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U.S. Sentencing Commission Authorizes Delayed Retroactive Sentence Reductions for Drug Offenders

July 19, 2014 Comments off

U.S. Sentencing Commission Authorizes Delayed Retroactive Sentence Reductions for Drug Offenders (PDF)
Source: United States Sentencing Commission

On July 18, 2014, the Commission voted unanimously to apply a reduction in the sentencing guideline levels applicable to most federal drug trafficking offenders retroactively. Unless Congress disapproves the amendment, beginning November 1, 2014, eligible offenders can ask courts to reduce their sentences. Offenders whose requests are granted by the courts can be released no earlier than November 1, 2015.

+ Retroactivity Amendment and Synopsis (PDF)
+ Chair’s Remarks on Retroactivity Vote (PDF)
+ Public Comment on Retroactivity
+ Impact Analysis: Retroactive Application of 2014 Drug Guidelines Amendment (PDF)
+ Recidivism Analysis: Offenders Receiving Retroactive Sentence Reductions (PDF)

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Decline in Drug Overdose Deaths After State Policy Changes — Florida, 2010–2012

July 15, 2014 Comments off

Decline in Drug Overdose Deaths After State Policy Changes — Florida, 2010–2012
Source: Morbidity and Mortality Weekly Report (CDC)

During 2003–2009, the number of deaths caused by drug overdose in Florida increased 61.0%, from 1,804 to 2,905, with especially large increases in deaths caused by the opioid pain reliever oxycodone and the benzodiazepine alprazolam (1). In response, Florida implemented various laws and enforcement actions as part of a comprehensive effort to reverse the trend. This report describes changes in overdose deaths for prescription and illicit drugs and changes in the prescribing of drugs frequently associated with these deaths in Florida after these policy changes. During 2010–2012, the number of drug overdose deaths decreased 16.7%, from 3,201 to 2,666, and the deaths per 100,000 persons decreased 17.7%, from 17.0 to 14.0. Death rates for prescription drugs overall decreased 23.2%, from 14.5 to 11.1 per 100,000 persons. The decline in the overdose deaths from oxycodone (52.1%) exceeded the decline for other opioid pain relievers, and the decline in deaths for alprazolam (35.6%) exceeded the decline for other benzodiazepines. Similar declines occurred in prescribing rates for these drugs during this period. The temporal association between the legislative and enforcement actions and the substantial declines in prescribing and overdose deaths, especially for drugs favored by pain clinics, suggests that the initiatives in Florida reduced prescription drug overdose fatalities.

CRS — Domestic Federal Law Enforcement Coordination: Through the Lens of the Southwest Border

July 8, 2014 Comments off

Domestic Federal Law Enforcement Coordination: Through the Lens of the Southwest Border (PDF)
Source: Congressional Research Service (via U.S. State Department Foreign Press Center)

Federally led law enforcement task forces and intelligence information sharing centers are ubiquitous in domestic policing. They are launched at the local, state, and national levels and respond to a variety of challenges such as violent crime, criminal gangs, terrorism, white-collar crime, public corruption, even intelligence sharing. This report focuses on those task forces and information sharing efforts that respond to federal counterdrug and counterterrorism priorities in the Southwest border region. More generally, the report also offers context for examining law enforcement coordination. It delineates how this coordination is vital to 21st century federal policing and traces some of the roots of recent cooperative police endeavors.

Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines — United States, 2012

July 3, 2014 Comments off

Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines — United States, 2012
Source: Morbidity and Mortality Weekly Report (CDC)

Background:
Overprescribing of opioid pain relievers (OPR) can result in multiple adverse health outcomes, including fatal overdoses. Interstate variation in rates of prescribing OPR and other prescription drugs prone to abuse, such as benzodiazepines, might indicate areas where prescribing patterns need further evaluation.

Methods:
CDC analyzed a commercial database (IMS Health) to assess the potential for improved prescribing of OPR and other drugs. CDC calculated state rates and measures of variation for OPR, long-acting/extended-release (LA/ER) OPR, high-dose OPR, and benzodiazepines.
Results: In 2012, prescribers wrote 82.5 OPR and 37.6 benzodiazepine prescriptions per 100 persons in the United States. State rates varied 2.7-fold for OPR and 3.7-fold for benzodiazepines. For both OPR and benzodiazepines, rates were higher in the South census region, and three Southern states were two or more standard deviations above the mean. Rates for LA/ER and high-dose OPR were highest in the Northeast. Rates varied 22-fold for one type of OPR, oxymorphone.

Conclusions:
Factors accounting for the regional variation are unknown. Such wide variations are unlikely to be attributable to underlying differences in the health status of the population. High rates indicate the need to identify prescribing practices that might not appropriately balance pain relief and patient safety.

Implications for Public Health:
State policy makers might reduce the harms associated with abuse of prescription drugs by implementing changes that will make the prescribing of these drugs more cautious and more consistent with clinical recommendations.

UN World Drug Report 2014

July 2, 2014 Comments off

World Drug Report 2014
Source: United Nations
From press release (PDF):

Drug use prevalence is stable around the world, according to the 2014 World Drug Report of the United Nations Office on Drugs and Crime (UNODC), with around 243 million individuals, or 5 per cent of the world’s population aged 15- 64 having used an illicit drug in 2012. Problem drug users meanwhile numbered about 27 million, roughly 0.6 per cent of the world’s adult population, or 1 in every 200 people.

Not an ‘Ebay for Drugs': The Cryptomarket ‘Silk Road’ as a Paradigm Shifting Criminal Innovation

June 6, 2014 Comments off

Not an ‘Ebay for Drugs': The Cryptomarket ‘Silk Road’ as a Paradigm Shifting Criminal Innovation
Source: Social Science Research Network

The online cryptomarket Silk Road has been oft-characterised as an ‘eBay for drugs’ with customers drug consumers making personal use-sized purchases. Our research demonstrates that this was not the case. Using a bespoke web crawler, we downloaded all drugs listings on Silk Road in September 2013. We found that a substantial proportion of transactions on Silk Road are best characterised as ‘business-to-business’, with sales in quantities and at prices typical of purchases made by drug dealers sourcing stock. High price-quantity sales generated between 31-45% of revenue, making sales to drug dealers the key Silk Road drugs business. As such, Silk Road was what we refer to as a transformative, as opposed to incremental, criminal innovation. With the key Silk Road customers actually drug dealers sourcing stock for local street operations, we were witnessing a new breed of retail drug dealer, equipped with a technological subcultural capital skill set for sourcing stock. Sales on Silk Road increased from an estimate of $14.4 million in mid 2012 to $89.7 million by our calculations. This is a more than 600% increase in just over a year, demonstrating the demand for this kind of illicit online marketplace. With Silk Road functioning to considerable degree at the wholesale/broker market level, its virtual location should reduce violence, intimidation and territorialism. Results are discussed in terms of the opportunities cryptomarkets provide for criminologists, who have thus far been reluctant to step outside of social surveys and administrative data to access the world of ‘webometric’ and ‘big data’.

Outbreaks of Infections Associated With Drug Diversion by US Health Care Personnel

June 5, 2014 Comments off

Outbreaks of Infections Associated With Drug Diversion by US Health Care Personnel (PDF)
Source: Mayo Clinic Proceedings

Objective
To summarize available information about outbreaks of infections stemming from drug diversion in US health care settings and describe recommended protocols and public health actions.

Patients and Methods
We reviewed records at the Centers for Disease Control and Prevention related to outbreaks of infections from drug diversion by health care personnel in US health care settings from January 1, 2000, through December 31, 2013. Searches of the medical literature published during the same period were also conducted using PubMed. Information compiled included health care setting(s), infection type(s), specialty of the implicated health care professional, implicated medication(s), mechanism(s) of diversion, number of infected patients, number of patients with potential exposure to blood-borne pathogens, and resolution of the investigation.

Results
We identified 6 outbreaks over a 10-year period beginning in 2004; all occurred in hospital settings. Implicated health care professionals included 3 technicians and 3 nurses, one of whom was a nurse anesthetist. The mechanism by which infections were spread was tampering with injectable controlled substances. Two outbreaks involved tampering with opioids administered via patient-controlled analgesia pumps and resulted in gram-negative bacteremia in 34 patients. The remaining 4 outbreaks involved tampering with syringes or vials containing fentanyl; hepatitis C virus infection was transmitted to 84 patients. In each of these outbreaks, the implicated health care professional was infected with hepatitis C virus and served as the source; nearly 30,000 patients were potentially exposed to blood-borne pathogens and targeted for notification advising testing.

Conclusion
These outbreaks revealed gaps in prevention, detection, and response to drug diversion in US health care facilities. Drug diversion is best prevented by health care facilities having strong narcotics security measures and active monitoring systems. Appropriate response includes assessment of harm to patients, consultation with public health officials when tampering with injectable medication is suspected, and prompt reporting to enforcement agencies.

See also press release: CDC Report: Patients Harmed After Health Care Providers Steal Patients’ Drugs

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