By Europol and US Drug Enforcement Administration

The EU drug landscape is populated by a diverse range of criminal actors involved in the production, trafficking and distribution of a variety of illicit substances. These actors benefit from a number of criminal enablers and facilitators in their operations. In recent years, seizures of methamphetamine and cocaine linked to Mexican criminal actors have emerged as a prominent feature of the EU drug landscape. Mexican criminal actors and EU-based criminal networks have been working together to traffic both of these illicit drug types from Latin America to the EU.

This report delves into the activities of these criminals and their methods. Drug trafficking operations benefit from a number of different actors, such as brokers, cooks, envoys, intermediaries and money laundering service providers. Examples of the methods used by the criminals include the corruption of officials in the public and private sectors and the exploitation of legal business structures. The report also provides an outlook on potential threats that may develop in the future.

In the first initiative of this kind, Europol and the United States Drug Enforcement Administration (DEA) have issued this joint strategic product with the aim of expanding the intelligence picture on the involvement of Mexican criminal actors in the EU drug market.

The Hague: Europol and the DEA, 2022. 8p.

By J. Travis Donahoe

This paper studies the effects of shutting down prescribers, dispensers, and distributors that inappropriately handle prescription opioids on local opioid supply and mortality. With competitive supply, theory suggests the effects of closing any single supplier will be offset by substitution. Closing a supplier may have an effect on overall supply, however, if the targeted supplier is more lax with prescriptions than others or if the action has general deterrence effects. To examine enforcement empirically, I exploit differential timing of initial enforcement actions across areas following a federal expansion of enforcement in 2008. I show enforcement reduced overall opioid shipments by 20 percent in the average affected county for three years. Results further show that enforcement actions targeting distributors primarily reduced opioid shipments to pharmacies and clinics with suspicious order patterns. Overall, these findings demonstrate a large role for supplier enforcement to reduce harmful prescription opioid supply. Enforcement actions had heterogeneous effects on mortality. In Florida, which experienced the most enforcement, overdose death rates fell by 22 percent due to enforcement actions for five years. Outside of Florida, where enforcement was less intensive, overall mortality was unaffected. This heterogeneity is an important policy issue. (Job Market Paper)

Cambridge, MA: Harvard University, 2022. 69p.

By Vanda Felbab-Brown

Colombia’s counternarcotics policy choices have profound impact on consolidating peace in the wake of the 2016 peace deal with the Revolutionary Armed Forces of Colombia — People’s Army (Fuerzas Armadas Revolucionarias de Colombia — Ejército del Pueblo, FARC) and on the building of an effective state. Strategies of forced or voluntary eradication of coca crops have proven ineffective. As evidence from around the world shows, a long-term comprehensive effort to promote alternative livelihoods for coca growers — integrated into rural development and supported by well-designed interdiction efforts, with eradication delayed until these alternative livelihoods are generating sustainable income — has the best prospects for producing peace and a capable state and for reducing drug production.

To achieve sustainable and robust reduction of illicit crop cultivation, Colombia must thus expand its timeline of drug policy and state-building intervention well beyond 15 years. To achieve any viable transformative effects, it will also have to concentrate resources to selected zones of strategic intervention and gradually connect them and expand them to encompass larger areas in state intervention efforts.

The alternative livelihoods approach requires a concerted effort to build international support, particularly with the United States. It also requires countering the objections of Colombia’s political right. Arguments can be framed around the ineffective and counterproductive outcomes of forced eradication, the demonstrated benefits of comprehensive alternatives livelihood combined with well-designed interdiction to reduce the power of criminal groups, and other counternarcotics priorities in the United States.

A zero-coca conceptualization that insists on eradication first and conditions development aid on prior eradication of coca jeopardizes peace-building and statebuilding. In Colombia and elsewhere in the world, it has consistently failed to produce a sustainable reduction of coca cultivation. Forced eradication undermines the peace deal with the FARC and the broader legitimacy and presence of the state by jeopardizing the state’s ability to establish meaningful presence in areas formerly dominated by nonstate armed groups and radicalizing communities and cocalero (coca cultivator) movements. Aerial spraying will only compound these problems; drones will not redress the negative political effects, even if somewhat increasing the precision of spraying.

Washington, DC: Brookings Foreign Policy , 2020. 30p.

By Enrico Lucca, et al.

In the wake of the Nazi regime’s policies, European Jewish cultural property was dispersed, dislocated, and destroyed. Books, manuscripts, and artworks were either taken by their fleeing owners and were transferred to different places worldwide, or they fell prey to systematic looting and destruction under German occupation. Until today, a significant amount of items can be found in private and public collections in Germany as well as abroad with an unclear or disputed provenance. Contested Heritage. Jewish Cultural Property after 1945 illuminates the political and cultural implications of Jewish cultural property looted and displaced during the Holocaust. The volume includes seventeen essays, accompanied by newly discovered archival material and illustrations, which address a wide range of topics: from the shifting meaning and character of the objects themselves, the so-called object biographies, their restitution processes after 1945, conflicting ideas about their appropriate location, political interests in their preservation, actors and networks involved in salvage operations, to questions of intellectual and cultural transfer processes revolving around the moving objects and their literary resonances. Thus, it offers a fascinating insight into lesser-known dimensions of the aftermath of the Holocaust and the history of Jews in postwar Europe.

Göttingen : Vandenhoeck and Ruprecht, [2020]

By Jos van Beurden

The discussion about objects, human remains and archives from former colonial territories is becoming increasingly heated. Over the centuries, a multitude of items – including a cannon of the King of Kandy, power-objects from DR Congo, Benin bronzes, Javanese temple statues, M.ori heads and strategic documents – has ended up in museums and private collections in Belgium and the Netherlands by improper means. Since gaining independence, former colonies have been calling for the return of their lost heritage. As continued possession of these objects only grows more uncomfortable, governments and museums must decide what to do. How did these objects get here? Are they all looted, and how can we find out? How does restitution work in practice? Are there any appealing examples? How do other former colonial powers deal with restitution? Do former colonies trust their intentions? The answers to these questions are far from unambiguous, but indispensable for a balanced discussion.

Amsterdam: Amsterdam University Press, 2022. 249p.

By Jos van Beurden

This pioneering study charts the one-way traffic of cultural and historical objects during five centuries of European colonialism. It presents abundant examples of disappeared colonial objects and systematises these into war booty, confiscations by missionaries and contestable acquisitions by private persons and other categories. Former colonies consider this as a historical injustice that has not been undone. Former colonial powers have kept most of the objects in their custody. In the 1970s the Netherlands and Belgium returned objects to their former colonies Indonesia and DR Congo; but their number was considerably smaller than what had been asked for. Nigeria’s requests for the return of some Benin objects, confiscated by British soldiers in 1897, are rejected. As there is no consensus on how to deal with colonial objects, disputes about other categories of contestable objects are analysed. For Nazi-looted art-works, the 1998 Washington Conference Principles have been widely accepted. Although non-binding, they promote fair and just solutions and help people to reclaim art works that they lost involuntarily. To promote solutions for colonial objects, Principles for Dealing with Colonial Cultural and Historical Objects are presented, based on the 1998 Washington Conference Principles on Nazi-Confiscated Art. They are part of a model to facilitate mediation in disputes about them. Europe, the former colonisers, should do more pro-active provenance research into the acquisitions from the colonial era, both in public institutions and private collections.

Leiden: Sidestone Press Dissertations, 2017. 206[p.

By Naomi Pfitzner · Kate Fitz-Gibbon · Sandra Walklate · Silke Meyer · Marie Segrave

This open access book brings together leading international violence researchers to examine the impact of the coronavirus pandemic on experiences of, and responses to, domestic and family violence. In April 2020 the United Nations predicted that for every three months the COVID-19 lockdowns continued an additional 15 million cases of domestic violence would occur worldwide, termed the "shadow pandemic". Drawing on empirical work situated within an international context, this book presents evidence alongside country specific case studies to provide a global exploration of how women’s insecurity increased during this global health crisis at the same as their access to support services reduced. It provides a timely analysis of the degree to which the pandemic and associated government restrictions impacted on women’s experiences of violence with particular attention to changes in its prevalence and severity, and in system and service responses to women’s help-seeking. In addition, the differential impacts of the pandemic in relation to the experiences of priority cohorts, including violence experienced by children and temporary migrant women is also explored. The key focus is on the nature, extent, and responses to the COVID-19 pandemic on service delivery, accessibility of support, and access to justice for women experiencing domestic and family violence.

Cham, Springer Nature (palgrave Pivot), 2023. 150p.

By Katherine Millar, James Shires, and Tatiana Tropina

Multilateral processes on cybersecurity have recently begun to include official statements drawing attention to its gendered dimensions. Several delegations participating in the United Nations Open Ended Working Group (OEWG) on developments in the field of information and telecommunications in the context of international security have stated the need for gender mainstreaming into cyber norm implementation and gender-sensitive capacity building, as well as a better understanding of the linkages between cybersecurity and gender equality frameworks. However, questions remain about the overall application of gender perspectives to cybersecurity, as well as what kinds of action are needed to effectively implement a gender approach to cybersecurity and turn those goals into reality. To tackle this knowledge gap, this report outlines the relevance of gender norms to cybersecurity. It draws on existing research, supplemented by stakeholder and expert interviews, to assess gender-based differences in the social roles and interaction of women, men and non-binary people of all ages reflected in the distribution of power (e.g. influence over policy decisions and corporate governance), access to resources (e.g. equitable access to education, wages or privacy protections), and construction of gender norms and roles (e.g. assumptions regarding victims and perpetrators of cyber-facilitated violence). Overall, gender norms inform cybersecurity in two ways. First, gender constructs individual identities, roles and expectations within cybersecurity and broader society, such as the frequent association of technical expertise with men and masculinity. Second, gender operates as a form of hierarchical social structure. This means that activities and concepts associated with masculinity, such as technical expertise, are often, but not always, valued over those associated with women and femininity, such as communications expertise or equality, diversity and inclusion initiatives. To understand how gender shapes specific cybersecurity activities, this report proposes a new cyber-centric framework based on the three pillars of design, defence and response, aligned with prevalent perspectives among cybersecurity practitioners and policymakers. In each of these three pillars, the research identifies distinct dimensions of cyber-related activities that need to be considered from a gender perspective.

Geneva, Switzerland: United Nations Institute for Disarmament Research , 2021. 80p.

By Nancy Lombard and katy Proctor

Scotland’s record of accomplishment in tackling issues such as stalking and coercive control has been identified as an exemplar. Most recently, the Domestic Abuse Scotland Act (2018) was implemented which for the first time recognised a coercively controlling course of conduct as the crime of Domestic Abuse, possibly indicating a more empathetic and understanding criminal justice system. However, it is important to recognise that despite victim-centred policies and legislation, institutional criminal justice processes can diminish their impact. As such, victims can feel disempowered and controlled simultaneously by the bureaucracy in which they find themselves and by the continued abuse of the perpetrator. Therefore, this research explored whether the Scottish Criminal Justice System facilitates the empowerment of the victims who access its support or exacerbate their disempowerment.

The aim of this study was to explore the lived experiences of victims of coercive control and/or stalking as they navigated the criminal justice system.

Glasgow: SCCJR - The Scottish Centre for Crime and Justice Research, 2023. 72p.

By Niombo Lomba, Cecilia Navarra and Meenakshi Fernandes

With the rise of new technology and social media, gender-based cyber violence is a constantly growing threat with impacts at individual, social and economic levels, on women and girls and on society generally. There is currently no common definition or effective policy approach to combating gender-based cyber violence at EU or national level. Action taken so far has been inadequate, and the cross-border nature of gender-based cyber violence has yet to be properly addressed either. This European added value assessment (EAVA) supports the European Parliament in its right to request legislative action by the Commission, and complements its own-initiative legislative report 'Combating gender-based violence: Cyber violence' (2020/2035(INL)). Examining the definition and prevalence of gender-based cyber violence, the legal situation and individual, social and economic impacts, the EAVA draws conclusions on the EU action that could be taken, and identifies eight policy options. The costs to individuals and society are substantial and shown to be in the order of €49.0 to €89.3billion. The assessment also finds that a combination of legal and non-legal policy options would generate the greatest European added value, promote the fundamental rights of victims, address individual, social and economic impacts, and support law enforcement and people working with victims. The potential European added value of the policy options considered is a reduction in the cost of gender-based cyber violence ranging from 1 to 24%

Brussels, European Union, EPRS | European Parliamentary Research Service, 2021. 242p.

By Danielle Keats Citron

For too long, cyber abuse has been misunderstood and ignored. The prevailing view is that cyber abuse is not “really real,” though in rare cases authorities take it seriously. Justices of the U.S. The Supreme Court, for instance, demanded and received extra protection for themselves after facing online threats, but, in oral argument, dismissed a woman as “overly sensitive” for reporting hundreds of threatening texts to law enforcement. In other words, protection for me (the powerful) but not for thee. For everyday women and minorities, cyber abuse is unseen and unredressed, due to invidious stereotypes and gender norms. Empirical proof now exists that makes non-recognition difficult to justify. Studies show that cyber abuse is widespread, the injuries profound, and disproportionately borne by women, who often have intersecting disadvantaged identities. (Hence, the moniker cyber gender abuse). After years of advocacy and scholarship, it pains me to acknowledge the continued invisibility of cyber gender abuse, but progress is possible if we recognize our failings and commit to structural reform. Internet exceptionalism must end for the businesses best situated to prevent destructive cyber gender abuse. Congress should condition the immunity afforded content platforms on a duty of care to address cyber gender abuse and eliminate the legal shield for platforms whose business is abuse. Companies must commit to safety by design as a core principle.

Yale Law Journal Forum, Forthcoming. Virginia Public Law and Legal Theory Research Paper No. 2023-57

By UN Women

The current survey arises as a joint initiative of the Observatory for Women's Equity (OEM) and the International Center for Private Enterprise (CIPE). The objective of this research is to characterize gender-based violence online, with a particular emphasis on businesswomen and/or female workers from companies registered in the chambers of commerce of Bogotá, Medellín, and Cali. The goal is to gain a deeper understanding of the nature and manifestations of gender-based violence in the digital environment, in order to propose policies that promote safe and equitable environments for all women in the business and labor sphere. The OEM is an initiative that emerged from the alliance between the WWB Colombia Foundation and the Universidad Icesi, with a mission to build, consolidate, and make visible projects that contribute to women's equity and inclusion. As a body for measurement, dissemination, institutional advocacy, and public policy, the Observatory focuses on analyzing factors that affect women's autonomy and equity in the Valle del Cauca region. Through systematic and timely measurement and analysis, it seeks to generate high-quality, accurate, and reliable information that contributes to regional and national debates on women's living conditions across various dimensions, promoting interventions in public policy and institutional programs that foster gender equity.

On the other hand, CIPE is one of the four core institutes of the National Endowment for Democracy (NED). Since 1983, CIPE has worked with business leaders, politicians, and journalists to build civic institutions that are vital for a democratic society. CIPE addresses fundamental issues for democracy and economic development, including women's participation in the business and labor sphere. Its commitment to promoting gender equity, framed within the work carried out by its Center for Women's Economic Empowerment (CWEE), makes it a strategic ally to conduct this survey on gender-based violence in the digital environment, with the purpose of shedding light on and combating the violence that affects women in the business and labor context. Both organizations, aware of the importance of addressing gender issues comprehensively and cross-cutting, have joined forces to carry out this survey to achieve a greater understanding of gender-based violence online. The alliance seeks to generate accurate and reliable data that reflect the experiences and perceptions of businesswomen and female workers in the digital environment, in order to propose strategies and policies that promote equal opportunities and the eradication of gender violence. The collaboration between OEM and CIPE represents a joint effort to promote workplaces and business environments free from violence and discrimination, where women can fully thrive, exercise their rights, and contribute to the economic and social development of their communities.

New York: UN Women, 2023. 48p.

Eric L. Sevigny, Jared Greathouse, Danye N. Medhin

Background. Globally, cannabis laws and regulations are rapidly changing. Countries are increasingly permitting access to cannabis under various decriminalization, medicalization, and legalization laws. With strong economic, public health, and social justice incentives driving these domestic cannabis policy reforms, liberalization trends are bound to continue. However, despite a large and growing body of interdisciplinary research addressing the policy-relevant health, safety, and socioeconomic consequences of cannabis liberalization, there is a lack of robust primary and systematic research that comprehensively investigates the consequences of these reforms.

Objectives. This evidence and gap map (EGM) summarizes the empirical evidence on cannabis liberalization policies. Primary objectives were to develop a conceptual framework linking cannabis liberalization policies to relevant outcomes, descriptively summarize the empirical evidence, and identify areas of evidence concentration and gaps.

Search Methods. We comprehensively searched for eligible English-language empirical studies published across 23 academic databases and 11 gray literature sources through August 2020. Additions to the pool of potentially eligible studies from supplemental sources were made through November 2020.

Selection Criteria. The conceptual framework for this EGM draws upon a legal epidemiological perspective highlighting the causal effects of law and policy on population-level outcomes. Eligible interventions include policies that create or expand access to a legal or decriminalized supply of cannabis: comprehensive medical cannabis laws (MCLs), limited medical cannabidiol laws (CBDLs), recreational cannabis laws (RCLs), industrial hemp laws (IHLs), and decriminalization of cultivations laws (DCLs). Eligible outcomes include intermediate responses (i.e., attitudes/behaviors and markets/environments) and longer-term consequences (health, safety, and socioeconomic outcomes) of these laws.

Data Collection and Analysis. Both dual screening and dual data extraction were performed with third person deconfliction. Primary studies were appraised using the Maryland Scientific Methods Scale and systematic reviews were assessed using AMSTAR 2.

Main Results. The EGM includes 447 studies, comprising 438 primary studies and nine systematic reviews. Most research derives from the United States, with little research from other countries. By far, most cannabis liberalization research focuses on the effects of MCLs and RCLs. Studies targeting other laws—including CBDLs, IHLs, and DCLs—are relatively rare. Of the 113 distinct outcomes we documented, cannabis use was the single most frequently investigated. More than half these outcomes were addressed by three or fewer studies, highlighting substantial evidence gaps in the literature. The systematic evidence base is relatively small, comprising just seven completed reviews on cannabis use (3), opioid-related harms (3), and alcohol-related outcomes (1). Moreover, we have limited confidence in the reviews, as five were appraised as minimal quality and two as low quality.

Authors’ Conclusions. More primary and systematic research is needed to better understand the effects of cannabis liberalization laws on longer-term—and arguably more salient—health, safety, and socioeconomic outcomes. Since most research concerns MCLs and RCLs, there is a critical need for research on the societal impacts of industrial hemp production, medical CBD products, and decriminalized cannabis cultivation. Future research should also prioritize understanding the heterogeneous effects of these laws given differences in specific provisions and implementation across jurisdictions

Systematic Reviews, vol. 19(4), 2023.

By U.S. Bureau of Justice Assistance

his brief reviews activities undertaken by states to expand the use of telehealth for justice-involved individuals with SUDs during the COVID-19 pandemic, shares lessons learned, and highlights considerations for governors who wish to leverage telehealth services to increase access to SUD treatment for those involved in the justice system. Justice-involved individuals have historically had difficulties accessing treatment for SUDs and co-occurring behavioral health disorders. These difficulties can be mitigated by the benefits provided by telehealth, which include increased access to care for patients, reduced stigma, improved safety for staff, cost reductions for correctional institutions, and overall improvements to quality of care. In recent years, governors and state correctional and health officials have made great strides to improve access to SUD treatment for justice-involved individuals—both those within correctional facilities and on community supervision. Lessons learned for expanding these programs include ensuring access to evidence-based medication and treatment, emphasizing collaboration among justice systems and health partners, developing tailored treatment plans, reducing treatment barriers upon release, staff training, and developing robust program evaluation plans. States that have implemented telehealth services for justice-involved populations recognize several advantages for using them for treatment. States also identified several challenges with using telehealth services. States may consider these challenges and lessons learned when implementing or expanding telehealth programs for justice-involved individuals with SUDs.

Washington, DC: BJA, 2023, 6p.

By of Justice Assistance

Co-occurrence of post-traumatic stress disorder (PTSD) and substance use disorder (SUD) are very common, so it is crucial that SUD treatment providers incorporate initial PTSD screening and ongoing PTSD symptom monitoring. Doing so will allow for early intervention opportunities and better long-term outcomes. PTSD and SUDs often occur together, and an individual with diagnosed PTSD-SUD faces several associated long-term health risks. As a result, SUD treatment providers should consider PTSD screening at the beginning of treatment programs as well as ongoing PTSD symptom monitoring. Screening and monitoring for PTSD-SUD will allow for early intervention using strategies that are tailored for a dual diagnosis. Lifetime PTSD is a common psychiatric diagnosis (occurring in approximately 6.1 percent of adults), with even higher rates among rural, low-income communities. PTSD alone is associated with several adverse health outcomes, but individuals with PTSD also are likely to suffer from other disorders, including substance use disorders (SUDs). Individuals with both PTSD and an SUD (PTSD-SUD) report more severe long-term functional impairments than individuals with only one of these diagnoses. In addition, SUD recovery rates are much lower in people with PTSD than in those without.

Washington, DC: BJA, 2023. 6p.

By Jonathan Klick and John MacDonald

Objectives This study examines the impact of alcohol consumption in a Major League Baseball (MLB) stadium on area level counts of crime. The modal practice at MLB stadiums is to stop selling alcoholic beverages after the seventh inning. Baseball is not a timed game, so the duration between the last call for alcohol at the end of the seventh inning and the end of the game varies considerably, providing a unique natural experiment to estimate the relationship between alcohol consumption and crime near a stadium on game days. Methods Crime data were obtained from Philadelphia for the period 2006–2015 and geocoded to the area around the MLB stadium as well as popular sports bars. We rely on difference-in-differences regression models to estimate the change in crime on home game days around the stadium as the game time extends into extra innings to other areas of the city and around sports bars in Philadelphia relative to days when the baseball team plays away from home. Results When there are extra innings and more game-time after the seventh inning alcohol sales stoppage crime declines signifcantly around the stadium. The crime reduction beneft of the last call alcohol policy is undone when a complex of sports bars opens in the stadium parking lot in 2012. The results suggest that alcohol consumption during baseball games is a contributor to crime. Conclusions The fndings provide further support for environmental theories of crime that note the congregation of people in places with excessive alcohol consumption is a generator of violent crime in cities. The consumption of alcohol in MLB stadiums appears to increase crime.

Journal of Quantitative Criminology (2021) 37:813–834

Aaron Chalfin, Benjamin Hansen and Rachel Ryley

For nearly every crime there is a victim. However, the vast majority of studies in the economics of crime have focused the causal determinants of criminality. We present novel evidence on the causal determinants of victimization, focusing on legal access to alcohol. The social costs of alcohol use and abuse are sizable and well-documented. We find criminal victimization — for both violent and property crimes — increases noticeably at age 21. Effects are not present at other birthdays and do not appear to be driven by a “birthday celebration effect.” The effects are particularly large for sexual assaults, especially those that occur in non-residential locations. Our results suggest prior research which has focused on criminality has understated the true social costs associated with increased access to alcohol.

Journal of Human Resources. Vol. 58, Issue 6. 1 Nov 2023

By A. Bukten , I. Skjærvø , M.R. Stavseth

Introduction: Despite a high prevalence of opioid use disorder (OUD) among people in prison, there is little knowledge of how many receive the recommended opioid agonist treatment (OAT) and what characterizes those who receive OAT and those who do not when it comes to mental health comorbidities. We aimed to describe people with OUD in Norwegian prisons over a ten-year period and their OAT status, and to investigate comorbidity of mental health disorders stratified by gender.

Methods: Data from the PriSUD study, including all people (≥19 years old) imprisoned in Norway between 2010 and 2019, linked to national patient registry data, including ICD-10 codes. We calculated the prevalence (1-year and 10-year) of OUD and OAT, and mental health comorbidity stratified on OAT-status and gender.

Results: Among the cohort (n=51,148), 7 282 (14.2%) were diagnosed with OUD during the period of observation. Of those, 4 689 (64.4%) received OAT. People with OUD had high levels of comorbidity, including other drug use disorders (92.4% OAT, 90.3% non-OAT), alcohol use disorder (32.1% OAT, 44.4% non-OAT) and any other mental health disorders (61.6% OAT, 68.2% non-OAT). The proportion receiving OAT among people with OUD increased markedly during the ten years of observation; from 35.7% in 2010–70.9% in 2019.

Conclusion. People with OUD, both receiving OAT and not, had substantially more mental health comorbidities than the non-OUD population. Understanding how the prison population changes over time especially in terms of mental health needs related to OUD, is important for correctional health service planning.

Drug and Alcohol Dependence. Volume 250, 1 September 2023, 110896

By Jon E. Zibbell , Arnie Aldridge, Megan Grabenauer , David Heller , Sarah Duhart Clarke, , DeMia Pressley, Hope Smiley McDonald

Summary Background The overdose epidemic in the United States (US) continues to generate unprecedented levels of mortality. There is urgent need for a national data system capable of yielding high-quality, timely, and actionable information on existing and emerging drugs. Public health researchers have started using law enforcement forensic laboratory data to obtain surveillance information on illicit drugs. This study is the first to use drug reports from the entire US to examine correlations between a changing drug supply and increasing opioid-involved overdose deaths (OOD) on a national scale. Methods This study is observational and investigates associations between law enforcement drug reports and OOD for the US from 2014 to 2019. OOD data are from the Centers for Disease Control and Prevention’s National Vital Statistics System restricted-use multiple cause of death files. The US Drug Enforcement Administration’s National Forensic Laboratory Information System (NFLIS) contains forensic laboratory–tested drug exhibit information for the entire US (NFLIS-Drug). Counts of forensic laboratory reports and OOD were aggregated for each state by month, quarter, and year. A two-way fixed effects model was used to estimate contemporaneous and lagged associations. Findings Between 2014 and 2019 in the US, 249,522 OOD were reported, with the annual number nearly doubling from 28,723 to 50,179. OOD involving illicitly manufactured fentanyls (IMF) also increased substantially during this period, from 19.4% to 72.9%. In addition, 3,817,438 forensic laboratory reports in the US that were reported to NFLIS-Drug contained an opioid, stimulant, or benzodiazepine. Reports of fentanyl and fentanyl-related compounds (FFRC) had the strongest association with OOD. Each additional FFRC exhibit was associated with a 2.97% (95% CI: 1.7%, 4.1%) increase in OOD per 100,000 persons per quarter. Interpretation Adding to the emerging consensus, protracted growth in IMF supply was more strongly associated with OOD than all other illicit drugs reported to NFLIS-Drug over the study time period. Findings demonstrate NFLIS-Drug data usefulness for research that require proxy indicators for the illicit drugs supply. A concerted effort between public health and public safety to make NFLIS-Drug more timely could strengthen its utility as a national, public health, drug surveillance system.

The Lancet Regional Health - Americas. Volume 25, September 2023, 100569

By Paul J. Larkin

The raw, agricultural form of cannabis is not capable of being approved for use by the Food and Drug Administration (FDA)—regardless of whether Congress or the U.S. Attorney General reschedules it downward from Schedule I. Rescheduling cannabis would not allow the drug to be distributed under federal law unless the FDA finds that it is a safe, effective, and uniform drug. The FDA could not do so under existing law, and the Attorney General cannot waive the Food, Drug, and Cosmetic Act’s requirements. Congress could do so by statute—but any such law would put at risk the health of users and nonusers in order to satisfy the desires of a minority for a transient high.

Washington, DC: The Heritage Foundation, 2023. 57p.