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      The Identification of Precursor Regulation Impact on the Methamphetamine Market and Public Health Indicators in the Czech Republic: Time Series Structural Break Analysis

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          Abstract

          Background: This study provides insight into the impact of methamphetamine precursor regulation, which is considered to be one of the most important tools of supply reduction and a tool with potential public health impact. Methods: It is based on a longitudinal and quasi-experimental design and it investigates the changes of methamphetamine precursor regulation in Czech Republic, which is treated as a natural experiment. The statistical analysis uses features from the generalized fluctuation test framework as well as from the F test framework to estimate structural changes in the methamphetamine-related arrests and nonfatal intoxications time series. Results: The analysis identified structural breaks in the majority of the methamphetamine drug market-related time series in the period related to the tightening of regulation. The results of this study show that methamphetamine precursor regulation was associated with the proliferation of international and organized crime groups and with no change in the overall number of arrests and nonfatal intoxications. Conclusions: The precursor regulation ceteris paribus plausibly leads to the change in drug supply towards more organized groups and to an increasing involvement of foreign nationals at the drug market and is not effective in suppressing the methamphetamine market and in reducing the public health indicator of nonfatal methamphetamine intoxications.

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          The use of controls in interrupted time series studies of public health interventions

          Interrupted time series analysis differs from most other intervention study designs in that it involves a before-after comparison within a single population, rather than a comparison with a control group. This has the advantage that selection bias and confounding due to between-group differences are limited. However, the basic interrupted time series design cannot exclude confounding due to co-interventions or other events occurring around the time of the intervention. One approach to minimizse potential confounding from such simultaneous events is to add a control series so that there is both a before-after comparison and an intervention-control group comparison. A range of different types of controls can be used with interrupted time series designs, each of which has associated strengths and limitations. Researchers undertaking controlled interrupted time series studies should carefully consider a priori what confounding events may exist and whether different controls can exclude these or if they could introduce new sources of bias to the study. A prudent approach to the design, analysis and interpretation of controlled interrupted time series studies is required to ensure that valid information on the effectiveness of health interventions can be ascertained.
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            imputeTS: Time Series Missing Value Imputation in R

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              Testing and dating of structural changes in practice

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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                26 October 2020
                November 2020
                : 17
                : 21
                : 7840
                Affiliations
                Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital, 128 00 Prague, Czech Republic; miroslav.bartak@ 123456lf1.cuni.cz
                Author notes
                [* ]Correspondence: benjamin.petruzelka@ 123456lf1.cuni.cz ; Tel.: +42-073-585-2437
                Author information
                https://orcid.org/0000-0002-7265-6514
                Article
                ijerph-17-07840
                10.3390/ijerph17217840
                7663038
                33114689
                347c971e-ecdd-437b-ad5f-d0868d7c00bb
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 14 September 2020
                : 19 October 2020
                Categories
                Article

                Public health
                methamphetamine,precursor,regulation,pseudoephedrine,czech republic,drug supply,drug market,time series,nonfatal intoxication,public health

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