The Elusive Search for Rights-Centred Public Health Approaches to Drug Policy: A Comment

Csete, Joanne

doi:10.31389/jied.60

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…Current intervention strategies may overflow prisons, enforce repressive practices against substance users, contribute to discriminatory attitudes, marginalize poor people, and cause enormous suffering by failing to treat physical and emotional pain [ 58 ]. Methadone use, however, could bring about benefits that exceed the risks, although this evaluation must be made given the course and prognosis of the illness, as well as the impact on other areas of substance users’ health care.…”

Section: Discussionmentioning

confidence: 99%

Structural violence and the need for compassionate use of methadone in Mexico

et al. 2022

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Background Epidemiological data from Mexico have documented an increase in heroin use in the last decade. However, there is no comprehensive care strategy for heroin users, especially those who have been accused of a crime. The objective of this study was to describe the heroin and methadone use of intravenous heroin users of both sexes who have been in jail, to offer evidence for the formulation of health policy. Methods This study used an ethnographic approach, with open-ended interviews carried out from 2014 to the present. Heroin users of both sexes attending a private methadone clinic in Mexico City were invited to participate. The sample was non-probabilistic. All interviews were audiotaped and transcribed, and narratives were analyzed using thematic analysis. Results Participants in this study were 33 users of heroin, two of them women, who had been in prison. They ranged in age from 33 to 62 years, had used heroin for a period of 13–30 years, and were from three states: Michoacan, Oaxaca, and Mexico City. Three principal categories of analysis were structured: 1. Pilgrimage for help (dynamics of the drama of suffering, pain, and time through health care spaces); 2) methadone use as self-care; and 3) accessibility to methadone treatment. The impossibility of access to methadone treatment is a condition which motivates users in their journey. The dynamics of methadone use are interpreted as a form of self-care and care to avoid substance use. Reducing the psychological, physical, and harmful effects of the substance allows them to perform daily activities. The inability to access treatment leads to a significant effect on users who experience structural violence. Conclusion Compassionate methadone treatment and holistic attention should be considered as a way to meet patients’ needs and mitigate their suffering, based on public health policy that allows for human rights-based care.

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Section: Discussionmentioning

confidence: 99%

Structural violence and the need for compassionate use of methadone in Mexico

et al. 2022

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“…In light of the limited success and negative consequences of current drug policies, (Reuter & Greenfield, 2018) focusing on rural development and alternative livelihoods for farmers involved in illicit drug production. By investing in sustainable development projects and providing economic opportunities for rural communities, it may be possible to reduce the incentives for farmers to participate in the drug trade.…”

Section: 2mentioning

confidence: 99%

Volume 6 Issue 2

2023

PJHSSR

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The main focus of this research is the American war on drugs in Colombia. It presents a comprehensive case study that delves into the country's drug policies and the influence they have had on Colombian society. The article will analyse the history of drug trafficking in Colombia, the measures implemented by the United States to fight against drug trafficking, and the impact of these policies on the social and economic realm of Colombian life. Additionally, it examines the unforeseen outcomes of US policies, such as the displacement of rural communities and the emergence of new criminal factions. This article conducts a thorough review of literature, primary as well as secondary data to critically assess the US War on Drugs in Colombia. It also offers suggestions for an enhanced and long-lasting drug policy.

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“…The main limitations of prior studies were short follow-ups that often overlapped completely with time in treatment, inappropriate control groups, and insufficient adjustment for confounding. Moreover, drug courts have been promoted as being more of a public health rather than criminal justice-based response to substance use problems [ 6 , 7 ]. The public health view on substance use has begun to place increasing emphasis on harm reduction, which aims to lessen the negative health consequences associated with alcohol or drug use [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of substance use disorder treatment as an alternative to imprisonment

Virtanen,

Aaltonen,

Latvala

et al. 2024

BMC Psychiatry

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Introduction Drug courts are criminal justice programs to divert people with substance use disorders from incarceration into treatment. Drug courts have become increasingly popular in the US and other countries. However, their effectiveness in reducing important public health outcomes such as recidivism and substance-related health harms remains ambiguous and contested. We used nationwide register data from Sweden to evaluate the effectiveness of contract treatment sanction, the Swedish version of drug court, in reducing substance misuse, adverse somatic and mental health outcomes, and recidivism. Methods In this prospective cohort study, two quasi-experimental designs were used: difference-in-differences and the within-individual design. In the latter, we compared the risk of outcomes during time on contract treatment to, 1) parole after imprisonment and, 2) probation. Results The cohort included 11,893 individuals (13% women) who underwent contract treatment. Contract treatment was associated with a reduction of 7 percentage points (95% CI: -.088, -.055) in substance misuse, 5 percentage points (-.064, -.034) in adverse mental health events, 9 percentage points (-.113, -.076) in adverse somatic health events, and 3 fewer charges (-3.16, -2.85) for crime in difference-in-differences analyses. Within-individual associations suggested that the same individual had longer times-to-event for all outcomes during contract treatment than on parole or on probation. Conclusions Contract treatment is an effective intervention from both public health and criminal justice perspective. Our findings suggest that it is a superior alternative to incarceration in its target group. Further, we find that an implementation approach that is less punitive and more inclusive than what is typical in the US can be successful.

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The Elusive Search for Rights-Centred Public Health Approaches to Drug Policy: A Comment

Cited by 3 publications

References 19 publications

Structural violence and the need for compassionate use of methadone in Mexico

Structural violence and the need for compassionate use of methadone in Mexico

Volume 6 Issue 2

Effectiveness of substance use disorder treatment as an alternative to imprisonment

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