How patterns of injecting drug use evolve in a cohort of people who inject drugs

This research found an overall movement away from street based drug purchasing and drug use, towards more activity in private settings, which has important implications for the harms experienced by people who inject drugs. Foreword This paper investigates the frequency of intravenous drug use in a cohort of people who inject drugs, and the decline in use over time. It provides an important indication of the effectiveness of current interventions at reducing the consumption of illicit drugs. Comparisons are made between the injection frequency of participants on or off Opioids Substitution Therapy (OST), and according to the settings in which drugs are most frequently purchased and used (eg street, house). This research found an overall movement away from street based drug purchasing and drug use, towards more activity in private settings. This has important implications for the harms experienced by people who inject drugs. Intravenous drug use was persistent, with only slow declines observed in the frequency of the cohort’s overall use. Lower injection frequency was associated with use in private rather than public locations as well as the uptake of OST. Additional work is needed to understand how this change in setting is affected by and also affects current interventions, and whether it can be used to help further reduce injecting drug use

Material Support: Counternarcotics vs. Counterinsurgency in Afghanistan

Microeconomic analysis of counternarcotics strategies in Afghanistan suggests that current policies lend material support to the enemy. Vigorous enforcement can increase the flow of funds to insurgents and other parties that profit from trafficking. Rural-development programs, promoted as elements of a counternarcotics strategy, are open to some of the same objections. The benefits of drug-fighting in Afghanistan for consumer countries in Europe and North America are likely to be modest. Anti-corruption efforts in Afghanistan and demand-reduction programs both in Afghanistan and in consumer countries, insofar as they are feasible, could serve both counternarcotics and counterinsurgency objectives

Placing the poor while keeping the rich in their place

A central objective of modern US housing policy is deconcentrating poverty through "housing mobility programs" that move poor families into middle class neighborhoods. Pursuing these policies too aggressively risks inducing middle class flight, but being too cautious squanders the opportunity to help more poor families. This paper presents a stylized dynamicoptimization model that captures this tension. With base-caseparameter values, cost considerations limit mobility programs before flight becomes excessive. However, for modest departures reflecting stronger flight tendencies and/or weaker destination neighborhoods, other outcomes emerge. In particular, we find state-dependence and multiple equilibria, including both de-populated and oversized outcomes. For certain sets of parameters there exists a Skiba point that separates initial conditions for which the optimal strategy leads to substantial flight and depopulation from those for which the optimal strategy retains or even expands the middle class population. These results suggest the value of estimating middle-class neighborhoods' "carrying capacity" for absorbing mobility program placements and further modeling of dynamic response.housing policy, multiple equilibria, negative externality, optimal control, segregation, separation, Skiba point

Why the DEA STRIDE data are still useful for understanding drug markets

In 2001, use of the STRIDE data base for the purpose of analyzing drug prices and the impact of public policies on drug markets came under serious attack by the National Research Council (Manski, et al., 2001; Horowitz, 2001). While some of the criticisms raised by the committee were valid, many of the concerns can be easily addressed through more careful use of the data. In this paper, we first disprove Horowitz's main argument that prices are different for observations collected by different agencies within a city. We then revisit other issues raised by the NRC and discuss how certain limitations can be easily overcome through the adoption of random coefficient models of drug prices and by paying serious attention to drug form and distribution levels. Although the sample remains a convenience sample, we demonstrate how construction of city-specific price and purity series that pay careful attention to the data and incorporate existing knowledge of drug markets (e.g. the expected purity hypothesis) are internally consistent and can be externally validated. The findings from this study have important implications regarding the utility of these data and the appropriateness of using them in econmic analyses of supply, demand and harms.Approved for public release; distribution is unlimited

Sulfur Dioxide Compliance of a Regulated Utility

Electric utilities can reduce sulfur dioxide emissions through a variety of strategies such as adding scrubbers, switching to low- sulfur coal, or shifting output between generating plants with different emissions. The cost of achieving a given emission target can be minimized using a market for emission allowances, as under the Clean Air Act Amendments of 1990, if firms with high abatement costs buy allowances while those with low abatement costs reduce emissions and sell allowances. However, public utility commissions regulate which costs can be passed to customers. Previous theoretical work has analyzed effects of regulations on a utility's choice between permits and a single continuous `abatement technology.' Here, we consider three abatement technologies and the discrete choices among them. Our numerical model uses market and engineering information on permit prices, scrubber cost and sulfur removal efficiency, alternative fuel costs and sulfur content, plus generating plant costs and efficiency. Using illustrative sets of parameters, we find that regulatory rules could more than double the cost of sulfur dioxide compliance.

Why the DEA STRIDE Data are Still Useful for Understanding Drug Markets

In 2001, use of the STRIDE data base for the purposes of analyzing drug prices and the impact of public policies on drug markets came under serious attack by the National Research Council (Manski et al., 2001; Horowitz, 2001). While some of the criticisms raised by the committee were valid, many of the concerns can be easily addressed through more careful use of the data. In this paper, we first disprove Horowitz's main argument that prices are different for observations collected by different agencies within a city. We then revisit other issues raised by the NRC and discuss how certain limitations can be easily overcome through the adoption of random coefficient models of drug prices and by paying serious attention to drug form and distribution levels. Although the sample remains a convenience sample, we demonstrate how construction of city-specific price and purity series that pay careful attention to the data and incorporate existing knowledge of drug markets (e.g. the expected purity hypothesis) are internally consistent and can be externally validated. The findings from this study have important implications regarding the utility of these data and the appropriateness of using them in economic analyses of supply, demand and harms.

An Assessment of U.S. Drug Problems and Policy

This PDF document was made available from www.rand.org as a public service of the RAND Corporation. Jump down to document6 INTERNATIONAL AFFAIR

The International Cannabis Toolkit (iCannToolkit) : A multidisciplinary expert consensus on minimum standards for measuring cannabis use

Background The lack of an agreed international minimum approach to measuring cannabis use hinders the integration of multidisciplinary evidence on the psychosocial, neurocognitive, clinical and public health consequences of cannabis use. Methods A group of 25 international expert cannabis researchers convened to discuss a multidisciplinary framework for minimum standards to measure cannabis use globally in diverse settings. Results The expert-based consensus agreed upon a three-layered hierarchical framework. Each layer—universal measures, detailed self-report and biological measures—reflected different research priorities and minimum standards, costs and ease of implementation. Additional work is needed to develop valid and precise assessments. Conclusions Consistent use of the proposed framework across research, public health, clinical practice and medical settings would facilitate harmonisation of international evidence on cannabis consumption, related harms and approaches to their mitigation