O objetivo deste artigo é analisar como se estrutura e se transforma o debate público sobre a política de drogas no Brasil entre os anos de 2003 e 2016. Para responder a essa problematização, foram ...analisados 306 materiais publicados no jornal Zero Hora. A análise demonstra que houve mudanças significativas na configuração do debate público sobre o "problema das drogas" no país na última década. Mais especificamente, é demonstrado que o debate público tende a ser mais heterogêneo, em termos de agentes e de enquadramentos, do que aquilo que se expressa na política de drogas vigente. Identificar e analisar essa heterogeneidade é importante para a compreensão das controvérsias e das posições em disputa sobre a política de drogas.
North America is experiencing an unprecedented overdose crisis driven by the proliferation of fentanyl and its analogues in the illicit drug supply. In 2018 there were 67,367 drug overdose deaths in ...the United States, and since 2016, there have been more than 14,700 overdose deaths in Canada, with most related to fentanyl. Despite concerted efforts and some positive progress, current public health, substance use treatment, and harm reduction interventions (such as widespread naloxone distribution and implementation of supervised consumption sites) have not been able to rapidly decrease overdose fatalities. In view of the persistent gaps in services and the limitations of available options, immediate scale-up of low-barrier opioid distribution programs are urgently needed. This includes “off-label” prescription of pharmaceutical grade opioids (e.g., hydromorphone) to disrupt the toxic drug supply and make safer opioids widely available to people at high risk of fatal overdose.
There has been a significant change in the types of substances consumed within English prison settings in the last eight years. There have been particular concerns regarding the acceleration in the ...use and availability of New Psychoactive Substances (NPS), mainly synthetic cannabinoids. Although NPS were identified as a ‘problem’ in prisons in 2011, government responses emerged only in 2015. As yet, there is no overarching policy document or strategy for dealing with NPS. This paper analyses the various strands of the response to NPS in prisons published from January 2015 to December 2016.
Drawing on Bacchi’s ‘What’s the problem represented to be’ framework, the ways in which the NPS ‘problem’ in prisons has been represented is analysed through a number of related policy texts including press releases, new legislative and regulatory measures, government documents and training package.
From the various measures introduced to deal with the ‘problem’, NPS use is produced primarily as a law, order and control ‘problem’ requiring regulation, penalties and control, rather than a ‘demand problem’ calling for prevention, education, treatment and harm reduction or a ‘regime problem’ demanding greater emphasis and resources for purposeful activities such as education, training and work opportunities. This problematisation of drug use in prisons has a history dating back to the 1995 prison drug strategy and has become entrenched and reproduced within policy development over time.
The law, order, and control problematization blames the volatility of the substances and the individual prisoners who use them as key factors contributing to the current prison crisis, rather than as consequences of the wider practices, cultures, contexts, and conditions. Multiple representations of the problem of NPS in prisons are needed in order to address the regime and structural issues which lead those imprisoned to use substances.
Aquaculture now produces nearly half of the seafood consumed globally. Atlantic salmon (Salmo salar) is one of the top aquaculture products and the most valuable farmed marine finfish species in the ...United States (U.S.). The aim of this study is to better understand veterinary drug use in U.S. net pen Atlantic salmon aquaculture and compare these findings to other salmon producing countries and U.S. livestock. We collected and analyzed records on Atlantic salmon production and veterinary drug use in Maine (2003 to 2017) and Washington (2012 to 2017). Antimicrobial medicated feeds were used in 8% and 93% of production cycles in Maine and Washington, respectively. Oxytetratcycline was the primary drug used in both states. Maine used no antimicrobials in eight of the past 15 yrs., including none in 2017. Emamectin benzoate, an antiparasitic medicated feed, was used in 28% production cycles in Maine (2014 to 2017; avg. 1.1 kg/yr) and no emamectin benzoate was administered in Washington over the time period studied. From 2014 to 2016, the U.S. farmed salmon industry contributed 0.8% ± 0.1% to annual global farmed salmon production and administered 1.2% ± 0.6% of antimicrobials used in global salmon farming. Over the same time period, Norway and Chile accounted for 53% ± 3% and 35% ± 3% of annual global production, and administered 0.06% ± 0.02% and 96% ± 0.09% of antimicrobials used in global salmon farming. Compared to U.S. terrestrial agriculture in 2016, the U.S. Atlantic salmon industry contributed 0.031% to U.S. food animal production and administered 0.057% of antimicrobials available to U.S. food animals. Based on the data we collected, the U.S. Atlantic salmon aquaculture industry is a relatively small user of antimicrobials compared to U.S. beef, pigs, poultry, and Chilean salmon industries. There are relatively few approved drugs in the U.S. to treat aquaculture diseases and more options are needed as well as continued work on vaccines. Antimicrobial resistance is a worldwide public health concern; the overuse or misuse of antimicrobials in any setting can compromise the treatment of bacterial infections. The U.S. net pen Atlantic salmon aquaculture industry appears to be the first U.S. food animal industry to report monthly antimicrobial use at the farm-level to the government. These data are critical to assess public health risks associated with antimicrobial use and resistance, and therefore, are needed from all U.S. food animal industries.
•We compiled and analyzed veterinary drug use in US net pen salmon aquaculture.•US salmon aquaculture administers 1.2% of global salmon antimicrobials.•US salmon aquaculture administers 0.057% of US food animal antimicrobials.•Antimicrobial use data is needed from all U.S. food animal industries.
Overdose deaths from prescription opioid pain relievers nearly quadrupled between 1999 and 2010. We study the consequences of one of the largest supply disruptions to date to abusable opioids—the ...introduction of an abuse-deterrent version of OxyContin in 2010. Supply-side interventions that limit access to opioids may have the unintended consequence of increasing use of substitute drugs, including heroin. Exploiting cross-state variation in OxyContin exposure, we find that states with the highest initial rates of OxyContin misuse experienced the largest increases in heroin deaths. Our results imply that the recent heroin epidemic is largely due to the reformulation of OxyContin.
Three hundred million people living with rare diseases worldwide are disproportionately deprived of in-time diagnosis and treatment compared with other patients. This review provides an overview of ...global policies that optimize development, licensing, pricing, and reimbursement of orphan drugs.
Pharmaceutical legislation and policies related to access and regulation of orphan drugs were examined from 194 World Health Organization member countries and 6 areas. Orphan drug policies (ODPs) were identified through internet search, emails to national pharmacovigilance centers, and systematic academic literature search. Texts from selected publications were extracted for content analysis.
One hundred seventy-two drug regulation documents and 77 academic publications from 162 countries/areas were included. Ninety-two of 200 countries/areas (46.0%) had documentation on ODPs. Thirty-four subthemes from content analysis were categorized into 6 policy themes, namely, orphan drug designation, marketing authorization, safety and efficacy requirements, price regulation, incentives that encourage market availability, and incentives that encourage research and development. Countries/areas with ODPs were statistically wealthier (gross national income per capita = $10 875 vs $3950, P < .001). Country/area income was also positively correlated with the scope of the respective ODP (correlation coefficient = 0.57, P < .001).
Globally, the number of countries with an ODP has grown rapidly since 2013. Nevertheless, disparities in geographical distribution and income levels affect the establishment of ODPs. Furthermore, identified policy gaps in price regulation, incentives that encourage market availability, and incentives that encourage research and development should be addressed to improve access to available and affordable orphan drugs.
•Before undertaking this study, we searched academic databases for all English systematic reviews on global orphan drug policies published before July 2019. We identified 1 review on orphan drug policies published in 2015 and 2 reviews on laws and national strategies for rare diseases from selected countries that were published in 2017 and 2018, respectively. These 3 reviews uncovered a plethora of governmental efforts that facilitate the availability of and access to orphan drugs, with critical differences in scope and approaches among countries.•Vast areas worldwide were omitted from previous reviews, such as Africa, India, Latin America, and Russia. No studies attempted an overview of orphan drug policies in all countries with both governmental and academic evidence. The current global landscape of orphan drug policy (ODP) remains unclear. By systematically reviewing pharmaceutical policies and academic literature from 200 countries/areas, our study presents the most comprehensive review on global ODP to date.•Of the 200 countries or areas examined, 92 had ODPs alongside a notable increase in ODP establishment in non-high-income countries/areas over the last decade. Our findings highlight disparities in ODP establishment and scope in countries/areas with different income levels. This allows respective stakeholders to reference orphan drug regulatory standards of countries/areas with similar political realities while informing policy formulation and advocacy direction for treatment access of patients with rare diseases.
Nederlag for rusreformen? Pedersen, Willy; Røgeberg, Ole; Holst, Cathrine
Tidsskrift for samfunnsforskning,
04/2023, Letnik:
64, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Rusreformutvalget ble nedsatt av Solberg-regjeringen i 2018 og anbefalte å avkriminalisere bruk av narkotika. Vi plasserer reformforslaget i en historisk kontekst og belyser debatten med vekt på ...hvordan forskning ble brukt i prosessen. Materialet er høringsuttalelsene som ble levert inn (N = 247). Norsk narkotikapolitikk er tuftet på visjonen om et harmonisk samarbeid mellom helse, sosial og justis. Forskere fra «den samfunnsvitenskapelige opposisjonen» advarte imidlertid fra 1970-tallet mot kriminaliseringens kostnader som tvangsmiddelbruk og stigmatisering. Men kritikken fikk først politisk kraft da brukerorganisasjonene vokste frem etter år 2000. I høringsrunden var tvang og stigmatisering begrunnelser for reform fra brukerorganisasjonene. Politiet og påtalemyndigheten var negative til reformen, som de mente kunne bidra til økt bruk av narkotika. Reformtilhengerne hevdet at kriminaliseringens forebyggende effekt var for usikker til å rettferdiggjøre kriminaliseringen, gitt de negative konsekvensene for brukerne. Motstanderne mente at usikkerheten talte imot å avvikle kriminaliseringen, gitt muligheten for økt bruk – en bekymring som ofte er underbygget med henvisning til forskere ved Folkehelseinstituttet. Det var få referanser til forskning rundt kriminaliseringens kostnader av den typen den samfunnsvitenskapelige narkotikaopposisjonen i sin tid sto for. Derimot støttet de som ønsket reform seg til uttalelser fra ulike FN-organer, som Verdens helseorganisasjon, samt Den europeiske menneskerettighetskonvensjon.
Objective
Can a fictional show affect its audience's perspectives on the issue of drug use and addiction in society? This article aims to answer that question.
Methods
We use a survey with an ...embedded experiment to assess the relationship between the popular HBO show Euphoria and attitudes of Gen Z on the issue of drugs, including: feelings toward drug users and those caught up in drug addiction; beliefs regarding the causes of drug addiction; and, attitudes toward harm reduction, treatment, and punitive drug policies. Subjects were recruited from Amazon's Mechanical Turk.
Results
We found that reevoking the show by showing photos of two of the main characters led to drug attitudes consistent with the messages about drugs found in Euphoria. We also found that self‐reported exposure to the show was associated with perspectives on drugs consistent with the content of the show for respondents who scored higher on individual transportability—results that conform closely to theoretical expectations. The fact that these results were found in a study 8 months after the final episode of Euphoria was aired hints at the durability of the show's effects.
Conclusions
The results add to the growing body of research on the political effects of entertainment media and provide additional validation of new and important measures of the propensity of individuals to be transported by narratives and eudaimonic motivation in entertainment media choice.
Prescription drug shortages can disrupt essential patient care and drive up drug prices.
To evaluate some predictors of shortages within a large cohort of generic drugs in the United States and to ...determine the association between drug shortages and changes in generic drug prices.
This was a retrospective cohort study. Outpatient prescription claims from commercial health plans between 2008 and 2014 were analyzed. Seven years of data were divided into fourteen 6-month periods; the first period was designated as the baseline period. The first model estimated the probability of experiencing a drug shortage using drug-specific competition levels, market sizes, formulations (e.g., capsules), and drug prices as predictors. The second model estimated the percentage change in drug prices from baseline on the basis of drug shortage duration.
From 1.3 billion prescription claims, a cohort of 1114 generic drugs was identified. Low-priced generic drugs were at a higher risk for drug shortages compared with medium- and high-priced generic drugs, with odds ratios of 0.60 (95% confidence interval CI 0.44–0.82) and 0.72 (95% CI 0.52–0.99), respectively. Compared with periods of no shortage, drug shortages lasting less than 6 months, 6 to 12 months, 12 to 18 months, and at least 18 months had corresponding price increases of 6.0% (95% CI 4.7-7.4), 10.9% (95% CI 8.5-13.4), 14.2% (95% CI 10.6-17.9), and 14.0% (95% CI 9.1-19.2), respectively.
Study findings may not be generalizable to drugs that became generic after 2008 or those commonly used in an inpatient setting. The lowest priced drugs are at a substantially elevated risk of experiencing a drug shortage. Periods of drug shortages were associated with modest increases in drug prices.
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