IS IMPLEMENTATION OF DRUG DECRIMINALIZATION POLICY ASSOCIATED WITH NATIONAL DRUG- RELATED DEATHS A CROSS-NATIONAL COMPARATIVE ANALYSIS

Background and Aim : The overall approach to drug policy is slowly shifting with the decriminalization of the personal use and possession of all drugs, putting public health and human rights at the center. This study explores the association between the implementation of drug policy reform and drug-related deaths at the national level, in the context of other relevant socioeconomic conditions, in developed and developing countries.Methods : Fuzzy Set Qualitative comparative analysis (fsQCA) was conducted to identify the conditions linked to drug-related deaths across 65 countries from all world health organization (WHO) regions. The outcome was number of drug-related deaths, mortality rates per million persons aged 15-64 years (2018). The relevant conditions according to the social determinants of health conceptual framework were level of implementation of drug decriminalization policy, level of country economic development (GDP PPP), good governance and availability of health-system resources. The data at country level were obtained from the UNODC data portal, the World Bank’s online database and WHO data sets during 2015-2018.Results : lacking drug decriminalization policy was a condition of configurations that were consistent with being usually sufficient to cause high drug-related death, beside high GDP (PPP), and high level of good governance and affluent health system. The case of IRAN with low-level implementation of drug decriminalization policy, low-level of good governance, poor health system and relatively high-level of national wealth indicated a configuration linked to relatively high-level of drug-related death (fuzzy score=0.83). Conclusion : Decriminalization of personal drug possession and use may decrease stigma, increase access to health and harm reduction services and reduce the drug- related deaths.

Keywords:

Drug Policy , Decriminalization , Social Determinants of Health , fsQCA