Controlling Cocaine: Supply Versus Demand Programs

Rydell, C. Peter; Everingham, Susan S. Sohler

doi:10.7249/mr331

Cited by 174 publications

(70 citation statements)

References 17 publications

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“…In humans, heavy cocaine use is characterized by an increased amount of cocaine consumed on any given episode and an increased frequency of use (Gawin 1991). Some scholars estimate that although heavy cocaine users represent approximately 20% of the cocaine using population, they account for two-thirds of domestic consumption of the drug (Rydell and Everingham 1994), and thus, create the greatest economic demand for cocaine in the United States. Because high dose consumption is associated with the greatest negative consequences for an individual and society, it is critical to understand the mechanisms that underlie escalation of consumption.…”

Section: Introductionmentioning

confidence: 99%

Continuous exposure to the competitive N-methyl-d-aspartate receptor antagonist, LY235959, facilitates escalation of cocaine consumption in Sprague–Dawley rats

2007

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Section: Introductionmentioning

confidence: 99%

Continuous exposure to the competitive N-methyl-d-aspartate receptor antagonist, LY235959, facilitates escalation of cocaine consumption in Sprague–Dawley rats

2007

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“…Such effects remain unmeasured, but are also considered in Hannan (1975), and Rydell and Everingham (1994). 19, 20 Fujii uses a relapse rate to adjust downward the expected benefits of heroin treatment. For detoxification, methadone maintenance as well as imprisonment and parole, a 12 percent annual rate of decay (patients re-addicted) is used once patients are released into the community.…”

Section: Introductionmentioning

confidence: 99%

Cost-benefit analysis of drug treatment services: review of the literature

Cartwright

2000

J. Mental Health Policy Econ.

120

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Background: How valuable is public investment in treatment for drug abuse and dependency in the real world of everyday practice? Does drug abuse treatment provide benefits and how are they valued? What are the costs of obtaining outcomes and benefits? Cost-benefit analysis attempts to answer these questions in a standard analytic framework. Aims: This paper reviews cost-benefit analyses with scientific merit so that analysts will have a current picture of the state of the research. It will also give public decision-makers information with regards to the available evidence for policy purposes. Method: Bibliographic searches were performed. Studies were obtained through the assistance of the Parklawn Health Library system, a component of the US Public Health Service. Selected studies were from the scientific literature with the exception of eight studies published as governmental reports. Results: Cost-benefit studies have fallen into the following categories: (i) planning models for delivery systems in states and cities; (ii) short-term follow-up studies of individuals, (iii) single individual programs and (iv) state system's monitoring of outcomes. In 18 cost-benefit studies, a persistent finding is that benefits exceed costs, even when not all benefits are accounted for in the analysis. Much variation is found in the implementation of costbenefit methods, and this is detailed across discussions of effectiveness, benefits and costs. Studies have emphasized the cost savings to society from the reduction in external costs created by the behavioral consequences of addiction and drug use. Discussion: Economic analysis of drug treatment requires sophisticated conceptualization and measurement. Cost-benefit analysis of drug treatment has been a significant analytical exercise since the early 1970s when the public drug treatment system was founded in the United States. Conclusion: Drug abuse treatment services may be considered as contributing positive economic returns to society. However, considerable work needs to be done to standardize methods used in the studies. A striking area of omission is the absence of studies for adolescents and only one for women in treatment. Implications for Health Care Provision and Use: Finding a positive net social benefit should assist policy-makers with decisions related to drug abuse treatment expenditures.

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“…The ratio 1/(a + b) is the average dwell time in the low-intensity use state; ratio b/(a + b) gives the proportion of initiates who escalate to high-intensity use; and ratio 1/g is the average dwell time in the high-intensity use state. 5 5 Dwell time is distributed as a geometric random variable whose mean is the reciprocal of the probability of leaving at the end of any given period. When there are two ways to leave a state -escalation or desistance in this case -the probability of leaving in each way is the probability of leaving that way in any given period divided by the sum of those probabilities for all ways of leaving.…”

Section: Flow Rate Parameter Estimationmentioning

confidence: 99%

“…Important policy-relevant insights emerge directly from these parameters plus some simple calculations [4]. Also, full-scale systems studies that provide more refined insights concerning the cost-effectiveness of various policy interventions [5][6][7][8][9] depend on estimates of such epidemic demand parameters. Hence, modeling drug demand is a fundamental contribution toward developing a coherent, quantitative approach to managing a nation's drug problems.…”

Section: Introductionmentioning

confidence: 99%

Markov Chain Modeling of Initiation and Demand: The Case of the US Cocaine Epidemic

Caulkins

Behrens

Knoll

et al. 2004

Health Care Manage Sci

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Everingham and Rydell's Markov chain model of cocaine demand is modified and updated in light of recent data. Key insights continue to hold, e.g., that the proportion of cocaine demand stemming from heavy vs. light users changed dramatically over the 1980s. New insights emerge, e.g., pertaining to the average duration of a career of heavy use (about 12 years) and the negative relationship between levels of heavy use and epidemic "infectivity" or the number of new initiates per current user per year. This illustrates how simple modeling can yield insights directly relevant to managing complex drug control policy questions.

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Controlling Cocaine: Supply Versus Demand Programs

Cited by 174 publications

References 17 publications

Continuous exposure to the competitive N-methyl-d-aspartate receptor antagonist, LY235959, facilitates escalation of cocaine consumption in Sprague–Dawley rats

Continuous exposure to the competitive N-methyl-d-aspartate receptor antagonist, LY235959, facilitates escalation of cocaine consumption in Sprague–Dawley rats

Cost-benefit analysis of drug treatment services: review of the literature

Markov Chain Modeling of Initiation and Demand: The Case of the US Cocaine Epidemic

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