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Global Strategy to Reduce the Harmful Use of Alcohol: First Step towards an Alcohol Framework Convention? English Summary: At the 61st World Health Assembly, the 193 member states discussed and ratified the global strategy to reduce the harmful use of alcohol. Firstly, 10 target areas have been identified within the strategy and alcohol policy should be structured according to these areas. The contribution of Anderson (2011) discusses these target areas with respect to supporting empirical evidence and policy implications. The final target area is Monitoring and Surveillance, and the other two contributions fall under this topic. Shield, Rehm, Patra & Rehm (2011) provide an overview of worldwide adult per capita consumption. Per capita consumption is associated indirectly to alcohol-related harm: as higher consumption generally leads to more harm, but the level of association varies according to economic indicators. Countries with lower GDP PPP experience more harm as they have more risks associated to alcohol such as infectious diseases like tuberculosis and/or a less developed health care system. The last contribution to this topic focuses solely on Germany and includes both health as well as social consequences ( Kraus, Piontek, Pabst & Bühringer, 2011 ). It needs to be recognized that the global strategy contains merely suggestions that are not binding to any of the member states. It is not yet shown whether this strategy is enough to combat the rising global alcohol-related harm and there have been suggestions to adopt a more binding form of international arrangement such as the Framework Convention for Tobacco Control.

Abstract: Aims: To describe the impact of the legalization of cannabis for recreational use under strict public health control in 2018 on the following outcomes: cannabis use and use patterns, attributable harm, economic considerations. Methodology: Narrative review based on government documents, surveys, and published literature. Results: The 12-month prevalence increased after legalization and has decreased during the COVID-19 pandemic. Little change in prevalence for adolescents. Persons with daily use remained stable. No rigorous studies on changes in attributable health harm, but some indication that harm, as measured in prevalence of cannabis use disorders, treatment rate, and attributable traffic injury remained stable. No data yet available for cancer. Cannabis attributable emergency visits increased, including among children (poisoning). Cannabis-related offences decreased as biggest public health gain. Economic predictions were not realized, and there is some pressure from cannabis industry to loosen public health regulations in order to increase use. Conclusions: Overall, while not achieving its main objectives of more youth protection and decreases in cannabis-attributable health harm, legalization with strict public health control resulted in less cannabis-related offences and up to now did not seem to increase cannabis-attributable disease burden.

Alcohol use is well established globally as one of the major risk factors for burden of disease and mortality. Although it is not yet clear how the COVID-19 pandemic has impacted the overall level of alcohol use in Canada, we do know that various levels of government have promoted its use – either by designating it essential or by increasing its availability. Such actions may have both an immediate and sustained impact on alcohol-related harm in Canada. We encourage all levels of government to support and prioritize the development and implementation of an evidence-informed framework for both alcohol policy and service delivery to reduce alcohol-related harms during the current pandemic and beyond.

With the epidemiological transition, causes of death shifted from communicable to non-communicable diseases (NCDs) and life expectancy increased, as these NCD deaths occurred later in life. However, in the United States, over the past years, life expectancy has been stagnating or decreasing despite decreasing NCD mortality rates. Analyses of the most important underlying causes of death with increasing premature mortality reveal that psychoactive substance use played a crucial role for these increases. Furthermore, it can be shown, that a high proportion of the increased premature mortality and decreased life expectancies happened in lower socio-economic strata. Substance use policies should thus focus on lowering the gap between substance-attributable mortality in higher versus lower socioeconomic strata.

<B>Zielsetzung:</B> In der Stadt Zürich wurden Kokaingebrauchende zu ihrem Kokainkonsum befragt, um Informationen zur Verbesserung von bestehenden Hilfeangeboten zu gewinnen. </P><P> <B>Methodik:</B> Die drei befragten Zielgruppen von Kokainkonsumierenden (n=201) weisen Unterschiede hinsichtlich Behandlung und sozialer Integration auf. </P><P> <B>Ergebnisse:</B> Kokainkonsumierende in drogenspezifischer Behandlung und solche aus der Drogenszene ohne Behandlung unterscheiden sich nur punktuell, während der Unterschied zu kokainkonsumierenden Partygängern hinsichtlich Konsumdauer, -häufigkeit und -form markant ist. </P><P> <B>Schlussfolgerungen:</B> Die Ergebnisse in Bezug auf Konsumform und Applikationsart von Kokain erfordern ein Überdenken der bestehenden Substitutionsangebote.