The illegal drug trade is a world phenomenon, which has had some adverse impact on societies. Significantly, the impact is damning in developing economies in Africa and Ghana in particular. This paper therefore seeks to address the causes and effects of the use and peddle of these illegal drugs in three communities in the capital city of the Asante Region of Ghana. It further ascertains the extent to which these drugs burden the security agencies in the communities and the (...) country in general. We have used documentary and non-documentary sources to arrive at some postulations on this important social question which has wider ramifications on Kumase, Asante, Ghana and Africa in general. (shrink)

Why does American law allow the recreational use of some drugs, such as alcohol, tobacco, and caffeine, but not others, such as marijuana, cocaine, and heroin? The answer lies not simply in the harm the use of these drugs might cause, but in the perceived morality—or lack thereof—of their recreational use. Despite strong rhetoric from moral critics of recreational drug use, however, it is surprisingly difficult to discern the reasons they have for deeming the recreational use of (some) drugs (...) morally wrong. In this book, Rob Lovering lays out and dissects various arguments for the immorality of using marijuana, cocaine, heroin, and other drugs recreationally. He contends that, by and large, these arguments do not succeed. Lovering's book represents one of the first works to systematically present, analyze, and critique arguments for the moral wrongness of recreational drug use. Given this, as well as the popularity of the morality-based defense of the United States' drug laws, this book is an important and timely contribution to the debate on the recreational use of drugs. (shrink)

The war on drugs is widely criticized as unjust. The idea that the laws prohibiting drugs are unjust can easily lead to the conclusion that those laws do not deserve our respect, so that our only moral reason to obey them flows from a general moral obligation to obey the law, rather than from anything morally troubling about drug use itself. In this paper, I argue that this line of thinking is mistaken. I begin by arguing that the (...) class='Hi'>drug laws are indeed unjust. However, so long as they remain prohibited, I argue that we have strong moral reasons to avoid drug use. First, drug users are partly responsible for the violent and exploitative conditions in which many drugs are produced and distributed. Second, the unequal ways in which drug laws are enforced make drug use by many an unethical exercise of privilege. These reasons do not depend on the existence of a general moral obligation to obey the law; we ought to refrain from illegal drug use even if prohibition is unjust and even if we have no general obligation to obey the law. In fact, drug laws turn out to represent an interesting exception case within the broader debate about this obligation, and I argue that it is the very injustice of the law that generates the reasons not to violate it. (shrink)

There is a wide array of arguments for the immorality of recreational drug use, ranging from the philosophically rudimentary to the philosophically sophisticated. But the vast majority of these arguments are unsuccessful, and those that succeed are quite limited in scope. In this article, I present and evaluate a few examples of such arguments.

A strong moral reason for prohibiting doping in sport is to be found in the bad choices that would be faced by clean athletes in a sporting world that tolerated doping. The case against doping is not, however, to be grounded in the concept of coercion. Instead, it is grounded in a general duty of sport to afford fair opportunity to the goods that are distinctively within sport's sphere of control. The moral reason to prohibit doping need not be balanced (...) against any autonomy claim of athletes who would prefer to dope because, upon closer examination, such claims have no force. The moral reason to prohibit doping does, however, need to be balanced against the enforcement costs imposed on all athletes by effective prohibition. (shrink)

Every day the news shows us provoking stories about what's going on in the world, about events which raise moral questions and problems. In Philosophers Take On the World a team of philosophers get to grips with a variety of these controversial issues, from the amusing to the shocking, in short, engaging, often controversial pieces. This chapter covers drug use, making you think again about the judgements we make on a daily basis and the ways in which we choose (...) to conduct our lives. (shrink)

Are universities justified in trying to regulate student use of cognitive enhancing drugs? In this article I argue that they can be, but that the most appropriate kind of regulatory intervention is likely to be voluntary in nature. To be precise, I argue that universities could justifiably adopt a commitment contract system of regulation wherein students are encouraged to voluntarily commit to not using cognitive enhancing drugs. If they are found to breach that commitment, they should be penalized by, for (...) example, forfeiting a number of marks on their assessments. To defend this model of regulation, I adopt a recently-proposed evaluative framework for determining the appropriateness of enhancement in specific domains of activity, and I focus on particular existing types of cognitive enhancement drugs, not hypothetical or potential forms. In this way, my argument is tailored to the specific features of university education, and common patterns of usage among students. It is not concerned with the general ethical propriety of using cognitive enhancing drugs. (shrink)

Modern military organizations are paternalistic organizations. They typically recognize a duty of care toward military personnel and are willing to ignore or violate the consent of military personnel in order to uphold that duty of care. In this paper, we consider the case for paternalism in the military and distinguish it from the case for paternalism in medicine. We argue that one can consistently reject paternalism in medicine but uphold paternalism in the military. We consider two well-known arguments for the (...) conclusion that military organizations should not be entitled to use experimental drugs on troops without first obtaining the informed consent of those troops. We argue that both of these are unsuccessful, in the absence of an argument for the rejection of paternalism in the military altogether. The case for military paternalism is widely accepted. However, we consider three ways in which it could be challenged. (shrink)

In this paper, I present and criticize several historical arguments in favour of prohibition and criminalization of illicit psychoactive substances. I consider several versions of Charles Brent’s argument from drug harms and an argument from addiction based on Kantian view on autonomy. My criticism will mainly rely on empirical evidence on drugs, drug use, and addiction. I think that in light of this evidence, all of the arguments lose their cogency or can be refuted altogether. Moreover, the evidence (...) reveals an inconsistency in the international drug law framework. In conclusion, I therefore provide a general argument challenging the legitimacy of the existing distinction between licit and illicit drugs based on the inconsistency. (shrink)

The article explains why we should not use dangerous drugs for pleasure.

Promotion of prescription drugs may appear to be severely limited in some jurisdictions due to restrictions on direct-to-consumer advertising. However, in most jurisdictions, strategies exist to raise consumer awareness about prescription drugs, notably through the deployment of direct-to-consumer information campaigns that encourage patients to seek help for particular medical conditions. In Canada, DTCI is presented by industry and regulated by Health Canada as being purely informational activities, but their design and integration in broader promotional campaigns raise very similar ethical concerns (...) as those associated with DTCA. Specifically, DTCI can be an effective means of familiarizing the public with the scope and benefits of a particular prescription drug and so, like DTCA, can promote increased patient-consumer demand and thus a problematic rise in the prescribing and use of medications that may be neither the most appropriate nor the most cost-effective. Yet, with DTCI the industry is playing within the existing rules and regulations set by health regulators. To respond appropriately to this regulatory incoherence, we argue that DTCI should be regulated as a type of direct-to-consumer indirect advertising. Even if the case and specific regulations presented here are Canadian, the implications extend to every country that has a partial or total prohibition on DTCA. (shrink)

Drug regulation is fraught with inductive risk. Regulators must make a prediction about whether or not an experimental pharmaceutical will be effective and relatively safe when used by typical patients, and such predictions are based on a complex, indeterminate, and incomplete evidential basis. Such inductive risk has important practical consequences. If regulators reject an experimental drug when it in fact has a favourable benefit/harm profile, then a valuable intervention is denied to the public and a company’s material interests (...) are needlessly thwarted. Conversely, if regulators approve an experimental drug when it in fact has an unfavourable benefit/harm profile, then resources are wasted, people are needlessly harmed, and other potentially more effective treatments are underutilized. Given that such regulatory decisions have these practical consequences, non-epistemic values about the relative importance of these consequences impact the way such regulatory decisions are made (similar to the analysis of laboratory studies on the toxic effects of dioxins presented in Douglas [2000]). To balance the competing demands of the pertinent non-epistemic values, regulators must perform what I call an “inductive risk calculus.” At least in the American context this inductive risk calculus is not well-managed. (shrink)

Prescribing drugs for elderly patients is not an easy task since elderly patients frequently have comorbid conditions. In Libya, there are no guidelines for the management of medications used in elderly patients and no specialized geriatric health institutions. This study aims to assess the pattern of medication use among hospitalized elderly patients in Sebha Medical Centre and the drug-related problems associated with these patterns. This report is a descriptive and retrospective cross-sectional study conducted at Sebha Medical Center in 2021. (...) Potential drug-related problems were assessed based on the classification of Hepler and Strand. In this study, out of 195 participants, most patients have been given antibiotics (92.0%). The majority of patients have been prescribed anti-gastric agents, vitamins and anti-thrombotic agents which accounted for 75.0%, 62.0% and 55.0%, respectively. To a lesser extent, anti-hypertensive agents, analgesics and antihyperlipidemic were reported by 45.0%, 43.0% and 38.0%, respectively. Almost all the patients have at least one event of drug-related problem and more than three-quarters of the patients had more than one event of drug-related problems. The highest rate was untreated indications which were reported for 77.0% then followed by drug use without indication in nearly half of the events 48.0%. To fewer extent rates were reported: “in improper drug selection”, “drug interaction” and “adverse effects” which were reported for 25.0%, 23.0% and 18.0% of the total events, respectively. Almost all elderly patients have been prescribed antibiotics, analgesics and vitamins. Drug-related problems are predominantly prevalent in the clinical practice at the center. This study highlights the importance of activation of clinical pharmacist interventions at hospitals which can contribute to reducing the chance of risk of drug-related problems events among hospitalized elderly patients and ensuring rational drug prescribing in the geriatric clinical settings. (shrink)

Historically, laws and policies to criminalize drug use or possession were rooted in explicit racism, and they continue to wreak havoc on certain racialized communities. We are a group of bioethicists, drug experts, legal scholars, criminal justice researchers, sociologists, psychologists, and other allied professionals who have come together in support of a policy proposal that is evidence-based and ethically recommended. We call for the immediate decriminalization of all so-called recreational drugs and, ultimately, for their timely and appropriate legal (...) regulation. We also call for criminal convictions for nonviolent offenses pertaining to the use or possession of small quantities of such drugs to be expunged, and for those currently serving time for these offenses to be released. In effect, we call for an end to the “war on drugs.”. (shrink)

Gerald Dworkin provides an insightful starting point for determining acceptable paternalism through his commitment to protecting our future autonomy and health from lasting damage. Dworkin grounds his argument in an appeal to inherent goods, which this paper argues is best considered as a commitment to human flourishing. However, socialconnectedness is also fundamental to human flourishing and an important consideration when determining the just limits of paternalistic drug controls, a point missing from Dworkin’ essay. For British philosopher Thomas Hill Green, (...) regulation of alcohol sales emerged from the social ideal. Green argued that policy interventions, including restricted opening hours and locations, improved the conditions for humans to flourish. Green offers a compelling political vision but fails to account for the fact pleasure is also an inherent good. He focused excessively on our social nature, excluding our more pleasure-seeking and egoistic characteristics. In contrast, a more realistic and complete vision of human flourishing can be found in an amended version of Gerald’s Dworkin’s arguments. In conclusion, this paper argues drug policy makers should remain committed to the harm principle as applied to criminal law whereby a person should never be criminalized for self-harm. Such a limit on paternalistic interventions is deemed necessary when eudaimonia is the end of government action. In practical terms, this means that the criminalization of drug use, as opposed to drug production, is always unjust. (shrink)

Background: Multi Drug Therapy approved by WHO is the best treatment option for Leprosy. There is a significant decline of mortality and morbidity after the introduction of multi drug therapy. But the adverse effects causing changes in clinical and laboratory parameters to multi drug therapy are the main limiting obstacle for the treatment course completion. Objective: The aim of this study is to find out the effects on routine laboratory parameters including hematological and biochemical changes before, during (...) and after the treatment of multi drug therapy in leprosy. Methodology: A descriptive cohort hospital based study on 85 multi drug therapy treated leprosy patients using standard laboratory tools for routine investigations for 18 months. Results: During the one year multidrug treatment period, most of the routine laboratory parameters showed mild to moderate change from normal level during the first 3 months with gradual recovery in the following months. Complete blood count assessment revealed mild decline in Hb, PCV, MCH, MCHC, and moderate decline in WBC and Platelet count. A mild increase in liver function tests (Bilirubin, AST, ALT, Alkaline phosphatase) and renal function tests (S.Creatinine, b. Urea) was observed. A moderate decline in S. Sodium with mild increase in S. Potassium was found on investigating S. Electrolytes. Patients were fully recovered from all hemato-biochemical adverse effects after 6 months of completion of the multi drug therapy. Conclusion: Despite of mild to moderate hematological and biochemical adverse reactions with multi drug therapy, recovery was excellent after 6 months of completion of therapy. (shrink)

There are a number of premises underlying much of the vigorous debate on pharmacological cognitive enhancement. Among these are claims in the enhancement literature that such drugs exist and are effective among the cognitively normal. These drugs are deemed to enhance cognition specifically, as opposed to other non-cognitive facets of our psychology, such as mood and motivation. The focus on these drugs as cognitive enhancers also suggests that they raise particular ethical questions, or perhaps more pressing ones, compared to those (...) raised by other kinds of neuroenhancement. Finally, the use of these drugs is often claimed to be significant and increasing. Taken together, these premises are at the heart of the flurry of debate on pharmacological cognitive enhancement. In this article, it is argued that these are presumptions for which the evidence does not hold up. Respectively, the evidence for the efficacy of these drugs is inconsistent; neurologically it makes little sense to distinguish the cognitive from non-cognitive as separate targets of pharmacological intervention; ethically, the questions raised by cognitive enhancement are in fact no different from those raised by other kinds of neuroenhancement; and finally the prevalence rates of these drugs are far from clear, with the bulk of the claims resting on poor or misrepresented data. Greater conceptual clarity along with a more tempered appreciation of the evidence can serve to deflate some of the hype in the associated literature, leading to a more realistic and sober assessment of these prospective technologies. (shrink)

The aesthetics of tea, in some practices, seems to focus on appreciating the mental effects of tea — the altered states of mind. Wine aesthetics, on the other hand, seems to actively exclude any inebriative effects. Wine experts are supposed to spit, in order to avoid inebriation when they judge wine. Why? The answer, I suggest, lies deep in several key suppositions in the traditional model of aesthetic experience: that aesthetic experience needs to be accurate of its object, and that (...) it needs to be inseparable from the particular details of its object. But, I argue, that model is not really incompatible with an aesthetics of drugs. The problematic presupposition is that the aesthetics of drugs is either an aesthetics of the world, as experienced while drugged, or an aesthetics of the physical substance itself. The aesthetics of some drugs, such as LSD, will turn out, instead, to be a self-reflective aesthetics — one in which the primary object of appreciation is the alteration of one’s own cognitive faculties. This can be valuable as a humbling aesthetic vision, of one’s own cognitive fragility. But the aesthetics of gastronomical drugs, such as wine and tea, will turn out to be even more complicated. Gastronomical drugs demand that we bridge the inwardly-focused aesthetics of inebriation and an outwardly focused gastronomical aesthetics. They open the door to the possibility of an aesthetic reconciliation between our capacity to get onto the world, and our fears about the fragility of that capacity. (shrink)

An exploration into the reciprocity between Nietzsche's drug use and his philosophy.

Programs of drug testing welfare recipients are increasingly common in US states and have been considered elsewhere. Though often intensely debated, such programs are complicated to evaluate because their aims are ambiguous – aims like saving money may be in tension with aims like referring people to treatment. We assess such programs using a proportionality approach, which requires that for ethical acceptability a practice must be: reasonably likely to meet its aims, sufficiently important in purpose as to outweigh harms (...) incurred, and lower in costs than feasible alternatives. In the light of empirical findings, we argue that the programs fail the three requirements. Pursuing recreational drug users is not important in the light of costs incurred, while dependent users who may require referral are usually identifiable without testing and typically need a broader approach than one focussing on drugs. Drug testing of welfare recipients is therefore not ethically acceptable policy. (shrink)

Drugs used to provide improvement of cognitive functioning have been shown to be effective in healthy individuals. It is sometimes assumed that the use of these drugs constitutes cheating in an academic context. We examine whether this assumption is ethically sound. Beyond providing the most up-to-date discussion of modafinil use in an academic context, this contribution includes an overview of the safety of modafinil use in greater depth than previous studies addressing the issue of cheating. Secondly, we emphasize two crucial, (...) but hitherto nearly overlooked, nuances to the issues: the potential for modafinil to decrease inequality and disadvantage in academic settings, and the fact that how modafinil is used dramatically impacts its effects on health, coercion, fairness, authenticity and effort. Finally, we explicitly defend the position that there are no qualitatively morally relevant differences between modafinil use and other enhancement modalities; any such differences are in degree,... (shrink)

In many jurisdictions, an offender’s remorse is considered to be a relevant factor to take into account in mitigation at sentencing. The growing philosophical interest in the use of neurointerventions in criminal justice raises an important question about such remorse-based mitigation: to what extent should technologically facilitated remorse be honoured such that it is permitted the same penal significance as standard instances of remorse? To motivate this question, we begin by sketching a tripartite account of remorse that distinguishes cognitive, affective (...) and motivational elements of remorse. We then describe a number of neurointerventions that might plausibly be used to enhance abilities that are relevant to these different elements of remorse. Having described what we term the ‘moral value’ view of the justification of remorse-based mitigation, we then consider whether using neurointerventions to facilitate remorse would undermine its moral value, and thus make it inappropriate to honour such remorse in the criminal justice system. We respond to this question by claiming that the form of moral understanding that is incorporated into a genuinely remorseful response grounds remorse’s moral value. In view of this claim, we conclude by arguing that neurointerventions need not undermine remorse’s moral value on this approach, and that the remorse that such interventions might facilitate could also be authentic to the recipient of the neurointerventions that we discuss. (shrink)

Disintegration is the most important step for drug bioavailability because after, the disintegration process, the ingredients of solid dosage forms dissolve and become bioavailable. Generally, the tablets and capsules should be taken with a glass of water otherwise the manufacturer gives instructions to use the proper beverage. Several drugs are taken with different forms of beverages to ensure easy swallowing of the tablet, masking the bad taste of the drug and overcoming the drug aftertaste, these beverages can (...) influence the disintegration of the solid dosage form. The most common cold beverages consumed by the Libyan population are juice, milk, and Coca-Cola. These beverages are consumed without awareness of the possible effect of these beverages on drugs, especially over-the-counter drugs such as analgesic, antipyretic, and anti-inflammatory drugs that are taken without a prescription. This study aimed to evaluate the influence of three beverages, namely: orange juice, milk, and Coca-Cola on the disintegration time of four over-the-counter-drugs: Panadol, Congestal, Brufen, and Reality Extra using disintegration test of drugs in 0.1 N HCL and in hybrid medium prepared by combination of 150 ml 0.1 N HCL and 550 ml of beverage to simulate in vivo condition. The findings show that the orange juice significantly increases the disintegration time of all the investigated drugs. Coca-Cola significantly increases the disintegration time of Reality Extra, and slightly increases the disintegration time of Brufen, Congestal, and Panadol and the full-fat milk significantly increases the disintegration time of Reality Extra and Panadol while slightly increasing the disintegration time for Brufen and Congestal. It is concluded that commonly used beverages affect the disintegration time of the examined over-the-counter drugs. Patients should be advised to take these medications without beverages which may delay the disintegration and the onset of action of the drug. (shrink)

In our recent article, together with more than 60 of our colleagues, we outlined a proposal for drug policy reform consisting of four specific yet interrelated strategies: (1) de jure decriminalization of all psychoactive substances currently deemed illicit for personal use or possession (so-called “recreational” drugs), accompanied by harm reduction policies and initiatives akin to the Portugal model; (2) expunging criminal convictions for nonviolent offenses pertaining to the use or possession of small quantities of such drugs (and releasing those (...) serving time for these offenses), while delivering retroactive ameliorative relief; (3) the ultimate legalization and careful regulation of currently illicit drugs; and (4) the delivery of a new “Marshall Plan” focused on community-building initiatives, expanded harm reduction programs, and social and health care support efforts (Earp et al. 2021). We were gratified to see so many thoughtful commentaries on our proposal, and we respond to them in part in this reply. (shrink)

Objective: Primary care, which is often the first level of contact for patients with various communicable diseases (CDs) and noncommunicable diseases (NCDs), might exhibit patterns of injectable drug utilization different from hospitals. We aimed to examine injection prescribing to adults with CD or NCD in primary care. -/- Methods: In this retrospective study, single-diagnosis injectable drug-containing prescription data from Family Medicine Information System comprising 32 provinces of Turkey were analysed. The prescriptions were grouped by diagnosis as “CD” (n=3848) (...) and “NCD” (n=9338). Injectable drug utilization patterns in these groups were analysed by demographics, diagnoses, and drug subgroups. -/- Results: Out of 13186 prescriptions, 70.8% were issued for NCDs. NCD prescriptions were mostly generated for women and elderly (p<0.05 for both). About 63.3% (n=2948) of injectable drugs in CD prescriptions were antibiotics and 12.6% were analgesics. Cefazolin (15.2%) was the most commonly prescribed antibiotic for acute pharyngitis and acute sinusitis, and benzathine benzylpenicillin (12.8%) was the top-choice for acute tonsillitis and rheumatic fever. In NCD prescriptions, 34.0% (n=4214) of injectable agents were analgesics and 16.9% were muscle relaxants. The most frequently encountered drug in NCD prescriptions was thiocolchicoside (16.3%), which was the top-choice in all seven common musculoskeletal diagnoses. -/- Conclusion: Muscle relaxants and analgesics were the most commonly prescribed injectable drugs for NCDs, musculoskeletal diseases in particular. Antibiotics were frequently encountered in CD prescriptions, mostly as broad-spectrum for lower respiratory tract infections (RTIs) and narrow-spectrum for upper RTIs. These findings may elucidate the issues to especially focus on regarding excessive use of injections. (shrink)

As a response to the opioid epidemic in the United States, the Centers for Disease Control and Prevention (CDC) published the CDC Guideline for Prescribing Opioids for Chronic Pain in 2016. This document served as a means to reduce risks and address harms of opioid use by recommending that clinicians conduct periodic urine drug testing for patients on chronic opioid therapy. As an unintended result of this recommendation, providers began using unexpected urine drug test results as a reason (...) to dismiss patients from practice, both out of concern for their patients’ wellbeing as well as their own legal risks. Using Husserl’s and Heidegger’s phenomenology, we argue that this science-based, black-and-white practice does not heed the patient as a whole person. Instead, we recommend a more contextual, patient-centered approach that can help us to better understand and manage patient needs in such contexts. (shrink)

The primary responsibility of the US Food and Drug Administration is to protect public health by ensuring the safety of the food supply. To that end, it sometimes conducts risk assessments of novel food products, such as genetically modified food. The FDA describes its regulatory review of GM food as a purely scientific activity, untainted by any normative considerations. This paper provides evidence that the regulatory agency is not justified in making that claim. It is argued that the FDA’s (...) policy stance on GM food is shaped by neoliberal considerations. The agency’s review of a genetically engineered animal, the AquAdvantage salmon, is used as a case study to track the influence of neoliberalism on its regulatory review protocol. After that, an epistemic argument justifying public engagement in the risk assessment of new GM food is outlined. It is because risk evaluations involve normative judgments, in a democracy, layperson representatives of informal epistemic communities that could be affected by a new GM food should have the opportunity to decide the ethical, political or other normative questions that arise during the regulatory review of that entity. (shrink)

Mandatory minimum sentencing provisions have been a feature of the U.S. justice system since 1790. But they have expanded considerably under the war on drugs, and their use has expanded considerably under the Trump Administration; some states are also poised to expand drug-related mandatory minimums further in efforts to fight the current opioid epidemic. In this paper I outline and evaluate three prominent arguments for and against the use of mandatory minimums in the war on drugs—they appeal, respectively, to (...) proportionality, consistency, and efficiency. I ultimately defend the view that the use of mandatory minimums in the war on drugs is unjust. -/- . (shrink)

We present some ideas on logical process descriptions, using relations from the DIO (Drug Interaction Ontology) as examples and explaining how these relations can be naturally decomposed in terms of more basic structured logical process descriptions using terms from linear logic. In our view, the process descriptions are able to clarify the usual relational descriptions of DIO. In particular, we discuss the use of logical process descriptions in proving linear logical theorems. Among the types of reasoning supported by DIO (...) one can distinguish both (1) basic reasoning about general structures in reality and (2) the domain-specific reasoning of experts. We here propose a clarification of this important distinction between (realist) reasoning on the basis of an ontology and rule-based inferences on the basis of an expert’s view. (shrink)

This paper analyzes the ethics of performance-enhancing drugs in professional baseball from the perspective of ethical theories: Kantianism, libertarianism, and utilitarianism. It argues that none of these theories can explain why performance-enhancing drugs should be prohibited. The paper argues that virtue ethics is the best moral framework for understanding the ethical problem of performance-enhancing drugs and why their use should be prohibited.

Solanum melongena (Eggplant) is a medicinal plant belonging to the family Solanaceae. This study aimed to perform a comparative assessment of the methanol extracts of the fruit and the leaf of Solanum melongena against multi-drug-resistant Staphylococcus aureus and Pseudomonas aeruginosa. The crude extracts were obtained from the leaves and fruits of the plant using methanol. The plant extracts were tested for the presence of various phytochemical constituents qualitatively. The antibacterial assay and minimum inhibitory concentration for the crude extracts were (...) carried out using the agar well diffusion and agar dilution methods, respectively. Phytochemical analysis of methanol extracts of Solanum melongena revealed the presence of various phytoconstituents. Antibacterial assay of methanol extracts of Staphylococcus melongena against multi-drug-resistant Staphylococcus aureus isolates with ciprofloxacin as a reference control revealed inhibition zone diameter ranging from 04.0±0.0 to 11.0±0.0 mm; in contrast that of multi-drug-resistant Pseudomonas aeruginosa isolates revealed inhibition zone diameter, with ciprofloxacin showing no inhibition. The minimum inhibitory concentration of the methanol extracts on Pseudomonas aeruginosa isolates ranges from 25.0 to 50.0 mg/ml and 25.0->50.0 mg/ml, respectively, in comparison, the minimum inhibitory concentration of the methanol extracts on Staphylococcus aureus isolates ranges from 6.25 to 50.0 mg/ml and 6.25->50.0 mg/ml respectively. Thus, the fruit extract had better activity against test multi-drug-resistant Pseudomonas aeruginosa and Staphylococcus aureus than the leaf extract of Solanum melongena. (shrink)

Recreational Drugs European Network (ReDNet) project aims to use the Psychonaut Web Mapping Project database (Psychonaut Web Mapping Group, 2009) containing novel psychoactive compounds usually not mentioned in the scientific literature and thus unknown to clinicians as a unique source of information. The database will be used to develop an integrated ICT prevention approach targeted at vulnerable individuals and focused on novel synthetic and herbal compounds and combinations. Particular care will be taken in keeping the health professionals working directly with (...) young people showing problematic behaviors regularly updated in terms of novel compounds and combinations as well. A user-friendly project website will be developed aimed primarily at delivering the information/prevention approaches, but will also be a way of communicating with project partners and relevant stakeholders (e.g. thematic forum facilities, instant messages, blogs, video chat, wikiblog, newsletters distributed via mailing list). The website will support various ICT prevention tools, including an SMS alert service. Different areas and sections will be aimed specifically at the different target groups. -/- . (shrink)

Introduction: The purpose of this study was to assess dental care professionals' drug prescription knowledge, practices, and reporting of adverse drug reactions (ADRs). -/- Methods: A cross-sectional exploratory study was conducted by using a face-to-face survey administered to a sample of dentists from tertiary care hospitals in Adana, Türkiye. A questionnaire consisted of six sections with closed-ended items including sociodemographic characteristics, knowledge about drugs, patient history information, counseling practices during prescribing, source of information and ADR reporting. -/- Results: (...) The study included 180 dentists, with a 95.3% response rate. More than half of the dentists (50.6%) stated their level of knowledge about drug price/cost as low. Most of the dentists (50.6%;n=91) claimed that they never/rarely asked about health insurance during patient history information. Moreover, most of the participants reported that they never/rarely and sometimes counsel the patients regarding drug mechanism of action, side effects of the drug, interaction of prescribed drug with other drugs/nutrients. It was determined that the dentists learned about the drugs from Vademecum (Turkish Medication Guidebook: 70%;n=126) and the internet (55%;n=99). A higher proportion (85.5%) of the dentists indicated that they did not report ADR during their clinical practice. -/- Conclusion: This study showed a general improvement in dentists prescribing knowledge and practices, although they reported some lack of knowledge regarding drug cost, discussion about the possible side effect of a drug/interaction with other drugs/nutrients with patients and under-reporting of ADRs. Periodic education and training for dentists are critical to overcoming any problem related to prescribing errors and potential ADRs. (shrink)

Mandatory minimum sentencing provisions have been a feature of the US justice system since 1790. But they have expanded considerably under the war on drugs, and their use has expanded considerably under the Trump Administration; some states are also poised to expand drug-related mandatory minimums further in efforts to fight the current opioid epidemic. In this chapter I outline and evaluate three prominent arguments for and against the use of mandatory minimums in the war on drugs—they appeal, respectively, to (...) proportionality, consistency, and efficiency. I ultimately defend the view that the use of mandatory minimums in the war on drugs is unjust. (shrink)

Disintegration is the most important step for drug bioavailability because after, the disintegration process, the ingredients of solid dosage forms dissolve and become bioavailable. Generally, the tablets and capsules should be taken with a glass of water otherwise the manufacturer gives instructions to use the proper beverage. Several drugs are taken with different forms of beverages to ensure easy swallowing of the tablet, masking the bad taste of the drug and overcoming the drug aftertaste, these beverages can (...) influence the disintegration of the solid dosage form. The most common cold beverages consumed by the Libyan population are juice, milk, and Coca-Cola. These beverages are consumed without awareness of the possible effect of these beverages on drugs, especially over-the-counter drugs such as analgesic, antipyretic, and anti-inflammatory drugs that are taken without a prescription. This study aimed to evaluate the influence of three beverages, namely: orange juice, milk, and Coca-Cola on the disintegration time of four over-the-counter-drugs: Panadol, Congestal, Brufen, and Reality Extra using disintegration test of drugs in 0.1 N HCL and in hybrid medium prepared by combination of 150 ml 0.1 N HCL and 550 ml of beverage to simulate in vivo condition. The findings show that the orange juice significantly increases the disintegration time of all the investigated drugs. Coca-Cola significantly increases the disintegration time of Reality Extra, and slightly increases the disintegration time of Brufen, Congestal, and Panadol and the full-fat milk significantly increases the disintegration time of Reality Extra and Panadol while slightly increasing the disintegration time for Brufen and Congestal. It is concluded that commonly used beverages affect the disintegration time of the examined over-the-counter drugs. Patients should be advised to take these medications without beverages which may delay the disintegration and the onset of action of the drug. (shrink)

The number of police departments carrying Narcan keeps increasing at a fast pace throughout the U.S., as it is considered an effective measure to fight the opioid epidemic. However, there have been strong oppositions to the idea of the police Narcan use. Still, in 2018, the nation is debating about it. Though not clearly visible to the public, there are important ethical arguments against the police Narcan use which necessarily involve understanding of the ethical roles and responsibilities of police as (...) the law enforcement agency and apprehension of the moral status of a non-therapeutic opioid use. The authors of the paper investigate, primarily, the existing ethical controversies surrounding the police Narcan use while touching upon the issue of the decriminalizing drug policy in the U.S. The authors conclude that the police can carry and administer Narcan without self-contradiction and that the policymakers’ investigation on the drug decriminalization policy should begin with the understanding of the “common morality” of the American public, the ethical view shared and practiced by the greatest number of people. (shrink)

Animal-derived constituents are frequently used in anaesthesia and surgery, and patients are seldom informed of this. This is problematic for a growing minority of patients who may have religious or secular concerns about their use in their care. It is not currently common practice to inform patients about the use of animal-derived constituents, yet what little empirical data does exist indicates that many patients want the opportunity to give their informed consent. First, we review the nature and scale of the (...) problem by looking at the groups who may have concerns about the use of animal-derived constituents in their care. We then summarise some of the products used in anaesthesia and surgery that can contain such constituents, such as anaesthetic drugs, surgical implants and dressings. Finally, we explore the problem of animal-derived constituents and consent using Beauchamp and Childress’ four principles approach, examining issues of autonomy, beneficence, nonmaleficence and justice. Disclosing the use of animal-derived constituents in anaesthesia and surgery is warranted under Beauchamp and Childress’ four principles approach to the problem. Although there exist systemic and practical challenges to implementing this in practice, the ethical case for doing so is strong. The Montgomery ruling presents additional legal reason for disclosure because it entails that patients must be made aware of risks associated with their treatment that they attach significance to. (shrink)

Recent studies in the History of Botany put forth that the books translated to and authored in Arabic have circulated from the East of the Caspian Sea, to the centre of Iberian Peninsula, strengthening the ‘traditional uses’ of plants and alike. An ancient genre of writing called the ‘book on the Materia medica’ was especially the most favourite in Medieval Islamic Geography. In these books, algae have been mentioned among the kinds of medicinal plants. In this study, I investigate several (...) Materia medica books among which I shall first focus on Avicenna’s Canon of Medicine, then have a look at Aliboron’s Book of Pharmacy since these two were contemporary sources from the 11th century. I shall also investigate two illustrated sources, an Arabic copy of Dioscorides’ Materia Medica and al-Ghafiqi’s Book on Simple Drugs, both from the 13th century. In doing so, on the one hand, I will be able to compare the drawings of algae, and on the other I will shed light on the transfer of knowledge on algae. These two methods will result in the textual apparatus and the illustrative apparatus in my study. (shrink)

In this paper, I identify an argument derived from the commitments of John Rawls’s liberalism for restricting the consumption of recreational drugs in a liberal society, but not because of a great passion for restriction at present. The argument can also be used to respond to Jonathan Quong’s example of an unresolvable disagreement between liberal citizens.

Placebos are often used by clinicians, usually deceptively and with little rationale or evidence of benefit, making their use ethically problematic. In contrast with their typical current use, a provocative line of research suggests that placebos can be intentionally exploited to extend analgesic therapeutic effects. Is it possible to extend the effects of drug treatments by interspersing placebos? We reviewed a database of placebo studies, searching for studies that indicate that placebos given after repeated administration of active treatments acquire (...) medication-like effects. We found a total of 22studies in both animals and humans hinting of evidence that placebos may work as a sort of dose extender of active painkillers. Wherever effective in relieving clinical pain, such placebo use would offer several advantages. First, extending the effects of a painkiller through the use of placebos may reduce total drug intake and side effects. Second, dose-extending placebos may decrease patient dependence. Third, using placebos along with active medication, for part of the course of treatment, should limit dose escalation and lower costs. Importantly, provided that nondisclosure is pre-authorized in the informed consent process and that robust evidence indicates therapeutic benefit comparable to that of standard full-dose therapeutic regimens, introducing dose-extending placebos into the clinical arsenal should be considered. This novel prospect of placebo use has the potential to change our general thinking about painkiller treatments, the typical regimens of painkiller applications, and the ways in which treatments are evaluated. (shrink)

This article argues that performance enhancing drugs ought to be allowed across all elite sporting competitions for athletes over the age of 16 so long as consuming them does not pose a significant risk to their health. I begin with a brief explanation of the current state of PED use in professional sports before assessing the prospect of allowing PEDs by three widely accepted measures of ethical merit: well-being, autonomy, and justice. I end with a critique of the World Anti-Doping (...) Agency's criteria for banning PEDs, concluding that allowing athletes to use PEDs is a superior alternative to the current prohibitive approach. (shrink)

A number of concerns have been raised about the possible future use of pharmaceuticals designed to enhance cognitive, affective, and motivational processes, particularly where the aim is to produce morally better decisions or behavior. In this article, we draw attention to what is arguably a more worrying possibility: that pharmaceuticals currently in widespread therapeutic use are already having unintended effects on these processes, and thus on moral decision making and morally significant behavior. We review current evidence on the moral effects (...) of three widely used drugs or drug types: propranolol, selective serotonin reuptake inhibitors, and drugs that effect oxytocin physiology. This evidence suggests that the alterations to moral decision making and behavior caused by these agents may have important and difficult-to-evaluate consequences, at least at the population level. We argue that the moral effects of these and other widely used pharmaceuticals warrant further empirical research and ethical analysis. (shrink)

We discuss the crucial, but easily missed, link between paternalism and incarceration. Legal paternalists believe law should be used to help individuals stay healthy or moral or become healthier or morally better. Criminal laws are paternalistic if they make it illegal to perform some action that would be bad for the actor to do, regardless of effects on others. Yet, one result of such laws is the punishment, including incarceration, of the very same actors—also clearly bad for them even if (...) meant to be rehabilitative. Therein lies an oddity: paternalist criminal law—and thepresumably rehabilitativepunishments that serve as responses to infringements of such laws—is meant to help the actor but in fact has the opposite effect on net. Incarceration is particularly problematic on this front as it harms the alleged criminal in ways that go beyond the harm they would have caused themselves. Incarceration also may undermine the actor’s ability to improve his decision-making abilities or his moral character. The effects of the punishment also drift to others—family and friends, as well as business associates, of the punished. Paternalists, inasmuch as they are motivated by beneficence or concern about moral character, must account for all of these costs as threats to well-being and the conditions for acting morally. Given the link between paternalism and incarceration, we propose that if we are to take seriously the problem of over-incarceration in the U.S., we must reconsider the use of paternalism in criminal law; we sketch several alternatives. We believe paternalists should support our resistance to incarceration and seriously consider these alternatives. (shrink)

It is largely unethical to sentence individuals who are addicted to drugs to prison. While substance use can be a crime, it must be treated differently from other crimes because addiction is a psychiatric disorder. Prisons are penal institutions. Legitimate goals of penal sanctions include retribution, deterrence, rehabilitation, and incapacitation.[i] Most of these goals do not speak to those with substance use disorder, and incarceration may be counterproductive given the wide availability of drugs and feeble rehabilitation efforts in prison. Further, (...) it may be the case that substance use disorder impairs an addict’s autonomy, calling into question his criminal culpability. Our understanding of substance use disorder has evolved and our prison sentencing practices must do the same. This paper will first provide background on substance use disorder as a psychiatric disorder. Then, the need to focus on rehabilitating rather than punishing those with substance use disorder who commit crimes will be explored. Finally, this paper will address whether an individual with substance use disorder can be considered culpable for any crime—regardless of severity—and whether that individual’s autonomy is impaired due to his addiction. I conclude that culpability should depend on whether the serious crime would have occurred in the absence of the drug addiction. In most cases, it is unethical to sentence an individual with substance use disorder to prison where other options such as home confinement are available. (shrink)

Limitless is a movie (released in 2011) as well as a novel (published in 2001) about a tormented author who (plagued by a writer’s block) becomes an early user of an experimental designer drug. The wonder drug makes him highly productive overnight and even allows him to make a fortune on the stock market. At the height of his career, however, the detrimental side-effects become increasingly noticeable. In this article, Limitless is analysed from two perspectives. First of all, (...) building on the views of the French novelist Emile Zola, the novel is seen as the report of a closely monitored experiment. Subsequently, building on the phenomenology of Ludwig Binswanger, I will show how the cognitive enhancement drug not only boosts the protagonist’s information processing capacities, but also modifies his experience of space and time, his sense of spatiality, his way of being-in-the-world. On the basis of these (complementary) analyses I will indicate how genres of the imagination (such as movies and novels) may play a significant role in assessing the societal implications of emerging technological developments such as neuro-enhancement, especially during the preparatory or anticipatory stage. (shrink)

Introduction: Liposomal bupivacaine (LB) is a long-acting analgesic that, due to its liposomal formulation, purportedly extends its analgesic effect up to 72 hours. However, the clinical efficacy of LB appears mixed. This systematic review seeks to evaluate the effectiveness of liposomal bupivacaine in improving postoperative outcomes compared to ropivacaine (ROPI), another commonly used long-acting analgesic. -/- Materials and Methods: Prospective and randomized controlled trials (RCTs) evaluating the efficacy of LB compared to ROPI were selected for review. Primary outcomes included hospital (...) length of stay (LOS) and postoperative opioid consumption measured in oral morphine equivalents (OME). Secondary outcomes included analgesic cost. -/- Results: 14 studies met the review criteria. We found that LB and ROPI are equivalent in managing postoperative pain. 8 of the 14 trials reported equal efficacy between LB and ROPI as determined by OME post-procedure and 10 of the 14 trials reported similar LOS after surgery. These findings remained consistent across multiple surgical procedures and multiple drug administrative modalities. -/- Conclusion: Our systematic review found that LB was not superior to ROPI in reducing postoperative OME use and hospital LOS. The only consistent finding was the significantly increased cost of LB compared to that of ROPI. Therefore, the use of LB over ROPI cannot be justified. (shrink)

Background: Recent literature on addiction and judgments about the characteristics of agents has focused on the implications of adopting a ‘brain disease’ versus ‘moral weakness’ model of addiction. Typically, such judgments have to do with what capacities an agent has (e.g., the ability to abstain from substance use). Much less work, however, has been conducted on the relationship between addiction and judgments about an agent’s identity, including whether or to what extent an individual is seen as the same person after (...) becoming addicted. Methods: We conducted a series of vignette-based experiments (total N = 3,620) to assess lay attitudes concerning addiction and identity persistence, systematically manipulating key characteristics of agents and their drug of addiction. Conclusions: In Study 1, we found that US participants judged an agent who became addicted to drugs as being closer to ‘a completely different person’ than ‘completely the same person’ as the agent who existed prior to the addiction. In Studies 2-6, we investigated the intuitive basis for this result, finding that lay judgments of altered identity as a consequence of drug use and addiction are driven primarily by perceived negative changes in the moral character of drug users, who are seen as having deviated from their good true selves. (shrink)

This is a phenomenologically grounded ethnographic study of the life-world of ecstasy users in the socio-cultural contexts of raving and clubs in Sydney, Australia. The thesis espouses existential-phenomenology as a framework for describing and understanding these experiences. I argue against and reject the widespread mechanistic-materialist paradigms that inform bio-medical and bio-psychological interpretations of drug-use and non-ordinary states of consciousness. -/- As an alternative to these dominant reductionist perspectives I draw on a holistic organismic approach and the application of phenomenology (...) to ethnographic field research. More specifically, my exploration of the experiences of ecstasy is based upon a dialogal phenomenology which enabled me to generate a processual morphology of the varieties of ecstasy experience and the users’ mode of being-in-the-world. Through this endeavour I also argue for a phenomenological foundation of the study of drug-use and non-ordinary states of consciousness in general. (shrink)

Normative thinking about addiction has traditionally been divided between, on the one hand, a medical model which sees addiction as a disease characterized by compulsive and relapsing drug use over which the addict has little or no control and, on the other, a moral model which sees addiction as a choice characterized by voluntary behaviour under the control of the addict. Proponents of the former appeal to evidence showing that regular consumption of drugs causes persistent changes in the brain (...) structures and functions known to be involved in the motivation of behavior. On this evidence, it is often concluded that becoming addicted involves a transition from voluntary, chosen drug use to non-voluntary compulsive drug use. Against this view, proponents of the moral model provide ample evidence that addictive drug use involves voluntary chosen behaviour. In this paper we argue that although they are right about something, both views are mistaken. We present a third model that neither rules out the view of addictive drug use as compulsive, nor that it involves voluntary chosen behavior. -/- . (shrink)