Farmacêutico como membro de equipes multiprofissionais tem impacto positivo na segurança da utilização do medicamento e na promoção do uso racional. Sua inclusão na equipe da atenção primária para assegurar Assistência Farmacêutica (AF) de qualidade é responsabilidade dos gestores municipais. Em Cássia dos Coqueiros ? SP, com 3000 habitantes, diagnóstico prévio indicou que 25% dos recursos da saúde eram destinados aos medicamentos, sugerindo uso irracional e inapropriado. Este estudo com intervenção teve como objetivo a aplicação de conceitos, princípios, regulamentações e práticas farmacêuticas para a utilização racional de medicamentos e organização de AF de qualidade no município, através da contratação de farmacêutico com habilidades clínicas. Compararam-se características da AF sem e com farmacêutico, empregando-se indicadores de estrutura, processo e resultados descritos na literatura. As intervenções para a organização da gestão da AF foram (i) de natureza gerencial e operacional, seguindo a legislação vigente e com desenho logístico para atender o paciente como alvo prioritário das ações da Farmácia em conjunto com profissionais de saúde, e (ii) de natureza clínica visando dispensação de qualidade, atenção farmacêutica, trabalho de colaboração com médico, orientação de acadêmicos e membros da equipe de saúde sobre prescrição e uso racionais de medicamentos. Indicadores de estrutura e processo mostraram aprimoramento da AF e os indicadores de resultados definiram as metas alcançadas com as práticas. Verificou-se redução de gastos com medicamentos da ordem de 66%. Um total de 3.976 pacientes distintos foi atendido de 2002 a 2005, e a 63,25% foi prescrito ou dispensado medicamento em um único ano, enquanto 5,44% tiveram dados de utilização de medicamento nos quatro anos. Na ausência de farmacêutico, ocorria acesso total e irrestrito aos medicamentos prescritos nas Unidades de Saúde. O processo de prescrição e dispensação e conseqüente uso pelo paciente tornaram-se mais racionais devido à presença do farmacêutico (desde fevereiro de 2004) e médico contratado (desde maio de 2004), à lista padronizada e outros requisitos de racionalização. A variedade média do biênio 2004-2005, com farmacêutico, de medicamentos, de especialidades expressa em nome genérico e de número de grupos farmacológicos ou similares (códigos ATC) reduziram 71,68%, 63,4 % e 62,17% respectivamente. Ao longo dos anos verificou-se redução de 41,8% a 53,8% do total de especialidades farmacêuticas utilizadas e de 47,1 a 48,4% do número de códigos ATC para corte em 95%. Os 50 itens mais prescritos sem farmacêutico perfizeram uma média de 35,7% do total, enquanto que os 10 itens mais freqüentes representavam somente 14,83. Com farmacêutico os 10 itens perfizeram uma média de 49,08% do total. A variação de medicamentos pertencentes à lista padronizada foi de 58,2 % sem e 89,6% com farmacêutico, concluindo-se que o profissional do medicamento pode, dentro de suas atividades clínicas, atuando em conjunto com o prescritor, promover a utilização racional de medicamentos e que as estratégias podem ser aplicadas a outros municípios. / Pharmacists as a multi-professional team member have positive impact on medication safety and on promotion of the rational drug use. Their inclusion in primary care team to assure quality of Pharmaceutical Assistance (PA) in Brazil is a municipal managers\' responsibility. In Cassia dos Coqueiros- SP, with 3000 inhabitants, previous diagnosis indicated that 25% of healthcare expenditures were related to medicines, suggesting irrational and inappropriate drug utilization. The aim of this interventional study was to apply concepts, principles, and regulations of pharmaceutical practices to improve rational use of medicines and establishing a high-quality PA in the district, through recruiting a pharmacist with clinical abilities. PA characteristics were compared prior and after the pharmacist interventions, using structure, process and outcome quality indicators as described in the literature. The interventions for PA management organization were (a) of administrative and operational nature, according to legal and logical principles to assist the patient as the primary target of Pharmacy actions together with other health care providers; and (b) of clinical nature, aiming qualified dispensing, pharmaceutical care, collaboration team drug management, and students and healthcare team members supervision on prescription and use of medicines. Structure and process indicators showed improved PA and outcome indicators defined the purpose achieved with pharmaceutical practices. Reduction of 66% in medication expenses was verified. A total of 3,976 different patients were assisted from 2002 to 2005, and to 63.25% of them, it was prescribed or dispensed medicine in a single year, while 5.44% had been given medications for four years round. Prior to pharmacist recruitment, total and unrestricted access to medicines prescribed at healthcare settings was observed. More rational prescribing and dispensing process and consequent use of medicines were attained due to pharmacist?s practice, after taking into service in February, 2004, to the hired physician since June 2004, to the essential medicine list, and to other rationalizing requirements. During the biennium 2004- 2005, with pharmacist, the average variety of drugs, pharmaceutical specialties product and number of pharmacological groups or similar (ATC codes) reduced 71.68%, 63.4% and 62.17%, respectively. Along the studied years, reduction of 41.8% to 53.8% of total pharmaceutical specialty product number was verified and from 47,1 to 48,4% of the number of ATC codes for a 95% cut off. Without the pharmacist, the 50 more prescribed items has reached an average of 35.7% of the total, while the 10 most frequent items has only represented 14.83%. With pharmacist, the top 10 utilized items yielded an average of 49.08% of the total. The variation of medicines in agreement with the essential medicines list was of 58.2% without and of 89.6% with pharmacist. Thus, pharmacist when performing clinical pharmacy practice, together with prescribers, can promote rational use of medicines. These strategies may be applied to other municipal districts.

The drug issue has a massive impact on almost every society nowadays. It has deep influences in people\'s quotidian and an almost ubiquitous growth in consumption. This study aims at assessing whether the textitde facto legal sale of cannabis influences real estate prices. Evaluating how these prices change gives us some notion of the externalities involved in those sales and how people regard it. We organized a panel with georeferenced data from Air Bnb lodgings offered in Amsterdam, from May 2014 until July 2017. During this period, several coffeeshops were closed due to new legislation. We estimate that losing the closest coffeeshop, when it is within a 250m radius from the lodging, decreases the renting price, on average, on 3%, and when it is farther has no significant impact. / A questão das drogas hoje em dia possui impacto massivo em praticamente todas as sociedades. Ela possui influências profundas no cotidiano das pessoas e um ubíquo crescimento no consumo. Esse estudo visa investigar se a venda legal de maconha influencia preços de imóveis. Avaliando como esses preços mudam nos dá uma noção tanto das externalidades envolvidas no processo de venda, quanto de como as pessoas se sentem com relação a elas. Organizamos um painel com dados georeferenciados de apartamentos do Air Bnb ofertados em Amsterdam, de Maio de 2014 à Julho de 2017. Durante esse período, diversos coffeeshops foram fechados devido a nova legislação local. Nós estimamos que este fechamento, quando ocorrido a menos de 250m de um apartamento, diminui o preço do aluguel, em média, em quase 3%, e não possui influências significantes para maiores distâncias.

The growth of the drug war and rates of narco-violence in Mexico has captured the attention of the international community, leading to international debates about the validity and effectiveness of the War on Drugs mantra. Since 2006, the Mexican government has been actively combating the cartels with armed troops, leading to high rates of human rights abuses as well as growing opposition to official prohibition policies. This thesis explores three movements advocating for alternatives to the Mexican drug war that have their foundation in civil society organizations: the movements for human rights protection, for drug policy liberalization and for the protection and restitution of victims of the drug war. These movements are analysed through a theoretical framework drawing on critical political economy theory, civil society and social movement theory, and political opportunity structures. This thesis concludes that, when aligned favourably, the interplay of agency and political opportunities converge to create openings for shifting dominant norms and policies. While hegemonic structures continue to limit agency potential, strong civil society advocacy strategies complemented by strong linkages with transnational civil society networks have the potential to achieve transformative changes in the War on Drugs in Mexico.

The drug issue has a massive impact on almost every society nowadays. It has deep influences in people\'s quotidian and an almost ubiquitous growth in consumption. This study aims at assessing whether the textitde facto legal sale of cannabis influences real estate prices. Evaluating how these prices change gives us some notion of the externalities involved in those sales and how people regard it. We organized a panel with georeferenced data from Air Bnb lodgings offered in Amsterdam, from May 2014 until July 2017. During this period, several coffeeshops were closed due to new legislation. We estimate that losing the closest coffeeshop, when it is within a 250m radius from the lodging, decreases the renting price, on average, on 3%, and when it is farther has no significant impact. / A questão das drogas hoje em dia possui impacto massivo em praticamente todas as sociedades. Ela possui influências profundas no cotidiano das pessoas e um ubíquo crescimento no consumo. Esse estudo visa investigar se a venda legal de maconha influencia preços de imóveis. Avaliando como esses preços mudam nos dá uma noção tanto das externalidades envolvidas no processo de venda, quanto de como as pessoas se sentem com relação a elas. Organizamos um painel com dados georeferenciados de apartamentos do Air Bnb ofertados em Amsterdam, de Maio de 2014 à Julho de 2017. Durante esse período, diversos coffeeshops foram fechados devido a nova legislação local. Nós estimamos que este fechamento, quando ocorrido a menos de 250m de um apartamento, diminui o preço do aluguel, em média, em quase 3%, e não possui influências significantes para maiores distâncias.

Farmacêutico como membro de equipes multiprofissionais tem impacto positivo na segurança da utilização do medicamento e na promoção do uso racional. Sua inclusão na equipe da atenção primária para assegurar Assistência Farmacêutica (AF) de qualidade é responsabilidade dos gestores municipais. Em Cássia dos Coqueiros ? SP, com 3000 habitantes, diagnóstico prévio indicou que 25% dos recursos da saúde eram destinados aos medicamentos, sugerindo uso irracional e inapropriado. Este estudo com intervenção teve como objetivo a aplicação de conceitos, princípios, regulamentações e práticas farmacêuticas para a utilização racional de medicamentos e organização de AF de qualidade no município, através da contratação de farmacêutico com habilidades clínicas. Compararam-se características da AF sem e com farmacêutico, empregando-se indicadores de estrutura, processo e resultados descritos na literatura. As intervenções para a organização da gestão da AF foram (i) de natureza gerencial e operacional, seguindo a legislação vigente e com desenho logístico para atender o paciente como alvo prioritário das ações da Farmácia em conjunto com profissionais de saúde, e (ii) de natureza clínica visando dispensação de qualidade, atenção farmacêutica, trabalho de colaboração com médico, orientação de acadêmicos e membros da equipe de saúde sobre prescrição e uso racionais de medicamentos. Indicadores de estrutura e processo mostraram aprimoramento da AF e os indicadores de resultados definiram as metas alcançadas com as práticas. Verificou-se redução de gastos com medicamentos da ordem de 66%. Um total de 3.976 pacientes distintos foi atendido de 2002 a 2005, e a 63,25% foi prescrito ou dispensado medicamento em um único ano, enquanto 5,44% tiveram dados de utilização de medicamento nos quatro anos. Na ausência de farmacêutico, ocorria acesso total e irrestrito aos medicamentos prescritos nas Unidades de Saúde. O processo de prescrição e dispensação e conseqüente uso pelo paciente tornaram-se mais racionais devido à presença do farmacêutico (desde fevereiro de 2004) e médico contratado (desde maio de 2004), à lista padronizada e outros requisitos de racionalização. A variedade média do biênio 2004-2005, com farmacêutico, de medicamentos, de especialidades expressa em nome genérico e de número de grupos farmacológicos ou similares (códigos ATC) reduziram 71,68%, 63,4 % e 62,17% respectivamente. Ao longo dos anos verificou-se redução de 41,8% a 53,8% do total de especialidades farmacêuticas utilizadas e de 47,1 a 48,4% do número de códigos ATC para corte em 95%. Os 50 itens mais prescritos sem farmacêutico perfizeram uma média de 35,7% do total, enquanto que os 10 itens mais freqüentes representavam somente 14,83. Com farmacêutico os 10 itens perfizeram uma média de 49,08% do total. A variação de medicamentos pertencentes à lista padronizada foi de 58,2 % sem e 89,6% com farmacêutico, concluindo-se que o profissional do medicamento pode, dentro de suas atividades clínicas, atuando em conjunto com o prescritor, promover a utilização racional de medicamentos e que as estratégias podem ser aplicadas a outros municípios. / Pharmacists as a multi-professional team member have positive impact on medication safety and on promotion of the rational drug use. Their inclusion in primary care team to assure quality of Pharmaceutical Assistance (PA) in Brazil is a municipal managers\' responsibility. In Cassia dos Coqueiros- SP, with 3000 inhabitants, previous diagnosis indicated that 25% of healthcare expenditures were related to medicines, suggesting irrational and inappropriate drug utilization. The aim of this interventional study was to apply concepts, principles, and regulations of pharmaceutical practices to improve rational use of medicines and establishing a high-quality PA in the district, through recruiting a pharmacist with clinical abilities. PA characteristics were compared prior and after the pharmacist interventions, using structure, process and outcome quality indicators as described in the literature. The interventions for PA management organization were (a) of administrative and operational nature, according to legal and logical principles to assist the patient as the primary target of Pharmacy actions together with other health care providers; and (b) of clinical nature, aiming qualified dispensing, pharmaceutical care, collaboration team drug management, and students and healthcare team members supervision on prescription and use of medicines. Structure and process indicators showed improved PA and outcome indicators defined the purpose achieved with pharmaceutical practices. Reduction of 66% in medication expenses was verified. A total of 3,976 different patients were assisted from 2002 to 2005, and to 63.25% of them, it was prescribed or dispensed medicine in a single year, while 5.44% had been given medications for four years round. Prior to pharmacist recruitment, total and unrestricted access to medicines prescribed at healthcare settings was observed. More rational prescribing and dispensing process and consequent use of medicines were attained due to pharmacist?s practice, after taking into service in February, 2004, to the hired physician since June 2004, to the essential medicine list, and to other rationalizing requirements. During the biennium 2004- 2005, with pharmacist, the average variety of drugs, pharmaceutical specialties product and number of pharmacological groups or similar (ATC codes) reduced 71.68%, 63.4% and 62.17%, respectively. Along the studied years, reduction of 41.8% to 53.8% of total pharmaceutical specialty product number was verified and from 47,1 to 48,4% of the number of ATC codes for a 95% cut off. Without the pharmacist, the 50 more prescribed items has reached an average of 35.7% of the total, while the 10 most frequent items has only represented 14.83%. With pharmacist, the top 10 utilized items yielded an average of 49.08% of the total. The variation of medicines in agreement with the essential medicines list was of 58.2% without and of 89.6% with pharmacist. Thus, pharmacist when performing clinical pharmacy practice, together with prescribers, can promote rational use of medicines. These strategies may be applied to other municipal districts.

The growth of the drug war and rates of narco-violence in Mexico has captured the attention of the international community, leading to international debates about the validity and effectiveness of the War on Drugs mantra. Since 2006, the Mexican government has been actively combating the cartels with armed troops, leading to high rates of human rights abuses as well as growing opposition to official prohibition policies. This thesis explores three movements advocating for alternatives to the Mexican drug war that have their foundation in civil society organizations: the movements for human rights protection, for drug policy liberalization and for the protection and restitution of victims of the drug war. These movements are analysed through a theoretical framework drawing on critical political economy theory, civil society and social movement theory, and political opportunity structures. This thesis concludes that, when aligned favourably, the interplay of agency and political opportunities converge to create openings for shifting dominant norms and policies. While hegemonic structures continue to limit agency potential, strong civil society advocacy strategies complemented by strong linkages with transnational civil society networks have the potential to achieve transformative changes in the War on Drugs in Mexico.

Voilà une vingtaine d’années que le concept d’addiction a été élaboré par quelques psychiatres et chercheurs en neurosciences afin de rendre compte, à travers un nouveau regard, des phénomènes de dépendance (en associant drogues illicites, alcool et tabac). Il a ensuite été utilisé pour la première fois en 1999 dans une politique publique en France, à savoir le plan triennal de la Mission Interministérielle de Lutte contre la Drogue et la Toxicomanie (MILDT).Le processus de construction du problème public des addictions constitue ainsi l’objet de cette thèse. Dans quelles mesures la reconfiguration de certains espaces des champs médical et politico-administratif a partie liée à l’institutionnalisation du paradigme addictologique et comment celui-ci a contribué à transformer les drug policies contemporaines ? Le problème public des addictions doit son émergence au succès politique d’un petit groupe d’acteurs qui a su transposer un concept médical dans le langage de l’action publique. Dans le prolongement des politiques de réduction des risques, les addictions bousculent le mode de régulation des usages de drogues, en favorisant leur sanitarisation plutôt que leur pénalisation. Par le biais d’une sociologie historique et politique de l’action publique, cette thèse retrace ainsi la genèse de l’addictologie et des drug policies françaises jusqu’au plan triennal de la MILDT de 1999. / It has been about twenty years that the addiction concept has been elaborated by some psychiatrists and neuroscientists in order to define dependence phenomena in a new way (by associating illicit drugs with alcohol and tobacco). Then it has been used for the first time in 1999 in a public policy in France, i.e. the three-year plan of the Mission Interministérielle de Lutte contre la Drogue et la Toxicomanie (MILDT).The construction process of the “addiction” public problem constitutes this thesis subject. In which way the reconfiguration of some spaces of the medical and political fields is connected to the institutionalization of the addictological paradigm and how this one has led to transform contemporary drug policies? The “addiction” public problem emerged thanks to the political success of a small group of actors who transposed a medical concept into the language of public policy. In the continuation of harm reduction policies, addictions reshape the regulation model of drug use by promoting their sanitarization rather than their criminalization. Through a political and historical sociology of public policy, this thesis thus traces the genesis of French addictology and drug policies until the MILDT’s three-year plan of 1999.

Mexico and the United States share not only an approximately 3000 km border but also important roles concerning drug traffic. With the U.S. as the major consumer and Mexico as its principal supplier, they make the perfect supply and demand equation. As a result, they share the threats related to drug traffic which affects the political, social, and economic level of both countries. During the last decade, the Mexican drug cartels have gained control of the drug entering the United States, so Mexico is a crucial issue in drug matters to their American neighbors. Currently, both nations accepted a shared responsibility in drug traffic cases and are working hand in hand to limit the capabilities of DTOs, but there remains the open question if such efforts are significantly useful. This thesis presents an analysis of the U.S. influence on the escalation of the fight against illicit drugs in Mexico during Bush and Obama administrations and the effectiveness of the counter-drug assistance program: the Merida Initiative. I argue that the Merida Initiative has been successful improving the U.S.-Mexican relations regarding bilateral counter-drug policies. However, the Mexican drug cartels have reached their momentum and seem to be leading the drug market. Besides, it is necessary to pursue a critical...

The European Union has created a common plan regarding narcotics use and abuse within the European member states. The aim here is to reduce the supply and demand for drugs among the citizens of the Union. However, the opinions on how to achieve these goals greatly differ among member states. The range of attitudes varies from the strictly restrictive attitudes of countries such as Sweden, to the complete decriminalization of personal possession of all narcotic substances in Portugal. The purpose of this paper is therefore to study the underlying attitudes and approaches that these two countries have, and hopefully to give some light to how come there is this big difference in legal frameworks regarding a rather delicate political question. A review and analyze of the current proposition for each country regarding drug policies is the method for the paper. By interpreting the content and quoting parts of these two propositions an ideology analysis is made. The theory chapter consists of the two different philosophies of Rousseau’s theory on the social contract and the general will, as well as objectivism. These theories are used in order to make a distinction in the empirical research between attitudes towards the states’ as well as the individuals’ role in the drug policies of Sweden and Portugal. A model with the most important features of these theories is constructed and works as a base for the analysis. Overall, the results from the empirical research show that while both countries initially share the same general value towards the narcotics situation, Sweden devotes their policies more frequently towards the Rousseauian values up until the point of treating drug addicts, where they change directions and instead argue in a more objectivistic manner. On the contrary, Portugal reason in a more individualistic and objectivistic way, but change ideological paths into Rousseauianism when starting to set up aims for the treatment of addicts and offenders.