 1994).Prólogo Introducción Capítulo 1. El panorama global: evolución reciente del fenómeno del consumo de sustancias psicoactivas Capítulo 2. La junta internacional de fiscalización de estupefacientes y la eficacia de la política antidrogas: el caso colombiano Capítulo 3. Hacia nuevos horizontes del análisis de política antidrogas Conclusiones Bibliografí

Collapse analysis, defect sensitivity and load paths in stiffened shell composite structures

An experimental program for collapse of curved stiffened composite shell structures encountered a wide range of initial and deep buckling mode shapes. This paper presents work to determine the significance of the buckling deformations for determining the final collapse loads and to understand the source of the variation. A finite element analysis is applied to predict growth of damage that causes the disbonding of stiffeners and defines a load displacement curve to final collapse. The variability in material properties and geometry is then investigated to identify a range of buckling modes and development of deep postbuckling deformation encountered in the experimental program. Finally the load paths for the damaged panels are used to visualise the load transfer and enhance the physical understanding of the load displacement history

A dynamical model for the penumbral fine structure and the Evershed effect in sunspots

Relying on the assumption that the interchange convection of magnetic flux tubes is the physical cause for the existence of sunspot penumbrae, we propose a model in which the dynamical evolution of a thin magnetic flux tube reproduces the Evershed effect and the penumbral fine structure such as bright and dark filaments and penumbral grains. According to our model, penumbral grains are the manifestation of the footpoints of magnetic flux tubes, along which hot subphotospheric plasma flows upwards with a few km/s. Above the photosphere the hot plasma inside the tube is cooled by radiative losses as it flows horizontally outwards. As long as the flowing plasma is hotter than the surroundings, it constitutes a bright radial filament. The flow confined to a thin elevated channel reaches the temperature equilibrium with the surrounding atmosphere and becomes optically thin near the outer edge of the penumbra. Here, the tube has a height of approximately 100 km above the continuum and the flow velocity reaches up to 14 km/s. Such a flow channel can reproduce the observed signatures of the Evershed effect.Comment: 5 pages, 2 figures, accepted for publication in ApJ letter

Unsung heroes: who supports social work students on placement?

Since the introduction of the three year degree programme in 2003, social work education has undergone a number of significant changes. The time students spend on placement has been increased to two hundred days, and the range of placement opportunities and the way in which these placements have been configured has significantly diversified. A consistent feature over the years, however, has been the presence of a Practice Educator (PE) who has guided, assessed and taught the student whilst on placement. Unsurprisingly, the role of the PE and the pivotal relationship they have with the student has been explored in the past and features in social work literature. This paper, however, concentrates on a range of other relationships which are of significance in providing support to students on placement. In particular it draws on research to discuss the role of the university contact tutor, the place of the wider team in which the student is sited, and the support offered by family, friends and others. Placements and the work undertaken by PE’s will continue to be integral to the delivery of social work education. It is, however, essential to recognise and value the often over looked role of others in providing support to students on placement