Examining the iatrogenic effect of law enforcement disruptions to the illicit drug market on overdose in the surrounding community

摘要 越来越多的研究表明，执法部门破坏非法毒品供应的努力 可能会无意中增加周围社区服药过量事件的数量。 当非法物质从社区中移除时，那些有化学依赖的人 对于那些被扣押的物质和熟悉已知物质的卖家，可以转向替代 物质或毒贩。新物质的含量可能是未知的，这让那些使用 有服药过量风险的药物。戒酒后致命的复发已被确定为一种危险因素 在那些离开快速戒毒计划以及监禁环境的人中，没有 用药跟踪；当药品市场被法律中断时，同样的效果也会发生 执法部门查获毒品。研究已经证明了这一点，在全州范围内，汇总，每月 限制因果推断的时间序列数据。 这项研究项目的首要目标是评估药物的潜在意外影响。 通过检查何时癫痫发作会增加服药过量的可能性来制定政策。要做到这点， 研究人员将使用街头数据来检查执法部门是否扰乱了毒品市场 特定物质(如甲基苯丙胺、可卡因、海洛因、芬太尼)对致命或 周边地区发生的非致命性过量事件以及有机会 进行干预。除此之外，研究人员将与吸毒者接触，公共卫生 官员和执法部门了解缉毒过程和机会 减轻伤害。 研究人员将通过四个主要目标来实现研究目标。第一个(1)将检查 药品比较法执法扰乱毒品市场与过量用药的关系 大都市辖区警察局查封财产室数据致死 和非致命的服药过量数据。第二个(2)将建立一个报告的缉获毒品事件数据库。 通过媒体来源，将这个数据库与警方财产室数据进行比较。第三(3)个将 确定当地媒体来源可在多大程度上充当毒品缉获事件数据 缺乏警察财产室数据作为其他司法管辖区通用的方法 追踪毒品缉获和过量服药之间的联系。第四(4)将评估来自以下方面的反馈 执法和公共卫生官员关于毒品缉获过程和公共卫生的信息 答复，包括吸毒者的第一手经验，这样就有机会 干预是可以识别的。

Abstract There is growing research to suggest that law enforcement efforts to disrupt the illicit drug supply might inadvertently increase the number of overdose events in the surrounding community. When illicit substances are removed from a community, those who have a chemical dependency to those seized substances and familiarity with a known substance seller, may shift to alternative substances or dealers. The content of new substances may be unknown, putting people who use drugs at risk of overdose. Fatal relapse following abstinence has been identified as a risk factor among those leaving rapid detoxification programs, as well as incarceration settings, with no medication follow-up; this same effect occurs when a drug market is interrupted by law enforcement drug seizures. Studies have demonstrated this using statewide, aggregated, monthly time series data which limits causal inference. The overarching goal of this research project is to assess the potential unintended effects of drug policing policies by examining when seizures increase the likelihood of overdose. To do this, researchers will use street-level data to examine whether law enforcement drug market disruption of specific substances (e.g., methamphetamine, cocaine, heroin, fentanyl) impacts fatal or nonfatal overdose events in the surrounding area and where there are the opportunities to intervene. In addition to this, researchers will engage with people who use drugs, public health officials, and law enforcement to understand drug seizure processes and opportunities for mitigating harm. Researchers will accomplish study goals through four primary aims. The first (1) will examine the association between law enforcement drug market disruption and overdose by comparing drug seizure property room data from a police department in a large metropolitan jurisdiction to fatal and nonfatal overdose data. The second (2) will develop a database of drug seizure events reported by media sources and compare this database to police property room data. The third (3) will determine the extent to which local media sources can serve as drug seizure event data in the absence of police property room data as a generalizable methodology for other jurisdictions to track associations between drug seizures and overdose. The fourth (4) will assess feedback from law enforcement and public health officials about drug seizure processes and public health responses and include first-hand experiences of people who use drugs such that opportunities for intervention can be identified.