There goes the neighborhood? The public safety enhancing effects of a mobile harm reduction intervention.

BACKGROUND: Buprenorphine is a gold-standard treatment for opioid use disorders, but most people with these disorders do not access it. Barriers to treatment access may be diminished by low-threshold mobile treatment programs but concern regarding their impact on local public safety challenges their adoption. METHODS: This quasi-experimental study uses difference-in-differences analyses to measure the impact of four mobile buprenorphine clinics in Pittsburgh on neighborhood arrest rates. The study period spans 2018 to 2022, with a pre-intervention period of 11 to 12 quarters and a post-intervention period of 7 to 8 quarters (dependent on neighborhood). A treatment group of 84 census block groups in the areas surrounding clinics during the time period after their establishment were compared to a control group of city census blocks not within one mile of a clinic plus treated block groups in the two years prior to clinic establishment. Outcome variables include drug, non-drug, and total arrests, measured quarterly per 100 in population. RESULTS: Compared to block groups further than 1 mile from a clinic, arrests fell by 34.13 % (b = -0.358, 95 % CI = -0.557, -0.158), drug arrests by 33.85 % (b = -0.087, 95 % CI = -0.151, -0.023), and non-drug related arrests by 22.29 % (b = -0.179, 95 % CI = -0.302, -0.057). Drug arrests declined significantly on days when the clinics were not present (b = -0.015, 95 % CI = -0.025, -0.006), with no significant change on clinic operational days (b = -0.002, 95 % CI = -0.016, -0.013). Total arrests declined significantly on days when clinics were and were not present (b = -0.045, 95 % CI = -0.078, -0.012; and b = -0.052, CI = -0.082, -0.023, respectively). CONCLUSIONS: Mobile clinics providing medication for opioid use disorders were associated with reduced neighborhood arrest rates. Expansion of mobile services could promote health equity and public safety.

Overdose deaths before and during the COVID-19 pandemic in a US county.

Introduction: Globally, overdose deaths increased near the beginning of the COVID-19 pandemic, which created availability and access barriers to addiction and social services. Especially in times of a crisis like a pandemic, local exposures, service availability and access, and system responses have major influence on people who use drugs. For policy makers to be effective, an understanding at the local level is needed. Methods: This retrospective epidemiologic study from 2019 through 2021 compares immediate and 20-months changes in overdose deaths from the pandemic start to 16 months before its arrival in Pinellas County, FL We examine toxicologic death records of 1,701 overdoses to identify relations with interdiction, and service delivery. Results: There was an immediate 49% increase (95% CI 23-82%, p < 0.0001) in overdose deaths in the first month following the first COVID deaths. Immediate increases were found for deaths involving alcohol (171%), heroin (108%), fentanyl (78%), amphetamines (55%), and cocaine (45%). Overdose deaths remained 27% higher (CI 4-55%, p = 0.015) than before the pandemic through 2021.Abrupt service reductions occurred when the pandemic began: in-clinic methadone treatment dropped by two-thirds, counseling by 38%, opioid seizures by 29%, and drug arrests by 56%. Emergency transport for overdose and naloxone distributions increased at the pandemic onset (12%, 93%, respectively) and remained higher through 2021 (15%, 377%,). Regression results indicate that lower drug seizures predicted higher overdoses, and increased 911 transports predicted higher overdoses. The proportion of excess overdose deaths to excess non-COVID deaths after the pandemic relative to the year before was 0.28 in Pinellas County, larger than 75% of other US counties. Conclusions: Service and interdiction interruptions likely contributed to overdose death increases during the pandemic. Relaxing restrictions on medical treatment for opioid addiction and public health interventions could have immediate and long-lasting effects when a major disruption, such as a pandemic, occurs. County level data dashboards comprised of overdose toxicology, and interdiction and service data, can help explain changes in overdose deaths. As a next step in predicting which policies and practices will best reduce local overdoses, we propose using simulation modeling with agent-based models to examine complex interacting systems.

Effects of Maternal Work Incentives on Teen Drug Arrests.

PURPOSE: This study exploits differences in the implementation of welfare reform across states and over time in the United States in the attempt to identify causal effects of welfare reform on youth arrests for drug-related crimes between 1990 and 2005, the period during which welfare reform unfolded. METHODOLOGY: Using monthly arrest data from the U.S. Federal Bureau of Investigation's Uniform Crime Reports, we estimate the effects of welfare reform implementation on drug-related arrests among 15-17 year olds in the United States between 1990 and 2005. We use a difference-in-differences (DD) approach that exploits the implementation of welfare reform across states and over time to estimate effects for teens exposed to welfare reform. FINDINGS: The findings, based on numerous different model specifications, suggest that welfare reform had no statistically significant effect on teen drug arrests. Most estimates were positive and suggestive of a small (3%) increase in arrests. ORIGINALITY/VALUE: This study investigated the effects of a broad-based policy change that altered maternal employment, family income, and other family characteristics on youth drug arrests.

Illegal drugs in Grenada: arrests and drug treatment from 2001-2009 / Drogas ilegales en Granada: arrestos por frogas y tratamiento de la drogadicción de 2001-2009

OBJECTIVE: Illegal drug use and abuse has increased in the Caribbean since the 1990s. In Grenada, statistical indicators such as admission rates to treatment facilities and drug arrests have provided evidence for the increased rates of illegal drug use and abuse. This study reviewed these statistical indicators and explored drug treatment options in Grenada from 2001 to 2009. METHODS: A search of statistical records from the Drug Control Secretariat and the Grenada Drug Information Network/National Observatory on Drugs (GRENDIN/NOD) was performed. Literature review of relevant articles from search engines was used to support findings. Additionally, semistructured interviews of key stakeholders from government and health agencies involved in drug prevention in Grenada were conducted to obtain information on recent developments surrounding drug arrests and treatments in Grenada. RESULTS: From 2001 to 2009, there were a 118% and a 23% increase in the arrest rate for males and females, respectively. There was also an increase in demand for drug treatment at the sole drug treatment facility. CONCLUSION: Preventive measures in schools and several forms of media programmes have raised awareness. However, drug use/abuse/activities still persist at a significant rate. Programmes that target improvement oftreatment facilities and increased inter-agency collaboration may be successful in enhancing drug arrests and treatments.

OBJETIVO: El uso y abuso de drogas ilegales ha aumentado en el Caribe desde la década de 1990. En Granada, los indicadores estadísticos tales como las tasas de ingreso a los centros de tratamiento de la drogadicción y los arrestos por drogas, han proporcionado evidencia del aumento de las tasas del uso y abuso de drogas ilegales. Este estudio examinó estos indicadores estadísticos, y exploró las opciones de tratamiento en Granada desde 2001 hasta 2009. MÉTODOS: Se realizó una búsqueda de registros estadísticos de la Secretaría de Control de Drogas, y la Red de Información de Drogas/Observatorio Nacional de Drogas de Granada (GRENDIN/NOD). Se utilizó una revisión de la literatura de los artículos pertinentes mediante los sistemas de búsqueda en internet para fundamentar los resultados. Además, se llevaron a cabo entrevistas semiestructuradas de grupos claves de interés (stakeholders) del gobierno y las agencias de salud involucradas en la prevención de drogas en Granada, a fin de obtener información sobre los últimos acontecimientos en relación con los tratamientos de drogadicción y arrestos por drogas en Granada. RESULTADOS: De 2001 a 2009, se produjeron aumentos de 118% y 23% en la tasa de arrestos de hombres y mujeres, respectivamente. También hubo un aumento en la demanda de tratamiento por drogas en el único centro de tratamiento de la drogadicción. CONCLUSIÓN: Las medidas preventivas en las escuelas y varias formas de los programas de los medios masivos de comunicación han traído consigo una toma de conciencia. Sin embargo, el uso, abuso, y las actividades en relación con las drogas todavía persisten en una tasa significativa. Los programas dirigidos a la mejora de los centros para el tratamiento de la drogadicción y una mayor colaboración interinstitucional pueden contribuir a mejorar con éxito el problema de los arrestos por drogas y los tratamientos de drogadicción.