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Drugs during Confinement: A look at different sources of information - - PowerPoint PPT Presentation

Drugs during Confinement: A look at different sources of information Jorge Ameth Villatoro Velzquez Coordinator of the Surveys and Data Analysis Unit Ramn de la Fuente Muiz National Institute of Psychiatry Online Training Seminar Drug


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Drugs during Confinement: A look at different sources of information

Jorge Ameth Villatoro Velázquez Coordinator of the Surveys and Data Analysis Unit Ramón de la Fuente Muñiz National Institute of Psychiatry

Online Training Seminar Drug Research in the Context of COVID-19 OAS-CICAD June 8, 2020

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Fabiola Vázquez Quiroz, INPRFM Norberto Hernández Llanes, CONADIC, SS Luis Alberto Segovia, Prevencasa A.C. Alfonso Chávez Rivera, Prevencasa A.C. Lilia Pacheco Bufanda, Prevencasa A.C. Marcela Tiburcio Sainz, INPRFM Nora Martínez Vélez, INPRFM Marycarmen Bustos Gamiño, INPRFM Stephanie Urueta Yamaguchi, Prevencasa A.C.

Acknowledgements

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Objective: To show data from various sources

  • n how drug use, availability and

treatment have been affected in the country.

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CHANGES IN PRICES DURING COVID-19

Source: Nielsen México, April 8, 2020.

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National Consumer Price Index Classification of Individual Consumption by Category

Percentage Change

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A c c u m u l a t e d C a s e s

2,000 4,000 6,000 8,000 10,000 12,000

S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 S11 S12 S13 S14 S15 S16 S17 S18 S19 S20 S21 S22 S23 S24 COVID WITHOUT CONFINEMENT

Acute Alcohol Intoxication

2020 2019

BEFORE COVID COVID WITH CONFINEMENT

SOURCE: SINAVE/DGE/Salud 2020

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SLIDE 7

300 600 900 1,200 1,500 1,800

S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 S11 S12 S13 S14 S15 S16 S17 S18 S19 S20 S21 S22 S23 S24 COVID WITHOUT CONFINEMENT

Alcohol-Related Liver Disease

2020 2019

BEFORE COVID COVID WITH CONFINEMENT

A c c u m u l a t e d C a s e s Fuente: SINAVE/DGE/Salud 2020

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500 1,000 1,500 2,000 2,500

S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 S11 S12 S13 S14 S15 S16 S17 S18 S19 S20 S21 S22 S23 S24 COVID WITHOUT CONFINEMENT

Alcohol-Induced Cirrhosis of the Liver

2020 2019

BEFORE COVID COVID WITH CONFINEMENT

A c c u m m u l a t e d C a s e s Source: SINAVE/DGE/Salud 2020

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1,000 2,000 3,000 4,000 5,000 6,000 7,000

S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 S11 S12 S13 S14 S15 S16 S17 S18 S19 S20 S21 S22 S23 S24 COVID WITHOUT CONFINEMENT

Pedestrian Injuries from Traffic Accidents

2020 2019

BEFORE COVID COVID WITH CONFINEMENT

A c c u n m u l a t e d C a s e s Source: SINAVE/DGE/Salud 2020

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5,000 10,000 15,000 20,000 25,000 30,000 35,000

S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 S11 S12 S13 S14 S15 S16 S17 S18 S19 S20 S21 S22 S23 S24 COVID WITHOUT CONFINEMENT

Traffic Accidents

2020 2019

BEFORE COVID COVID WITH CONFINEMENT

A c c u m u l a t e d C a s e s Source: SINAVE/DGE/Salud 2020

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300 600 900 1,200 1,500 1,800

S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 S11 S12 S13 S14 S15 S16 S17 S18 S19 S20 S21 S22 S23 S24 COVID WITHOUT CONFINEMENT

Mild Dengue

2020 2019

COVID WITH CONFINEMENT BEFORE COVID

A c c u m u l a t e d C a s e s Source: SINAVE/DGE/Salud 2020

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50 100 150 200 250

S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 S11 S12 S13 S14 S15 S16 S17 S18 S19 S20 S21 S22 S23 S24 COVID WITHOUT CONFINEMENT

Severe Dengue

2020 2019

COVID WITH CONFINEMENT BEFORE COVID

A c c u m u l a t e d C a s e s Source: SINAVE/DGE/Salud 2020

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Poisoning from drinking adulterated alcoholic beverages in Mexico

Ags. Baja California Sur Baja California Campeche Coahuila Chiapas Chihuahua Durango Oaxaca Nayarit Qro. Tamaulipas Tabasco Sonora Sinaloa Yucatán Guerrero Hidalgo Nuevo León Puebla S.L.P.

  • Q. Roo

Veracruz Zacatecas Gto. Colima Mor. Jalisco Michoacán Edo. Mex Tlax.

Morelos

29 deaths

Yucatán

14 poisonings 10 deaths

Campeche

5 deaths

Jalisco

97 poisonings 38 deaths

Puebla

72 deaths

182 deaths identified nationwide

Tlaxcala

3 poisonings

Veracruz

6 poisonings 5 deaths

Coahuila

14 poisonings 4 deaths

Chiapas

3 deaths

Guerrero

16 deaths

Source: CONADIC. As of June 3, 2020.

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Surveys in Mexico and in other countries

  • Economic impact.

https://docs.google.com/forms/d/e/1FAIpQLSfkKcZelrDzdsLOxdeHL3myLIKbE8MXeGjIhFmj_mr2LDr_Jg/viewform

  • Effects on women of staying home.

https://www.facebook.com/173801859497748/posts/1394003227477599/?d=n

  • Household living conditions in the face of social distancing.

https://docs.google.com/forms/d/e/1FAIpQLSfK9MJRVj1M0P6TTCvsPnO19m19Ep8gZyp7CLZcYbYb2mJxuQ/closedform

  • COVID-19 Survey in Mexico, UNAM.

https://sites.google.com/view/covid-formulario

  • State of mind and drug use, from the University of Veracruzana.

https://docs.google.com/forms/d/e/1FAIpQLSdFgA288EexlS0cRjjRnEBVYDP2k8SM6Qf1iejEQIMapypamQ/viewform

  • COVID social impact survey, National Institute of Public Health.

https://sars.mx/

  • Alcohol consumption IAPA (Institute for the Care and Prevention
  • f Addictions).

https://docs.google.com/forms/d/e/1FAIpQLSds2RqP2LfEz78Orepil7TL5tsf4hjETJFcbqXAxDLiR8-ODQ/viewform

  • COVID and stress in Mexico. International study UAM

(Metropolitana Autonomous University).

https://sites.google.com/view/covid-estres-mx/

  • Results of the survey "The effects of COVID on the well-being of

Mexican households", IBERO (Iberoamericana University).

file:///C:/Users/Vostro/Downloads/comunicado_encovid-19_completo.pdf

  • Preliminary results of the exploratory study on social distancing

due to COVID, from the ORT University, Mexico.

https://www.ort.edu.mx/noticias/resultados-preliminares-del-estudio-exploratorio-sobre-el-covid-19/

  • Drug use during the pandemic, ITSON University.

https://docs.google.com/forms/d/e/1FAIpQLSez067kK622MRBN59UL2bGkL- 93V_nGqBMuacTCE3DB5C5W6g/viewform?fbclid=IwAR0LKISQiEs9wgxtaxqXf-Q3vjinqBrw73vPcFVfvBoQyyRqsyNfx8_7mgA

  • International, GLOBAL DRUG SURVEY.

https://www.globaldrugsurvey.world/s3/COVID-19

  • Survey on alcohol use, Spain

https://bildungsportal.sachsen.de/umfragen/limesurvey/index.php/684654?lang=es

  • Substance Use Study, Brazil.

https://docs.google.com/forms/d/e/1FAIpQLSdFWpZ7DzdnZVWS-9arU-CM6Iuod2M5JjyL3H0i8ZMLiHeAwQ/viewform

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Frequency of alcohol consumption before and during quarantine*

6.6 7.5 13.3 12.6 24.4 30.1 22.9 22.3 27.9 32.2 19.2 22.6 32.5 26.1 27.9 27.6 8.6 4.1 16.6 15 10 20 30 40 50 60 70 80 90 100 Hombres Mujeres

As of May 31, 2020

* p=.000 differences in consumption between men and women before quarantine Never Once a month or less 2 to 4 times per month Once a week Daily or almost daily Source : Tiburcio, M.; Martínez, N.; Fernández, M.; Sánchez, Y.; Arroyo, M.; Natera, G. (2020) Consumption of alcohol, tobacco and other substances during the coronavirus pandemic (COVID-19. Project in process, reproduced with permission of the main researcher

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Frequency of tobacco use before and during quarantine

51 53.4 57.3 60.9 13 12.1 7.2 8.1 5.1 5.9 5.5 3.8 9.1 8.3 6.7 6.7 21.9 20.2 23.3 20.4 10 20 30 40 50 60 70 80 90 100 Hombres Mujeres

As of May 31, 2020

Never Once a month or less 2 to 4 times per month Once per week Daily or almost daily Source: Tiburcio, M.; Martínez, N.; Fernández, M.; Sánchez, Y.; Arroyo, M.; Natera, G. (2020) ) Consumption of alcohol, tobacco and other substances during the coronavirus pandemic (COVID-19. Project in process, reproduced with permission of the main researcher.

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TOBACCO Prevalence 11.4% Quantity of cigarettes or electronic cigarettes before the contingency. ALCOHOL Prevalence 28.8% Number of cups before the contingency. n % n % Same 67 55.4 147 48.5 Higher 25 20.7 36 11.9 Less 29 24.0 118 38.9 Dont know/No Response 2 0.7

  • No. of users

121 303

Tobacco and Alcohol Consumption in the Mexican Population

Source: Shamah Levy, T. Y cols INSP. Results of the ENSARS-VOC-19 study, June 2020.

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Frequency of marijuana use before and during quarantine

79.1 86.5 82.6 90 9.5 8.2 2.6 3.9 3.6 1.9 4.1 1.7 3.4 1.4 4.3 2 4.3 2 6.5 2.3 10 20 30 40 50 60 70 80 90 100 Hombres Mujeres

As of May 31, 2020

Never Once a month or less 2 to 4 times per month Once per week Daily or almost daily Fuente: Tiburcio, M.; Martínez, N.; Fernández, M.; Sánchez, Y.; Arroyo, M.; Natera, G. (2020) ) Consumption of alcohol, tobacco and other substances during the coronavirus pandemic (COVID-19. Project in process, reproduced with permission of the main researcher

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Frequency of tranquilizer use before and during quarantine

87.3 78.5 87.2 75.3 5.5 8.3 2.8 5.9 1.5 3.6 2.2 5 2.4 2.7 1.8 3.8 3.3 6.8 2.1 6.5 10 20 30 40 50 60 70 80 90 100 Hombres Mujeres

As of May 31, 2020

Never Once a month or less 2 to 4 times per month Once per week Daily or almost daily Fuente: Tiburcio, M.; Martínez, N.; Fernández, M.; Sánchez, Y.; Arroyo, M.; Natera, G. (2020) ) Consumption of alcohol, tobacco and other substances during the coronavirus pandemic (COVID-19. Project in process, reproduced with permission of the main researcher

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Calls for Psychological Support

2018 2019 2020 n % n % n % ADDICTIONS 907 6.61 774 5.04 745 4.26 EMOTIONAL CONFLICTS 7,331 53.44 8,951 58.32 8,554 48.88 SCHOOL 206 1.50 189 1.23 122 0.70 FAMILY 1,480 10.79 1,442 9.40 1,451 8.29 PEER GROUP 56 0.41 57 0.37 55 0.31 LABOR 135 0.98 133 0.87 155 0.89 ENGAGEMENT 182 1.33 325 2.12 301 1.72 COUPLE 1,443 10.52 1,353 8.82 1,685 9.63 HEALTH 145 1.06 145 0.94 188 1.07 SEXUALITY 172 1.25 190 1.24 296 1.69 VIOLENCE 1,662 12.11 1,789 11.66 3,948 22.56 13,719 15,348 17,500 Source: Data Portal of Mexico City. Calls made to women line.

100 200 300 400 500 600 700 800 900 1,000 ENERO FEBRERO MARZO ABRIL MAYO

Addiction calls per year

2018 2019 2020

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Emergency calls for gender-based violence increase 6%: Inmujeres

The National Institute of Women (Inmujeres), warned that it has seen a 6% increase in emergency calls to 911 for cases of gender violence. Olga Sánchez Cordero, Secretary of the Interior, assured that for the Federal Government it is important to eliminate violence against women, as well as eradicate corruption, which is why there will be sufficient financial resources to address this problem and they will work together with national and international institutions. "We are convinced that promoting public policies, strategies and mechanisms to end sexist violence is so important, as well as banishing the rapacious corruption that was causing so much damage to our country, Sánchez Cordero mentioned."

Organized crime is co-opting women

Between 40 and 50 percent of the femicides that occur in the streets, sometimes by couples, but many times there is this phenomenon that women are spoils of war: "I kill your wife to send a message to you", Nadine Gasman noted. The Secretary of the Interior, Sánchez Cordero said: Unfortunately, women are already being captured as hawks (paid vigilantes) from organized crime, in addition, they hook them with the drug, they give them pills to co-opt them either as being hawks or as sex slaves on the topic of trafficking.

Source: Ortiz A. Emergency calls for gender violence increase 6%: Inmujeres. The Universal; June 25, 2020.

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Source Prevencasa A.C.

Context of heroin users on the northern border of Mexico (1) There is no shortage of the drug and no major withdrawal syndrome has been observed. Users indicate that the cost of the heroin dose is the same. In places where they sell white powder heroin, the sale of black powder heroin mixed with fentanyl has increased. There is not much mobility of users to other points of sale to buy drugs. Users perceive that the number of cases of overdose has increased according to the perception of users, particularly because new users are arriving who are not accustomed to the power of the drug.

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Context of heroin users on the northern border of Mexico (2)

Source: Prevencasa A.C.

It has been more difficult for them to get money, so they dose what they can buy to avoid the withdrawal syndrome. Naloxone donation has decreased due to border closings. Violence has grown for a long time, mainly in the channel where the cartels dispute the territory. Few cases of covid-19 have been reported, no more than those reported in the general population.

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How the drug market has evolved according to the UNODC

UNODC warns of increased drug use, due to an oversupply at a lower price due to a reduction in demand. The difficulty of obtaining imported inputs for drug production, given border closings and restrictions on international trade, has reduced the supply of synthetic and prepared drugs. Measures that restrict mobility have affected the transit of drug shipments between national borders, the sea route being the least affected, and the use

  • f boats to traffic other drugs such as heroin has increased.

Source: WDR 2020, presentation by Lic. Sofía Días Menció; Note by Espino M. Crisis and Covid-19: UNODC. The Universal; June 17, 2020.

These restrictive measures, as indicated by the UNODC in its recent World Drug Report, have made the northern border of the country a large store of drugs, due to the low mobility that exists (Reported by Sofía Díaz Menció, in the presentation of the WDR 2020). This difficulty appears to have motivated Mexican cartels more to produce fentanyl in Mexico so as not to depend on inputs from China.

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Measures have been taken through messages, especially on social networks, to invite the population to reduce their consumption or not to consume (alcohol, tobacco and other drugs) In particular, a campaign was carried out to inform the population about how to detect the symptoms derived from consuming adulterated alcohol, given the increase in cases of intoxication and deaths from said situation; however, these campaigns must be established on a regular basis and with clearer messages for the entire population, and incorporate local authorities to identify the particular risks of their communities. As clearly mentioned in the WDR, disrupting the finances of criminal groups is one of the best tools to decrease the supply of drugs. However, the population that is dependent on drugs is the most affected by the pandemic, due to the closure of services, government, private, and mutual aid or self-help. Even when help lines or support have been opened through electronic platforms, not everyone in this population has access to a cell phone

  • r a computer.

Injecting drug users, in particular, have been a population greatly affected by the lack of access to economic resources and support in general. Access to methadone for them is very difficult, even though it would be of great help to them if they were infected by covid-19. Additionally, with less access to naloxone,

  • verdose care is complicated

Considerations: