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Drivers of Functional and non-Functional Drug Use: A Latent Class AnalysisRoberts, Eric Thomas January 2022 (has links)
Drug prohibition has dramatically affected countries worldwide. It fuels violence and corruption in Latin America, and Central and Southeast Asia, and is a major contributing factor behind the United States having the highest rate of incarceration in the world. Yet there is scant evidence that prohibition reduces drug use. Despite this lack of evidence, prohibition is the preferred policy stance of governments worldwide. One of the primary justifications of prohibition is that drug use causes individuals’ harm. While there is evidence of individual harms associated with drug use there is also a literature suggesting it is possible to use drugs functionally – defined here as use with minimal impairment to mental and physical health, and social roles and expectations.
However, drug use is a politically charged topic and as such little research on functional drug use has come to prominence. The existence of persons who use drugs functionally would allow us to consider alternative approaches to drug control that address the harms that stem from both prohibition and individual use.In this dissertation I conducted three independent but related studies to explore the existence and drivers of functional drug use.
In Chapter 1 I systematically reviewed peer-reviewed literature from Ovid MEDLINE, PsycINFO, Scopus, and Web of Knowledge databases regarding functional drug use and find robust evidence that all illegal drugs can be used functionally. Drawing on the narratives of participants across the studies the typical person who uses drugs functionally is marked by three characteristics. First, they actively avoid addiction and take steps to maintain overall good physical and mental health. Second, they are socially integrated with lives that do not revolve solely around procuring and consuming drugs; hallmarks of this included holding a job, attending school, and maintaining connections to non-drug using family and friends. Third, persons who use drugs functionally take pains to avoid negative stereotypes attached to persons who use drugs – paying for their drugs with excess income, avoiding other illegal activities and attending to important socially sanctioned activities.
In Chapter 2 I used data from the Inner-City Mental Health Study Predicting HIV/AIDS, Club and Other Drug Transitions (IMPACT) study, a cross-sectional dataset of former and current persons who use drugs in New York City selected via random street intercept between 2005 and 2008, to apply the findings of our review to find participants reflective of the phenomenon of functional drug use. Using exploratory latent class analysis on questions regarding drug use behaviors I report different patterns of drug use within the IMPACT sample and regress measures of social functioning on these classes as distal outcomes to assess the functionality of each class. My solution is a 6-class model consisting of the following use patterns: former non-persons who inject drugs (PWID); former PWID; marijuana use; cocaine, crack and marijuana use; low frequency polydrug use; high frequency polydrug use.
Among the classes containing persons who use drugs currently, there was a clear pattern of relative functionality based on the probability of drug related interference and having an illegal main source of income. From most functional to least functional these were: marijuana use (2% interfering use; 5% illegal main source of income), cocaine, crack and marijuana use (48%; 31%), low frequency polydrug use (58%; 38%), and high frequency polydrug use (80%; 57%); compared to 37% of the overall sample reporting interfering use and 24% reporting having an illegal main source of income. Comparing the classes to former non-PWID, marijuana use had a lower odds of drug use interference (OR = 0.07, p-value < 0.01) whereas all other classes had significantly increased odds of drug use interference with increasing odds from former PWID (OR = 1.80, p-value = 0.04), cocaine, crack and marijuana use (OR = 4.46, p-value < 0.01), low frequency polydrug use (OR = 6.48, p-value < 0.01), and high frequency polydrug use (OR = 18.66, p-value < 0.01). Regarding main source of income there was no significant difference between the marijuana use class with the former non-PWID (OR = 0.88, p-value = 0.81). The other classes however, followed a similar step-wise pattern as for drug use interference: former PWID (OR = 2.68, p-value = 0.04), cocaine, crack and marijuana use (OR = 7.21, p-value < 0.01), low frequency polydrug use (OR = 10.08, p-value < 0.01), and high frequency polydrug use (OR = 21.30, p-value < 0.01).
In Chapter 3 I built on the results from Chapter 2 to test whether childhood physical abuse, sexual abuse, and neglect (CAN) was associated with membership in less compared with more functional drug use classes using multinomial logistic regression. This analysis builds on literature summarized in Chapter 1 suggesting non-functional drug use is associated with feelings of negative affect and a large body of work documenting associations between CAN and psychiatric and behavioral disorders generally, and drug use specifically. I report that childhood neglect is not associated with different patterns of drug use behaviors but is positively associated with having an illegal main source of income (OR = 1.40, 95%CI 1.02, 1.92). Participants experiencing physical abuse were 1.65 (95% CI 1.06-2.59) times more likely to engage in high frequency polydrug use compared to marijuana use but had no association with drug use interference after adjustment for drug use class. There were positive associations between all measures of sexual abuse with drug use interference and having an illegal main source of income. Adjustment for drug use class accounted for the association with drug use interference but not having an illegal main source of income.
This exploration of functional drug use found a strong evidence base of qualitative work supporting its existence; however, there are few extant quantitative investigations. Applying the results of our review to an epidemiologic sample I found a hierarchy of functionality related to different patterns of drug use. Moving this body of work forward requires the development of new scales to measure functional drug use to more fully characterize the phenomenon. Replication across samples will generate much needed estimates of the prevalence of functional and non-functional drug use, key data for drug policy debates.
These scales should take into account the three key dimensions outlined by participants across the studies reviewed and be applicable across various kinds of drugs and meaningful cross-culturally. I report evidence supporting an association between CAN with different patterns of drug use and reduced social functioning. Future analyses should measure other sources of childhood trauma if they are interested in the direct effect of CAN on drug use, as well as modifiers of the CAN-drug use relationship to fully characterize the phenomenon. However, it should also be noted that the model this analysis is based on, like most extant theories of use, is rooted in the moral panic over drugs that has engulfed the United States for the last 100 years.
These models treat drug use as unequivocally harmful, hence an irrational activity and therefore, implicitly, the result of some trauma. Functional drug use subverts this paradigm and considers multiple reasons for and patterns of use. While there are likely negative inducements towards less functional patterns of drug use we would do well to update our models by considering pleasure and incorporating both positive and negative inducements. New models should then be tested systematically across samples.
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Essays on Cannabis LegalizationThomas, Danna Kang January 2018 (has links)
Though the drug remains illegal at the federal level, in recent years states and localities have increasingly liberalized their marijuana laws in order to generate tax revenue and save resources on marijuana law enforcement. Many states have adopted some form of medical marijuana and/or marijuana decriminalization laws, and as of 2017, Washington, Colorado, Maine, California, Oregon, Massachusetts, Nevada, Alaska, and the District of Columbia have all legalized marijuana for recreational use. In 2016 recreational marijuana generated over $1.8 billion in sales. Hence, studying marijuana reforms and the policies and outcomes of early recreational marijuana adopters is an important area of research.
However, perhaps due to the fact that legalized recreational cannabis is a recent phenomenon, a scarcity of research exists on the impacts of recreational cannabis legalization and the efficacy and efficiency of cannabis regulation. This dissertation aims to fill this gap, using the Washington recreational marijuana market as the primary setting to study cannabis legalization in the United States.
Of first order importance in the regulation of sin goods such as cannabis is quantifying the value of the marginal damages of negative externalities. Hence, Chapter 1 (co-authored with Lin Tian) explores the impact of marijuana dispensary location on neighborhood property values, exploiting plausibly exogenous variation in marijuana retailer location. Policymakers and advocates have long expressed concerns that the positive effects of the legalization--e.g., increases in tax revenue--are well spread spatially, but the negative effects are highly localized through channels such as crime. Hence, we use changes in property values to measure individuals' willingness to pay to avoid localized externalities caused by the arrival of marijuana dispensaries. Our key identification strategy is to compare changes in housing sales around winners and losers in a lottery for recreational marijuana retail licenses. (Due to location restrictions, license applicants were required to provide an address of where they would like to locate.) Hence, we have the locations of both actual entrants and potential entrants, which provides a natural difference-in-differences set-up. Using data from King County, Washington, we find an almost 2.4% decrease in the value of properties within a 0.5 mile radius of an entrant, a $9,400 decline in median property values.
The aforementioned retail license lottery was used to distribute licenses due to a license quota. Retail license quotas are often used by states to regulate entry into sin goods markets as quotas can restrict consumption by decreasing access and by reducing competition (and, therefore, increasing markups). However, license quotas also create allocative inefficiency. For example, license quotas are often based on the population of a city or county. Hence, licenses are not necessarily allocated to the areas where they offer the highest marginal benefit. Moreover, as seen in the case of the Washington recreational marijuana market, licenses are often distributed via lottery, meaning that in the absence of an efficiency secondary market for licenses, the license recipients are not necessarily the most efficient potential entrants.
This allocative inefficiency is generated by heterogeneity in firms and consumers. Therefore, in Chapter 2, I develop a model of demand and firm pricing in order to investigate firm-level heterogeneity and inefficiency. Demand is differentiated by geography and incorporates consumer demographics. I estimate this demand model using data on firm sales from Washington. Utilizing the estimates and firm pricing model, I back out a non-parametric distribution of firm variable costs. These variable costs differ by product and firm and provide a measure of firm inefficiency. I find that variable costs have lower inventory turnover; hence, randomly choosing entrants in a lottery could be a large contributor to allocative inefficiency.
Chapter 3 explores the sources of allocative inefficiency in license distribution in the Washington recreational marijuana market. A difficulty in studying the welfare effects of license quotas is finding credible counterfactuals of unrestricted entry. Therefore, I take a structural approach: I first develop a three stage model that endogenizes firm entry and incorporates the spatial demand and pricing model discussed in Chapter 2.
Using the estimates of the demand and pricing model, I estimate firms' fixed costs and use data on locations of those potential entrants that did not win Washington's retail license lottery to simulate counterfactual entry patterns. I find that allowing firms to enter freely at Washington's current marijuana tax rate increases total surplus by 21.5% relative to a baseline simulation of Washington's license quota regime. Geographic misallocation and random allocation of licenses account for 6.6\% and 65.9\% of this difference, respectively.
Moreover, as the primary objective of these quotas is to mitigate the negative externalities of marijuana consumption, I study alternative state tax policies that directly control for the marginal damages of marijuana consumption. Free entry with tax rates that keep the quantity of marijuana or THC consumed equal to baseline consumption increases welfare by 6.9% and 11.7%, respectively. I also explore the possibility of heterogeneous marginal damages of consumption across geography, backing out the non-uniform sales tax across geography that is consistent with Washington's license quota policy. Free entry with a non-uniform sales tax increases efficiency by over 7% relative to the baseline simulation of license quotas due to improvements in license allocation.
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Confronting the drug control establishment : Alfred Lindesmith as public intellectual /Keys, David Patrick, January 1998 (has links)
Thesis (Ph. D.)--University of Missouri-Columbia, 1998. / Typescript. Vita. Includes bibliographical references. Also available on the Internet.
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Confronting the drug control establishment Alfred Lindesmith as public intellectual /Keys, David Patrick, January 1998 (has links)
Thesis (Ph. D.)--University of Missouri-Columbia, 1998. / Typescript. Vita. Includes bibliographical references. Also available on the Internet.
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"Ei, polícia, maconha é uma delícia!" : o proibicionismo das drogas como uma política de criminalização socialLunardon, Jonas Araujo January 2015 (has links)
Este artigo tem como objetivo analisar as políticas proibicionistas com relação às drogas, no Brasil, como políticas públicas voltadas à criminalização social. A partir de um histórico sobre o processo de proibição, define-se como tais políticas se deram por iniciativas de reprimir a população negra e pobre, ex-escrava, do início do século XX. Avançando no tempo, a segunda parte do trabalho analisa como a política criminal contemporânea no tratamento às drogas exemplifica uma vontade de Estado criminalizador, sendo fator fundamental na criminalização e no extermínio da juventude pobre, majoritariamente negra, brasileira. O trabalho se utiliza de uma abordagem, principalmente, qualitativa, a partir de uma ótica foucaultiana acerca das relações sociais e de poder, além das análises de criminólogos e sociólogos reconhecidos na temática de estudo no país. / This article objective is to analyze drug’s prohibition policies, in Brazil, as public policies aimed to social criminalization. From a historical view regarding the process of prohibition, it is defined that such policies were initiatives based on the repression of the black, poor and former slave population of the beginning of the 20th century. Advancing in History, the second part of the text brings the analysis of how the contemporary criminal policy concerning drug treatment exemplifies a desirability of a criminalizing State, becoming a fundamental factor in what we can define as the criminalization and the extermination of the poor, mostly black, Brazilian youth population. This work utilizes mainly qualitative approaches, based on Foucault studies on social relations and power. Besides, it brings out the studies of criminologists and social scientists, known for their views on these subjects in Brazil. / Este artículo tiene como objetivo analizar las políticas prohibicionistas con relación a las drogas, en Brasil, como políticas públicas dirigidas a la criminalización social. Desde un histórico acerca del proceso de prohibición, se define como estas políticas fueran iniciativas para la represión de la populación negra y pobre, ex esclava, del inicio del siglo XX. Avanzando en el tiempo, la segunda parte del texto analiza como la política criminal contemporánea en el que dice respecto al tratamiento a las drogas ejemplifica una voluntad del Estado criminalizante, siendo factor fundamental en la criminalización y en el exterminio de la juventud pobre, mayoritariamente negra, brasileña. El trabajo utiliza de una abordaje, principalmente cualitativa, a partir de una visión foucaultiana sobre las relaciones sociales y de poder, además de las análisis de sociólogos y criminólogos reconocidos en la temática de estudio.
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"Ei, polícia, maconha é uma delícia!" : o proibicionismo das drogas como uma política de criminalização socialLunardon, Jonas Araujo January 2015 (has links)
Este artigo tem como objetivo analisar as políticas proibicionistas com relação às drogas, no Brasil, como políticas públicas voltadas à criminalização social. A partir de um histórico sobre o processo de proibição, define-se como tais políticas se deram por iniciativas de reprimir a população negra e pobre, ex-escrava, do início do século XX. Avançando no tempo, a segunda parte do trabalho analisa como a política criminal contemporânea no tratamento às drogas exemplifica uma vontade de Estado criminalizador, sendo fator fundamental na criminalização e no extermínio da juventude pobre, majoritariamente negra, brasileira. O trabalho se utiliza de uma abordagem, principalmente, qualitativa, a partir de uma ótica foucaultiana acerca das relações sociais e de poder, além das análises de criminólogos e sociólogos reconhecidos na temática de estudo no país. / This article objective is to analyze drug’s prohibition policies, in Brazil, as public policies aimed to social criminalization. From a historical view regarding the process of prohibition, it is defined that such policies were initiatives based on the repression of the black, poor and former slave population of the beginning of the 20th century. Advancing in History, the second part of the text brings the analysis of how the contemporary criminal policy concerning drug treatment exemplifies a desirability of a criminalizing State, becoming a fundamental factor in what we can define as the criminalization and the extermination of the poor, mostly black, Brazilian youth population. This work utilizes mainly qualitative approaches, based on Foucault studies on social relations and power. Besides, it brings out the studies of criminologists and social scientists, known for their views on these subjects in Brazil. / Este artículo tiene como objetivo analizar las políticas prohibicionistas con relación a las drogas, en Brasil, como políticas públicas dirigidas a la criminalización social. Desde un histórico acerca del proceso de prohibición, se define como estas políticas fueran iniciativas para la represión de la populación negra y pobre, ex esclava, del inicio del siglo XX. Avanzando en el tiempo, la segunda parte del texto analiza como la política criminal contemporánea en el que dice respecto al tratamiento a las drogas ejemplifica una voluntad del Estado criminalizante, siendo factor fundamental en la criminalización y en el exterminio de la juventud pobre, mayoritariamente negra, brasileña. El trabajo utiliza de una abordaje, principalmente cualitativa, a partir de una visión foucaultiana sobre las relaciones sociales y de poder, además de las análisis de sociólogos y criminólogos reconocidos en la temática de estudio.
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"Ei, polícia, maconha é uma delícia!" : o proibicionismo das drogas como uma política de criminalização socialLunardon, Jonas Araujo January 2015 (has links)
Este artigo tem como objetivo analisar as políticas proibicionistas com relação às drogas, no Brasil, como políticas públicas voltadas à criminalização social. A partir de um histórico sobre o processo de proibição, define-se como tais políticas se deram por iniciativas de reprimir a população negra e pobre, ex-escrava, do início do século XX. Avançando no tempo, a segunda parte do trabalho analisa como a política criminal contemporânea no tratamento às drogas exemplifica uma vontade de Estado criminalizador, sendo fator fundamental na criminalização e no extermínio da juventude pobre, majoritariamente negra, brasileira. O trabalho se utiliza de uma abordagem, principalmente, qualitativa, a partir de uma ótica foucaultiana acerca das relações sociais e de poder, além das análises de criminólogos e sociólogos reconhecidos na temática de estudo no país. / This article objective is to analyze drug’s prohibition policies, in Brazil, as public policies aimed to social criminalization. From a historical view regarding the process of prohibition, it is defined that such policies were initiatives based on the repression of the black, poor and former slave population of the beginning of the 20th century. Advancing in History, the second part of the text brings the analysis of how the contemporary criminal policy concerning drug treatment exemplifies a desirability of a criminalizing State, becoming a fundamental factor in what we can define as the criminalization and the extermination of the poor, mostly black, Brazilian youth population. This work utilizes mainly qualitative approaches, based on Foucault studies on social relations and power. Besides, it brings out the studies of criminologists and social scientists, known for their views on these subjects in Brazil. / Este artículo tiene como objetivo analizar las políticas prohibicionistas con relación a las drogas, en Brasil, como políticas públicas dirigidas a la criminalización social. Desde un histórico acerca del proceso de prohibición, se define como estas políticas fueran iniciativas para la represión de la populación negra y pobre, ex esclava, del inicio del siglo XX. Avanzando en el tiempo, la segunda parte del texto analiza como la política criminal contemporánea en el que dice respecto al tratamiento a las drogas ejemplifica una voluntad del Estado criminalizante, siendo factor fundamental en la criminalización y en el exterminio de la juventud pobre, mayoritariamente negra, brasileña. El trabajo utiliza de una abordaje, principalmente cualitativa, a partir de una visión foucaultiana sobre las relaciones sociales y de poder, además de las análisis de sociólogos y criminólogos reconocidos en la temática de estudio.
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An evaluation of the drugs crime nexus, legalization of drugs, drug enforcement, and drug treatment rehabilitationKeesling, James Richard 01 January 2000 (has links)
Law enforcement agencies are faced with the problem of how to reduce crime in the most economical method possible without violating the law. Since drug offenders also engage in a disproportionate amount of non-drug crime, then drug enforcement is considered as an acceptable general crime control method. Unfortuantely, this is an expensive option because incarcerating offenders is both costly and ony a short-term solution to the problem. A review of existing research examining the prior criminal histories of drug offenders compared to their previous involvement in violent and property crime is conducted to evaluate this relationship.
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Cannabis confusion : criminalization and decriminalization revisitedSmith, Alex January 1995 (has links)
No description available.
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An Exploration of Efforts to Re-Define the Drug Problem Through State Ballot MeasuresPritchett, Anne McDonald 14 June 2005 (has links)
Historically, the federal government has been the institution responsible for setting the nation's drug policy. Since 1996, however, the federal government's authority and legitimacy in this issue area has increasingly been challenged through state ballot measures introduced via the initiative process. While only eight percent of ballot measures historically are approved by voters (Initiative and Referendum Institute 2004), half of the 28 state ballot measures on illegal drugs have been approved by voters over the past decade. The stated goal of those supporting legalization through ballot measures is to "build a political movement to end the war on drugs" (Nadelmann 2004). Nadelmann (2004) suggests that victories in the states show that the "nascent drug policy reform movement" can win in the "big leagues of American politics" and that the successful models presented through the ballot measures will increase "public confidence in the possibilities and virtue" of regulating the non-medical use of illicit drugs. To date there has been no detailed examination of the issue framing strategies in this venue; nor has there been an effort to link the problem definition and direct democracy literatures. This dissertation links the problem definition and direct democracy literatures, using drug policy as the vehicle and applying Stone's (2002) analytic framework of problem definition to make descriptive inferences about the issue framing devices employed in state ballot measures on illegal drugs. The research examines a range of materials related to the state ballot measures on illegal drugs including the language appearing on voter ballots; the full text of the ballot measures, including ballot titles and political preambles; and the voter information statements and their authors. In addition, the dissertation describes the elements of legalization proposed by the ballot measures that were approved by voters and examines three key legal challenges to Proposition 215, one of the first ballot measures on illegal drugs approved by voters in California in 1996, including two U.S. Supreme Court cases. / Ph. D.
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