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，执法部门为切断非法药物供应所做的努力 可能会无意中增加周围社区的过量事件数量。 当非法物质从社区中清除时，那些有化学依赖的人 对于那些被缉获的物质和熟悉已知的物质销售商，可能会转向替代品 物质或经销商。新物质的含量可能是未知的， 药物过量的风险。禁欲后致命的复发已被确定为一个风险因素 在那些离开快速戒毒计划，以及监禁环境，没有 药物随访;当药物市场被法律中断时，也会产生同样的效果 执法缉毒研究表明，使用全州范围内，汇总，每月 时间序列数据限制了因果推理。 本研究项目的总体目标是评估药物的潜在非预期作用 通过检查何时缉获会增加过量服用的可能性来监督政策。要执行此操作， 研究人员将使用街头数据来研究执法部门是否会扰乱毒品市场 特定物质（例如，甲基苯丙胺，可卡因，海洛因，芬太尼）的影响致命或 在周围地区以及有机会 介入除此之外，研究人员还将与使用药物的人，公共卫生 官员和执法人员了解毒品缉获过程和机会， 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 通过比较药物，执法药物市场中断与过量之间的关联 从一个大都市管辖区的警察局扣押财产室数据， 和非致命性过量数据。第二（2）个项目将建立一个报告的药物缉获事件数据库 并将此数据库与警方财产室数据进行比较。第三（3）将 确定当地媒体来源在多大程度上可以作为毒品缉获事件数据， 缺乏警察财产室数据作为其他司法管辖区的通用方法， 追踪毒品缉获和吸毒过量之间的联系第四（4）次会议将评估来自 执法和公共卫生官员了解毒品缉获过程和公共卫生 答复，包括吸毒者的第一手经验， 干预可以识别。

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.