Heroin is universally considered the world's most harmful illegal drug. This is due not only to the damaging effects of the drug itself, but also to the spread of AIDS tied to its use. Burgeoning illegal mass consumption in the 1960s and 1970s has given rise to a global market for heroin and other opiates of nearly 16 million users. The production and trafficking of opiates have caused crime, disease, and social distress throughout the world, leading many nations to invest billions of dollars trying to suppress the industry. The failure of their efforts has become a central policy concern. Can the world heroin supply actually be cut, and with what consequences? The result of a five-year-long research project involving extensive fieldwork in six Asian countries, Colombia, and Turkey, this book is the first systematic analysis of the contemporary world heroin market, delving into its development and structure, its participants, and its socio-economic impact. It provides a sound and comprehensive empirical base for concluding that there is little opportunity to shrink the global supply of heroin in the long term, and explains why production is concentrated in a handful of countries--and is likely to remain that way. On the basis of these findings, the authors identify a key set of policy opportunities, largely local, and make suggestions for leveraging them. This book also offers new insights into market conditions in India, Tajikistan, and other countries that have been greatly harmed by the production and trafficking of illegal opiates. A deft integration of economics, sociology, history, and policy analysis, The World Heroin Market provides a rigorous and vital look into the complex--and resilient--global heroin trade.

Heroin is universally considered the world's most harmful illegal drug. This is due not only to the damaging effects of the drug itself, but also to the spread of AIDS tied to its use. Burgeoning illegal mass consumption in the 1960s and 1970s has given rise to a global market for heroin and other opiates of nearly 16 million users. The production and trafficking of opiates have caused crime, disease, and social distress throughout the world, leading many nations to invest billions of dollars trying to suppress the industry. The failure of their efforts has become a central policy concern. Can the world heroin supply actually be cut, and with what consequences? The result of a five-year-long research project involving extensive fieldwork in six Asian countries, Colombia, and Turkey, this book is the first systematic analysis of the contemporary world heroin market, delving into its development and structure, its participants, and its socio-economic impact. It provides a sound and comprehensive empirical base for concluding that there is little opportunity to shrink the global supply of heroin in the long term, and explains why production is concentrated in a handful of countries--and is likely to remain that way. On the basis of these findings, the authors identify a key set of policy opportunities, largely local, and make suggestions for leveraging them. This book also offers new insights into market conditions in India, Tajikistan, and other countries that have been greatly harmed by the production and trafficking of illegal opiates. A deft integration of economics, sociology, history, and policy analysis, The World Heroin Market provides a rigorous and vital look into the complex--and resilient--global heroin trade.

The 2019 World Drug Report will include an updated overview of recent trends on production, trafficking and consumption of key illicit drugs. The Report contains a global overview of the baseline data and estimates on drug demand and supply and provides the reference point for information on the drug situation worldwide.

Why do the vast majority of heroin users live in cities? In his provocative history of heroin in the United States, Eric C. Schneider explains what is distinctively urban about this undisputed king of underworld drugs. During the twentieth century, New York City was the nation's heroin capital—over half of all known addicts lived there, and underworld bosses like Vito Genovese, Nicky Barnes, and Frank Lucas used their international networks to import and distribute the drug to cities throughout the country, generating vast sums of capital in return. Schneider uncovers how New York, as the principal distribution hub, organized the global trade in heroin and sustained the subcultures that supported its use. Through interviews with former junkies and clinic workers and in-depth archival research, Schneider also chronicles the dramatically shifting demographic profile of heroin users. Originally popular among working-class whites in the 1920s, heroin became associated with jazz musicians and Beat writers in the 1940s. Musician Red Rodney called heroin the trademark of the bebop generation. "It was the thing that gave us membership in a unique club," he proclaimed. Smack takes readers through the typical haunts of heroin users—52nd Street jazz clubs, Times Square cafeterias, Chicago's South Side street corners—to explain how young people were initiated into the drug culture. Smack recounts the explosion of heroin use among middle-class young people in the 1960s and 1970s. It became the drug of choice among a wide swath of youth, from hippies in Haight-Ashbury and soldiers in Vietnam to punks on the Lower East Side. Panics over the drug led to the passage of increasingly severe legislation that entrapped heroin users in the criminal justice system without addressing the issues that led to its use in the first place. The book ends with a meditation on the evolution of the war on drugs and addresses why efforts to solve the drug problem must go beyond eliminating supply.

This report offers one of the most comprehensive insights into global trends in international culture, production, seizure and price of illicit drugs. It examines trends in the world's four major markets: opium and heroin, coca and cocaine, cannabis, and amphetamine-type stimulants. This edition provides an in-depth examination of the link between transnational organized crime and drug trafficking. A detailed statistical appendix on production, prices and consumption completes this book, which gives the reader a comprehensive picture of the world's drug problem.

The contemporary opioid crisis is widely seen as new and unprecedented. Not so. It is merely the latest in a long series of drug crises stretching back over a century. In White Market Drugs, David Herzberg explores these crises and the drugs that fueled them, from Bayer’s Heroin to Purdue’s OxyContin and all the drugs in between: barbiturate “goof balls,” amphetamine “thrill pills,” the “love drug” Quaalude, and more. As Herzberg argues, the vast majority of American experiences with drugs and addiction have taken place within what he calls “white markets,” where legal drugs called medicines are sold to a largely white clientele. These markets are widely acknowledged but no one has explained how they became so central to the medical system in a nation famous for its “drug wars”—until now. Drawing from federal, state, industry, and medical archives alongside a wealth of published sources, Herzberg re-connects America’s divided drug history, telling the whole story for the first time. He reveals that the driving question for policymakers has never been how to prohibit the use of addictive drugs, but how to ensure their availability in medical contexts, where profitability often outweighs public safety. Access to white markets was thus a double-edged sword for socially privileged consumers, even as communities of color faced exclusion and punitive drug prohibition. To counter this no-win setup, Herzberg advocates for a consumer protection approach that robustly regulates all drug markets to minimize risks while maintaining safe, reliable access (and treatment) for people with addiction. Accomplishing this requires rethinking a drug/medicine divide born a century ago that, unlike most policies of that racially segregated era, has somehow survived relatively unscathed into the twenty-first century. By showing how the twenty-first-century opioid crisis is only the most recent in a long history of similar crises of addiction to pharmaceuticals, Herzberg forces us to rethink our most basic ideas about drug policy and addiction itself—ideas that have been failing us catastrophically for over a century.

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.

The Golden Triangle region that joins Burma, Thailand, and Laos is one of the global centers of opiate and methamphetamine production. Opportunistic Chinese businessmen and leaders of various armed groups are largely responsible for the manufacture of these drugs. The region is defined by the apparently conflicting parallel strands of criminality and efforts at state building, a tension embodied by a group of individuals who are simultaneously local political leaders, drug entrepreneurs, and members of heavily armed militias.Ko-lin Chin, a Chinese American criminologist who was born and raised in Burma, conducted five hundred face-to-face interviews with poppy growers, drug dealers, drug users, armed group leaders, law-enforcement authorities, and other key informants in Burma, Thailand, and China. The Golden Triangle provides a lively portrait of a region in constant transition, a place where political development is intimately linked to the vagaries of the global market in illicit drugs.Chin explains the nature of opium growing, heroin and methamphetamine production, drug sales, and drug use. He also shows how government officials who live in these areas view themselves not as drug kingpins, but as people who are carrying the responsibility for local economic development on their shoulders.

Mental, neurological, and substance use disorders are common, highly disabling, and associated with significant premature mortality. The impact of these disorders on the social and economic well-being of individuals, families, and societies is large, growing, and underestimated. Despite this burden, these disorders have been systematically neglected, particularly in low- and middle-income countries, with pitifully small contributions to scaling up cost-effective prevention and treatment strategies. Systematically compiling the substantial existing knowledge to address this inequity is the central goal of this volume. This evidence-base can help policy makers in resource-constrained settings as they prioritize programs and interventions to address these disorders.