Copyright (c) 2009 Berkeley Electronic Press All rights reserved. http://www.bepress.com/jdpa Recent documents in Journal of Drug Policy Analysis en-us Tue, 03 Nov 2009 23:22:02 PST 3600 http://www.bepress.com/jdpa/vol2/iss1/art3 http://www.bepress.com/jdpa/vol2/iss1/art3 Mon, 02 Nov 2009 14:37:36 PST Poverty and corruption are pervasive in Afghanistan and opium production is rampant, especially in the country's most insecure southern regions. Afghanistan's opium production now accounts for the overwhelming majority of the world's heroin supply. The International Council on Security and Development, a European think tank formerly known as the Senlis Council, is advocating a policy response that it refers to as "Poppy for Medicine." Under the Council's proposal, poppy farmers in Afghanistan would gain access to the world's legal pharmaceutical market through a two-tiered licensing program. A careful examination of India's experience as the world's sole licensed exporter of raw opium and of the world market for legal opiates casts serious doubt on this proposal. Legal medicinal opium production is an improbable answer for at least five reasons: first, illegal production will continue; second, diversion from the legal market to the illegal market is inevitable; third, diversion will involve further corruption; fourth, there may not be a market; and fifth, Afghanistan lacks the institutional capacity to support a legal pharmaceutical industry. Victoria A. Greenfield international drug control policy opium production pharmaceutical licensing Afghanistan India http://www.bepress.com/jdpa/vol2/iss1/art2 http://www.bepress.com/jdpa/vol2/iss1/art2 Sun, 25 Oct 2009 11:02:30 PDT The federal government has a fundamental as well as critical role in the successful development, implementation and utilization of controlled medications for the treatment of opioid abuse and dependence. The development and implementation of a federal regulatory structure establishes minimum standards which provide the basis for the development of treatment policies and medical best practices for the treatment of drug abuse and dependence. In the United States, the use of pharmacotherapies in combination with counseling, behavior therapies and other core services including primary medical care provide a comprehensive therapeutic approach termed as an evidence-based best practice termed "Medication Assisted Treatment" (MAT). Federally supported research studies have shown that the most efficacious treatment for opioid abuse and dependence comprises treatment programs that utilize pharmacotherapies and include psychosocial counseling, financial, legal, educational services as well as wrap around social services (NIDA, 2000). Federal programs catalogue such evidence-based best medical practices and promote their implementation in the care and treatment of patients to optimize good medical outcomes. In a non regulatory role, federal programs can also mandate medical education and training as well as support the piloting of treatment improvement projects to develop national implementation strategies. Drug treatment programs that utilize MAT are regulated by the federal government in their adherence to treatment standards through accreditation and in their record keeping requirements for use of controlled pharmaceuticals. Thus, multiple federal agencies combine to support MAT in the treatment of opioid dependence throughout the treatment continuum from drug discovery to patient care and treatment outcome. Salient policy issues that involve MAT as a direct result of the federal regulatory structure(s) include the provision and integration of medical services into Opioid Treatment Programs (OTPs), infectious diseases prevention counseling, the availability of opioid treatment using either buprenorphine or methadone, the limited use of Suboxone/Subutex in OTPs and which health care providers can prescribe as well as the number of patients prescribed Suboxone/Subutex in an office based setting. Thomas F. Kresina substance abuse treatment policy and regulation http://www.bepress.com/jdpa/vol2/iss1/art1 http://www.bepress.com/jdpa/vol2/iss1/art1 Wed, 25 Mar 2009 12:41:09 PDT Many more people die each year from alcohol and tobacco use than from illicit substance use, yet the American public appears far more concerned about illegal drugs. This paper suggests that some of this mismatch in concern may stem from differences in the types of deaths created, with deaths associated with illicit drugs being, on average, "scarier" to the public than are the deaths associated with legal substances. Hence, the mismatch between actual risks and public concern is not necessarily entirely wrong or irrational, but rather may embody stable preferences. Jonathan P. Caulkins http://www.bepress.com/jdpa/vol1/iss1/art3 http://www.bepress.com/jdpa/vol1/iss1/art3 Thu, 09 Oct 2008 10:14:38 PDT Current Federal laws over-punish minor crack dealers. A legislative fix for the problem has proven politically infeasible. Drug, form, and quantity, which form the basis of the existing sentencing schema, are relatively poor proxies of the dangerousness of the offender or the harm created by the conduct-pattern underlying the case. An administrative requirement that low-level crack prosecutions be approved centrally could ensure that the five-years-for-five-grams mandatory sentence is not over-used, while keeping that sentence available for the relatively rare cases (e.g., as part of crackdowns on gang violence) in which it is justified. Mark A. R. Kleiman Crack sentencing http://www.bepress.com/jdpa/vol1/iss1/art2 http://www.bepress.com/jdpa/vol1/iss1/art2 Thu, 09 Oct 2008 09:20:12 PDT Federal and state excise taxes on alcoholic beverages have declined sharply in real value over the last 50 years. The result is cheaper alcohol, more alcohol abuse, and more alcohol-related problems of all sorts than would otherwise have occurred. Frequently voiced concerns that such taxes are regressive, or that they penalize the majority who drink moderately and safely, are off base. An increase in the federal alcohol taxes could provide almost everyone but the heaviest drinkers with a net financial gain even if there were no behavioral effects; the evidence that there are behavioral effects that improve health and safety is an important bonus. In a sense, alcohol taxes are the proverbial free lunch. Philip J. Cook http://www.bepress.com/jdpa/vol1/iss1/art1 http://www.bepress.com/jdpa/vol1/iss1/art1 Thu, 09 Oct 2008 09:04:55 PDT It is now possible for probation officers to detect probationer alcohol use remotely and continuously. This essay describes three devices intended to collect Drug and alcohol use Information from REmote and Continuous Testing, or what I call DIRECT surveillance. It also highlights some of the major questions associated with the implementation, consequences, and future of DIRECT surveillance. While most of the focus is on alcohol use among probationers and parolees, the essay does discuss the use of these technologies in other settings, and for other drugs. It also addresses issues related to other types of electronic monitoring which can be used separately or in conjunction with DIRECT surveillance (e.g., GPS). Beau Kilmer Criminal justice substance use technology