This analysis offers an empirical basis for a per se limit for THC that allows identification of drivers impaired by cannabis. The limited epidemiological data render this limit preliminary.

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The results of this preliminary study have demonstrated that a maintenance pharmacotherapy programme of daily sustained-release amphetamine dispensing under pharmacist supervision is both feasible and safe. The increased retention in the dexamphetamine group, together with the general decreases in methamphetamine use, degree of dependence and withdrawal symptom severity, provide preliminary evidence that this may be an efficacious treatment option for methamphetamine dependence.

BackgroundThe world prison population is large and growing. Poor health outcomes after release from prison are common, but few programmes to improve health outcomes for ex-prisoners have been rigorously evaluated. The aim of this study was to evaluate the impact of individualised case management on contact with health services during the first 6 months postrelease. Methods Single-blinded, randomised, controlled trial. Baseline assessment with N=1325 adult prisoners in Queensland, Australia, within 6 weeks of expected release; follow-up interviews 1, 3 and 6 months postrelease. The intervention consisted of provision of a personalised booklet ('Passport') at the time of release, plus up to four brief telephone contacts in the first 4 weeks post-release. Results Of 1179 eligible participants, 1003 (85%) completed ≥1 follow-up interview. In intention-to-treat analyses, 53% of the intervention group and 41% of the control group reported contacting a general practitioner (GP) at 1 month post-release (difference=12%, 95% CI 5% to 19%). Similar effects were observed for GP contact at 3 months (difference=9%, 95% CI 2% to 16%) and 6 months (difference=8%, 95% CI 1% to 15%), and for mental health (MH) service contact at 6 months post release (difference=8%, 95% CI 3% to 14%). Conclusions Individualised case management in the month after release from prison increases usage of primary care and MH services in adult ex-prisoners for at least 6 months post-release. Given the poor health profile of ex-prisoners, there remains an urgent need to develop and rigorously evaluate interventions to increase health service contact in this profoundly marginalised population. Trial registration number ACTRN12608000232336. INTRODUCTIONMore than 10 million people are incarcerated around the world on any given day.1 Prisoners are characterised by profound social disadvantage and a high prevalence of complex, chronic and often preventable health problems including substance dependence, mental disorder, communicable and non-communicable disease.2 3 Prisoners also underutilise health services in the community, 4 and at least in high-income countries, their health typically improves in custody where food and shelter are provided at no or low cost, illicit drugs are less readily available, and the threshold for access to healthcare is relatively low.5 Time in custody provides unique opportunities to screen for disease and initiate care, 4 with the benefits potentially flowing to the wider community once prisoners are released. 6 An estimated 30 million people are released from prisons each year, 7 however, any health gains achieved in custody are typically lost soon after release. Those released from prison experience high rates of preventable morbidity 8-10 and mortality, 11 12 and are heavy users of expensive, tertiary healthcare services.13 14 Some of these poor health outcomes are associated with an increased risk of recidivism.6 15 Under-utilisation of preventive care post-release may be an important driver of these outcomes, 16 h...

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