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1.
Nature ; 621(7978): 318-323, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37612502

RESUMO

The Amazon forest carbon sink is declining, mainly as a result of land-use and climate change1-4. Here we investigate how changes in law enforcement of environmental protection policies may have affected the Amazonian carbon balance between 2010 and 2018 compared with 2019 and 2020, based on atmospheric CO2 vertical profiles5,6, deforestation7 and fire data8, as well as infraction notices related to illegal deforestation9. We estimate that Amazonia carbon emissions increased from a mean of 0.24 ± 0.08 PgC year-1 in 2010-2018 to 0.44 ± 0.10 PgC year-1 in 2019 and 0.52 ± 0.10 PgC year-1 in 2020 (± uncertainty). The observed increases in deforestation were 82% and 77% (94% accuracy) and burned area were 14% and 42% in 2019 and 2020 compared with the 2010-2018 mean, respectively. We find that the numbers of notifications of infractions against flora decreased by 30% and 54% and fines paid by 74% and 89% in 2019 and 2020, respectively. Carbon losses during 2019-2020 were comparable with those of the record warm El Niño (2015-2016) without an extreme drought event. Statistical tests show that the observed differences between the 2010-2018 mean and 2019-2020 are unlikely to have arisen by chance. The changes in the carbon budget of Amazonia during 2019-2020 were mainly because of western Amazonia becoming a carbon source. Our results indicate that a decline in law enforcement led to increases in deforestation, biomass burning and forest degradation, which increased carbon emissions and enhanced drying and warming of the Amazon forests.


Assuntos
Dióxido de Carbono , Sequestro de Carbono , Conservação dos Recursos Naturais , Política Ambiental , Aplicação da Lei , Floresta Úmida , Biomassa , Brasil , Dióxido de Carbono/análise , Dióxido de Carbono/metabolismo , Política Ambiental/legislação & jurisprudência , Atmosfera/química , Incêndios Florestais/estatística & dados numéricos , Conservação dos Recursos Naturais/estatística & dados numéricos , El Niño Oscilação Sul , Secas/estatística & dados numéricos
2.
Proc Natl Acad Sci U S A ; 121(24): e2402375121, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38830090

RESUMO

Recent work has emphasized the disproportionate bias faced by minorities when interacting with law enforcement. However, research on the topic has been hampered by biased sampling in administrative data, namely that records of police interactions with citizens only reflect information on the civilians that police elect to investigate, and not civilians that police observe but do not investigate. In this work, we address a related bias in administrative police data which has received less empirical attention, namely reporting biases around investigations that have taken place. Further, we investigate whether digital monitoring tools help mitigate this reporting bias. To do so, we examine changes in reports of interactions between law enforcement and citizens in the wake of the New York City Police Department's replacement of analog memo books with mobile smartphones. Results from a staggered difference in differences estimation indicate a significant increase in reports of citizen stops once the new smartphones are deployed. Importantly, we observe that the rise is driven by increased reports of "unproductive" stops, stops involving non-White citizens, and stops occurring in areas characterized by a greater concentration of crime and non-White residents. These results reinforce the recent observation that prior work has likely underestimated the extent of racial bias in policing. Further, they highlight that the implementation of digital monitoring tools can mitigate the issue to some extent.


Assuntos
Aplicação da Lei , Polícia , Humanos , Cidade de Nova Iorque , Aplicação da Lei/métodos , Tecnologia Digital , Smartphone , Racismo/estatística & dados numéricos , Crime/estatística & dados numéricos
3.
Proc Natl Acad Sci U S A ; 121(25): e2321479121, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38857393

RESUMO

Conservation enforcement is a direct strategy to combat illegal wildlife trade in open markets. Yet, its large-scale effectiveness has not been widely assessed due to the lack of extensive market data. Between August 2016 and June 2017, a national coordinated enforcement campaign led by the leading Chinese authority to combat illegal migratory bird trade coincided with the largest-ever pet bird market survey across China by voluntary birdwatchers before and after the enforcement, which served as a unique natural experiment. Across 73 markets from 22 Chinese provinces, the dataset contains 140,723 birds of 346 species from 48 families and recorded a drastic decline in bird abundance traded after enforcement. Notably, species protected under China's Wildlife Protection Law declined significantly, while commercially bred species increased, although responses to enforcement were spatially heterogeneous. Our model showed that the national protection level was the best predictor for the trend of traded species, even after accounting for confounding factors such as regional baseline enforcement pressure and wild native bird populations. However, the widely traded native songbirds were not offered adequate national protection. Future policies should consider the pet bird trade patterns, target key areas of trade, and develop a more systematic market survey design to monitor trade.


Assuntos
Aves , Comércio , Conservação dos Recursos Naturais , Aplicação da Lei , Animais de Estimação , Animais , China , Comércio/legislação & jurisprudência , Conservação dos Recursos Naturais/legislação & jurisprudência , Animais Selvagens
4.
Proc Natl Acad Sci U S A ; 121(19): e2314653121, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38696470

RESUMO

Recent work finds that nonviolent resistance by ethnic minorities is perceived as more violent and requiring more policing than identical resistance by ethnic majorities, reducing its impact and effectiveness. We ask whether allies-advantaged group participants in disadvantaged group movements-can mitigate these barriers. On the one hand, allies can counter negative stereotypes and defuse threat perceptions among advantaged group members, while raising expectations of success and lowering expected risks among disadvantaged group members. On the other hand, allies can entail significant costs, carrying risks of cooptation, replication of power hierarchies, and marginalization of core constituencies. To shed light on this question we draw on the case of the Black Lives Matter (BLM) movement, which, in 2020, attracted unprecedented White participation. Employing a national survey experiment, we find that sizeable White presence at racial justice protests increases protest approval, reduces perceptions of violence, and raises the likelihood of participation among White audiences, while not causing significant backlash among Black audiences. Black respondents mostly see White presence as useful for advancing the movement's goals, and predominant White presence reduces expectations that protests will be forcefully repressed. We complement these results with analysis of tens of thousands of images shared on social media during the 2020 BLM protests, finding a significant association between the presence of Whites in the images and user engagement and amplification. The findings suggest that allyship can be a powerful tool for promoting sociopolitical change amid deep structural inequality.


Assuntos
Atitude , Política , Adulto , Feminino , Humanos , Masculino , Negro ou Afro-Americano/psicologia , Justiça Social/psicologia , Estados Unidos , Violência/psicologia , População Branca/psicologia , Brancos , Aplicação da Lei , Etnicidade , Racismo Sistêmico
5.
Proc Natl Acad Sci U S A ; 120(29): e2221654120, 2023 07 18.
Artigo em Inglês | MEDLINE | ID: mdl-37432991

RESUMO

Survivor testimonies link survival in deadly POW camps, Gulags, and Nazi concentration camps to the formation of close friendships with other prisoners. To provide evidence free of survival bias on the importance of social ties for surviving the Holocaust, we study individual histories of 30 thousand Jewish prisoners who entered the Auschwitz-Birkenau concentration camp on transports from the Theresienstadt ghetto. We ask whether the availability of potential friends among fellow prisoners on a transport influenced the chances of surviving the Holocaust. Relying on multiple proxies of preexisting social networks and varying social-linkage composition of transports, we uncover a significant survival advantage to entering Auschwitz with a larger group of potential friends.


Assuntos
Holocausto , Prisioneiros , Humanos , Amigos , Judeus , Aplicação da Lei
6.
Proc Natl Acad Sci U S A ; 120(41): e2301842120, 2023 10 10.
Artigo em Inglês | MEDLINE | ID: mdl-37782786

RESUMO

One of the most troubling trends in criminal investigations is the growing use of "black box" technology, in which law enforcement rely on artificial intelligence (AI) models or algorithms that are either too complex for people to understand or they simply conceal how it functions. In criminal cases, black box systems have proliferated in forensic areas such as DNA mixture interpretation, facial recognition, and recidivism risk assessments. The champions and critics of AI argue, mistakenly, that we face a catch 22: While black box AI is not understandable by people, they assume that it produces more accurate forensic evidence. In this Article, we question this assertion, which has so powerfully affected judges, policymakers, and academics. We describe a mature body of computer science research showing how "glass box" AI-designed to be interpretable-can be more accurate than black box alternatives. Indeed, black box AI performs predictably worse in settings like the criminal system. Debunking the black box performance myth has implications for forensic evidence, constitutional criminal procedure rights, and legislative policy. Absent some compelling-or even credible-government interest in keeping AI as a black box, and given the constitutional rights and public safety interests at stake, we argue that a substantial burden rests on the government to justify black box AI in criminal cases. We conclude by calling for judicial rulings and legislation to safeguard a right to interpretable forensic AI.


Assuntos
Inteligência Artificial , Criminosos , Humanos , Medicina Legal , Aplicação da Lei , Algoritmos
7.
Proc Natl Acad Sci U S A ; 120(41): e2301845120, 2023 10 10.
Artigo em Inglês | MEDLINE | ID: mdl-37782811

RESUMO

Accurate witness identification is a cornerstone of police inquiries and national security investigations. However, witnesses can make errors. We experimentally tested whether an interactive lineup, a recently introduced procedure that enables witnesses to dynamically view and explore faces from different angles, improves the rate at which witnesses identify guilty over innocent suspects compared to procedures traditionally used by law enforcement. Participants encoded 12 target faces, either from the front or in profile view, and then attempted to identify the targets from 12 lineups, half of which were target present and the other half target absent. Participants were randomly assigned to a lineup condition: simultaneous interactive, simultaneous photo, or sequential video. In the front-encoding and profile-encoding conditions, Receiver Operating Characteristics analysis indicated that discriminability was higher in interactive compared to both photo and video lineups, demonstrating the benefit of actively exploring the lineup members' faces. Signal-detection modeling suggested interactive lineups increase discriminability because they afford the witness the opportunity to view more diagnostic features such that the nondiagnostic features play a proportionally lesser role. These findings suggest that eyewitness errors can be reduced using interactive lineups because they create retrieval conditions that enable witnesses to actively explore faces and more effectively sample features.


Assuntos
Rememoração Mental , Reconhecimento Psicológico , Humanos , Aplicação da Lei , Polícia , Culpa
8.
Proc Natl Acad Sci U S A ; 120(20): e2220580120, 2023 05 16.
Artigo em Inglês | MEDLINE | ID: mdl-37159477

RESUMO

About a decade ago, Super-Recognizers (SRs) were first described as individuals with exceptional face identity processing abilities. Since then, various tests have been developed or adapted to assess individuals' abilities and identify SRs. The extant literature suggests that SRs may be beneficial in police tasks requiring individual identification. However, in reality, the performance of SRs has never been examined using authentic forensic material. This not only limits the external validity of test procedures used to identify SRs, but also claims concerning their deployment in policing. Here, we report the first-ever investigation of SRs' ability to identify perpetrators using authentic case material. We report the data of 73 SRs and 45 control participants. These include (a) performance on three challenging tests of face identity processing recommended by Ramon (2021) for SR identification; (b) performance for perpetrator identification using four CCTV sequences depicting five perpetrators and police line-ups created for criminal investigation purposes. Our findings demonstrate that the face identity processing tests used here are valid in measuring such abilities and identifying SRs. Moreover, SRs excel at perpetrator identification relative to control participants, with more correct perpetrator identifications, the better their performance across lab tests. These results provide external validity for the recently proposed diagnostic framework and its tests used for SR identification (Ramon, 2021). This study provides the first empirical evidence that SRs identified using these measures can be beneficial for forensic perpetrator identification. We discuss theoretical and practical implications for law enforcement, whose procedures can be improved via a human-centric approach centered around individuals with superior abilities.


Assuntos
Reconhecimento Facial , Medicina Legal , Humanos , Aplicação da Lei , Polícia
9.
Proc Natl Acad Sci U S A ; 120(23): e2216162120, 2023 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-37253013

RESUMO

Across the United States, police chiefs, city officials, and community leaders alike have highlighted the need to de-escalate police encounters with the public. This concern about escalation extends from encounters involving use of force to routine car stops, where Black drivers are disproportionately pulled over. Yet, despite the calls for action, we know little about the trajectory of police stops or how escalation unfolds. In study 1, we use methods from computational linguistics to analyze police body-worn camera footage from 577 stops of Black drivers. We find that stops with escalated outcomes (those ending in arrest, handcuffing, or a search) diverge from stops without these outcomes in their earliest moments-even in the first 45 words spoken by the officer. In stops that result in escalation, officers are more likely to issue commands as their opening words to the driver and less likely to tell drivers the reason why they are being stopped. In study 2, we expose Black males to audio clips of the same stops and find differences in how escalated stops are perceived: Participants report more negative emotion, appraise officers more negatively, worry about force being used, and predict worse outcomes after hearing only the officer's initial words in escalated versus non-escalated stops. Our findings show that car stops that end in escalated outcomes sometimes begin in an escalated fashion, with adverse effects for Black male drivers and, in turn, police-community relations.


Assuntos
Negro ou Afro-Americano , Aplicação da Lei , Polícia , Humanos , Masculino , Aplicação da Lei/métodos , Estados Unidos , Racismo , Emoções
10.
Proc Natl Acad Sci U S A ; 120(41): e2312529120, 2023 10 10.
Artigo em Inglês | MEDLINE | ID: mdl-37782804

RESUMO

For nearly 25 y, the Committee on Science, Technology, and Law (CSTL), of the National Academies of Sciences, Engineering, and Medicine, has brought together distinguished members of the science and law communities to stimulate discussions that would lead to a better understanding of the role of science in legal decisions and government policies and to a better understanding of the legal and regulatory frameworks that govern the conduct of science. Under the leadership of recent CSTL co-chairs David Baltimore and David Tatel, and CSTL director Anne-Marie Mazza, the committee has overseen many interdisciplinary discussions and workshops, such as the international summits on human genome editing and the science of implicit bias, and has delivered advisory consensus reports focusing on topics of broad societal importance, such as dual use research in the life sciences, voting systems, and advances in neural science research using organoids and chimeras. One of the most influential CSTL activities concerns the use of forensic evidence by law enforcement and the courts, with emphasis on the scientific validity of forensic methods and the role of forensic testimony in bringing about justice. As coeditors of this Special Feature, CSTL alumni Tom Albright and Jennifer Mnookin have recruited articles at the intersection of science and law that reveal an emerging scientific revolution of forensic practice, which we hope will engage a broad community of scientists, legal scholars, and members of the public with interest in science-based legal policy and justice reform.


Assuntos
Disciplinas das Ciências Biológicas , Medicina Legal , Humanos , Aplicação da Lei , Políticas , Justiça Social , Ciências Forenses
11.
Proc Natl Acad Sci U S A ; 119(38): e2206567119, 2022 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-36099301

RESUMO

Much of forensic practice today involves human decisions about the origins of patterned sensory evidence, such as tool marks and fingerprints discovered at a crime scene. These decisions are made by trained observers who compare the evidential pattern to an exemplar pattern produced by the suspected source of the evidence. The decision consists of a determination as to whether the two patterns are similar enough to have come from the same source. Although forensic pattern comparison disciplines have for decades played a valued role in criminal investigation and prosecution, the extremely high personal and societal costs of failure-the conviction of innocent people-has elicited calls for caution and for the development of better practices. These calls have been heard by the scientific community involved in the study of human information processing, which has begun to offer much-needed perspectives on sensory measurement, discrimination, and classification in a forensic context. Here I draw from a well-established theoretical and empirical approach in sensory science to illustrate the vulnerabilities of contemporary pattern comparison disciplines and to suggest specific strategies for improvement.


Assuntos
Tomada de Decisões , Ciências Forenses , Crime , Humanos , Aplicação da Lei
12.
Proc Natl Acad Sci U S A ; 119(45): e2203089119, 2022 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-36322743

RESUMO

A large and growing share of the American public turns to Facebook for news. On this platform, reports about crime increasingly come directly from law enforcement agencies, raising questions about content curation. We gathered all posts from almost 14,000 Facebook pages maintained by US law enforcement agencies, focusing on reporting about crime and race. We found that Facebook users are exposed to posts that overrepresent Black suspects by 25 percentage points relative to local arrest rates. This overexposure occurs across crime types and geographic regions and increases with the proportion of both Republican voters and non-Black residents. Widespread exposure to overreporting risks reinforcing racial stereotypes about crime and exacerbating punitive preferences among the polity more generally.


Assuntos
Polícia , Mídias Sociais , Humanos , Estados Unidos , Aplicação da Lei , Crime
13.
Proc Natl Acad Sci U S A ; 119(17): e2117779119, 2022 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-35412863

RESUMO

It has been over 1 year since we observed the policing of the George Floyd protests in the United States [R. R. Hardeman, E. M. Medina, R. W. Boyd, N. Engl. J. Med. 383, 197-199 (2020)]. Multiple injury reports emerged in medical journals, and the scientific community called for law enforcement to discontinue the use of less-lethal weapons [E. A. Kaske et al., N. Engl. J. Med. 384, 774-775 (2021) and K. A. Olson et al., N. Engl. J. Med. 383, 1081-1083 (2020)]. Despite progress in research, policy change has not followed a similar pace. Although the reasoning for this discrepancy is multifactorial, failure to use appropriate language may be one contributing factor to the challenges faced in updating policies and practices. Here, we detail how language has the potential to influence thinking and decision-making, we discuss how the language of less-lethal weapons minimizes harm, and we provide a framework for naming conventions that acknowledges harm.


Assuntos
Idioma , Aplicação da Lei , Metáfora , Armas , Tomada de Decisões , Humanos , Polícia , Estados Unidos , Armas/classificação
14.
Proc Natl Acad Sci U S A ; 119(14): e2118780119, 2022 04 05.
Artigo em Inglês | MEDLINE | ID: mdl-35344441

RESUMO

SignificanceOur study is a randomized trial in policing confirming that intensive training in procedural justice (PJ) can lead to more procedurally just behavior and less disrespectful treatment of people at high-crime places. The fact that the PJ intervention reduced arrests by police officers, positively influenced residents' perceptions of police harassment and violence, and also reduced crime provides important guidance for police reform in a period of strong criticism of policing. This randomized trial points to the potential for PJ training not simply to encourage fair and respectful policing but also to improve evaluations of the police and crime prevention effectiveness.


Assuntos
Polícia , Justiça Social , Crime/prevenção & controle , Humanos , Aplicação da Lei , Violência/prevenção & controle
15.
J Gen Intern Med ; 39(11): 2051-2059, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38698296

RESUMO

BACKGROUND: Police and security presence in healthcare settings have grown. There are few studies exploring perceptions of these law enforcement agents among US Latine immigrants, who can be vulnerable to immigration enforcement actions due to past and ongoing criminalization and anti-immigrant policies. OBJECTIVE: To explore Latine immigrants' perceptions of law enforcement in healthcare settings. DESIGN: Exploratory, semi-structured qualitative interviews asked participants about their perspectives of law enforcement in healthcare settings. PARTICIPANTS: English- and Spanish-speaking adult patients (n = 19) from a Federally Qualified Health Center (FQHC) in Los Angeles, CA, serving predominantly low-income Latine immigrants. APPROACH: We used the framework method for analysis to establish a codebook and inform our thematic interpretation. KEY RESULTS: We identified three themes: (1) perceptions of safety offered by police officers are separated from the role of immigration officers; (2) perceptions of police officers are integrated into broader perceptions of the healthcare system; and (3) lived experiences, including immigration status, influenced valence response to officer uniforms and perceptions of officers. Most participants viewed police officers positively as maintaining order and safety, separating them from federal immigration enforcement actions, and reflecting on local, state, and organizational "sanctuary" or immigrant-friendly policies. Individuals with precarious immigration status more often saw officers as intimidating. Immigration enforcement remained a key concern. CONCLUSIONS: Differentiating police and security roles from immigration enforcement in healthcare could improve Latine immigrant trust and access. Future studies should explore perspectives of Latine immigrants in localities without sanctuary laws or organizational immigrant-friendly policies.


Assuntos
Emigrantes e Imigrantes , Aplicação da Lei , Humanos , Feminino , Aplicação da Lei/métodos , Masculino , Adulto , Emigrantes e Imigrantes/legislação & jurisprudência , Pessoa de Meia-Idade , Hispânico ou Latino/psicologia , Polícia , Pesquisa Qualitativa , Emigração e Imigração/legislação & jurisprudência , Los Angeles , Adulto Jovem , Idoso
16.
Milbank Q ; 102(1): 43-63, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38219273

RESUMO

Policy Points People with disabilities experience a vicious cycle of poverty, poor health, and marginalization partly because of the inequitable implementation and enforcement of laws, including underenforcement of civil rights and housing laws and overenforcement of punitive nuisance and criminal laws. Inequitable enforcement reflects policy choices that prioritize powerful entities (e.g., landlords, developers) to the detriment of people who experience intersectional structural discrimination based on, for example, race, disability, and income. Equitable enforcement, a process of ensuring compliance with the law while considering and minimizing harms to marginalized people, can promote health and disability justice by increasing access to safe, stable, and accessible housing.


Assuntos
Pessoas com Deficiência , Habitação , Humanos , Promoção da Saúde , Direitos Civis , Direito Penal , Aplicação da Lei
17.
Am J Public Health ; 114(6): 642-650, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38574318

RESUMO

Objectives. To examine sudden and unexpected or trauma-related deaths that occurred in the presence of law enforcement in Johnson County, Iowa, between 2011 and 2020. Methods. We identified deaths in the presence of law enforcement using definitions from the National Association of Medical Examiners. We obtained data, including demographics, cause and manner of death, toxicology results, and circumstances and location of event leading to death, from comprehensive medical examiner investigative reports. Results. There were 165 deaths that occurred in the presence of law enforcement: 114 were from a known disease, and 51 were either trauma related or the sudden, unexpected initial presentation of a previously unrecognized disease. Three deaths occurred in the context of physical restraint by law enforcement. Suicide was the leading manner of death among trauma-related deaths; the means of suicide was predictable based on in-custody (hanging) or precustody (firearm) circumstances. Conclusions. Our findings highlight the potential role of medical examiners and coroners in improving completeness of data on reporting death in the presence of law enforcement to public health agencies. (Am J Public Health. 2024;114(6):642-650. https://doi.org/10.2105/AJPH.2024.307616).


Assuntos
Causas de Morte , Aplicação da Lei , Humanos , Iowa/epidemiologia , Masculino , Adulto , Pessoa de Meia-Idade , Feminino , Idoso , Adolescente , Suicídio/estatística & dados numéricos , Adulto Jovem , Criança , Médicos Legistas , Pré-Escolar
18.
MMWR Morb Mortal Wkly Rep ; 73(5): 110-113, 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38329911

RESUMO

In 2021, an 8-mg intranasal naloxone product was approved by the Food and Drug Administration; however, no studies have examined outcomes among persons who receive the 8-mg naloxone product and those who receive the usual 4-mg product. During March 2022-August 2023, New York State Department of Health (NYSDOH) supplied some New York State Police (NYSP) troops with 8-mg intranasal naloxone; other troops continued to receive 4-mg intranasal naloxone to treat suspected opioid overdose. NYSP submitted detailed reports to NYSDOH when naloxone was administered. No significant differences were observed in survival, mean number of naloxone doses administered, prevalence of most postnaloxone signs and symptoms, postnaloxone anger or combativeness, or hospital transport refusal among 4-mg and 8-mg intranasal naloxone recipients; however, persons who received the 8-mg intranasal naloxone product had 2.51 times the risk for opioid withdrawal signs and symptoms, including vomiting, than did those who received the 4-mg intranasal naloxone product (95% CI = 1.51-4.18). This initial study suggests no benefits to law enforcement administration of higher-dose naloxone were identified; more research is needed to guide public health agencies in considering whether 8-mg intranasal naloxone confers additional benefits for community organizations.


Assuntos
Overdose de Drogas , Overdose de Opiáceos , Humanos , Analgésicos Opioides/uso terapêutico , Overdose de Drogas/tratamento farmacológico , Overdose de Drogas/epidemiologia , Aplicação da Lei , Naloxona/uso terapêutico , Antagonistas de Entorpecentes/uso terapêutico , New York/epidemiologia
19.
Br J Clin Pharmacol ; 90(4): 987-995, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38072974

RESUMO

AIMS: We explored trends in gabapentinoid prescribing, drug seizures and postmortem toxicology using a national pharmacy claims database, law enforcement drug seizures data and a population-based postmortem toxicology database. METHODS: Gabapentinoid prescribing rates per 100 000 eligible population (2010-2020), annual number of drug seizures involving gabapentinoids (2012-2020) and gabapentinoid detection (positive) rates per 100 postmortem toxicology case (2013-2020) were calculated. Negative binomial regression models were used to evaluate longitudinal trends for gabapentin and pregabalin separately. RESULTS: Gabapentin (adjusted rate ratio [RR] 1.06, 95% confidence interval [CI] 1.05-1.06, P < .001) and pregabalin (adjusted RR 1.08, 95% CI 1.08-1.09, P < .001) prescribing increased annually, with higher rates of pregabalin (vs. gabapentin) observed every year. Drug seizures involving pregabalin also increased over time (RR 1.54 95% CI 1.25-1.90, P < .0001). Of the 26 317 postmortem toxicology cases, 0.92% tested positive for gabapentin, and 6.37% for pregabalin. Detection rates increased for both gabapentin (RR 1.28, 95% CI 1.11-1.48, P < .001) and pregabalin (RR 1.13, 95% CI 1.11-1.48, P < .001) between 2013 and 2020. A total of 1901 cases (7.2%) tested positive for heroin/methadone; this sub-group had a higher detection rate for pregabalin (n = 528, 27.8%) and gabapentin (n = 41, 2.2%) over the study period, with a high burden of codetections for pregabalin with benzodiazepines (peaking at 37.3% in 2018), and pregabalin with prescription opioids (peaking at 28.9% in 2020). CONCLUSION: This study raises concerns regarding the wide availability of pregabalin in Ireland, including a growing illicit supply, and the potential for serious harm arising from poly drug use involving pregabalin among people who use heroin or methadone.


Assuntos
Heroína , Aplicação da Lei , Humanos , Gabapentina/efeitos adversos , Pregabalina/efeitos adversos , Irlanda/epidemiologia , Convulsões/induzido quimicamente , Convulsões/tratamento farmacológico , Convulsões/epidemiologia , Metadona
20.
Prev Med ; 185: 108058, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38969022

RESUMO

OBJECTIVE: Following changes to drug criminalization policies, we re-examine the epidemiology of drug arrests among people who use drugs (PWUD) in the U.S. METHODS: Serial cross-sectional data from the National Survey on Drug Use and Health (2015-2019) were utilized. Past-year illicit drug use (excluding cannabis) and drug arrests were described by year, area of residence, drug use characteristics and participant demographics. Adjusted associations between race and drug arrest were estimated using multivariable logistic regression. RESULTS: Past-year illicit drug use remained consistent over time and was highest among non-Hispanic (NH) white respondents. Of those reporting past-year illicit drug use (n = 25,429), prevalence of drug arrests remained stable over time overall and in metro areas while increasing in non-metro areas. Arrests were elevated among NH Black participants and those with lower income, unemployment, housing transience, non-metro area residence, polysubstance use, history of drug injection, substance use dependence and past-year drug selling. Adjusted odds of drug arrest remained significantly higher among NH Black individuals [aOR 1.92, 95% CI 1.30, 2.84]. CONCLUSION: Despite recent shifts away from punitive drug policies, we detected no reduction in drug arrests nationally and increasing prevalence in non-metro areas. Despite reporting the lowest level of illicit substance use and drug selling, NH Black individuals had significantly increased odds of arrest across years. Findings highlight the need for further examination of policy implementation and policing practices in different settings, with more research focused non-metro areas, to address enduring structural racism in drug enforcement and its consequences for health.


Assuntos
Transtornos Relacionados ao Uso de Substâncias , Humanos , Estados Unidos/epidemiologia , Masculino , Feminino , Estudos Transversais , Adulto , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Pessoa de Meia-Idade , Prevalência , Drogas Ilícitas , Adolescente , Adulto Jovem , Inquéritos Epidemiológicos , Aplicação da Lei , Usuários de Drogas/estatística & dados numéricos
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