Search

Begin New Search Topic Drugs Political Geography North America

1. The Effects of US-China Cooperation on Fentanyl Markets and Overdose Deaths

Author:
Marcus Noland, Julieta Contreras, and Lucas Rengifo-Keller
Publication Date:
05-2025
Content Type:
Working Paper
Institution:
Peterson Institute for International Economics (PIIE)
Abstract:
Drug overdose is the leading cause of death among Americans aged 15–44, exceeding heart disease, cancer, suicide, vehicular accidents, and COVID-19 in 2023. Most drug deaths are associated with fentanyl. This paper uses data on illicit drug prices to estimate reduced-form price equations of fentanyl, oxycodone, and alprazolam based on supply and demand, including hedonic characteristics. The results are used to estimate the relationship between fentanyl prices and overdoses. They suggest that the Chinese embargo on fentanyl shipments to the United States beginning in May 2019 raised street prices for a limited period, reducing fentanyl overdose deaths in the United States by roughly one-quarter over a three- to five-month period after the announcement.
Topic:
Bilateral Relations, Drugs, Opioid Crisis, Cooperation, and Fentanyl
Political Geography:
China, Asia, North America, and United States of America

2. CTC Sentinel: July 2023 Issue

Author:
Matthew Levitt, Lauren Von Thaden, Don Rassler, and Tore Hamming
Publication Date:
07-2023
Content Type:
Journal Article
Journal:
CTC Sentinel
Institution:
The Combating Terrorism Center at West Point
Abstract:
In this month’s feature article, Matthew Levitt and Lauren von Thaden examine the recent heightened smuggling challenge at Israel’s borders with Jordan and Egypt. They write: “The guns and drugs that are flowing into Israel are creating societal problems and public safety issues. The influx of weapons is also a major counterterrorism concern. Smuggled weapons have been a contributing factor to the surge of violence that has plagued the West Bank and Israel.” Building on the assessments of Israeli, Jordanian, and Egyptian officials, their study draws on a dataset they compiled of “105 cases of identified, thwarted, or disrupted weapons or drug smuggling attempts into Israel from March 2021 through April 2023 across all of Israel’s borders.” Our interview is with Ravi Satkalmi, the director of intelligence of the United States Capitol Police. He describes the post-January 6 security challenge as “fundamentally different than that posed by 9/11. The risk is fundamentally different when we’re discussing this kind of normalization of political violence against each other—an erosion of our civic norms—rather than a terrorist organization seeking to launch an attack from overseas.” He says that “our goal is essentially to be the premier intel shop for anti-government violence, full stop. We are sitting on a vast trove of threat information that’s being sent to us by our members’ offices and that we are finding on our own. And the key distinction here is we get it from all sides all the time. We’re protecting Democrats; we’re protecting Republicans, people of all political persuasions.” Satkalmi came out publicly as a gay man while previously working at NYPD and describes the importance of inclusivity in the national security and counterterrorism domain. He notes that “essentially, anybody can experience the challenge of belonging and anybody can be part of the solution. If we can check some of our own assumptions about who may be struggling and who effective change agents can be, we improve the likelihood for progress.” Tore Hamming draws on a new cache of Islamic State documents he collected to examine how the Islamic State’s General Directorate of Provinces has managed the Islamic State’s global network. He writes: “With the deaths of successive caliphs, the territorial demise in the Levant, and the growing importance of its external provinces, the General Directorate of Provinces has emerged as the organization’s most decisive body.” His article “describes the institution’s decisive role in the group’s military and economic affairs and its growing responsibility managing its external attack planning and execution.”
Topic:
Political Violence, Counter-terrorism, Weapons, Islamic State, Borders, LGBT+, Drugs, Smuggling, and January 6
Political Geography:
Middle East, Israel, Palestine, North America, Egypt, Jordan, and United States of America

3. Pricing for Medicine Innovation: A Regulatory Approach to Support Drug Development and Patient Access

Author:
Rosie Collington and William Lazonick
Publication Date:
02-2022
Content Type:
Working Paper
Institution:
Institute for New Economic Thinking (INET)
Abstract:
The United States represents the world’s largest market for pharmaceutical drugs. It is also the only advanced economy in the world that does not regulate drug prices. There is no upper threshold for the prices of medicines in the United States. List prices are instead set by manufacturers in negotiation with supply-chain intermediaries, though some federal programs have degrees of discretion in price determinations. In practice, this deregulated system means that drug prices in the United States are generally far higher than in other advanced economies, adversely affecting patient accessibility and system affordability. In this paper, we draw on the “theory of innovative enterprise” to develop a framework that provides both a critique of the existing pricing system in the United States and a foundation for developing a new model of pricing regulation to support safety and effectiveness through drug development as well as accessibility and affordability in the distribution of approved medicines to patients. We introduce a regulatory approach we term “Pricing for Medicine Innovation” (PMI), which departs dramatically from the market-equilibrium assumptions of conventional (neoclassical) economics. The PMI approach recognizes the centrality of collective investments by government agencies and business firms in the productive capabilities that underpin the drug development process. PMI specifies the conditions under which, at the firm level, drug pricing can support both sustained investment in these capabilities and improved patient access. PMI can advance both of these objectives simultaneously by regulating not just the level of corporate profit but also its allocation to reinvestment in the drug development process. PMI suggests that although price caps are likely to improve drug affordability, there remain two potential issues with this pricing approach. Firstly, in an innovation system where a company’s sales revenue is the source of its finance for further drug development, price caps may deprive a firm of the means to invest in innovation. Secondly, even with adequate profits available for investment in innovation, a firm that is run to maximize shareholder value will tend to use those profits to fund distributions to shareholders rather than for investment in drug innovation. We argue that, if implemented properly, PMI could both improve the affordability of medicines and enhance the innovative performance of pharmaceutical companies.
Topic:
Health Care Policy, Drugs, Innovation, Medicine, and Price
Political Geography:
North America and United States of America

4. Behavioral Responses to Supply‐​Side Drug Policy during the Opioid Epidemic

Author:
Simone Balestra, Heige Liebert, and Nicole Maestas
Publication Date:
12-2022
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
In the last 20 years, the use of prescription opioids has grown dramatically in the United States. Since 1999, the number of opioid prescriptions increased by 300 percent, surpassing 255 million prescriptions in 2012 (81.3 prescriptions per 100 people) before declining to 153 million prescriptions by 2019 (46.7 per 100 people). Opioids may be an effective analgesic for acute pain, but they are also associated with high risks of addiction and overdose. Death rates from opioid poisoning tripled between 2000 and 2014, contributing to a stunning reversal in 1999 of the long‐​running decline in midlife mortality. The increase in overdose deaths was initially driven by prescription opioid poisonings, but the more recent surge in deaths has been attributed to illicit opioids such as heroin and fentanyl.
Topic:
Economy, Drugs, Public Health, and Opioid Crisis
Political Geography:
North America and United States of America

5. The Caribbean in the Crossfire Between Covid-19, Narcotics, China, and Russia’s Invasion of Ukraine

Author:
R. Evan Ellis
Publication Date:
04-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies (CSIS)
Abstract:
The Caribbean is strategically vital as the southeast maritime approach to the United States. It is a key hub and transit area for commercial logistics serving the eastern coast of the United States as well as the Atlantic side of Central and South America. The region is connected to the United States through ties of commerce, geography, and family. Not only is the U.S. territory of Puerto Rico situated centrally in the Caribbean between the Dominican Republic and the Leeward Antilles islands, but significant diasporas of Cubans, Jamaicans, Dominicans, Haitians, and others are found in U.S. communities, from South Florida to New York and New Jersey and beyond. The United States relies on good governance in the Caribbean and partnership on a range of national security issues, including the entry of illegal narcotics (principally moving north from Colombia and Venezuela) and other contraband goods. Even more importantly, the Caribbean touches—or is proximate to—a substantial number of important U.S. ports and military facilities, such as Jacksonville, Florida; Savannah and Kings Bay, Georgia; Charleston, South Carolina; and Norfolk, Virginia. Not only are these facilities critical to U.S. international maritime commerce, but military facilities in some of those areas play important roles in the deployment and sustainment of forces in a range of potential conflicts, be they in Africa, Europe, or Asia. Indeed, during the wars of the previous century, German submarines sought to operate in or near the Caribbean in order to put U.S. facilities and ship convoys at risk.
Topic:
Security, Narcotics Trafficking, Military Intervention, Drugs, and COVID-19
Political Geography:
Latin America, Caribbean, and North America

6. Mexico Peace Index 2022: Identifying and measuring the factors that drive peace

Author:
Institute for Economics and Peace (IEP)
Publication Date:
01-2022
Content Type:
Special Report
Institution:
Institute for Economics & Peace (IEP)
Abstract:
This is the ninth edition of the Mexico Peace Index (MPI), produced by the Institute for Economics & Peace (IEP). It provides a comprehensive measure of peacefulness in Mexico, including trends, analysis and estimates of the economic impact of violence in the country. The MPI is based on the Global Peace Index, the world’s leading measure of global peacefulness, produced by IEP every year since 2007. The MPI consists of 12 sub-indicators aggregated into five broader indicators.
Topic:
Corruption, Crime, Economics, Trafficking, Peace, Drugs, Data, and Organized Crime
Political Geography:
North America and Mexico

7. U.S.-Mexico Drug Trafficking: Globalization, Cooperation and Challenges

Author:
Juan Carlos Gachúz Maya
Publication Date:
06-2019
Content Type:
Journal Article
Journal:
Journal on International Security Studies (RESI)
Institution:
International Security Studies Group (GESI) at the University of Granada
Abstract:
Criminal organizations have taken advantage of some of the benefits of the globalization process, have expanded their networks and have become groups that operate regionally and transnationally. The context of globalization entails the need to reform the structure of institutions and their way of operating at the domestic and regional levels. International cooperation between national institutions is not enough to face international challenges such as regional and global crime. The fight against drug trafficking networks between the U.S.and Mexico demands new institutional structures that involve the participation of state and non-state actors at a regional and global level.
Topic:
Globalization, Narcotics Trafficking, Drugs, and Organized Crime
Political Geography:
North America, Mexico, and United States of America

8. The New Opium War: A National Emergency

Author:
Celina B. Realuyo
Publication Date:
02-2019
Content Type:
Journal Article
Journal:
PRISM
Institution:
Institute for National Strategic Studies (INSS), National Defense University
Abstract:
Sadly, the current opioid crisis is reminiscent of past periods of addiction and overdose deaths in the United States. The crisis today, however, is on a much larger scale owing to how the American appetite for opioids has changed the nature of the drug trade in North America, from the consumption of marijuana and cocaine to that of heroin and fentanyl, and that Mexican transnational criminal organizations have been quick to capitalize on this demand signal at the expense of record levels of drug-related violence and homicides in Mexico. The opioid epidemic is now a health, security, social, economic welfare, and national security crisis. The public, private, and civic sectors must take a more active role in raising awareness of drug abuse and addiction to reduce the demand for opioids, particularly since this opioid epidemic does not discriminate against gender, race, age, economic status, or location. As a transnational crisis, international cooperation to address the supply of illicit opioids is also essential. A whole-of-society approach is required to triumph in the new opium war and overcome this latest opioid epidemic in North America.
Topic:
Narcotics Trafficking, Social Policy, Drugs, Illegal Trade, and Health Crisis
Political Geography:
North America, Mexico, and United States of America

9. Energy and Security in Mexico: The Real Winners of a Drug War

Author:
Guadalupe Correa-Cabrera
Publication Date:
07-2018
Content Type:
Journal Article
Journal:
Fletcher Security Review
Institution:
The Fletcher School, Tufts University
Abstract:
The rapid growth of organized crime in Mexico and the government’s response have driven an unprecedented rise in violence and impelled major structural economic changes, including the recent passage of energy reform. My latest book entitled Los Zetas Inc. asserts that these phenomena are a direct and intended result of the emergence of the brutal Zetas criminal organization and the corporate business model they have advanced in Mexico. Because the Zetas share some characteristics with legal transnational businesses that operate in the energy and private security industries, the criminal corporation is compared in the book with ExxonMobil, Halliburton, and Blackwater (renamed “Academi” and now a Constellis company). ​ Combining vivid interview commentary with in-depth analysis of organized crime as a transnational and corporate phenomenon, I propose a new theoretical framework for understanding the emerging face, new structure, and economic implications of organized crime in Mexico. Arguing that the armed conflict between criminal corporations (like the Zetas) and the Mexican state resembles a civil war, I identify the key winners and losers of this episode in Mexico’s most recent history. The groups that seem to have benefited — or will potentially benefit — the most (directly or indirectly) from the novel criminal scheme introduced by the Zetas, the Mexican government’s reaction to it, and the resulting brutality appear to be corporate actors in the energy sector, transnational financial companies, private security firms (including private prison companies), and the United States border-security/military-industrial complex.
Topic:
Security, Crime, Energy Policy, and Drugs
Political Geography:
North America and Mexico

10. The Limits of Material Benefits: Remittances and Pro-Americanism in Mexico

Author:
Convadonga Meseguer, Jaupart Pascal, and Javier Aparicio
Publication Date:
06-2017
Content Type:
Journal Article
Institution:
German Institute of Global and Area Studies
Abstract:
We explore how the reception of remittances affects perceptions of the bilateral relationship between Mexico and the United States. Scholars have claimed that the economic benefits of the relationship with the US prevail over imperialistic concerns as a result of the asymmetry of power between the two countries. Empirical research shows that Latin American public opinion is indeed more supportive of the US than theory indicates. However, we identify two gaps in this literature. First, scholars have explored the determinants of generic expressions of sentiment toward the US, overlooking more concrete instances of cooperation between the two countries. Second, scholars have focused on trade and investment and have ignored how the material gains of emigration shape attitudes toward the US. The present paper fills these two gaps by using novel survey data on the bilateral relationship between Mexico and the US. On one hand, we find that while the reception of remittances correlates positively with good sentiments toward the US, the recipients of remittances are consistently more opposed to cooperation with the US in the fight against drug trafficking. We argue that this finding can be explained by the different nature of the migratory phenomenon, and the connection between anti-drug trafficking policies and the close scrutiny of illegal flows of money and people.
Topic:
Imperialism, Migration, Regional Cooperation, Bilateral Relations, Trafficking, Borders, and Drugs
Political Geography:
United States, Latin America, North America, and Mexico