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Included in this document are selections of topic-specific articles on heroin research reprinted from the National Institute on Drug Abuses (NIDA) research newsletter, NIDA Notes. Titles include: Buprenorphine Taken Three Times Per Week Is as Effective as Daily Doses in Treating Heroin Addiction; 33-Year Study Finds Lifelong, Lethal Consequences of Heroin Addiction; Buprenorphine Proves Effective, Expands Options for Treatment of Heroin Addiction; Nicotine Craving and Heavy Smoking May Contribute to Increased Use of Cocaine and Heroin; Drug Abuse Treatment Programs Make Gains in Methadone Treatment and HIV Prevention; Recovery Harder for Addicts Who Start Young; High-Dose Methadone Improves Treatment Outcomes; Heroin Snorters Risk Transition to Injection Drug Use and Infectious Disease; Heroin, Marijuana, Methamphetamine Use on the Rise; Linking Medical Care with Drug Abuse Treatment Stems Tuberculosis among HIV-Infected Drug Users; NIH Panel Calls for Expanded Methadone Treatment for Heroin Addiction; NIDA Conference Aims Preemptive Strike at Increased Heroin Use among Nations Young People; Applying Scientific Research Can Counter Rise in Heroin Use; Rate and Duration of Drug Activity Play Major Roles in Drug Abuse, Addiction, and Treatment; Vocational Screener Helps Methadone Patients Overcome Job Barriers; and Heroin Update: Smoking, Injecting Cause Similar Effects: Usage Patterns May Be Shifting. (GCP)

Originally published in 1992 as The Facts About Drug Use, this updated edition contains new information about the effects of alcohol and recreational, mood-altering drugs on the body. The multiple causes of drug use and the options available to those dependent on drugs as a way of life are thoroughly described. Knowledge of the adverse effects of mood-altering drugs and why and how they are used excessively is a centerpiece of this book. It presents ways to identify persons at risk and identify problems that the addicted encounter in attempts to become drug free. This book enables those with little or no background in science or health care to understand the complex issues surrounding drug use. It provides current, reliable information on methods for dealing with dependency upon alcohol and central nervous system depressants, hallucinogens, heroin, nicotine, marijuana, caffeine, amphetamines, designer drugs like Ecstasy, and steroids. This comprehensive volume discusses: who typically uses drugs and the reasons why they do; how to classify mood-altering drugs; how to identify and treat drug dependency; areas of special concern such as multiple drug use, AIDS and drug use, drugs and pregnancy, drugs and sports, and drug testing technology. Chapter by chapter, this book seeks to help readers develop a better understanding of the effects of mood-altering substances and the reasons many continue to use them despite serious consequences. Two appendixes provide drug use reporting sources and a glossary listing common street names for drugs. (Contains over 600 references and an index.) (GCP)

Offspring of mothers using ethanol, heroin, cocaine, or cannabis during pregnancy are known to suffer from developmental delay and/or a variety of behavioral changes. It is yet unknown how many of these changes result from intrauterine exposure, genetic causes, or postnatal environmental deprivation. Hence, the therapeutic approach toward children and their mothers may be influenced by each one of these factors. In this chapter, we discuss separately the effects of each of these substances on the developing embryo and fetus, the mechanism of action, and the modes of treatment to mothers and children. Ethanol, the most teratogenic agent of this group of substances, may affect the developing fetus in a dose-dependent manner. With very high repetitive doses, there is a 6-10% chance of the fetus developing fetal alcohol syndrome manifested by prenatal and postnatal growth deficiency, specific craniofacial dysmorphic features, mental retardation, behavioral changes, and a variety of major anomalies. With lower repetitive doses, there is a risk of ˵alcoholic effects″ mainly manifested by mild intellectual impairment, growth disturbances, and behavioral changes. By ingesting high doses of ethanol (binge drinking) several times during pregnancy, there seems to be some danger of mild intellectual deficiency. Maternal continuous use of heroin and opiates (i.e., addiction) during pregnancy may cause stillbirths, prematurity, and fetal growth retardation. The children may suffer from mild intellectual impairment, learning and behavioral problems, and a high rate of inattention and/or hyperactivity. It does not seem to increase the rate of major congenital anomalies. Cocaine may affect the developing fetus in a way similar to heroin. It increases the rate of intrauterine death mainly as a result of placental abruption, intracerebral hemorrhage, prematurity, and growth retardation, but probably not of congenital anomalies. It also increases the rate of perinatal complications. Postnatally, it may impair intellectual abilities and increase the rate of behavioral problems including attention deficit hyperactivity disorder. Cannabis use during pregnancy may cause decreased birth weight and gestational age at birth, but apparently only few postnatal sequelae. Lactation is contraindicated if the mother uses any of these substances. The long-term intellectual outcome of children born to drug-dependent mothers is influenced to a large extent by the environment in which the exposed child is raised. It is advised to offer maternal abstinence programs prior to pregnancy, but they may also be initiated during pregnancy with accompanying close medical care. [ABSTRACT FROM AUTHOR]

Drug addiction is a pathophysiological disorder characterized by the progression of acute drug use into patterns of chronic drug abuse associated with craving and seeking behavior as well as increasing risk for relapse in drug use during attempts at withdrawal. Drugs of abuse include a wide variety of substances diverse in structure, pharmacology, toxicology, and long-term clinical sequelae but with the common target of brain reward centers. The authors discuss drugs within each of the major classes of abused substances from the perspectives of the history of each drug΄s use as well as chemical properties, mechanisms of action including selective receptor interactions, pharmacokinetics of distribution-metabolism-elimination, and the toxicology of these drugs. The major classes of drug reviewed include the two most commonly used substances, ethanol and tobacco, as well as stimulants, opiates, cannabinoids, hallucinogens, barbiturates, and benzodiazepines. [ABSTRACT FROM AUTHOR]

INTRODUCTION There is growing debate in the United Kingdom on the number and nature of street gangs and their contribution to crime and violence. However, the discussion is impeded to some extent by a lack of agreement on the definition of what constitutes a gang. Confusion over definitions of gangs is not confined to the United Kingdom. Klein (2001) argued that the concept of gangs in the United States has been shaped by the stereotype of the West Side Story gang and the image of gang ‘colors’. He argued that both are distortions of reality, and that few American gangs fit this stereotype. He argues instead that gang formations are much more variable and proposes a typology of observable gang structures based on five discrete forms (traditional, neo-traditional, compressed, collective, and specialty). Decker (2001) argued that the concept of the gang has been distorted by the dominance of the view that gangs are well organized and tightly structured. However, an alternative view, supported by his own research, shows that gangs are often disorganized and typically do not have leaders. It is not necessary to enter into the complexities of this debate in this chapter because it has been discussed at length elsewhere (see Klein et al., 2001, for an overview). However, it is worth noting that the aim of this chapter is to investigate what are typically called ‘street gangs’ (Klein, 2001) or ‘youth gangs’ (Sanders, 1994) rather than ‘criminal gangs’ or ‘crime firms’ that come together solely to commit a particular criminal act and then disperse. [ABSTRACT FROM AUTHOR]

INTRODUCTION There is surprisingly little research in the United Kingdom on drug misuse and associated problems among members of ethnic minority groups. In 1998, the Advisory Council on the Misuse of Drugs (1998) reported that the influence of ethnicity on illicit drug use in the United Kingdom was an ‘under-researched topic’ (p. 25). This lack of information on ethnicity and drugs also has been reported in other countries. Fountain and colleagues (2004) noted the following in relation to Europe: In several European Union countries drug use amongst black and minority ethnic communities is largely unacknowledged, ignored, unrecognised, or hidden by some policy-makers, drugs researchers, drug service planners and commissioners and by some members of some black and minority ethnic communities themselves. (p. 362) Rounds-Bryant, Motivans, and Pelissier (2003) claimed that even in studies where ethnic minorities had been included, many investigators fail to report findings for individual ethnic groups. Others have criticized drug research for focusing on some ethnic groups and ignoring others (Fountain, Bashford, Winters, and Patel, 2003). The absence of research in this area has been attributed in part to the differing cultural values of ethnic groups. Reid, Crofts, and Beyer (2001) state that illicit drug use in minority ethnic communities is often associated with denial, shame, stigma, and loss of face. As a result, there might be some reluctance among researchers to investigate these sensitive topic areas. [ABSTRACT FROM AUTHOR]

INTRODUCTION In this final chapter of the book, we reflect on what has been found from the results of the New English and Welsh Arrestee Drug Abuse Monitoring (NEW-ADAM) program as a whole. We briefly review the main findings from each chapter and consider the themes that have emerged. We also discuss what has happened to the NEW-ADAM program in the United Kingdom and the Arrestee Drug Abuse Monitoring (ADAM) program in the United States since their demise. Finally, we consider some of the policy and research implications of the study. SUMMARY In Chapter 2, we discussed the research methods used in the NEW-ADAM program and described the method of urine collection and the personal interview. Arrestees were selected by a system of two-stage sampling with the first stage based on purposive rather than random sampling. We noted some of the limitations of the research including the considerable difficulties of interviewing arrestees in the chaotic conditions of police custody suites. Arrestees were often highly agitated, and some were potentially violent having been free on the streets just hours before interview. Despite these barriers, the research team succeeded in interviewing more than 4,500 arrestees during the research period and collected urine samples from almost all of them. Chapter 3 examined the prevalence and incidence of drug misuse among arrestees. The results presented in the chapter provide evidence for the first time in the United Kingdom of the high levels of involvement of arrestees in drug misuse. [ABSTRACT FROM AUTHOR]

INTRODUCTION Since 1997, the United Nations Office on Drugs and Crime (UNODC) has published estimates of the extent of drug misuse in the world. The most recent figures were presented in the World Drug Report 2005 (UNODC, 2005). It was estimated that about 200 million people, comprising 5 percent of the world's population aged 15 to 64, had used drugs at least once in the last 12 months. Cannabis was found to have been consumed by approximately 160 million people or (4% of the population aged 15 to 64). At the global level the main hard drugs reported were opiates and cocaine. In addition to providing global estimates of drug misuse, the World Drug Report 2005 also published estimates for individual countries. The results show wide variation in the prevalence of drug use across countries. Opiate use in the last 12 months, for example, was found to range from a low of 0.01 percent in Brunei, Saudi Arabia, and Kuwait to a high of 2.8 percent in Iran. Estimates of cocaine use in the last 12 months ranged from 0.001 percent in Hong Kong to 3 percent in the United States. Cannabis use was estimated to be particularly high in some African and Caribbean countries with an estimate of 21.5 percent in Ghana and 16.1 percent in Haiti. By contrast, cannabis use was estimated to be just 0.02 percent in Brunei. [ABSTRACT FROM AUTHOR]

INTRODUCTION Disaggregating the drug-crime relationship refers to breaking down the association between drug use and crime by various types of drug use and various types of crime. A number of reasons might make it useful to disaggregate findings. One is that it can reveal variations in the drug-crime relation that might be obscured when looking at aggregated categories. It is possible, for example, that certain kinds of drugs might be associated with certain kinds of crimes. Another reason is that drug policy needs to be efficient as well as effective. It might be the case that a blanket policy covering all drug types or all crime types might be unnecessary and wasteful. Instead, a more focused approach on specific drug-crime combinations might be more cost effective. The idea that there might be variations in the drug-crime relationship depending on the type of drugs and type of crimes being considered has been suggested before in the research literature. It has been argued that drugs vary substantially in terms of their pharmacological properties, their addictive qualities, and their costs. It is unlikely, therefore, that their impact on criminal behavior would be identical (Farabee et al., 2001). Parker and Auerhahn (1998) make a similar point in relation to the study of drugs and violence and note the tendency of research to “lump all illicit drugs together, as if all drugs might be expected to have the same relationship to violent behavior” (p. 293). [ABSTRACT FROM AUTHOR]

INTRODUCTION The relationship between gender and drug use has been referred to as ‘the big neglected question’ in the field of substance misuse (Measham, 2003, p. 22). Historically, the addiction literature has focused on male drug users, and less attention has been given to the problems of female users (Neale, 2004a). During the 1990s, this focus began to change, and female drug users became a topic of interest among researchers (Broom, 1994). However, it did not wholly answer the question of whether there were gender differences in drug misuse (Broom, 1994). As a result, relatively little research was done on the broader issue of whether women and men were fundamentally different in any way in the characteristics of their drug misuse and the problems associated with it. Nevertheless, information relating to gender differences is now emerging. Recent research has shown that female and male drug users differ in terms of the nature of their drug use and in associated problems, including patterns of drug use (Neale, 2004a), the development of drug-use careers (Kandel, 2000), drug-use initiation (Eaves, 2004), and treatment outcomes (Hser, Huang, Teruya, and Anglin, 2004). These findings are important and suggest that both the nature of the problem and the nature of the solution might be different for women and men. However, the number of studies investigating any single issue within this broad area is small and the results obtained so far are contradictory (Hser et al., 2004). Hence, generalization is difficult and few definitive findings have emerged. [ABSTRACT FROM AUTHOR]

INTRODUCTION This chapter discusses treatment needs of arrestees and treatment methods provided for drug misuse. In particular, it looks at treatment offered by traditional programs aimed at drug users who voluntarily present themselves and treatment offered through court orders or other criminal justice processes whereby treatment for drug misuse as part of the disposal. The former is sometimes referred to as ‘voluntary’ treatment in that they are based on self-referral. The latter is sometimes described as ‘coercive treatment’ in that they are based on referral to treatment by the criminal justice system. One of the central platforms of the government's drug strategy is to tackle drug misuse and drug-related crime through treatment provision. To be effective, the strategy needs to encourage users who have not sought treatment to enter into treatment. It also needs to satisfy the demand for treatment of users who have sought treatment. It is also important that drug users enter into treatment programs that have been shown in the past to reduce drug misuse or drug-related crime. This chapter reviews the literature on the type of treatment services available and user demand for these services. It then looks at the level of demand for treatment among drug-using arrestees and the extent to which this demand is met. [ABSTRACT FROM AUTHOR]

INTRODUCTION In any particular country, the overall drug market might be thought of as comprising a number of submarkets. Pearson and Hobbs (2001) identified what they refer to as a four-tier classification of drug markets: importers, wholesalers, middle-market brokers, and retail dealers. Dorn and Hunter (1992) suggested a seven-tier typology based on the type of ‘firms’, or groups of individuals, involved in drug trafficking (trading charities, mutual societies, sideliners, criminal diversifiers, opportunistic irregulars, retail specialists, and state-sponsored traders). Lupton et al. (2002) described two types of drug markets operating in deprived neighborhoods (central place markets and local markets), and Edmunds, Hough, and Urquia (1995) identified two types of market operating at the local level (open and closed). Dorn, Levi, and King (2005) described drug trafficking in terms of individual motives (political, financial, and risk). Hence, researchers to date have tended to use typologies as a means of describing the nature of drug markets. Although these typologies provide useful descriptive information about different aspects of drug markets, none provides a picture of the drug market as whole. Further, little is known about when these typologies apply and when they do not apply. It is likely that methods of drug trafficking and dealing vary markedly in terms of organization and operation over time and location. In some locations or times, small organized crime groups might cover almost the entire range of operations from importation to street dealing (Brookman, Bennett, and Maguire, 2004). [ABSTRACT FROM AUTHOR]

INTRODUCTION It is widely believed that drug use causes crime. The current UK drugs policy is based on this assumption and one of the aims of the strategy is to reduce crime by reducing the availability of drugs (Home Office, 2002). However, it is not wholly certain that there is a connection. Although many studies have shown a link between drug use and crime, many others have not. There have also been few systematic reviews of the literature as a whole which might help unravel these different findings. It is possible that drugs and crime are connected under certain conditions and not under others. The data collected as part of the New English and Welsh Arrestee Drug Abuse Monitoring (NEW-ADAM) program adds to this body of knowledge on the links between drug use and crime. In particular, it provides an opportunity to investigate variations in the association and some of the conditions that might affect it. PREVIOUS RESEARCH A considerable body of research has attempted to establish whether there is a statistical connection between drug use and crime. The association has been investigated in part by looking at samples of criminals to determine their level of drug use and, in part, at samples of drug users to determine their level of criminality. The following section summarizes selected research findings from different countries and a brief overview of some reviews of the literature. [ABSTRACT FROM AUTHOR]

INTRODUCTION A wide variety of health problems can be experienced by drug users including dependency, infectious diseases, harmful physiological effects of certain drugs, and risk of overdose and death. These problems are important not only for the individual drug user but also for those people (such as the police) who come into regular contact with them. They are also important in that they increase the burden on the health service and its personnel, including general practitioners and hospital-based services. PREVIOUS RESEARCH Previous research on the health problems of drug misusers has tended to focus on the problem of dependency and addiction. However, research has also been conducted on general health problems, the prevalence of injection and sharing equipment, the spread of infectious diseases such as HIV and AIDS, and the link between drug use and alcohol and tobacco consumption. General health problems. Most drugs that are commonly misused can cause short-term negative effects on mental and physical functioning. Heroin can produce various kinds of physiological change including dry mouth, drowsiness, impaired mental functioning, and slowed breathing. At high dosages, heroin consumption can lead to respiratory failure. Chronic users can develop collapsed veins, infection of the heart lining, abscesses, and liver disease. Street heroin is often mixed with various substances, including sugar, starch, and some poisons that may also have harmful physiological effects. Cocaine use can cause constricted blood vessels, increased temperature, heart rate, and blood pressure. [ABSTRACT FROM AUTHOR]Drug side effects. Most drugs that are commonly misused can cause short-term negative effects on mental and physical functioning. Heroin can produce various kinds of physiological change including dry mouth, drowsiness, impaired mental functioning, and slowed breathing. At high dosages, heroin consumption can lead to respiratory failure. Chronic users can develop collapsed veins, infection of the heart lining, abscesses, and liver disease. Street heroin is often mixed with various substances, including sugar, starch, and some poisons that may also have harmful physiological effects. Cocaine use can cause constricted blood vessels, increased temperature, heart rate, and blood pressure. [ABSTRACT FROM AUTHOR]

INTRODUCTION Several methods of monitoring drug misuse already exist, including surveys of the general population, medical records of users entering treatment, and official statistics on prosecutions for drug offenses. However, each of these measures has problems in providing an accurate estimation of drug misuse. General population surveys do not cover the entire population and tend to omit difficult-to-reach groups, such as homeless people and those currently living in institutions. They also exclude those who are criminally active who might decline to be interviewed and those in custody (either in prison or in police cells) at the time of the survey. Similarly, medical records and official statistics do not cover the entire population as they exclude drug users who do not present for treatment and those not convicted of a drug offense. On each occasion, the omitted groups are likely to include the most problematic drug users. It is important in assessing drug-use patterns that monitoring covers a broad spectrum of the population and, therefore, that information is available on the more difficult-to-reach groups and more problematic drug users. This chapter aims to shed light on drug misuse among one of these difficult-to-reach groups. The following sections examine what is known about drug misuse among arrestees from the results of the New English and Welsh Arrestee Drug Abuse Monitoring (NEW-ADAM) surveys. In particular, it looks at the proportion of arrestees that use various types of drugs, the rates of drug use among drug users, and weekly expenditure on drugs. [ABSTRACT FROM AUTHOR]

INTRODUCTION The previous chapters have focused mainly on the statistical association between drug use and crime. We have not yet discussed whether drug use and crime are causally connected. It might be the case that the two are statistically associated (when you get one, you tend to get the other) but not causally connected (one does not cause the other). There has been no shortage of theories of the possible causal connection between drug use and crime. These include economic explanations (e.g., crimes are committed to fund drug use), psychopharmacological explanations (e.g., crimes are committed as a result of judgment impairment from drugs), and sociological explanations (e.g., drugs are purchased from the proceeds of crime) mentioned earlier. However, little is known about whether these explanations are valid, whether some are linked to certain conditions or apply only to certain individuals, or whether some are more common than others. It is possible that the causal connection between drug use and crime is different for women compared with men, younger people compared with older people, heroin users compared with amphetamine users, or car thieves compared with street robbers. Common sense tells us that different circumstances will involve different causal processes. However, it is still unclear when one explanation might apply compared with another. The New English and Welsh Arrestee Drug Abuse Monitoring (NEW-ADAM) surveys were not designed to investigate causality directly because this would have required determining the main elements of a causal process including establishing a statistical association, identifying the temporal order between the presumed cause and effect, and ruling out any rival hypotheses (other events that might have caused the changes). [ABSTRACT FROM AUTHOR]

INTRODUCTION Research on the connection between drug misuse and crime has tended to focus on either aggregated measures of drug misuse and criminal behavior or specific types of drugs and specific types of offenses. Little attention has been paid to the extent to which combinations of drug misuse might be connected to crime. This is surprising for at least two reasons. First, there has been considerable attention paid in the research literature to what is sometimes referred to as polydrug or multiple drug misuse. However, much of this discussion has focused on explaining the phenomenon of multiple drug misuse or the implications of multiple drug misuse for treatment. Second, there are a number of plausible reasons to suspect that drug use combinations might be important in explaining crime. These include direct effects, such as the potential interactive or additive effects of drug mixing on judgment or behavior, and indirect effects, such as the potential amplifying effect of involvement in drug misuse on offending. Research that has investigated the association between specific drug types, and crime has tended to investigate the use of the specific drug type in isolation from other drugs. Many studies, for example, have investigated the association between heroin misuse and criminal behavior. However, few have investigated the association between heroin use in combination with other drugs and criminal behavior. [ABSTRACT FROM AUTHOR]

INTRODUCTION The New English and Welsh Arrestee Drug Abuse Monitoring (NEW-ADAM) program was based on surveys of arrestees currently held for official processing, typically in relation to a suspected offense, in police custody suites in England and Wales. The research methods were similar to those used in the early version of the Arrestee Drug Abuse Monitoring (ADAM) program in the United States and in other International Arrestee Drug Abuse Monitoring (I-ADAM) programs. The main methods of data collection were structured face-to-face interviews and collection of urine specimens suitable for urinalysis. It should be noted that the main features of the research design were outlined in the specifications for the research prepared by the Home Office. Some of these criteria emerged from the experience gained during the two developmental stages of the research. Other criteria, such as the overall budget and scale of the research, were determined from the outset by the Home Office based on financial and policy considerations. Hence, the final research design comprised a combination of elements generated by the Home Office and the research team. SAMPLES Sampling method The NEW-ADAM surveys used two-stage sampling. In the first stage, 16 sites were selected using a method of ‘purposive’ sampling of custody suites. In the second stage, approximately 210 arrestees were interviewed in each site. The decision to include 16 first-stage sampling points and 210 second-stage cases was influenced in part by practical aspects of conducting the research. These are discussed in more detail later in the chapter. [ABSTRACT FROM AUTHOR]

INTRODUCTION In 1999, the UK government allocated £6 million of new money for research and information gathering in support of the government's strategy to reduce drug-related crime. Part of the £6 million was used to set up a national program of research to investigate drug use and crime among arrestees. In July 1999, after two developmental stages, a program of arrestee monitoring was established in the United Kingdom under the title of the New English and Welsh Arrestee Drug Abuse Monitoring (NEW-ADAM) program. The program was designed primarily to collect urine specimens and to conduct personal interviews with recently arrested offenders to understand better the nature of the drug-crime connection. The surveys were also to provide information on related issues, such as use of weapons and guns in crime, gang membership, and drug markets. The program was initially funded to run for three years with the view of continuing funding subject to review. The broad aim of this book is to present the findings of the NEW-ADAM surveys. Some of the results of the NEW-ADAM program have already been published in government reports and in articles in peer-reviewed journals. However, other findings have not yet been published. As a result, the findings of the NEW-ADAM program have not been fully documented in a single source. This book brings together the results of the NEW-ADAM program in a single volume by summarizing the findings of previously published papers and presenting new findings. [ABSTRACT FROM AUTHOR]

Facts in contrast to the in 2000, the first years of the new century have evinced an impressively flat trajectory in crime. By 2000, crime rates were well below those of 1985, the year just prior to the surge in crime that preceded the drop. With violent crime rates now down to levels not seen since the 1960s, it was unlikely that the trend could maintain its sharply declining slope. Indeed, there were reasons to predict an increase in crime. The economy was stagnant, with largely immovable unemployment rates and especially bleak job prospects for those without specialized work skills suited to the information economy. Social services and financial supports funded by state and local governments had been reduced. Controls on gun sales were being weakened, in part through the powerful lobbying of the NRA for its individual-ownership interpretation of the Second Amendment. Methamphetamine and stronger varieties of heroin were showing up in urban markets. Suppression of crime through incapacitation was softening as net growth in imprisonment (intake minus outflow) was declining from a yearly compound growth rate of nearly 9 percent in the 1980s and more than 6 percent in the 1990s to less than 2 percent after 2000. [ABSTRACT FROM AUTHOR]The Crime Drop in America in 2000, the first years of the new century have evinced an impressively flat trajectory in crime. By 2000, crime rates were well below those of 1985, the year just prior to the surge in crime that preceded the drop. With violent crime rates now down to levels not seen since the 1960s, it was unlikely that the trend could maintain its sharply declining slope. Indeed, there were reasons to predict an increase in crime. The economy was stagnant, with largely immovable unemployment rates and especially bleak job prospects for those without specialized work skills suited to the information economy. Social services and financial supports funded by state and local governments had been reduced. Controls on gun sales were being weakened, in part through the powerful lobbying of the NRA for its individual-ownership interpretation of the Second Amendment. Methamphetamine and stronger varieties of heroin were showing up in urban markets. Suppression of crime through incapacitation was softening as net growth in imprisonment (intake minus outflow) was declining from a yearly compound growth rate of nearly 9 percent in the 1980s and more than 6 percent in the 1990s to less than 2 percent after 2000. [ABSTRACT FROM AUTHOR]

A biography of Irvine Welsh, Scottish novelist is presented. He was born in 1961 at Leith in Edinburgh, Scotland and studied at Ainslee Park Secondary School and Heriot-Watt University. It also offers information on his novels that includes "Trainspotting," in which he discussed use of heroin among people in Leith and Muirhouse in Edinburgh, Scotland.

This chapter focuses on the problems and possibilities associated with sexual behavior change among users of heroin. Most community interventions share an understanding that individualistic models of intervention are limited in their scope for achieving or sustaining behavior change. It is recognized that HIV prevention interventions need to target more than individuals and individual behavior change alone. The common tendency to reduce behavior change and the factors which precipitate or influence such change, to the individualized unit of one is fast becoming outmoded by intervention models which target interconnected groups of individuals and social relationships as agents of change. Contemporary research constructions of risk associated with heroin use view risk behavior as inextricably bound up with the act of injection. It is probably fair to say that most epidemiological definitions of risk behavior among heroin users are synonymous with injection.

Chapter 5 of the book "Two Badges: The Lives of Mona Ruiz" is presented. The chapter details the author's experience of becoming an associate of the Troopers gang in Santa Ana, California. The author recalls that drugs, such as heroin, were easy to get at that time. It also notes that the author realized that she wants to be a cop.

The average citizen of the United Kingdom has only a superficial knowledge of the problems caused by illicit drugs and the writer was no different until a military posting to Central America (as Commander of the British forces in Belize) brought the difficulties home in a most vivid manner.* Across the world drugs have been smoked, chewed or sniffed for thousands of years. We have learnt how Helen of Troy offered Telemachus nepenthe in Homer's Odyssey and there is definitive evidence of the use of coca leaves as stimulants found on pottery and in wall-paintings of the Amerindians. The coca shrub enjoyed a pre-eminent position in the Inca Empire and it was regarded as a sacred manifestation of divinity, which was buried with the deceased to speed them on their way to another and better world. Unlike tobacco and chocolate, coca was never exported to Europe from the Americas under Spanish rule, although the Moors are thought to have brought marijuana to Spain from Africa for use as a tranquilliser or pain-killer. Opiates from the East made their appearance in Britain largely through the successes of the great British trading companies. Clive of India was an addict for twenty years, before dying in a fit after a double dose of opium. Whilst the British East India Company's opium trade was finally curtailed towards the end of the nineteenth century, cocaine had by then begun to make its appearance in the Western world – first as a wonder-drug manufactured by the US pharmaceutical firm Parke-Davis. [ABSTRACT FROM AUTHOR]

An encyclopedia entry for "The Pizza Connection" is presented. It refers to the case involving 20 members of the Sicilian and American Mafia who were arraigned on October 24, 1984 on conspiracy charges of smuggling heroin and cocaine into the U.S. The smuggling activities of the gang were estimated to be worth 1.6 billion U.S. dollars. The investigation about the gang started in July 1979, after the murder of the Bonanno Family boss Carmine Galante. The gang transport the drugs using pizzas and other commodities such as lemons, shirts and pears.

An encyclopedia entry for "smuggling narcotics" is presented. In Great Britain, cocaine were attempted to be smuggled through Heathrow airport in spectacle frames, television cathode tubes, shoe heels, children's books, nun's habits, fish cakes, and antique chair-legs. One high-technology ploy infuses cocaine into fibre glass and plastic products. The Balkan route serves as the passage of 80 percent of Europe's heroin. The entry highlights the financial parallels between the illegal trade in rare birds and the exponential mark-up on drugs.

An encyclopedia entry for "The Golden Triangle" is presented. It refers to an area of rugged terrain occupying parts of Thailand, Laos and Burma that is a major source of the world's opium and heroin. The region is dominated by sharp mountain ranges, deep valleys and thick jungle, where hill tribes harvest some 1,500 tons of opium annually under Triad control.

An encyclopedia entry for "The French Connection," a scheme wherein heroin was smuggled, is presented.

The article discusses the use of heroin prescription in treating opioid dependence. The establishment of heroin-assisted treatment become one of the treatment options in Switzerland. A review by a World Health Organization expert group supported the findings of the Swiss study, but recommended to have further research in order to better identify the specific benefits of prescribed heroin.