VOLUME 11, ISSUE 1- Winter 2017
Challenges in the Use and Control of Narcotics
In this edition of the Journal, the first of our featured papers, An Analysis of the Data on the Effectiveness of Policies in Controlling Production of Illicit Narcotics in Afghanistan, is by M. Reza Amirkhizi, PhD, lecturer of international law and politics at the University of California, Irvine. His experience with the United Nations Office on Drugs and Crime and Middle East diplomacy render a valuable and unique perspective on the situation of opium production in Afghanistan. The continued cultivation of opium in Afghanistan is quite concerning given its detrimental effect on the security, health and welfare of its citizens and also considering the international support to replace current opium cultivation practices with equally lucrative agricultural alternatives.
Our second paper in this edition is entitled, Are Prescription Opioids Creating a New Type of Heroin User?, by Robert L. DuPont, MD, Institute for Behavior and Health, Inc., Rockville, MD; Katherine Garcia-Rosales, BS, Center for Substance Abuse Research (CESAR), University of Maryland, College Park, MD; Corinne L. Shea, MA, Institute for Behavior and Health, Inc.; Helen DuPont, MBA, Institute for Behavior and Health, Inc.; Michael D. Campbell, PhD, Institute for Behavior and Health, Inc.; George Kolodner, MD, Kolmac Outpatient Recovery Centers, Burtonsville, MD; and Eric D. Wish, PhD, Center for Substance Abuse Research (CESAR), University of Maryland, College Park, MD. In this interesting study, research suggests that heroin abuse by prescription opioid users may be reduced by identifying a prior history of polydrug or early non-medical drug use in patients.
Our commentary, a reprint with permission from the Mayo Clinic Proceedings, entitled, Medical Marijuana in Patients Prescribed Opioids: A Cloud of Uncertainty, by William C. Becker, MD VA Connecticut Healthcare System, West Haven, CT, and Jeanette M. Tetrault, MD, Yale University School of Medicine, New Haven, CT, reveals the conundrum physicians may find themselves in when treating patients with long-term opioid pain management who are concurrently using “medical” marijuana. Consideration of the potential harms that marijuana may cause the patient, unknown potency levels, non-existing standardized dosing information and the conflicting legal issues are just a few of the concerns doctors must address as they weigh the risks of treating these individuals.