Drug policy and the public good: Evidence for effective interventions

King's College London, National Addiction Centre, London, UK.
The Lancet (Impact Factor: 45.22). 01/2012; 379(9810):71-83. DOI: 10.1016/S0140-6736(11)61674-7
Source: PubMed

ABSTRACT Debates about which policy initiatives can prevent or reduce the damage that illicit drugs cause to the public good are rarely informed by scientific evidence. Fortunately, evidence-based interventions are increasingly being identified that are capable of making drugs less available, reducing violence in drug markets, lessening misuse of legal pharmaceuticals, preventing drug use initiation in young people, and reducing drug use and its consequences in established drug users. We review relevant evidence and outline the likely effects of fuller implementation of existing interventions. The reasoning behind the final decisions for action might be of a non-scientific nature, focused more on what the public and policy-makers deem of value. Nevertheless, important opportunities exist for science to inform these deliberations and guide the selection of policies that maximise the public good.

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Available from: John Strang, Jan 20, 2014
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    • "The abuse of psychoactive substances is associated with many adverse consequences to health (Chipman et al., 2009; Degenhardt and Hall, 2012; Schuckjt, 2009) and consequently to safety at work, such as violence, accidents (Li and Bai, 2008), injuries (Trent, 1991) and absenteeism. An increasing number of countries and companies are coping with this risk (Strang et al., 2012) by the application of means of control, also in the scope of Occupational Safety and Health (OSH), such as screening for psychoactive substances in employees. "
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    ABSTRACT: Programmes for testing Alcohol and Drugs (A&D) at the workplace, at random and by surprise, are believed to have a positive impact on safety and to reduce individual’s accident risk. Despite this perception, there is limited scientific evidence and poor statistical support of this assumption. This study aims at testing whether there is such a cause-effect relationship between A&D testing and post-accident reduction, and how to quantify it. The methodology applied data-mining techniques together with classical statistics hypothesis testing. It covers a wide range of data concerning accidents, alcohol and drug tests, biographical and occupational records of a large railway transportation company in Portugal, for a period of 5½ years. Results give sound statistical evidence of individual’s accident risk decrease after being tested, by quantifying the relations between A&D testing and post-testing accidents. Results also estimate the optimal testing frequency that balances testing costs and accident reduction. Optimum rates of tests per year per worker are in the ranges ]0.5–1.0] in white-collars and professions at large, and ]0.0–0.5] in operations/technical personnel. The fraction of accident victims that are prevented by the application of optimal frequencies are around 59% for workers onboard trains, 72% for those working near trains, and 85% for white-collars. Testing at the optimal frequency generates net savings of at least 15:1, in onboard personnel. In conclusion, testing for alcohol and drugs at workplace, at random and by surprise, has a statistically significant preventive effect in overall professions, but is stronger within white-collars.
    Safety Science 10/2014; 68(Oct 2014):108–120. DOI:10.1016/j.ssci.2014.03.007 · 1.67 Impact Factor
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    • "UCs can be distinguished as those that arise from CN policy and those resulting from implementation of CN programmes (Reuter 2009). Table 1 below provides a brief summary of some of the unintended consequences of intervention design and implementation (i.e., Strang et al 2012, Reuter 2009, Vargas 2002, Paoli 2002, Malinowska-Sempruch et al 2003). Studies evaluating the outcomes of supply reduction interventions extensively document the intervention outcomes from political-economic and political-ecological perspectives, overlooking the socio-psychological drivers of individual behavioural responses to the interventions in question (i.e., Reuter 2009, Vargas 2002). "
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    • "As such, it is reasonable to question whether low SES in an antecedent to negative changes in family structure and quality or affiliation with substance-using peers. The current literature on the relationship between SES and adolescent cannabis use is mixed (Hall & Pacula, 2003; Spooner, 2009; Strang et al., 2012; Tu et al., 2008). Hanson and Chen (2007) recently reviewed 25 studies examining the relationship between SES and adolescent cannabis use. "
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