Drug Policy Programmes Research Articles

Towards a Public Health Approach to Homicides in Mexico

Background: Homicide was the fifth cause of death in Mexico in 2019 and has been among the top ten causes of death since 2009. Despite its relevance, homicide has neither been considered a public health problem by health authorities nor has been a point of focus for the development of effective prevention strategies, compared to other leading and preventable causes of death. This study aims to establish homicide as a relevant public health problem in Mexico. Methods: We analyzed publicly available data in Mexico from 1998 to 2019 to calculate homicide rates and compare them to other causes of death stratified by age and sex. We also described the age, period, and cohort trends of homicides. Findings: Homicide has been the leading cause of death for both sexes for several age groups since 2010, surpassing cardiovascular disease, diabetes mellitus, cancer, and accidents. Since 2018, homicides have been the main cause of death for females 15 to 24 years old and the second cause of death for 25 to 34 years old. Males 25 to 34 years old experienced the highest homicide rates across all the study period, exceeding 1 per 1,000 in 2019. Interpretation: Homicides are one of the major causes of death in Mexico and currently represent a national public health threat. This study reveals important patterns of homicide deaths that can inform national and regional public health policy. Funding: This study was supported by grants from Open Society Foundations (OSF) and the Drug Policy Program at CIDE. Declaration of Interests: FAE reports funds from Open Society Foundations (OSF) and the Drug Policy Program at CIDE. All authors declare no competing interests.

The “War on Drugs” in Mexico: (Official) Database of Events between December 2006 and November 2011

The objective of this text is to describe the three categories that the Drug Policy Program at the Center for Teaching and Research in Economics (CIDE-PPD) database comprises, their limitations, and their main features. Additionally, we explain what we believe to be the source of the database we originally received and analyze its accuracy by comparing it with public records. We describe the validation and codification processes the database was subjected to, as well as the main biases and limitations the database may have. Additionally, we offer a preliminary analysis of the type of research that the CIDE-PPD Database can support. This analysis is not only relevant to those interested in studying the “war on drugs” in Mexico but also to those studying conflict in other countries involved in illegal drug production and trafficking, as well as countries experiencing conflicts related to organized crime.

Fragmentation and cooperation: the evolution of organized crime in Mexico

Some researchers suggest that the observed boom in the levels of violence in Mexico since 2008 are a consequence of placing federal military forces in states with a significant organized crime presence. However, little has been said about the role of the changeable, competitive, and violent nature of criminal organizations on this increasing violence. Using the literature on inter- and intra-state conflicts as matter of analogy to explain organized crime developments in Mexico, fragmentation and cooperation seem to be determinant forces that alter the equilibrium within Mexican criminal groups, affecting their territorial control. By using a private dataset gathered by the Drug Policy Program at the Center for Economic Research and Teaching (CIDE), we examine the evolution of criminal organizations in Mexico by focusing on their different alliances and fragmentations from December 2006 to December 2011. Our analysis suggests that violence is a consequence not only of the law enforcement actions, but also of the fragmentation and cooperation within and between private groups.

The Structure of Public Spending on Drug Policy in Croatia: What are the Priorities?

The national policy responses to the rising drug problem are effectuated by financing a large set of activities aimed at combating drug abuse. This paper provides an analysis of drug-related public expenditures in Croatia. We have examined the expenditures of public sector institutions in Croatia in the period from 2009 to 2012. Our main research goal was to identify the total drug-related public expenditures including the unlabelled ones, and to develop the method of estimating and allocating unlabelled expenditures by the type of drug policy program. The estimated total expenditures according to Reuter's drug program division are allocated into prevention, treatment and social reintegration, harm reduction, and law enforcement. The results indicate which types of drug policy programs public authorities in Croatia are really committed to in the sense that those programs absorb the largest proportions of total drug policy expenditures. The methodology applied could contribute to the development of the international methodological standards in this field. The findings are discussed in terms of future monitoring of public expenditures and policy recommendations, in order to facilitate better design programs and activities carried out by policy makers in fighting drug abuse in Croatia.

Management of Human Resources Associated with Misuse of Prescription Drugs: Analysis of a National Survey

Nonmedical use of prescription drugs is increasingly prevalent in the United States, but limited research is available on prescription drugs misuse in the workforce. We investigated whether absenteeism and turnover are associated with having problems linked to prescription drug misuse among employees. We also further explored the moderating effects of employee drug policy and testing on the relation between having problems linked to misuse of prescription pain relievers (PPRs) and absenteeism and turnover. This is a cross-sectional study (n=2,249) using the 2007 U.S. national survey data (“National Survey on Drug Use and Health”). the multivariate logistic analysis results illustrate, after controlling confounding factors (gender, age, tobacco use, and heroin use), absenteeism and turnover linked to having problems of PPRs misuse. Our findings suggest the moderating effects of employee drug policy on the association between absenteeism and turnover and having problems linked to misuse of PPRs. Also, drug testing was found to moderate the link between having negative outcomes of misuse of PPRs and absenteeism. Having problems associated with misuse of PPRs is linked to absenteeism and turnover. a drug policy program including drug testing may play a significant role in reducing absenteeism and turnover in relation to having problems linked to misuse of PPRs.

Rhetoric versus Practice in Czech Drug Policy

Modern official Czech drug policies were initiated in 1993 when the government approved its first national drug policy program for 1993 to 1996. The current policy was defined in the National Drug Policy Strategy 2005–2009, a document that calls for an evidence-based drug policy and a balanced and interdisciplinary approach to the problem of drug use. In order to assess the existence of possible discrepancies between these official statements and their practical implementation, the author provides an analysis of Czech drug policy based on a review of official and other documents as well as interviews with representatives and key players in the Czech drug policy arena. The main finding is that several conflicts exist between the official policy and its practical application and that these disparities serve as obstacles to its effectiveness. These differences exist because of the wide variety of ways in which key players have conceptualized drug use per se and the manner in which they have constructed particular reform measures to implement and mirror their main interests and priorities. Particular areas of concern that have been especially impacted by these phenomena are illustrated and discussed below. In order to assure the effectiveness of future Czech drug policy, further research, especially regarding its practical application, needs to occur.

Knowing when but not how!--mothers' perceptions and use of antibiotics in a rural area of Viet Nam.

Given the world-wide focus on how to rationally use antibiotics, national drug policy programmes have been developed in many countries in order to minimize the environmental antibiotic pressure and thereby hopefully limit increasing bacterial resistance. This study investigated perceptions of antibiotics in a health system with weak drug regulation. The study was conducted in two rural communes in Viet Nam, with a drug market characterized by the increased accessibility and consumption of pharmaceuticals. The study focused on rural mothers' perceptions and use of antibiotics in the treatment of acute respiratory infections (ARI) in children 5 years and under. A combination of qualitative and quantitative methods were used including key informant interviews, focus group discussions, and interviews with mothers and drug vendors. The study demonstrated that using a combination of qualitative and quantitative methods gives a better understanding of the prevailing perceptions and use of antibiotics in communities. The results showed that the mothers recognized well the signs of severe ARI and that antibiotics were reserved for more severe illness episodes, where penicillin V and ampicillin were first drugs of choice. However, the mothers' perceptions and use of antibiotics reflects indigenization of antibiotics into traditional Vietnamese thinking and medical practice. This resulted in self-medication and a respect for antibiotics from the mothers' point of view. A first step towards the rational use of antibiotics is already taken where mothers, as the health decision-maker, know when to initiate antibiotic treatment and try to limit unnecessary use of antibiotics. The next step is to develop a well-functioning health education programme in order to promote the correct use of antibiotics for a successful clinical outcome. This requires acknowledgement of the mothers' culture based behaviour.