By Ashly Fuller | Marie Vasek | Enrico Mariconti  | Shane D. Johnson

Issues: The sale of illicit drugs online has expanded to mainstream social media apps. These platforms provide access to a wide audience, especially children and adolescents. Research is in its infancy and scattered due to the multidisciplinary aspects of the phenomena. Approach: We present a multidisciplinary systematic scoping review on the advertisement and sale of illicit drugs to young people. Peer-reviewed studies written in English, Spanish and French were searched for the period 2015 to 2022. We extracted data on users, drugs studied, rate of posts, terminology used and study methodology. Key Findings: A total of 56 peer-reviewed papers were included. The analysis of these highlights the variety of drugs advertised and platforms used to do so. Various methodological designs were considered. Approaches to detecting illicit content were the focus of many studies as algorithms move from detecting drug-related keywords to drug selling behaviour. We found that on average, for the studies reviewed, 13 in 100 social media posts advertise illicit drugs. However, popular platforms used by adolescents are rarely studied. Implications: Promotional content is increasing in sophistication to appeal to young people, shifting towards healthy, glamourous and seemingly legal depictions of drugs. Greater inter-disciplinary collaboration between computational and qualitative approaches are needed to comprehensively study the sale and advertisement of illegal drugs on social media across different platforms. This requires coordinated action from researchers, policy makers and service providers. 

Drugs and Alcohol Review, 2023

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 Tobias Kammersgaard

Background: In 2018 the Norwegian government appointed a committee to prepare the implementation of a drug decriminalization reform. The overall goal of the committee was to propose a model where responsibility for society’s response to the use and possession of illegal drugs for personal use would be transferred from the justice sector to the health service, under the catchphrase ‘from punishment to help’. While the proposal ultimately did not get the necessary backing in parliament, the proposed reform still constitutes a very comprehensive and recent proposal for reforming national drug policy and it provides an ideal case for studying contemporary discourses on ‘drug decriminalization’. Methods: The analysis of this reform proposal is guided by the post-structuralist “What’s the Problem Represented to be” (WPR) approach, which is used for investigating the problem representation(s) in the proposal, as well as the rationalities, practices and deep-seated assumptions underpinning these. In doing this, the paper explores how the strategy represents both changes and continuities in discourses around illicit drugs and the people who use them. Results: Based on the WPR approach, two problem representations in the proposal are identified: the ‘problem of illicit drug use’ and the ‘problem of criminalization’. However, the ‘problem of illicit drug use’ is argued to be the authoritative representation that takes precedence over the other. In that regard, the paper points to how the proposed shift from the justice sector to the health sector would only be partial, given that the role of the police and drug law enforcement would be retained in the reform. Furthermore, the paper points to how illicit drug use continued to be fundamentally pathologized in the proposed reform. Conclusion: The paper concludes with a discussion about the overall ambition of shifting from a crime-centered to a health-centered approach to people who use drugs and some reflections on the potential of an additional rights-based approach is provided.

International Journal of Drug Policy. Volume 113, March 2023, 103963.

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 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.

By Canada. Dept. of Labour.

Printed by order of Parliament. Sir,—In the report recently presented, of the settlement of the claims of the Chinese residents of the city of Vancouver, B.C., for losses occasioned by the anti- Asiatic riots of September last, I drew attention to a report of the evidence before the commission, disclosing the existence of opium manufacturing on a considerable scale in the province of British Columbia, and respectfully submitted that the operations of the opium industry should receive the immediate attention of parliament, and of the legislatures, with a view to the enactment of such measures as would effectually suppress the opium traffic in Canada, and wholly eradicate this evil and its baneful effects.

Ottawa: S.E. Dawson, 1908. 13p.