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This paper aims to explore the role of tramadol in pain management and the impact of regulatory measures on supply and medical access in Ghana and other African countries.

The study adopted an exploratory design and qualitative methods to explore the perspectives of different actors, including officials of regulatory agencies, law enforcement agents, health-care providers and non-medical tramadol users. Data were collected through individual and group interviews, and transcripts were subjected to thematic analysis.

Findings show that tramadol fills a critical gap in treating pain across Ghana in areas with an acute shortage of opioid analgesics due to scheduling-related barriers. This was partly due to porous borders allowing for an influx of tramadol into the countries. The study further found that most tramadol purchases in Ghana and other West African countries were made from market traders rather than from health-care settings and were mainly generic medicines categorised as “substandard/spurious/falsely-labelled/falsified/counterfeit medical products” within the World Health Organization standards.

Although the findings are instructive, there were some limitations worth noting. The study encountered several limitations, especially with the non-medical users, because the environment is highly criminalised, People who use drugs were unwilling to avail themselves for fear of law enforcement officers’ harassment. Obtaining ethical clearance had its own bureaucracy – challenges that delayed the study time frame.

Placing tramadol under the list of internationally controlled substances would create barriers to access to effective pain medications, particularly by the poor, and encourage victimisation of users by law enforcement authorities.

The study is based on empirical research on tramadol use and regulation in African countries, contributing to knowledge in an under-researched subject area on the continent. The comparative approach further adds value to the research.

The purpose of this study is to examine the politics, political economy, and fallout of hawkish regulatory policy on prescription drugs in Nigeria. Hawkish regulatory policy on prescription drug in Nigeria, such as opioid analgesics, is a very complex and multifaceted one, which usually involves the interplay of many factors and parties.

Policy manuals, official government gazettes (legislations, regulations, Acts and decrees), academic literature and a direct ethnographic observation of events surrounding the regulation of prescription drugs were reviewed and engaged.

The results revealed that Nigerian and global political economy and politics interface to define the direction of the new restrictive opioid policy, with resultant friction between prohibition and consumption. The reviews showed that the overarching “get-tough” and “repressive” policy are not necessarily founded on empirical evidence of an increase in prescription drug sales or use, but more as a product of the interplay of both internal and external politics and the prevailing socioeconomic order.

Instead of borrowing extensively from or being influenced by repressive Western drug laws and perspectives, Nigerian policymakers on prescription opioids should take control of the process by drawing up a home-grown policy that is less intrusive and punitive in nature for better outcomes. A mental sea change is required to understand the intrigues of Western power in Nigeria’s politics and political economy to avoid the continuous symptomatic failure of drug policy.

The politics and economic influence of the United Nations, USA and Western powers, as well as the axiom of moral panic of prescription drugs scares within the Nigerian environment, are particularly significant in the making of the emerging hawkish policy on prescription drugs in Nigeria.

This study aims to analyse how different types of public policies have supported the internationalisation of latecomer science-based firms, taking the case of large Brazilian pharmaceutical companies (LBPCs).

The methodology comprises a multiple case study and uses a literature review, fieldwork interviews and document analysis of eight LBPCs, five policymakers and three sector experts.

Direct and indirect policies differ in supporting LBPCs’ internationalisation motivation. The indirect policies created the necessary conditions to accumulate knowledge and capacity in the domestic market. LBPCs that adhere more to policies supporting production and technological capabilities development are internationalising as an extension of their innovative efforts. In contrast, LBPCs that have built productive capacities and have not yet reached a minimum level of technological capacity go abroad to exploit their production capabilities with the support of direct policies.

This study contributes to international business and evolutionary literature, demonstrating the channels through which public policies support latecomer science-based firms. The results show that direct and indirect policies assist firms’ internationalisation in different ways, according to actors’ perception: providing support to strengthen their domestic capabilities, which have become competitive advantages in the international market; or offering support to external expansion. It emphasises that industrial policies are relevant to support companies in creating the initial conditions (ownership advantages) to internationalise, and direct policies are important to help companies to design international strategies. This study also debates that policies supporting companies’ internationalisation depend on their adhesion to programmes and incentives and their routines and capabilities, which are specific to each company and lead to different motivations for international expansion.

Through its 1922 Act on poisonous substances and more recent national normative guidance, Morocco attempts to address high prevalence of HIV among people who inject illegal opioids, and to lift legal and policy barriers to the availability of opioid-based essential controlled medicines. This paper aims to map the Moroccan opioid regulation environment, with a focus on responses to the legal and illegal markets.

The policy paper focuses on legal provisions for the control of opioids for pain relief and methadone for substitution therapies. It reviews existing reported data from official national, regional and international sources, studies and grey literature. It allows, by presenting the current state of affairs, to measure the limited pace of policy changes.

The authors provide a clear mapping of the laws and regulations restricting access to opioids in Morocco; the health impacts on populations; and an overall overview of institutional barriers to policy change despite more efforts such as the introduction of opioid agonist therapies.

Due to limited available data and sources, the policy paper exploits the maximum of existing evidence from national and international sources to provide an overall review of opioid control policies in Morocco.

To the best of the authors’ knowledge, this policy paper is among the first to explore the legal environment of opioid use and control in Morocco, to highlight policy reforms, and to analyse the barriers to access to opioids.

The purpose of this study is to understand the complex interplay between illicit opioids trade and consumption practices and state policies that aim to reduce their misuse.

The study adopted an exploratory design. Data were gathered through in-depth interviews with 31 commercially oriented drug dealers in Uyo, Nigeria. The framework approach was used in data analyses, while “friction” provided the interpretive lens.

Accounts revealed public concerns over the misuse of tramadol and other opioids among young people and the associated health and social harms. These concerns provided support for enforcement-based approaches to prescription opioids control, including police raids on pharmacy stores. These measures did not curtail opioids supply and consumption. Instead, they constrained access to essential medicines for pain management, encouraged illegal markets and fuelled law enforcement corruption in the form of police complicity in illegal tramadol trade.

The findings reveal the frictions of drug control in Nigeria, wherein enforcement-based approaches gained traction through public concerns about opioids misuse but also faced resistance due to the persistence of non-medical use and illegal supply channels made possible by law enforcement complicity. These indicate a need to prioritize approaches that seek to reduce illegal supply and misuse of opioids while ensuring availability of these medications for health-care needs.

The study is unique in its focus on the creative tension that exists between state control measures and local opioids supply and consumption practices.

The study focuses on drug safety regulation capture, reveals the inner mechanism and evolutionary characteristics of drug safety regulation capture and provides suggestions for effective regulation by pharmacovigilance.

The article introduces prospect theory into the game strategy analysis of drug safety events, constructs a benefit perception matrix based on psychological perception and analyzes the risk selection strategies and constraints on stable outcomes for both drug companies and drug regulatory authorities. Moreover, simulation was used to analyze the choice of results of different parameters on the game strategy.

The results found that the system does not have a stable equilibrium strategy under the role of cognitive psychology. The risk transfer coefficient, penalty cost, risk loss, regulatory benefit, regulatory success probability and risk discount coefficient directly acted in the direction of system evolution toward the system stable strategy. There is a critical effect on the behavioral strategies of drug manufacturers and drug supervisors, which exceeds a certain intensity before the behavioral strategies in repeated games tend to stabilize.

In this article, the authors constructed the perceived benefit matrix through the prospect value function to analyze the behavioral evolution game strategies of drug companies and FDA in the regulatory process, and to evaluate the evolution law of each factor.

This paper aims to examine the friction that has surfaced since the adoption of policy measures restricting access to tramadol, a synthetic opioid, in Nigeria in 2018. Our analysis reveals how non-licensed pharmaceutical actors, who have played an integral part in the supply chain, have been criminalised for activities that have previously been sanctioned by the state. This criminalisation has given rise to friction between what is perceived as illegal by the state and what is acceptable for other actors in the tramadol economy.

The paper is based on more than 20 in-depth interviews with illicit actors and regulators in the tramadol economy in Lagos, Nigeria’s commercial centre, and a review of key policy documents, media reports and popular cultural outputs on tramadol.

The paper highlights the effects of prohibitionist policies and the voices of criminalised actors to provide a contextual view of the Nigerian tramadol economy. Relying on the concepts of friction and quasilegality, we show how social relationships have become the main backbone of the illicit tramadol economy and how they enable participants to resolve the pervasive friction between illegality and social acceptability of tramadol.

This paper provides an inside understanding of the nuances of the rarely studied illicit trade in synthetic opioids and how restrictive policies that are seemingly not well thought through have created friction in the Nigerian context.

Increased outsourcing and importation of drugs from different parts of the world to the Latin America and the Caribbean (LAC) region result in the proliferation of substandard and fake medicines, posing a threat to public health. The presence of substandard and fake medications in LAC regions is a source of public health concern and causes an economic burden to the governments in these regions. Whereas testing and detecting medication quality can easily be achieved in developed countries, the situation is different in developing countries such as LAC. This paper aims to examine the public health challenges faced by LAC regarding substandard, fake and counterfeit medicines and how the region can tackle these challenges.

Databases such as Scopus, PubMed, ScienceDirect, Embase, HINARI, EBSCOhost, Google Scholar, unpublished data, conference abstracts and papers from World Health Organization, Pan-American Health Organization and electronic newspapers were searched concerning medicine quality and in LAC.

Drug treatment improves the quality of life while decreasing morbidity and mortality among diseased populations. Absence of or inadequate testing laboratories, old and ineffective legislature, lack of enforcement or willpower and lack of effective surveillance are challenges in LAC for the proliferation of substandard and falsified medicines (SFMs).

The most significant limitation of this study was the need for the reviewers to have used articles written in other languages besides English. The LAC region has a large population in non-English-speaking countries, and many articles are written using local languages. Hence, excluding those articles is a limitation worthy of note in this review. The articles accessed needed to provide adequate information on SFM markets and illegal pharmacies or hospitals but did not. Future reviews may focus on providing illegal substandard and falsified medicines markets in the region and how they can be minimized or eliminated.

This review highlights the challenges faced by LAC countries regarding substandard, fake and counterfeit medicines. The sources, prevalence and consequences of substandard and falsified drugs were identified to suggest the measures needed to curb the infiltration of low-quality medicines in LAC.

The study aimed to identify and define core components of Throughcare. The global prison population has reached its highest level to date (11.5 million), with comparative data on recidivism unavailable. Despite the global shift away from punitive and towards rehabilitative approaches, reintegration programming (Throughcare) is limited, ill-resourced or non-existent in many countries.

This study conducted a global e-Delphi consensus study of professionals working in prison and correctional services to define critical components of effective rehabilitation and reintegration programming. Consensus was defined a priori as 70% or more participants scoring an outcome from 7 to 9 and fewer than 15% scoring it 1 to 3.

Following a call for expression of interest circulated to the International Corrections and Prisons Association member list (n = 7282), 175 members agreed to partake in the e-Delphi rounds. In Round One, 130 individuals completed an online survey where 35 statements were scored by importance, each with opportunity to provide written feedback. A total of 33 statements exceeded the set threshold of consensus. Written feedback supported refinement and further development of statements in Round Two. A total of 108 individuals completed Round Two. A total of 39 out of the 40 statements exceeded the set threshold of consensus.

Consensus statements are useful to provide a shared understanding for inter-agency Throughcare partnerships, to inform national prison policies and to expand prison and support staff capacity building and programmes all over the world.

To the best of the authors’ knowledge, to date, this is the first known attempt to elicit consensus from a broad range of professionals working in the field of prison and correctional services on core components of effective rehabilitation and reintegration programming.