A Structural Model of the Retail Market for Illicit Drugs.

We estimate a model of illicit drugs markets using data on purchases of crack cocaine. Buyers are searching for high-quality drugs, but they determine drugs' quality (i.e., their purity) only after consuming them. Hence, sellers can rip off first-time buyers or can offer higher-quality drugs to induce buyers to purchase from them again. In equilibrium, a distribution of qualities persists. The estimated model implies that if drugs were legalized, in which case purity could be regulated and hence observable, the average purity of drugs would increase by approximately 20 percent and the dispersion would decrease by approximately 80 percent. Moreover, increasing penalties may raise the purity and affordability of the drugs traded by increasing sellers' relative profitability of targeting loyal buyers versus first-time buyers.

Drogas en la contemporaneidad: 100 miligramos de reflexiones / Drug contemporaneity: 100 milligrams of reflections / Drogas na contemporaneidade: 100 miligramas de reflexões

ResumenIntroducción: El siguiente estudio delimitó como objetivo reflexionar sobre el fenómeno del consumo de drogas, tomando como eslabón vinculante el caso del crack en la actualidad.Desarrollo: El escándalo vinculado al fenómeno del consumo de drogas no reside en la ilegalidad de la acción, ni en los riesgos de daños a la salud o en la cooperación financiera con las transiciones criminosas; por esta razón, para su análisis deben ser estudiadas otras variables contextuales relacionadas a la contemporaneidad del acto en sus diferentes dimensiones económicas, sociales, políticas, semánticas y representacionales.Conclusiones: Las drogas vistas como productos mercantiles, deben ser tratadas como tales, no solo porque se encuentran inmersas en un proceso de acumulación en una sociedad que presenta características estrictamente post-coloniales y capitalistas; sino que su comportamiento de intercambio, consumo, oferta y demanda, las hace responder a esa realidad intrínseca propia de las mercadurías En este sentido, el análisis del fenómeno de las drogas debe ser realizado a partir de su particularidad histórica y contextualizada a las diversas implicaciones de las cuales proceden.

AbstractIntroduction: The aimof this study is to reflect on the phenomenon of drug taking as a binding link the crack today.Development: The scandal linked to the phenomenon of drug is not on the illegality of the action, or the risks of injury to health or financial cooperation with criminosas transitions; for this reason, for analysis they must be studied other contextual variables related to contemporaneity act in different economic, social, political, semantic and representational dimensions.Conclusions: Drugs seen as commercial products should be treated as such, not only because they are immersed in a process of accumulation in a society that has characteristics strictly post-colonial and capitalist; but their behavior exchange, consumption, supply and demand makes them answer that own intrinsic reality of merchandises In this regard, the analysis of the phenomenon of drugs should be made from its historical particularity and contextualized the various implications of which come.

ResumoIntrodução: O seguinte estudo delimitou como objetivo refletir sobre o fenômeno do consumo de drogas, tomando como elo vinculante o caso do crack na atualidade.Desenvolvimento: O escândalo vinculado ao fenômeno do consumo de drogas não reside na ilegalidade da ação, nem nos riscos de dano à saúde ou na cooperação financeira com as organizações criminosas; por esta razão, para sua análise devem ser estudadas outras variáveis contextuais relacionadas com a contemporaneidade da ação em suas diferentes dimensões econômicas, sociais, políticas, semânticas e representacionais.Conclusões: As drogas vistas como produtos mercantis, devem ser tratadas como tais, não só porque se encontram imersas em um processo de acumulação em uma sociedade que apresenta características estritamente pós-coloniais e capitalistas; senão que seu comportamento de intercâmbio, consumo, oferta e demanda, faz com que elas respondam a essa realidade intrínseca própria das mercadorias. Neste sentido, a análise do fenômeno das drogas deve ser realizado a partir de sua particularidade histórica e contextualizada nas diversas implicações das quais procedem.

A cost-benefit/cost-effectiveness analysis of an unsanctioned supervised smoking facility in the Downtown Eastside of Vancouver, Canada.

BACKGROUND: Smoking crack involves the risk of transmitting diseases such as HIV and hepatitis C (HCV). The current study determines whether the formerly unsanctioned supervised smoking facility (SSF)-operated by the grassroot organization, Vancouver Area Network of Drug Users (VANDU) for the last few years-costs less than the costs incurred for health-care services as a direct consequence of not having such a program in Vancouver, Canada. METHODS: The data pertaining to the attendance at the SSF was gathered in 2012-2013 by VANDU. By relying on this data, a mathematical model was employed to estimate the number of HCV infections prevented by the former facility in Vancouver's Downtown Eastside (DTES). RESULTS: The DTES SSF's benefit-cost ratio was conservatively estimated at 12.1:1 due to its low operating cost. The study used 70% and 90% initial pipe-sharing rates for sensitivity analysis. At 80% sharing rate, the marginal HCV cases prevented were determined to be 55 cases. Moreover, at 80% sharing rate, the marginal cost-effectiveness ratio ranges from $1,705 to $97,203. The results from both the baseline and sensitivity analysis demonstrated that the establishment of the SSF by VANDU on average had annually saved CAD$1.8 million dollars in taxpayer's money. CONCLUSIONS: Funding SSFs in Vancouver is an efficient and effective use of financial resources in the public health domain; therefore, Vancouver Coastal Health should actively participate in their establishment in order to reduce HCV and other blood-borne infections such as HIV within the non-injecting drug users.

Demand curves for hypothetical cocaine in cocaine-dependent individuals.

RATIONALE: Drug purchasing tasks have been successfully used to examine demand for hypothetical consumption of abused drugs including heroin, nicotine, and alcohol. In these tasks, drug users make hypothetical choices whether to buy drugs, and if so, at what quantity, at various potential prices. These tasks allow for behavioral economic assessment of that drug's intensity of demand (preferred level of consumption at extremely low prices) and demand elasticity (sensitivity of consumption to price), among other metrics. However, a purchasing task for cocaine in cocaine-dependent individuals has not been investigated. OBJECTIVES: This study examined a novel Cocaine Purchasing Task and the relation between resulting demand metrics and self-reported cocaine use data. METHODS: Participants completed a questionnaire assessing hypothetical purchases of cocaine units at prices ranging from $0.01 to $1,000. Demand curves were generated from responses on the Cocaine Purchasing Task. Correlations compared metrics from the demand curve to measures of real-world cocaine use. RESULTS: Group and individual data were well modeled by a demand curve function. The validity of the Cocaine Purchasing Task was supported by a significant correlation between the demand curve metrics of demand intensity and O max (determined from Cocaine Purchasing Task data) and self-reported measures of cocaine use. Partial correlations revealed that after controlling for demand intensity, demand elasticity and the related measure, P max, were significantly correlated with real-world cocaine use. CONCLUSIONS: Results indicate that the Cocaine Purchasing Task produces orderly demand curve data, and that these data relate to real-world measures of cocaine use.

The whole is just the sum of its parts: limited polydrug use among the "big three" expensive drugs in the United States.

Data from surveys of arrestees and the household population in the U.S. suggest there is only modest overlap among demand for the big three expensive illegal drugs (cocaine/crack, heroin, and methamphetamine). In particular, the number of chronic users of these substances (defined as consuming on four or more days in the previous month) is only about 10% below a naïve estimate obtained by simply summing the numbers of chronic users for each of the three substances, while ignoring polydrug use entirely. This finding does not gainsay that polydrug use is common or important. One would estimate greater overlap if one adopted a more expansive definition of polydrug use (e.g., has the individual ever used another substance at any time in their life) or a more expansive list of substances (e.g., allowing marijuana or alcohol to count as one of the substances makes polydrug use seem much more common). However, it does suggest that when focusing on the illegal drug markets that generate the most crime, violence, and overdose death in the U.S., one can usefully think of three more or less separate markets populated at any given time by largely distinct populations of drug users.

Uptake, benefits of and barriers to safer crack use kit (SCUK) distribution programmes in Victoria, Canada--a qualitative exploration.

BACKGROUND: Crack use is prevalent amongst street drug users in Canadian cities, and associated with severe drug use, health and social problems. Whilst few targeted interventions are available for crack use, the common use and sharing of hazardous makeshift paraphernalia are a key concern, as these risks may be associated with oral injury and blood-borne virus (BBV)--e.g., hepatitis C virus (HCV)--transmission amongst users. Recently, distribution programmes of so-called 'safer crack use kits' (SCUKs) have been initiated in select Canadian cities, primarily to reduce the use of unsafe materials and paraphernalia sharing amongst crack users. This study explored uptake and benefits of, barriers to, and possible improvements to two recently implemented SCUK distribution programme in Victoria, Canada. METHODS: N=31 regular crack smokers were recruited through community-based efforts between June and August 2010, and assessed via an interviewer-administered protocol involving quantitative and qualitative data items. Descriptive analyses were completed with the quantitative data, and thematic content analyses were conducted with the qualitative data in order to identify and extract prominent themes and issues. RESULTS: The sample indicated high levels of socio-economic marginalization, poly-substance use, health problems, lengthy crack use histories and common crack paraphernalia sharing. Most participants exclusively utilized the SCUK programme including glass-stems in addition to other paraphernalia materials. Participants described: lesser need to share--or to commit property crimes to obtain resources for--crack to paraphernalia, increased health awareness, and increased personal and community safety as benefits experienced from SCUK use. Limitations in SCUK resources and distribution, shortcomings in materials, and police interference were cited as barriers to current SCUK program delivery. CONCLUSIONS: SCUK distribution in Victoria appears to result in a variety of individual and community health benefits. These benefits could be solidified by addressing current programme limitations, including better resourcing, expanding geographic distributions and eliminating police interference.

Correlates of exchanging sex for drugs or money among women who use crack cocaine.

This study examined the correlates of trading sex for drugs or money among women who use crack cocaine. Using baseline data (n = 669) from a woman-focused HIV intervention study among African American women who use crack cocaine, we conducted logistic regression analysis to examine the odds of trading sex associated with distal and proximal factors. The results indicate that heavier crack use, homelessness, and unemployment are associated with trading sex. In addition, childhood abuse is associated with trading sex and this relationship is, in part, mediated by psychological distress. This suggests that distal factors may underlie the relationship between current variables and sex trading. These findings underscore the importance for public health interventions to address both distal and proximal factors that contribute to and/or co-occur with women's drug use which, in turn, may affect their HIV risk and overall well-being.

Risks for HIV infection among users and sellers of crack, powder cocaine and heroin in central Harlem: implications for interventions.

This article investigates behaviours that may be associated HIV infection among users and sellers of crack, powder cocaine and heroin in central Harlem. Chain referral sampling and other strategies were combined to acquire a sample of 637 (Users = 546; Sellers = 91) who provided urine specimens that were tested for the presence of drugs and HIV. Nearly a quarter (23.9%) of all respondents were HIV positive. Drug injectors were more than 2.5 times more likely to have HIV infections than other respondents (OR = 2.66; 95% CI 1.66-4.26). Those involved in frauds/cons were almost as likely to be HIV positive (OR = 2.58; 95% CI 1.64-4.06). Those with a marital status of being separated, divorced or widowed were twice as likely to be HIV infected (OR 2.16; 95% CI 1.43-3.25). Respondents currently having multiple partner sex (OR = 1.66; 95% CI 1.1-2.51) or who were female (OR = 1.66; 95% CI 1.12-2.45) were more than 1.5 times more likely to be HIV positive. Thus, controlling for lifetime drug injection and current multiple partner sex, other factors, such as participating in frauds/cons, as well as relationship status and being female, were also associated with HIV infection.

Cocaine use in New South Wales, Australia, 1996-2000: 5 year monitoring of trends in price, purity, availability and use from the illicit drug reporting system.

This paper describes trends in the price, purity, availability and use of cocaine in Sydney, Australia monitored by the Illicit Drug Reporting System (IDRS) between 1996 and 2000. The IDRS monitors illicit drug trends by means of triangulation of data from interviews with injecting drug users (IDU), reports of key informants, and analysis of indicator data. The price of a 'cap' of cocaine fell from 80 Australian dollars in 1997 to 50 Australian dollars in 1998, and remained at the lower price in subsequent years. Cocaine purity was high in all years (range 50-64%), and was highest in the 1997-1998 period. The availability of cocaine and its use by IDU increased substantially, 1997 and 1998, and remained high in subsequent years. The median number of cocaine use days also increased substantially between 1997 (4 days) and 1998 (25 days), and remained at higher levels than prior to 1998 in subsequent years. Cocaine use was primarily of powder, by injection, and strongly associated with existing heroin injectors. The availability and use of crack remained rare in Sydney. Use of cocaine among IDU was associated with more frequent injections, more injection-related health problems, higher levels of needle sharing, and higher levels of criminality. It is concluded that the use and availability of cocaine in Sydney increased substantially between 1997 and 1998, and has remained entrenched in the Sydney illicit drug market. The regular and formal monitoring of illicit drug trends enabled substantial changes in the cocaine market in Sydney to be detected, and the information to be fed back to the health and law enforcement sectors.

Prevention of alcohol and drug abuse: what works?

There is no single "best" prevention program, and no one program or approach will stop all drug use. There are many effective research-based programs; the best approach for any particular population requires selecting the best intervention for the target population on the basis of a knowledge of the risk and protective factors in that population. Unfortunately, the most highly marketed school or family programs are generally not those programs with the best outcomes. The best approach to prevention is to begin early to reduce emerging behavioral and emotional problems in youth. Longer-lasting effects should accrue from changing school, community, and family environmental conditions that promote and maintain drug problems in youth. More and more prevention specialists are considering moving from a focus on the individual to changes in total systems or the environmental contexts that promote or hinder drug use. On the basis of economic considerations, the "whole family" systems-change approach of family skills training classes is becoming popular even in the managed care environment. The greatest challenge facing the drug abuse prevention field is to get information out to practitioners and communities about the best prevention programs, approaches, and principles of effectiveness. Researchers and funding agencies must learn how to effectively market the most successful programs to bridge the gap between research and practice. We must become as effective at marketing drug prevention programs as drug dealers are at promoting and selling drugs. Communities need health care professionals who are knowledgeable about substance abuse prevention and who can advocate the implementation and ongoing improvement of prevention programs with known effectiveness.

Supporting the habit: income generation activities of frequent crack users compared with frequent users of other hard drugs.

US Federal sentencing guidelines punish possession of crack cocaine very differently from powder cocaine, based partially upon the assumption that crack users engage more frequently in criminal behavior to pay for their habit. This article analyzed frequent users (those who have used at least 15 of the last 30 days) of crack with subgroups of less frequent hard drug users in terms of various income generation activities reported during the past 30 days. The sample consists of 602 African-Americans who were current (in past 30 days) users or sellers of cocaine powder, crack, and heroin. They were carefully recruited from randomly selected blocks in the Central Harlem area of New York City and interviewed extensively in 1998-1999. Their IGAs were classified into six categories. Compared with not-frequent (less than 15 days) hard drug users, frequent crack and multiple hard drug users were equally likely to be involved in drug distribution activities, but were significantly less likely to have full-time jobs, part-time jobs, aid to families with dependent children or welfare support. They had much higher odds ratios for non-drug related illegal (theft mainly) income generation activities and sex work among women. Often, gender and birth cohort variables had higher odds ratios with specific income generation activities than the frequent use of the primary drug(s). This evidence suggests that very frequent crack users have been stigmatized by, are largely excluded from, and perform very marginal economic roles in the legal economic system (jobs and welfare), the illegal economic system, and even in the hard drug distribution system.

Is crack cheaper than (powder) cocaine?

AIMS: To compare the prices of cocaine powder and crack cocaine in the United States. DESIGN: Retail prices for crack and powder cocaine are compared for 14 US cities between 1986 and 1991 using regression analysis and t-tests. MEASUREMENTS: Prices are estimated from the United States Drug Enforcement Administration's System to Retrieve Information from Drug Evidence (STRIDE) database. FINDINGS: On average, crack is neither more nor less expensive per pure unit than powder cocaine. Prices are not equal in every city in every year, but crack is equally likely to be more or less expensive, and the differences are not large relative to variation in prices of both forms of cocaine between cities and over time. CONCLUSIONS: Crack has been widely believed to be cheaper than powder cocaine, and this "fact" has been used to help explain why US drug problems worsened in the 1980s. However, crack is not, in fact, cheaper per pure unit than powder cocaine. Other explanations must be sought for why crack spread so rapidly relative to powder cocaine.

Crack: new directions in drug research. Part 2. Factors determining the current functioning of the crack economy--a program for ethnographic research.

Factors which hypothetically influence rates, volumes, and methods of income generation in crack distribution, use, and misuse are indicated, and a research program to investigate them is suggested. This research will contribute significantly to the development of a theoretical framework which adequately relates substance using/abusing and trafficking populations to the wider community and will explain why crack use and distribution have had such different outcomes than marijuana. Factors to be researched include: polyethnicity, crack-related deculturation, gender differentiation in crack use and effects, neighborhood effects, vertically organized crack-distributing organizations, crack-related violence and crime, and replacement of previous drug markets by crack.

Crack: new directions in drug research. Part 1. Differences between the marijuana economy and the cocaine/crack economy.

Crack use and trafficking in low-income, minority communities in New York City have pushed into prominence many aspects of drug use/misuse and distribution which had formerly received inadequate attention. For example, the generation and reinvestment of drug incomes are important determinants of how various drugs are experienced. While in retrospect marijuana trafficking appears to have been an almost benign affair, crack trafficking is fast-paced, ruthless, steeped in violence, and impoverishes everyone who becomes engaged in it. In this part the differences between rates, volumes, and methods of income generation related to the use and distribution of marijuana and cocaine are elaborated. The contrast raises a question: Do economies like drug distribution follow a particular rhythmic pattern (capital accumulation during the benign marijuana passage followed by capital depletion in the overheated crack era), and how is it related to the changing demands of the regional economy? Viewed from this perspective, drug distributors and users appear not so much as "deviant" or "alienated" or as a "reserve pool of labor," but rather as a type of labor force which does indispensable work for the whole society.

Crack: new directions in drug research. Part 1. Differences between the marijuana economy and the cocaine/crack economy

Crack use and trafficking in low-income, minority communities in New York City have pushed into prominence many aspects of drug use/misuse and distribution which had formerly received inadequate attention. For example, the generation and reinvestment of drug incomes are important determinants of how various drugs are experienced. While in retrospect marijuana trafficking appears to have been an almost benign affair, crack trafficking is fast-paced, ruthless, steeped in violence, and improvishes everyone who becomes engaged in it. In this part the differences between rates, volumes, and methods of income generation related to the use and distribution of marijuana and cocaine are elaborated. The contrast raises a question: Do economies like drug distribution follow a particular rhythmic pattern (capital accumulation during the benign marijuana passage followed by capital depletion in the overheated crack era), and how is it related to the changing demands of the regional economy? Viewed from this perspective, drug distributors and users appear not so much as "deviant" or "alienated" or as a "reserve pool of labor," but rather as a type of labor force which does indispensable work for the whole society. (AU)

From Ganja to crack: Caribbean participation in the underground economy in Brooklyn, 1976-1986. Part 2. Establishment of the cocaine (and crack) economy.

Shortages in the supply of marijuana, which became acute around 1981, caused Rastafari marijuana distributors very reluctantly to disregard religious injunctions against the use of any psychoactive substance except marijuana, and to experiment with the use and distribution of cocaine hydrochloride powder for intranasal administration and, later, for smoking (freebase and crack). This experimentation proved ruinous, and many were retired ignominiously from drug distribution. In the crack era they have been succeeded by completely new social, cultural, and economic arrangements.

From Ganja to crack: Caribbean participation in the underground economy in Brooklyn, 1976-1986. Part 2. Establishment of the cocaine (and crack) economy

Shortages in the supply of marijuana, which became acute around 1981, caused Rastafari marijuana distributors very reluctantly to disregard religious injunctions against the use of any psychoactive substance except marijuana, and to experiment with the use and distribution of cocaine hydrochloride powder for intranasal administration and, later, for smoking (freebase and crack). This experimentation became ruinous, and many were retired ignominiously from drug distribution. In the crack era they have been succeeded by completely new social, cultural, and economic arrangements. (AU)