Use of psychoactive substances and drug trafficking for funding purposes is a well-known practice acted by terrorist groups. Europe appears to be more and more involved in this mechanism, as both an active and passive element, and increased attention should be payed to this phenomenon by potentially interested actors.

Despite evidence that cannabinoid receptors are located in movement-related brain regions (e.g., basal ganglia, cerebral cortex, and cerebellum), and that chronic cannabis use is associated with structural and functional brain changes, little is known about the long-term effect of cannabis use on human movement. The aim of the current study was to investigate balance and walking gait in adults with a history of cannabis use. We hypothesised that cannabis use is associated with subtle changes in gait and balance that are insufficient in magnitude for detection in a clinical setting.Cannabis users (n = 22, 24 ± 6 years) and non-drug using controls (n = 22, 25 ± 8 years) completed screening tests, a gait and balance test (with a motion capture system and in-built force platforms), and a clinical neurological examination of movement.Compared to controls, cannabis users exhibited significantly greater peak angular velocity of the knee (396 ± 30 versus 426 ± 50°/second, P = 0.039), greater peak elbow flexion (53 ± 12 versus 57 ± 7°, P = 0.038) and elbow range of motion (33 ± 13 versus 36 ± 10°, P = 0.044), and reduced shoulder flexion (41 ± 19 versus 26 ± 16°, P = 0.007) during walking gait. However, balance and neurological parameters did not significantly differ between the groups.The results suggest that history of cannabis use is associated with long-lasting changes in open-chain elements of walking gait, but the magnitude of change is not clinically detectable. Further research is required to investigate if the subtle gait changes observed in this population become more apparent with aging and increased cannabis use.

Available data from the sub-Saharan Africa (SSA) region indicates the use of alcohol, cannabis, psychotropic substances, khat, organic solvents, heroin and cocaine. Alcohol and cannabis use is reported in almost all countries, khat is used mainly in the East African sub-region, while the abuse of methaqualone is a major concern in South and East African sub-regions. An increase in the use of heroin and cocaine is reported in many countries such as Nigeria, Côte D'Ivoire, Ghana, Kenya, South Africa and Mauritius. Injecting of heroin and cocaine is a growing problem in a few countries, although no causal link has been established between this practice and the AIDS epidemic in the continent. Educational and public awareness campaigns form the bedrock of preventative programs. Treatment of addicts takes place mainly in psychiatric and general hospitals but non-governmental organizations, and alternative care givers now play an increasing role. Factors that may militate against the adoption of the harm reduction (HR) approach include lack of scientific evidence linking HIV to injecting drug use, costs, inadequate social welfare and health care systems, unfavorable legal systems, low prioritization and the current moralistic views on substance use. Nonetheless, there exists a unique opportunity in SSA countries to complement and strengthen the currently practised demand reduction (DR) approach with the pragmatic principles of the HR approach, with the key aim of discouraging transition from non-injecting to injecting pattern of substance use.

The Opiate Treatment Index (OTI), an instrument designed to monitor treatment outcome of opioid users, is becoming increasingly popular among clinicians and researchers in the United Kingdom. This study was designed to examine how the OTI would perform when administered by clinic staff compared to externally contracted researchers in clinical settings. In a confidential setting, the OTI was administered twice to 55 opioid users from two London clinics, in a random fashion, once by trained clinic staff and once by researchers within a 2-week period. The data generated by both groups were similar with respect to social functioning, physical health and psychological adjustment. Where differences occurred, in almost all the cases they were not statistically significant. Clients reported slightly higher levels of drug use episodes, injecting behaviour and criminal activity to researchers. In both groups, none of the clients admitted to paid sex, and low levels of criminal activity and illicit drug use are reported-findings which are most probably related to the stability of these patients rather than systematic under-reporting. Although this cross-sectional study showed that the OTI could be applied equally effectively by clinic staff and researchers in clinical settings, further research is needed to examine whether the situation would hold true in routine outcome monitoring. To ensure that reliable and valid data are generated in routine monitoring of treatment programmes, several issues relating to clinic staff (e.g. motivation, time); clients (e.g. co-operation, confidentiality) and researchers (e.g. cost) need to be addressed.

The limited available data indicate that substances known to be abused in the west African subregion include alcohol, cannabis, psychotropic drugs, heroin, cocaine and other synthetic narcotic analgesics. The current major concern is the increased trafficking in, and abuse of, heroin and cocaine. A disquieting trend is the report of the development of drug injecting, particularly among inaccessible populations of hard drug users. The health care system is beset with multiple problems, and may not be able to cope with an additional marked rise in the prevalence of HIV/AIDS and other blood-borne disorders arising from the rapid diffusion of drug injecting. Drug control strategy in the subregion hinges on a combination of supply control and demand reduction programmes. Although the demand reduction strategy is now being pursued with greater zeal, there is an urgent need to develop standard manuals and to evaluate the component programmes. The national coordinating bodies need to be strengthened and the current subregional cooperative efforts sustained. The assistance being provided by voluntary and international organizations will continue to be vital to achieving the drug control goals of the subregion.

To validate the Opiate Treatment Index (OTI) for use in the United Kingdom, 72 subjects attending two methadone clinics in London completed confidential interviews with two researchers at two points in time, 1-2 weeks apart. About half the interviews were conducted by the same interviewer on both occasions, and the remaining by different interviewers. These research designs enabled an estimation of the test-retest and inter-rater reliability of the instrument. Subjects' responses were validated against key worker reports and self-reported drug use against urinalysis results. The majority of the respondents were males (65%) and their mean age was 34.2 years (range 21-52; SD 8.5). Test-retest reliability coefficients were high for all the scales (range 0.77-0.86) in both the same and different interviewer situations. The internal reliability of the scales was generally high (Cronbach's alpha: range 0.34-0.93). The correlation with key workers' reports was high with the percentage agreement on the items ranging 74-100 (mean 87). The percentage agreement of self-reported drug use with urinalysis results was high (range 69-95; mean 89). These findings are similar to those obtained among Australian subjects and suggest a high cross-cultural validity for the OTI. Minor changes to the OTI have been incorporated into a modified version for use in the UK.

We report on the psychosocial and substance use profiles of the 55 "Area Boys and Girls" (ABG) admitted to a Rehabilitation Camp in Lagos between March and May 1993 under the main auspices of the People's Bank of Nigeria. The majority were males (73%); young adults (mean age/SD: 30.6/6.3); unemployed (73%); not married (80%); of low educational standing (87%) and from low socio-economic background (over 70%). Almost all were current users of heroin (89%) and cocaine (87%), procured with a substantial amount of money and administered mainly through smoking and "chasing the dragon". None of the clients reported injecting the drug. These findings have highlighted the intricate nature of the problems of ABG and the need for a comprehensive rehabilitation package encompassing general medical, psychological and psychiatric care. Such programmes, ideally free, should be a joint venture between the government, international agencies, non-governmental organizations and the community as a whole. The key emphasis should be on equipping the clients with occupational skills for life-long economic sustenance. To curtail the growing numbers of displaced young people in the country, the government should give due attention to the root causes of the multiple social ills in the society.

The possible correlates of alcohol, tobacco and cannabis use were investigated in a survey conducted among undergraduate students of the University of Ilorin, Nigeria. Factors that emerged as common correlates to the three substances investigated were peer influence, self-reported poor mental health, religiousity, parental/guardian supervision, perceived availability and perceived harmfulness. In addition, drinking and smoking were found to be commoner among the male sex and among respondents who reported study difficulty. There was also a significant positive relationship between cannabis use and a polygamous family background and belonging to an older age group. Although the data used in the analysis is limited due to its cross-sectional nature, the observations made are useful enough for the formulation of primary prevention strategies. A further and more elaborate longitudinal study is, however, suggested.

Earlier studies on alcohol use in Nigeria identified young and middle-aged male adults as mainly concerned. In the last decade however, there has been a noticeable trend of youths getting more and more involved in alcohol use. Some of these latter studies, apart from indicating the increasing involvement of the female sex, have also shown various pathologies associated with alcohol use in Nigeria youths. Most of these reports only looked at alcohol use in the broader context of drug and alcohol abuse in the Nigerian society. However, in the present cross-sectional study of drug use involving 2079 senior secondary school students in two major cities of Nigeria (Ibadan and Abeokuta), prevalence rates of alcohol use was 56% for Ibadan and 51.5% for Abeokuta. The male/female ratio of the users was 1.1: 1 in Ibadan and 1.2: 1 in Abeokuta. Males used alcohol significantly more than females in each of the two cities (P < 0.025).