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Shifting North American drug markets and challenges for the system of care Krausz, Michael, MD, PhD, FRCPc; Westenberg, Jean; Mathew, Nickie; Budd, George; Wong, James S. H.; Tsang, Vivian; Vogel, Marc; King, Conor; Seethapathy, Vijay; Jang, Kerry L. (Kerry Leslie), 1962-; Choi, Fiona

Abstract

Drug markets are dynamic systems which change based on demand, competition, legislation and revenue. Shifts that are not met with immediate and appropriate responses from the healthcare system can lead to public health crises with tragic levels of morbidity and mortality, as experienced Europe in the early 1990s and as is the case in North America currently. The major feature of the current drug market shift in North America is towards highly potent synthetic opioids such as fentanyl and fentanyl analogues. An additional spike in stimulant use further complicates this issue. Without understanding the ever-changing dynamics of drug markets and consequent patterns of drug use, the healthcare system will continue to be ineffective in its response, and morbidity and mortality will continue to increase. Economic perspectives are largely neglected in research and clinical contexts, but better treatment alternatives need to consider the large-scale macroeconomic conditions of drug markets as well as the behavioural economics of individual substance use. It is important for policy makers, health authorities, first responders and medical providers to be aware of the clinical implications of drug market changes in order to best serve people who use drugs. Only with significant clinical research, a comprehensive reorganization of the system of care across all sectors, and an evidence-driven governance, will we be successful in addressing the challenges brought on by the recent shifts in drug markets.

Item Metadata

Title
Shifting North American drug markets and challenges for the system of care
Creator
Krausz, Michael, MD, PhD, FRCPc; Westenberg, Jean; Mathew, Nickie; Budd, George; Wong, James S. H.; Tsang, Vivian; Vogel, Marc; King, Conor; Seethapathy, Vijay; Jang, Kerry L. (Kerry Leslie), 1962-; Choi, Fiona
Contributor
British Columbia Centre on Substance Use; Provincial Health Services Authority (B.C.); University of British Columbia. Addictions and Concurrent Disorders Research Group
Publisher
BioMed Central
Date Issued
2021-12-20
Description
Drug markets are dynamic systems which change based on demand, competition, legislation and revenue. Shifts that are not met with immediate and appropriate responses from the healthcare system can lead to public health crises with tragic levels of morbidity and mortality, as experienced Europe in the early 1990s and as is the case in North America currently. The major feature of the current drug market shift in North America is towards highly potent synthetic opioids such as fentanyl and fentanyl analogues. An additional spike in stimulant use further complicates this issue. Without understanding the ever-changing dynamics of drug markets and consequent patterns of drug use, the healthcare system will continue to be ineffective in its response, and morbidity and mortality will continue to increase. Economic perspectives are largely neglected in research and clinical contexts, but better treatment alternatives need to consider the large-scale macroeconomic conditions of drug markets as well as the behavioural economics of individual substance use. It is important for policy makers, health authorities, first responders and medical providers to be aware of the clinical implications of drug market changes in order to best serve people who use drugs. Only with significant clinical research, a comprehensive reorganization of the system of care across all sectors, and an evidence-driven governance, will we be successful in addressing the challenges brought on by the recent shifts in drug markets.
Subject
Drug markets; Drug policy; Fentanyl; Overdose; Public health crisis
Genre
Article
Type
Text
Language
eng
Date Available
2022-01-18
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0406293
URI
http://hdl.handle.net/2429/80673
Affiliation
Medicine, Faculty of; Non UBC; Psychiatry, Department of
Citation
International Journal of Mental Health Systems. 2021 Dec 20;15(1):86
Publisher DOI
10.1186/s13033-021-00512-9
Peer Review Status
Reviewed
Scholarly Level
Faculty; Other
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
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Rights

Attribution 4.0 International (CC BY 4.0)