Search results

Illicit drug use amongst women in Zimbabwe is increasing. The most common drugs of choice are marijuana and new psychoactive substances like ecstasy, cough syrups with a high content of codeine, and other small intoxicating pills like mangemba (diazepam). The most affected population group are women between the ages of 20 to 40.

In a community engagement undertaken by Zimbabwe Civil Liberties and Drug Network in five of Zimbabwe’s provinces, socio, cultural and economic factors were identified as the drivers of increased engagement with the drug trade. The urge to be independent and the inter-related aspect of sex work were also identified as push factors accounting for the increase in illicit drug usage in the country. The community engagement showed most women use illicit drugs as a way of liberating themselves within a heavily patriarchal society and due to the traumas associated with sex work. Sex work in turn exposes women to opportunistic infections, rape, violence and sexual violence. Women perform different roles in the illicit drug economy. In their role as sellers of controlled drugs, women aimed to support their families, maximising the opportunities presented by life in illicit economies. Whilst advocacy groups are pressing for drug policy reform in Zimbabwe, interventions can be designed to help women extricate themselves from this quagmire through empowering them and having a drug policy that among other facets, strengthens communities.

The online sourcing, supply, and purchase of illicit drugs is fast transforming drug markets worldwide. Although the long-term development of simple communications technology over time (from pagers to mobile phones) continues to impact and extend local drug supply dynamics, it is the recent developments of dark web cryptomarkets, social media applications (like Instagram), encrypted messaging applications (like WhatsApp), and surface web platforms, such as LeafedOut, that are changing the drug supply landscape online. The use of technology in drug supply has tended to go hand in hand with improving the efficiency of supply and opportunities to reduce exchange-related risks for both buyers and sellers. In relation to app-mediated supply, for example, the use of encrypted messaging provides enhanced security for arranging purchases beyond the lurking surveillance of law enforcement. Despite the perception of improved safety, however, the use of social media apps and other online platforms can expose both buyers and sellers to risk scenarios they may not fully appreciate. Drawing on two recent studies on the use of social media apps and the online platform LeafedOut as mediators of drugs supply, this chapter will consider how these mid-range (between cryptomarkets and traditional telecommunications such as basic texting/calling and material ‘street’ markets) virtual spaces are being utilised for drug supply and the extent to which this is ‘just more of the same’ or provides new structures and experiences for those engaging with it and in what ways. Consideration will also be given to contradictions in the mid-range market space where the broad perception of reduced risk from the use of encrypted messaging can in fact produce greater levels of risk for some buyers and sellers depending on how they engage with the process/es.

In 2017, the opioid epidemic was declared a public health emergency in the United States. The federal and state governments are still struggling to contain the crisis through various legislations and to stem the tide of overdoses and deaths. This paper looks specifically at the issue of high prescriptions of opioids disbursed to patients by physicians.

This paper evaluates this evolving policy issue through a critical review and synthesis of academic literature, government policy documents (at states and national levels) and articles in the popular press.

Over-prescription is a legal problem because it inevitably leads to diversion of these substances for non-medical usage. The Prescription Drug Monitoring Program (PDMP) laws have been passed by all 50 states and the main policy responses are covered. However, there are hindrances to their effectiveness, which have to be addressed. Two state level policy alternatives are discussed as potential solutions — PDMP mandates and Pain Management Clinic Laws (PMCLs). After a comparative evaluation, it is recommended that all states should pass the mandatory PDMP review and usage laws urgently.

This is the first detailed policy evaluation on the specific and time-sensitive aspect of physician over-prescribing, within the larger opioid abuse problem. Moreover, critique on the public health leadership issue is raised.