Drug Policy: Insights from Mathematical Analysis

Caulkins, Jonathan P.

doi:10.1007/1-4020-8066-2_12

Cited by 5 publications

(14 citation statements)

References 57 publications

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“…Intelligent management of a nation's drug control problem depends on having a clear understanding of the underlying epidemic dynamics [4]. This paper assembles for the first time a nearly 30-year time series on cocaine prevalence broken down by intensity of use.…”

Section: Discussionmentioning

confidence: 99%

“…A few that involved more picking and choosing among survey years gave slightly better fits than the ones just described, but not by much, and most had little effect on the final results. 4 One other issue, however, deserves mention. The 1982 survey records much higher initiation for 1979-1981 than does any subsequent survey.…”

Section: Cocaine Initiation By Yearmentioning

confidence: 99%

“…cess of $400,000. But even the $300,000 figure implies that modestly expensive treatment or other interventions that carry even a 1% chance of leading to sustained abstinence can be cost-effective [4].…”

Section: Comparison Of Flow Rate Estimatesmentioning

confidence: 99%

“…Important policy-relevant insights emerge directly from these parameters plus some simple calculations [4]. Also, full-scale systems studies that provide more refined insights concerning the cost-effectiveness of various policy interventions [5][6][7][8][9] depend on estimates of such epidemic demand parameters.…”

Section: Introductionmentioning

confidence: 99%

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Markov Chain Modeling of Initiation and Demand: The Case of the US Cocaine Epidemic

Caulkins

Behrens

Knoll

et al. 2004

Health Care Manage Sci

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Everingham and Rydell's Markov chain model of cocaine demand is modified and updated in light of recent data. Key insights continue to hold, e.g., that the proportion of cocaine demand stemming from heavy vs. light users changed dramatically over the 1980s. New insights emerge, e.g., pertaining to the average duration of a career of heavy use (about 12 years) and the negative relationship between levels of heavy use and epidemic "infectivity" or the number of new initiates per current user per year. This illustrates how simple modeling can yield insights directly relevant to managing complex drug control policy questions.

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Section: Discussionmentioning

confidence: 99%

Section: Cocaine Initiation By Yearmentioning

confidence: 99%

Section: Comparison Of Flow Rate Estimatesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Markov Chain Modeling of Initiation and Demand: The Case of the US Cocaine Epidemic

Caulkins

Behrens

Knoll

et al. 2004

Health Care Manage Sci

Self Cite

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“…For instance, experts have suggested that ‘enforcement swamping’ - in which an increase in the frequency of contact between drug law enforcement and individuals at risk of drug use - operates through a positive feedback mechanism wherein increased enforcement reduces the risk of drug use initiation. 25,26 This is based on optimal control theory, a mathematical discipline that explores the efficient application of interventions on a system. 27 In the context of drug use, optimal control theory has been cited as a method to optimize the application of drug law enforcement, taking into account various stages of the epidemic-like expansion of drug use initiation across a vulnerable population.…”

mentioning

confidence: 99%

Post-war prevention: Emerging frameworks to prevent drug use after the War on Drugs

Werb

2018

International Journal of Drug Policy

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The prevention of drug use is one of the primary goals of the War on Drugs. However, despite investment in high-profile interventions such as social marketing campaigns and enforcement-based deterrence, these efforts have generally failed. With the emergence of novel policy frameworks to control and regulate drug use, a window of opportunity exists to test approaches to drug prevention that take into account existing evidence and the rights of individuals who use drugs. Specifically, there is a growing consensus that entry into drug use is a socially-defined event that individuals experience within particular socio-structural contexts. This understanding, coupled with a distinction between the value of preventing problematic drug use rather than all drug use, provides a useful framework within which to develop effective and rights-based approaches to drug prevention.

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Do law enforcement interactions reduce the initiation of injection drug use? An investigation in three North American settings

Melo

Garfein

Hayashi

et al. 2018

Drug and Alcohol Dependence

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Background: The prevention of drug injecting is often cited as a justification for the deployment of law enforcement and for the continuation of drug criminalization policies. We sought to characterize the impact of law enforcement interactions on the risk that people who inject drugs (PWID) report assisting others with injection initiation in three North American countries. Methods: Cross-sectional data from PWID participating in cohort studies in three cities (San Diego, USA; Tijuana, Mexico; Vancouver, Canada) were pooled (August 2014-December 2016). The dependent variable was defined as recently (i.e., past six months) providing injection initiation assistance; the primary independent variable was the frequency of recent law enforcement interactions, defined categorically (0 vs. 1 vs. 2–5 vs. ≥6). We employed multivariable logistic regression analyses to assess this relationship while controlling for potential con- founders. Results: Among 2122 participants, 87 (4.1%) reported recently providing injection initiation assistance, and 802 (37.8%) reported recent law enforcement interactions. Reporting either one or more than five recent interactions with law enforcement was not significantly associated with injection initiation assistance. Reporting 2–5 law enforcement interactions was associated with initiation assistance (Adjusted Odds Ratio = 1.74, 95% Confidence Interval: 1.01 −3.02). Conclusions: Reporting interactions with law enforcement was not associated with a reduced likelihood that PWID reported initiating others into injection drug use. Instead, we identified a positive association between reporting law enforcement interactions and injection initiation assistance among PWID in multiple settings. These findings raise concerns regarding the effectiveness of drug law enforcement to deter injection drug use initiation.

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Drug Policy: Insights from Mathematical Analysis

Abstract: I. Introduction

Cited by 5 publications

References 57 publications

Markov Chain Modeling of Initiation and Demand: The Case of the US Cocaine Epidemic

Markov Chain Modeling of Initiation and Demand: The Case of the US Cocaine Epidemic

Post-war prevention: Emerging frameworks to prevent drug use after the War on Drugs

Do law enforcement interactions reduce the initiation of injection drug use? An investigation in three North American settings

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