Search

Background and aims: Multiple countries are considering revising cannabis policies. This study aimed to measure long‐term trends in cannabis use in the United States and compare them with alcohol use. Design and setting: Secondary analysis of United States general population survey data. Participants: The national surveys had a total of 1 641 041 participants across 27 surveys from 1979 to 2022. Measurements: Rates of use reported to the US National Survey on Drug Use and Health and its predecessors are described, as are trends in days of use reported. Four milepost years are contrasted: 1979 (first available data and end of relatively liberal policies of the 1970s), 1992 (end of 12 years of conservative Reagan‐Bush era policies), 2008 (last year before the Justice Department signaled explicit federal non‐interference with state‐level legalizations) and 2022 (most recent data available). Findings Reported cannabis use declined to a nadir in 1992, with partial recovery through 2008, and substantial increases since then, particularly for measures of more intensive use. Between 2008 and 2022, the per capita rate of reporting past‐year use increased by 120%, and days of use reported per capita increased by 218% (in absolute terms from the annual equivalent of 2.3 to 8.1 billion days per year). From 1992 to 2022, there was a 15‐fold increase in the per capita rate of reporting daily or near daily use. Whereas the 1992 survey recorded 10 times as many daily or near daily alcohol as cannabis users (8.9 vs. 0.9 M), the 2022 survey, for the first time, recorded more daily and near daily users of cannabis than alcohol (17.7 vs. 14.7 M). Far more people drink, but high‐frequency drinking is less common. In 2022, the median drinker reported drinking on 4–5 days in the past month, versus 15–16 days in the past month for cannabis. In 2022, past‐month cannabis consumers were almost four times as likely to report daily or near daily use (42.3% vs. 10.9%) and 7.4 times more likely to report daily use (28.2% vs. 3.8%). Conclusions: Long‐term trends in cannabis use in the United States parallel corresponding changes in cannabis policy, with declines during periods of greater restriction and growth during periods of policy liberalization. A growing share of cannabis consumers report daily or near daily use, and their numbers now exceed the number of daily and near daily drinkers. [ABSTRACT FROM AUTHOR]

Background and aims: Synthetic opioids, mostly illegally manufactured fentanyl (IMF), were mentioned in 60% of United States (US) drug overdose deaths in 2020, with dramatic variation across states that mirrors variation in IMF supply. However, little is known about IMF markets in the United States and how they are changing. Researchers have previously used data from undercover cocaine, heroin, and methamphetamine purchases and seizures to examine how their use and related harms respond to changes in price and availability. This analysis used US Drug Enforcement Administration (DEA) data to address two questions: (i) "To what extent does IMF supply vary over time and geography?" and (ii) "What has happened to the purity‐adjusted price of IMF?" Methods: We developed descriptive statistics and visualizations using data from 66 713 observations mentioning IMF and/or heroin from the DEA's System to Retrieve Information from Drug Evidence (STRIDE; now STARLIMS) from 2013 to 2021. Price regressions were estimated with city‐level fixed effects examining IMF‐only powder observations with purity and price information at the low‐to‐medium wholesale level (>1 g to ≤100 g; n = 964). Results: From 2013 to 2021, the share of heroin and/or IMF observations mentioning IMF grew from near zero to more than two‐thirds. The share of heroin observations also containing IMF grew from <1% to ~40%. There is important geographic variation: in California, most IMF seizures involved counterfeit tablets, whereas New York and Massachusetts largely involved powder formulation. The median price per pure gram of IMF powder sold at the >10 to ≤100 g level fell by more than 50% from 2016 to 2021; regression analyses suggested an average annual decline of 17% (P < 0.001). However, this price decline appears to have been driven by observations from the Northeast. Conclusions: Since 2013, the illegally manufactured fentanyl problem in the United States has become more deadly and more diverse. [ABSTRACT FROM AUTHOR]

Cannabis prohibition has created disparate harms--especially for Black, Indigenous, and People of Color ("BIPOC")--largely through arrest disparities for possession and their downstream effects. Addressing inequities is increasingly featured in discussions to legalize cannabis supply and adult possession for nonmedical purposes. While there is little disagreement that these inequities exist, those hoping to use cannabis policy to respond to them have proposed multiple options that each come with their own set of potential benefits and costs. This Essay describes some of these opportunities as well as some major puzzles and trade-offs surrounding the use of cannabis policy to advance social equity. Additionally, it offers insights into the number of people who could benefit from various social equity efforts related to cannabis policy. In particular, sealing or expunging cannabis possession convictions could affect many more BIPOC--possibly close to two orders of magnitude more--than prioritizing these individuals for entrepreneurship or employment opportunities in the cannabis industry. These options are not mutually exclusive, but decision makers should consider the possibility of federal legalization and what it will mean for small cannabis businesses when developing cannabis equity programs. [ABSTRACT FROM AUTHOR]

• There are interesting parallels between fireworks policy and drug policy. • Injury rates are similar in the U.S. per dollar spent on fireworks and cannabis. • Fireworks have alternately been prohibited or legalized in different places and times. • Fireworks prohibitions have been less strenuously enforced than drug prohibitions. • Use is highly concentrated in time for fireworks but by person for drugs. Nations wrestle with whether to prohibit products that can harm consumers and third parties but whose prohibition creates illegal markets. For example, cannabis is banned in most of the world, but supply for non-medical use has been legalized in Uruguay, Canada, and much of the United States and possession restrictions have been liberalized in other countries. Likewise, supply and possession of fireworks have been subject to varying degrees of prohibition in multiple countries, with those bans prompting significant evasion. Current and past history of fireworks regulations, sales, and harms are reviewed and contrasted with those for cannabis. The focus is on the United States, but literature from other countries is incorporated when possible and appropriate. This extends the insightful literature comparing drugs to other vices (such as gambling and prostitution) by comparing a drug to a risky pleasure that is not seen as a vice but which has been subject to prohibition. There are many parallels between fireworks and cannabis in legal approaches, harms to "users", harms to others, and other externalities. In the U.S. the timing of prohibitions were similar, with prohibitions on fireworks being imposed a little later and repealed a little sooner. Internationally, the countries that are strictest with fireworks are not always those that are strictest with drugs. By some measures, harms are of roughly similar magnitude. During the last years of U.S. cannabis prohibition, there were about 10 emergency department (ED) events per million dollars spent on both fireworks and illegal cannabis, but fireworks generated very roughly three times as many ED events per hour of use/enjoyment. There are also differences, e.g., punishments were less harsh for violating fireworks prohibitions, fireworks consumption is heavily concentrated in just a few days or weeks per year, and illegal distribution is primarily of diverted legal products, not of illegally produced materials. The absence of hysteria over fireworks problems and policies suggests that societies can address complex tradeoffs involving risky pleasures without excessive acrimony or divisiveness when that product or activity is not construed as a vice. However, the conflicted and time-varying history of fireworks bans also show that difficulty balancing freedoms and pleasure with harms to users and others is not restricted to drugs or other vices. Use-related harms fell when fireworks were banned and rose when those bans were repealed, so fireworks prohibitions can be seen as "working" from a public health perspective, but not well enough for bans to be employed in all times or places. [ABSTRACT FROM AUTHOR]

Introduction: Voters in eight U.S. states have passed initiatives to legalize large-scale commercial production of cannabis for non-medical use. All plan or require some form of "seed-to-sale" tracking systems, which provide a view of cannabis market activity at a heretofore unimagined level of detail. Legal markets also create a range of new matters for policy makers to address.Data: Publicly available data were obtained on approximately 45 million individually priced items purchased in the 35 million retail transactions that took place during the first two and a half years of Washington State's legal cannabis market. Records include product type (flower, extract, lotion, liquid edible, etc.), product name, price, and potency with respect to multiple cannabinoids, notably THC and CBD. Items sold can be traced back up the supply chain through the store to the processor and producer, to the level of identifying the specific production batch and mother plant, the firm that tested the product, and test results.Method: Data visualization methods are employed to describe spatial-temporal patterns of multiple correlated attributes (e.g., price and potency) broken down by product. Text-analytic methods are used to subdivide the broad category of "extracts for inhalation" into more homogeneous sub-categories. To understand the competitiveness of the legal cannabis market in Washington we calculate the Herfindahl-Hirschman index (HHI) for processors and retailers.Results: Cannabis prices fell steadily and proportionally at the processor and retailer levels. Retail and wholesale price maintained a roughly 3:1 ratio for multiple product types after some initial fluctuations. Although a wide range of edibles are sold, they account for a modest share of consumer spending; extracts for inhalation are a larger and heterogeneous market segment. The HHI indicates the cannabis market is highly competitive at the processor level, but less so for retail markets at the county level.Conclusions: Washington's state-legal cannabis market is diverse and rapidly evolving in terms of pricing, products, and organization. Post-legalization, researchers and policy makers may need to think in terms of a family of cannabis products, akin to how we think of new psychoactive substances and amphetamine-type stimulants, not a single drug "cannabis." [ABSTRACT FROM AUTHOR]

U.S. drug policy has sometimes implicitly — and incorrectly — assumed that all drug-related harm is caused by drug use, so reducing drug use necessarily reduces drug harm proportionately. Instead, drug policy should try to reduce the sum of both harms incident to drug consumption — including harms to users as well as harms to others — and policy-generated harm in the form of illicit markets, enforcement costs, and increased harmfulness of drug-taking due to controls. A strict prohibition can meet these criteria when it succeeds in keeping illicit markets “thin” and consumption very low. However, promulgating wise policies toward “thick” markets with widespread consumption necessarily involves trade-offs among competing objectives. Recent U.S. history illustrates both the futility of trying to control already “thick” markets using very long prison sentences for dealers (as in the cocaine market) and the risks of allowing “thin” markets to “thicken” by neglecting regulatory and enforcement efforts as prevalence starts to rise (as in the market for prescription opioids). [ABSTRACT FROM AUTHOR]

Aims To (1) assess trends and variation in the market share of product types and potency sold in a legal cannabis retail market and (2) estimate how potency and purchase quantity influence price variation for cannabis flower. Design Secondary analysis of publicly available data from Washington State's cannabis traceability system spanning 7 July 2014 to 30 September 2016. Descriptive statistics and linear regressions assessed variation and trends in cannabis product variety and potency. Hedonic regressions estimated how purchase quantity and potency influence cannabis flower price variation. Setting Washington State, USA. Participants (1) A total of 44 482 176 million cannabis purchases, including (2) 31 052 123 cannabis flower purchases after trimming price and quantity outliers. Measurements Primary outcome measures were (1) monthly expenditures on cannabis, total delta-9-tetrahydrocannabinol (THC) concentration and cannabidiol (CBD) concentration by product type and (2) excise tax-inclusive price per gram of cannabis flower. Key covariates for the hedonic price regressions included quantity purchased, THC and CBD. Findings Traditional cannabis flowers still account for the majority of spending (66.6%), but the market share of extracts for inhalation increased by 145.8% between October 2014 and September 2016, now comprising 21.2% of sales. The average THC-level for cannabis extracts is more than triple that for cannabis flowers (68.7% compared to 20.6%). For flower products, there is a statistically significant relationship between price per gram and both THC [coefficient = 0.012; 95% confidence interval (CI) = 0.011-0.013] and CBD (coefficient = 0.017; CI = 0.015-0.019). The estimated discount elasticity is −0.06 (CI = −0.07 to −0.05). Conclusions In the state of Washington, USA, the legal cannabis market is currently dominated by high-THC cannabis flower, and features growing expenditures on extracts. For cannabis flower, both THC and CBD are associated with higher per-gram prices, and there are small but significant quantity discounts. [ABSTRACT FROM AUTHOR]

The U.S. appears to be on a path toward legalizing cannabis on the alcohol model, which is to say allowing for-profit corporations to produce, sell, and promote its use. Even after national legalization, it will take decades to observe the full effects on industry structure and behavior, or on use and misuse. However, we should not be surprised if after markets have matured and consumption patterns stabilized, legalization increases acute cannabis intoxication in the U.S. by 40 billion hours per year. This increase in use will be the most important cannabis-specific effect of legalization. The bulk of it will be consumption by daily and near-daily users, and it is possible that roughly half will be by people who meet the medical criteria for substance use disorder. Much resulting harms will be borne by the users, and their families, and the harms are not primarily "medical", at least not in the narrow sense. Hence, legalization replaces the current problems of crime and black markets not so much with a medical or public health problem, but rather with a problem of potentially excessive consumption of a "temptation good" whose acute effects are performance degrading, not performance-enhancing. As legalization removes formal social controls, it might be prudent for society to develop stronger informal social norms - akin to "friends don't let friends drive drunk" - to protect the public and more importantly the users themselves from the performance degradation of bouts of nearly perpetual intoxication. [ABSTRACT FROM AUTHOR]

Many judge the American criminal justice system to have largely failed in its drug enforcement role, and the justice system itself has suffered a loss of community support and internal morale as a consequence. Five principles should guide improvement of drug enforcement, including that drug enforcement be viewed as a preventive activity, whose main goal is reducing drug abuse and related harms, and it should be designed for sustainability. Six more specific proposals are, first, make marijuana enforcement a minor matter for police through decriminalization of possession or outright legalization; second, induce drug users who are under criminal justice supervision to refrain from drug use by imposing appropriate monitoring and graduated sanctions programs; third, expand opioid substitution therapy for heroin- and other opioid-using offenders; fourth, reduce the average severity of sentences for drug offenses, particularly for minor functionaries who are easily replaced; fifth, base sentence length on culpability, danger, and replaceability, not quantity possessed or number of prior convictions; and sixth, reduce prescription drug abuse by policing that reinforces regulatory efforts. Jointly these proposals would provide an evidence-informed approach that should both reduce America's drug abuse problem and increase the perceived legitimacy of the criminal justice system. [ABSTRACT FROM AUTHOR]

An editorial is presented which addresses the author's views about advertising restrictions on cannabis products that are used for nonmedical purposes, and it mentions another article which appears in the same issue of the journal and deals with the legal aspects of cannabis and advertising in the U.S. America's Food and Drug Administration (FDA), the nation's Controlled Substances Act (CSA), and marijuana laws in places such as Oregon are assessed.

Most proposals for legalizing cannabis production and sale ban sales to minors. But such bans are not self-executing. There is at least the risk--if not the overwhelming probability--that legal availability for adults will change price and availability for minors in a way that will increase the prevalence of underage use. This is especially problematic with respect to use by younger adolescents and to heavy use. It might be possible, with vigorous enforcement, to reduce the impact of legalization on use by minors, but the costs and unwanted side effects of such efforts may make them, on balance, inadvisable. The example of alcohol shows that it is possible to make it difficult for minors to buy directly from licensed stores and that doing so reduces alcohol consumption and alcohol-related harms in the target population. But strong efforts to prevent minors from buying cannabis illegally from adults, who in turn buy it from licensed stores, may not be advisable. With minors now accounting for approximately 25 percent of the volume in the cannabis markets, giving strictly illicit producers and vendors a firmer grip on the underage market would undermine the goal of reducing illicit-market harms, including violence, the need for enforcement, and the supply of products of uncertain potency, perhaps containing harmful contaminants. If this is so, then the harms associated with increased juvenile use are not entirely separable from the decision to make cannabis lawfully available to adults. [ABSTRACT FROM AUTHOR]

Aims Drug policy strategies and discussions often use prevalence of drug use as a primary performance indicator. However, three other indicators are at least as relevant: the number of heavy users, total expenditures and total amount consumed. This paper stems from our efforts to develop annual estimates of these three measures for cocaine (including crack), heroin, marijuana and methamphetamine in the United States. Methods The estimates exploit complementary strengths of a general population survey ( National Survey on Drug Use and Health) and both survey and urinalysis test result data for arrestees ( Arrestee Drug Abuse Monitoring Program), supplemented by many other data sources. Results Throughout the 2000s US drug users spent in the order of $100 billion annually on these drugs, although the spending distribution and use patterns changed dramatically. From 2006 to 2010, the amount of marijuana consumed in the United States probably increased by more than 30%, while the amount of cocaine consumed in the United States fell by approximately 50%. These figures are consistent with supply-side indicators, such as seizures and production estimates. For all the drugs, total consumption and expenditures are driven by the minority of users who consume on 21 or more days each month. Conclusions Even for established drugs, consumption can change rapidly. The halving of the cocaine market in five years and the parallel (but independent) large rise in daily/near-daily marijuana use are major events that were not anticipated by the expert community and raise important theoretical, research, and policy issues. [ABSTRACT FROM AUTHOR]

Until November 2012, no modern jurisdiction had removed the prohibition on the commercial production, distribution, and sale of marijuana for nonmedical purposes—not even the Netherlands. Government agencies in Colorado and Washington are now charged with granting production and processing licenses and developing regulations for legal marijuana, and other states and countries may follow. Our goal is not to address whether marijuana legalization is a good or bad idea but, rather, to help policymakers understand the decisions they face and some lessons learned from research on public health approaches to regulating alcohol and tobacco over the past century. [ABSTRACT FROM AUTHOR]

The article discusses the potential decriminalization of marijuana use and possession in the U.S. in relation to tax revenues, black and gray markets, and marijuana legalization efforts and laws in American states such as Colorado and Washington as of June 2013. The U.S. Controlled Substances Act is addressed, along with excise taxes, ad valorem taxation, and various types of cannabis. Sales taxes and government monopolies are also mentioned.

ABSTRACT Aims Decisions on whether and how to 'schedule' drugs (i.e. to determine their legal status and penalties to be applied for sale or possession) are often heavily criticized. We sought to assess more comprehensively the results of such decisions for newly emerging drugs. Methods Through analysis of legislation and secondary sources, we identified 63 substances that have emerged since 1971, including all that have been added to the most restrictive schedule by the United Nations, United States, United Kingdom, Canada, Australia and/or New Zealand. Measurements For each jurisdiction we recorded whether, when, and how the substance was scheduled and note what decisions engendered substantial criticism or controversy within the international treaties' framework of balancing medical benefits with risk of abuse. Findings (i) The rate of emergence of new drugs has been fairly steady. (ii) There is broad cross-national agreement on what should be scheduled. (iii) The United States often acts first. (iv) Temporary bans that delay final decisions by 12-18 months can sometimes allow final decisions to be grounded on a substantially expanded research base. (v) It appears that no more than seven of the decisions reached by the United States with respect to the 63 substances are candidates for being considered errors, and arguably the United States has committed at most one serious Type I and one serious Type II error. Results for other countries are broadly similar. Conclusions The process for determining the legal status of new psychoactive substances appears to function reasonably well, within the framework of international treaty obligations. Most criticisms relate to one or a few substances (e.g. 3,4-methylenedioxymethamphetamine) and/or complaints that the decisions discount benefits that are not recognized by the treaties (e.g. recreational or religious use). [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Enforcement against drug selling remains the principal tool of drug control in the United States and many other countries. Though the risk of incarceration for a drug dealer has risen fivefold or more over the last 25 years in the United States, the prices of cocaine and heroin have fallen substantially. Different models of how enforcement affects drug supply may help explain the paradox. There are substantial periods in which drug markets are not in the stable equilibrium that has informed much of the empirical research. Enforcement is likely to be more effective in preventing the formation of a mass market than in suppressing such a market once it has formed. Once a mass market is established, there may be little return to intense enforcement. A modest level of enforcement may generate most of the benefits from prohibition. [ABSTRACT FROM AUTHOR]

Abstract: Drug producing regions often supply several geographically distinct drug consumption markets. Disruptions of opium cultivation in Afghanistan and cocaine production in Colombia show that consumption reductions can be much smaller in some final markets than are reductions in cultivation. This paper derives a model for predicting how production deficits will be “allocated” across downstream markets in the form of reduced use. Plausible parameterization suggests that for cocaine, markets outside the US may serve as a sort of “shock absorber”, partially shielding US markets from sharp fluctuations in consumption. One implication is that multi-lateral efforts may be appropriate for source country control. [Copyright &y& Elsevier]

We extend the two-dimensional model of drug use introduced in [Behrens et al., 1999, 2000, 2002] by considering two additional states that represent in more detail newly initiated ("light") users' response to the drug experience. Those who dislike the drug quickly "quit" and briefly suppress initiation by others. Those who like the drug progress to ongoing ("moderate") use, from which they may or may not escalate to "heavy" or dependent use. Initiation is spread contagiously by light and moderate users, but is moderated by the drug's reputation, which is a function of the number of unhappy users (recent quitters + heavy users). The model reproduces recent prevalence data reasonably well from the U.S. cocaine epidemic, with one pronounced peak followed by decay toward a steady state. However, minor variation in parameter values yields both long-run periodicity with a period akin to the gap between the first U.S. cocaine epidemic (peak ~1910) and the current one (peak ~1980), as well as short-run periodicity akin to that observed in data on youthful use for a variety of substances. The combination of short- and long-run periodicity is reminiscent of the elliptical burstors described by Rubin and Terman [2002]. The existence of such complex behavior including cycles, quasi periodic solutions, and chaos is proven by means of bifurcation analysis. [ABSTRACT FROM AUTHOR]

Estimates are developed for the number of people incarcerated in the United States for drug law violations between 1972 and 2002, broken down by type of institution (federal prison, state prison, or jail) and, to the extent possible, by nature of drug offense (possession or use, trafficking, or other). These time series are compared to trends in drug use indicators, revealing at best weak correlations, and the absolute levels are compared to different market indicators to draw various inferences. For example, even though about 480,000 people are incarcerated for drug law violations, on average retail sellers spend less than 2 hours behind bars per sale. Still, full-time sellers might expect to spend 3 months incarcerated per year of selling, suggesting that there are roughly four active drug sellers for every one who is incarcerated. [ABSTRACT FROM AUTHOR]

We present a two-state, one-control model of a seller's decision about how good a "deal" to give customers when price and quantity are observable, but the customer does not observe quality until after committing to the transaction, so the quality of the bargain affects future demand only indirectly by influencing the reputation of the seller. This situation describes well the markets for many illicit drugs. Analysis reveals two optimal strategies: converging to a unique steady state with a positive sales volume or exploiting the initial customer base by selling cut-rate products until the seller's reputation is so bad that sales go to zero. Numerical analysis with parameters based on the U.S. cocaine market shows that there is a so-called Dechen-Nishimura-Skiba (DNS) curve in the state space, where the seller is indifferent between these two strategies. Convergence to the steady state with positive sales is oscillatory. Because different sellers may be at different phases of the oscillation at any given time, this oscillation implies that a population of homogenous sellers can generate dispersion in market prices--a phenomenon characteristic of drug markets that has been difficult to explain. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This article discusses a brief history of the decision to deploy the computer-assisted passenger prescreening system II (CAPPS II). Not only might CAPPS II not improve safety, it could even reduce security if it crowded out other initiatives or if scrutiny were reduced for people not flagged by the system. In as much as CAPPS II threatens privacy, involves some direct cost to taxpayers and risks complacency, it would seem incumbent on the U.S. Transportation Safety Administration to prove to the taxpayer that CAPPS II works. The impetus for CAPPS II came from the Aviation and Transportation Security Act, signed into law on November 19, 2001 in response to the September 11, 2001 attacks. It called for improved passenger screening and invited the use of advanced information technologies, although it did not specify that data mining or any other specific method should be employed. Indeed, the vision for CAPPS II has evolved considerably as more has been learned about the capabilities of various technologies. The permanent deployment of CAPPS II was not a done deal from the outset. Provision was clearly made for reviews with opportunities for corrective action, both between inception and the present and still to come.

Investigates the incorporation of uncertainty in public policy models in Maryland. Concept of behavioral decision theory; Consideration of sampling variability in policy analysis; Use of the econometric methods.

So-called “three strikes and you're out” sentencing laws for criminal offenders have proliferated in the United States. The laws vary considerably in their definitions of what constitutes a “strike.” This paper adapts the classic Poisson process model of criminal offending to investigate how varying sentence lengths and definitions of what constitutes a strike affect the effectiveness and cost-effectiveness of these sentencing laws. In particular, it asks whether, by using different definitions for the first, second, and third strikes or different sentence lengths, one can make the resulting incarceration more “efficient” in the sense of incapacitating more crimes per cell-year served. [ABSTRACT FROM AUTHOR]

There has been considerable debate about what share of drug control resources should be allocated to treatment vs. enforcement. Most of the debate has presumed that there is one answer lo that question, but it seems plausible that the mix of interventions should vary as the size of the problem changes. We formulate the choice between treatment and enforcement as an optimal control problem and reach the following conclusions. If initiation into drug use is an increasing function of the current number of users and control begins early, then it is optimal 10 use very large amounts of both enforcement and treatment to cut short the epidemic. Otherwise the optimal policy is not to slop the growth of the epidemic, but rather to moderate it. Initially this should be done primarily with enforcement. Over time, enforcement spending should increase, but not nearly so fast as treatment spending. Hence, treatment should receive a larger share of control resources when a drug problem is mature than when it is first growing. If initiation rates subsequently decline, enforcement's budget share should drop further in the ensuing declining stage of the epidemic. [ABSTRACT FROM AUTHOR]

Focuses on the micro-distributional consequences in the United States of cigarette taxation and its equivalents. Excise taxes; Settlement of tobacco liability litigation; Welfare economics; Use of a lump-sum transfer to solve the distributional problem; Case for price discrimination.

Background: Many nations place drugs into various "schedules" according to their risk of abuse and/or recognized medical value that vary in terms of their restrictions. To mitigate diversion or abuse, drugs sometimes get rescheduled or are scheduled for the first time. Until now, there have not been efforts to integrate lessons from across the range of such past events.Methods and Data: We searched for peer-reviewed evaluations of instances of (re-)scheduling drugs in the United States after 1969 and a comparably large set of instances from other countries. Those 109 articles were supplemented by 30 others found in other ways but not meeting those search criteria (e.g., because the information on rescheduling was a minor part of a more general article).Findings: Findings are reported for many outcomes and with diverse measures over different timelines, making standardization of outcomes difficult. For more than half of the events for which quantitative outcomes were reported, there were declines in use-related measures by at least 40 percent. It is common for there to be reports of increases in indicators pertaining to other substances, sometimes more dangerous but sometimes less dangerous; overall, substitution appears to occur, but be partial.Conclusion: Scheduling and up-scheduling can - though does not always - have substantial effects on a range of outcomes. Substitution to other substances is a possibility and so should be anticipated. [ABSTRACT FROM AUTHOR]

Aims. To compare the prices of cocaine powder and crack cocaine in the United States. Design. prices for crack and powder cocaine are compared for 14 US cities between 1986 and 1991 using regression analysis and t -tests. Measurements. Prices are estimated from the United States Drug Enforcement Administration's System to Retrieve Information from Drug Evidence (STRIDE) database. Findings. On average, crack is neither more nor less expensive per pure unit than powder cocaine. Prices are not equal in every city in every year, but crack is equally likely to be more or less expensive, and the differences are not large relative to variation in prices of both forms of cocaine between cities and over time. Conclusions. Crack has been widely believed to be cheaper than powder cocaine, and this "fact" has been used to help explain why US drug problems worsened in the 1980s. However, crack is not, in fact, cheaper per pure unit than powder cocaine. Other explanations must be sought for why crack spread so rapidly relative to powder cocaine. Retail. [ABSTRACT FROM AUTHOR]

Examines the importance of use reduction and harm reduction drug policy in the United States. Brief history of drug policy in the United States; Differences between use and harm reduction goal; Formulating measurable objectives for use and harmful reduction.

The Department of Transportation (DOT) rates commercial airlines' on-time performance every month, but its ratings may unfairly penalize airlines that disproportionately fly into airports at which it is inherently more difficult to land in on-time. We propose several rating methods that we consider more equitable and apply them to 36 months of DOT data. Rating airlines' promptness is an example of the more general problem of evaluating players who compete in overlapping but not identical sets of tournaments, where there is no exogenous knowledge about the quality of the players or the "difficulty" of the tournaments. [ABSTRACT FROM AUTHOR]

States that heroin in the US appears to have grown substantially in recent years, although it is not clear what impact this has had on consumption. Problems with making heroin a new policy focus; The `wait and see' approach in the history of cocaine in the late 1970s and early 80s; Suggested courses of actions; The effect of supply conditions on consumption and drug-related harm; Current trends; Conclusion.

Editorial. Focuses on methamphetamine precursor regulations and its impact on hospital admissions in the U.S. Reasons behind impact of precursor regulations on hospital admissions; Observation of methamphetamine use during 1994 to 1997; Impact of increase in price of cocaine on hospital admissions.

A response is provided to articles in the same issue of the journal which address additional data sources for cannabis markets, the legalization of the cannabis industry, and changes in cannabis policies as of 2017. The economic profitability of marijuana as a commodity is examined, along with the structure, performance, and conduct of an industrial organization. Company loyalty and frequent buyer programs are assessed, along with data mining and smart vaporizer pens.

Commentary to: Considering marijuana legalization carefully: insights for other jurisdictions from analysis for Vermont [ABSTRACT FROM AUTHOR]

In this article Jonathan P. Caulkins, Beau Kilmer, Peter H. Reuter and Gregory Midgette respond to commentaries within the issue which focus on their article "Cocaine’s Fall and Marijuana’s Rise: Questions and Insights Based on New Estimates on Consumption and Expenditures in US Drug Markets". In the article they offer opinions on several points which are raised within the commentaries and on several aspects of their own article which are discussed in the commentaries.

The author discusses the article by Peter Reuter and Harold Pollack on the relationship between drug prices and enforcement intensity. He mentions that the empirical evidence speaks just to the failures of the past practice of enforcement, and enforcement has not optimized in producing the maximal effect on prices. He states that law enforcement does not frequently think in terms of maximization of social welfare or efficient production with respect to prices or objective function.

Abstract: Data on illicit drug purity and prices are invaluable but challenging. Academic purists argue they are unsuitable for economic analysis [Manski, C.F., Pepper, J.V., Petrie, C.V., 2001. Informing America''s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us. National Academy Press, Washington, DC], but in practice they are used frequently [ONDCP, 2001a. What America''s Users Spend on Illegal Drugs. Office of National Drug Control Policy, The White House, Washington, DC; ONDCP, 2001b. The Price of Illicit Drugs: 1981 Through the Second Quarter of 2000. Office of National Drug Control Policy, The White House, Washington, DC; ONDCP, 2004. The Price and Purity of Illicit Drugs: 1981 Through the Second Quarter of 2003. Office of National Drug Control Policy, The White House, Washington, DC; Grossman, M., 2004. Individual behaviors and substance use: the role of price. Plenary Address for the 24th Arne Ryde Symposium on Economics of Substance Abuse at Lund University, Lund, Sweden, August 13–14, 2004]. This paper reviews data and conceptual issues that people producing, analyzing, and consuming drug price and purity series should understand in order to reduce the likelihood of misinterpretation. It also identifies aspects of drug markets that are both poorly understood and relevant to some of these issues. They constitute a useful research agenda for health and law enforcement communities who would benefit from better data on the supply, availability, and use of illicit drugs. [Copyright &y& Elsevier]

Background: Some countries allow physicians to prescribe pharmaceutical-grade diamorphine to dependent users who have previously undergone treatment but are still using street-sourced heroin; this is not allowed in the US. This study provides the first nationally representative US data concerning public support for prescribing diamorphine to dependent users. We also test the hypothesis that calling it "diamorphine" instead of "heroin" increases support for this approach.Methods: The RAND American Life Panel is a nationally representative, probability-based survey of US adults. Of the 3345 panel members invited to take the survey, 2530 (75.6%) provided a valid response to our question module. Respondents were randomly assigned to have the question refer to the prescribed drug as either "heroin" or "diamorphine." The groups did not significantly differ on sex, age, race/ethnicity, or education. We compare the distribution of responses for the two groups and conduct Pearson's chi-squared test with the Rao-Scott correction.Results: For those asked whether the US should try prescribing pharmaceutical-grade "heroin," the share answering "Yes" (20.8%) was 15 percentage points lower than those responding "No" (35.8%). When the question asked about "diamorphine," the results were nearly reversed: the share answering "Yes" (30.6%) was almost 12 percentage points higher than those responding "No" (18.9%). The distributions of responses were significantly different (p < 0.001).Conclusions: Support for prescribing diamorphine to dependent users is low in the US. While the results are consistent with the hypothesis that referring to heroin as diamorphine may reduce stigma associated with the substance and increase support for prescribing it, opinions may change as individuals learn they are different names for the same substance. [ABSTRACT FROM AUTHOR]

Background: Cannabis policy is developing faster than empirical evidence about policy effects. With a panel of experts in substance use policy development and research, we identified key cannabis policies and their provisions enacted by U.S. states; rated their theoretical efficacy in a restrictive form for reducing problematic use and impaired driving in the context of a recreational cannabis market as judged by experts; and rated the strength of evidence for each policy.Methods: Using a modified Delphi approach, 9 panelists rated the comparative efficacy of 18 state cannabis policies for reducing youth use of cannabis, excessive cannabis use among the general population, and cannabis-impaired driving. Each outcome was rated separately using a Likert scale, and panelists also rated the strength of evidence supporting each efficacy rating. Investigators provided descriptions of each policy so that the nine panelists had similar conceptions of each policy.Results: State monopoly (state owns all production, manufacturing, wholesale, and retail operations) was rated as the most effective policy for all three outcome areas. Restrictions on retail physical availability, taxes, retail price restrictions, and retail operations restrictions were also highly rated for all three outcomes. Policies regulating cannabis businesses and products were judged more effective than policies targeting consumer use and behavior. Panelists reported there was little or no direct evidence from the cannabis policy literature for most of the included policies.Conclusion: These ratings can facilitate research as well as policy-making decisions. A relatively small number of policies were judged to be highly effective across all three domains, indicating that for the most part adult excessive use, youth use, and impaired driving can all be reduced with the same set of policies; these policies tended to target the behaviors of businesses rather than consumers. The low levels of direct evidence available to inform policy ratings, as reported by the policy panelists, makes clear the need for ongoing and sustained cannabis policy research. [ABSTRACT FROM AUTHOR]

Background: To address the overdose crisis in the United States, expert groups have been nearly unanimous in calls for increasing access to evidence-based treatment and overdose reversal drugs. In some places there have also been calls for implementing supervised consumption sites (SCSs). Some cities-primarily in coastal urban areas-have explored the feasibility and acceptability of introducing them. However, the perspectives of community stakeholders from more inland and rural areas that have also been hard hit by opioids are largely missing from the literature.Methods: To examine community attitudes about implementing SCSs for people who use opioids (PWUO) in areas with acute opioid problems, the research team conducted in-depth interviews and focus groups in four counties: Ashtabula and Cuyahoga Counties in Ohio, and Carroll and Hillsborough Counties in New Hampshire, two states with high rates of opioid overdose. Participants were policy, treatment, and criminal justice professionals, frontline harm reduction and service providers, and PWUO.Results: Key informants noted benefits to SCSs, but also perceived potential drawbacks such as that they may enable opioid use, and potential practical barriers, including lack of desire among PWUO to travel to an SCS after purchasing opioids and fear of arrest. Key informants generally believed their communities likely would not currently accept SCSs due to cultural, resource, and practical barriers. They viewed publication of evidence on SCSs and community education as essential for fostering acceptance.Conclusions: Despite cultural and other barriers, implementation of SCSs may be more feasible in urban communities with existing (and perhaps more long-standing) harm reduction programs, greater treatment resources, and adequate transportation, particularly if there is strong evidence to support them. [ABSTRACT FROM AUTHOR]

The 2000-2001 and the 2022-2023 Taliban opium bans were and could be two of the largest ever disruptions to a major illegal drug market. To help understand potential implications of the current ban for Europe, this paper analyzes how opioid markets in seven Baltic and Nordic countries responded to the earlier ban, using literature review, key informant interviews, and secondary data analysis. The seven nations' markets responded in diverse ways, including rebounding with the same drug (heroin in Norway), substitution to a more potent opioid (fentanyl replacing heroin in Estonia), and substitution to one with lower risk of overdose (buprenorphine replacing heroin in Finland). The responses were not instantaneous, but rather evolved, sometimes over several years. This variety suggests that it can be hard to predict how drug markets will respond to disruptions, but two extreme views can be challenged. It would be naive to imagine that drug markets will not adapt to shocks, but also unduly nihilistic to presume that they will always just bounce back with no lasting effects. Substitution to another way of meeting demand is possible, but that does not always negate fully the benefits of disrupting the original market. Nonetheless, there is historical precedent for a European country's opioid market switching to synthetic opioids when heroin supplies were disrupted. Given how much that switch has increased overdose rates in Canada and the United States, that is a serious concern for Europe at present. A period of reduced opioid supply may be a particularly propitious time to expand treatment services (as Norway did in the early 2000s)., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Background: Jalal et al. discovered that between 1979 and 2020 total rates and counts of fatal drug overdoses in the United States exhibited exponential growth at a very steady rate even though deaths from individual drugs did not. That is a startling result because it means that the different drugs are in effect "taking turns", with one growing faster just as another drug's death rate growth ebbs. That raises the question of whether this steadiness in the all-drug death rates is in some sense just a coincidence peculiar to the United States or whether it might reflect some more general phenomenon and so manifest in other countries., Methods: We fit the same model used by Jalal et al. to data on drug-related death rates for the countries of the United Kingdom., Results: The main finding is largely a failure to replicate the United States result. Simple graphical display of the trends and a number of statistical measures show that the growth in the United Kingdom was not only slower than in the United States, it was also less steady, with the exception of Northern Ireland., Conclusions: Steady exponential growth in the all-drugs mortality rate may be a phenomenon specific to certain contexts. It remains an open question whether the explanation of steady exponential growth in the United States and Northern Ireland relates to demand and supply mechanisms, to social and political conditions, or to coincidence., Competing Interests: Declaration of Competing Interest None to declare., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

The spread of illegally manufactured opioids, including fentanyl, has brought unprecedented levels of drug overdose deaths in North America. In some markets, illegally manufactured fentanyl (IMF) is essentially displacing heroin, not just being used to adulterate it. It is not possible at this time to provide an accurate point estimate of the amount of IMF consumed in the United States. Yet for various purposes (e.g. assessing changes in production levels and the appropriate role for various supply reduction efforts), it is important to have a sense of scale. This article provides guidance through two thought experiments that provide a hypothetical upper bound on U.S. consumption. The first considers a scenario in which IMF replaces heroin in all illegal opioid markets. The second starts with the number of individuals with an opioid use disorder and considers what total consumption would be if IMF was the only opioid they consumed. Both calculations suggest it is unlikely that the annual consumption of IMF in 2021 could have been more than single digit pure metric tons. For comparison, the most recent best estimates of the amount of cocaine and heroin consumed in the U.S. are 145 and 47 pure metric tons, respectively. The article also raises questions about the limitations of using traditional equianalgesic morphine equivalent dose conversions to estimate the total market consumption of IMF.