By Vanda Felbab-Brown, Jonathan P. Caulkins, Carol Graham, Keith Humphreys, Rosalie Liccardo Pacula, Bryce Pardo, Peter Reuter, Bradley D. Stein, and Paul H. Wise

This Brookings opioid project, “The Opioid Crisis in America: Domestic and International Dimensions,” has analyzed policy options for reducing demand, providing treatment, designing regulatory frameworks, and implementing domestic law enforcement and international supply control measures. It has explored local impacts on communities as well as state and federal level responses and international actions. It has paid special attention to vulnerable communities, such as politically and economically disenfranchised Americans, women and children, and military veterans.

Washington DC: The Brookings Institution, 2020. 15p.

By Nazgol Ghandnoosh and Casey Anderson

More people died from opioid-related deaths in 2015 than in any previous year. This record number quadrupled the level of such deaths in 1999. Unlike the heroin and crack crises of the past, the current opioid emergency has disproportionately affected white Americans—poor and rural, but also middle class or affluent and suburban. This association has boosted support for preventative and treatment-based policy solutions. But the pace of the response has been slow, critical components of the solution—such as health insurance coverage expansion and improved access to medication assisted treatment—face resistance, and there are growing efforts to revamp the failed and costly War on Drugs.

This report examines the sources of the opioid crisis, surveys health and justice policy responses at the federal and state levels, and draws on lessons from past drug crises to provide guidance on how to proceed.

Washington, DC: The Sentencing Project, 2017. 35p.

By John Walsh

More than half a century after the advent of a global drug prohibition regime and the launch of the U.S. “war on drugs,” the results have been disastrous for Latin America and the Caribbean, and for the United States itself. Even worse, prohibition’s consequences are exacerbating other grave problems—corruption and organized crime, violence perpetrated with impunity, forest loss and climate change, and displacement and migration—making solutions to these challenges even more difficult to achieve. The Biden administration’s historic embrace of harm reduction represents an enormous, lifesaving advance for U.S. drug policy. But even with harm reduction services, moves to decriminalize drug possession, and shifts underway to legally regulate recreational cannabis, the brunt of drug prohibition remains intact and the drug war rages on in the Americas. The principal victims of government repression in the name of drug control and of the predations of organized crime have always been and continue to be the most impoverished and marginalized communities…. Regulatory models must prioritize the interests and inclusion of those communities most harmed by the punitive enforcement of drug prohibition. Such regulatory frameworks will be far better suited than prohibition to protecting human rights and promoting health, gender and racial equality, security and environmental sustainability.

Washington, DC: WOLA, 2022. 28p.

By Stephen Rolles

Global drug policy is rooted in a laudable urge to address the very real harms that non-medical psychoactive drugs can create. Such concerns have driven a prohibitionist global agenda: an agenda that gives clear and direct moral authority to those who support it, while casting those who are against it as ethically and politically irresponsible. However, such binary thinking can be problematic. By defining the most stringent prohibition as the most moral position, it makes nuanced consideration of the impacts of prohibition difficult. In particular, it makes it very difficult to look at and learn from the impacts and achievements of prohibition. Historic attempts to do so have foundered on a sense that analysing prohibition means questioning prohibition, and that questioning prohibition is in itself an immoral act—one that allies the questioner with the well known infamies of the world’s illegal drug trade. Ironically, supporting the status quo perpetuates that trade, and the harms that it creates.

It is not the purpose of this report to revisit these various findings; they are freely and easily available elsewhere. Rather, we seek to reconsider the management of illicit drugs in the light of the experience that they represent and embody. Using that experience, we will set out a blueprint for non-medical drug management policies that will minimise the harms that such drug use creates, both on a personal and on a societal level. In short, our goal is to define a set of practical and effective risk and harm management and reduction policies. Such policies will represent a clear and positive step towards the positive outcomes that prohibition has tried, and failed, to achieve. A strictly prohibitionist stance would understand them to be immoral, because they call for the legally regulated production and availability of many currently proscribed drugs. Transform’s position is, in fact, driven by an ethics of effectiveness, and as such represent an attempt to re-frame the global harm management debate in exclusively practical terms

London: Transform Drug Policy Foundation, 2009. 232p.

By Marie Claire Van Hout and Tim Bingham

This research aimed to assemble an evidence base around perceived anti-social behaviour associated with the provision of drug treatment in Dublin’s city centre, upon which to build a strategic response incorporating short/medium/long term goals and actions within the area. It will be used to guide discussions on how to reduce visibility of drug related public nuisance, improve public perceptions of safety in the area and provide comprehensive, safe, effective and appropriate treatment services within a series of short, medium and long-term strategies.

Dublin:Strategic Response Group, 2012. 187p.

By Tim McSweeney, Paul J. Turnbull, and Mike Hough

This summary sets out the main findings from a review of the recent literature on strategies to tackle illicit drug markets and distribution networks in the UK. The report was commissioned by the UK Drug Policy Commission and has been prepared by the Institute for Criminal Policy Research, School of Law, King’s College London. The main literature searches for this review were conducted during late September 2007 using a number of search terms and bibliographic data sources. In drawing together the evidence for this review we aimed to answer four broad questions: • What is the nature and extent of the problem? • What are current UK responses? • What are effective strategies for dealing with these issues? • Where are the gaps in our knowledge and understanding? This review restricted itself to domestic measures for tackling the drugs trade. As well as production control (e.g. assisting the Afghan government to implement its National Drug Control Strategy), there are a range of measures as part of the current drug strategy that are aimed at tackling drug markets and distribution networks within the UK’s borders.

London: The UK Drug policy Commission, 2008. 90p.

By The UK Drug Policy Commission

Over the past ten years, UK drug strategies have increasingly focused on providing treatment and support services for drug-dependent offenders – who commit a disproportionate number of acquisitive crimes (e.g. shoplifting and burglary) – as a way of reducing overall crime levels. This criminal justice focus has been reinforced in the recent 2008 UK drug strategy (new Welsh and Scottish drug strategies are also being developed). The UK Drug Policy Commission (UKDPC) has analysed the evidence for the effectiveness of these initiatives for reducing drug use and reoffending and of the wider impact of this more prominent criminal justice approach. To inform our analysis we commissioned an independent review of the published evidence from leading researchers at the Institute for Criminal Policy Research (ICPR), King’s College London. We also listened to policy experts, local commissioners, drug workers and current and ex-drug users.

London: The UK Drug Policy Commission (UKDPC), 2008. 80p.

By The UK Drug Policy Commission

In this report, UKDPC proposes a radical rethink of how we structure our response to drug problems. It analyses the evidence for how policies and interventions could be improved, with recommendations for policymakers and practitioners to address the new and established challenges associated with drug use.

London: The UK Drug Policy Commission, 2012.173p.

By Hal Brands.

In late 2007, the U.S. and Mexican governments unveiled the Merida Initiative. A 3-year, $1.4 billion counternarcotics assistance program, the Merida Initiative is designed to combat the drug-fueled violence that has ravaged Mexico of late. The initiative aims to strengthen the Mexican police and military, permitting them to take the offensive in the fight against Mexico’s powerful cartels. As currently designed, however, the Merida Initiative is unlikely to have a meaningful, long-term impact in restraining the drug trade and drug-related violence. Focussing largely on security, enforcement, and interdiction issues, it pays comparatively little attention to the deeper structural problems that fuel these destructive phenomena. These problems, ranging from official corruption to U.S. domestic drug consumption, have so far frustrated Mexican attempts to rein in the cartels, and will likely hinder the effectiveness of the Merida Initiative as well. To make U.S. counternarcotics policy fully effective, it will be imperative to forge a more holistic, better-integrated approach to the “war on drugs.”

Carlisle, PA: U.S. Army War College Press, 2008. 68p.

By George W. Grayson.

The United States has diplomatic relations with 194 independent nations. Of these, none is more important to America than Mexico in terms of trade, investment, tourism, natural resources, migration, energy, and security. In recent years, narco-violence has afflicted Mexico with more than 50,000 drug-related murders since 2007 and some 26,000 men, women, and children missing. President Enrique Peña Nieto has tried to divert national attention from the bloodshed through reforms in energy, education, anti-hunger, health-care, and other areas. Even though the death rate has declined since the chief executive took office on December 1, 2012, other crimes continue to plague his nation. Members of the business community report continual extortion demands; the national oil company PEMEX suffers widespread theft of oil, gas, explosives, and solvents (with which to prepare methamphetamines); hundreds of Central American migrants have shown up in mass graves; and the public identifies the police with corruption and villainy. Washington policymakers, who overwhelmingly concentrate on Asia and the Mideast, would be well-advised to focus on the acute dangers that lie principally below the Rio Grande, but whose deadly avatars are spilling into our nation.

Carlisle, PA: U.S. Army War College Press, 2014. 103p.

By Geoffrey Till.

The 21st century has seen the growth of a number of nontraditional threats to international stability on which, trade, and thus U.S. peace and security, depends, and for the moment at least a reduced likelihood of continental scale warfighting operations, and something of a de-emphasis on major involvement in counterinsurgency operations. These nontraditional threats are, however, very real and should command a higher priority than they have done in the past, even in a period of budgetary constraint. The military have cost-effective contributions to make in countering the manufacture and distribution of illicit drugs, and in many cases can do so without serious detriment to their main warfighting role. Successfully completing this mission, however, will require the military to rethink their integration with the nonmilitary aspects of a whole-of-government approach, and almost certainly, their institutional preference for speedy victories in short wars.

Carlisle, PA: U.S. Army War College Press, 2020. 81p.

By John P. Sullivan and Robert J. Bunker.

Contemporary Mexican cartel use of car bombs began in mid-July 2010 and has since escalated. Given the proximity to the United States, some literally within miles of the border, the car bombings, with about 20 incidents identified over the last 2 1/2 years, should be of interest to local, state, and federal U.S. law enforcement, the U.S. Army, and other governmental institutions which are providing increasing support to Mexican federal agencies. An historical overview and analysis of cartel car bomb use in Mexico provides context, insights, and lessons learned stemming from the Medellin and Cali cartel car bombing campaigns. In order to generate insights into future cartel car bombings in Mexico, the identification of such potentials offers a glimpse into cartel “enemy intent,” a possible form of actionable strategic intelligence. For Mexico, steady and both slowly and quickly increasing car bomb use trajectories may exist. The prognosis for decreasing car bomb deployment appears unlikely. If cartel car bombs were to be deployed on U.S. soil or against U.S. personnel and facilities in Mexico, such as our consulates, we could expect that a pattern of indications and warnings (I&W) would be evident prior to such an attack(s). In that case, I&W would be drawn from precursor events such as grenade and improvised explosive device (IED) attacks (or attempted attacks) on our personnel and facilities and on evolving cartel car bomb deployment patterns in Mexico. The authors conclude with initial recommendations for U.S. Army and defense community support to the military and the federal, state, and local police agencies of the Mexican state, and the various U.S. federal, state, and local police agencies operating near the U.S.-Mexican border. The extent of support in intelligence, organization, training, and equipment is highlighted, as well as the extent that these forms of support should be implemented to counter cartel vehicle-borne IEDs and overall cartel threats.

Carlisle, PA: U.S. Army War College Books, 2013. 72p.

National Research Council.

Despite efforts to reduce drug consumption in the United States over the past 35 years, drugs are just as cheap and available as they have ever been. Cocaine, heroin, and methamphetamines continue to cause great harm in the country, particularly in minority communities in the major cities. Marijuana use remains a part of adolescent development for about half of the country's young people, although there is controversy about the extent of its harm.

Given the persistence of drug demand in the face of lengthy and expensive efforts to control the markets, the National Institute of Justice asked the National Research Council to undertake a study of current research on the demand for drugs in order to help better focus national efforts to reduce that demand.

This study complements the 2003 book, Informing America's Policy on Illegal Drugs by giving more attention to the sources of demand and assessing the potential of demand-side interventions to make a substantial difference to the nation's drug problems. Understanding the Demand for Illegal Drugs therefore focuses tightly on demand models in the field of economics and evaluates the data needs for advancing this relatively undeveloped area of investigation.

Washington, DC: The National Academies Press. 2010. 124p.