This paper argues for two claims. First, recreational drug use is immoral because it undermines cognitive functioning. Second, for similar reasons, the state has a prima facie public policy interest in enacting legal restrictions on recreational drug use. In this context, “recreational drug use” refers to activities in which a person uses some intoxicating substance to impair, destroy, or otherwise frustrate the functioning of his cognitive faculties for the sake of pleasure or enjoyment.

Why does American law allow the recreational use of some drugs, such as alcohol, tobacco, and caffeine, but not others, such as marijuana, cocaine, and heroin? The answer lies not simply in the harm the use of these drugs might cause, but in the perceived morality—or lack thereof—of their recreational use. Despite strong rhetoric from moral critics of recreational drug use, however, it is surprisingly difficult to discern the reasons they have for deeming the recreational (...) use of (some) drugs morally wrong. In this book, Rob Lovering lays out and dissects various arguments for the immorality of using marijuana, cocaine, heroin, and other drugs recreationally. He contends that, by and large, these arguments do not succeed. Lovering's book represents one of the first works to systematically present, analyze, and critique arguments for the moral wrongness of recreational drug use. Given this, as well as the popularity of the morality-based defense of the United States' drug laws, this book is an important and timely contribution to the debate on the recreational use of drugs. (shrink)

There is a wide array of arguments for the immorality of recreational drug use, ranging from the philosophically rudimentary to the philosophically sophisticated. But the vast majority of these arguments are unsuccessful, and those that succeed are quite limited in scope. In this article, I present and evaluate a few examples of such arguments.

Individual differences in moral views are often explained as the downstream effect of ideological commitments, such as political orientation and religiosity. Recent studies in the U.S. suggest that moral views about recreational drug use are also influenced by attitudes toward sex and that this relationship cannot be explained by ideological commitments. In this study, we investigate student samples from Belgium, The Netherlands, and Japan. We find that, in all samples, sexual attitudes are strongly related to views about (...) class='Hi'>recreational drug use, even after controlling for various ideological variables. We discuss our results in light of reproductive strategies as determinants of moral views. (shrink)

_Illegal Leisure _offers a unique insight into the role drug use now plays in British youth culture. The authors present the results of a five year longitudinal study into young people and drug taking. They argue that drugs are no longer used as a form of rebellious behaviour, but have been subsumed into wider, acceptable leisure activities. The new generation of drug user can no longer be seen as mad or bad or from subcultural worlds - they (...) are ordinary and everywhere. Illustrated throughout with interview material, _Illegal Leisure _shows how drug consumption has become normalised, and provides a well-informed analysis of the current debate. (shrink)

The current debate on recreational drug policy is roughly a contest between prohibition advocates and legalization advocates. This paper offers a third alternative that is a compromise between those two. The centralized-use compromise can secure the autonomy interests that are important to defenders of legalization, and it can prevent harms to others that are the focus of prohibition arguments. The centralized-use compromise also offers a possible way to reduce the black market while also reducing the rate of addiction (...) and the associated debasing harms to self. (shrink)

Recreational Drugs European Network (ReDNet) project aims to use the Psychonaut Web Mapping Project database (Psychonaut Web Mapping Group, 2009) containing novel psychoactive compounds usually not mentioned in the scientific literature and thus unknown to clinicians as a unique source of information. The database will be used to develop an integrated ICT prevention approach targeted at vulnerable individuals and focused on novel synthetic and herbal compounds and combinations. Particular care will be taken in keeping the health professionals working directly (...) with young people showing problematic behaviors regularly updated in terms of novel compounds and combinations as well. A user-friendly project website will be developed aimed primarily at delivering the information/prevention approaches, but will also be a way of communicating with project partners and relevant stakeholders (e.g. thematic forum facilities, instant messages, blogs, video chat, wikiblog, newsletters distributed via mailing list). The website will support various ICT prevention tools, including an SMS alert service. Different areas and sections will be aimed specifically at the different target groups. -/- . (shrink)

In this paper, I identify an argument derived from the commitments of John Rawls’s liberalism for restricting the consumption of recreational drugs in a liberal society, but not because of a great passion for restriction at present. The argument can also be used to respond to Jonathan Quong’s example of an unresolvable disagreement between liberal citizens.

A critical survey of arguments for and against the morality and the legality of recreational drug use, deploying Feinberg's analysis of liberty-limiting principles.

Herbert, Michael Several children are experiencing behavioural and psychological problems at a younger age, due to the harms inflicted by illicit drug use. Professor Patrick McGorry of Orygen Youth Health, an organisation helping teenagers with mental health problems, believes that many young people experiment with drugs recreationally and for fun, but the situation gets worse once it becomes necessary as a relief from their problems.

Earp and colleagues make a strong case for the complete decriminalization and even the legalization of recreational drug use based on the negative impact of the “War on drugs” on racialized...

Recent proposals to punish athletes for taking drugs or to impose mandatory drug testing cannot be defended in ethical terms. Nor is it possible to distinguish consistently between ethical and unethical uses of restorative drugs, additive drugs, painkillers, and recreational drugs. We oppose drugs in sports because they violate the majority notion of acceptable behavior. But such opposition has more to do with defending the ideals of the community than with creating policies that are ethically sound.

This important book was the first serious work of philosophy to address the question: Do adults have a moral right to use drugs for recreational purposes? Many critics of the 'war on drugs' denounce law enforcement as counterproductive and ineffective. Douglas Husak argues that the 'war on drugs' violates the moral rights of adults who want to use drugs for pleasure, and that criminal laws against such use are incompatible with moral rights. This is not a polemical tract but (...) a scrupulously argued work of philosophy that takes full account of all available data concerning drug use in the United States today. The author is careful to describe the properties a recreational drug would have to possess before the state would be justified in prohibiting it. Since criminal laws against the use of recreational drugs are justified neither by the harm users cause to themselves nor by the harm users cause to each other, Professor Husak concludes that such laws are, in almost all cases, unjustified. (shrink)

This paper1 uses concepts of anxiety and Foucauldian governmentality to investigate the ways that the discourses supporting the ban on performance-enhancing drugs in sport have been manipulated and broadened to treat this issue as a public policy and health issue rather than an example of rule violation in sport. Some effects of this expansion include the broadening of drug testing to include testing for recreational drugs, the intrusion of both central governments and scientific experts into the issue and (...) the curtailment of civil liberties for athletes. A further effect has been the perpetration of injustices against athletes under the guise of such injustices being necessary to maintain the integrity of sport. (shrink)

Historically, laws and policies to criminalize drug use or possession were rooted in explicit racism, and they continue to wreak havoc on certain racialized communities. We are a group of bioethicists, drug experts, legal scholars, criminal justice researchers, sociologists, psychologists, and other allied professionals who have come together in support of a policy proposal that is evidence-based and ethically recommended. We call for the immediate decriminalization of all so-called recreational drugs and, ultimately, for their timely and appropriate (...) legal regulation. We also call for criminal convictions for nonviolent offenses pertaining to the use or possession of small quantities of such drugs to be expunged, and for those currently serving time for these offenses to be released. In effect, we call for an end to the “war on drugs.”. (shrink)

This textbook introduces students to the various arguments for and against the prohibition of recreational drugs. The arguments are carefully presented and analyzed, inviting students to consider the competing principles of liberty rights, paternalism, theories of punishment, legal moralism, and the social consequences of drug use and drug laws. Meyers extends this examination by presenting alternatives to the prohibition/legalization dichotomy, including harm reduction, decriminalization, and user licensing or on-premise use. The presentation invites readers to think clearly about (...) the reasons and principles that should determine public policy and law, while also delving into the deeper philosophical questions underlying the drug prohibition debate. Is it morally wrong to use drugs? If so, would that be reason enough to make it illegal? Are there good reasons in favor of using illicit drugs? Do addicts lack free will, and if so, would it be unjust to punish them? What is (or ought to be) the purpose of punishment? Is the state justified in limiting the freedom of competent adults for their own good? What should be the goal of drug policy, reduced use or reduced harm? The purpose of the book is twofold. First, it is a review of the arguments for and against drug prohibition, a useful tool for policy makers, activists, and concerned citizens with an understanding of the relevant considerations for determining how we should reform our failing drug policy. Second, the book serves as a case study in the deeper issues of justice, the nature of law, rights and liberties, and the public good. Students studying applied ethics, political science, or public policy will benefit greatly from Meyers' approach. (shrink)

In our recent article, together with more than 60 of our colleagues, we outlined a proposal for drug policy reform consisting of four specific yet interrelated strategies: (1) de jure decriminalization of all psychoactive substances currently deemed illicit for personal use or possession (so-called “recreational” drugs), accompanied by harm reduction policies and initiatives akin to the Portugal model; (2) expunging criminal convictions for nonviolent offenses pertaining to the use or possession of small quantities of such drugs (and releasing (...) those serving time for these offenses), while delivering retroactive ameliorative relief; (3) the ultimate legalization and careful regulation of currently illicit drugs; and (4) the delivery of a new “Marshall Plan” focused on community-building initiatives, expanded harm reduction programs, and social and health care support efforts (Earp et al. 2021). We were gratified to see so many thoughtful commentaries on our proposal, and we respond to them in part in this reply. (shrink)

Children who experience well-being are engaging more confidently and positively with their caregiver and peers, which helps them to profit more from available learning opportunities and support current and later life outcomes. The goodness-of-fit theory suggests that children’s well-being might be a result of the interplay between their temperament and the environment. However, there is a lack of studies that examined the association between children’s temperament and well-being in early childhood education and care, and whether this association is affected by (...) ECEC process quality. Using a multilevel random coefficient approach, this study examines the association between toddlers’ temperament and well-being in Norwegian ECEC and investigates whether process quality moderates this association. Results reveal an association between temperament and well-being. Staff-child conflict moderates the association between shyness and well-being, and between activity and well-being. Moreover, high emotional behavioral support moderates the association between activity and well-being. Extra attention should be paid by the staff to these children’s needs. (shrink)

Should the recreational use of drugs such as marijuana, cocaine, heroin, and LSD, be prohibited by law? Prohibitionists answer yes. They usually argue that drug use is extremely harmful both to drug users and to society in general, and possibly even immoral, and they believe that these facts provide sufficient reasons for prohibition. Legalizers answer no. They usually give one or more of three arguments: First, some argue that drug use is not as harmful as prohibitionists (...) believe, and even that it is sometimes beneficial. Second, some argue that drug prohibition “does not work”, i.e., is not very successful in preventing drug use and/or has a number of very bad consequences. Lastly, some argue that drug prohibition is unjust or violates rights. I won’t attempt to discuss all these arguments here. Instead, I will focus on what seem to me the three most prominent arguments in the drug legalization debate: first, the argument that drugs should be outlawed because of the harm they cause to drug users; second, the argument that they should be outlawed because they harm people other than the user; and third, the argument that drugs should be legalized because drug prohibition violates rights. I shall focus on the moral/philosophical issues that these [134] arguments raise, rather than medical or sociological issues. I shall show that the two arguments for prohibition fail, while the third argument, for legalization, succeeds. (shrink)

Programs of drug testing welfare recipients are increasingly common in US states and have been considered elsewhere. Though often intensely debated, such programs are complicated to evaluate because their aims are ambiguous – aims like saving money may be in tension with aims like referring people to treatment. We assess such programs using a proportionality approach, which requires that for ethical acceptability a practice must be: reasonably likely to meet its aims, sufficiently important in purpose as to outweigh harms (...) incurred, and lower in costs than feasible alternatives. In the light of empirical findings, we argue that the programs fail the three requirements. Pursuing recreational drug users is not important in the light of costs incurred, while dependent users who may require referral are usually identifiable without testing and typically need a broader approach than one focussing on drugs. Drug testing of welfare recipients is therefore not ethically acceptable policy. (shrink)

This important book was the first serious work of philosophy to address the question: Do adults have a moral right to use drugs for recreational purposes? Many critics of the 'war on drugs' denounce law enforcement as counterproductive and ineffective. Douglas Husak argues that the 'war on drugs' violates the moral rights of adults who want to use drugs for pleasure, and that criminal laws against such use are incompatible with moral rights. This is not a polemical tract but (...) a scrupulously argued work of philosophy that takes full account of all available data concerning drug use in the United States today. The author is careful to describe the properties a recreational drug would have to possess before the state would be justified in prohibiting it. Since criminal laws against the use of recreational drugs are justified neither by the harm users cause to themselves nor by the harm users cause to each other, Professor Husak concludes that such laws are, in almost all cases, unjustified. (shrink)

Ethical consumerism theory aims to describe, explain, and evaluate the ways in which producers and consumers use the market to support social and environmental values. The literature draws insights from empirical studies of sectors that largely take place on the legal market, such as textiles and agri-food. This paper takes a first step toward theorizing ethical consumerism in semi-legal sectors where market activities occur legally and illegally. How does extant theory extend to sectors such as sex work, cigarettes, and (...) class='Hi'>recreational drugs? This study draws on the case of recreational cannabis (marijuana) in Portland, OR (USA). Data from 33 interviews, structured fieldwork at 64 dispensaries, and the US Census Bureau American Community Survey are analyzed using qualitative, quantitative, and spatial methods. The findings are compared to 12 suggestions that emerge from the literature on fair trade, organics, alternative agriculture, and political consumerism. I argue that not all ethical consumerism theory extends to semi-legal sectors. Cannabis closely resembles theoretical expectations in terms of supply/demand, prioritization of ethical issues, and pervasiveness of false claims, but differs in terms of who organizes, which types of strategies are pursued, and how ethical products are framed. The differences stem from several pervasive stigmas about cannabis. I also argue that the stigmas that set cannabis apart from other (more legal sectors) and present challenges to ethical consumerism in cannabis are directly related to the War on Drugs. These insights suggest that prohibition (and its lingering effects) can inhibit the emergence of ethical consumerism. (shrink)

BackgroundEnhancement involves the use of biomedical technologies to improve human capacities beyond therapeutic purposes. It has been well documented that enhancement is sometimes difficult to distinguish from treatment. As a subtype of enhancement, neuroenhancement aims to improve one’s cognitive or emotional capacities.Main bodyThis article proposes that the notion of neuroenhancement deserves special attention among enhancements in general, because apart from the notion of treatment, it also overlaps with other concepts such as prevention, pain relief, and pleasure seeking. Regarding prevention, patients’ (...) mental endurance can be enhanced when a patient is prescribed a selective serotonin reuptake inhibitor for the purpose of preventing the relapse of depression following a stressful situation. As for pain relief, psychiatrists use medication to alleviate distress in patients who experience various types of anxiety; the alleviation of distress is equal to psychological pain relief, but is also an enhancement of the patient’s temperamental traits. Regarding pleasure seeking, insidious transition exists between neuroenhancement and pleasure seeking when using psychotropic drugs. It is well known that people use psychostimulants for recreational purposes and to induce overconfidence in one’s performance. The polysemy of psychotropics derives from their effects on human sensibility. Therefore, when using psychotropic agents, psychiatrists should pay close attention to what the agent is used for on each patient in each situation, and explicitly share the continuity and overlap in the purpose of prescribing a medication with the patients to make a better clinical decision.ConclusionsThe notion of neuroenhancement overlaps not only with the notion of treatment, but also with other concepts of prevention, pain relief, and pleasure seeking. The continuity between those concepts makes the issues concerning the prescription of psychotropic drugs subtler. Psychiatrists should explicitly share the continuity with the patients to make a better clinical decision. (shrink)

The “hijacking” and “drug instrumentalization” models of psychoactive drug use predict opposite outcomes in terms of adaptive behavior and fitness benefits. Which is the range of applicability of each model? To answer this question, we need more data than those reported by studies focusing on medical, psychiatric, and legal problems in addicted users. An evolutionary analysis requires a much wider focus.

This paper discusses archaeological, historical, and contemporary ethnographic evidence for the use of the San Pedro cactus in northern Peru as a vehicle for traveling between worlds and for imparting the “vista” (magical sight) necessary for shamanic healers to divine the cause of their patients' ailments. Using iconographic, ethnohistorical, and ethnographic evidence for the uninterrupted use of this sacred plant as a means of access to the Divine and as a tool for healing, it describes the relationship between San Pedro, (...) ancestor worship, water/fertility cults and also the common symbolic associations between San Pedro and wind-spirits. It closes by suggesting that the more than 2000 year time-depth of using this plant as a means for accessing the realms of Spirit and as a tool for healing should serve to challenge the unfortunate tendency in the contemporary United States to consider this plant as a “recreational drug.”. (shrink)

Investigation of “out-of-body experiences” has implications for understanding both normal bodily-self integration and its vulnerabilities. Beyond reported associations between OBEs and specific brain regions, however, there have been few investigations of neurochemical systems relevant to OBEs. Ketamine, a drug used recreationally to achieve dissociative experiences, provides a real-world paradigm for investigating neurochemical effects. We investigate the strength of the association of OBEs and ketamine use relative to other common drugs of abuse. Self-report data from an online survey indicate that (...) both lifetime frequency of ketamine use and OBEs during ketamine intoxication were more strongly related to the frequency of OBEs and related phenomena than other drugs. Moreover, the apparent effects of other drugs could largely be explained by associated ketamine use. The present results, consistent with the role of NMDA receptors in OBEs, should encourage future studies of the role of neurochemical systems in OBEs. (shrink)

In the developing world, the dramatic male bias in tobacco use is usually ascribed to pronounced gender disparities in social, political, or economic power. This bias might also reflect under-reporting by woman and/or over-reporting by men. To test the role of gender inequality on gender differences in tobacco use we investigated tobacco use among the Aka, a Congo Basin foraging population noted for its exceptionally high degree of gender equality. We also tested a sexual selection hypothesis—that Aka men’s tobacco use (...) is related to risk taking. Tobacco use, income, tobacco purchases, tobacco sharing, reasons for using tobacco, risk taking, and other variables were measured using structured surveys and peer reports. Tobacco use was verified by testing for salivary cotinine, a nicotine metabolite. Contrary to expectations, we found a very large male bias in tobacco use. Low levels of use among females appeared to be explained by aversions to tobacco, concerns over its negative effects on fetal health, and a desire to attract husbands, who prefer nonsmoking wives. High male use appeared to be related to a desire to enhance hunting abilities and attract and/or retain wives, who prefer husbands that smoke. We conclude that low levels of smoking by Aka women are better explained by the hypothesis that women evolved to avoid plant toxins to protect their fetuses and nursing infants. High male use might be better explained by sexual selection. We also highlight the important role that recreational drugs appear to play in hunter-gatherer sharing relationships. (shrink)

Genetic intervention is on the near horizon for the treatment of substance abu se. Genetic intervention involves a reprogramming of a person’s own genetic instructions so that that person will no longer have the physical craving for the drug of choice. Unlike pharmacologic intervention, genetic intervention will change the genetic identity of the person, albeit slightly. The legal issue is whether one has a fundamental right to this medical procedure. A fundamental right is one that the government cannot deny (...) without a compelling interest. The case law indicates that the right o f medical necessity applies when the person’s affliction is serious, there are no reasonable or effective alternatives, the person did not intentionally cause the condition, and the treatment is effective for the long term. Unlike the medical marijuana ph enomenon, genetic intervention is per se anti - drug, unrelated to illegal, recreational drug use, and on its face has a medical use. Legal doctrines to date though not directly on point are conceptually compatible with the existence of a fundamental right of medical necessity for genetic intervention. (shrink)

Chemicals have penetrated everyday lives of men who have sex with men as never before, along with new online and mobile technologies used to seek pleasures and connections. Poststructuralist (including queer) explorations of these new intensities show how bodies exist in the form of (political) surfaces able to connect with other bodies and with other objects where they may find/create a function (e.g., reproduce or disrupt hegemonies). This federally funded netnographic study explored how a variety of chemicals such as (...) class='Hi'>recreational drugs, pharmaceuticals and steroids are contributing to the construction of gay, bisexual and other men having sex with men (GBMSM) communities and their interactions with idealized masculinities in the age of increasing technology. Five major thematic categories emerged from our analysis: (1) assembling bodies and technologies, (2) becoming orgiastic, (3) experiencing stigma, (4) becoming machinic and (5) negotiating practices. Our analysis explores how and why GBMSM pursue excesses of pleasure and connection through the assemblages they make with sexualized drug use, online platforms and other men. (shrink)

This book analyses contemporary gay "pig" masculinities, which have emerged alongside antiretroviral therapies, online porn, and new sexualised patterns of recreational drug use, examining how they trouble modern European understandings of the male body, their ethics, and their political underpinnings. This is the first book to reflect on an increasingly visible new form of sexualised gay masculinity, and the first monograph to move debates on condomless sex amongst gay men beyond discourses of HIV and/or AIDS. It contributes to (...) existing critical histories of sexuality, pornography and other sex media at a crucial juncture in the history of gay male sex cultures and the HIV epidemic. The book draws from fieldwork, interviews, archival research, visual analysis, philosophy, queer theory, and cultural studies, using empirical, critical, and speculative methodologies to better think gay "pig" masculinities across their material, affective, ethical and political dimensions, in a future-oriented, politically-inflected, reflection on what queer bodies may become. Spanning historical context to empirical and theoretical study, Bareback Porn, Porous Masculinities, Queer Futures will be of key interest to academics and students in sexuality studies, film, media, visual culture, cultural studies, and porn studies concerned with masculinities, sex and sexualities and their circulation across an array of media. (shrink)

Seeking integration of drug consumption research by a theory of memory function and emphasizing drug consumption rather than addiction, Müller & Schumann (M&S) treat drug self-administration as part of a general pattern of consumption. This insight is located within a more comprehensive framework for understanding drug use as consumer behavior that explicates the reinforcement contingencies associated with modes of drug consumption.

The making and taking of psychotropic drugs, whether on medical prescription or as self-medication, whether marketed by pharmaceutical companies or clamoured for by an anxious population, has been an integral part of the twentieth century. In this modern era of speed, uncertainty, pleasure and anguish the boundaries between healing and enhancing the mind by chemical means have been redefined. Long before Prozac would become a household name for an ‘emotional aspirin’ did consumers embrace the idea and practice of taking psychotropics (...) not only to treat mental illness but also to make them feel better about living in a modern world. The Freudian promise that each individual can remake him- or herself in the pursuit of health and happiness was helpful in promoting and legitimizing the idea and practice of seeking wellness on prescription. We will argue that the modern consumer-driven political culture of medicine will continue to transverse the boundaries of therapy and enhancement of the mind into the largely unexplored territories of human cognition and behaviour. However exciting, this endeavour will come at the cost of further widening the problem of iatrogenic addiction in the age of happiness pills as ‘botox’ for the mind. (shrink)

Most people who are regular consumers of psychoactive drugs are not drug addicts, nor will they ever become addicts. In neurobiological theories, non-addictive drug consumption is acknowledged only as a “necessary” prerequisite for addiction, but not as a stable and widespread behavior in its own right. This target article proposes a new neurobiological framework theory for non-addictive psychoactive drug consumption, introducing the concept of “drug instrumentalization.” Psychoactive drugs are consumed for their effects on mental states. Humans (...) are able to learn that mental states can be changed on purpose by drugs, in order to facilitate other, non-drug-related behaviors. We discuss specific “instrumentalization goals” and outline neurobiological mechanisms of how major classes of psychoactive drugs change mental states and serve non-drug-related behaviors. We argue that drug instrumentalization behavior may provide a functional adaptation to modern environments based on a historical selection for learning mechanisms that allow the dynamic modification of consummatory behavior. It is assumed that in order to effectively instrumentalize psychoactive drugs, the establishment of and retrieval from a drug memory is required. Here, we propose a new classification of different drug memory subtypes and discuss how they interact during drug instrumentalization learning and retrieval. Understanding the everyday utility and the learning mechanisms of non-addictive psychotropic drug use may help to prevent abuse and the transition to drug addiction in the future. (shrink)

The Müller & Schumann (M&S) view of drug use is courageous and compelling, with radical implications for drug policy and research. It implies that most nations prohibit most drugs that could promote happiness, social capital, and economic growth; that most individuals underuse rather than overuse drugs; and that behavioral scientists could use drugs more effectively in generating hypotheses and collaborating empathically.

Based on their framework, Müller & Schumann (M&S) propose a staged drug policy that matches well the neoliberal governance scheme. To mend the sad loss of the sociocultural dimension in their model, I propose three such considerations: first, sociocultural interactions with the brain; second, sociocultural context and justice of drug use; and third, sociocultural preparedness for implementing their drug policy.

ZusammenfassungDer Einsatz von Psychopharmaka im Altenpflegeheim unterliegt aufgrund institutioneller und struktureller Besonderheiten dieses Versorgungsbereiches, aber auch aufgrund der großen Abhängigkeit und Vulnerabilität eines großen Teils der Altenpflegeheimbewohner in besonderer Weise der Gefahr, in inadäquater und missbräuchlicher Weise durchgeführt zu werden. Die Beachtung der ethischen Grundprinzipien des Wohltuns und des Nichtschadendürfens sowie des Respekts vor der Autonomie der Bewohner sollte für alle an der Versorgung unmittelbar und mittelbar Beteiligten handlungsleitend sein. Zum Schutz der Heimbewohner, aber auch mit dem Ziel die Versorgungsqualität (...) in diesem Bereich nachprüfbar zu verbessern, werden in diesem Beitrag Kriterien zur Definition einer inadäquaten bzw. adäquaten Anwendung von Psychopharmaka explizit formuliert, sowie deren Implementierung in prozessorientierte Handlungsalgorithmen und Behandlungsleitlinien vorgeschlagen. Darüber hinaus sollen die Möglichkeiten und Grenzen nicht-pharmakologischer, psychologischer Interventionen als Alternative zur Psychopharmakamedikation diskutiert und hinsichtlich ihrer ethischen Implikationen reflektiert werden. (shrink)

The term “off-label drug use” refers to drugs that have not yet acquired “approved” status or drugs that have acquired “approved” status but are used with a different dosage, route, or administration method other than that for which the drug has been approved. In New Zealand, the Medicines Act 1981 specifically allows for off-label drug use. However, this authority is limited by the Health and Disability Commissioner Regulations 1996 and the common law, which require that off-label (...) class='Hi'>drug use is of an acceptable standard, that the patient should be fully informed, and that the patient should give informed consent. Off-label drug use is an important issue because the current law provides medical practitioners very wide discretionary power, without providing clarification for what is required of the practitioner in exercising his or her discretion in prescribing off-label. This paper discusses possible solutions to this issue, for example, establishing protocol for off-label use, an electronic database of off-label use, and the amendment of legal provisions. (shrink)

This research is part of the last study Drugs and School IX developed in the Basque Country (Spain) by the Instituto Deusto de Drogodependencias (Deusto Institute of Drug Addiction) of the University of Deusto and the data gathered by means of cluster sampling in two stages. The sample is made up of N= 6.007 girls and boys ranging from 12 to 22 years of age in Secondary Education and the aim is to answer the following new research questions based (...) on those parameters: (1) describe the reality of drug consumption and some psychosocial variables in this sample, as well as analyse several relations between variables; (2) analysing the role of school well-being, self-esteem and self-concept regarding consumption; (3) taking a close look at the moderating role of age and gender on the relationship of school well-being, self-concept and self-esteem with consumption; and (4) understand the existing interaction between all these variables, studying the moderating role of self-esteem and self-concept in the influence of school well-being on consumption. Using a correlation, hierarchical regression and mediation analysis with SPSS (v. 26) and Amos (v. 26) applications, three main conclusions were reached. Firstly, that educational and academic well-being, academic self-concept and self-esteem seem to play the role of protecting factors in adolescence, while assertiveness is linked to a higher consumption level. Secondly, that academic self-concept has a mediating effect between well-being and consumption. Some of these relations are moderated by the variables of gender and age. Thirdly, that age and gender are very relevant sociodemographic variables that must be taken into account in order to understand this phenomenon. Age has shown its covariant effect, which is especially relevant in the influence of academic well-being measured as being held back years. It has also proved to be important in order to understand its experiential or experimental and transitory character. Moreover, significant differences in consumptions have been found based on gender. (shrink)

This article analyzes the rise and fall of a public health ‘fact’ in the US: the assertion that gay men’s Viagra use is inherently recreational and increases STD risk. Extending the science studies argument that drug development and marketing entail the construction of new publics, this article shows how strategic drug marketing silences can also constitute new populations of users. It shows how Viagra marketing’s silence about gay users, which facilitated legitimization of the drug as an (...) aid for companionate heterosexuality, created a cultural space for the development of health discourse about gay men as illegitimate, recreational and risky Viagra users. Using Susan Leigh Star’s concepts of ‘simplification’ and ‘complexification’, this article traces the construction and deployment of this public health fact, as well as its subsequent contestation. Using an arena analysis approach, this article demonstrates how marketing discourse and public health fact-making came together in the case of gay Viagra use to refresh long-standing and politically harmful American cultural associations between gay sex and sickness. (shrink)

Against Patrick Devlin, H. L. A. Hart rejects the enforcement of morals as such. Hart defends an expanded version of John Stuart Mill’s harm principle, but this expanded version is no more defensible than Mill’s original claim. Hart’s discussion fails to clarify what is really at stake in controversies regarding the moral acceptability of criminal prohibition of such activities as suicide and assisted suicide, recreational drug use, prostitution, and so on. Regarding the enforcement of morals as such, we (...) should acknowledge that the jury is still out. (shrink)

The potential to instrumentalize drug use based upon the detection of very many different drug states undoubtedly exists, and such states may play a role in psychiatric and many other drug uses. Nevertheless, nonaddictive drug use is potentially more parsimoniously explained in terms of sensation seeking/impulsivity and drug expectations. Cultural factors also play a major role in nonaddictive drug use.

The newly proposed framework for non-addictive psychoactive substances postulated by Müller & Schumann (M&S) provides an interesting and plausible explanation for non-addictive drug use. However, with specific reference to the relevant behavioral addiction literature, this commentary argues that the model may unexpectedly hold utility not only for non-addictive use of drugs, but also for non-addictive use of other potentially addictive behaviors.

Varcoe, Shane Until recently, there has been a largely unnoticed contingent of stakeholders who have not merely abandoned the ideal scenario of a drug free culture, but have quickly stepped through a phase of passive indifference, into what is a 'pro-drug' position in active pursuit of rights for individuals to be protected and supported in their consumption of currently illicit drugs. The players engaged in attempting to bring about this disturbing cultural shift are varied, but certainly these advocates (...) are 'spinning' data and even engaging noble platforms such as 'human rights' to speciously gain leverage. A key strategy in what is now a further 'push' down the slippery slope of dysfunction is the notion of normalisation. (shrink)