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Booze, dope, smokes, and weed. Mind-altering, mood-changing substances have been part of human society for millennia. Pleasure and Panic reveals how attitudes toward drug and alcohol consumption have always been deeply embedded in cultural fears and social, political, and economic disparities. Contributors to this collection explore how drugs and alcohol intersect with diverse histories, including gender, medicine, popular culture, and business. Pleasure and Panic brings a dispassionate voice to current debates about liberalizing drug and alcohol laws and challenges existing ideas about how to deal with the so-called problems of drug and alcohol use

A revelatory, moving narrative that offers a harrowing critique of the war on drugs from voices seldom heard in the conversation: drug users who are working on the front lines to reduce overdose deaths Media coverage has established a clear narrative of the overdose crisis: In the 1990s, pharmaceutical corporations flooded America with powerful narcotics while lying about their risk; many patients developed addictions to prescription opioids; then, as access was restricted, waves of people turned to the streets and began using heroin and, later, the dangerous synthetic opioid fentanyl. But that's not the whole story. It fails to acknowledge how the war on drugs has exacerbated the crisis and leaves out one crucial voice: that of drug users themselves. Across the country, people who use drugs are organizing in response to a record number of overdose deaths. They are banding together to save lives and demanding equal rights. Set against the backdrop of the overdose crisis, Light Up the Night provides an intimate look at how users navigate the policies that criminalize them. It chronicles a rising movement that's fighting to save lives, end stigma, and inspire commonsense policy reform. Told through embedded reporting focused on two activists, Jess Tilley in Massachusetts and Louise Vincent in North Carolina, this is the story of the courageous people stepping in where government has failed. They are standing on the front lines of an underground effort to help people with addictions use drugs safely, reduce harms, and live with dignity.

The etiology of illicit substance involvement is a multidimensional problem shaped by factors across individual, social, and environmental domains. In this study, a multicriteria framework is employed to incorporate the input of specialists regarding risk and protective factors and the effectiveness of alternative interventions to mitigate the adverse harms and consequences associated with adolescent drug initiation and subsequent use. Using a seven-stage drug use continuum (nonuse, priming, initial use, experimental use, occasional use, regular use, and dysfunctional use), experts rate social and environmental factors as the most important from nonuse to occasional use. Experts often support preventive and harm-minimizing strategies to interrupt the progression of drug involvement and accumulation of drug-related harms among adolescents. Compared with preferable interventions, less preferable options (e.g., drug testing/monitoring) are considered to have a negative policy impact on key social, environmental, and drug dimension domains, which tend to override their positive impacts on other areas.

Background Since there is a paucity of research on support for people using Anabolic Androgenic Steroids (AAS), we aimed to identify and synthesise the available evidence in this field. Gaining an understanding of the support both accessed and wanted by recreational AAS users will be of use to professionals who provide services to intravenous substance users and also to those working in the fields of public health and social care, with the aim to increase engagement of those using AAS. Methods A systematic scoping review of the literature to explore and identify the nature and scope of information and support both accessed and wanted by non-prescribed AAS users. Any support services or information designed to help people who use AAS were considered. Results We identified 23 papers and one report for review, which indicated that AAS users access a range of sources of information on: how to inject, substance effectiveness, dosages and side effects, suggesting this is the type of information users want. AAS users sought support from a range of sources including medical professionals, needle and syringe programmes, friends, dealers, and via the internet, suggesting that, different sources were used dependent on the information or support sought. Discussion AAS users tended to prefer peer advice and support over that of professionals, and access information online via specialist forums, reflecting the stigma that is experienced by AAS users. These tendencies can act as barriers to accessing services provided by professionals. Conclusions Support needs to be specific and targeted towards AAS users. Sensitivity to their perceptions of their drug-use and the associated stigma of being classified in the same sub-set as other illicit drug users is relevant to facilitating successful engagement.

Background Since July 2022, the Australian government has required online wagering operators to send all active customers activity statements as part of the National Consumer Protection Framework in an effort to reduce gambling harms. Having access to clear and accurate gambling expenditure data is intended to facilitate awareness and reflection and enhance consumer self-awareness for their spending, which can consequently enable informed and considered decisions regarding future gambling spend. This study aimed to explore Australian wagering customers’ use of activity statements and their impact on gambling behaviour. Methods Data was gathered through surveys distributed via two online gambling operators to assess problem gambling severity, self-reported use and impact of activity statements, and ability to recall gambling spend. The operators provided matched customer account data for each participant, which was de-identified but enabled gambling behaviour to be objectively assessed and the accuracy of self-reported spending to be determined. The final sample comprised 1647 participants (85% male) with a mean age of 44 years. Results Our results suggest that 57.2% of participants opened their statements at least “sometimes”, indicating consumer interest in activity statements. Of the customers who opened statements, 17.6% reported that the statements decreased their gambling, and a very small proportion (0.8%) reported a subsequent increase in their gambling. There was some evidence of a dose-dependent relationship whereby the more people engaged with statements, the more effective they were perceived to be. Reading statements more often and more recently was not associated with improved recall of recent gambling spend or net outcome. There were no significant changes in gambling behaviour (betting frequency and deposit amount) observed around the time when statements were sent. Conclusions A notable proportion of online wagering customers are using activity statements and many feel these are useful in tracking their gambling spending and may help them to reduce their gambling. Importantly, there was minimal evidence of negative unintended consequences observed in self-report and objective behavioural data. Efforts to enhance engagement with activity statements would likely result in further benefits. These findings contribute to the evaluation of a national policy regarding consumer protection tools designed to reduce gambling harm.

\"Just say no\" just doesn't work for everyone.If you've tried to quit and failed, simply want to cut down, or wish to work toward sobriety gradually, join the many thousands of readers who have turned to this empathic, science-based resource--now thoroughly revised.

Several universal school-based prevention programs, notably the Australian Climate Schools program, have proven efficacious at reducing and maintaining a lower level of harmful alcohol consumption relative to a control condition. Yet, there are limited studies investigating the potential mechanisms that account for the reduction in harmful alcohol consumption. The current study utilised modern causal mediation analysis to investigate whether several harm minimisation and social influence mediators could jointly account for the intervention effect observed in a large school-based sample. Four mediators representing knowledge, attitudes, normative perceptions, and self-efficacy to resist peer pressure were entered into a multiple casual mediation model using the potential outcomes framework. The results did not provide evidence for a joint multiple mediation model consisting of the hypothesised harm minimisation and social influence mediators. Additional research is required to further investigate the potential mechanisms underlying universal school-based prevention programs including social connectedness and cultural/environmental factors.

The prospective introduction of autonomous cars into public traffic raises the question of how such systems should behave when an accident is inevitable. Due to concerns with selfinterest and liberal legitimacy that have become paramount in the emerging debate, a contractarian framework seems to provide a particularly attractive means of approaching this problem. We examine one such attempt, which derives a harm minimisation rule from the assumptions of rational self-interest and ignorance of one's position in a future accident. We contend, however, that both contractarian approaches and harm minimisation standards are flawed, due to a failure to account for the fundamental difference between those 'involved' and 'uninvolved' in an impending crash. Drawing from classical works on the trolley problem, we show how this notion can be substantiated by reference to either the distinction between negative and positive rights, or to differences in people's claims. By supplementing harm minimisation with corresponding constraints, we can develop crash algorithms for autonomous cars which are both ethically adequate and promise to overcome certain significant practical barriers to implementation.

This paper examines how it is possible for firms in controversial sectors, which are often marked by social taboos and moral debates, to act in socially responsible ways, and whether a firm can be socially responsible if it produces products harmful to society or individuals. It contends that a utilitarian justification can be used to support the legal and regulated provision of goods and services in these areas, and the regulated and legal provision of these areas produces less harm than the real alternative—illegal and unregulated supply. Utilitarianism is concerned as much with harm minimisation as good maximisation, and both are equally important when it comes to maximising welfare (Bentham 1789, 1970; Mill [1863] 1964). Any adequate theory of CSR must, therefore, have the capacity to handle a business that minimises harm as well as those that more straightforwardly maximise good. In this paper we therefore attempt two tasks. First, we argue that the legal but regulated provision of products and services may be better from an overall utilitarian perspective than a situation in which these harmful or immoral goods and services are illegal but procurable via a black market. Porter and Kramer's (2006) strategic CSR framework is then presented to describe how firms in these controversial sectors can act in socially responsible ways. This model highlights the importance of firm strategy in selecting areas of socially responsible behaviours that can be acted upon by firms in each industry.

School-based programs can effectively prevent substance use; however, systematic reviews and consultation with stakeholders identified a need for effective, culturally inclusive programs for Aboriginal and/or Torres Strait Islander (hereafter Aboriginal) youth. This paper describes the development of Strong & Deadly Futures, a six-lesson, curriculum-aligned wellbeing and substance use prevention program that was designed for, and with, the Aboriginal youth. Formative reviews and consultation recommended that the program (i) combine effective components of mainstream prevention with cultural elements, highlighting Aboriginal cultural strengths; (ii) avoid stigma and celebrates the cultural diversity by catering to both Aboriginal and non-Aboriginal students; and (iii) use digital technology to enhance engagement, implementation and scalability. Guided by an Appreciative Inquiry approach, the program was developed in partnership with an Indigenous Creative Design Agency, and four schools in New South Wales and Queensland, Australia. Aboriginal (n = 41) and non-Aboriginal students (n = 36) described their role models, positive aspects of their community and reasons to avoid substance use; these formed the basis of an illustrated story which conveyed the key learning outcomes. Feedback from teachers, students and content experts supported the acceptability of the program, which will be evaluated in a subsequent randomised controlled trial.