Illicit Supply Research Articles

Towards spatially disaggregated cocaine supply chain modeling

Despite the global reach and economic scale of cocaine trafficking, our best geographic understanding of the global trade remains coarse. A more spatially disaggregated understanding of how the cocaine supply chain embeds across multiple locations is necessary for informing security policies and anticipating the spread and intensity of social and environmental harms associated with the cocaine trade. In this research, modeling methods used for legal supply chains are adapted to spatially disaggregate illicit supply chain flows. Profit and supply maximization model versions were compared to elucidate key decision parameters cocaine traffickers might be facing. Cocaine flows to EU+3 (Norway, Turkey, and United Kingdom) markets were estimated based on the smuggling capacity of major Central American ports and bilateral trade volumes of selected commodities most often seized with cocaine shipments. The resulting estimates of cocaine volumes diverted to EU+3 countries from Central America ranged between 938 and 1526 metric tons (MT). Generally, easier concealment and storage in Central America led to less volume supplied to the United States (US) and increased shipments to EU+3 markets. Importantly, the value of this modeling approach is not in the quantitative estimates produced, but in the methodological approach that provides the ability to rigorously ground any quantitative estimates of clandestine phenomenon in the best available data.

Monitoring illicit pentobarbital availability in the United States: A National Drug Early Warning System briefing

BackgroundPentobarbital is a Schedule II/III short-acting barbiturate with limited medical use in humans. Veterinary professionals use pentobarbital to euthanize dogs, cats, and other companion animals. Pentobarbital is also utilized in capital punishment and small amounts are illegally shipped or diverted to assist in suicides. However, five kilograms of pentobarbital smuggled in from Mexico was recently seized by an organized crime drug enforcement task force (along with fentanyl, heroin, and cocaine), which may suggest a shift in illicit supply. We investigated potential indicators of illicit pentobarbital use or availability in the US to help determine whether this drug is becoming an emerging public health concern. MethodsThe National Drug Early Warning System requested information on pentobarbital from its sentinel surveillance sites and collaborators and conducted a search of current literature. ResultsIn early 2024, multiple batches of counterfeit pills (e.g., pressed as “M30s” to represent oxycodone) confiscated near the Southwest border tested positive for pentobarbital plus combinations of fentanyl, fentanyl analogs, and xylazine. Other indicators suggest pentobarbital is being smuggled in powder form and possibly sold as another drug such as heroin. One national drug analysis program detected pentobarbital in 217 drug submissions from 2020 to 2023, and there were at least 12 fatal exposures linked to use from 2020 to 2022. ConclusionContinued monitoring of illicit use and availability is needed as pentobarbital may continue to appear on the illicit market. Unknown exposure can occur if the drug is mixed into counterfeit pills or sold in powder form represented to be another drug.

Mapping Opium Poppy Cultivation: Socioeconomic Insights from Satellite Imagery

Over 30 million people globally consume illicit opiates. In recent decades, Afghanistan has accounted for 70–90% of the world’s illicit supply of opium. This production provides livelihoods to millions of Afghans, while also funneling hundreds of millions of dollars to insurgent groups every year, exacerbating corruption and insecurity, and impeding development. Remote sensing and field surveys are currently used in official estimates of total poppy cultivation area. These aggregate estimates are not suited to study the local socioeconomic conditions surrounding cultivation. Few avenues exist to generate comprehensive, fine-grained data under poor security conditions, without the use of costly surveys or data collection efforts. Here, we develop and test a new unsupervised approach to mapping cultivation using only freely available satellite imagery. For districts accounting for over 90% of total cultivation, our aggregate estimates track official statistics closely (correlation coefficient of 0.76 to 0.81). We combine these predictions with other grid-level data sources, finding that areas with poppy cultivation have poorer outcomes such as infant mortality and education, compared to areas with exclusively other agriculture. Surprisingly, poppy-growing areas have better healthcare accessibility. We discuss these findings, the limitations of mapping opium poppy cultivation, and associated ethical concerns.

Ghost guns and crime: a tale of two California cities

BackgroundPrivately made firearms (PMFs) or “ghost guns” are homemade, unserialized, untraceable firearms that have been increasingly used in violent crime in the United States. Very little is known about the types of PMFs recovered by law enforcement agencies and the crimes associated with these recoveries. This lack of information limits effective violence prevention policies and practices. Comparative analysis of PMF recoveries in specific cities helps clarify whether local PMF patterns and characteristics vary or reflect more general trends. This research advances epidemiological understanding of emergent violent gun injury prevention challenges by identifying variations in recovered PMF types and use in violent, drug, and weapon-related offenses in Los Angeles and San Diego, California.MethodsConjunctive analysis of case configurations (CACC) identifies patterns among observations (i.e., case configurations) and calculates their probability associated with a given outcome. CACC was used to identify the most common types of PMFs recovered by the Los Angeles (LAPD) and San Diego (SDPD) police departments. For each department and offense type, case configurations with above-average probabilities of offense involvement were determined. Comparisons across departments were made to identify similarities and differences in PMF characteristics and usage.ResultsPMFs were more likely to be involved in violent and weapon-related offenses in Los Angles but more likely to be involved in drug-related offenses in San Diego. In both cities, the 9 mm Polymer 80 handgun was the dominant PMF. However, 9 mm handguns were most likely to be involved in weapon-related offenses in Los Angeles compared to 0.40 handguns in San Diego. Furthermore, large-caliber handguns tended to display above-average probabilities of involvement in violent and drug offenses in Los Angeles. Long guns were represented in case configurations with above-average probabilities of involvement in substantive crimes, including violence.ConclusionsComparative analyses of PMF recovery patterns in Los Angeles and San Diego reveal meaningful contextual variations in PMF characteristics and suggest intentional firearm type selections by offenders. The results support increased regulation of PMFs and highlight the importance of efforts to identify and disrupt the illicit supply of large-caliber PMF handguns and PMF long guns.

Dimensions of data sparseness and their effect on supply chain visibility

Supply chain visibility concerns the ability to track parts, components, or products in transit from supplier to customer. The data that organizations can obtain to establish or improve supply chain visibility is often sparse. This paper presents a classification of the dimensions of data sparseness and quantitatively explores the impact of these dimensions on supply chain visibility. Based on a review of supply chain visibility and data quality literature, this study proposes to characterize data sparseness as a lack of data quality across the entire supply chain, where data sparseness can be classified into three dimensions: noise, bias, and missing values. The quantitative analysis relies on a stylized simulation model of a moderately complex illicit supply chain. Scenarios are used to evaluate the combined effect of the individual dimensions from actors with different perspectives in the supply chain, either supply or demand-oriented. Results show that when a data sparseness of 90% is applied, supply chain visibility reduces to 52% for noise, to 65% for bias, and to 32% for missing values. The scenarios also show that companies with a supply-oriented view typically have a higher supply chain visibility than those with a demand-oriented view. The classification and assessment offer valuable insights for improving data quality and for enhancing supply chain visibility.

Advertising with Anonymity and Impunity: The Harmful Consequences of Counterfeit PPE Supply Chains

The rapid growth of illicit supply chains during and after the Covid-19 pandemic reveals a need for effectively combating and preventing the cross-border movement of contraband, including but not limited to counterfeit goods. A proactive approach by companies along with public stakeholders, such as government agencies and individual consumers, toward disrupting illicit supply chains operating across borders is especially important during moments of global crisis when consumers are more susceptible to unknowingly purchasing substandard counterfeit products such as respirators. While marketplaces, platforms, and other legitimate businesses have worked to prevent movement of counterfeits and illicit goods through their services, the high adaptability and sophistication of counterfeiters requires more preventative and multistakeholder approaches. This article outlines a multidisciplinary and multilayered approach to detecting and disrupting illicit supply chains of counterfeit personal protective equipment (PPE) with a focus on respirators. It utilizes research conducted for a National Science Foundation (NSF) grant on Covid-19 related crime, including the advertising and sale of counterfeit respirators. One layer examines online content as seen by the end user and the activity of vendors or sellers used to advertise and sell counterfeit products. The research is also informed by data on the information, financial, and physical flows of counterfeit respirators obtained through a public-private partnership with George Mason University’s Terrorism, Transnational Crime and Corruption Center (TraCCC-GMU) and 3M, one of the largest manufacturers of respirators in the world. The article examines an important and relatively recent trend - how emerging technological shifts in the marketplace are affecting global security. Research from the TraCCC-GMU and 3M partnership, including a data sharing agreement, revealed that counterfeiters constantly change their modus operandi to continue selling illicit goods with impunity, facilitating illicit activity with the use and abuse of legitimate companies such as ecommerce marketplaces and social media. The article presents an overview of the current state of counterfeit supply chains and provides concrete policy recommendations on how legitimate companies can move beyond just removing listings but must also actively prevent these transnational crimes through innovative multidisciplinary approaches, advanced data analytics, and public awareness campaigns. The research also seeks to connect the dots to broader policy implications in terms of the legitimate economy and environmental sustainability.

Effects of xylazine in illicit fentanyl supply: Report from OASAS

At the COMPA (Coalition of Medication‐Assisted Treatment Providers and Advocates) Symposium last month in Albany, New York, officials from the New York Office of Addiction Services and Supports (OASAS) presented information on the effects of xylazine, increasingly present in the street supply of opioids, especially fentanyl. Pamela Mund, M.D., OASAS associate medical officer, and Sarah Gorry, M.S., an Empire State Fellow with OASAS, shared the following information. Xylazine is

ШЛЯХИ ВДОСКОНАЛЕННЯ ЗАПОБІГАННЯ НЕЗАКОННОМУ ПОВОДЖЕННЮ ЗІ ЗБРОЄЮ, БОЙОВИМИ ПРИПАСАМИ АБО ВИБУХОВИМИ РЕЧОВИНАМИ

The article analyzes the current state of illegal handling of weapons, ammunition or explosives in Ukraine and ways to solve this issue. Not one country, being in active wars, conflicts or skirmishes cannot boast of a high level of social, economic and moral condition of the population. With the onset of the local armed conflict in eastern Ukraine, namely in Donetsk and Luhansk regions, increased, social tensions the psychological state of the population deteriorated, and the number of crimes, including the use of weapons, ammunition and explosives. The problem of the spread of crime with the use of weapons, ammunition or explosives requires state regulation and the search for effective ways to solve it. The presence of a scattered legal framework in the form of a large number of instructions, departmental orders and directives leads to contradictions The article presents the expediency of adopting a single legal act on the civil circulation of weapons. This proposal will make it possible to gather in one document the issues of subject composition, permitting nature, procedural system and the order of use of weapons. Ukraine is a state governed by the rule of law, and all relations must be regulated by law, including intercourses related to weapons. The main sources of illicit supply of arms and ammunition in Ukraine remain the resale of internal supplies and a cross-border trade. All things considered, it is proposed to carry out a number of preventive measures in the law enforcement system. Due to the high latency nature of weapons theft, there is an emphasis on cooperation between the police and the military prosecutor’s office and sufficient attention to places where weapons can be stored, as well as to control and close the black ways of hittings weapons from the war zone. The conclusions emphasize the implementation of the proposed effective ways to combat the illicit handling of weapons, ammunition or explosives. Key words: prevention, firearms, ammunition, explosives, armed conflict, civilian circulation.

Addressing Illegal Transnational Trade of Totoaba and Its Role in the Possible Extinction of the Vaquita

Demand for totoaba swim bladders has created a transnational illicit supply chain network. Organised crime groups are instrumental in this process, impacting Mexico at social, environmental, economic, and political levels. There are five main points within the supply chain: the poachers in the Upper Gulf of California, the Mexican illegal traders, the Chinese illegal traders in Mexico, illegal traders and retailers in China and Hong Kong, and the consumers and investors located primarily in China. Illegal fishers in Mexico use gillnets to capture totoaba, leading to bycatch and decline of the critically endangered vaquita. There have been significant conservation efforts by the local and international communities to reduce this bycatch, but these have been unsuccessful in addressing the continued trafficking of totoaba and the decline of the vaquita. Here we highlight the complexity of the totoaba supply chain and argue that totoaba illegal trade has to be viewed as organised environmental crime rather than as a conservation issue. A particularly enforceable point in the chain is through the Chinese organised crime group in Mexico, which is a crucial link to onward trafficking through ports and airports. While recent efforts have been made with regard to totoaba seizures and prosecutions, to dismantle the supply chain, strong transnational collaboration is needed at multiple levels, and in particular between Mexico, the USA, and China.

Perceptions of Illicit Tobacco Sources Following a Proposed Reduction in Tobacco Availability: A Qualitative Analysis of New Zealanders Who Smoke.

Tobacco companies claim that substantially reducing tobacco retail outlets in Aotearoa New Zealand will increase illicit tobacco trade and crime. However, we know little about whether people who smoke anticipate using illicit tobacco once this measure is implemented. Exploring current illicit tobacco use and expected market development would clarify the likely scale of this potential problem. We undertook online in-depth interviews with 24 adults who smoke and explored their experiences of illicit tobacco, perceptions of illicit market growth once legal tobacco became less available, intentions to engage in this market, and potential measures that could curb illicit market development. We interpreted the data using a qualitative descriptive approach. Few participants had purchased illegally imported or stolen tobacco. While most did not know how to access illicit tobacco products, many expected illicit trade and crime would increase, if legal tobacco became difficult to access. While cheaper tobacco appealed to many, most perceived illicit supply routes as unsafe and saw products obtained via these sources as likely to be of poor quality. Few suggested measures to control illicit markets, though a minority called for social reforms to reduce poverty, which they thought fueled illegal practices. Although illicit trade may appear to threaten new policy initiatives, participants' limited knowledge of these markets and concerns regarding product safety suggest illegal tobacco may pose less of a threat than tobacco companies have claimed. Policy makers should not be deterred from reducing tobacco availability by industry arguments. Although participants believed illicit trade would increase if the number of tobacco retailers was substantially reduced, few anticipated purchasing illegal tobacco. They viewed supply routes as unsafe and product quality as likely to be low. Industry predictions that illicit tobacco trade will grow if tobacco becomes less available do not reflect how people who smoke expect to engage with these markets and should not deter the introduction of retail reduction measures.

Advancing interdisciplinary science for disrupting wildlife trafficking networks

Wildlife trafficking, whether local or transnational in scope, undermines sustainable development efforts, degrades cultural resources, endangers species, erodes the local and global economy, and facilitates the spread of zoonotic diseases. Wildlife trafficking networks (WTNs) occupy a unique gray space in supply chains—straddling licit and illicit networks, supporting legitimate and criminal workforces, and often demonstrating high resilience in their sourcing flexibility and adaptability. Authorities in different sectors desire, but frequently lack knowledge about how to allocate resources to disrupt illicit wildlife supply networks and prevent negative collateral impacts. Novel conceptualizations and a deeper scientific understanding of WTN structures are needed to help unravel the dynamics of interaction between disruption and resilience while accommodating socioenvironmental context. We use the case of ploughshare tortoise trafficking to help illustrate the potential of key advancements in interdisciplinary thinking. Insights herein suggest a significant need and opportunity for scientists to generate new science-based recommendations for WTN-related data collection and analysis for supply chain visibility, shifts in illicit supply chain dominance, network resilience, or limits of the supplier base.

Illicit activity and scarce natural resources in the supply chain: A literature review, framework, and research agenda

AbstractThis article reviews extant multidisciplinary literature to uncover existing themes and directions in the knowledge of the overlap between natural resource scarcity and illicit supply chain activity. In doing so, the authors present a novel review of this nascent, complex, and multidisciplinary research area. This review has uncovered 127 articles that have not been synthesized or organized in a meaningful way with the supply chain literature. It extracts insights and develops a comprehensive process framework encompassing the following: (a) antecedents associated with natural resource extraction, which foments the opportunity for illicit activity to thrive; (b) resulting economic, social, and environmental outcomes from illicit activity as it relates to natural resource extraction; and (c) potential moderating processes, which either enable or inhibit illicit activity to occur, including firm‐level tactics that businesses can employ to counteract illicit activity throughout the supply chain and to promote sustainable long‐term operations. An extensive agenda is presented suggesting future research paths, methodologies, theories, and potential contributions.

Angels against demons: Fight against smuggling in an illicit supply chain with uncertain outcomes and unknown structure

Illegal smuggling is one of the main concerns in many countries due to its significant negative economic and societal impacts. To control the problem, law enforcement officials work to prevent illegal smuggling operations. However, these officials usually encounter a multi-commodity network with an unidentified structure where traffickers trade illicit commodities at different levels. Therefore, they should manage their resources to prioritize identifying the network members, monitoring the identified members, and arresting them to remove their corresponding illegal trades from the network. To manage these operations, this study aims to utilize a mathematical approach, including a formulation and solution method, to manage the available resources in the network and minimize the illicit flows between the origins and destinations. The proposed approach considers real-world conditions, including multi-commodity flows and operations uncertainty. In other words, we investigate a multi-commodity maximum flow network interdiction problem with uncertain outcomes and an unknown network structure. The network under investigation denotes the relationships among criminals who trade illegal commodities in the distribution network. Given the complexity of the problem, this study contributes to the literature by developing a bi-level mixed-integer programming formulation to interdict maximum flow in a multi-commodity, multi-source relationship network considering uncertain outcomes of leader’s attacks. In addition, it develops a solution procedure based on the Benders decomposition algorithm to solve the developed formulation. Finally, to show the practicality of the developed formulation and solution method in real-world problems and to demonstrate their performance, we conduct a simulation analysis to determine how considering uncertainty affects the decisions. Our obtained results reveal that although considering the outcome uncertainty increases the solution time, it also increases the number of arrested criminals by about 29% on average and decreases the volume of trafficking by up to 14%.

Uncovering illicit supply networks and their interfaces to licit counterparts through graph-theoretic algorithms

The rapid market growth of different illicit trades in recent years can be attributed to their discreet, yet effective, supply chains. This article presents a graph-theoretic approach for investigating the composition of illicit supply networks using limited information. Two key steps constitute our strategy. The first is the construction of a broad network that comprises entities suspected of participating in the illicit supply chain. Two intriguing concepts are involved here: unification of alternate Bills-of-materials and identification of entities positioned at the interface of licit and illicit supply chain; logical graph representation and graph matching techniques are applied to achieve those objectives. In the second step, we search for a set of dissimilar supply chain structures that criminals might likely adopt. We provide an integer linear programming formulation as well as a graph-theoretic representation for this problem, the latter of which leads us to a new variant of Steiner Tree problem: Generalized Group Steiner Tree Problem. Additionally, a three-step algorithmic approach of extracting single (cheapest), multiple and dissimilar trees is proposed to solve the problem. We conclude this work with a semi-real case study on counterfeit footwear to illustrate the utility of our approach in uncovering illicit trades. We also present extensive numerical studies to demonstrate scalability of our algorithms.

Cooperation between China and ASEAN in Combating Wildlife Trade under the Framework of Regional Legal System

Because of its greater biodiversity, ASEAN has long been a source and transit hub for transnational wildlife trafficking. Although several international and domestic wildlife enforcement mechanisms have been established, the scope and effectiveness of international legal cooperation and policy coordination between China and ASEAN remain limited. Governments have been hampered in their efforts to combat wildlife trafficking by the difficulties of investigation and prosecution in overseas jurisdictions and the maintenance of illicit supply chains by organized crime groups. This paper reviews the main trends of legal and illegal wildlife trade between China and ASEAN, explores the existing legal and policy frameworks of ASEAN countries and China, and discusses the effectiveness of cooperation between China and ASEAN countries by referring to the United Nations Convention against Transnational Organized Crime (UNTOC). Finally, put forward the legal cooperation between China and ASEAN countries in combating transnational illegal wildlife trafficking.

Alprazolam-related deaths in Scotland, 2004-2020.

Background:The benzodiazepine drug alprazolam, a fast-acting tranquiliser, cannot be prescribed on the National Health Service in the United Kingdom. Illicit alprazolam supply and consumption have increased. Concern about increasing numbers of alprazolam-related fatalities started circulating in 2018. However, statistics on this issue are very limited. This study examined patterns in such mortality in Scotland.Methods:Statistics on deaths where alprazolam was mentioned in the ‘cause of death’ were obtained from official mortality registers. Anonymised Scottish case-level data were obtained. Data were examined in respect of the characteristics of decedents and deaths using descriptive statistics.Results:Scotland registered 370 deaths in 2004–2020; 366 of these occurred in 2015–2020: most involved males (77.1%); mean age 39.0 (SD 12.6) years. The principal underlying cause of death was accidental poisoning: opiates/opioids (77.9%); sedatives/hypnotics (15.0%). Two deaths involved alprazolam alone. Main drug groups implicated: opiates/opioids (94.8%), ‘other benzodiazepines’ (67.2%), gabapentinoids (42.9%), stimulants (30.1%), antidepressants (15.0%). Two-thirds (64.2%) involved combinations of central nervous system (CNS) depressants.Discussion:Alprazolam-related deaths are likely due to an increasing illicit supply. The fall in deaths in 2019–2020 is partially due to increased use of designer benzodiazepines. Treatment for alprazolam dependence is growing. Clinicians need to be aware of continuing recreational alprazolam use. When such consumption occurs with CNS depressants, overdose and death risks increase.Conclusions:More awareness of alprazolam contributing to deaths, especially in conjunction with other CNS depressants, is needed by consumers and clinicians. Improved monitoring of illicit supplies could identify emerging issues of medicines’ abuse.

Misuse of over the counter and prescription only medication by people accessing specialist treatment services: a systematic review

Abstract Introduction Over the Counter (OTC) and Prescription Only Medication (POM) are misused by people who access substance misuse services (SMS). Harms include impact upon physical/mental wellbeing and potentially fatal overdoses, with concerns growing amongst healthcare professionals, commissioners and the general public (1). SMS must respond to increasing demand and no known systematic review has explored this (2). Aim To examine the literature on the pattern of OTC/POM misuse among adults accessing SMS, including the types of medication, prevalence and associated characteristics. Methods The protocol for this systematic review has been published (2), registered on PROSPERO (CRD42020135216) and undertaken in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search was conducted, incorporating Cochrane, OVID Medline, Pubmed, Scopus and Web of Science databases and grey literature. Two independent reviewers conducted the title and abstract screenings, followed by full-text reviews, using predetermined selection criteria. Only publications in English, outlining OTC/POM misuse by adults (18 years or over) in receipt of psychological/pharmacological interventions for substance misuse were included. A third reviewer resolved disagreements if consensus could not be reached. Data was extracted using a pilot-tested form, from full-texts of included studies to ensure a consistent approach. Heterogeneity was assessed and the Mixed Methods Appraisal Tool (MMAT) considered the risk of bias for all studies. Results In 2021, the database search provided 3684 results, reducing to 2047 after reviewing grey literature, hand-checking reference lists and removing duplicates. Ineligible publications were excluded, resulting in 143 potentially relevant papers. Restricting to UK-based publications reduced this to thirteen with notable heterogeneity. The third reviewer was consulted on one occasion. Meta-/subgroup analyses were not feasible due an absence of randomised controlled trials/systematic reviews, the limited consistent information available and insufficient detail across all publications; therefore, a narrative synthesis was conducted. To reduce bias risk and add robustness, all publications were included. Based on the MMAT assessment, GRADE-CERQual indicated ‘high confidence’ for all review findings, despite moderate methodological limitations. Benzodiazepines, opioids and antihistamines were most frequently cited, and predominantly sourced online, from (various) GPs/pharmacies, street dealers and friends/family. Some older publications mentioned medicines that are no longer used in clinical practice. Adverse consequences included complications from injecting, criminal activity and withdrawal symptoms which perpetuated use. Misuse also occurred for other reasons, including desired psychoactive effect, to manage psychiatric/pain conditions and street drug shortages. There was significant variance in use, often alongside other substances, especially amphetamine, cannabis and opioids. Conclusion Restricting to UK-only due to the resource available notably limited the number of publications; however, this enabled a more detailed assessment and increased the relevance of findings, because there are differences in drug markets and medicine availability between countries. OTC/POM misuse is common amongst people accessing SMS and polypharmacy is concerning. A different approach to the management of OTC/POM misuse may be required: SMS improvements including withdrawal management must be considered and the need for further UK-based research was highlighted. References (1) Advisory Council on the Misuse of Drugs. Diversion and Illicit Supply of Medicines. London: Home Office; 2016. (2) Gittins R, Missen L, Maidment I. Misuse of medication in adult substance misuse services: a systematic review protocol. BMJ Open 2021;11:e047283.

Angels Against Demons: Fight Against Smuggling in an Illicit Supply Chain with Uncertain Outcomes and Unknown Structure

Angels Against Demons: Fight Against Smuggling in an Illicit Supply Chain with Uncertain Outcomes and Unknown Structure

Cannabis Use for Endometriosis: Clinical and Legal Challenges in Australia and New Zealand.

Introduction: Endometriosis is a difficult to manage condition associated with a significant disease burden. High levels of illicit cannabis use for therapeutic purposes have been previously reported by endometriosis patients in Australia and New Zealand (NZ). Although access to legal medicinal cannabis (MC) is available through medical prescription via multiple federal schemes, significant barriers to patient access remain. Methods: An anonymous cross-sectional online survey was developed and distributed through social media via endometriosis advocacy groups worldwide. Respondents were asked about legal versus illicit cannabis usage, their understanding of access pathways and legal status, and their interactions with health care professionals. Results: Of 237 respondents who reported cannabis use with a medical diagnosis of endometriosis, 186 (72.0%) of Australian and 51 (88.2%) NZ respondents reported self-administering cannabis illicitly. Only 23.1% of Australian and 5.9% of NZ respondents accessed cannabis through a doctor's prescription, with 4.8% of Australian and no NZ respondents reporting to legally self-administer cannabis. Substantial substitution effects (>50% reduction) were observed in users of nonopioid analgesia (63.1%), opioid analgesia (66.1%), hormonal therapies (27.5%), antineuropathics (61.7%), antidepressants (28.2%) and antianxiety medications (47.9%). Of Australian respondents, 18.8% and of NZ respondents, 23.5% reported not disclosing their cannabis use to their medical doctor, citing concern over legal repercussions, societal judgment, or their doctors' reaction and presumed unwillingness to prescribe legal MC. Conclusions: Respondents self-reported positive outcomes when using cannabis for management of endometriosis, demonstrating a therapeutic potential for MC. Despite this, many are using cannabis without medical supervision. While evidence for a substantial substitution effect by cannabis was demonstrated in these data, of particular concern are the clinical consequences of using cannabis without medical supervision, particularly with regard to drug interactions and the tapering or cessation of certain medications without that supervision. Improving doctor and patient communication about MC use may improve levels of medical oversight, the preference for legal MC adoption over acquisition via illicit supply and reducing cannabis-associated stigma.

Trafficking of a Tiger (Panthera tigris) in northeastern Mexico: A social network analysis

This study examines the possession of Tigers (Panthera tigris) as pets in Mexico through statistical analysis of governmental seizures on a period of 11 years, a review of socio-political factors related to this phenomenon and an analysis of a particular illicit supply network of a Tiger (P. tigris) specimen seized from a criminal group in northern Tamaulipas, Mexico. We found that socio-political factors such as the prohibition on the use of animals for circuses; environmental regulation strategies; the dominance of criminal groups in most of the Mexican territory and their traditional interest in exotic animals have an influence in the presence of tigers in private homes and ranches. This study contributes to the theoretical understanding of the possession of exotic animals, wildlife illegal networks and wildlife trafficking in Mexico.