Which of the following was a major unintended effect of the publication

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Volume 101, March 2022, 103550

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Antidrug policies enacted in illicit crop producing countries have mainly focused on forced eradication through aerial spraying, and alternative development programs. In most cases, neither policy has proven to be very successful in reducing illicit crops (Ávila Ceron et al., 2018; Díaz & Sánchez, 2004; Higginson et al., 2017; Mejía et al., 2017; Moya, 2005; Tabares & Rosales, 2005). Alternative development programs target structural causes for growing illicit crops and, until now, have not been identified as having unintended negative effects (Higginson et al., 2017; Ladino et al., 2021; Lee & Clawson, 1993; Mejía et al., 2021; Moya, 2005; Tabares & Rosales, 2005).

Aerial spraying increases deforestation, health problems, and violence (Abadie et al., 2014; Camacho & Mejía, 2017; Dávalos et al., 2016; Peceny & Durnan, 2002; Rozo, 2018; Van Bruggen et al., 2018). To the best of my knowledge, the only paper to address the question of unintended effects of alternative development programs found no statistical evidence on violence, measured through insurgent attacks (Vargas, 2012). Theoretically, crop substitution programs could have unexpected consequences on community members who are in charge of the implementation of the policies (Rodríguez Parra, 2017).

This article explores whether political violence was a potential unintended effect of Colombia's recent illicit crop substitution program. The National Comprehensive Program for the Substitution of Illicit Crops (pnis) was established in 2017 as a result of the recent peace process between the Colombian Government and the Revolutionary Armed Forces of Colombia (farc). To date, the pnis constitutes the largest substitution program in the world with more than 99,000 households involved. One of its novelties was a community agreement between government delegates, farc members, and the community, as a prerequisite for implementation in each municipality1. This agreement represented the community's willingness to become involved in the program through voluntary substitution of illicit crops.

This consultation process required the active participation of local activists, referred to in this paper as “social leaders”, who represent the interests of their communities (Somos Defensores, 2008; Prem et al., 2021). In contexts of internal conflict, social leaders are fundamental to building local state institutions due to the lack of State presence (Arjona, 2016). Community agreements could easily expose social leaders as these agreements represent their opposition to the interests of organized crime groups if no joint institutional strategy is implemented to protect their lives. Coca growers’ associations involved in the substitution program reported the killings of 56 of their members since the implementation of the pnis (Gutiérrez et al., 2020)2. Fig. 1 presents the evolution of the monthly moving average rate of social leader killings in pnis and non-pnis municipalities3. The rate evolved similarly in both groups from 2005 to 2016, before the implementation of the pnis (denoted by the red vertical line). A disproportionate increase of such killings occurred following the implementation of the program in pnis municipalities, compared with non-pnis. Accordingly, the purpose of this article is to determine whether this increase was caused by the crop substitution program.

The empirical approach used a unique monthly dataset of killings of social leaders at municipal level, from January 2005 to December 2019, including the exact month in which community agreements were signed in each pnis municipality4. This is a novel dataset, as it makes it possible to exploit cross-sectional and time variations through the signing of pnis community agreements.

This research employed an event study identification strategy, comparing pnis municipalities with potential pnis beneficiaries that were not enrolled in the program. Baseline results suggest a positive and statistically significant effect of the pnis on the killing of social leaders. In particular, the pnis increased the monthly rate of social leader killings by 481%, and the program's agreements raised the monthly probability of a social leader killing by 1.1 percentage points, representing a 122% increase. Findings are robust to several specifications and the identification assumptions are likely to be fulfilled in all econometric models.

I extended the analysis to heterogenous effects for acres of coca crops and the presence of armed groups. Analysis shows that pnis community agreements increased political violence in municipalities with small and intermediate coca crops —because these municipalities are likely to enjoy higher institutional quality; hence, lower civilian cooperation with armed groups— and armed group presence and disputes5. Thus, unintended effects, specifically killings of social leaders, were present in municipalities with territorial disputes among armed groups that did not hold complete power and where there were expectations to expand coca leaf crops.

The contribution of this paper is threefold. First, it contributes to the literature on antidrug policies concerning illicit crops, as it reveals unintended violence consequence of alternative development programs. As such, it weakens the case for antidrug policies in targeting illegal crop cultivation, instead of focusing on the higher levels of the cocaine production chain (Zuleta, 2017).

Secondly, this article contributes to the growing literature on political violence suggesting a potential effect of this antidrug policy on political actors. The killing of these actors —whose importance is fundamental in peacebuilding contexts— has constituted a systematic strategy used by armed groups to gain territorial control (Arjona, 2016; Rodríguez Parra, 2017; Steele, 2017). Indeed, there is evidence of increasing violence against social leaders, while other security indicators present sustained decreases. These facts suggest a surge of new political violence dynamics (Ball et al., 2018; Gutiérrez et al., 2020). The causes of these dynamics are not entirely understood, except for the role that farc demobilization had on increased targeted killings of social leaders from remaining armed groups and their disputes for territorial control (Prem et al., 2021).

Finally, this paper builds evidence of the unintended consequences of peace agreements and associated challenges within a peacebuilding context, such as the need to implement comprehensive policies that account for these collateral effects throughout the peace building process. At present, some aspects of the recent peace negotiations in Colombia suggest unintended effects in terms of violence and deforestation (Prem et al., 2020, 2021).

The oldest Latin American guerrilla army —FARC— was formed in the 1960s, and similar to other left-wing armed groups such as the National Liberation Army (ELN), had Marxist ideologies. During the 80s, there was a surge of right-wing armed groups, formed in response to the expansion of left-wing guerrillas. Both left and right-wing groups were mainly financed through illicit drug production and trafficking.

Political violence is an enduring phenomenon that has lasted over six decades in Colombia.

To develop the empirical strategy, I employed data from several sources. Firstly, Somos Defensores reports the killing of every social leader including community, ethnic, and agrarian leaders, and victims’ representatives, among others9

In the empirical strategy, I employed the timing variation of pnis community agreements across beneficiary municipalities. This set allowed an event study approach, where the treatment group is made up of pnis municipalities and the event is defined by the period in which the community agreement took place in each municipality. The baseline econometric specification is defined as follows:ym,s=μm+μs+δdms+βXm,s+εm,swhere ym,s is a vector including the rate of social leader killings per 100,000

Table 2 presents results of Eq. (1) including the probability and rate of social leader killings as dependent variables. These results suggest a positive and statistically significant effect of pnis on the probability and rate of social leader killings. In the case of the continuous model, pnis community agreements seemed to raise the average monthly rate by 0.125 killings per 100,000 inhabitants, which implies a 481% increase in the rate of social leader killings, compared with the

To deepen the understanding of current political violence in Colombia, the purpose of this section is to determine whether or not the PNIS had differential impacts based on municipality attributes, especially illicit economies and conflict-related attributes. Two potential mechanisms to explain the economic and statistically positive effect of the program's community agreements on the killing of social leaders are: i) coca crops cultivation and ii) armed group presence. In the case of the

This article explores the effect of an alternative development program on political violence in Colombia. Employing an event study methodology —in which the treatment group is made up of pnis beneficiary municipalities, and the control group includes non-pnis coca growing municipalities— results suggest a 481% increase in the monthly rate of social leader killings and a 122% increase in the probability of a killing caused by PNIS community agreements. These results are consistent with several

This research did not receive any specific grant from funding agencies in the public, commercial, or non-for-profit sectors.

This article did not involve the use of animals nor human participants.

None.

I am especially grateful to María Alejandra Vélez, Cecilia Suescún, Sandra García, Manuel Fernández, Andrés Moya, Hernando Zuleta, Paul Reuter and two anonymous referees for numerous discussions and in-depth comments during the development of this article. I thank Ana María Herrera and Jaime Bonet for providing fundamental comments to a previous version of this paper, and Juan Fernando Vargas for generously sharing his data on social leaders’ killings. Suggestions by Santiago Pérez, Diana

A.H.C. Van Bruggen et al.
M. Prem et al.
J.F. Ladino et al.
A. Camacho et al.
A. Abadie et al.
J.D. Angrist et al.
A. Arjona
Arjona, A. (2010). One national war, multiple local orders: An Inquiry into the unit of analysis of war and post-war...
A. Arjona
A. Arjona

C.A. Ávila Ceron et al.

P. Ball et al.

M. Chacón et al.

P.A. Chouvy

S.E. Cornell

L.M. Dávalos et al.

A.M. Díaz et al.

C. Erasso et al.

T. Glazebrook et al.

F. Gutiérrez

F. Gutiérrez et al.

A. Higginson et al.

In this paper, we study whether leadership and community organisation can explain differences in the presence and expansion of coca crops in rural Afro-Colombian collective territories. Following a mixed-method approach that combines the analysis of satellite imagery, semi-structured interviews and household surveys, our results suggest that leadership and community organisation help explain differences in the presence of illegal coca crops by activating pre-existing ‘stocks’ of social capital that enable rural Afro-Colombian communities in the country's southern Pacific region to resist the penetration and/or expansion of illegal coca crops. Results also show that resistance is more effective when the interests and strategies of leadership and communities are aligned. We argue that the effectiveness and sustainability of resistance depend on: (a) the stock of social capital that determines organisational capabilities, (b) the specific normative content with which this capital is infused, (c) the legitimacy and influence of leadership on the community, and (d) synergies among different levels of grass-root community organisation. We conclude that investing in social capital and community capabilities is thus one way to reorient policy interventions, a goal to which the Colombian state can only partially contribute given its policy priorities and structural limitations.

HIV incidence in Eastern Europe and Central Asia (EECA) continues to increase, primarily among people who inject drugs (PWID) and people in prisons. In Kyrgyzstan, an estimated 35% of people in prison are PWID, and 10% have been diagnosed with HIV. In 2008, Kyrgyzstan became the first country in EECA to provide free and voluntary methadone in prisons. We examine the impact of this national program on methadone within prison as well as linkage to and retention in treatment upon release to the community.
Administrative data from a national methadone registry with de-identified information were assessed retrospectively. We examined the delivery of methadone services, including the duration of treatment both within prison and after release, for all prisoners who were prescribed methadone in Kyrgyz prisons from 2008 to 2018. Reasons for discontinuing methadone, HIV status and methadone dose are also analyzed.
Between 2008 and 2018, nine of Kyrgyzstan's 16 prisons offered methadone, and 982 incarcerated people initiated methadone within prison. Prisoners prescribed methadone were mostly male (96.2%), in their mid-30s (mean=34.9 years), and had been incarcerated for a relatively long time (mean = 44.1 months); their mean treatment duration in prison was 12.5 months, and 31.6% had HIV. A subsample (N = 645; 65.7%) of these were released to the community. Of these 645 people, 356 (55.2%) were not taking methadone at the time of release, 128 (19.8%) were on methadone and continued it after release, and the remainder (N=161, 25.0%) were on methadone at the time of release, but subsequently discontinued it, most within the first 7 days after release. Among those continuing methadone, 14.8% (N=19) remained on treatment ≥ 12 months. Independent correlates of linkage to methadone after release included positive HIV status (adjusted hazard ratio (aHR)=1.55; p = 0.033), receipt of methadone before their incarceration (aHR=2.01; p = 0.039), and receipt of methadone at the time of release (aHR = 20.81; p<0.001).
This is the first evaluation of within-prison methadone treatment in EECA. Uptake of methadone within prison and retention in treatment after release were both low. Continuous maintenance of treatment throughout incarceration is an opportunity to optimize HIV prevention and link patients to methadone post-release.
Buprenorphine-naloxone (BUP-NX) is a first-line treatment for opioid use disorder and has a superior safety profile compared to other forms of opioid agonist therapy. In Canada, restrictions on BUP-NX prescribing were relaxed in 2016, which may have had an effect on rates of diversion and non-prescribed use. We sought to longitudinally examine the reported availability and use of non-prescribed BUP-NX among people who use drugs (PWUD) in an urban Canadian setting.
We collected data from two linked prospective cohorts of PWUD in Vancouver, Canada, and examined self-reported availability and use of non-prescribed BUP-NX over time. We used a multivariable generalized estimating equations model to identify trends and factors associated with the immediate availability (i.e., within 10 min) of non-prescribed BUP-NX.
Among 1617 participants between 2014 and 2020, the immediate availability of non-prescribed BUP-NX increased from 16% to 63% (p<0.001). In the multivariable analysis, factors independently associated with immediate BUP-NX availability included calendar year (adjusted odds ratio = 1.19, 95% confidence interval: 1.15–1.23), along with a number of other variables suggestive of more severe substance use disorders. Only 17 participants ever reported use of non-prescribed BUP-NX.

We observed that BUP-NX has become increasingly available in the unregulated drug supply in recent years but its use has remained infrequent in this setting. These results suggest that relaxed restrictions on BUP-NX prescribing have not been a major driver of increased non-prescribed use in this population.
In the context of global declines in alcohol consumption, studies have recently shown that middle-aged women's alcohol use has increased in the past decade. Limited research has focused on this demographic group. We aimed to understand the perspectives of women aged 40–65 years on the role of alcohol in their lives and their motivations for consuming alcohol. We used social practice theory to identify distinctive assemblages of meanings, materials, competences and temporalities relating to alcohol use.
We used qualitative methods incorporating Human Centred-Design principles into activity-based workshops. We conducted ten 3-hour workshops with a total of 39 women aged 40–65 years. We coded the transcribed data using the three original components of social practice theory – meanings, materials, competences as well as the fourth component of temporality.
Women described their alcohol use as nuanced, with different meanings across contexts and settings. ‘Wine o'clock’ was the term used by many women to describe the practice of consuming wine as soon as they finished their day's duties. Women appeared conscious of representing their drinking as rational, measured and safe, particularly when discussing weekday use, and drinking alone. Women described it as an act of relaxation, and rationalised it as earned. Alcohol consumption on weekends was strongly tied to social connection. Alcohol was explicitly described as the means to see people socially and was also implicitly present in social gatherings such as lunches, barbecues and dinners on weekends. Although women rejected the notion of experiencing social pressures to consume alcohol, they also described needing excuses for not consuming alcohol, such as partaking in temporary abstinence periods such as Dry July.
Our study describes how midlife women use alcohol to demarcate between duty and pleasure and for social connection. Prevention efforts which focus on social connection, relaxation and changing the discourse on alcohol's role in women's social lives may be beneficial for reducing women's alcohol consumption.
Poppers (alkyl nitrites) are vasodilators used by many gay, bisexual, and other men who have sex with men (GBMSM) to relieve pain, enhance pleasure, and facilitate penetration during sex. In 2013, the Canadian government cracked down on the sale of poppers products, however prevalence of poppers use among GBMSM in Canada remains high. Poppers have been studied by medical researchers since the 1980s, yet qualitative and community-based research to inform federal policy, remains somewhat less common.
We conducted a critical interpretive synthesis (CIS) to better understand poppers health literature using the medical model of health as a point of reference. Analysis was performed using inductive and deductive methods including reflexive note-taking, mind-mapping, and close coding. 153 publications were identified to inform this review of which 5 were chosen for coding based on a purposive sampling framework.
Our findings are unified within a theoretical construct we term responsibility. Responsibility is a construct we use to describe the bias we identified in health sciences literature regarding poppers use that tends to exaggerate the necessity for poppers cessation, and devalue both the benefits of poppers use and the perspectives and experiences of people who use poppers. The emphasis on individual behavior change within the literature appears to be motivated less by objective measures or assessments of health risks and outcomes, and more by harmful stereotypes that position gay men and people who use drugs as inherently irresponsible.
We conclude by discussing how these findings have important implications for the review of current policy on poppers sales in Canada which remains influenced by a literature base prejudiced by factors such as homophobia, heteronormativity, and drug stigma, and recommend areas for future work.
Concurrent opioid-related overdose and COVID-19 crises in the U.S. have imposed unprecedented challenges on people who use illicit opioids.

Using the experiences of 324 people who use illicit opioids between April 2020 and March 2021, we examined four domains of health and well-being potentially impacted by COVID-19: drug risks and responses, healthcare and related services, material hardship, and mental health. Data were drawn from participants’ completed monthly survey assessments which were grouped into four periods of interest for the unfolding pandemic: April-June 2020, July-October 2020, November-January 2021, and February-March 2021.
A majority of measures in our four domains showed early COVID-19 related impacts, which quickly diminished as people and agencies responded to the pandemic. Difficulty obtaining food was the most frequently reported material hardship and appeared worst in April-June 2020. Over half of the population reported depression in April-June 2020, but this declined over the study period. Some participants reported changes to the heroin supply, including higher prices, lower quality, difficulty finding the drug, and fentanyl contamination. There was no discernable temporal shift in the frequency of use of each substance or the frequency of withdrawal symptoms. Over the study period, the mean number of overdoses per month decreased while the percent of opioid use events at which both a witness and naloxone were present (i.e., protected events) increased. Most participants receiving MOUD experienced an increase in take-home doses.
Findings speak to the resilience of people who use drugs as a population with disproportionate experience of trauma and crisis and also to the rapid response of NYC health agencies and service providers working with this population. Despite evident signs of adaptability and resilience, the COVID-19 pandemic has highlighted some of the unique vulnerabilities of people who use illicit opioids and the need for greater rates of “protected” opioid use and greater availability of wrap-around services to efficiently address the safety, food security, mental health, and treatment needs of the population.
In many parts of the world, the social mobility restrictions and stay-at-home orders introduced during the early months of the COVID-19 pandemic have been associated with significant reductions in crime. However, contrary to this general finding, illicit drug offence detections increased significantly. In this study, we explore the geographical distribution of the increase in Queensland, Australia, using spatiotemporal generalised additive model (GAM) to identify locations in the Local Government Area (LGA) of Brisbane where drug offence detection rates were unusually high during the three months of the COVID-19 lockdown (April-June 2020). Contrary to expectation, we find that the increase in drug offence detection rates appears to have been modest in most places, but widespread and diffuse throughout the city. We conclude that drug offence detections are most likely to have increased incidentally, probably as a consequence of general street policing initiatives which saw an increase in the visibility and vulnerability of drug user communities. We do, however, identify several locations in Brisbane where the drug offence detection rate exceeded the prediction by a considerable margin (in one case, more than double the upper limit of the prediction). We argue that in these locations the increase was likely the result of some spatial displacement of inner-city drug markets coupled with a series of targeted policing activities. Further research is needed to clarify the true mechanism of change in these locations.