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This chapter examines representations of gender in online modafinil markets. While gender has often been absent from scholarship on online drug markets, our analysis demonstrates the ubiquity of gender in representations of modafinil users and sellers. The analysis draws on visual images, blogs, and marketing emails relating to three websites selling modafinil, discussed pseudonymously. We describe the range of ways that notions of gender are represented in advertising. Although women represent around 40% of that buying modafinil online, websites and communications tended not to feature women. Although sexist stereotypes of women were rarely present (in contrast to direct-to-consumer pharmaceutical advertising), the ways that modafinil was imagined tended to focus narrowly on corporate spheres of work and productivity. We contrast this narrow imaginary with female journalists’ own accounts of using modafinil to manage illness and enhance creativity. Thus, we conclude that the ways that modafinil has been imagined reflects working assumptions as to who is considered the ‘normal’ participant in online modafinil markets.

Drug cryptomarkets increase information available to market actors, which should reduce information asymmetry and increase market efficiency. This study aims to determine whether cryptomarket listings accurately represent the advertised substance, weight or number and purity, and whether there are differences in products purchased from the same listing multiple times.

Law enforcement drug purchases – predominantly cocaine, methamphetamine, MDMA and heroin – from Australian cryptomarket vendors (n = 38 in 2016/2017) were chemically analysed and matched with cryptomarket listings (n = 23). Descriptive and comparative analyses were conducted.

Almost all samples contained the advertised substance. In most of these cases, drugs were either supplied as-advertised-weight or number, or overweight or number. All listings that quantified purity overestimated the actual purity. There was no consistent relationship between advertised purity terms and actual purity. Across the six listings purchased from multiple times, repeat purchases from the same listing varied in purity, sometimes drastically, with wide variation detected on listings purchased from only one month apart.

In this data set, cryptomarket listings were mostly accurate, but the system was far from perfect, with purity overestimated. A newer, larger, globally representative sample should be obtained to test the applicability of these findings to currently operating cryptomarkets.

This paper reports on the largest data set of forensic analysis of drug samples obtained from cryptomarkets, where data about advertised drug strength/dose were obtained.

The paper demonstrates prejudicial effects of the rising private participation and the lacuna of state in ensuring the accessibility and affordability of healthcare.

Secondary data analysis from national and international databases is employed to demonstrate the low government spending and the alternate healthcare financing mechanisms in the country. The company reports of six Indian pharma companies are examined to map the profits and revenues, and also taking into account the sales growth and return on investment.

The paper observes the pharmaceutical sector, via its spiralling drug prices, is the primary contributor to the huge out-of-pocket expenses borne by households. The study findings indicate that there is an increased divergence between the out-of-pocket expenses of households and exorbitant profits of the private drug companies in the country over the years.

Amidst debates on the importance of public health in the aftermath of the pandemic, the paper examines the rising hands of private sector in healthcare, and implores – who benefits? The authors study the implications via looking into the rise in the wealth of pharma giants; at the time of crisis when the lives of common citizens in the country were at stake.

The paper emphasises the repercussions of the higher markup of the pharma industry in raising the healthcare costs of households. The authors emphasise that the nonregulation of the pharma sector leads to high medical debts/poverty, in the wake of growing out-of-pocket expenditures of the citizens.

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.

The purpose of this paper is to provide a high-level analysis of the intersection emerging cryptocurrency sector with anti-money laundering (AML) regulations and risk-based AML diligence systems maintained by financial institutions.

The analysis begins with a description of cryptocurrencies, focusing specifically on how the supporting technologies and applications increase vulnerabilities. The information will lay the foundation for examining the vulnerabilities existing in the architecture of cryptocurrency technology, as well as potential targets for regulations. The second part of the analysis will then shift focus to defining the scope of the money laundering problem associated with cryptocurrencies. An in-depth understanding of the problem is necessary to inform tailored AML legislation and regulations. The third part of the analysis will explore emerging AML regulations that govern cryptocurrencies, focusing specifically on those being developed and implemented in the United Arab Emirates (UAE). The UAE regulations will then be compared to those of the USA and European Union (EU) for comparative analysis and best practices.

The UAE has a robust legal system aimed at bolstering AML efforts while supporting widespread integration of crypto assets into business and government operations. A review of the UAE’s legislative framework reveals critical issues. First, the current regulations do not cover decentralized finance (DeFi) and non-fungible tokens (NFTs). The absence of clear regulations for DeFi and NFT protocols has created a leeway for money laundering and related criminal activities. Second, there is a high level of fragmentation in the UAE’s legislative landscape. The UAE does not have uniform, national laws that apply to all the Emirates. Fragmentation is not unique to the UAE but a major global problem that affects the USA and EU. Therefore, it is necessary to adopt a tailored approach where standard rules and regulations are responsive to the diverse aspects of cryptocurrencies. The strategy is vital, as it will be impractical to create a single legislation or law that will cover all the crypto assets, including their diverse applications. Furthermore, the Financial Action Task Force (FATF) should develop a global standard that will support a unified/harmonized application of AML/counter-terrorist financing (CTF) laws and regulations related to cryptocurrencies and the blockchain technology.

The borderless nature of digital currency and exchanges means that the existing laws and regulations are inadequate to address cross-border money laundering activities. Thus, there is an urgent need of harmonizing global regulations to ensure uniformity in applications. The quest for harmonization should be a priority as the FATF works towards developing a global standard. The global standard will support a uniform application of AML/CTF laws and regulations related to cryptocurrencies and the blockchain technology.

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.

Almost five years after legalization, the unlicensed cannabis market is still thriving in Canada, and legacy cannabis retailers continue to face barriers to legal market entry. This study aims to shed light on these challenges and offer policy recommendations supporting legacy retailers and the government’s goals of enhancing public safety and displacing the unlicensed market.

This study reviewed online sources, including the media, gray literature, government, and other policy and legal websites, to identify legacy retailers’ challenges to entering the Canadian ecosystem since legalization and policy approaches of legalized jurisdictions with similar issues.

Legacy retailers face financial, legal and social barriers to entering the legal market. The Canadian government should focus on lowering and eliminating these barriers by developing programs that reduce financial risks and required capital, facilitate partnership programs and accelerators, provide innovative options that reduce overhead expenses, encourage pooled ownership to support small businesses, prioritize market entry for equity-deserving individuals and enable automatic expungement. A description of programs that have been implemented in other jurisdictions to address similar barriers is provided.

The policy recommendations in this paper would enable increased entrepreneurship and employment in a growing sector. While the tax revenue earned from the new market entrants may not be enough to support all the recommended policy initiatives, it could be reinvested to fund some of them creating sustainable growth opportunities.

The paper provides practical, timely policy recommendations on expanding the legal cannabis market in Canada and addressing unintended negative consequences of current policies.

The purpose of this study was to examine consumer data acquired by branded prescription drug websites and the ethics of privacy related to the interconnected web of personal information accessed, packaged and resold by tracker technologies.

The research used the DMI Tracker Tool to collect data on the top 17 branded prescription drug websites, with a specific interest in the tracker technologies embedded in those websites. That data was analyzed using Gephi, an open-source data visualization tool, to map the network of trackers embedded in those branded prescription drug websites.

Findings visualize the interconnections between tracker technologies and prescription drug websites that undergird a system of personal data acquisition and programmatic advertising vehicles that serve the interests of prescription drug marketers and Big Tech. Based on the theory of platform ethics, the study demonstrated the presence of a technostructural ecosystem dominated by Big Tech, a system that goes unseen by consumers and serves the interests of advertisers and resellers of consumer data.

The 17 websites used in this study were limited to the top-selling prescription drugs or those with the highest ad expenditures. As such this study is not based on a random sampling of branded prescription drug websites. The popularity of these prescription drugs or the expanse of advertising associated with the drugs makes them appropriate to study the presence of tracking devices that collect data from consumers and serve advertising to them. It is also noted that websites are dynamic spaces, and some trackers within their infrastructures are apt to change over time.

Branded prescription drug information has over the past three decades become part of consumers’ routine search for information regarding what ails them. As drug promotion moved from print to TV and the Web, searching for drug information has become a part of everyday life. The implications of embedded trackers on branded prescription drug websites are the subject of this research.

This study has significant social implications as consumers who are searching for information regarding prescription medications may not want drug companies tracking them in a way that many perceive to be an invasion of privacy. Yet, as the Web is dominated by Big Tech, web developers have little choice but to remain a part of this technostructural ecosystem.

This study sheds light on branded prescription drug websites, exploring the imbalance between the websites under study, Big Tech and consumers who lack awareness of the system that operates backstage.

A key feature of human rights in health is access to safe, effective and affordable medicines. Pharmacovigilance is advocated for monitoring intended/unintended effects of medicines to assure their safety. The purpose of this paper is to synthesize knowledge about supply chain impediments to safe medicines in developing nations and contribute to future development of research in this field.

This paper conducts a structured literature review based on Preferred Reporting Items for the Systematic Reviews and Meta-Analyses guidelines. It aims at profiling supply chain impediments to safe medicines in developing nations by reviewing 46 recent pharmacovigilance-specific papers published between 2005 and 2020.

Analysis of reviewed articles identified criticality of supply chain impediments that affect constituents across pharmaceutical in developing nations, which still struggle to maintain robust national pharmacovigilance systems due to lack of awareness, policy and practices.

Research results can be applied by pharmaceutical industry decision-makers and drug safety professionals in developing nations. Because the review is qualitative in nature, its implication ought to be tested after actual implementation.

This review can help identify underinvestigated impediments and methods to aid in developing new pharmacovigilance knowledge areas in developing nation context.

The review uncovers gaps in global health equity dialogue in developing nations. It also recognizes that macrolevel supply chain impediments exist due to unfair disease burden and health inequities in developing nations.

The paper examines supply chain impediments to safe medicines in developing nations with insights for future pharmacovigilance research. Identifying and classifying supply chain impediments through this review is the first step toward creating effective interventions for these impediments to safe medicines.