evidence based drug policy? …..not yet in italy carla rossi illicit drug market institute e...
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Evidence based drug policy?…..Not yet in Italy
Carla RossiIllicit Drug Market Institute
eConsiglio Italiano per le Scienze Sociali
12 ottobre 2010, Università Commerciale Luigi Bocconi, Milano
Consiglio italianoper le Scienze Sociali
After the white books CSS and IDM…
• EU projects:• New methodological tools for policy and
programme evaluation (February 2011-February 2013)
• Study on the further analysis of the EU illicit drugs market and responses to it – responding to future challenges (September 2011-November 2012)
Evidences
• Several new data bases have been acquired and new methods of analysis have been developed in the framework of the two EU projects.
• These new tools allow assessment and evaluation of drug policies and interventions.
• Various different approaches have been compared: Italian, Portuguese, Czech, Swedish, Dutch.
• Some “best practices” can be identified.
The size of the Italian market• First the size of the hidden population of street
dealers has been estimated on the basis of two different data bases: the data base of the persons registered for dealing and the data base of the persons incarcerated for drug dealing (in both cases the individuals breached art. 73 of the drug law). The reference to the various substances was possible using the information on police operations and seizures provided by the Directorate of Anti Drug Services (DCSA).
• From the two data bases quite similar estimates have been obtained.
Estimates of the size of the dealers populationyear Zero-truncated Model 95%CI
2005
Chao 351890 339168-365159Chao (covariates) 352129 339379-365428Zelterman 353566 340367-367351Zelterman (covariates) 353806 340579-367621Negative Binomial (covariates) 305418 295589-315246
2006
Chao 351780 339717-364338Chao (covariates) 353208 340973-365950Zelterman 353530 340988-366603Zelterman (covariates) 354962 342249-368220Negative Binomial (covariates) 304491 295211-313770
2007
Chao 372523 360141-385396Chao (covariates) 372613 360222-385496Zelterman 374446 361570-387851Zelterman (covariates) 374541 361655-387957Negative Binomial (covariates) 319456 310129-328781
2008
Chao 384885 372499-397748Chao (covariates) 385940 373437-398928Zelterman 386584 373706-399976Zelterman (covariates) 387648 374652-401166Negative Binomial (covariates) 339503 329725-349280
2009
Chao 385365 372499-397748Chao (covariates) 387056 373599-401068Zelterman 386684 372953-400994Zelterman (covariates) 388372 374436-402902Negative Binomial (covariates) 349281 338218-360344
Estimates from the prison population data set
Zelterman estimate for 2007 from the other data set was: 374,541 and Chao was: 372,613
For 2008 Zelterman was: 387,648 and Chao was: 385,940
Estimates from prison data set are inside the confidence intervals of the estimates from the other data set.
Adjustments
• Part time dealing (from literature 6 months a year);
• Different capture rates per substance (seizure data and literature);
• Dealer population not at risk for only cannabis dealing (from literature).
Consumer population estimation
SubstanceEstimated active dealers
Ratio (Reuter)
Ratio (Bouchard & Tremblay) Estimated
active consumers (Reuter)
Estimated active consumers (Bouchard & Tremblay)
Average
Cannabis 143,700 4032 5,748,000 4,598,400 5,173,200
Cocaine 56,600 2528 1,415,000 1584,800 1,499,900
Opiates 47,000 1516 705,000 752,000 728,500
Total247,300
These estimates are affected by double counting for poly-use and poly-dealing
Market estimation (supply side)
SubstanceEstimated active dealers
Median number of doses sold per week of activity
Sample size dose
Mean price per dose
Sample size price
Total amount (billion euro)
Cannabis 143,700 10091 10 351
7.472
Cocaine 56,600 50164 75 387 11.037
Opiates 47,000 50156 35 504 4.277
Total 247,300 22.786
Market estimation (demand side)
SubstanceEstimated active consumers
Average number of doses per month per person
Mean price per dose
Total amount (billion euro)
Cannabis 5,173,200 10 10 6.208
Cocaine 1,499,907 9 75 12.149
Opiates 728,500 15 35 4.590
Total 7,401,607 22.947
Estimation of the cannabis market from other sources (Transcrime)
• Transcrime estimates of consumers: 7,280,000• 50% occasional, • 21% regular, • 29% intensive• Average number of doses per month=12• Price per dose (average)=10 euro• Estimate of the cannabis market=
7,280,000*10*12 *12 billion euro=10.483.
• Estimates of consumers: 5,173,200• 55% occasional (50%)• 23% regular (21%)• 22% intensive (29%)• Average grams consumed per year• Occasional: 7.9• Regular: 107.4• Intensive: 352.3• Total value of the market=
5,173,200(0.55*7.9+0.23*107.4+352.3*0.22)*10=5.512 billion euro (6.656 billion euro)
Estimation of the cannabis market from other sources (Study on the further analysis of the EU illicit drugs market and responses to it – responding to future challenges)
Interception rate (Italy 2011)
Interception rate for cannabis= 19.32% (with plants)Intercepton rate for cannabis= 5.35% (without plants)
Seizures 2011
SubstanceAmount (Kgs)
unit price wholesale (euro)
Total (million euro)
value retail market (million euro)
Ratio(value sized/value of the retail market)
cocaine 6,346.3 39,000 247,505.700 12,149,000 0.020heroin 810 24,700 20,007 4,509,000 0.004marjuana 10,907.88 1,360 14,834.717 hashish 20,257.57 2,200 44,566.654 Plants (in Kgs of product) 1,008,22.8 1,360 137,119.008 6,208,000 0.032
Total 464,033.079 22,866,000 0.028
Age at onset of cannabis use and problem drug use
• It is often mentioned that starting earlier consuming drugs (for about 75% the first drug used is cannabis) is a risk factor for the use of more harmful substances.
• We had the possibility to analyse two different sets of data: the data from the survey among PDUs and the web-survey on cannabis users (mostly non problematic) and to compare the proportions of first use of cannabis before 15 years of age for Italy and Portugal.
CAST scores for the web-survey (7=moderate dep; 12=severe dep)
Occasional Regular Intensive
Czech Republic
Mean 4.1 6.3 9.0
Median 3.0 6.0 8.0
Italy Mean 4.2 6.7 7.9
Median 4.0 6.0 8.0
Portugal Mean 3.8 6.5 9.6
Median 4.0 6.0 9.0
Median 4.0 7.0 9.0
ODD’S RATIO Italy Males <15 15≤ TotalWeb 180 633 813Survey 202 221 423Total 382 854 1236
OR=3.2143 p=0.00000
Italy Females <15 15≤ TotalWeb 47 189 236Survey 32 34 66Total 79 223 302
OR=3.7847 p=0.00052
Portugal Males
<15 15≤ Total
Web 20 77 97
Survey 107 139 246
Total 127 216 343
OR=2.9637 p=0.0011
Portugal Females
<15 15≤ Total
Web 7 47 54
Survey 20 25 45
Total 27 72 99
OR=5.3714 p=0.0055
Remarks
• Law enforcement interventions seems to produce quite negligible damages to the drug traffickers. Hsi is also confirmed by the stable or decreasing behaviour of the prices.
• New and new substances are offered on the market. These substances are not illicit until their
• Effects are not assessed. In the first months of 2012 more than 100 new substnes have been detected.
• What about the outcomes of less repressive policies such as the Portuguese one? Is it true that this approach might push more young people to star consuming?
Incidence indicators
• Indicators based on incidence are the most appropriate for evaluation of policies and interventions.
• It is generally recognised that early use of cannabis is associated with higher risk of harmful use of other substances.
• Thus it is important to estimate incidence of cannabis use among teenagers. This can be obtained by combining various sources of information.
Estimating incidence from prevalence
• Denote by g(a) the density function and G(a) the (cumulative) distribution function of the age at first use of a specific substance.
• Denote by P(a,t) the prevalence of users aged a at time t.
• The expected number of subjects of the population P(a,t) who started using that substance at time t is denoted by I(a,t).
Estimating incidence from prevalence
• I(a,t) can be estimated by multiplying the prevalence P(a,t) by the probability of onset at age a g(a) given that the age at onset is not higher than a G(a):
)(
)(),(),(
aG
agtaPtaI
P(a,t), G(a), g(a) and I(a,t) among teenagers in Italy (2012)
Age
g(a): source web-survey on cannabis
use
G(a)P(a,t): source
SPS and demographic
data I(a,t)
15 0.22 0.438 25,983 13,133
16 0.21 0.652 59,023 19,415
17 0.14 0.793 84,435 15,020
18 0.10 0.890 101,725 11,109
19 0.04 0.931 110,712 4,873
Total 381,878 63,550
About incidence
• Overall the incident cases among teenagers aged 15-19 are about 17% of the prevalent cases.
• I(15,t)/P(15,t)>0.5 is the highest value and corresponds to the mode of the onset age distribution.
• The minimum value of the ratio is for a=19:• I(19,t)/P(19,t)<0.05.
Example: estimate for Portugal
Age
P(a,t): source estimates from ESPAD Study
g(a): source web-survey on cannabis use G(a) I(a,t)
15 4,800 0.11 0.29 1,821
16 9,200 0.27 0.56 4,436
17 11,600 0.16 0.72 2,578
18 15,700 0.14 0.86 2,556
Total 41,300 11,390
Remarks• In the case of Portugal the ratio
incidence/prevalence for ages 15-18 is 0.28.• If ages 15-18 are considered for Italy, the ratio
is 0.22.• The difference is due to the onset age
distributions.• In Italy the proportion of those who start
before 15 is higher than in Portugal (22% versus 21% for males and 20% versus 13% for females).
White books
• AA.VV., “Act upon the market to fight the illicit drug industry”, IDM editions, 2010.
• Rey G.A., Rossi C., Zuliani A., “Il mercato delle droghe: dimensione, protagonisti, politiche”, Marsilio Editori, Venezia, 2011.
Thank you very much
•Comments, questions?