scholarly journals Drug Checking for Novel Insights into the Unregulated Drug Supply

2021 ◽  
Author(s):  
Nabarun Dasgupta ◽  
Mary C Figgatt
Keyword(s):  
British Columbia ◽  
Large Scale ◽  
People Who Use Drugs ◽  
Drug Supply ◽  
Public Health Response ◽  
Epidemiologic Surveillance ◽  
Crucial Component ◽  
Health Response ◽  
Drug Checking ◽  
Nuanced Understanding

Abstract Tobias et al. (Am J Epidemiol. XXXX;XXX(XX):XXXX–XXXX) present a novel analysis of time trends in fentanyl concentrations in the unregulated drug supply in British Columbia, Canada. The pre-existing knowledge about unregulated drugs had previously come from law enforcement seizures and post-mortem toxicology. As both of these data sources are subject to selection bias, large scale drug checking programs are poised to be a crucial component of the public health response to the unrelenting increase in overdose in North America. As programs expand, we offer two guiding principles. First, the primary purpose of these programs is to deliver timely results to people who use drugs to mitigate health risks. Second, innovation is needed to go beyond criminal justice paradigms in laboratory analysis for a more nuanced understanding of health concerns. We provide examples of the role adulterants play in our understanding of drug harms. We also describe the applications and limitations of common laboratory assays, with implications for epidemiologic surveillance. While the research and direct service teams in British Columbia have taken groundbreaking steps, there is still a need to establish best practices for communicating results to sample donors in an approachable yet non-alarmist tone.

Auras of Detection: Power and Knowledge in Drug Prohibition

2021 ◽  
pp. 009145092110354
Author(s):  
Jennifer J. Carroll
Keyword(s):  
Law Enforcement ◽  
Knowledge Production ◽  
Illicit Drug ◽  
Drug Market ◽  
Epistemic Authority ◽  
People Who Use Drugs ◽  
Drug Supply ◽  
Political Implications ◽  
Starting Point ◽  
Drug Checking

Drug checking is an evidence-based strategy for overdose prevention that continues to operate (where it operates) in a legal “gray zone” due to the legal classification of some drug checking tools as drug paraphernalia—the purview of law enforcement, not public health. This article takes the emergence of fentanyl in the U.S. drug supply as a starting point for examining two closely related questions about drug checking and drug market expertise. First, how is the epistemic authority of law enforcement over the material realities of the drug market produced? Second, in the context of that authority, what are the socio-political implications of technologically advanced drug checking instruments in the hands of people who use drugs? The expertise that people who use drugs maintain about the nature of illicit drug market and how to navigate the illicit drug supply has long been discounted as untrustworthy, irrational, or otherwise invalid. Yet, increased access to drug checking tools has the potential to afford the knowledge produced by people who use drugs a technological validity it has never before enjoyed. In this article, I engage with theories of knowledge production and ontological standpoint from the field of science, technology, and society studies to examine how law enforcement produces and maintains epistemic authority over the illicit drug market and to explore how drug checking technologies enable new forms of knowledge production. I argue that drug checking be viewed as a form of social resistance against law enforcement’s epistemological authority and as a refuge against the harms produced by drug criminalization.

scholarly journals Health and human rights are inextricably linked in the COVID-19 response

2020 ◽  
Vol 5 (9) ◽  
pp. e003359
Author(s):  
Sharifah Sekalala ◽  
Lisa Forman ◽  
Roojin Habibi ◽  
Benjamin Mason Meier
Keyword(s):  
Human Rights ◽  
Large Scale ◽  
Public Health Response ◽  
Transit Systems ◽  
Economic Rights ◽  
Health And Human Rights ◽  
The Public ◽  
Health Response ◽  
Regulatory Measures ◽  
Pandemic Response

To mitigate the spread of COVID-19, governments throughout the world have introduced emergency measures that constrain individual freedoms, social and economic rights and global solidarity. These regulatory measures have closed schools, workplaces and transit systems, cancelled public gatherings, introduced mandatory home confinement and deployed large-scale electronic surveillance. In doing so, human rights obligations are rarely addressed, despite how significantly they are impacted by the pandemic response. The norms and principles of human rights should guide government responses to COVID-19, with these rights strengthening the public health response to COVID-19.

scholarly journals Global Telemedicine Implementation and Integration Within Health Systems to Fight the COVID-19 Pandemic: A Call to Action

10.2196/18810 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e18810 ◽  
Author(s):  
Robin Ohannessian ◽  
Tu Anh Duong ◽  
Anna Odone
Keyword(s):  
Public Health ◽  
National Health ◽  
Large Scale ◽  
The United States ◽  
Response Strategy ◽  
World Health ◽  
Public Health Response ◽  
Levels Of Care ◽  
Health Response ◽  
Health Organization

On March 11, 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19) outbreak as a pandemic, with over 720,000 cases reported in more than 203 countries as of 31 March. The response strategy included early diagnosis, patient isolation, symptomatic monitoring of contacts as well as suspected and confirmed cases, and public health quarantine. In this context, telemedicine, particularly video consultations, has been promoted and scaled up to reduce the risk of transmission, especially in the United Kingdom and the United States of America. Based on a literature review, the first conceptual framework for telemedicine implementation during outbreaks was published in 2015. An updated framework for telemedicine in the COVID-19 pandemic has been defined. This framework could be applied at a large scale to improve the national public health response. Most countries, however, lack a regulatory framework to authorize, integrate, and reimburse telemedicine services, including in emergency and outbreak situations. In this context, Italy does not include telemedicine in the essential levels of care granted to all citizens within the National Health Service, while France authorized, reimbursed, and actively promoted the use of telemedicine. Several challenges remain for the global use and integration of telemedicine into the public health response to COVID-19 and future outbreaks. All stakeholders are encouraged to address the challenges and collaborate to promote the safe and evidence-based use of telemedicine during the current pandemic and future outbreaks. For countries without integrated telemedicine in their national health care system, the COVID-19 pandemic is a call to adopt the necessary regulatory frameworks for supporting wide adoption of telemedicine.

Bioterrorism

2021 ◽  
pp. 287-296
Author(s):  
Peter Katona
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Global Economy ◽  
Large Scale ◽  
Severe Disease ◽  
Public Health Response ◽  
Health Response ◽  
Bioterrorism Agent ◽  
Public Health Surveillance System

History shows us that individuals have used and likely will continue to use biological agents for terrorism purposes. Bioterrorism agents can be easily disseminated, cause severe disease and high mortality rates if cases are not treated properly, and pose significant challenges for management and response. A robust public health surveillance system that includes laboratory (including routine reportable disease surveillance), syndromic, and environmental surveillance is crucial for detection of the release of a bioterrorism agent and the resulting cases. This detection can then set into motion a robust and comprehensive public health response to minimize morbidity and mortality. A large-scale bioterrorism event would be unprecedented, straining and challenging every facet of medical and public health response and would quickly become a global emergency because of both the potential risk of infection and the shock to the global economy. A robust public health and medical workforce is necessary to respond effectively and efficiently to these types of events.

Tracking antimicrobials dispensed during an anthrax attack: A case study from the New Hampshire anthrax exercise

2011 ◽  
Vol 9 (1) ◽  
pp. 65
Author(s):  
Jeanne Tropper, MS, MPH ◽  
Chris Adamski, RN, MSN ◽  
Cynthia Vinion, MEA ◽  
Sanjeeb Sapkota, MBBS, MPH
Keyword(s):  
Public Health ◽  
New Hampshire ◽  
Large Scale ◽  
Performance Metrics ◽  
Automated System ◽  
Rural Setting ◽  
Public Health Services ◽  
Public Health Response ◽  
Health Response

The Countermeasure and Response Administration (CRA) system is a Centers for Disease Control and Prevention informatics application developed to track countermeasures, including medical interventions (eg, vaccinations and pharmaceuticals) and nonmedical interventions (eg, patient isolation, quarantine, and personal protective equipment), administered during a public health response. This case study follows the use of CRA as a supplement to paper-based processes during an exercise in which antimicrobials dispensed to individual exposed persons were captured after a simulated bioterrorist attack of anthrax spores. The exercise was conducted by the New Hampshire Division of Public Health Services on April 14, 2007.Automated systems like CRA can track when medications are dispensed. The data can then be used for performance metrics, statistics, and in locating victims for follow-up study. Given that this case study was limited to a single location in a relatively rural setting, the authors concluded that more study is needed to compare the feasibility of using an automated system rather than paper-based processes for effectively managing a very large-scale urgent public health response.

scholarly journals The effect of the definition of ‘pandemic’ on quantitative assessments of infectious disease outbreak risk

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Benjamin J. Singer ◽  
Robin N. Thompson ◽  
Michael B. Bonsall
Keyword(s):  
Infectious Disease ◽  
Large Scale ◽  
Disease Risk ◽  
Pandemic Preparedness ◽  
Public Health Response ◽  
Infectious Disease Outbreak ◽  
Health Response ◽  
Modelling Studies ◽  
Definition Of ◽  
Quantitative Definition

AbstractIn the early stages of an outbreak, the term ‘pandemic’ can be used to communicate about infectious disease risk, particularly by those who wish to encourage a large-scale public health response. However, the term lacks a widely accepted quantitative definition. We show that, under alternate quantitative definitions of ‘pandemic’, an epidemiological metapopulation model produces different estimates of the probability of a pandemic. Critically, we show that using different definitions alters the projected effects of key parameters—such as inter-regional travel rates, degree of pre-existing immunity, and heterogeneity in transmission rates between regions—on the risk of a pandemic. Our analysis provides a foundation for understanding the scientific importance of precise language when discussing pandemic risk, illustrating how alternative definitions affect the conclusions of modelling studies. This serves to highlight that those working on pandemic preparedness must remain alert to the variability in the use of the term ‘pandemic’, and provide specific quantitative definitions when undertaking one of the types of analysis that we show to be sensitive to the pandemic definition.

A Large-scale, Rapid Public Health Response to Rabies in an Organ Recipient and the Previously Undiagnosed Organ Donor

2014 ◽  
pp. n/a-n/a ◽  
Author(s):  
R. M. Wallace ◽  
D. Stanek ◽  
S. Griese ◽  
D. Krulak ◽  
N. M. Vora ◽  
...  
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Organ Donor ◽  
Public Health Response ◽  
Health Response

scholarly journals The effect of the definition of ‘pandemic’ on quantitative assessments of infectious disease outbreak risk

2020 ◽  
Author(s):  
Benjamin J Singer ◽  
Robin N Thompson ◽  
Michael B Bonsall
Keyword(s):  
Infectious Disease ◽  
Large Scale ◽  
Disease Risk ◽  
Pandemic Preparedness ◽  
Public Health Response ◽  
Infectious Disease Outbreak ◽  
Health Response ◽  
Modelling Studies ◽  
Definition Of ◽  
Quantitative Definition

AbstractIn the early stages of an outbreak, the term ‘pandemic’ can be used to communicate about infectious disease risk, particularly by those who wish to encourage a large-scale public health response. However, the term lacks a widely accepted quantitative definition. We show that, under alternative quantitative definitions of ‘pandemic’, an epidemiological metapopulation model produces different estimates of the probability of a pandemic. Critically, we show that using different definitions alters the projected effects on the pandemic risk of key parameters such as inter-regional travel rates, degree of pre-existing immunity, and heterogeneity of transmission rates between regions. Our analysis provides a foundation for understanding the scientific importance of precise language when discussing pandemic risk, illustrating how alternate definitions affect the conclusions of modelling studies. This serves to highlight that those working on pandemic preparedness must remain alert to the variability in the use of the term ‘pandemic’, and provide specific quantitative definitions when undertaking one of the types of analysis that we show to be sensitive to the pandemic definition.

scholarly journals Shades of grey: the need for a multi-disciplinary approach to research investigating alcohol and ageing

2014 ◽  
Vol 3 (1) ◽  
Author(s):  
Celia Wilkinson ◽  
Julie Dare
Keyword(s):  
Public Health ◽  
Alcohol Use ◽  
Older People ◽  
Social Engagement ◽  
Public Health Response ◽  
Public Health Perspective ◽  
Potential Health ◽  
Social Drinking ◽  
Health Response ◽  
Nuanced Understanding

This paper calls for an increase in multi-disciplinary research on the issue of alcohol and ageing, to ensure public health interventions reflect the complex and diverse needs of older drinkers. Older people (65+ years) represent a unique segment of the population; compared to adolescents and younger people, they are more likely to have a range of co-morbid conditions and be taking prescribed medication, and are more physiologically vulnerable to the effects of alcohol. This suggests that from a public health perspective, alcohol use by older people is problematic. However, as with younger people, alcohol use is closely associated with socialisation and social engagement. While social engagement is important at all stages of life, it is particularly critical as people age, when many of the formal social roles which provide a catalyst for social integration shift or are lost. Currently, however, there is little evidence of an integrated public health response to the complex issue of alcohol and ageing. That is, what is needed is a concurrent acknowledgement of the health problems that may be associated with contraindicated alcohol use, <em>versus</em> the potential health benefits that can accrue from social drinking. This will require a holistic rather than reductionist approach that integrates biomedical and social science insights to develop a more comprehensive and nuanced understanding of the implications of alcohol use amongst diverse populations of older people.

Sign in / Sign up

Export Citation Format

Share Document