Search

This paper explains how the current architecture of the pharmaceutical markets has created a misalignment of financial incentives and public health that is a central cause of harmful practices. It explores three possible solutions to address that misalignment: taxes, increased financial penalties, and drug pricing based on value. Each proposal could help to partly realign financial incentives and public health. However, because of the limits of each proposal, there is no easy solution to fixing the problem of financial incentives. [ABSTRACT FROM AUTHOR]

Background: An unintended consequence of drug prohibitions is that they often fail to absolutely deter potential drug dealers and users and instead restrictively deter them. One way in which dealers sometimes alter their behaviour in response to these prohibitions is by using violent forms of social control to prevent their customers from committing careless behaviour or from becoming police informants. Many dealers, however, are reluctant to use violent forms of social control for various reasons. Little research has explored how these dealers use nonviolent threats and promises to prevent these behaviours among their customers and how these forms of social control then influence their perceptions of the risk of formal punishment.Methods: To perform this examination, this paper employs information gathered through semi-structured interviews with 33 unincarcerated illicit drug sellers operating in and around St. Louis, Missouri.Results: This group of drug dealers relied on threats of nonviolent outcomes to prevent their customers from behaving carelessly before, during, and after drug transactions and used implicit promises of continued rewards to dissuade customers from providing information to the police. They presumed that these measures reduced the likelihood of their customers committing these actions. This then decreased their perceptions of the risks of selling illicit drugs.Conclusion: The present findings suggest that an unintended impact of drug prohibitions is that they sometimes restrictively deter drug dealers instead of preventing them from selling illicit drugs. They also suggest that restrictive deterrence among drug dealers can take the shape of social control. The findings also indicate that friendship norms can serve to inoculate dealers against the threat of formal punishment. Finally, the study suggests that levels of drug market violence may be related more to the nature of the relationships between drug market participants and their cultures. [ABSTRACT FROM AUTHOR]