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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. Beyond Punishment: From Criminal Justice Responses to Drug Policy Reform

Author:
Global Commission On Drug Policy
Publication Date:
12-2024
Content Type:
Special Report
Institution:
Global Commission On Drug Policy
Abstract:
The Global Commission on Drug Policy’s report, Beyond Punishment: From Criminal Justice Responses to Drug Policy Reform, exposes how punitive drug policies have driven mass incarceration and grave human rights violations. In 2023 alone, over 3.1 million people were arrested for drug-related offenses, with 20% of the global prison population detained for such crimes - nearly half for simple possession. The report underscores the devastating consequences of prohibitionist policies, including over one million overdose deaths in the U.S. in the past two decades and 40,000 in Canada in just eight years. It also highlights systemic inequities, such as Indigenous peoples in Canada being six times more likely to face drug-related arrests than white counterparts. Furthermore, the report illustrates the disproportionate burdens on women and children, deepening cycles of poverty and marginalization. It examines the broad spectrum of criminal justice responses to drug offenses, ranging from stop-and-search practices that disproportionately target marginalized communities to extreme measures like the death penalty and enforced treatment. These approaches often violate human rights, perpetuate stigma, and fail to address the root causes of substance use. Offering a roadmap for reform, the report advocates for evidence-based strategies, including harm reduction measures (e.g., Overdose Prevention Centers, naloxone distribution, and safer supply programs), decriminalization and the legal regulation of drug markets. These approaches not only save lives but also reduce societal harms, foster dignity, and promote health and equity.
Topic:
Human Rights, Reform, Criminal Justice, Mass Incarceration, Drugs, and Harm Reduction
Political Geography:
Global Focus

3. 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

4. A Mongoose Walked into a Narcotics Den…

Author:
Ed Marks
Publication Date:
08-2023
Content Type:
Journal Article
Journal:
American Diplomacy
Institution:
American Diplomacy
Abstract:
The American embassy in Sri Lanka, like its counterparts worldwide, has the task of liaison and coordination with local authorities on the subject of narcotics. When I served there from 1986 to 1989, narcotics’ use was not a major problem, nor was the country an exporter or a major transit point. Nevertheless, these are relative terms, and the Sri Lankan government was worried that narcotics activity in the country was growing. Both governments were concerned about the increasing evidence that at least one of the Tamil separatist groups was funding its activities by drug smuggling from South Asia to Europe. Soon after my arrival in Colombo, a young colleague who held the narcotics portfolio (among his other duties) arranged a luncheon with four of his most important contacts in the narcotics area: police, customs, etc. We discussed various aspects of the problem and of our bilateral cooperation in the field. At one point, we discussed inspection and control mechanisms at airports and ports, and especially the virtues of specially trained sniffer dogs. The subject interested me as I had some knowledge of the subject from my days in counterterrorism. We all realized that, useful as they are, dogs have disadvantages: scarcity, cost of procurement and maintenance, difficulty of adaptation to tropical climates, and a negative cultural reaction to them among many Moslems. I cannot remember exactly who first broached the thought (although I would like to take credit), but suddenly we were discussing the possibility of replacing sniffer dogs in Sri Lanka and elsewhere in Asia with an indigenous animal, to wit, the mongoose. The more we talked, the more the idea seemed worth pursuing. The senior police officer present claimed experience with local mongooses as pets and insisted that they were clever and trainable, and notable for their ability to smell.
Topic:
Foreign Policy, Diplomacy, Memoir, and Drugs
Political Geography:
South Asia, Sri Lanka, and United States of America

5. HIV, Hepatitis & Drug Policy Reform

Author:
Global Commission On Drug Policy
Publication Date:
12-2023
Content Type:
Special Report
Institution:
Global Commission On Drug Policy
Abstract:
This report, “HIV, Hepatitis & Drug Policy Reform” follows the Global Commission’s thematic reports on “The War on Drugs and HIV/AIDS” (2012) and “The Negative Impact of the War on Drugs on Public Health: The Hidden Hepatitis C Epidemic” (2013). Despite a decade-old call for urgent action, current drug control efforts fail, with HIV and hepatitis prevalence persisting among drug users. In 2023, approximately 354 million people around the world are currently living with hepatitis B or C. People who use drugs, especially people who inject drugs, are at a higher risk for blood- borne HIV, hepatitis B and hepatitis C. Although there has been some success — for example, the scale-up of antiretroviral treatments that reduced HIV related deaths to their lowest in almost three decades — progress has been uneven and people who use drugs are still left behind. This must change. Prohibition and criminalization of drug use hinder HIV and hepatitis prevention, escalating risks and obstructing treatment. People who use drugs face disproportionate incarceration, abusive policing, and stigma. Inadequate resources are dedicated to proven harm reduction options while billions are spent on punitive law enforcement measures. Achievable UN targets for ending these epidemics by 2030 exist, but a crucial course correction demands political will to embrace a new approach to drugs. The time to act is now.
Topic:
HIV/AIDS, Reform, Drugs, Public Health, and Hepatitis
Political Geography:
Global Focus

6. Impact of depenalization on drugs deaths in England and Wales. An instrumental variable approach

Author:
Alessandra Foresta and Andrew Pickering
Publication Date:
07-2023
Content Type:
Working Paper
Institution:
Nottingham Interdisciplinary Centre for Economic and Political Research (NICEP)
Abstract:
This article investigates the role of drug depenalization on drug related deaths in England and Wales. We use an instrumental variable approach, based on Police and Crime Commissioners elections and voters left-wing preferences corresponds a decrease in drug-related arrests. The IV results indicate that a decrease in our instrumented variables generates an increase in deaths related to drug poisoning/drug misuse. Specically, to a decrease of 1% in our instrumented variables corresponds to an increase between 0.04% and 0.07% in the drug poisoning/misuse deaths ratio. We replicate our analysis using different definitions of political preferences, lag specications, dependent and independent variables and the findings are similar.
Topic:
Politics, Law Enforcement, Drugs, Public Health, and Depenalization
Political Geography:
Europe, England, and Wales

7. Drugs and State Vigilantism as a Strategy of Political Activity: The Example of Thailand, the Philippines, and Indonesia

Author:
Kornel Bielawski
Publication Date:
01-2023
Content Type:
Journal Article
Journal:
Polish Political Science Yearbook
Institution:
Polish Political Science Association (PPSA)
Abstract:
The problem of distribution and consumption of intoxicating substances is considered a socially harmful phenomenon and Southeast Asia is a region particularly affected by drugs. In the face of this challenge, the heads of many states undertake radical actions, going beyond the legal framework, referred to as state vigilantism. Based on the example of three selected political leaders (Thaksin Shinawatra, Rodrigo Duterte and Joko Widodo), the author points out how radical strategies for fighting the drug problem contribute to increasing popularity, even though the problem has not been resolved since the early 1970s. Cross-comparison analysis of the three mentioned cases aims at identifying sources of effectiveness and attractiveness of populist methods that have not changed significantly for fifty years. Among them the author argues that vigilantism grows out of populism and takes the form of a spectacle containing such elements as dehumanising discourse, extrajudicial killings and the theme of the nation’s morality at risk.
Topic:
Politics, Populism, Drugs, and Vigilantism
Political Geography:
Indonesia, Philippines, Thailand, and Southeast Asia

8. 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

9. Fiscal Policy in the Regulation of Adult-Use Cannabis in Colombia

Author:
Anníbal Ramírez Rodrígues, Luis Felipe Cruz-Oliveira, and Isabel Pereira-Arana
Publication Date:
08-2022
Content Type:
Book
Institution:
Dejusticia
Abstract:
The document is divided into five sections. The first is an introduction, where we describe the background of the regulatory debate and the goals we propose for marijuana regulation in Colombia. In the second section, we present the theoretical framework for explaining why it is necessary to create a legal space for marijuana and what fiscal policy and human rights principles would be applicable to that process. In the third section, we explore comparative experiences, focusing on measures to raise revenue and resource allocation, and analyze lessons learned for the Colombian case. After that, in the fourth section, we home in on the Colombian context, considering how marijuana production and use has evolved in the country, and describing the places where production takes place and their needs. Finally, in the fifth section, we unveil our proposal: the cannabis fiscal principles.
Topic:
Markets, Regulation, Fiscal Policy, Drugs, and Cannabis
Political Geography:
Colombia and South America

10. 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