Purpose Spanning almost 30 years, Italy’s experience with take-home-naloxone (THN) provides an interesting case study on the international scene because of its specific history, regulation and trends in overdose (OD) rates. Accordingly, this study aims to contribute to the evidence base for THN and its delivery in a different setting. Design/methodology/approach The study focuses on service providers’ perceptions of the benefits, risks and barriers associated with THN provision. Data was collected using a mixed-methods approach as follows: an online structured questionnaire (no. of respondents = 63) and two focus groups (no. of total participants = 18). Findings Findings show that service providers believe the benefits of THN far outweigh the risks and accrue to services, as well as users. The study also suggests that the barriers in Italy are mostly ideological and political, and illustrates how resistance to administering THN can re-emerge when ODs are no longer a social emergency. Furthermore, the study found that health and social workers have different attitudes which are also reflected at the level of public and private services, thereby shaping slightly different models of THN supply. Originality/value The study suggests that barriers associated to THN are more ideological and political rather than concrete, which explains why, even where it seems long established, can easily re-emerge once ODs are no longer a social emergency.
Purpose International policy approaches to cannabis production and use are changing rapidly, and within the Irish context, alternatives to prohibition are being considered. This study aims to explore policymaker’s attitudes towards the decriminalisation and legal regulation of cannabis for recreational use in the midst of an unfolding policy process, examining the degree which a “policy window” might be open for the implementation of cannabis policy change. Design/methodology/approach Semi-structured interviews were held with eight key informants within the policy field in Dublin, Ireland. Kingdon’s (2014) Multiple Streams framework was used to consider whether the problems, policy and political streams were aligning to support progressive policy change. Findings Irish policymakers indicated broad support for the decriminalisation of cannabis. The legal regulation of cannabis received more qualified support. Existing policy was heavily criticised with criminalisation identified as a clear failure. Of particular interest was the willingness of policymakers to offer opinions which contrasted with the policy positions of their organisations. While a policy window did open – and close – subsequent governmental commitments to examine the issue of drugs policy in a more deliberative process in the near future highlight the incremental nature of policy change. Originality/value This study provides unique insight into the opinions of policymakers in the midst of a prolonged period of policy evolution. A latent aspiration for historical policy change was situated within the realpolitik of more traditional approaches to policy development, demonstrating that the alignment of Kingdon’s (2014) problem, policy and political streams are essential for change in cannabis policy.
Purpose Public support for various policy options for managing cannabis in the Caribbean and the characteristics of those most likely to support specific policy options remains largely unknown. The purpose of this study is to investigate the impact of age, sex and employment status on the public attitudes towards the full legalisation of cannabis, partial legalisation (that is for medical or religious purposes) or its continued prohibition. Design/methodology/approach Using secondary data collected from nationally representative public opinion polls conducted by Caribbean Research and Development Services from 2016-2018, this paper compares the public attitudes towards cannabis in Barbados, St. Vincent and the Grenadines, St. Lucia, Antigua and Barbuda and Dominica using a multinomial logistic model. Findings Support for the continued prohibition, legalisation or partial legalisation of cannabis varied significantly by age, employment status and country of residence. Women, people over 51 years of age and the employed were more likely to support full prohibition. Attitudes towards cannabis policy in the Caribbean are by no means homogenous, neither are the policy shifts occurring across the region, with some of these changes occurring slowly and not necessarily reflective of cultural dynamics. Originality/value This study is unique in its cross-country analysis in the Caribbean and providing valuable insight into the levels public support for cannabis legalisation. Its findings can help shape targeted public education in these countries.
Purpose This study aimed to understand the extent to which cannabis-related risk perception and COVID-19-related health worries were associated with the reported reduction in sharing cannabis smoking products to mitigate the risk of the coronavirus transmission or infection. This association was tested in two different periods in terms of toughness of national lockdown policy imposed in the first months of the pandemic in Israel. Design/methodology/approach The study population included adult recreational cannabis users who completed one of the two online cross-sectional surveys dedicated to COVID-19 and the cannabis use situation in Israel in the first half of the 2020. The two surveys were conducted six weeks apart. One survey was conducted in the period when strict lockdown measures were in place (N1 = 376). The other survey was conducted in the period when many lockdown measures were lifted (N2 = 284). Differences between the samples regarding risk perception, health stressors and reduction in sharing cannabis products were assessed using t-test. Regression analysis was used to test the independent correlates of reported reduction in sharing cannabis products. Findings Means of risk perception, health stressors and reported reduction in sharing cannabis products were higher in the sample surveyed in the period of the strict lockdown measures than in the sample surveyed in the period of eased lockdown measures. Risk perception was associated with reported reduction in sharing cannabis products only in the sample surveyed in the period of strict lockdown measures. In contrast, health stressors were related to reported reduction in sharing cannabis products in both samples. Social implications Health stressors may represent a more stable mechanism by which cannabis users engage in protective behavior during the pandemic than risk perceptions. Originality/value To the best of the authors’ knowledge, the current research is one of the first studies that examine the associations among risk perception, primary stressors and protective behavior in recreational cannabis users while referring to cannabis-related behavior other than use.
Purpose This paper aims to explore how enforced forms of social isolation arising from the first COVID-19 lockdown influenced experiences of problem substance use, relapse and coping strategies for recovery in individuals engaging with harm reduction recovery services. Design/methodology/approach A qualitative semi-structured interview design was adopted for this research. Seven participants were recruited from a harm reduction recovery organisation. During their initial interview, participants volunteered information regarding their experience of the first lockdown due to emerging concerns of the COVID-19 pandemic. Participants completed a second semi-structured interview at the end of the first lockdown regarding their experience of enforced isolation during this time. Findings Three themes identified from the analysis were isolation resulting in hindered human capabilities; adjusting to a new normal: an individual experience; and unexpected benefits to recovery resulting from isolation. While some participants reported boredom, loneliness and relapse events, others reported that the national response to the virus did not adversely affect them as they had already adjusted to living in a state of anxiety, isolation and uncertainty. These findings illuminate negative, neutral and positive aspects of substance use recovery throughout the COVID-19 lockdown as well as highlighting the complex and individualised role that social connectedness plays in relapse occurrence. Originality/value Participants reported differences in how they were affected by the pandemic, leading to theoretical implications for the effect of social isolation on recovery. For this reason, individuals with a history of dependency should be considered potentially vulnerable to the effects of enforced isolation and should be supported accordingly.
