John R. Pamplin II, Saba Rouhani,, Corey S. Davis, Carla King, and Tarlise N. Townsend,

The US overdose crisis continues to worsen and is disproportionately harming Black and Hispanic/Latino people. Although the “War on Drugs” continues to shape drug policy—at the disproportionate expense of Black and Hispanic/Latino people—states have taken some steps to reduce War on Drugs–related harms and adopt a public health–centered approach. However, the rhetoric regarding these changes has, in many cases, outstripped reality. Using overdose Good Samaritan Laws (GSLs) as a case study, we argue that public health–oriented policy changes made in some states are undercut by the broader enduring environment of a structurally racist drug criminalization agenda that continues to permeate and constrict most attempts at change. Drawing from our collective experiences in public health research and practice, we describe 3 key barriers to GSL effectiveness: the narrow parameters within which they apply, the fact that they are subject to police discretion, and the passage of competing laws that further criminalize people who use illicit drugs. All reveal a persisting climate of drug criminalization that may reduce policy effectiveness and explain why current reforms may be destined for failure and further disadvantage Black and Hispanic/Latino people who use drug

Am J Public Health. 2023;113(S1):S43–S48. https://doi.org/ 10.2105/AJPH.2022.307037)

By The European Parliament

Cannabis is by far the most commonly used illicit drug (referred to as drug in this briefing) in the European Union (EU), where its distribution, cultivation, possession and use (consumption) are largely prohibited. The prohibition of drug-related activities other than those performed for medical or scientific purposes is the defining feature of the international drug control system. Set up by the United Nations (UN), this system is composed of three complementary conventions, to which all EU Member States are parties. Various countries around the world have made use of the flexibility of the UN system, not applying criminal penalties in some cases (e.g. for possession of small amounts of drugs for personal use) or replacing them with administrative ones. The UN bodies monitoring compliance with the conventions seem to have come to accept these policy choices. However, they remain resistant to the still rare yet increasingly common practice of legalising the recreational use of cannabis, which may entail regulating drug distribution and sale in a manner akin to that for alcohol and tobacco. In the EU, drug policy has remained primarily the Member States' preserve. The EU has fostered the Member States' cooperation on law enforcement and health-related issues, while at the same time respecting their diverse philosophies on how to address recreational drug use. National approaches range from very restrictive policies that prioritise criminal law responses, to more liberal ones that focus primarily on reducing the health and social harms resulting from drug use. In 2021, Malta became the first Member State to legalise recreational cannabis, and since then several others have taken steps that could potentially lead to similar drug policy reforms.

Brussels: European Union, 2023. 12p.

By Bradley Ray, Steven J. Korzeniewski, George Mohler, Jennifer J. Carroll, et al.

Objectives. To test the hypothesis that law enforcement efforts to disrupt local drug markets by seizing opioids or stimulants are associated with increased spatiotemporal clustering of overdose events in the surrounding geographic area. Methods. We performed a retrospective (January 1, 2020 to December 31, 2021), population-based cohort study using administrative data from Marion County, Indiana. We compared frequency and characteristics of drug (i.e., opioids and stimulants) seizures with changes in fatal overdose, emergency medical services nonfatal overdose calls for service, and naloxone administration in the geographic area and time following the seizures. Results. Within 7, 14, and 21 days, opioid-related law enforcement drug seizures were significantly associated with increased spatiotemporal clustering of overdoses within radii of 100, 250, and 500 meters. For example, the observed number of fatal overdoses was two-fold higher than expected under the null distribution within 7 days and 500 meters following opioid-related seizures. To a lesser extent, stimulant-related drug seizures were associated with increased spatiotemporal clustering overdose. Conclusions. Supply-side enforcement interventions and drug policies should be further explored to determine whether they exacerbate an ongoing overdose epidemic and negatively affect the nation’s life expectancy.

Am J Public Health. 2023;113(7):750–758

 By Peter Hillen, Elizabeth Speakman, Nadine Dougall, Inga Heyman, Jennifer Murray, Michelle Jamieson, Elizabeth Aston, Andrew McAuley  

This report describes the findings of an independent evaluation of a Police Scotland test of change (pilot) of the carriage and administration of intranasal naloxone as an emergency first aid measure to persons suspected of experiencing an opioid overdose. The pilot was conducted between March and October 2021 in three test areas in Scotland: Falkirk, Dundee City and Glasgow East, and subsequently extended to include Caithness, Falkirk and Glasgow custody and community police officers in Stirling. Research aims and objectives The evaluation focused on the implementation and processes of the pilot to allow elements of learning and best practice to be identified and to inform any potential future national implementation of naloxone carriage/administration within Police Scotland. The evaluation assessed: • Police officer attitudes towards drug use and people who use drugs; • Police officer experiences of witnessing and responding to overdose; • Police officer understanding and awareness of drug overdose incidents and naloxone as a first aid intervention; • Effectiveness of naloxone training (considering knowledge/skills of officers both before and after training); • Experience of naloxone carriage/administration by officers; • Barriers/facilitators (actual or perceived) impacting on police carriage/administration of naloxone; • Perceptions from local communities, including recovery communities, people who use drugs, their families and/or relevant support services.   

Edinburgh; Napier University ,2022. 98p.

By Jonathan P. Caulkins and Keith Humphreys

Drug policy often comprises efforts to reduce the supply of drugs, to provide health and social services to addicted individuals, and to prevent the development of addiction in the first place. The last of these efforts—prevention—is the subject of this paper. The scientific literature on drug policy offers some insights on the relative effectiveness and cost-effectiveness of different strategies for preventing traditional opioid misuse and related harm. But these insights don’t apply perfectly to the current opioid crisis in the U.S. and Canada, due to many important differences between today’s epidemic and those of the past (e.g., heroin in the 1960s and 1970s). School-based universal primary prevention programs, for example, will probably remain only modestly effective, mainly because it is mostly adults, rather than adolescents, who initiate opioid use through prescription drugs. However, there are new opportunities for prevention, including promoting safer opioid prescribing, and issuing public health warnings about fentanyl’s dangers and the need to keep prescription opioids locked up. Importantly, the audience for these prevention interventions can include prescribers and pharmacists, not just potential users, and the mechanisms should involve incentives and nudges, not just information and education. Classic drug law enforcement against retail sellers and their suppliers may become even less effective than it has been in the past. However, other forms of supply control are possible because most of the prescription opioids that get misused come from legal and regulated distribution. Because prescription opioids remain the dominant route through which opioid use disorder is initiated, reducing its incidence can translate over time into reduced deaths not only from prescription opioids, but also from heroin and fentanyl. Enforcement against licensed producers and distributors may perform well even if enforcement against traditional dealers does not, and there are a wide range of actions visa-vis these licensees that do not require arrest or incarceration.

Washington, DC: The Brookings Institution, 2020. 24p.