Shifting drug markets in North America - a global crisis in the making?

Understanding drug market dynamics and their underlying driving factors is paramount to developing effective responses to the overdose crisis in North America. This paper summarises the distinct drug market trends observed locally and internationally over the past decade to extrapolate future drug market trajectories. The emergence of fentanyl on North American street markets from 2014 onwards led to a shift of street drug use patterns. Previously perceived as contaminants, novel synthetic opioids became the drugs of choice and a trend towards higher potency was observed across various substance classes. The diversification of distribution strategies as well as the regionalisation and industrialisation of production followed basic economic principles that were heavily influenced by prosecution and policy makers. Particularly, the trend towards higher potency is likely most indicative of what to expect from future illicit drug market developments. Nitazenes and fentanyl-analogues, several times more potent than fentanyl itself, are increasingly detected in toxicological testing and have the potential of becoming the drugs of choice in the future. The dynamic of drug import and local production is less clear and influenced by a multitude of factors like precursor availability, know-how, infrastructure, and the success of local drug enforcement strategies. Drug market dynamics and the current trajectory towards ultrapotent opioids need to be recognised by legislation, enforcement, and the health care system to prepare effective responses. Without significant improvements in treatment access, the implementation of preventative approaches and early warning systems, the mortality rate will continue to increase. Furthermore, there is no mechanism in place preventing the currently North American focused overdose crisis to spread to other parts of the globe, particularly Europe. A system of oversight, research, and treatment is needed to address mortality rates of historic proportions and prevent further harm.

Government intervention, market development, and pollution emission efficiency: Evidence from China

The government and the market are the two main means for resource allocation, and both play important roles in economic development and environmental protection. Based on the theoretical mechanism analysis, this study empirically investigated the relationship between government intervention, market development, and China's provincial pollution emission efficiency by using the static panel OLS, system generalized method of moments (SYS-GMM), and panel threshold effect model during the period 2000-2017. The results show that the impact of government intervention on China's provincial pollution emission efficiency shows a non-linear U-shaped curve relationship, and there is a positive correlation between market development and provincial pollution emission efficiency in China. Government intervention and market development are complementary, rather than a substitute for each other, in promoting China's provincial pollution emission efficiency. When government intervention is set as the threshold variable, the impact of government intervention on China's provincial pollution emission efficiency shows the feature of "promotes first, then inhibits." However, when market development is set as the threshold variable, government intervention is only conducive to the improvement of China's provincial pollution emission efficiency at a moderate marketization level. Lastly, some policy implications related to the government and the market in enhancing China's provincial pollution emission efficiency are presented.

Making Markets in Long-Term Care: Or How a Market Can Work by Being Invisible

Many Western countries have introduced market principles in healthcare. The newly introduced financial instrument of “care-intensity packages” in the Dutch long-term care sector fit this development since they have some characteristics of a market device. However, policy makers and care providers positioned these instruments as explicitly not belonging to the general trend of marketisation in healthcare. Using a qualitative case study approach, we study the work that the two providers have done to fit these instruments to their organisations and how that enables and legitimatises market development. Both providers have done various types of work that could be classified as market development, including creating accounting systems suitable for markets, redefining public values in the context of markets, and starting commercial initiatives. Paradoxically, denying the existence of markets for long-term care and thus avoiding ideological debates on the marketisation of healthcare has made the use of market devices all the more likely. Making the market invisible seems to be an operative element in making the market work. Our findings suggest that Dutch long-term care reform points to the need to study the ‘making’ rather than the ‘liberalising’ of markets and that the study of healthcare markets should not be confined to those practices that explicitly label themselves as such.

Developing Bisexual Attract-and-Kill for Polyphagous Insects: Ecological Rationale versus Pragmatics

We discuss the principles of bisexual attract-and-kill, in which females as well as males are targeted with an attractant, such as a blend of plant volatiles, combined with a toxicant. While the advantages of this strategy have been apparent for over a century, there are few products available to farmers for inclusion in integrated pest management schemes. We describe the development, registration, and commercialization of one such product, Magnet(®), which was targeted against Helicoverpa armigera and H. punctigera in Australian cotton. We advocate an empirical rather than theoretical approach to selecting and blending plant volatiles for such products, and emphasise the importance of field studies on ecologically realistic scales of time and space. The properties required of insecticide partners also are discussed. We describe the studies that were necessary to provide data for registration of the Magnet(®) product. These included evidence of efficacy, including local and area-wide impacts on the target pest, non-target impacts, and safety for consumers and applicators. In the decade required for commercial development, the target market for Magnet(®) has been greatly reduced by the widespread adoption of transgenic insect-resistant cotton in Australia. We discuss potential applications in resistance management for transgenic cotton, and for other pests in cotton and other crops.