Abstract Mark A.R. Kleiman and his colleagues (hereafter Kleiman) have done the public a service by highlighting the problem of “driving while stoned.” Drug-impaired driving is a serious national problem. Numerous drugs other than alcohol, whether legal or illegal—such as opioids, cocaine, tranquilizers, sleep aids, hallucinogens, and marijuana—degrade driving performance and increase the risk of highway morbidity and mortality. Other than alcohol, marijuana is the biggest problem because it is the most commonly used drug, and its use is increasing, given marijuana legalization. Two facts aggravate that problem: (1) marijuana is often combined with alcohol and (2) a marijuana-alcohol cocktail has an enhanced debilitating effect on safe motor vehicle handling. As the U.S. Office of National Drug Control Policy has noted, driving while impaired is a major public health problem. Kleiman is correct that identifying impairment attributable to substances other than alcohol is a difficult problem. Two twentieth century developments helped society reduce the number of alcohol-related crashes, injuries, and deaths: the passage of 0.08 g/dL blood-alcohol content laws, and the development of reliable, easily operated, hand-held Breathalyzers for roadside use. Unfortunately, we cannot successfully use that approach for impairing drugs other than alcohol. We do not know what amount of THC impairs a majority of drivers. In any event, we do not have a measurement device comparable to a Breathalyzer. Kleiman argues that, given those enforcement problems, we should use only administrative measures to penalize marijuana-impaired driving. I think that there is room for the criminal justice system. People who use marijuana and drive put others at risk of injury or death. Just as legislatures can force a factory to bear the risk of pollution-related injury, so too can a legislature force marijuana users to internalize any costs of their drug use. If you use marijuana, don’t drive for at least eight hours. Use public transportation. Take a cab. Call Uber. Walk. Ask a friend for a lift. Or just remain where you are. No one has a constitutional right to drink alcohol, to smoke marijuana, or to drive an automobile. Society hardly asks too much of its citizens to demand that they not do all three simultaneously or to delay driving for eight hours after either of the first two activities. That is not all. States should test every driver involved in a crash, particularly one involving a fatality, not only for alcohol but also for legal and illegal impairing drugs. Moreover, all 50 states fix 21 as the minimum drinking age and the minimum age for recreational marijuana use. Whatever administrative penalty the states impose for underage drinking and driving—such as license suspension—should apply as well to everyone under that age who tests positive for any illegal drug use. States should also report on a regular basis the data regarding motorists’ use of impairing drugs, inc
{"title":"The Problem of “Driving while Stoned” Demands an Aggressive Public Policy Response","authors":"P. Larkin","doi":"10.1515/jdpa-2018-0012","DOIUrl":"https://doi.org/10.1515/jdpa-2018-0012","url":null,"abstract":"Abstract Mark A.R. Kleiman and his colleagues (hereafter Kleiman) have done the public a service by highlighting the problem of “driving while stoned.” Drug-impaired driving is a serious national problem. Numerous drugs other than alcohol, whether legal or illegal—such as opioids, cocaine, tranquilizers, sleep aids, hallucinogens, and marijuana—degrade driving performance and increase the risk of highway morbidity and mortality. Other than alcohol, marijuana is the biggest problem because it is the most commonly used drug, and its use is increasing, given marijuana legalization. Two facts aggravate that problem: (1) marijuana is often combined with alcohol and (2) a marijuana-alcohol cocktail has an enhanced debilitating effect on safe motor vehicle handling. As the U.S. Office of National Drug Control Policy has noted, driving while impaired is a major public health problem. Kleiman is correct that identifying impairment attributable to substances other than alcohol is a difficult problem. Two twentieth century developments helped society reduce the number of alcohol-related crashes, injuries, and deaths: the passage of 0.08 g/dL blood-alcohol content laws, and the development of reliable, easily operated, hand-held Breathalyzers for roadside use. Unfortunately, we cannot successfully use that approach for impairing drugs other than alcohol. We do not know what amount of THC impairs a majority of drivers. In any event, we do not have a measurement device comparable to a Breathalyzer. Kleiman argues that, given those enforcement problems, we should use only administrative measures to penalize marijuana-impaired driving. I think that there is room for the criminal justice system. People who use marijuana and drive put others at risk of injury or death. Just as legislatures can force a factory to bear the risk of pollution-related injury, so too can a legislature force marijuana users to internalize any costs of their drug use. If you use marijuana, don’t drive for at least eight hours. Use public transportation. Take a cab. Call Uber. Walk. Ask a friend for a lift. Or just remain where you are. No one has a constitutional right to drink alcohol, to smoke marijuana, or to drive an automobile. Society hardly asks too much of its citizens to demand that they not do all three simultaneously or to delay driving for eight hours after either of the first two activities. That is not all. States should test every driver involved in a crash, particularly one involving a fatality, not only for alcohol but also for legal and illegal impairing drugs. Moreover, all 50 states fix 21 as the minimum drinking age and the minimum age for recreational marijuana use. Whatever administrative penalty the states impose for underage drinking and driving—such as license suspension—should apply as well to everyone under that age who tests positive for any illegal drug use. States should also report on a regular basis the data regarding motorists’ use of impairing drugs, inc","PeriodicalId":38436,"journal":{"name":"Journal of Drug Policy Analysis","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/jdpa-2018-0012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42158000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Despite being the global legislative reality for more than half a century, when it comes to the control and management of illicit drugs, there is still a sharp academic divide between strict prohibitionists and open access legalisers, with both sides claiming supremacy in their ability to reduce the harms drug users face. Spanning these opposing academic extremes, governments around the world have experimented with, or put into practice a range of alternatives to prohibition that generally hold harm reduction as a centrally guiding principle. However, in the realm of drugs control, harm reduction is not a simple utilitarian problem and is often clouded by a number of moral aspects that will seemingly continue to frustrate the prospects for consensus among the various drug control stakeholders for the near future. Moreover, while proponents of reform and legalisation have put forth seemingly plausible and well considered theories for the regulation and control of drugs in lieu of prohibition, it has become rather clear in the wake of the recent United Nations Special Assembly on Drugs in 2016 that a significant top-down change in international drugs control policy is unlikely for the foreseeable future. This is not to say the global prohibitionist framework is destined to remain predominant, and clear lines are emerging for the practical evolution of international drugs control policy. With an ever expanding variety of novel alternative methods being implemented by countries around the world to reduce the harm from illicit drug use, especially with regards to the unique challenges faced by intractable, chronic users of ’hard’ drugs such as heroin, coupled with a softening of hard-line attitudes, a path towards sensible drug reforms is becoming clearer. This short article examines a number of those alternative methods, where it is argued that medicalised harm reduction for ’hard’ drugs is the most likely to find broad acceptance under the international drug regime and the growing tolerance and liberalisation of cannabis laws will likely continue because of its relatively low risk profile and high cost of prohibition.
{"title":"International Drug Reform: Medicalised Harm Reduction, Cannabis and the Global Legislative Reality","authors":"D. White","doi":"10.1515/jdpa-2018-0002","DOIUrl":"https://doi.org/10.1515/jdpa-2018-0002","url":null,"abstract":"Abstract Despite being the global legislative reality for more than half a century, when it comes to the control and management of illicit drugs, there is still a sharp academic divide between strict prohibitionists and open access legalisers, with both sides claiming supremacy in their ability to reduce the harms drug users face. Spanning these opposing academic extremes, governments around the world have experimented with, or put into practice a range of alternatives to prohibition that generally hold harm reduction as a centrally guiding principle. However, in the realm of drugs control, harm reduction is not a simple utilitarian problem and is often clouded by a number of moral aspects that will seemingly continue to frustrate the prospects for consensus among the various drug control stakeholders for the near future. Moreover, while proponents of reform and legalisation have put forth seemingly plausible and well considered theories for the regulation and control of drugs in lieu of prohibition, it has become rather clear in the wake of the recent United Nations Special Assembly on Drugs in 2016 that a significant top-down change in international drugs control policy is unlikely for the foreseeable future. This is not to say the global prohibitionist framework is destined to remain predominant, and clear lines are emerging for the practical evolution of international drugs control policy. With an ever expanding variety of novel alternative methods being implemented by countries around the world to reduce the harm from illicit drug use, especially with regards to the unique challenges faced by intractable, chronic users of ’hard’ drugs such as heroin, coupled with a softening of hard-line attitudes, a path towards sensible drug reforms is becoming clearer. This short article examines a number of those alternative methods, where it is argued that medicalised harm reduction for ’hard’ drugs is the most likely to find broad acceptance under the international drug regime and the growing tolerance and liberalisation of cannabis laws will likely continue because of its relatively low risk profile and high cost of prohibition.","PeriodicalId":38436,"journal":{"name":"Journal of Drug Policy Analysis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/jdpa-2018-0002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43180428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Kleiman, Tyler Kirkland Jones, Celeste J. Miller, Ross Halperin
Abstract THC is the most commonly detected intoxicant in US drivers, with approximately 13 % of drivers testing positive for marijuana use, compared to the 8 % that show a measurable amount of alcohol . Because cannabis use remains detectable for much longer than alcohol, and also for long after the driver is no longer impaired, the difference in rates does not show that stoned driving is more common than drunk driving. Nonetheless, cannabis intoxication while driving is on the rise and has been shown to impair reaction time and visual-spatial judgment. Many states, including those where cannabis sales are now permitted by state law, have laws against cannabis-impaired driving based on the drunk-driving model, defining criminally intoxicated driving as driving with more than a threshold amount of intoxicant in one’s bloodstream—a per se standard—as opposed to actual impairment. That approach neglects crucial differences between alcohol and cannabis in their detectability, their pharmacokinetics, and their impact on highway safety. Cannabis intoxication is more difficult to reliably detect chemically than alcohol intoxication. A breath alcohol test is (1) cheap and reliable; (2) sufficiently simple and non-invasive to administer at the roadside; and (3) a good proxy for alcohol in the brain, which in turn is (4) a good proxy for subjective intoxication and for measurable driving impairment. In addition, (5) the dose-effect curve linking blood alcohol to fatality risk is well-established and steep. None of those things is true for cannabis. A breath test remains to be developed. Oral-fluid testing can demonstrate recent use but not the level of impairment. A blood test requires a trained phlebotomist and therefore a trip to a medical facility, and blood THC levels drop very sharply over time-periods measured in minutes. Blood THC is not a good proxy either for recency of use or for impairment, and the dose-effect curve for fatality risk remains a matter of sharp controversy. The maximum risk for cannabis intoxication alone, unmixed with alcohol or other drugs, appears to be more comparable to risks such as talking on a hands-free cellphone (legal in all states) than to driving with a BAC above 0.08, let alone the rapidly-rising risks at higher BACs. Moreover, the lipid-solubility of THC means that a frequent cannabis user will always have measurable THC in his or her blood, even when that person has not used recently and is neither subjectively intoxicated nor objectively impaired. That suggests criminalizing only combination use, while treating driving under the influence of cannabis (however this is to be proven) as a traffic offense, like speeding.
{"title":"Driving While Stoned: Issues and Policy Options","authors":"M. Kleiman, Tyler Kirkland Jones, Celeste J. Miller, Ross Halperin","doi":"10.1515/jdpa-2018-0004","DOIUrl":"https://doi.org/10.1515/jdpa-2018-0004","url":null,"abstract":"Abstract THC is the most commonly detected intoxicant in US drivers, with approximately 13 % of drivers testing positive for marijuana use, compared to the 8 % that show a measurable amount of alcohol . Because cannabis use remains detectable for much longer than alcohol, and also for long after the driver is no longer impaired, the difference in rates does not show that stoned driving is more common than drunk driving. Nonetheless, cannabis intoxication while driving is on the rise and has been shown to impair reaction time and visual-spatial judgment. Many states, including those where cannabis sales are now permitted by state law, have laws against cannabis-impaired driving based on the drunk-driving model, defining criminally intoxicated driving as driving with more than a threshold amount of intoxicant in one’s bloodstream—a per se standard—as opposed to actual impairment. That approach neglects crucial differences between alcohol and cannabis in their detectability, their pharmacokinetics, and their impact on highway safety. Cannabis intoxication is more difficult to reliably detect chemically than alcohol intoxication. A breath alcohol test is (1) cheap and reliable; (2) sufficiently simple and non-invasive to administer at the roadside; and (3) a good proxy for alcohol in the brain, which in turn is (4) a good proxy for subjective intoxication and for measurable driving impairment. In addition, (5) the dose-effect curve linking blood alcohol to fatality risk is well-established and steep. None of those things is true for cannabis. A breath test remains to be developed. Oral-fluid testing can demonstrate recent use but not the level of impairment. A blood test requires a trained phlebotomist and therefore a trip to a medical facility, and blood THC levels drop very sharply over time-periods measured in minutes. Blood THC is not a good proxy either for recency of use or for impairment, and the dose-effect curve for fatality risk remains a matter of sharp controversy. The maximum risk for cannabis intoxication alone, unmixed with alcohol or other drugs, appears to be more comparable to risks such as talking on a hands-free cellphone (legal in all states) than to driving with a BAC above 0.08, let alone the rapidly-rising risks at higher BACs. Moreover, the lipid-solubility of THC means that a frequent cannabis user will always have measurable THC in his or her blood, even when that person has not used recently and is neither subjectively intoxicated nor objectively impaired. That suggests criminalizing only combination use, while treating driving under the influence of cannabis (however this is to be proven) as a traffic offense, like speeding.","PeriodicalId":38436,"journal":{"name":"Journal of Drug Policy Analysis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/jdpa-2018-0004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48272517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Illicit substance misuse has become a serious problem in contemporary China. The number of officially registered illicit substance misusers totals close to 3 million, having increased every year since the government’s first annual report on drug control in 1998. In recent years, synthetic drugs such as methamphetamine and ketamine, have become more popular than heroin which was previously dominant. However, illicit substance use continues to receive little sympathy from the public, despite government’s efforts to move towards treatment and rehabilitation. For many years, compulsory detoxification centers and “education-through-labor” camps were the only treatment options. More humane approaches are emerging, including methadone maintenance, therapeutic communities, and faith-based halfway houses. Government response to drug trafficking remains draconian. Drug distribution and trafficking are among the dwindling number of criminal offenses that qualify for the death penalty. For future drug control policy, China appears willing to accelerate its experiment with decriminalizing substance abuse and applying a public health approach to the treatment of substance misusers. Evidence-based treatment programs through scientific research and rigorous evaluation should be the norm, and harm reduction needs to be seriously explored as an alternative to the harsh criminal justice regime. More importantly, reliable and multi-faceted forecast systems need to be established to monitor and estimate the size of substance misuser population and trends in illicit drug consumption. Finally, China should continue to expand its international collaboration and insulate its counter-narcotic programs from global politics.
{"title":"China’s New Long March to Control Illicit Substance Use: From a Punitive Regime towards Harm Reduction","authors":"Sheldon X. Zhang, K. Chin","doi":"10.1515/jdpa-2015-0023","DOIUrl":"https://doi.org/10.1515/jdpa-2015-0023","url":null,"abstract":"Abstract Illicit substance misuse has become a serious problem in contemporary China. The number of officially registered illicit substance misusers totals close to 3 million, having increased every year since the government’s first annual report on drug control in 1998. In recent years, synthetic drugs such as methamphetamine and ketamine, have become more popular than heroin which was previously dominant. However, illicit substance use continues to receive little sympathy from the public, despite government’s efforts to move towards treatment and rehabilitation. For many years, compulsory detoxification centers and “education-through-labor” camps were the only treatment options. More humane approaches are emerging, including methadone maintenance, therapeutic communities, and faith-based halfway houses. Government response to drug trafficking remains draconian. Drug distribution and trafficking are among the dwindling number of criminal offenses that qualify for the death penalty. For future drug control policy, China appears willing to accelerate its experiment with decriminalizing substance abuse and applying a public health approach to the treatment of substance misusers. Evidence-based treatment programs through scientific research and rigorous evaluation should be the norm, and harm reduction needs to be seriously explored as an alternative to the harsh criminal justice regime. More importantly, reliable and multi-faceted forecast systems need to be established to monitor and estimate the size of substance misuser population and trends in illicit drug consumption. Finally, China should continue to expand its international collaboration and insulate its counter-narcotic programs from global politics.","PeriodicalId":38436,"journal":{"name":"Journal of Drug Policy Analysis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/jdpa-2015-0023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48552915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract A Federal tax on cannabis requires answers to several questions: 1. What should we tax? What should be the “base” or bases of a cannabis tax? (Possible bases include: price; weight of various product types [like flower, trim, and concentrate]; and THC content.) 2. Given any base, what should the tax rate be? 3. Should medical cannabis bear full tax? 4. Should marijuana advertising and selling expenses become deductible for federal income tax purposes? (That would treat cannabis businesses like other businesses; current Internal Revenue Code section 280E bars such deductions.) Recently introduced federal legislation provides answers, some more aligned with drug policy than others, to those questions.
{"title":"Designing a Federal Tax on Cannabis","authors":"Pat Oglesby","doi":"10.1515/jdpa-2017-0007","DOIUrl":"https://doi.org/10.1515/jdpa-2017-0007","url":null,"abstract":"Abstract A Federal tax on cannabis requires answers to several questions: 1. What should we tax? What should be the “base” or bases of a cannabis tax? (Possible bases include: price; weight of various product types [like flower, trim, and concentrate]; and THC content.) 2. Given any base, what should the tax rate be? 3. Should medical cannabis bear full tax? 4. Should marijuana advertising and selling expenses become deductible for federal income tax purposes? (That would treat cannabis businesses like other businesses; current Internal Revenue Code section 280E bars such deductions.) Recently introduced federal legislation provides answers, some more aligned with drug policy than others, to those questions.","PeriodicalId":38436,"journal":{"name":"Journal of Drug Policy Analysis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/jdpa-2017-0007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43874407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Myanmar is the world’s second largest producer of opium after Aghanistan. Following a decade of decline, cultivation has more than doubled since 2006. The production and use of amphetamine-type stimulants (ATS) is also rising. Most of the opium is turned into heroin and exported via neighboring countries, especially to China. Decades of civil war and military rule have stimulated drug production and consumption, and marginalized ethnic communities. Myanmar has high levels of injecting drug users infected with HIV/AIDS and hepatitis C. Drug policies in Myanmar are repressive and outdated, with an ineffective focus on arresting drug users and eradicating poppy fields. The central government is unable to provide quality treatment for drug users. Past political repression and human rights violations by the military government caused an international boycott which prevented international donors from providing assistance. The reform process by the new quasi-civilian government includes both a peace process to end the civil war and a review of the country’s drug laws, raising hope for more effective and humane drug policies.
{"title":"The Current State of Counternarcotics Policy and Drug Reform Debates in Myanmar","authors":"Tom Kramer","doi":"10.1515/jdpa-2015-0017","DOIUrl":"https://doi.org/10.1515/jdpa-2015-0017","url":null,"abstract":"Abstract Myanmar is the world’s second largest producer of opium after Aghanistan. Following a decade of decline, cultivation has more than doubled since 2006. The production and use of amphetamine-type stimulants (ATS) is also rising. Most of the opium is turned into heroin and exported via neighboring countries, especially to China. Decades of civil war and military rule have stimulated drug production and consumption, and marginalized ethnic communities. Myanmar has high levels of injecting drug users infected with HIV/AIDS and hepatitis C. Drug policies in Myanmar are repressive and outdated, with an ineffective focus on arresting drug users and eradicating poppy fields. The central government is unable to provide quality treatment for drug users. Past political repression and human rights violations by the military government caused an international boycott which prevented international donors from providing assistance. The reform process by the new quasi-civilian government includes both a peace process to end the civil war and a review of the country’s drug laws, raising hope for more effective and humane drug policies.","PeriodicalId":38436,"journal":{"name":"Journal of Drug Policy Analysis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/jdpa-2015-0017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43446513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Russia is suffering from a serious and worsening challenge from narcotics, with 6% of the population using or addicted to drugs, which is also leading to a growing public health crisis. A particular problem is the growing availability of heroin from Afghanistan, with Russia an increasingly important transit country, as well as market. Efforts to control this have been severely limited by issues of resourcing, political will and turf wars between security agencies. Russia’s growing economic problems have also led to a need for liquidity on the part of many financial institutions that leads them to turn a blind eye to dirty money. However, the fundamental issues are that the Kremlin regards this as a nationalist, securitized and moral problem. The influx of Afghan heroin reflects at best Western failure and at worse a malign attempt to damage Russia. This needs to be considered a security threat and is therefore best addressed through interdiction and punitive measures rather than harm reduction and civil outreach, especially because drug addiction is considered a moral rather than a medical issue. Thus, Russia needs to adopt a more inclusive and comprehensive strategy that balances policing with treatment, prevention and harm reduction methods, in partnership with local governments, communities and NGOs, as well as foreign partners. Not only must law enforcement cooperation not continue to be a hostage to geopolitical rivalries, but policy over Afghanistan needs to be about encouraging productive efforts to reduce production rather than using the issue as a means to asserting regional hegemony.
{"title":"Securitizing Narcotics: The Politics and Prospects of Russian Counterdrug Policies","authors":"M. Galeotti","doi":"10.1515/jdpa-2015-0010","DOIUrl":"https://doi.org/10.1515/jdpa-2015-0010","url":null,"abstract":"Abstract Russia is suffering from a serious and worsening challenge from narcotics, with 6% of the population using or addicted to drugs, which is also leading to a growing public health crisis. A particular problem is the growing availability of heroin from Afghanistan, with Russia an increasingly important transit country, as well as market. Efforts to control this have been severely limited by issues of resourcing, political will and turf wars between security agencies. Russia’s growing economic problems have also led to a need for liquidity on the part of many financial institutions that leads them to turn a blind eye to dirty money. However, the fundamental issues are that the Kremlin regards this as a nationalist, securitized and moral problem. The influx of Afghan heroin reflects at best Western failure and at worse a malign attempt to damage Russia. This needs to be considered a security threat and is therefore best addressed through interdiction and punitive measures rather than harm reduction and civil outreach, especially because drug addiction is considered a moral rather than a medical issue. Thus, Russia needs to adopt a more inclusive and comprehensive strategy that balances policing with treatment, prevention and harm reduction methods, in partnership with local governments, communities and NGOs, as well as foreign partners. Not only must law enforcement cooperation not continue to be a hostage to geopolitical rivalries, but policy over Afghanistan needs to be about encouraging productive efforts to reduce production rather than using the issue as a means to asserting regional hegemony.","PeriodicalId":38436,"journal":{"name":"Journal of Drug Policy Analysis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/jdpa-2015-0010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46154179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Criminal-justice (CJ) offenders with opioid-use disorders (OUDs) are at increased risk for recidivism and overdose (Durose et al. 2014, “Recidivism of Prisoners Released in 30 States in 2005: Patterns from 2005 to 2010.” Washington, DC: Bureau of Justice Statistics 28; Binswanger et al. 2007, “Release from Prison – A High Risk of Death for Former Inmates.” New England Journal of Medicine 356 (2):157–165). For the CJ system, this presents not just a challenge but a unique opportunity to improve public health and public safety. In particular, medication-assisted treatments (MATs) have shown the potential to reduce both recidivism and relapse. Nevertheless, access to MAT in this setting remains limited; for example, although U.S. drug courts were created chiefly to expand access to drug addiction treatment services, only about one-half make MAT available (Matusow et al. 2013, “Medication Assisted Treatment in US Drug Courts: Results from a Nationwide Survey of Availability, Barriers and Attitudes.” Journal of Substance Abuse Treatment 44 (5):473–480). In this commentary, we explore the reasons for which access to MAT is limited in this setting, and lay out the evidence and arguments for a particular type of MAT: extended release (ER) naltrexone.
{"title":"One Good Decision: The Policy Argument for Extended Release Naltrexone in the Criminal Justice Setting","authors":"Stephen Koppel, P. Skolnick","doi":"10.1515/jdpa-2017-0001","DOIUrl":"https://doi.org/10.1515/jdpa-2017-0001","url":null,"abstract":"Abstract Criminal-justice (CJ) offenders with opioid-use disorders (OUDs) are at increased risk for recidivism and overdose (Durose et al. 2014, “Recidivism of Prisoners Released in 30 States in 2005: Patterns from 2005 to 2010.” Washington, DC: Bureau of Justice Statistics 28; Binswanger et al. 2007, “Release from Prison – A High Risk of Death for Former Inmates.” New England Journal of Medicine 356 (2):157–165). For the CJ system, this presents not just a challenge but a unique opportunity to improve public health and public safety. In particular, medication-assisted treatments (MATs) have shown the potential to reduce both recidivism and relapse. Nevertheless, access to MAT in this setting remains limited; for example, although U.S. drug courts were created chiefly to expand access to drug addiction treatment services, only about one-half make MAT available (Matusow et al. 2013, “Medication Assisted Treatment in US Drug Courts: Results from a Nationwide Survey of Availability, Barriers and Attitudes.” Journal of Substance Abuse Treatment 44 (5):473–480). In this commentary, we explore the reasons for which access to MAT is limited in this setting, and lay out the evidence and arguments for a particular type of MAT: extended release (ER) naltrexone.","PeriodicalId":38436,"journal":{"name":"Journal of Drug Policy Analysis","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/jdpa-2017-0001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43050608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract As the international community prepares for the 2016 United Nations Special Session of the General Assembly on the World Drug Problem (UNGASS 2016), the global counternarcotics regime faces profound challenges. An increasing number of countries now find the regime’s emphasis on punitive approaches to illicit drugs to be problematic and are asking for reform. However, critical players such as Russia and China remain committed to the preservation of the existing approaches. At the global level, much has changed since 1998 that undermines the previous global consensus on punitive counternarcotics strategies: illicit markets and networks have shifted; the harms and costs of drugs are unevenly distributed; and states no longer agree on what drug policies work. This moment of global disagreement, which is reflected at UNGASS 2016, provides an important opportunity to evaluate the effectiveness and problematic side-effects of existing counternarcotics policies and to emphasize evidence-based strategies. This article argues that UNGASS 2016 should inject realism into the global discussion of drug policy objectives, instead of once again setting an unattainable goal of a drug-free world. The overall goal should be to strengthen states as they cope with the costs, harms, and threats posed by drug use and drug trade, and to do so in ways that increase, not erode, their legitimacy through policies that advance human rights and strengthen the bonds between the state and their citizens.
{"title":"UNGASS 2016 in Comparative Perspective: Improving the Prospects for Success","authors":"V. Felbab-Brown, Harold A. Trinkunas","doi":"10.1515/jdpa-2015-0014","DOIUrl":"https://doi.org/10.1515/jdpa-2015-0014","url":null,"abstract":"Abstract As the international community prepares for the 2016 United Nations Special Session of the General Assembly on the World Drug Problem (UNGASS 2016), the global counternarcotics regime faces profound challenges. An increasing number of countries now find the regime’s emphasis on punitive approaches to illicit drugs to be problematic and are asking for reform. However, critical players such as Russia and China remain committed to the preservation of the existing approaches. At the global level, much has changed since 1998 that undermines the previous global consensus on punitive counternarcotics strategies: illicit markets and networks have shifted; the harms and costs of drugs are unevenly distributed; and states no longer agree on what drug policies work. This moment of global disagreement, which is reflected at UNGASS 2016, provides an important opportunity to evaluate the effectiveness and problematic side-effects of existing counternarcotics policies and to emphasize evidence-based strategies. This article argues that UNGASS 2016 should inject realism into the global discussion of drug policy objectives, instead of once again setting an unattainable goal of a drug-free world. The overall goal should be to strengthen states as they cope with the costs, harms, and threats posed by drug use and drug trade, and to do so in ways that increase, not erode, their legitimacy through policies that advance human rights and strengthen the bonds between the state and their citizens.","PeriodicalId":38436,"journal":{"name":"Journal of Drug Policy Analysis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/jdpa-2015-0014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48557997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Colorado and Washington were the first states to legalize the production and sale of cannabis without a medical recommendation; Oregon and Alaska have followed suit, and additional states will likely do so in coming years. The effects of legalization are multi-dimensional, hard to predict, difficult to measure, and dependent on policy details. The primary gains from legal availability (beyond personal liberty and enjoyment) are likely to take the form of reduced illicit activity and reduced need for enforcement, along with relatively modest revenues. The primary losses will likely involve increased problematic drug use, which may include use by minors. The extent of those gains and losses is likely sensitive to price; very high prices (substantially above prices in the illicit markets) will likely frustrate the aim of shrinking illegal production and dealing; very low prices – which are technically possible, given how inexpensive it is to produce cannabis under legal conditions – risk accentuating the increase in problematic use and generating illegal diversion of legally sold product for out-of-state sale and sale to minors. Because the systems of supply for medically recommended use in Colorado and Washington were sufficiently loose to make cannabis easily available to virtually any adult; because regulatory restrictions on commercial supplies have so far kept the commercial prices above illicit and medical-dispensary levels; and because those prices have now begun to fall and are likely to fall rapidly, the results in Colorado and Washington so far cannot be used to evaluate the effects of legalization, especially in states without readily-available quasi-medical supplies. Patience is required.
{"title":"Legal Commercial Cannabis Sales in Colorado and Washington: What Can We Learn?","authors":"M. Kleiman","doi":"10.1515/jdpa-2015-0020","DOIUrl":"https://doi.org/10.1515/jdpa-2015-0020","url":null,"abstract":"Abstract Colorado and Washington were the first states to legalize the production and sale of cannabis without a medical recommendation; Oregon and Alaska have followed suit, and additional states will likely do so in coming years. The effects of legalization are multi-dimensional, hard to predict, difficult to measure, and dependent on policy details. The primary gains from legal availability (beyond personal liberty and enjoyment) are likely to take the form of reduced illicit activity and reduced need for enforcement, along with relatively modest revenues. The primary losses will likely involve increased problematic drug use, which may include use by minors. The extent of those gains and losses is likely sensitive to price; very high prices (substantially above prices in the illicit markets) will likely frustrate the aim of shrinking illegal production and dealing; very low prices – which are technically possible, given how inexpensive it is to produce cannabis under legal conditions – risk accentuating the increase in problematic use and generating illegal diversion of legally sold product for out-of-state sale and sale to minors. Because the systems of supply for medically recommended use in Colorado and Washington were sufficiently loose to make cannabis easily available to virtually any adult; because regulatory restrictions on commercial supplies have so far kept the commercial prices above illicit and medical-dispensary levels; and because those prices have now begun to fall and are likely to fall rapidly, the results in Colorado and Washington so far cannot be used to evaluate the effects of legalization, especially in states without readily-available quasi-medical supplies. Patience is required.","PeriodicalId":38436,"journal":{"name":"Journal of Drug Policy Analysis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/jdpa-2015-0020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46000158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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