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Dejure, capital punishment was the only solution applied to defendants accused of sodomy. [...]it was not until the Second Spanish Enlightenment that, under the influence of penological humanitarianism and social utilitarianism, discourses in favour of the decriminalisation of sodomy began to be observed. In addition to understanding the parliamentary debates and the short period of validity of the '20's' Code -officially repealed in 1824- it is also of interest here to understand the framework of its effective application to crimes against nature. To this end, various legal cases for nefarious sins brought before the Royal Chancery of Valladolid are studied in order to understand the application -or influence- of the new legal corpus; the ruptures and continuities in procedural praxis; the institutional assimilation of the new liberal regime; and, ultimately, the administration of justice through the final sentence.

Tyndall examines the pragmatic and ethical response to overdose crisis. He cites the research by Crabtree and colleagues that provides an important snapshot of the toxic drug supply fuelling an overdose epidemic that has killed more than 6,000 people in British Columbia (BC) since 2014. Their descriptive study of drug overdose deaths involving at least 1 illicit substance identified by the BC Coroners Service from 2015 to 2017 showed that the vast majority were related to synthetic opioids purchased from the illicit market, with prescription opioids playing a minor role. The authors conclude that strategies to address the current overdose crisis in Canada need to go far beyond opioid deprescribing. His argumentation that the only pragmatic and ethical way forward is to offer a regulated, safer supply of opioids, decriminalize drug use, and redeploy resources that are used for drug law enforcement into health and social programs is also highlighted.

Expected reforms to loosen Poland’s historically strict abortion laws have been derailed by a political “betrayal”—with potentially lasting consequences for women’s health. Owen Dyer reports

House Speaker Nancy Pelosi (D-Calif.) on March 31 said federal cannabis decriminalization would reduce inequities in the justice system.

Background On January 31 st 2023, the Canadian province of British Columbia temporarily decriminalized the personal possession of certain illegal drugs up to 2.5 g, cumulatively, for adults. A stated aim of this policy directive was to reduce the stigmatization of people who use drugs and increase access to health and harm reduction services. The aim of this study was to capture the prevalence and nature of potential barriers to such services under drug decriminalization. Methods We employed a mixed-methods study design, triangulating survey data from harm reduction service users in 2022 ( n  = 503) and 2023 ( n  = 433) alongside qualitative interviews with people who use drugs in British Columbia ( n  = 78) collected in 2023. Qualitative and quantitative findings were analysed convergently. Results Findings across both datasets suggest that reported barriers to health and harm reduction services persisted during British Columbia’s decriminalization pilot. Quantitative and qualitative data reflecting these barriers are presented in parallel under four themes: (1) stigma and fear of substance use disclosure, (2) stigma and access to services, (3) service-specific barriers, and (4) police-related barriers. Conclusion Decriminalization alone may be insufficient to address and/or mitigate the barriers that continue to constrain people who use drugs’ access to care. If the policy goal is to reduce barriers to health and harm reduction services, additional structural and institutional supports may be required. Highlights Barriers to accessing health and harm reduction services persisted during BC’s decriminalization pilot. Perceived stigma limited access to health and harm reduction services. Inhalation services remain limited at observed consumption sites across BC. Despite the legal reform, policing practices discouraged health service attendance. Decriminalization alone may be insufficient in eliminating service barriers.

Background. Cannabis use is common in North America, especially among young people, and is associated with a risk of various acute and chronic adverse health outcomes. Cannabis control regimes are evolving, for example toward a national legalization policy in Canada, with the aim to improve public health, and thus require evidence-based interventions. As cannabis-related health outcomes may be influenced by behaviors that are modifiable by the user, evidence-based Lower-Risk Cannabis Use Guidelines (LRCUG)—akin to similar guidelines in other health fields—offer a valuable, targeted prevention tool to improve public health outcomes. Objectives. To systematically review, update, and quality-grade evidence on behavioral factors determining adverse health outcomes from cannabis that may be modifiable by the user, and translate this evidence into revised LRCUG as a public health intervention tool based on an expert consensus process. Search methods. We used pertinent medical search terms and structured search strategies, to search MEDLINE, EMBASE, PsycINFO, Cochrane Library databases, and reference lists primarily for systematic reviews and meta-analyses, and additional evidence on modifiable risk factors for adverse health outcomes from cannabis use. Selection criteria. We included studies if they focused on potentially modifiable behavior-based factors for risks or harms for health from cannabis use, and excluded studies if cannabis use was assessed for therapeutic purposes. Data collection and analysis. We screened the titles and abstracts of all studies identified by the search strategy and assessed the full texts of all potentially eligible studies for inclusion; 2 of the authors independently extracted the data of all studies included in this review. We created Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow-charts for each of the topical searches. Subsequently, we summarized the evidence by behavioral factor topic, quality-graded it by following standard (Grading of Recommendations Assessment, Development, and Evaluation; GRADE) criteria, and translated it into the LRCUG recommendations by the author expert collective on the basis of an iterative consensus process. Main results. For most recommendations, there was at least “substantial” (i.e., good-quality) evidence. We developed 10 major recommendations for lower-risk use: (1) the most effective way to avoid cannabis use–related health risks is abstinence, (2) avoid early age initiation of cannabis use (i.e., definitively before the age of 16 years), (3) choose low-potency tetrahydrocannabinol (THC) or balanced THC-to-cannabidiol (CBD)–ratio cannabis products, (4) abstain from using synthetic cannabinoids, (5) avoid combusted cannabis inhalation and give preference to nonsmoking use methods, (6) avoid deep or other risky inhalation practices, (7) avoid high-frequency (e.g., daily or near-daily) cannabis use, (8) abstain from cannabis-impaired driving, (9) populations at higher risk for cannabis use–related health problems should avoid use altogether, and (10) avoid combining previously mentioned risk behaviors (e.g., early initiation and high-frequency use). Authors’ conclusions. Evidence indicates that a substantial extent of the risk of adverse health outcomes from cannabis use may be reduced by informed behavioral choices among users. The evidence-based LRCUG serve as a population-level education and intervention tool to inform such user choices toward improved public health outcomes. However, the LRCUG ought to be systematically communicated and supported by key regulation measures (e.g., cannabis product labeling, content regulation) to be effective. All of these measures are concretely possible under emerging legalization regimes, and should be actively implemented by regulatory authorities. The population-level impact of the LRCUG toward reducing cannabis use–related health risks should be evaluated. Public health implications. Cannabis control regimes are evolving, including legalization in North America, with uncertain impacts on public health. Evidence-based LRCUG offer a potentially valuable population-level tool to reduce the risk of adverse health outcomes from cannabis use among (especially young) users in legalization contexts, and hence to contribute to improved public health outcomes.