Background Synthetic cannabinoids (SCs) are a class of new psychoactive substances that have been rapidly evolving around the world throughout recent years. Many different synthetic cannabinoid analogues are on the consumer market and sold under misleading names, like “spice” or “incense.” A limited number of studies have reported serious health effects associated with SC use. In this study, we compared clinical and subclinical psychopathological symptoms associated with SC use and natural cannabis (NC) use. Methods A convenience sample of 367 NC and SC users was recruited online, including four validated psychometric questionnaires: The Drug Use Disorders Identification Test (DUDIT), Insomnia Severity Index (ISI), Altman Mania Scale (Altman), and Brief Symptom Inventory (BSI). The two groups were compared with analysis of variance (ANOVA) and covariance (ANCOVA), chi 2 tests, and logistic regression when appropriate. Results The SC user group did not differ in age from the NC user group (27.7 years), but contained less females (21% and 30%, respectively). SC users scored higher than NC users on all used psychometric measures, indicating a higher likelihood of drug abuse, sleep problems, (hypo)manic symptoms, and the nine dimensions comprising the BSI, somatization, obsessive-compulsive behavior, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. Odds ratios (95% CI) for the SC user group vs NC user group were, respectively, drug dependence 3.56 (1.77–7.16), (severe) insomnia 5.01 (2.10–11.92), (hypo-)mania 5.18 (2.04–13.14), and BSI psychopathology 5.21 (2.96–9.17). Discussion This study shows that SC use is associated with increased mental health symptomatology compared to NC use.

BackgroundKhat is a green leaf with amphetamine-like effects. It is primarily used among people in Africa, the Middle East and in the diaspora communities from these countries. Prior to the prohibition of khat in the UK on 24 June 2014, there was almost no information available on key aspects of the local khat market.MethodsA cross-sectional study was conducted in 2012 using snowball sampling, Privileged Access Interviewing and area mapping in order to identify khat sale establishments. Data was collected via face-to-face interviews using mixed methods for data collection. This included information about the establishments selling khat, khat pricing and its use among different ethnic minority groups, in addition to the potential sale of khat to children and risk assessment (e.g. use of pesticides on khat).ResultsFive out of seven sellers identified agreed to participate. Sellers described their khat sale establishments as ‘community centres’ which included, for example, a restaurant basement. The sellers’ history of selling khat ranged between 1–15 years and khat’s sale took place between 2pm-10pm. Miraa (e.g. Lara) from Kenya was the most popularly used khat variety, sold in pre-wrapped bundles of approximately 250 g costing £3 each and delivered four days a week. Harari (e.g. Owdi) from Ethiopia was sold in 200 g, 400 g and 1 kg bundles, priced between £5 and £20 and delivered two days a week. The primary benefit of khat use was reported to be social interaction. The customers were predominantly adult males of Somali origin. Most sellers claimed a self-imposed ban on sales to children under 18 years old. Khat bundles had no labelling describing variety or weight and sellers had no knowledge of the use of pesticides on khat and did not advertise the risks associated with khat use.ConclusionsKhat selling establishments were businesses that did not adhere to trade standards regulations (e.g. labelling khat bundles). They claimed to provide a community service (facilitating social interaction) to their predominately Somali customers. Without a better understanding of the dynamics of the khat market there is a risk that both health and social needs of the vulnerable populations involved in the market continue to go unaddressed. Future research should track changes in the now illicit khat market in order to evaluate the social and public health implications following the recent changes to the current UK regulatory environment regarding khat.Electronic supplementary materialThe online version of this article (doi:10.1186/s12954-015-0048-z) contains supplementary material, which is available to authorized users.

Purpose -This article aims to analyse the discourse about khat in the Swedish newspaper media and to present the concept of moral entrepreneurship as a useful analytical tool for understanding mobilisation against khat use in the Somali diaspora. Design/methodology/approach -The material analysed consists of daily newspaper articles about khat published between 1986 and 2012. The method of analysis is inspired by the critical discourse analysis framework developed by Norman Fairclough. Drawing on Howard S. Becker's concept of moral entrepreneur, the article focuses on anti-khat campaigners who speak out against khat in the media. These are often representatives from Somali voluntary associations or organisations, who sometimes employ moral entrepreneurship. The article discusses these actors' role in framing khat use as a tangible threat to the Somali community in Sweden. Findings -When employing moral entrepreneurship, anti-khat campaigners spread a certain type of knowledge about khat that is presented to the general public via the media. The key issues that repeatedly are of concern are how khat destroys Somali families and how the use might spread to other groups. In this manner khat use is constructed as a threat to Somali social cohesion. The knowledge produced could potentially influence policy makers to introduce stricter punishments for possession, sale and use of khat, thereby possibly increasing stigma and marginalisation in relation to the Somali immigrant community. Originality/value -The literature about khat has pointed to the centrality of Somali organisations mobilising against khat in the diaspora. This article presents moral entrepreneurship as a theoretical tool to further the understanding of the mobilisation against khat and its use.

Background In Denmark, Norway and Sweden, the use of the psychoactive plant khat is widely seen as a social and health problem exclusively affecting the Somali immigrant population. Several projects by governmental and municipal bodies and agencies have been initiated to reduce khat use and abuse within this target population. Aim This article analyses the khat abuse discourse as it is presented in evaluation reports describing projects initiated by the social services to reduce khat abuse. Methods Six publicly available and formally evaluated khat projects conducted in the Scandinavian countries were found, and these evaluation reports were subjected to a Foucauldian discourse analysis. The “What's the problem represented to be?” approach was used to generate questions, which were then applied to the material. Results & CONCLUSIONS The problem of khat abuse is represented to be that it is the cause of unemployment, lack of integration and relationship issues among Somali immigrants. The analysis shows that the notion of cultural competence is used instrumentally to govern the target population and that the Somali immigrant group is exclusively targeted. This instrumental use of cultural competence partly places the onus on the “Somali community” itself to reduce khat use, which may engender stigmatisation of Somali immigrants in general. The author maintains that an overreliance on cultural explanations overlooks socioeconomic issues and that the focus should be on potentially problematic patterns of khat use rather than Somali immigrants in general.

Codependency is a term used to describe a range of behaviors among persons who are affected by the problematic drug use of family members. This article analyzes how 32 Swedish parents of adult children with drug problems talked about and understood codependency. The sociology of trouble was used as a theoretical framework and three significant themes were identified in the interviews. The parents spoke about how they defined codependency troubles, how they discovered codependency, and how they set boundaries for their children. The parents talked about their situations as highly distressing, and third-party troubleshooters defined their troubles and problems as codependency. The parents generally rejected the advice to “close the door” on their children and engaged in a range of remedial actions. The analytical focus of this study on the identification, definition, and remedial actions of parents gives valuable insights into family disruptions related to drug problems.