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We assess the current and describe possible future public health impacts of the legalisation of cannabis production, sale, and use in the Americas. First, we describe global patterns of cannabis use and their most probable adverse health effects. Second, we summarise evidence regarding the effectiveness of cannabinoids for medicinal use and describe approaches that have been used to regulate the use of medicinal cannabis and how these approaches might have affected medicinal and recreational use and harms (eg, road crashes). Third, we describe how jurisdictions that have legalised recreational use have regulated production and sale of cannabis. Fourth, we evaluate the effects of cannabis legalisation on cannabis use and harms and on the use of alcohol, tobacco, and other drugs. Fifth, we use alcohol and tobacco policy examples to identify possible long-term public health effects of cannabis legalisation. Finally, we outline policy approaches that could minimise harms to public health arising from the legalisation of a commercial cannabis industry.

The article looks at the opioid epidemic in the U.S. and examines strategies to prevent widespread abuse around the world. It cites the overuse of legal painkillers and the spread of fentanyl as the causes of the opioid epidemic and looks at potential consequences for public health. In response, the authors suggest that governments treat addicted individuals and reduce the supply of opioids through regulations on the pharmaceutical industry.

We present models of differential terror queue games, wherein terrorists seek to determine optimal attack rates over time, while simultaneously the government develops optimal counterterror staffing levels. The number of successful and interdicted terror attacks is determined via an underlying dynamic terror queue model. Different information structures and commitment abilities derive from different assumptions regarding what the players in the game can and cannot deduce about the underlying model. We compare and explain the impact of different information structures, i.e., open loop, closed loop, and asymmetric. We characterize the optimal controls for both the terrorists and the government in terms of the associated state and costate variables and deduce the costate equations that must be solved numerically to yield solutions to the game for the different cases. Using recently assembled data describing both terror attack and staffing levels, we compare the differential game models to each other as well as to the optimal control model of Seidl et al. (Eur J Oper Res 248:246–256, 2016). The paper concludes with a discussion of the lessons learned from the entire modeling exercise.

The past decade has seen a remarkable liberalization of marijuana policies in many parts of the United States. We analyze data from the National Survey on Drug Use and Health (NSDUH) for coinciding changes in the marijuana market from 2002 to 2013, including market size, number and demographics of customers, and varying means of acquiring the drug. Results suggests that (a) the national market has grown, especially in terms of the number of daily users; (b) marijuana users remained economically “downscale” over this period, and in many ways resemble cigarette users; (c) distribution networks appear to be professionalizing in a sense, as fewer users obtain marijuana socially; (d) the typical purchase has gotten smaller by weight but not price paid, suggestive of a trend toward higher potencies; (e) marijuana expenditures vary by user group; and (f) respondents with medical marijuana recommendations differ from other users in systematic ways.

Legalization has been debated for decades, but California’s Fall 2010 vote on Proposition 19 makes passage seem suddenly more plausible. Proposition 19, which would have legalized not only personal consumption but also production and distribution to supply recreational use, was defeated narrowly (53.5% to 46.5%). This article synthesizes several threads of evidence concerning public support for legalization in the U.S. to shed light on the likelihood some similar effort will pass in the future. The overall conclusion is noncommittal, but the exercise generates a number of insights. In particular, simple what-if exercises suggest that the effects of generational turnover and voting occurring in a presidential vs. an “off” year may be smaller than some thought. The concluding section translates some of the observations into implications for both proponents and opponents of marijuana legalization.

Debates about which policy initiatives can prevent or reduce the damage that illicit drugs cause to the public good are rarely informed by scientific evidence. Fortunately, evidence-based interventions are increasingly being identified that are capable of making drugs less available, reducing violence in drug markets, lessening misuse of legal pharmaceuticals, preventing drug use initiation in young people, and reducing drug use and its consequences in established drug users. We review relevant evidence and outline the likely effects of fuller implementation of existing interventions. The reasoning behind the final decisions for action might be of a non-scientific nature, focused more on what the public and policy-makers deem of value. Nevertheless, important opportunities exist for science to inform these deliberations and guide the selection of policies that maximise the public good.

California nearly legalized commercial marijuana production in 2010; in coming years, other states and California are expected to entertain similar proposals. This raises the question of whether marijuana diverted from legal production could displace current sources of marijuana in other states. Combining prior estimates of legal production cost with new estimates of the cost of smuggling within the United States suggests that in most states, diverted legal production would substantially undercut current prices. So, if one state legalized, then (illegal) interstate “exports” could depress marijuana prices throughout the United States, even if taxes are collected before diversion and export. The authors proxy smuggling costs by the current gradient in prices observed for Mexican or commercial-grade marijuana; based on seven different data sets, it appears to be roughly US$325 to US$475 per pound per 1,000 miles as one moves north from the Mexican border.

This article raises the question of how drug policy should respond to take advantage of market disruptions. A simple mathematical model of the spread of drug use is adapted to a two-stage problem in which drug prices are abnormally low or high in the first stage, and the policy planner is allowed to adjust the level of drug control funding continuously over time. Optimal policies for this model are derived using the methods of optimal control theory. They suggest that whether it is better to increase or decrease drug control efforts in response to a market disruption can depend on the initial number of users and, hence, on the stage of the epidemic, as well as the length and intensity of the drought or glut. Although simple prescriptions are not possible, the potential for adaptive policies to improve outcomes is illustrated.

An empirically-derived model of national drug initiation is combined with a compartment model of trends in illicit drug use parameterized for Australia. Numbers of initiates seem to oscillate over time but with fluctuations whose aptitude diminishes over time. Lags and interpersonal variation in drug use careers smooth those oscillations for measures of problem use and total drug-related social cost, so even abrupt changes in initiation barely ripple the trajectory of drug-related social cost. Hence, the benefits of interventions that successfully disrupt initiation may be “hidden in plain sight” by being spread broadly over time so that they leave only the faintest finger-print detectable by before-and-after comparison. Thus, the absence of clear drops in drug-related problems does not imply that an upstream ntervention such as prevention or supply disruption did not produce substantial social benefits. More generally, drug use and related problems are often perceived of as stubborn, even intractable. Some of that perception stems from real limitations in the effectiveness of drug-control interventions. However, inertia inherent in the evolution of drug use can make even cost-effective interventions appear weak (and detrimental interventions appear benign).

Spreadsheets are both ubiquitous and error-prone, but there is less evidence concerning whether spreadsheet errors frequently lead to bad decisions. We interviewed forty-five executives and senior managers / analysts in the private, public, and non-profit sectors about their experiences with spreadsheet errors and quality control. Almost all report spreadsheet errors are common. Most can report instances in which errors directly led to losses or bad decisions, but opinions differ as to whether the consequences of spreadsheet errors are severe. Quality control procedures are in most cases informal. A significant minority of respondents believe such ad hoc processes are sufficient because the “human in the loop” can detect any gross errors. Others thought more formal spreadsheet quality control could be beneficial.

Generally more is known about drug use and demand than about markets and supply, in large part because population survey data are available while market data are not. Although the household population represents a relatively small proportion of users of hard drugs, it represents a large proportion of the population using marijuana and participating in marijuana markets. This paper provides a description of marijuana market and acquisition patterns as reported by participants in the 2001 National Household Survey on Drug Abuse. We find that most respondents obtain marijuana indoors (87%), from a friend or relative (89%), and for free (58%). Retail marijuana distribution appears to be embedded in social networks rather than being dominated by “professional” sellers. Despite these contrasts with stereotypical street markets for cocaine and heroin, there are also similarities, such as evidence of quantity discounts and a minority of users accounting for the majority of purchases. We estimate that there are on the order of 400 million retail marijuana purchases in the U.S. each year and that the average purchase size is small, about six or seven joints.

Data from the Survey of Inmates in Federal and State Correctional Facilities, 1997 are used to estimate the number of drug-law violators in U.S. prisons solely because of their drug use and not because of involvement in drug distribution or other offenses. The estimates (5,380 to 41,047) are much lower than would be implied by naively assuming that conviction for drug possession implies no involvement in drug distribution. Implied imprisonment risk per year of use is also low, perhaps an hour per year of use for marijuana, in part because expected time served is half that for those clearly involved in drug distribution.

Drug markets have been targeted for increasingly tough enforcement, yet retail prices for cocaine and heroin have fallen by 70–80%. No research has explained adequately why prices have fallen. This paper explores the possibility that part of the explanation may lie in the failure of drug dealers to respond to risks the way the simplest rational actor models might predict.

AbstractA convergence of technological and institutional factors has driven rapid and dramatic change in the way introductory management science is taught, making it far more valuable for students preparing for careers in public administration, management, and policy analysis. This article sketches the origins and nature of these changes and their implications for management science instruction. It then describes one “modern” management science course taught at Carnegie Mellon University's Heinz School of Public Policy and Management and gives pointers to resources readers can use to create or adapt courses for their own institutions.

Interviews with low-level drug dealers in New York City reveal that the monetary costs of distributing drugs are modest. Hence, the proportion of sales revenue retained by these sellers is a meaningful indicator of their earnings. There are four distinct types of sellers, with systematic differences across types in the proportion of sales revenue retained. Entrepreneurs who own the drugs they sell retain the largest share (about 50 percent). Independent consignment sellers retain less (about 25 percent). Consignment sellers who operate within fixed selling locations or “spots” retain still less (10 percent), and the sellers who were paid hourly to sell from spots retained the smallest proportion (3 percent). These differences might explain variation in reports of sellers' earnings and may have significant implications for the relative ability of enforcement against spots and enforcement against sellers operating outside of spots to drive up drug prices and suppress drug use.

This paper reviews empirical evidence on drug prices and discusses implications for understanding of drug markets and for policy. The most striking characteristics of drug prices are their high levels and extreme variability over time and space. High prices deter consumption but have ambiguous effects on drug-related crime. The consequences of the variability are largely unexplored and are difficult to determine. Conclusions are mixed with respect to the ability of policy to influence prices. Prohibition plus some degree of enforcement can drive prices far above what they would be if drugs were legal. In certain circumstances, additional severity of enforcement can create transient spikes in price or alter the source of drugs by driving up prices from one source relative to another. However, increasing enforcement over and above an already strongly enforced prohibition appears to have only limited ability to drive prices up further.

The U.S. devotes substantial resources to interdicting illicit drugs. The goal of most prior research on interdiction has been to assess its impact on the price and availability of drugs in retail markets. Interdiction may also, however, affect the export-import industry itself in ways that are of interest to policy makers.

Prevalence estimations of drug-related phenomena, including numbers of users, extent of consequences, and levels of consumption and expenditures, can provide information useful in assessing the scope of the problem, identifying patterns and trends in consumption, evaluating the effectiveness of intervention programs, and allocating resources. The authors summarize the policy needs for, the current status of, and recent developments in prevalence estimation, as described in the preceding articles. Implications raised in the collective work and specific recommendations to improve prevalence estimation in the service of policy are discussed.

This article discusses displacement of drug markets, that is, the phenomenon of markets adapting to police enforcement rather than being eliminated by it. The extent to which displacement occurs and the forms that it takes must ultimately be resolved by empirical observation, but it is important to clarify some issues surrounding displacement now so that these questions are framed properly before the data is collected.This article argues that markets displace in method of operation as well as in physical location; that different forms of physical displacement can be distinguished; that the extent to which displacement occurs is a continuous and not a binary variable; and that even when there is “complete” displacement, interventions may still yield benefits to society.

International prohibitions create asymmetries; production and transshipment concentrate in relatively few places that bear the bulk of the negative externalities created by the illegal trade. These externalities fuel calls for altering the United Nations treaty framework and for individual nations to legalize outside of the framework. Analyses of the pros and cons of legalization usually adopt the perspective of a single nation acting in isolation. However, one nation’s legalization alters incentives for others to act, and not always in obvious ways. So the proper perspective is that of a dynamic game.

Many more people die each year from alcohol and tobacco use than from illicit substance use, yet the American public appears far more concerned about illegal drugs. This paper suggests that some of this mismatch in concern may stem from differences in the types of deaths created, with deaths associated with illicit drugs being, on average, "scarier" to the public than are the deaths associated with legal substances. Hence, the mismatch between actual risks and public concern is not necessarily entirely wrong or irrational, but rather may embody stable preferences.

Many more people die each year from alcohol and tobacco use than from illicit substance use, yet the American public appears far more concerned about illegal drugs. This paper suggests that some of this mismatch in concern may stem from differences in the types of deaths created, with deaths associated with illicit drugs being, on average, "scarier" to the public than are the deaths associated with legal substances. Hence, the mismatch between actual risks and public concern is not necessarily entirely wrong or irrational, but rather may embody stable preferences.