Drug Abuse Research Today is a free monthly online journal that collates and summarizes the latest research about Drug Abuse, including details on psychology, rehabilitation, consequences, treatment.

Giving addicts their drug of choice: the problem of consent.

Walker T

Centre for Applied Ethics at the University of Keele, Keele, Staffordshire, UK. chuckk@umich.edu

Researchers working on drug addiction may, for a variety of reasons, want to carry out research which involves giving addicts their drug of choice. In carrying out this research consent needs to be obtained from those addicts recruited to participate in it. Concerns have been raised about whether or not such addicts are able to give this consent. Despite their differences, however, both sides in this debate appear to be agreed that the way to resolve this issue is to determine whether or not addicts have irresistible cravings for drugs - if they do, then they cannot consent to this type of research; if they do not, then they can. This I will argue is a mistake. Determining whether or not addicts can say 'No' to offers of drugs will not help us to make much progress here. Instead we need to look at the various ways in which different types of research may undermine an addict's competence to give consent. What we will find is that the details of the research make a big difference here and that, as such, we need to steer a course between, on the one hand, painting all addicts as being unable to consent to research which involves providing them with drugs, and, on the other, maintaining that there are no problems in obtaining consent from addicts to take part in such research.

Published 4 June 2008 in Bioethics, 22(6): 314-20.
Full-text of this article is available online (may require subscription).

Articles on Drug Abuse published 16 May 2008:

High HIV risk among Uigur minority ethnic drug users in northwestern China.   Trop Med Int Health, 13(6): 814-7.

OBJECTIVE: To assess differences of HIV risk between ethnicities in northwestern China. METHOD: Cross-sectional serosurvey and structured questionnaire interview of 383 injection drug users of either Han or Uigur ethnicity in Urumqi, Xinjiang. RESULTS: Both Uigur minority ethnicity and residence in a Uigur or mixed Uigur/Han community were independently associated with higher HIV risk. CONCLUSION: HIV prevention programs should give special focus on minority ethnic drug users and their ... [Abstract] [Full-text]

Articles on Drug Abuse published 14 May 2008:

The epidemic history of hepatitis C among injecting drug users in Flanders, Belgium.   J Viral Hepat, 15(6): 399-408.

We employed recently developed statistical methods to explore the epidemic behaviour of hepatitis C subtype 1a and subtype 3a among injecting drug users (IDUs) in Flanders, Belgium, using new gene sequence data sampled among two geographically distinct populations of IDUs. First the extent of hepatitis C transmission across regions/countries was studied through calculation of association indices. It was shown that viral exchange had occurred between both populations in Flanders as well as ... [Abstract] [Full-text]

HCV-specific T-cell responses in injecting drug users: evidence for previous exposure to HCV and a role for CD4+ T cells focussing on nonstructural proteins in viral clearance.   J Viral Hepat, 15(6): 409-20.

In order to understand the parameters associated with resolved hepatitis C virus (HCV)-infection, we analysed the HCV-specific T-cell responses longitudinally in 13 injecting drug-users (IDUs) with a prospectively identified acute HCV infection. Seven IDUs cleared HCV and six IDUs remained chronically infected. T-cell responses were followed in the period needed to resolve and a comparable time span in chronic carriers. Ex vivo T-cell responses were measured using interferon-gamma Elispot ... [Abstract] [Full-text]

Articles on Drug Abuse published 7 May 2008:

Baseline subjective stress predicts 1-year outcomes among drug court clients.   Int J Offender Ther Comp Criminol, 52(3): 346-57.

Psychological stress has long been known to predict negative changes in physical and behavioral health in the general population. The same relationships have been found in research on drug abusers. In this longitudinal study, 477 clients of two Kentucky drug courts were followed for 1 year to examine the relationship between subjective stress at intake and outcomes 1 year after the baseline of this 18-month drug court program. Greater baseline subjective stress was significantly associated with ... [Abstract] [Full-text]

Articles on Drug Abuse published 1 May 2008:

Applying drug dependence research to prevention interventions in Spain.   Eval Health Prof, 31(2): 182-97.

This article examines the status of evidence-based interventions for preventing drug dependence in Spain. The evolution of the perception that the Spanish have of the problem and how this has influenced prevention efforts is described. An analysis is made of how programs designed to prevent drug use have been translated from the field of experimental research to implementation. The characteristics of evidence-based programs developed in Spain are outlined, analyzing their efficacy and the ... [Abstract] [Full-text]

Articles on Drug Abuse published 25 April 2008:

A randomized intervention trial to reduce the lending of used injection equipment among injection drug users infected with hepatitis C.   Am J Public Health, 98(5): 853-61.

OBJECTIVES: We evaluated the efficacy of a peer-mentoring behavioral intervention designed to reduce risky distributive injection practices (e.g., syringe lending, unsafe drug preparation) among injection drug users with hepatitis C virus (HCV) infection. METHODS: A randomized trial with a time-equivalent attention-control group was conducted among 418 HCV-positive injection drug users aged 18 to 35 years in 3 US cities. Participants reported their injection-related behaviors at baseline and at ... [Abstract] [Full-text]

Articles on Drug Abuse published 23 April 2008:

Interactive "Video Doctor" counseling reduces drug and sexual risk behaviors among HIV-positive patients in diverse outpatient settings.   PLoS ONE, 3(4): e1988.

BACKGROUND: Reducing substance use and unprotected sex by HIV-positive persons improves individual health status while decreasing the risk of HIV transmission. Despite recommendations that health care providers screen and counsel their HIV-positive patients for ongoing behavioral risks, it is unknown how to best provide "prevention with positives" in clinical settings. Positive Choice, an interactive, patient-tailored computer program, was developed in the United States to improve ... [Abstract] [Full-text]

Articles on Drug Abuse published 22 April 2008:

Revealing the paradox of drug reward in human evolution.   Proc Biol Sci, 275(1640): 1231-41.

Neurobiological models of drug abuse propose that drug use is initiated and maintained by rewarding feedback mechanisms. However, the most commonly used drugs are plant neurotoxins that evolved to punish, not reward, consumption by animal herbivores. Reward models therefore implicitly assume an evolutionary mismatch between recent drug-profligate environments and a relatively drug-free past in which a reward centre, incidentally vulnerable to neurotoxins, could evolve. By contrast, emerging ... [Abstract] [Full-text]

© 2005-2008 Drug Abuse Research Today. All Rights Reserved.