Essays on Regulating Pain and Pleasure

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Psychoactive substances play an important role in modern society. They can be of therapeutic value, but their abuse by individuals remains an important policy challenge. Changes in technology and medicine, coupled with evolving norms surrounding the use of psychoactives, have altered much of the drug policy landscape in the last two decades. Currently, the opioid overdose crisis is one of the most challenging public health problems facing state and local jurisdictions. Excessive supply of prescription medications and the arrival of new synthetic opioids, often designed to circumvent regulatory control, have been linked to a tens of thousands of fatal overdoses in the United States in recent years. Advances in chemistry and trade contribute to the recent increase in number of new psychoactive substances (NPS) that mimic controlled drugs, overwhelming many regulatory systems. At the same time, an increasing number states in the US have started to relax access to cannabis for medical and recreational purposes.

The following three essays explore questions related to contemporary drug policy. Chapter 2 quantitatively assesses the relationship between the design of prescription drug monitoring programs (PMPs) and opioid overdose-related outcomes. The analysis departs from a dichotomous specification found in much of the literature and shows that robustness of policy design is negatively associated with prescription opioid overdose-related outcomes.

Chapter 3 provides a comprehensive and theoretical analysis of how jurisdictions across the globe have approached new psychoactive substances (NPS). It includes a conceptual framework for regulating new substances, assesses the market drivers behind NPS, and offers some considerations regarding policy evaluations going forward.

Chapter 4 applies some of the analytical considerations in Chapter 3 to empirically assess the relationship between cannabis and its synthetic analogs. Using two years of data for all fifty states, I quantitatively explore the relationship between legal access to medical cannabis and exposure to cannabimimetics, showing that there may be a substitution effect. I end with a summary chapter of policy implications and avenues for future research.