On July 1, 1994, Taiwan¡¦s Executive Yuan ratified and determined the Ministry of Justice would dispatch personnel from drug enforcement related units and the Taiwanese High Prosecutor¡¦s Office would establish a ¡§Drug Enforcement Unit.¡¨ Each District Prosecutor¡¦s Office established an ¡§executive drug enforcement unit¡¨ and attempts were made to resolve problems arising from drug enforcement units being subsumed under different units. However, at present drug enforcement still suffers from the problem of various actors vying for jurisdiction over various matters related to drug enforcement. In addition, no national database for drug enforcement, has, as yet, been established, making it more difficult to solve drug related criminal cases. The drug related units of various government organs lack horizontal lines of communication, thus leading to wasted cooperative resources when dealing with international organs. That is why a study of drug enforcement responsible authorities has been an important and pressing issue. This thesis will discuss cross-national drug enforcement institutions in the United States based on exploring their social, political, economic background, to consider the provisions of international drug trends, and reference to the U.S. Drug Enforcement Administration of manpower, budget , training and other mechanisms so on, and provide future scholars and explore the practical possibility of development of anti-drug system. It will be expected to let our drug enforcement work more effective and reduce the spread of drugs in our country by researching U.S. law enforcement cooperation model.

No description available.

For over a century the international community has widely accepted a policy of universal drug prohibition. However, an increasing number of countries have been willing to experiment with progressive drug policies as the shortcomings of strict prohibition become more clear. This thesis is a study of the structures of drug laws in four countries – the Netherlands, Portugal, the United States, and Mexico – and their economic, public health, and human rights outcomes. The policies range in restrictiveness from the decriminalization of all drugs in Portugal to complete criminalization in Mexico. This thesis focuses on cannabis and heroin, two drugs which differ markedly in their risk for addiction and acute harm. A wide range of sources in the drug policy literature was analyzed. Evidence suggests that progressive policies in Portugal and the Netherlands have not significantly increased drug use and have led to numerous favorable public health outcomes. States in America that have legalized marijuana face many legal and economic challenges, and they should be observed closely as their policies develop further. Strict supply-control enforcement in Mexico has, on the other hand, led to an extreme upsurge in violent crime. These results suggest that in the future policymakers should drastically reallocate resources from ineffective supply-side strategies and pursue proven policies centered on public health and the protection of human rights.

Background: In 2007, Saskatchewan’s Ministry of Health launched the Seniors’ Drug Plan (SDP), whereby provincial beneficiaries at or above the age of 65 receive medications at a maximum self-payment of $15. The purpose of this study was to document the impact of the SDP using provincial health-administrative databases. Methods: Aggregate medication utilization and costs were described using the prescription drug database starting two years before the implementation of the SDP and continuing for two years after. Interrupted time series analysis using segmented regression models were developed to test the impact of the SDP. Also, the probability of achieving optimal medication adherence was examined among cohorts receiving medications after SDP implementation versus similar patients receiving medications before the SDP and also a group of patients <65 years who were not eligible for the SDP at all. The impact of the SDP on the outcome of optimal adherence was estimated using logistic regression models with generalized estimating equations (GEE). Results: Monthly government spending on medications increased by 47.5% following implementation of the SDP, while total medication dispensations only increased by 5.8%. The SDP was associated with more dispensations per month among prevalent users (+5.4%, 95% CI: 1.3% to 9.5%) but not incident users who did not receive the study medication in the previous 365 days (+1.3%, 95% CI: -8.0% to 10.7%). Similarly, the SDP did not appear to impact the use of blood-glucose-lowering agents, (-0.5%, 95% CI: -6.2% to 5.2%). A small but significant increase in the odds of optimal medication adherence was observed after the SDP compared with before (OR=1.08, 95% CI 1.04 to 1.11). However, the impact was only observed in prevalent users (OR=1.08, 95% CI 1.04 to 1.12), but not incident users (OR=1.05, 95% CI 0.98 to 1.13). Also, the impact of the SDP on medication adherence was not consistent for all medication classes examined. Discussion: In summary, the SDP resulted in substantially higher government investment into drug costs without a major effect on medication utilization and adherence. However, cost reduction for seniors must have provided substantial relief independent of the impact on adherence and utilization.

Prescription opioid pain reliever utilization has been increasing since the 1990s, due in part to changes in recommendations for the treatment of chronic pain, but also to abuse and diversion. One innovative policy solution to the abuse and diversion of prescription opioids is state prescription drug monitoring programs (PDMPs), which provide prescribers and other selected parties with patient controlled substance dispensation history; thereby, correcting an information asymmetry problem between prescribers and patients. The widespread implementation of state PDMPs, which vary in program design and requirements, has resulted in a variety of intended and unintended consequences. Previous PDMP evaluations have suggested such outcomes as the reduction of consumer access to opioids, the influencing of healthcare provider prescribing behaviors for opioids, and the re-shaping of the United States market for prescription opioids. PDMPs may also be associated with unintended outcomes: namely, the restriction of pharmaceutical opioids could be associated with an increase in heroin use, as evidenced by increases in heroin substance abuse treatment facility discharges. The analyses in this project examine the influence of PDMPs on healthcare providers and the market for prescription drugs by comparing trends in opioid utilization in states with varying PDMP features using Medicaid prescription utilization data and commercial insurance claims. The effect of PDMPs on consumers is explored with an analysis comparing substance abuse treatment facility discharge data for heroin abuse with pharmaceutical opioid prescriptions before and after PDMP regulatory change. Finally, the impact of other related opioid policy interventions, opioid overdose medication access laws, are analyzed by comparing opioid overdose mortality across states with differing overdose medication access policies over time. Contributions to the understanding about the impacts of these state-level opioid abuse and diversion policies can be used to improve or amplify intended outcomes and ameliorate unintended consequences.

National drug policy development is essential for effective drug policies, yet the process through which they emerge, the role of evidence and the theoretical basis for drug policy development are poorly understood. The present research adopted a cross-national analytical-descriptive approach to examine drug policy development between 1994 and 2006 in two nations: Portugal and Australia. Through contrasting atypical reforms - namely decriminalisation in Portugal and the Illicit Drug Diversion Initiative (IDDI) in Australia – with the preceding periods of typical reform, it provides a detailed examination of how atypical reforms are proposed, negotiated and adopted. Moreover, it critically analyses the application of three public policy theories – Multiple Streams, Advocacy Coalition and Punctuated Equilibrium – to identify common drivers and processes underpinning the developments. / Through a primarily qualitative approach involving interviews with 42 expert policy makers, supplemented with secondary sources and publicly available evaluations, this research demonstrates that the major drivers of atypical reform are policy advocates and their ability to convert opportunities into pragmatic responses. In Portugal policy entrepreneurs utilised the emergence of a problem opportunity, typified by a public health crisis in Casal Ventoso, to form an alliance between experts and politicians and adopt a paradigmatic change: decriminalisation. Policy entrepreneurs in Australia used the emergence of a highly politicised opportunity to convert what was initially a doctrinal solution of “zero tolerance” into a more humane response: drug diversion. / The research reveals that the process of policy formulation has critical impacts upon the mechanism, implementation and potential outcomes of reform, most notably whether there is evidence-based policy or policy-based evidence. It concludes by identifying practical and theoretical implications for more effective drug policy development, including the need for greater application of the theory of Punctuated Equilibrium. The current research asserts that policy makers must have realistic expectations over the role of evidence in policy making, but that the likelihood of pragmatic reform may be enhanced through expanding attention from “what works” to include alternative tools of persuasion. It further recommends that greater attention to the latter may increase the likelihood of effective reform. Due to the formation of an alliance between politicians and experts the Portuguese policy making process facilitated a more pragmatic reform. However, a paradigmatic change – and hence the potential for effective drug policy – would not have been possible without advocacy for a new vision of the drug user as a citizen.

This thesis examines the history of legal and illegal narcotics in the United States. This thesis explores the impact criminalizing drug use has on communities of color. The current criminal justice system seeks to correct behavior society and the law deems deviant but has not proven to be effective as shown by rates of recidivism. The present research uses a literature review to investigate how alternative dispute resolution practices and prison abolition meet the needs of the criminal justice system. The purpose of this thesis is to examine two proposed reforms: one that would abolish prison sentences except in cases where offenders pose a high risk to public safety, and another that would employ conflict resolution techniques to serve the retributive, and rehabilitative purposes of the criminal sanction. This thesis will suggest that these proposed reforms, if undertaken concurrently, will likely shrink the US prison population while advancing penal goals.

This thesis addresses the confluence of the issues of drug use and migration. Using data that explores the needs of new communities, it argues that members of new minority communities who use drugs suffer double discrimination as migrants and as drug users. In failing to address this intersection of need, drug policy and practice compound this discrimination. The data for this submission was drawn from three empirical research projects undertaken for Peterborough Drug Action Team and the National Treatment Agency for Substance Misuse. These research projects addressed previously unreached communities and gathered new data. I published my work among peer-reviewed literature in the form of two journal articles and a book chapter. The research reports and published works inform my thesis. This submission reanalyses the research, using an intersectional lens to understand problems emanating from drug use in the context of migration. Black and minority ethnic people form a small proportion of problem drug users and their needs were under-researched until the late 1990s. A growing body of research has focused on established minority communities, while the drug treatment needs of members of new groups of migrants, whether economic migrants or refugees, remain hidden. My research addresses the impact of policy and practice on new communities. Engaging with members of hard-to-reach groups via community-based researchers, I gathered views about the attitudes and needs of new minority groups and developed a fresh perspective. My work demonstrates that while drug misusers suffer very real discrimination and stigma they also have strengths that could be assets for their recovery. I offer an analysis of the reasons why these strengths are underutilised by a policy agenda that perceives drug misuse as the main feature of the lives of service users in new minority communities. This perception dates back to the first phase of modern drug policy. During the 1980s drug use spread throughout the country, driven by the availability of cheap heroin. The demography of drug users shifted towards white, younger unemployed men and the drugs/crime nexus became the focus of attention. This determined policy development. The context and profile of drug use has changed since 1980; however the decisions of the past affect those taken in the present, and I argue that policy continues to view other issues in individuals' lives as subsidiary to drug use and its treatment. My work has had an impact in practice and in the academic literature and presents significant new knowledge. In order to respond effectively to drug use in new minority communities, policy and practice must employ an intersectional viewpoint, sharing power and developing coalitions of interest.

Made available in DSpace on 2018-06-06T11:36:17Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-03-21 / O estudo teve por objetivo geral caracterizar o ensino sobre a Política Nacional de Medicamentos (PNM) na graduação médica da Universidade Federal do Tocantins, focalizando a instituição e seus atores - coordenador do curso, docentes e alunos. Trata-se de um estudo descritivo, em caráter exploratório, apoiado em abordagem qualitativa, que comportou três movimentos investigativos. O primeiro se propôs a identificar, por meio do Projeto Político e Pedagógico, as disposições relativas ao ensino disponibilizado na instituição. O segundo, através de entrevistas semiestruturadas, buscou apreender o ensino da questão do medicamento na perspectiva do coordenador do curso e de docentes das disciplinas de Saúde Coletiva, Saúde da Família: Vivências em Atenção Básica I, Farmacologia Básica e Farmacologia Médica. O terceiro movimento, por sua vez, utilizando a estratégia de grupos focais, viabilizou a qualificação deste ensino sob a perspectiva de estudantes no ciclo básico (sétimo período) e no internato (nono e décimo períodos). Para efeito de análise, foi utilizada a técnica de análise do conteúdo, modalidade temática. Os resultados mostram que o PPP especificou o propósito de formar o aluno para atuar no SUS, com conhecimento aprimorado para as necessidades da população amazônica. Para tanto, em conformidade às Diretrizes Curriculares Nacionais, preconiza a articulação entre a instituição formadora e os serviços de saúde. De forma coerente, ao lado da valorização do ensino pela prática, na perspectiva pedagógica, o projeto aponta para o recurso às metodologias de participação ativa do aluno. No entanto, o PPP não permite antever o tratamento político explícito da questão dos medicamentos. As ementas das áreas de conhecimento da Saúde Coletiva e Farmacologia não abordam a questão formalmente e seus conteúdos não se cruzam. No Internato, algumas áreas discutem o tema, mas de forma pontual. Na perspectiva do coordenador do curso a temática não é priorizada na universidade como deveria. Os professores, por sua vez, afirmaram a falta de preparo a respeito da PNM. Segundo eles não constam do conteúdo programático das disciplinas a abordagem sobre a RENAME. A URM constitui tema mais valorizado, particularmente na Farmacologia, prevalecendo o foco restrito do ensino ao tratamento individual. Os estudantes declararam, enfim, que não foram orientados de forma sistemática sobre a assistência farmacêutica no SUS e reconheceram que esta falta de orientação compromete a prescrição e o acesso dos pacientes aos medicamentos (por eles) indicados. Diante do exposto, emerge a sugestão de aprimorar a relação teórico-prática desde o início do curso, sendo apontada “a prescrição e o acesso aos medicamentos no SUS” como temática relevante a ser explorada em todas as oportunidades existentes no currículo. / The proposed study aimed to characterize the teaching concerning the Brazilian National Drugs Policy (NDP) offered to medical students at the Federal University of Tocantins, focusing on the medicine course coordination, faculty members, students as well as on the institution itself. This is a qualitative descriptive study, of exploratory nature. It has three investigative movements. The first one, based on the medical Political and Pedagogical Project (PPP) of the University, aimed to identify provisions related to the education provided by the institution. The second one, through semi-structured interviews, sought to grasp the teaching of the National Drugs Policy from the perspective of the Medicine course coordinator and the faculty members, specifically those responsible for the Public Health and Family Health courses: Experiences in Primary Care I, Basic Pharmacology and Medical Pharmacology. The third movement, in turn, using focal groups strategy enabled the qualification of the teaching from the perspective of students still in a basic cycle semester (seventh semester) and in the first year of their clinical rotation internship (ninth and tenth semesters). Content and thematic terms analysis technique have been used for analysis purposes. Results showed that the specified PPP aims to prepare students to work in the Brazilian National Health System (NHS), enhancing their knowledge to fulfill the Amazonian population needs. For that, pursuant to the National Curriculum Guidelines, it is necessary to enhance a good educational institution versus health services articulation. In a coherent fashion, valuing teaching by practice, based on a pedagogical perspective, the project aims to use active student participation methodologies. However, the project does not allow to predict explicit political treatment addressing the Drugs issue. Menus covering Public Health and Pharmacology courses do not cover it formally either and their contents do not intersect well. During medical Internship that issue may be discussed but just occasionally. According to the course coordinator, that thematic is not prioritized at the university. Faculty members, in turn , point out that there is a lack of preparation regarding the Brazilian National Drugs Policy and affirm that the National Essential Drugs List (NEDL) is not part of the medical regular curriculum. The Rational Use of Drugs (RUD) is the most valued related subject, particularly in Pharmacology, placing teaching on an individual treatment basis. Students at last declared they have not been systematically instructed about legal aspects concerning pharmaceutical care in the NHS and admitted that it impacts negatively on their prescriptions practice, compromising patients access to medicines. Given the above, it is suggested the improvement of the theory-practice relationship since the beginning of the medical school activities. It is important to single out "the prescription and access to medicines in the NHS" as a relevant topic to be explored in every opportunity found in the curriculum.

Health and social situation of illicit drug users and the aid they receive from the respective social and healthcare institutions in the Czech Republic This thesis is composed of two main parts: theoretical and practical. Theoretical part contains chiefly categorization of illicit drugs, where we learn how they are divided according to their origin, effects, and their chemical composition, as well as their seriousness for the society. The thesis also maps the development of the illicit drug scene before and after 1989 and also discusses the importance of the year 1994{---}considered a breakthrough{---}since even before the convertibility of the Czech currency, it witnesses a massive invasion of high-quality and cheap heroine import. Furthermore, the harmful effects of drug abuse and their categorization is presented. Health hazards are correlated with data covering the HIV and viral hepatitis diffusion in the Czech Republic. This part also contains a list and description of institutions dealing with illicit drug abuse and issues connected with it. An analysis of social, health, and economic situation of illicit drug users, those filed in a L/K center. In conclusion, the thesis deals with the illicit drug use policy in the Czech Republic, where prevention, repression, prohibition and regulations are discussed, within the framework of sample of other national drug policies. The reader will find here the description of individual illicit drugs as well. The thesis aims to map the activities of K-centers, and the way their work{---}in its result, the aid to illicit drug users{---}is being made harder by the low-threshold institutions. Low-threshold institutions were chosen to represent the group of relevant institutions since they are attended by the illicit drug users most often, as well as being the first institution of this kind the users come to. The author also explored what suggestions of improvement the centers present. Three hypotheses were set: 1. The offer of services is broad in K-centers 2. Low-threshold institutions lack resources 3. Low-threshold institution representatives hold serious reservations to the illicit drug use policy in the Czech Republic The data were collected in questionnaires and secondary analysis of data from annual reports of K-centers. The questionnaires were filled in by low-threshold centers representatives. The data confirmed the set hypotheses. In the discussion, the author debates the results of his research and discusses expert literature, while explaining difficulties that he encountered composing this thesis. The conclusion deals with the suggestions for improvement, particularly of the illicit drug use policy and sums up the thesis.