Implementation Of Drug Policy Research Articles

The Pyschoactive Politics Framework and the Beginning of Coca Eradication in Peru

Objective/Context: The present article develops a theoretical tool to explain drug policy decisions called the Psychoactive Politics Framework. It is built on the assumption that the design and implementation of drug policies affect several political goals, such as popularity, winning elections, material benefits, and international reputation. Therefore, the framework expects these policies to be the result of national and international incentives that will help policy makers achieve those goals. These are incentives related to public opinion, policy advocacy, crises, pressure, standing, and leadership. Methodology: The second part of the article applies the Psychoactive Politics Framework to explain Peru’s first legislation to eradicate illicit coca crops: the Decree Law 22095 of 1978. Through examining diplomatic cables, protocols of international meetings, and media sources, the analysis gathers evidence in favor and against each of the incentives outlined in the framework. Conclusions: While Peru’s drug policy reform took place in an increasingly prohibitionist international environment, its primary driver was the advocacy of national actors, such as the Ministry of the Interior, the Investigative Police, and the attorney general. Originality: The findings question the popular notion that prohibitionist drug policies in South America resulted exclusively from US pressure. Furthermore, the article presents a coherent tool to carry out theory-guided research about past and present drug policy decisions.

Harm Minimisation Drug Policy Implementation Qualities: Their Efficacy with Australian Needle and Syringe Program Providers and People Who Inject Drugs.

(1) Background: Policies and laws in several jurisdictions across the globe have aimed to promote harm minimisation or reduction, through the implementation of Needle and Syringe Programs (NSP) for people who inject drugs (PWID), for whom abstinence may not be possible or desired. While NSPs hold great promise, their implementation qualities are understudied. (2) Aim: We aimed to examine the implementation quality priorities of NSP providers and PWID consumers in an Australian setting. (3) Method: This study utilised a Quantitative-qualitative (QUAN-qual) mixed methods approach. Survey participants included both PWID (n = 70) and NSP providers (n = 26) in Australia. (4) Results: Results following non-parametric data analysis indicate NSP providers prioritised NSP implementation qualities in the following order: compatibility, observability, relative advantage, resourcing and trialability. Contrary to which, PWID prioritised resourcing, compatibility, relative advantage and trialability, respectively. Findings demonstrate that efficacy of implementation qualities is dependent on the juxtaposition of service provision and utilisation whereby implementation quality priorities are balanced. (5) Conclusions: This research presents novel findings guiding NSP harm reduction programmes for sustainability framed on provider and consumer implementation quality priorities. We envisage future studies on boundary conditions of NSP harm reduction implementation in other jurisdictions.

A Study on the National Drug Policies of Bangladesh to Ensure Health for All

Bangladesh approved the proposal for a National Drug Policy on May 29, 1982. We know that such drug policies are developed gradually over a period of time and may contain a lot of comprehensive documents. But in Bangladesh, the expert committee worked out the policy, based on 16 standards within 15 days. This vital document, almost unchanged, was made a law on 12 June 1982. A few years later, it can be observed that despite opposition from many concerns, the output of essential drugs has increased from about 30 to about 80 percent, prices have in almost all cases gone down considerably, the domestic industry has grown rapidly, the quality of its production has increased dramatically, and people’s awareness about quality medicines has been steadily growing. The World Health Organization (WHO) has stressed the need of a formulated drug policy in every country of the world in 1986. Bangladesh responded very early to this respect. Subsequently, two more national drug policies were promulgated in 2005 and 2016 respectively. Experience over the decades has shown that the said policies could not fulfill the declared objective of ensuring health for all. Our aim is to describe some of the lacunae for which total implementation of drug policy is still struggling. To find the root causes, a total of five hundred volunteers were surveyed by supplying a questionnaire on drug policy. It was observed that most of the participants opined that the incumbent government needs to be more stringent to implement the drug policy into reality by utilizing the public servants and public sectors, especially health personnel to ensure health for all.
 Dhaka Univ. J. Pharm. Sci. 20(1): 41-48, 2021 (June)

Conflicting Laws and Priorities as Drug Policy Implementation Barriers: A Qualitative Analysis of Police Perspectives in Tijuana, Mexico

AbstractBackground and AimsDrug policy reforms typically seek to improve health among people who use drugs (PWUD), but flawed implementation impedes potential benefits. Mexico’s 2009 drug policy reform emphasized public health-oriented measures to address addiction. Implementation has been deficient, however. We explored the role of municipal police officers’ (MPOs) enforcement decision-making and local systems as barriers to reform operationalization.MethodsBetween February-June 2016, 20 semi-structured interviews were conducted with MPOs in Tijuana. Interviews were transcribed, translated and coded using a consensus-based approach. Emergent themes, trends and frameworks were analyzed through a hermeneutic grounded theory protocol.ResultsIn conceptualizing their orientation towards municipal (not state) law, MPOs reported prioritizing enforcement of nebulous anti-vice ordinances to control PWUD activity. Local laws were seen as conflicting with drug policy reforms. Incentives within the police organization were aligned with ordinance enforcement, generating pressure through quotas and reinforced by judges. Driven by discretion, fuzzy understanding of procedures, and incentives to sanitize space, detention of PWUD for minor infractions was systematic.ConclusionsFailure to harmonize policies and priorities at different levels of government undermine effective operationalization of health-oriented drug policy. Implementation must address local priorities and administrative pressures shaping MPO decision-making and enforcement practice.

The Philippines’ antidrug campaign: Spatial and temporal patterns of killings linked to drugs

BackgroundAs soon as President Rodrigo Duterte assumed office in 2016, the Philippine government launched a nationwide antidrug campaign based on enforcement-led anti-illegal drugs policies primarily implemented by the national police. This was followed by a spate of killings resulting from both acknowledged police operations and by unidentified assailants. This study assembles a victim-level dataset of drug-related killings covered by the media during the Philippine government’s antidrug campaign, and presents a spatial and temporal analysis of the killings. MethodsThe dataset covers information on 5021 people killed from May 10, 2016 to September 29, 2017. Data collected systematically through online search procedures and existing listings of media organizations detailing information about incidences of drug-related police operations and drug-related killings in 'vigilante-style' manner reveal patterns for who were being killed, where, and how. ResultsOver half of the killings were due to acknowledged police operations, and the rest were targeted in so-called 'vigilante-style' killings. The first three months after Mr. Duterte was sworn in were the deadliest months. Those who were killed were mostly low-level drug suspects.The analysis of temporal pattern reveals the scale of killings in the country, with rapid escalation starting in July 2016 and lasting throughout the rest of that year. Observable declines occurred during periods when the 'drug war' was suspended and operations were moved to a non-police enforcement unit and rose again when police were brought back into operations. The spatial analysis indicates a large concentration of deaths in the National Capital Region (40%) compared to the rest of the country with wide variations across cities and regions. ConclusionsOverall, the Philippine 'drug war' exhibits similarities with violent wars on drugs waged in other countries such as Thailand, with heavily police-led interventions leading to fatalities in the thousands over a span of under two years. Findings of this study point to important policy adjustments that need to be made, including the role that local governments play in drug policy implementation, the disproportionate negative impacts of enforcement-led policies against drugs on urban and poor areas, the targeting of low-level suspected drug dealers and users, and the importance of proper data monitoring and transparency by the government to inform policy adjustments in the face of high costs to human life. We also discuss the importance of independent monitoring systems when the government reports conflicting information.

The Effect of National Drug Policy Implementation and Apparatus Work Motivation on Health Service Quality in the Government Hospitals of Gorontalo

The research intends to investigate and analyze the effects of national drug policy implementation and apparatus work motivation on health service in the government hospitals of Gorontalo.Method used in the quantitative research was exploratory survey. Meanwhile, data collection was conducted by using questionnaires and interviews to confirm the data. Furthermore, data were analyzed by using the PLS (Partial Least Square) approach by the Smart PLS 3.1 application. Research population consisted of 383 implementers of National Drug Policy in the government hospitals of Gorontalo; while the sample consisted of 93 respondents. The findings clarified that: (1) Implementation of National Drug Policy positively and significantly affected health service quality with the effect coefficient of 0.309. The figure confirmed that although it was significant, the effect was inadequate to improve health service quality in the government hospitals of Gorontalo, hence needed other implementation variables, (2) Implementation of National Drug Policy positively and significantly affected apparatus work motivation with the effect coefficient of 0.706, conveying that the implementation strongly affected apparatus work motivation in the government hospitals of Gorontalo, (3) Apparatus work motivation positively and significantly affected health service quality with the effect coefficient of 0.523, declaring that the motivation strongly affected health service quality in the government hospitals of Gorontalo, (4) Implementation of National Drug Policy mediated by apparatus work motivation positively and significantly affected health service quality with the effect coefficient of 0.615, defining the implementation should be mediated by apparatus work motivation to affect health service quality in the government hospitals of Gorontalo, and (5) Public policy integration and apparatus work motivation and commitment created a prototype of new public policy implementation model as the HSQ-MK model. Keywords: Policy, Motivation, Commitment, and Quality DOI : 10.7176/PPAR/9-6-07 Publication date :June 30 th 2019

Más allá de los límites del Estado. Instituciones católicas y evangélicas de partidos del Gran Buenos Aires (Argentina) en la implementación de políticas públicas sobre drogas

El artículo explora las relaciones de las organizaciones de la sociedad civil (OSC) identificadas con un credo religioso que se dedican al tratamiento de los consumos de drogas, con el Estado, otras OSC y otros actores no estatales. El objetivo es describir y analizar los vínculos entre dichas organizaciones, el Estado (en sus distintos niveles, organismos y poderes) y otras organizaciones no estatales (iglesias, federaciones de Organizaciones No Gubernamentales, redes trasnacionales, partidos políticos), en el proceso de implementación de políticas públicas de drogas en partidos del Gran Buenos Aires (PGBA), territorio conocido popularmente como el “conurbano”. Analizamos tres dimensiones de los vínculos entre estas OSC religiosas y el Estado: las relaciones económicas; la articulación en los tratamientos propiamente dichos; y los argumentos de sus referentes para explicar la falta de apoyo y/o articulación. Además, describimos el tipo de relaciones de estas instituciones con otras OSC y otros actores no estatales que dan origen, colaboran en el funcionamiento y permiten el sustento económico de estos dispositivos. El artículo se basa en observaciones y entrevistas a referentes instituciones evangélicas y católicas orientadas a la atención de usuarios con consumos de drogas en la Ciudad de Buenos Aires y los partidos del GBA.

Determinants of Public Support for Marijuana Legalization in Uruguay, the United States, and El Salvador

What are the determinants of public support for marijuana legalization? In the last 3 years, Uruguay and the states of Colorado and Washington have legalized the production, sale, and consumption of recreational marijuana. Although Uruguay and the United States have followed different paths toward legalization, these cases provide an excellent opportunity to explore the relationship between drug policy implementation and public opinion in different political contexts. Using logistic regressions on data from the 2014 AmericasBarometer cross-national surveys conducted in Uruguay, the United States, and El Salvador, this article examines citizen views toward marijuana regulation and the individual determinants of support for legalization in a comparative fashion. Results underline the role of political socialization variables in those countries in which legalization is being debated. Across countries, some of the most important factors for predicting positive attitudes toward marijuana regulation are related to political tolerance, ideology, and the views toward the government.

PCV148 - Assessment of Generic Drug Policy Implementation by Measuring Persistence with Antihypertensive Drug Therapies After Patent Expiry

PCV148 - Assessment of Generic Drug Policy Implementation by Measuring Persistence with Antihypertensive Drug Therapies After Patent Expiry

Differential genetic hitchhiking around mutant pfcrt alleles in the Indian Plasmodium falciparum population

To study the origin and spread of the chloroquine-resistant Plasmodium falciparum population in the Indian subcontinent. Fourteen microsatellites spanning a ∼120 kb region, flanking the P. falciparum chloroquine resistance transporter (pfcrt) gene, were analysed in 185 parasite isolates. The Indian P. falciparum population exhibited a selective valley of reduced genetic variation in the flanking microsatellites of the mutant pfcrt alleles (up to ±29 kb) as compared with the wild-type allele. This valley is much narrower than the ±200 kb valley reported from African and South-East Asian countries. The majority of the isolates showed asymmetry in the selective valley, where upstream microsatellites showed less genetic variation than the downstream microsatellites. Regional variation in the width and symmetry of the selective valley was noticed, which seems to be related to the number of pfcrt alleles present in the parasite population of a region. Forty-six different microsatellite haplotypes were observed among the P. falciparum isolates containing mutant pfcrt alleles. Parasite populations from different regions of mainland India shared microsatellite haplotypes between them, but they shared none with the isolates from the Andaman and Nicobar Islands, and vice versa. Indian isolates shared microsatellite haplotypes with the isolates from Papua New Guinea and Thailand. With regard to chloroquine there is regional variation in the selection pressure on the P. falciparum population in India. These findings will help the regional implementation of drug policy in India's malaria control programme.

Economía de los medicamentos genéricos en América Latina

In terms of economics, implementing generic drug policy is nothing other than consolidating (or even, creating) drug markets that set competitive prices, the result of which favors public access to essential drugs. This article approaches the topic of generic drugs from the economic perspective by examining various regulatory models in order to evaluate and leverage generic drug policy implementation options as a mechanism for battling some of the markets' specific weaknesses. The conclusion is that there is no single unequivocal method for promoting the use of generic drugs, and that the most favorable way to integrate markets may be through a broad combination of alternatives. These alternatives are grouped and analyzed according to the market issues or challenges that must be overcome. Several options are then identified based on the degree of market consolidation to be obtained.

National drug policy of Bangladesh: some pitfalls in implementation.

Drug development, manufacturing and marketing have become one of the most important sectors throughout the world for various reasons. Realizing its importance, the World Health Organization (WHO) has stressed the need of a formulated drug policy in every country of the world. Bangladesh responded very early to this. Experiences over the decades have shown that the said policy could not fulfill in toto the declared objectives. Our aim is to describe some of the lacunae for which total implementation of drug policy is still struggling. For this purpose, we meticulously analysed our Drugs Control Ordinance 1982 (with an amendment brought in 1994) and upcoming National Drug Policy. We mainly focussed on three factors pointed out by WHO, which are crucial of a drug policy, which include price limitation, quality and rational use. We found great variations in price which need to be controlled. Regarding quality, safety and efficacy, we have to be more cautious. Rational use of drugs is also an area to be focussed on. Every physician should prescribe proper drug with due indication and in rational way. This pitfall of implementation might happen in many countries of the world and it needs a global discussion so that the future policy makers can mitigate the demand of the nation.

Local Implementation of Drug Policy and Access to Treatment Services for Juveniles

Although there is a vigorous national debate regarding effective drug policy, such policies are implemented at the local level. Using a national sample of prosecutors, we examine reported typical processing for first-time juvenile marijuana, cocaine, or crack possession/sales offenders. The relationship between drug offense charge and adjudication outcomes providing treatment versus a deterrence/punitive approach is explored. Findings indicate that marijuana offenses and possession offenses generally are more likely to result in access to treatment services for juveniles whereas cocaine/crack offenses and sales offenses generally are more likely to result in the application of punitive penalties such as transfer to criminal court.

Pharmacovigilance: a necessary tool

This paper discusses the potential benefits of pharmacovigilance in promoting rational drug use and the implementation of drug policies, especially drug regulation, based on the WHO International Drug Monitoring Program. The initial development of pharmacovigilance in Brazil is presented and the need for a national pharmacovigilance system is stressed.

Models of hospital drug policy in the UK.

Pharmacists in UK National Health Service (NHS) hospitals have a long tradition of involvement in the development of drug policy. This paper describes various approaches that have been employed in the development and implementation of drug policy in hospitals and examines the evidence for their effectiveness and acceptability in the context of a changing health service. A series of focused interviews was conducted with a range of staff, including doctors, nurses, pharmacists and managers at eight hospitals. Interview sites were selected on the basis of a national survey of clinical pharmacy roles and were broadly representative of UK NHS hospitals. Interview data were analysed using constant comparison and analytic induction. Three models used in the development of drug policy were identified: a 'traditional' model, in which a drug and therapeutics committee establishes a hospital-wide formulary which is implemented by pharmacists; a 'combined' model, in which there is much more emphasis on tailoring policies and feedback to specialties or clinical directorates; and a 'medical control' model, in which prescribing decisions are made by individual doctors without reference to explicit policies and with little active pharmacy involvement. Pharmacy involvement was seen as vital to the development of effective policies but hospital-specific factors influenced the choice of model at particular sites. Hospitals may be moving towards the 'combined' model which could have advantages in the current internal market within the NHS. However, evaluations of the various approaches to drug policy should help inform this decision.

No consensus on fighting the drug war: differences between state policy elites and the mass public.

This article explores implications for the implementation of drug policy in the United States, based on the findings from a 1990 survey of state drug policy coordinators in all 50 states and the responses to a national mass public survey. State drug policy elites' perceptions of the relative seriousness of nine different specific drugs are assessed, together with their evaluations of federal drug policy. Significant differences in state elites' attitudes are found for certain regional effects, for the relative degree of state urbanism, and for relative state income levels. These results are compared against the findings from a 1989 CBS News/New York Times mass opinion survey measuring citizen perceptions on drug misuse and the efficacy of Bush administration policy initiatives. This comparison reveals a wide disparity between elite and mass attitudes regarding appropriate funding of the drug war, the rating of federal drug policy initiatives, and federal drug policy strategies. Such mass/elite perceptual disparities accentuate the difficulties inherent in pursuing a "drug war" strategy.