RESUMO
BACKGROUND: In 2009, Mexican Federal Government enacted "narcomenudeo" reforms decriminalizing possession of small amounts of drugs, delegating prosecution of retail drug sales to the state courts, and mandating treatment diversion for habitual drug users. There has been insufficient effort to formally assess the decriminalization policy's population-level impact, despite mounting interest in analagous reforms across the globe. METHODS: Using a dataset of municipal police incident reports, we examined patterns of drug possession, and violent and non-violent crime arrests between January 2009 and December 2014. A hierarchical panel data analysis with random effects was conducted to assess the impact of narcomenudeo's drug decriminalization provision. RESULTS: The reforms had no significant impact on the number of drug possession or violent crime arrests, after controlling for other variables (e.g. time trends, electoral cycles, and precinct-level socioeconomic factors). Time periods directly preceding local elections were observed to be statistically associated with elevated arrest volume. CONCLUSIONS: Analysis of police statistics parallel prior findings that Mexico's reform decriminalizing small amounts of drugs does not appear to have significantly shifted drug law enforcement in Tijuana. More research is required to fully understand the policy transformation process for drug decriminalization and other structural interventions in Mexico and similar regional and international efforts. Observed relationship between policing and political cycles echo associations in other settings whereby law-and-order activities increase during mayoral electoral campaigns.
Assuntos
Crime/estatística & dados numéricos , Política de Saúde/legislação & jurisprudência , Drogas Ilícitas/legislação & jurisprudência , Aplicação da Lei , Legislação de Medicamentos , Crime/tendências , Humanos , MéxicoRESUMO
BACKGROUND: Mexico's 2009 "narcomenudeo reform" decriminalized small amounts of drugs, shifting some drug law enforcement to the states and mandating drug treatment diversion instead of incarceration. Data from Tijuana suggested limited implementation of this harm reduction-oriented policy. We studied whether a police education program (PEP) improved officers' drug and syringe policy knowledge, and aimed to identify participant characteristics associated with improvement of drug policy knowledge. METHODS: Pre- and post-training surveys were self-administered by municipal police officers to measure legal knowledge. Training impact was assessed through matched paired nominal data using McNemar's tests. Multivariable logistic regression was used to identify predictors of improved legal knowledge, as measured by officers' ability to identify conceptual legal provisions related to syringe possession and thresholds of drugs covered under the reform. RESULTS: Of 1750 respondents comparing pre- versus post training, officers reported significant improvement (p < 0.001) in their technical understanding of syringe possession (56 to 91%) and drug amounts decriminalized, including marijuana (9 to 52%), heroin (8 to 71%), and methamphetamine (7 to 70%). The training was associated with even greater success in improving conceptual legal knowledge for syringe possession (67 to 96%) (p < 0.001), marijuana (16 to 91%), heroin (11 to 91%), and methamphetamine (11 to 89%). In multivariable modeling, those with at least a high school education were more likely to exhibit improvement of conceptual legal knowledge of syringe possession (adjusted odds ratio [aOR] 2.6, 95% CI 1.4-3.2) and decriminalization for heroin (aOR 2.7, 95% CI 1.3-4.3), methamphetamine (aOR 2.2, 95% CI 1.4-3.2), and marijuana (aOR 2.5, 95% CI 1.6-4). CONCLUSIONS: Drug policy reform is often necessary, but not sufficient to achieve public health goals because of gaps in translating formal laws to policing practice. To close such gaps, PEP initiatives bundling occupational safety information with relevant legal content demonstrate clear promise. Our findings underscore additional efforts needed to raise technical knowledge of the law among personnel tasked with its enforcement. Police professionalization, including minimum educational standards, appear critical for aligning policing with harm reduction goals.
Assuntos
Polícia/educação , Política Pública , Adulto , Cannabis , Feminino , Redução do Dano , Heroína , Humanos , Drogas Ilícitas , Conhecimento , Aplicação da Lei , Masculino , Metanfetamina , México , Programas de Troca de Agulhas , Fatores SocioeconômicosRESUMO
The usefulness of five different laboratory tests for differential diagnosis in bacterial and viral meningoencephalitides was assessed. The clinical manifestations and cytochemical alterations of cerebrospinal fluid (CSF) were used as criteria for diagnostic selection. The causal agent was identified by means of CSF cultures in 47.8 per cent of bacterial meningoencephalitis cases; Gram stain was postive in CSF smear in 34.8 per cent and protein electrophoresis in CSF did not show significant differences when compared to cases of bacterial or viral etiology and the control group. PH and CSF lactate determinations allowed diagnosis of all cases of bacterial meningoencephalitis and was not modified in those cases where this disease was of a viral origin. We suggest to add these determinations to the initial cytochemical study of CSF in all cases where meningoencephalitis is suspected.