Heroin Supply Research Articles

An outbreak of serious illness and death among injecting drug users in England during 2000.

An outbreak of serious illness and death occurred in injecting drug users during 2000 in Scotland, Ireland and England. National and international collaboration was necessary for the investigation and management of this outbreak. In England and Wales active case-finding was initiated, coupled with standardised data collection and microbiological investigation of cases. Twenty-six definite or probable cases were identified in England between 1 April and 31 Aug. 2000; 17 of these occurred in the North. The overall case fatality was 50% (13/26). The principal apparent risk factor was a history of intramuscular or subcutaneous injection of heroin and the limited duration of the outbreak suggested that the problem might have been related to a particular supply of heroin. Clostridium novyi was isolated from two English cases. Taken in conjunction with contemporaneous microbiological and epidemiological results from Scottish and Irish cases, the probable aetiology for this outbreak was infection with C. novyi associated with both a particular supply of heroin and the method of preparation and injection used. A 'toolkit' was distributed in Sept. 2000 to all Consultants for Communicable Disease Control in England and Wales to assist them with the ongoing surveillance, investigation and management of this condition. Lessons learned have been used to produce guidance for the investigation and management of outbreaks of unexplained serious illness of possible infective aetiology.

Interpreting changes in heroin supply in Melbourne: droughts, gluts or cycles?

In this Harm Reduction Digest Paul Dietze and John Fitzgerald provide another possible way of understanding what has come to be referred to as Australia's heroin 'drought'. They examine evidence from Melbourne, Victoria and suggest that the apparent downturn in heroin availability in 2000 may, in part, be the result of an end of a heroin 'glut' and that perceptions of this phenomenon may be coloured by the development of more sophisticated indicators of the heroin market. They conclude with claims that the reasons for the reduction in drug consumption and adverse health outcomes, such as those attributed to interdiction, are thus premature

Affective disorders and craving to drugs in heroin addiction

Due to prohibitionist policies and practices, a poisoned illegal drug supply, and inadequate access to flexible substitution programs, Canada is currently experiencing the worst illegal drug overdose death epidemic in its history. In examining past policies, practices, and discourse that support heroin regulation and drug prohibition, the drivers of the current illegal drug overdose death epidemic in Canada are brought more clearly into focus.This article provides a critical socio-historical analysis of heroin (opioid) regulation with a focus on Canadian federal and provincial policies in the province of B.C., especially the city of Vancouver. Drawing from primary and secondary sources, this article provides a critical socio-historical analysis of heroin (opioid) regulation in Canada.Examining Canada's history of heroin criminalization provides a window to understand the systemic discrimination against people who use illegal heroin and other opioids. From its inception, heroin prohibition has worked to brutally punish a small segment of the population, especially those who are poor, racialized, and gendered. Negative heroin discourse and stereotyping about people who use heroin had an effect, shaping drug law, policing, prisons, and policy and treatment options.Little attention has been given to the increase in heroin possession offences across Canada over nine consecutive years and the lack of heroin substitution programs. Resistance to drug prohibition and criminal approaches to drug use emerged in the 1950s and continue today. Those most affected by drug policies demand inclusion and representation, access to a legal heroin supply, and the establishment and maintenance of heroin buyer clubs, contesting the very foundations of drug control in the twenty-first century.

DID Drug Prohibition Work?: Reflections on the End of the First Cocaine Experience in the United States, 1910–45

The use of cocaine in the United States began during the mid-1880s, reached a peak between 1900 and 1915, and then went into a period of sustained decline. This study examines several explanations for cocaine's decline, and concludes that the start of legal prohibition was only partly responsible. Legal controls virtually eliminated the licit supply of cocaine, and increased the costs of obtaining illicit supplies. These trends, however, had begun much earlier as a result of regulation and informal controls. Moreover, the “successs” of legal prohibition depended upon a number of unique historical circumstances, including the ready supply of cheap heroin for domestic drug markets. The conclusion of the first cocaine era was neither an inevitable end to a “cycle” of drug use, nor the outcome of a well-planned set of drug policies, but the product of a combination of national and international trends.

Pak-Afghan Drug Trade in Historical Perspective

The growth in the global heroin supply during the past decade can be traced in large part to geopolitical developments around Afghanistan and two significant aspects of U.S. policy: the failure of the Drug Enforcement Administration's interdiction efforts and the CIA's covert operations. The CIA's aid to the Afghan mujaheddin (freedom fighters) in the 1980s expanded opium production in Afghanistan and linked Pakistan's nearby heroin laboratories to the world market. In 1989, after a decade as the sites of major CIA covert operations, Afghanistan and Pakistan ranked, respectively, as the world's largest and second largest suppliers of illicit heroin. In the decade that followed, these areas proved to be centers of international criminal activity, particularly narcotics-related crime, which posed a serious threat to democratic advances and economic accomplishment in that part of the world. In view of Afghanistan's emergence as a major opium source country and Pakistan's role as a leading processor and exporter of heroin, the entire world is faced with a challenge to advance political stability and improve international cooperation for counter-narcotics operations. A historical analysis of this phenomenon can serve as a useful insight to understand and thus help combat this global threat. In the highlands spanning Iran, Afghanistan, and northwest Pakistan, tribal farmers used to grow limited quantities of opium for the merchant caravans bound for the cities of Iran and India. During the decade of Cold War confrontations with the Soviet Union, however, CIA intervention provided the political protection and logistics linkage that joined Afghanistan's poppy fields, through Pakistan's land mass, to heroin markets in Europe and America. Now although Soviet forces are gone and CIA aid has slackened,

Sexual behaviour and its relationship to drug-taking among prostitutes in south London.

The precise manner in which the use of different types of drugs is related to prostitution has not been adequately researched. This study investigates patterns of drug-taking and sexual behaviour among a group of women working as prostitutes in south London; it also looks at prostitution in which sex is offered in return for drugs, at the links between heroin, cocaine and alcohol use and sexual behaviour, and at the association between severity of dependence and sexual behaviour. All of the women in our sample (n = 51) were actively working as prostitutes. More than half of them had given sex for drugs, though this was a relatively infrequent occurrence. The majority of them were using heroin and many of them were moderately or severely dependent upon heroin. More than one-third had shared injecting equipment after it had already been used. Almost two-thirds reported that they only worked as a prostitute in order to fund their use of drugs (predominantly heroin), and that they would not continue working as a prostitute if they were not still using drugs. The more severely dependent upon heroin they were, the more likely they were to report these links between heroin use and prostitution. About half of the women in our sample said that they first started to work as a prostitute in order to pay for drugs. The women who began to use heroin prior to prostitution were more severely dependent on heroin and described themselves as being trapped in prostitution by the need to maintain a supply of heroin. Very few women regularly used cocaine in association with their prostitution. There are grounds for concern about the alcohol consumption of these women. About one-quarter of the women said that they used alcohol every day; some of them reported drinking at levels which greatly exceed recommended limits for women, and some were drinking at levels which were likely to be physically damaging.

"War on drugs" continues in United States under new leadership.

Criticism of the "war on drugs" pursued under Republican administrations has grown in the United States. With the election of Bill Clinton many experts expected a shift from law enforcement policies to an approach favouring treatment and prevention. The budget announced in April, however, revealed no such shift in allocation of resources. Although the war on drugs has apparently failed to reduce the supply of cheap heroin and cocaine to the United States, the prevention strategy favoured by its opponents--school based prevention programmes--has not yet been shown to be effective in dealing with the concentration of drug misuse among the socially disadvantaged. In looking for new strategies Clinton must satisfy both liberals and conservatives in Congress, and community policing might therefore prove to be a politically expedient option.

Heroin Policy for the Next Decade

The supply of heroin in the United States appears to have grown substantially in recent years, although it is not clear what impact this has had on consumption. Conventional indicators have shown only modest increases, but for a variety of reasons one would not expect increases even if we are in the early years of a new heroin use epidemic. It is even less clear what, if anything, should be done. Drug control resources are finite. Making heroin a new policy focus may impose substantial opportunity costs as resources are diverted from other worthy programs. On the other hand, the history of cocaine in the late 1970s and early 1980s demonstrates that “wait and see” can be an extremely expensive option. A prudent course may be to implement relatively low-cost interventions that one would not regret undertaking even if a new epidemic never materialized and to enhance monitoring. If these enhanced monitoring programs gave strong signs of increasing use, particularly by new users, bolder interventions might be warranted.

Prohibition or regulation: an economist's view of Australian heroin policy

Concern for the spread of HIV infection and with the growing social costs associated with the policy of heroin prohibition have recently led many to reconsider the policy. A large question facing advocates of decriminalisation or legalisation is to what extent the numbers of users would grow under a more regulated scheme. “More regulated” because under prohibition there is a completely unregulated market, which is, however, illegal: lawless laissez-faire. This article advocates some degree of regulation for the supply of heroin, and abandonment of the unsuccessful policy of prohibition. In attempting to answer the question of the number of users under different regimes — and their importance to society — the article closely examines the structure of the black market, using a previously unpublished survey of the illegal industry performed in Victoria some years ago by the illicit industry itself. This confirms recent findings that there are relatively large numbers of occasional users who seldom come to the attention of medical or law-enforcement authorities, and whose heroin use per se imposes little cost on society.

The Chinese laundry: International drug trafficking and Hong Kong's banking industry

Hong Kong — Britain's Crown Colony in Asia — is reputed to be one of the world's leading centers for the laundering1 of drug money. Located on the southeast coast of China, Hong Kong is not far from the Golden Triangle in Burma, Laos and Thailand, the source of much of the world's heroin supply. Ethnic Chinese criminal organizations based in Hong Kong and elsewhere have long been involved in the refining, transporting and financing of Southeast Asian heroin. With its bank secrecy laws, its large and sophisticated international banking industry, and its complete absence of currency exchange controls, Hong Kong has all of the necessary components of a modern financial secrecy jurisdiction. It is alleged that billions of dollars are being washed in Hong Kong by both local and overseas drug traffickers, to be reinvested eventually throughout the world. Hong Kong government officials deny the allegation, and cite other reasons to account for the vast sums of U.S. currency that are being repatriated to the West Coast. This paper examines critically the arguments for both positions.

Adjunctive drug use among opiate addicts

In a study of 249 opiate (mainly heroin) addicts special attention was paid to adjunctive drug use. Generally, nicotine (cigarette smoking), alcohol and cannabis preceded the use of heroin, and continued to be used as adjunctive drugs after the establishment of heroin addiction. Nicotine was the most common substance used together with opiates. Alcohol and cannabis were used as adjunctive drugs in about two-thirds of the cases. In the late stages of heroin addiction, benzodiazepines were also used concomitantly with opiates. The most frequently reported reason for the use of adjunctive drugs was to intensify the effect of the opiate. Three-quarters or more of the addicts had used different adjunctive drugs to boost the euphoric feeling derived from the primary drug, i.e. heroin. Attempt at self-treatment of withdrawal symptoms was a less frequently reported reason for adjunctive drug use. The findings show that heroin addiction is the major problem. The use of adjunctive drugs, especially benzodiazepines, can be partly explained on economic grounds. They must be clearly distinguished from the primary drug of abuse, heroin. For policy-making decisions, it is important that the elimination of heroin abuse through effective prevention measures would ultimately wipe out the problem of adjunctive drug use, while reduction of the overall supply of heroin without reduction in actual demand might result in an increasing trend to adjunctive drug use.

A Freer Market for Heroin in Australia: Alternatives to Subsidizing Organized Crime

The problems associated with illicit drug use in general, and the illicit use of heroin in particular, have led to stringent attempts by Australian governments to enforce the laws against drug abuse. The strongest reaction of the criminal justice system has been toward heroin, with a total prohibition on heroin importation, manufacture, distribution, possession, and use. Before attempting to evaluate the extent and costs of heroin use today, this paper reviews the evolution of laws and social attitudes toward heroin in Australia. Using an economic framework for analyzing the black market in heroin, the paper examines proposals for enforcing the prohibition by tightening the supply side, and by reducing the demand for heroin. It argues that attempts to restrict the supply have had the effect of increasing the costs borne not only by the users but by society at large, through increases in acquisitive crime and police corruption. On utilitarian grounds it concludes that the costs to society of the prohibition far outweigh the costs of a policy of freer availability, and suggests that a policy of government supply of price-controlled heroin and methadone would be far preferable to today's failed policy of prohibition.

A system dynamics model for estimating heroin imports into the United States

AbstractA small system dynamics model of the heroin supply in the United States has proved useful in estimating heroin imports and anticipating effects of changes in imports. This paper describes the structure of the model and its application to import data over a ten‐year period. Of particular interest is the way in which the model has been used to flag inconsistencies and fill gaps in federal data.

Continuing Shifts in the United States' Heroin Supply

Continuing Shifts in the United States' Heroin Supply

Heroin activity in New York City, 1970-1978.

Heroin activity in New York City is traced from 1970 using a variety of indicators. A steady decline in the number of new "intensive" users (those who required treatment) is noted, beginning around 1970. Various possible explanations of this decline are examined. Reductions in the supply of heroin or in the demand for heroin do not appear to be causes of the decline in new users, as these reductions occurred after the decline in new users had already begun. Demographic changes--the passing of the baby boom cohort through the period of highest risk of beginning heroin use--also does not appear to be a viable explanation, as trends in use of other drugs do not show a decline. Changes in attitudes toward heroin as a specific drug are left as the most plausible explanation of the decline in the number of new intensive heroin users.

Epidemiology Abuse: Epidemiological and Psychosocial Models of Drug Abuse

Epidemiological and psychosocial approaches to drug abuse are discussed, with specific reference to the limits of the narrow epidemiological model when applied to the dynamics of heroin addiction, especially the elimination of heroin supply. During the early sixties there was much controversy between medical and psychosocial models of drug abuse with respect to methadone maintenance treatment programs versus drug free treatment programs. Frequently drug abuse treatment facilities would refuse to have both types of programs available, but after some time the differences which were thought to be irreconcilable were in fact reconciled and the field moved towards a synthesis of drug free and methadone maintenance approaches. The same thing needs to occur with respect to epidemiological and psychosocial approaches to drug abuse. The current narrow epidemiological approaches to drug abuse focus on heroin itself and ways of eliminating heroin supply. Psychosocial models are concerned with alienation, societal inadequacies, and psychological deficiencies of addicts. Psychosocial approaches define heroin addiction as a symptom of a more widespread social and psychological malaise, while narrow epidemiological approaches consider the heroin addiction itself the sole problem. Epidemiological and psychosocial approaches to drug abuse should be integrated so that much valuable information produced by epidemiologists such as the dynamics of the spread of heroin addiction, the period of time that addicts remain infectious, and the natural life-history of epidemics can be combined with knowledge produced by psychosocial approaches to fashion a more comprehensive approach to drug abuse. An epidemiologically based approach calling for stringent control of heroin distribution to non-addict populations coupled with easy access to low cost heroin for addicted persons would reflect an appreciation of the psychological/social/political realities involved in addiction as well as a grounding in epidemiological principles and data.

Epidemiology Abuse: Epidemiological and Psychosocial Models of Drug Abuse

Epidemiological and psychosocial approaches to drug abuse are discussed, with specific reference to the limits of the narrow epidemiological model when applied to the dynamics of heroin addiction, especially the elimination of heroin supply. During the early 60's there was much controversy between medical and psychosocial models of drug abuse with respect to methadone maintenance treatment programs versus drug free treatment programs. Frequently drug abuse treatment facilities would refuse to have both types of programs available, but after some time the differences which were thought to be irreconcilable were in fact reconciled and the field moved towards a synthesis of drug free and methadone maintenance approaches. The same thing needs to occur with respect to epidemiological and psychosocial approaches to drug abuse. The current narrow epidemiological approaches to drug abuse focus on heroin itself and ways of eliminating heroin supply. Psychosocial models are concerned with alienation, societal inadequacies, and psychological deficiencies of addicts. Psychosocial approaches define heroin addiction as a symptom of a more widespread social and psychological malaise, while narrow epidemiological approaches consider the heroin addiction itself the sole problem. Epidemiological and psychosocial approaches to drug abuse should be integrated so that much valuable information produced by epidemiologists such as the dynamics of the spread of heroin addiction, the period of time that addicts remain infectious, and the natural life-history of epidemics can be combined with knowledge produced by psychosocial approaches to fashion a more comprehensive approach to drug abuse. An epidemiologically based approach calling for stringent control of heroin distribution to non-addict populations coupled with easy access to low cost heroin for addicted persons would reflect an appreciation of the psychological/social/political realities involved in addiction as well as a grounding in epidemiological principles and data.

III. the Economics of Control of the Illegal Supply of Heroin

III. the Economics of Control of the Illegal Supply of Heroin

The Social Costs of the Discovery and Suppression of the Clandestine Distribution of Heroin

Previous articleNext article No AccessThe Social Costs of the Discovery and Suppression of the Clandestine Distribution of HeroinEdward EricksonEdward Erickson Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Journal of Political Economy Volume 77, Number 4, Part 1Jul. - Aug., 1969Part 1 Article DOIhttps://doi.org/10.1086/259535 Views: 2Total views on this site Citations: 13Citations are reported from Crossref Copyright 1969 The University of ChicagoPDF download Crossref reports the following articles citing this article:James A. Piazza The illicit drug trade, counternarcotics strategies and terrorism, Public Choice 149, no.3-43-4 (Oct 2011): 297–314.https://doi.org/10.1007/s11127-011-9846-3Jin-Long Liu, Jin-Tan Liu, James K. Hammitt, Shin-Yi Chou The price elasticity of opium in Taiwan, 1914–1942, Journal of Health Economics 18, no.66 (Dec 1999): 795–810.https://doi.org/10.1016/S0167-6296(99)00023-5Robert T. Burrus Do efforts to reduce the supply of illicit drugs increase turf war violence? a theoretical analysis, Journal of Economics and Finance 23, no.33 (Sep 1999): 226–234.https://doi.org/10.1007/BF02757707Kai A. Konrad Drug policy and federalism, Public Choice 80, no.1-21-2 (Jul 1994): 55–68.https://doi.org/10.1007/BF01047947Bruce L. Benson, Iljoong Kim, David W. Rasmussen, Thomas W. Zhehlke Is property crime caused by drug use or by drug enforcement policy?, Applied Economics 24, no.77 (Jul 2006): 679–692.https://doi.org/10.1080/00036849200000036BRUCE L. BENSON, DAVID W. RASMUSSEN RELATIONSHIP BETWEEN ILLICIT DRUG ENFORCEMENT POLICY AND PROPERTY CRIMES, Contemporary Economic Policy 9, no.44 (Oct 1991): 106–115.https://doi.org/10.1111/j.1465-7287.1991.tb00354.xGodwin Bernard An Economic Analysis of the Illicit Drug Market, International Journal of the Addictions 18, no.55 (Jul 2009): 681–700.https://doi.org/10.3109/10826088309027363Harold L. Votey, Llad Phillips Minimizing the social cost of drug abuse: An economic analysis of alternatives for policy, Policy Sciences 7, no.33 (Sep 1976): 315–336.https://doi.org/10.1007/BF00137626Richard Bookstaber Risk and the Structure of the Black Market for Addictive Drugs, The American Economist 20, no.11 (Mar 1976): 26–29.https://doi.org/10.1177/056943457602000105STANLEY EINSTEIN Economic Aspects and Drug Use, (Jan 1975): 227–240.https://doi.org/10.1016/B978-0-08-017767-0.50017-5 Billy J. Eatherly Drug-Law Enforcement: Should We Arrest Pushers or Users?, Journal of Political Economy 82, no.11 (Oct 2015): 210–214.https://doi.org/10.1086/260183John Holahan III. the Economics of Control of the Illegal Supply of Heroin, Public Finance Quarterly 1, no.44 (Oct 1973): 467–477.https://doi.org/10.1177/109114217300100411James V. Koch, Stanley E. Grupp The Economics of Drug Control Policies, International Journal of the Addictions 6, no.44 (Jul 2009): 571–584.https://doi.org/10.3109/10826087109058954