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Evidence-based policy? The re-medicalization of cannabis and the role of expert committees in the UK, 1972-1982
Abstract
Background
Cannabis was introduced to the UK as a medical product in the nineteenth century. However, with questions over its safety, efficacy, and possible harms its medical role diminished and by the 1950s it was viewed as a drug of misuse. Nonetheless, scientific and lay knowledge around cannabis expanded from the 1960s and cannabis re-appeared in different therapeutic forms. In re-medicalizing cannabis, science-policy transfer proved important and was enabled by the developing mechanism of expert committees, most notably the Advisory Council on the Misuse of Drugs (ACMD).
Methods
This article draws upon previously unknown archival material on the ACMD held at the National Archives and covers the period 1972–1982. It considers how expert groups were established, their membership, and the evolving discussion over therapeutic cannabis within the broader drug policy debate.
Results
Three distinct periods emerged: 1972–1976 with the creation of the Working Group on Cannabis; 1977–1979 when the Working Group focused on potential amendments to the Misuse of Drugs Act and recommended downgrading cannabis from Class B to Class C; 1980–1982 when the Expert Group on the Effects of Cannabis recommended downgrading cannabis and encouraged research into cannabis as a medicine. Sources reveal that driven by drug control imperatives the ACMD stimulated research on cannabis leading to increased research on medical applications.
Conclusion
Expert advice was critical in the process of re-medicalization. Initially, discourse occurred in the closed expert committees of the ACMD. The drug problem had been framed under the criminal justice system but as the limitations of this were revealed, and there was continuing uncertainty over cannabis’ impact, new approaches to cannabis were sought. It was this combination of more relaxed attitudes towards cannabis, research incentives, as well as a developing desire to draw medical needs away from discussion of drug control that was to allow re-medicalization to develop.
... Taylor et al. 2016 [25] The authors collected previously unknown archival data to analyze changing attitudes towards the control of cannabis, the relationship between science and policy, and the impact of the policy environment on the process of re-medicalization. ...
... In an effort to include empirical evidence in future MC policies, further research regarding effects of MC reforms proposed included price and tax structures [24], increased cannabis research for re-medicalization [25], and bridging the lack of current political evidence were suggested [20]. Three studies mentioned the reciprocal impacts of MC regulation and clinical research. ...
... A common theme noted between five studies was the implied value of the advice and expertise of policy officials and relevant stakeholders in order to facilitate MC regulation. Strategic planning to establish legitimacy and indications for cannabis use may be facilitated through a multidisciplinary expert committee [25], healthcare professionals [29], medical associations [27], law enforcement [15,21], and patient advocates [21,29]. ...
Background
In recent decades, several political, legislative, judicial, consumer, and commercial processes around the world have advanced legalization efforts for the use of medical cannabis (MC). As the use of MC evolves through legislative reform, with an increase in public acceptance and therapeutic potential, a need exists to further investigate the facilitators and barriers to MC regulation.
Methods
A scoping review was conducted to identify the facilitators and barriers associated with the implementation of MC regulations. MEDLINE, EMBASE, AMED and PsycINFO databases were systematically searched; no restrictions were placed on geographic location/jurisdiction. Eligible articles included those that evaluated the MC regulatory framework of one or more countries.
Results
Twenty-two articles were deemed eligible and included in this review. Themes identified include: (1) effects of conflicts, mindset, and ideology of state population, (2) the use of comparisons to analyze MC regulation, and (3) the need for more knowledge, advice, and empirical/clinical evidence to inform future MC policies.
Conclusion
Policymakers should be aware of facilitators to the MC regulation implementation process, such as the influence of state and federal congruence, increased transparency, and the incorporation of stakeholder concerns, in order to effectively respond to a growing societal acceptance of MC and its use among patients. Given a comprehensive understanding of these influential factors, policymakers may be better equipped to meet the consumer and commercial demands of a rapidly evolving MC regulatory environment.
... In an effort to include empirical evidence in future MC policies, further research regarding effects of MC reforms including price and tax structures, 24 increased cannabis research for re-medicalization, 25 and bridging the lack of current political evidence were suggested. 20 Three articles mentioned the reciprocal impacts of MC regulation and clinical research. ...
... A common theme noted between ve articles was the implied value of the advice and expertise of policy o cials and relevant stakeholders in order to facilitate MC regulation. Strategic planning to establish legitimacy and indications for cannabis use can be facilitated through a multidisciplinary expert committee, 25 healthcare professionals, 29 medical associations, 27 law enforcement, 15,21 and patient advocates. 21,29 We found six articles which emphasized revising MC policy implementation processes to improve patient and community experiences. ...
Background: In recent decades, several political, legislative, and judicial processes around the world have advanced legalization efforts for the use of medical cannabis (MC). As MC usage evolves through legislative reform, with an increase in public acceptance and therapeutic potential, a need exists to further investigate the facilitators and barriers to MC regulation.
Methods: A scoping review was conducted to identify the facilitators and barriers associated with the implementation of international MC regulations. MEDLINE, EMBASE, AMED and PsycINFO databases were systematically searched. Eligible articles included primary studies that evaluated the MC regulatory framework of one or more countries globally.
Results: Twenty-two articles were deemed eligible and included in this review. Themes identified include: (1) effects of conflicts, mindset and ideology of state population, (2) the use of comparisons to analyze MC regulation, and (3) the need for more knowledge, advice and empirical/clinical evidence to inform future MC policies.
Conclusion: We identified a number of facilitators and barriers to MC regulation and provide a holistic overview of what factors are proposed to affect MC regulation. In recognizing that the evidence-base surrounding MC, MC usage among patients, and general societal acceptance of MC are all increasing across many parts of the globe, our review allows for relevant stakeholders to better understand these facilitators and barriers to inform future MC policy making.
... As a part of this development, public and scientific interest in biomedical research, biological explanations of mental health problems, and the brain disease model of addiction (BDMA) has grown (Midanik and Room 2005;Midanik 2006;O'Connor and Joffe 2013;Heim 2014;Haslam and Kvaale 2015;Volkow and Koob 2015). Currently, the BDMA is influential among scientists (Midanik 2006;Campbell 2012;Taylor 2016), treatment professionals (Russell et al. 2011;Lawrence et al. 2013;Samuelsson and Wallander 2015), and public institutions, and appears to have a particularly strong footing in the US. Both the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA) officially endorse the model (Volkow and Koob 2015). ...
... Instead, most research has focused on the views of influential professional groups, patient and interest groups, and people with drinking problems without considering the role of the mass media (e.g. Midanik 2006;Conrad 2007;Edman 2009;Campbell 2012;Edman and Olsson 2014;Samuelsson and Wallander 2015;Wiens and Walker 2015;Taylor 2016;Fraser et al. 2017). Moreover, while surveys support the premise that there is a gap between what trained researchers know and what the lay public knows (Miller 2010), theories that focus on the lack of public knowledge fail to consider that scientists' and journalists' professional status, identities, and concerns, as well as laypeople's identities and concerns, shape the relationship between science and society (Bucchi 2008;Dunwoody 2008;Hansen 2016). ...
Aim: In recent decades, the notion of addiction as a brain disease has become influential among scientists, public institutions, and addiction treatment professionals, and its popularity raises the question of how biomedical science affects public perceptions of illness. Although existing research has examined how laypeople interpret disease models of addiction, few studies address how they interpret the brain disease model as presented by the media, the version that most citizens are likely to encounter in their everyday lives. This article contributes to existing research by examining Swedish laypeople’s interpretations of a news article presenting biomedical research on addiction and analyzing how trust intervenes in their interpretations.
Methods: Drawing on an audience study design with qualitative interviews, the participants were asked to read and discuss a newspaper article that explained how alcohol, amphetamine, and nicotine affect the brain.
Results: The analysis shows that their interpretations depended on how they perceived their own ability to assess the science portrayed in the article. The participants trust doctors and scientists but doubt their own ability to assess the science, and trust is therefore provisional or pending until this situation changes. In addition, trust requires that the participants are able to recognize and identify with the contents of the news article.
Conclusion: This pattern can be understood as a way of dealing with the contradictory expectations laypeople face – they are expected to trust scientific knowledge and to evaluate knowledge claims rationally, but they do not have access to the knowledge that would, supposedly, enable them to do so.
... The literature on EBPM, in itself been prolific, has mostly focused on countries with strong native EBPM cultures (e.g. Pallett, 2020;Taylor, 2016). Notably less attention has been dedicated to the "export" of such practices in context where they have traditionally been poorly utilised. ...
Evidence-based policy making (EBPM) has been a key pillar of the better regulation agenda of the European Union. However, the extent to which it has genuinely impacted domestic policy making practices has remained largely unexplored. This study sets out to address this gap by focusing on EBPM adoption in settings with historically weak culture of technocratic rationality. To this end, the article proposes a novel analytical framework combining the concept of Europeanisation with insights from the scholarship on knowledge and evidence utilisation. The framework is then applied to the “least likely” case of Bulgaria and its National Climate and Energy Plan for 2021–2030. The article draws on 26 semi-structured interviews to analyse the use of different types of evidence in the Plan’s formulation. The study finds that genuine adoption of EBPM practices remains relatively low with evidence serving predominantly a perfunctory role. In contrast, instrumental and conceptual uses of evidence remain rare. Still, the findings point at the possibility, albeit limited, for gradual Europeanisation and uptake of evidence-based practices even in highly unfavourable conditions. This can be facilitated by a prolonged exposure to evidence-based practices, targeted EU pressure, the establishment of forums facilitating evidence exchange and the presence of “evidence-friendly” individuals within the civil service.
... 21 Some proposals to this end include price and tax structural reforms, increased cannabis research for remedicalization, and bridging the lack of political evidence. [22][23][24] ...
Cannabinoids have recently gained a renewed interest due to their potential applicability to various medical conditions, specifically the management of chronic pain conditions. Unlike many other medications, medical cannabis is not associated with serious adverse events, and no overdose deaths have been reported. However, both safety and efficacy data for medical cannabis treatment of chronic, nonmalignant pain conditions are lacking. Therefore, representatives from the American Society of Pain and Neuroscience summarize the evidence, according to level and grade, for medical cannabis treatment of several different pain conditions. Treatment of cancer-related pain has prospective evidentiary support for the use of medical cannabis. Although 3 large and well-designed randomized controlled trials investigated cannabis treatment of cancer-related pain, the evidence yielded only a grade D recommendation. Neuropathic pain has been investigated in prospective studies, but a lack of high-quality evidence renders cannabis treatment for this indication a grade C recommendation. Both safety and efficacy data are lacking for use of medical cannabis to treat chronic nonmalignant pain conditions.
... Christensen and Holst 2020;Fischer 2013;Góra, Holst, and Warat 2019;Hesstvedt 2018;Holst and Molander 2017;Jasanoff 1994;Krick 2021;Krick and Holst 2020;May, Koski, and Stramp 2016;Rich 2004;Vibert 2007). So too a number of publications have investigated the relationship between expertise and policy-making in specific areas, including environmental policy (Gulbrandsen 2008;Lehtonen 2014;Pellizzoni 2011;Tangney 2019;Turnhout et al. 2015), health policy (Adekola, Fischbacher-Smith, and Fischbacher-Smith 2019;Cohen 2013;Lepont 2021), immigration policy (Boswell 2009), social policy (Duke and Thom 2014;Monaghan, Wincup, and Wicker 2018;Taylor 2016), economic policy (Christensen 2017;Eisner 1991;Schrefler 2013) and cultural policy (Flew 1998;Hylland and Mangset 2018;James and Winter 2017;Prince 2015). Still, essential questions remain unanswered: what are the proper and de facto democratic roles of experts when it comes to cultural policy? ...
The article summarises a study of two Scandinavian cultural policy expert reports, namely Sweden’s SOU 2009:16 and Norway’s NOU 2013:4, comparing how strongly these reports focus on advice relating to overall policy objectives. The two reports were produced roughly during the same period and in culturally interconnected countries, so they might be expected to have many similarities. The study finds that they are similar in some ways. Both the reports show that the normative power of experts in Scandinavian cultural policy is significant, although this is shown in different ways. In the case of SOU 2009:16, the normative power of the experts is primarily demonstrated in the mandate of the report, which explicitly requests the experts to suggest changes in overall policy objectives. On the other hand, the discussions of overall policy objectives are significantly more elaborate in NOU 2013:4 than in SOU 2009:16. Also, in NOU 2013:4, the normative power of experts is confirmed by their suggestions of controversial overall policy objectives. Thus, although both the reports confirm the normative power of experts in cultural policy, the reports also differ in important ways. The article explores possible explanations for these differences.
... | 3 LÉVESQUE understandings of contemporary political processes which focus more so on the increasing role of rationalization and technocracy throughout the twentieth century. For instance, some highlight the emergence and recent popularity of evidence-based policy, whereby debates are more and more influenced by science, expertise, and data (Cairney, 2016;Freiberg & Carson, 2010;Oliver et al., 2014;Taylor, 2016). Others emphasize the decline of democratic norms that has ensued from a rationalization of political debates (Habermas, 1990;Hess, 2016, pp. ...
Cannabis legalization is often referred to as a moral issue. However, given the limits of morality policy as a distinct policy subcategory and the contemporary dominance of technocratic politics, one could wonder if it is really framed as such within political institutions. In this article, I ask how moral frames compete and interact with other frames in debates over morality policy. Working with a moral/epistemic dichotomy, I conduct framing analysis on parliamentary debates in Quebec, Ontario, and Maine, which have recently reformulated their cannabis policy. Although trends in framing vary across cases, moral frames are consistently less salient than epistemic frames. Furthermore, a pattern of complementary framing is found, whereby actors combine moral and epistemic frames. Overall, this study shows that cannabis policy is often framed as nonmoral, and that its moral component is nonexclusive. I conclude by discussing some implications of these findings in the post‐legalization landscape.
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Brekken, Katheryn C., and Vanessa M. Fenley. 2021. “Part of the Narrative: Generic News Frames in the U.S. Recreational Marijuana Policy Subsystem.” Politics & Policy 49(1): 6–32. https://doi.org/10.1111/polp.12388 .
Fisk, Jonathan M., Joseph A. Vonasek, and Elvis Davis. 2018. “‘Pot’Reneurial Politics: The Budgetary Highs and Lows of Recreational Marijuana Policy Innovation.” Politics & Policy 46(2): 189–208. https://doi.org/10.1111/polp.12246 .
... However, in various public discussions marijuana, apart from being treated as a dangerous substance ("poison"), is sometimes considered as a "remedy" (Acevedo, 2007). Since the 1990s, marijuana as well as other cannabis derivatives have been (re)medicalised and have become the object of scientific and political debates (Sznitman & Lewis, 2015;Taylor, 2016). ...
Aim
This study analyses discourses on marijuana in the Polish daily press and explores ways of defining “the marijuana problem” during a debate about legalisation of medical marijuana.
Methods
384 press articles published in three national newspapers in 2015–2016 were analysed. The method used was discourse analysis. The theoretical background was social constructionism, including Spector and Kitsuse’s four-stage constructionist model of defining social problems.
Results
The study shows that marijuana problems were mainly constructed through criminal and politically medical discourses. In addition to celebrity and pop culture discourses, recreational marijuana use discourses and social problems discourses were identified.
Discussion
The marijuana problem can be defined differently through various discourses. Definitions pertain to diverse marijuana meanings ranging from a negative marijuana-as-drug, through an ambivalent recreational marijuana up to a positively valued medical marijuana. The research pointed out that, from a discursive standpoint, the marijuana problem may be viewed as a complex network of relations between particular discourses, marijuana meanings, claim-makers and the media.
Conclusion
Different definitions of the marijuana problem are constructed through a dynamic discursive and social process. Various claim-makers try to impose their meanings on marijuana. Mass media are not neutral. They also participate in defining the marijuana problem.
... As noted above, a growing number of scholars, laypersons and policymakers have been using the term "medicalization of cannabis" or "medicalization of marijuana" (See, for example, Newhart & Dolphin, 2019;O'Brien, 2013;Taylor, 2008Taylor, , 2016Vila-Henninger, 2018). Scientists and physicians use this phrase in publications and surveys as well (e.g., Naftali & Konikoff, 2017;Reiman, Aggarwal, & Reinarman, 2014;Sharon, Goldway, Goor-Aryeh, Eisenberg, & Brill, 2018;Wilkinson & D'Souza, 2014). ...
Background:
Although researchers, laypersons and policymakers have been debating about the "medicalization of cannabis" for years, few have attempted to unpack this phrase and clarify what it actually means. The present qualitative research addresses this issue by tracing the trajectory of "medical cannabis" (MC) in Israel.
Methods:
This article draws on multiple sources, including in-depth interviews, parliamentary protocols, conference observations, policy documents, and media coverage.
Results:
The analysis shows that while patients, growers, and certain physicians advocated for a more inclusive type of cannabis medicalization, other physicians and sick funds strove to curtail this medicalization; for its part, the Ministry of Health (MoH) attempted to find a pathway that would bridge their conflicting standpoints. In the first phase of medicalization patients' and regulators' trajectories coincided; however, they diverged in the second phase as regulators sought to transform MC into a standardized medication in line with the biomedical model. Patients and physicians criticized the new policy reform and highlighted some of its negative effects on patient care. The trajectories of patients and regulators then intersected in a way that led to some alterations in the MC trajectory.
Conclusion:
This study enhances our understanding of how MC was, and is still being, incorporated into medicine in Israel. The study illuminates the plurality of meanings that have been assigned to the concept of medicalization and the contingent nature of MC. Additionally, this study sheds light on the under-investigated role of regulators as drivers of the medicalization of "solutions," and it shows how different engines of medicalization may drive the process in diverging directions.
... To a large extent, cannabis remains a mystery, a medically unexplained medicine whose therapeutic effects are not well understood but are deeply felt by users (Pedersen and Sandberg 2013;Taylor 2016). We therefore term MC a contested medicine. ...
Few empirical studies have explored how different types of knowledge are associated with diverse objectivities and moral economies. Here, we examine these associations through an empirical investigation of the public policy debate in Israel around medical cannabis (MC), which may be termed a contested medicine because its therapeutic effects, while subjectively felt by users, are not generally recognized by the medical profession. Our findings indicate that beneath the MC debate lie deep-seated issues of epistemology, which are entwined with questions of ethics and morality. Whereas some stakeholder groups viewed evidence-based medicine and mechanical objectivity as the only valid knowledge base, others called for recognition of a particular experience-based knowledge, championing regulatory, administrative, or strong objectivity. Stakeholders’ interpretations of what should be considered as ethical courses of (in)action corresponded to their epistemological views, with most criticizing the regulators for relying on regulatory subjectivity instead of objectivity. Our in-depth mapping of this arena allowed us not only to shed light on the emergence of the new entity called “medical cannabis” but also to reexamine the link between epistemology, ethics, and action and to elucidate how heterogeneous groups view the validity and objectivity of knowledge and the interface between medicine, science, and policy.
... Some stakeholders call for greater tightening of the boundaries between medical and recreational cannabis; others call for their loosening (Fischer et al., 2015;Hall, 2015). Some stakeholder groups actively try to change boundaries by engaging in lay research (Sobo, 2017); others do so through participation in expert committees (Taylor, 2016). This article sheds light on the sources of and processes in which these controversies emerge and develop, drawing attention to who is responsible for demarcating and policing boundaries in rhetoric, formal policy and its implementation, and how this is accomplished. ...
Recent studies have explored how professionals draw boundaries to reach workable solutions in conflictual and contested areas. Yet they neglected to explore the relationships and dynamics between how boundaries are demarcated in rhetoric and in policy. This article examines these relationships empirically through the case of medical cannabis (MC) policy-making in Israel. Drawing on interviews with key stakeholders in the MC policy field, formal policy documents, and observations of MC conferences, this article sheds light on the dynamics between rhetorical boundary-work and what we term regulatory boundary-work, namely setting rules and regulations to demarcate boundaries in actual practice. Results show how certain definitions of and rationales for a discursive separation between "medical" and "recreational" cannabis and between cannabis "medicalization" and "legalization" prevailed and were translated into formal policy, as well as how stakeholders' reactions to this boundary-work produced policy changes and the shifting of boundaries. Both rhetorical and regulatory boundary-works emerge as ongoing contested processes of negotiation, which are linked in a pattern of reciprocal influence. These processes are dominated by certain actors who have greater power to determine how and why specific boundaries should be drawn instead of others.
... An increasing number of countries across the world, including Israel, have established medical cannabis programs to allow and regulate the use of medical cannabis (MC). This process has often been referred to as "the medicalization of cannabis" (e.g., Reiman, Aggarwal, & Reinarman, 2014;Taylor, 2016;Wilkinson & D'Souza, 2014). However, the meaning of this phrase for diverse stakeholders has not been explored. ...
Background:
Despite the frequent use of the phrase "medicalization of cannabis," it is not clear what it means to different stakeholders involved in medical cannabis (MC) policy development. This report examines Israeli stakeholders' understandings of how cannabis should be medicalized.
Methods:
Following principles of constructivist grounded theory method, we analyzed Israeli parliament protocols and different policy documents related to MC policy and legislation.
Results and discussion:
There was support for the incorporation of cannabis into medicine across the various stakeholders. Nonetheless, controversies remained surrounding how cannabis should be medicalized. Specifically, whereas most stakeholders argued that cannabis should be medicalized as a medication by relying on the biomedical model of medicine, others contended that cannabis should be medicalized as a treatment, akin to how complementary or alternative treatment has been co-opted by medicine. Biomedicalization of cannabis was the dominant frame, and was supported by the Ministry of Health, which has been entrusted to oversee the MC program in Israel.
Conclusion:
Due to its extensive experience with MC policy and its pioneering research, many consider Israel to be a leading actor in the global MC arena. It is therefore possible that other countries will follow Israel's lead in its path to the biomedicalization of cannabis.
... Suzanne Taylor examines the role of expert committees and different forms of scientific expertise in the debates about cannabis and its medical usage in the 1970s and early 1980s in the UK. She uses previously unused archival material to analyse the basis of opposing scientific and policy positions (Taylor, 2016). And a discussion of the opium policies of the Shanghai Municipal Council in the early 1900s illustrates how the move away from a system of licensing to one of suppression was in its turn influenced by colonialism, in this case the Anglo Indian agreement for the ending of the opium trade and national rather than local policies in China. ...
History is often dismissed as of little utility in the analysis of policy. This paper provides a justification for its use as evidence. It surveys the rise of the use of history, including public history and history and policy. It looks at two issues which draw on the author's own work: the relationship between regulation and culture for smoking and alcohol; and the response to electronic cigarettes in the light of smoking and public health history. It analyses what history can contribute. Responses are time dependent and change is an essential parameter in understanding policy. Historical research can challenge stereotypes, for example that prohibition was abandoned because it ‘failed’. It also forms the bedrock of historical interpretation, which is mutable and often misunderstood outside the profession. History provides policy analysis rather than policy prescription and is a challenging approach, not just a convenient support for established positions. The paper concludes that history is far from moribund as a policy science.
This chapter charts the formulation and development between 2018 and 2022 of Child First as the new guiding principle for youth justice in England and Wales. From the position of leading its development, the authors provide a unique contemporary ‘inside’ analysis of the discourse-framing and negotiation processes involved in turning an evidence-base advocating reform into a policy-level proposal that is both acceptable and useful to stakeholders. Analysis of its formulation reveals how stakeholders’ concerns were extensively anticipated and already navigated in Child First’s initial drafting, leading the chapter to call for academic models of policymaking process to recognise the influence of stakeholders as earlier and greater than typically understood (in active negotiation). The core understandings in the Child First principle have been widely accepted by stakeholders, enabling progress embedding it in national standards and guidance. Initial stakeholders’ concerns (both anticipated in drafting and during consultation) have not spoken to the discourse dichotomies usually presented in youth justice literature (e.g. child vs offender), but instead to how specific elements of the principle may affect their own diverse agendas. Critical frameworks for understanding youth justice policy must be reframed to reflect the highlighted multiplicity of agendas of those involved, which may themselves not be primarily about children in the criminal justice system.The chapter demonstrates the usefulness of policy-level actors developing the methodology of ‘textual reflexivity’, adopted from social sciences, in the interests of both engagement with stakeholders and academic insight.
As states legalize medical cannabis, school nurses face increased parent questions about administration at school. Although school nurses frequently collaborate on the development and implementation of medication administration policies, their perceptions of barriers to school-based medical cannabis administration are not well-documented. To explore these perceptions, we surveyed school nurses (n=379) in sixteen states about their beliefs .related to school-based medical cannabis administration policy development. Findings revealed school nurses from states completely legalizing cannabis expressed significantly fewer concerns about the safety, stigma, and federal status of medical cannabis than their peers in more restrictive states. Implications for practice include (a) education of key stakeholders, (b) collaboration with stakeholders to formulate medication administration policy, and (c) development of state-level guidance for school professionals.
This study explored whether personal attitudes toward drug users are associated with professional approaches and whether the association between personal and professional attitudes varies across different mental health professions. Participants (N = 347) included medical (psychiatrists and psychiatric nurses) and other (clinical psychologists and social workers) mental health professions from all 13 mental health centers in Israel. They completed questionnaires aimed to assess familiarity with medical usage of hallucinogenic drugs, personal attitudes toward recreational drug users and willingness to use five hallucinogens in research of clinical practice. Hypotheses were tested using multiple-group structural equation modeling (SEM). Psychiatrists reported the highest levels of familiarity with and willingness to use all types of hallucinogenic drugs, as compared to other mental health professionals. Psychiatrists held the strongest belief in the potential utility of hallucinogenic drugs; yet, their personal attitudes toward drug users affected negatively their willingness to try hallucinogenic drugs in clinical practice. This was the only significant association that was found. Future research and treatment programs should address the topic of hallucinogenic drug therapy, and specifically the need to separate between individual beliefs and professional clinical decision-making.
This research paper examines to what extent the most recent policies around cannabis
in the UK, namely declassification in 2004 and reclassification of cannabis in 2009
under the Misuse of Drugs Act 1971 lack Evidence-Based Policy-Making. In doing it
will first look at the history of cannabis and analyse the formation of first international
drug control under the US Leadership which established UN Drug Conventions 1961,
1971 and 1988 and their impact on UK’s domestic cannabis policies as a signatory
state. This will allow us to understand the origins of UK’s current prohibition on
cannabis. Secondly, the research paper will focus on the recent amendments on
cannabis classification in the UK which will be analysed through the framework
suggested by Head (2008) ‘Three Lenses of Evidence-Based Policy’. This will
demonstrate us that not only does scientific-knowledge exist within the Evidence-
Based Policy but practical implementation and most importantly political knowledge as
well. Having identified the extent to which these types of knowledge exists within
domestic cannabis policies in the UK, we will reach the conclusion that alterations
which took place on the classification of cannabis in 2009 show lack scientific
knowledge but can still be considered Evidence-Based Policy.
Over the past two decades, policymakers have been encouraged to develop evidence-based policies in collaboration with experts. Drug policy is unique since it has an established inbuilt mechanism for soliciting expertise via the Advisory Council for the Misuse of Drugs (ACMD). Increasingly alternative mechanisms have been used. Based upon detailed analysis of two case studies of drug policymaking using alternative methods to solicit expertise, we argue that the framing of the policy problem, the mechanisms used to involve experts and the type of evidence actively sought, have continued to marginalise the involvement of the drug user in policymaking.
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.