Impact of increased drug law enforcement on public health: first results from Czechia

Background: According to a number of studies, increased drug law enforcement has different consequences in many areas [Burris et al. (2004); Dixon & Maher (2005); Fitzgerald (2005); Maher & Dixon (1999); Kerr et al. (2005)]. The systematic reviews of Kerr et al. (2005) and DeBeck et al. (2017) shows that one of these areas is public health. In this case, the impact of increased law enforcement on public health is primarily negative (e.g. incidence of infectious diseases and overdoses).

This research is based on the significant increase of drug law enforcement activity in Czech Republic between 2010 and 2014. This increase allows us to test the hypothesis if law enforcement activity was associated with subsequent increase in selected public health indicators among injecting drug users, for example incidence of infectious diseases.

Methods: To test the hypothesis, longitudinal data from different institutions were collected for years 2004-2016. Feasibility analysis showed that the available data are fit for the analysis. The public health indicators selected for the analysis are: incidence of viral hepatitis among injecting drug users and incidence of STDs among injecting drug users. The drug law enforcement indicator selected for the analysis is the number of drug offenders collected by Czech national anti-drug squad. Only the drug offenders who were dealing with methamphetamines or opiates, which are substances used by injecting drug users, were included. Furthermore, public health and law enforcement indicators were linked to the geographical units. The data were aggregated on the level of months. The multivariate time series analysis (ARIMA) is used to test similarity of patterns across the time for the selected variables.

Results: First results of the analysis focused on the impact of increased drug law enforcement on selected public health indicators are presented.