The challenges associated with the prevention of smuggling and counterfeiting health goods in Iran.

BACKGROUND: Smuggling health goods given the importance and critical nature of health services should be undeniably addressed and controlled by all countries. This issue is especially more widespread in developing countries with more damaging consequences. This paper therefore aims to identify and analyze the challenges of preventing smuggling of health goods in Iran. METHOD: Within this qualitative study, we conducted face-to-face, semi-structured interviews with 30 purposefully recruited key informants and stakeholders in the detection, prevention, and combating of health goods smuggling. Each interview was analyzed thematically, using an inductive approach to generate codes, then categorized and presented in the form of main themes and sub-themes. Maxqda 11 assisted in coding, analysis, and data management. RESULTS: Three main themes emerged representing the challenges of prevention of smuggling in Iran in the areas of anti-smuggling policy development, including categories of inefficient policy and plan, and failure to reach agenda; policy implementation; categorized into actors, resources and instruments, and implementation guarantee; and finally monitoring and evaluation; including, procedures and practices, and the role of surveyors. CONCLUSION: Prevention of smuggling health goods proves to be a highly complex, challenging, and multi-faceted practice. Therefore, strengthening policy-making, regulatory frameworks, and facilitation functions about smuggling, counterfeiting, and corruption should be promoted in parallel.

Modeling Opioid Abuse: A Case Study of the Opioid Crisis in New England.

For the past two decades, the USA has been embroiled in a growing prescription drug epidemic. The ripples of this epidemic have been especially apparent in the state of Maine, which has fought hard to mitigate the damage caused by addiction to pharmaceutical and illicit opioids. In this study, we construct a mathematical model of the opioid epidemic incorporating novel features important to better understanding opioid abuse dynamics. These features include demographic differences in population susceptibility, general transmission expressions, and combined consideration of pharmaceutical opioid and heroin abuse. We demonstrate the usefulness of this model by calibrating it with data for the state of Maine. Model calibration is accompanied by sensitivity and uncertainty analysis to quantify potential error in parameter estimates and forecasts. The model is analyzed to determine the mechanisms most influential to the number of opioid abusers and to find effective ways of controlling opioid abuse prevalence. We found that the mechanisms most influential to the overall number of abusers in Maine are those involved in illicit pharmaceutical opioid abuse transmission. Consequently, preventative strategies that controlled for illicit transmission were more effective over alternative approaches, such as treatment. These results are presented with the hope of helping to inform public policy as to the most effective means of intervention.

The responsiveness of criminal networks to intentional attacks: Disrupting darknet drug trade.

Physical, technological, and social networks are often at risk of intentional attack. Despite the wide-spanning importance of network vulnerability, very little is known about how criminal networks respond to attacks or whether intentional attacks affect criminal activity in the long-run. To assess criminal network responsiveness, we designed an empirically-grounded agent-based simulation using population-level network data on 16,847 illicit drug exchanges between 7,295 users of an active darknet drug market and statistical methods for simulation analysis. We consider three attack strategies: targeted attacks that delete structurally integral vertices, weak link attacks that delete large numbers of weakly connected vertices, and signal attacks that saturate the network with noisy signals. Results reveal that, while targeted attacks are effective when conducted at a large-scale, weak link and signal attacks deter more potential drug transactions and buyers when only a small portion of the network is attacked. We also find that intentional attacks affect network behavior. When networks are attacked, actors grow more cautious about forging ties, connecting less frequently and only to trustworthy alters. Operating in tandem, these two processes undermine long-term network robustness and increase network vulnerability to future attacks.

Evaluation of two 13-loci STR multiplex system regarding identification and origin discrimination of Brazilian Cannabis sativa samples.

According to the Brazilian Federal Police (BFP), the Brazilian Cannabis sativa illicit market is mainly supplied by drugs originated from Paraguay and Northeastern Brazil (Marijuana Polygon region). These two known routes, the increasing indoor cultivations (supported by online market), and drugs from Uruguay are also in BFP's sight. Forensic tools to aid police intelligence were published in the past years. In genetics, microsatellites have gained attention due to their individualization capability. This study aims to evaluate the effectiveness and efficiency of two STR multiplex systems previously proposed in 94 Cannabis sativa samples seized in Brazil. Principal coordinate analyses (PCoA), forensic parameters, and genetic structure analysis were executed. Both panels were effective in individualizing and origin discriminating all samples, and the system proposed in 2015 demonstrated better results. For this marker set, the probability of identity for a random individual is approximately one in 65 billion; also, the PCoA shows a clear genetic distinction among samples according to its origin. Bayesian inference populational structure analysis indicated a significant genetic diversity among seizure groups, matching with its origin. Overall, the STR multiplex systems were able to achieve its purpose in individualizing and differentiating, according to geographic region, Brazilian Cannabis sp. samples.

Legislation targeting head shops selling new psychoactive substances and changes in drug-related psychiatric admissions: A national database study.

AIM: New psychoactive substance (NPS) use can negatively impact mental health and may result in drug-related psychiatric admissions (DRPA). Irish youth reported very high rates of NPS use by international standards, the most common being synthetic cannabinoids and cathinones. This occurred in the context of a rapid expansion in specialist high street shops, called head shops, selling NPS in 2010. Government responded to public protests about head shops by enacting legislation in May and August 2010 to end this trade. Many academics argued that such actions were futile. We sought to determine if changes in head shop activity coincided with changes in DRPA. METHOD: The national database on psychiatric admissions was examined focusing on young adults admitted from 2008 to 2012. Joinpoint regression analysis was utilized to examine for the presence of trend changes in DRPA. RESULTS: The monthly rate of DRPA was higher in 2010 than 2008, 2009 and 2012 (P < 0.01). Joinpoint regression analysis identified a significant downward trend change which occurred in July 2010 (95% CI Feb 2010 to April 2011). Young males aged 18 to 24 years showed evidence of greatest change, DRPA falling by 1.4% per month (95% CI 0.7 to 3.7% decline) from May 2010 to December 2012. CONCLUSIONS: Cessation of NPS sale by head shops coincided with a reversal in the upward trend of DRPA, this change being most evident in young men. While correlation does not imply causation, legislation which successfully targets the sale of NPS may result in reduced drug-related mental disorders.

Education to legality and doping.

When planning actions to prevent doping in the general population, public health operators may collide against the interests of criminal organizations involved in illicit trafficking of drugs. In addition to technical and professional expertise, or clinical and pharmacological skills, also a deep knowledge of legal and social issues is strongly required to face the problem and assure the effectiveness of the preventive actions. Sports competitions, athletes training or adapted physical activity may all represent conditions and environments at risk for misusing or abusing drugs and dietary supplements. A correct approach to sport and physical activity implies respect of competition rules, attention to own body limits and knowledge of risk factors. Health education campaigns and preventive actions should also consider education to legality in the different settings. The comprehension of the complex net that is available to access doping, locally or globally through online Internet sites, is essential as well as the awareness of the huge economic burden of crime interests behind the illicit trafficking of drugs. A modern whole rounded approach needs to consider doping not only as a violation of sport rules but also of the own body health, representing almost a form of addiction involving individuals and communities, and being supported by crime. Within this frame, doping is considered not just as a sport violation or a risk factor for individual's health, but as a disease of the society, in the society, against the society. A peculiar equilibrium seems to prevail between crime external pressures and resigned internal acceptance, according to the 'mafia hypothesis' model, where hosts accept parasitism to avoid retaliation. Here, main contributes and topics from the Erice 53rd Course are summarized and reviewed, providing links and references for further studies in the field. Health education and education to legality represent two sides of a same question, concerning both the general population and the health authorities. In conclusion, education to legality is a key component for prevention of doping and a priority for public health operators involved in protecting population health.

Drug-related community issues and the required interventions in open drug scenes in Tehran, Iran: a qualitative study protocol.

BACKGROUND AND OBJECTIVES: Many low-income and middle-income countries experience problems with open drug scenes and drug-related community issues (DRCIs). These experiences occur in settings with varying levels of health and law enforcement initiatives, and accordingly a range of approaches are implemented to curb the problem. Most of the published literature stems from Western and high-income societies. With this concern, the present study aims to describe a planned project to explore DRCIs in the open drug scenes of Tehran, including its typology, and predisposing and reinforcing factors. In addition, the study attempts to investigate the perceptions with respect to the required interventions and barriers to their accessibility. METHODS: To this end, the current study focuses on the Farahzad drug scene due to its structure and the difficult access to the scene by harm reduction providers. Data collection techniques encompass field observation, indepth interview and focus group discussion. Further, semistructured interviews are conducted with people who use drugs and other key informants who are engaged at this drug scene, including business, community, voluntary and statutory stakeholders, for an average of 90 min (average of 45 min for each part of the study). Furthermore, as a complementary method, field observation is performed regarding the themes of DRCIs at this scene. Then, focus group discussions are held to further describe the themes of DRCIs as well as to explore the required interventions, for an average of 90 min. Finally, the results are evaluated using qualitative content analysis. ETHICS AND DISSEMINATION: Ethical approval for the study was obtained from the Ethics Committee of Iran University of Medical Sciences, Iran. Additionally, participants are to provide written informed consent. The findings of the study are expected to play a role in promoting the current intervention.

International Control Efforts to Curb the Global Production and Trafficking of Fentanyl and Other Synthetic Opioids.

The purpose of this Policy Watch column is to provide a brief overview of the global problems associated with the illicit production and trafficking of synthetic opioids as well as international efforts and policy approaches designed to curb them. An in-depth evaluation of drug control efforts of many different nations is important for a comprehensive analysis. However, because of the vast amount of information available, this column is limited to cooperative global control efforts, not efforts specific to any one nation. A great deal of information about production methods, clandestine laboratories, international trafficking methods, and online sales over the dark Web has been omitted. It is important to understand key issues regarding the illicit cultivation and distribution of plant-based opioids derived from natural compounds found in opium poppies (heroin, opium, morphine, codeine) or other drugs (cocaine, methamphetamines, etc.), but the scope of this column is limited to discussion about synthetic opioids including fentanyl, fentanyl analogues, and fentanyl precursor chemicals. Issues about human rights and ethical considerations for nurses and other addictions professionals are also discussed.

A drug court by any other name? An analysis of problem-solving court programs.

Beginning with the original drug court model, specialized court programs (SCPs) have expanded to address a variety of offense-related problems, such as domestic violence courts, mental health courts, veteran courts, and homeless courts. To date, there has been no empirical assessment as to whether these types of court programs share similar program characteristics with the drug court model. To address this gap, we used data from the 2012 Census of Problem-Solving Courts of 2,793 problem-solving court programs in the United States to examine differences between drug courts and other court types. We used multinomial logistic regression to analyze program-level characteristics between SCPs and drug courts. SCPs were similar on several key characteristics to drug courts, such as specialization and services, staff training, and procedures. Where SCPs tend to differ were whether felony offenders were allowed, charges dismissed after program completion, and participants entering the program post-adjudication. Though they may go by different names, many SCPs continue to rely on the original drug court model. Future research within the drug court paradigm should consider expanding to other types of SCPs to provide more comprehensive knowledge on the "black box" of problem-solving courts and how courts can more effectively implement court programs. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Tobacco industry's elaborate attempts to control a global track and trace system and fundamentally undermine the Illicit Trade Protocol.

BACKGROUND: The Illicit Trade Protocol (ITP) requires a global track and trace (T&T) system to reduce tobacco smuggling. Given the tobacco industry's (TI) historical involvement in tobacco smuggling, it stipulates that T&T 'shall not be performed by or delegated to the tobacco industry'. This paper explores the rationale for & nature of the TI's effors to influence the ITP & its T&T system. METHODS: Analysis of leaked TI documents and publicly available data; ,investigation of front groups, trademark and patent ownership. FINDINGS: Growing & diverse sources of evidence indicate that the TI remains involved in tobacco smuggling and that TI cigarettes account for around two-thirds of the illicit cigarette market. The TI therefore has a vested interest in controlling the global T&T system aimed to curtail this behaviour. To this end, Philip Morris International (PMI) adapted its pack marker system, Codentify, to meet T&T requirements, licensed it for free to its three major competitors who then collectively promoted it to governments using front groups and third parties including companies claiming to be independent despite clear TI links. PMI also sought to suggest Codentify was independent by selling some parts of its intellectual property on Codentify while retaining others, leaving a complex web of shared interests. In Africa, British American Tobacco used payments to obtain data suggesting its smaller competitor companies were evading taxes and secure influence with tax authorities. Regulatory capture has been enhanced by a public relations effort involving TI funding for conferences, training, research, and international police and anti-corruption organisations. Collectively this has created public messaging and a powerful network of organisations supportive of the TI's misleading postion on illicit. CONCLUSIONS: Governments should assume the TI seeks to control T&T systems in order to avoid scrutiny and minimise excise tax payments and that any T&T system based on Codentify, on intellectual property currently or previously owned by the TI, or being promoted or implemented by companies with TI links, is incompatible with the ITP and would not serve to reduce illicit trade.

Operational impact of canine teams in the fight against drug trafficking in Colombia: review of their contribution, strategies and recent trends. / Impacto operacional de los equipos caninos en la lucha contra el narcotráfico en Colombia: una revisión de la contribución, estrategias y tendencias recientes.

As part of national and international cooperation to fight the drug-trafficking system, the Colombian National Police (PNC) has created institutional operational synergy to combat organised armed groups. To this end, it uses police service dog and handler teams which are distributed across Colombia in 75 canine units and which are specialised in different policing tasks. The focus of canine teams is to counter actions that undermine peaceful co-existence and citizen security by checking for explosive substances around coca, marijuana and poppy fields. In 2016, these teams discovered 16% of the 12,500 kg of improvised explosive devices, anti-personnel mines and unexploded ordnance (conventional guns and grenades) that were seized by the PNC. In addition, dogs have detected 19% of all controlled substances (cocaine, marijuana, heroin, coca paste and synthetic drugs) seized at ports, airports, land terminals and highways, striking a blow at drug-trafficking structures at all stages, from the illicit cultivation of drugs, through to their production, distribution, sale and use, countering small-scale dealing and the factors associated with drug-related social disorder. It is the responsibility of the PNC Police Service Dog and Handler Training School (ESGAC) to provide a framework for academic endeavour and technological advances aimed at achieving defined strategic roles for dog and handler teams. This involves the genetic selection and breeding of candidate detection dogs, assessment, training, operant conditioning, odour-discrimination during searches, certification, dog/ handler relationship, the dogs' living environment, and animal health, production and welfare management. All of the above is designed to achieve real, effective and successful outcomes when policing with dogs, enshrined within the national government's Vision 2030 project for safe and peaceful communities.

Dans le cadre de la coopération nationale et internationale contre les réseaux de trafic de stupéfiants, la police nationale de Colombie a mis en place une synergie opérationnelle institutionnelle contre les groupes armés organisés. Pour ce faire, elle recourt à des binômes d'intervention (un maître-chien et un chien) répartis en 75 unités cynotechniques sur tout le territoire colombien, spécialisés dans différentes tâches opérationnelles. La contribution des équipes cynotechniques consiste à neutraliser les activités qui menacent la cohabitation et la sécurité des citoyens, en détectant la présence de substances explosives aux alentours des champs de culture de cocaïne, cannabis et pavot, celles-ci ayant représenté 16 % des engins explosifs improvisés, mines antipersonnel et munitions non explosées (fusils et grenades conventionnelles) saisis par la police colombienne en 2016 sur un total de 12 500 kg. De surcroît, les chiens ont détecté 19 % du total des saisies de substances illicites (cocaïne, cannabis, héroïne, dérivés de cocaïne et drogues de synthèse) dans les ports, aéroports, gares routières et routes. Ceci atteint les structures du narcotrafic depuis les cultures illicites jusqu'à la production, la distribution, la commercialisation et la consommation tout en neutralisant le microtrafic ainsi que d'autres facteurs liés à la décomposition sociale due aux drogues. L'École de maîtres-chiens et de dressage de chiens de la Police colombienne prend en charge les efforts de formation ainsi que la recherche technologique afin que les fonctions stratégiques attribuées aux binômes soient réalisées avec succès. Ceci requiert la prise en compte de plusieurs aspects : la sélection génétique, la reproduction, les chiens potentiellement candidats pour être formés à la détection de drogue, l'évaluation, la formation, la gestion comportementale opérationnelle, la capacité de discriminer entre les odeurs lors des recherches, la certification, la relation entre le maître-chien et son chien, l'habitat, la gestion sanitaire et zootechnique ainsi que la protection du bien-être animal. Ces différents aspects sont destinés à garantir l'efficience et l'efficacité des résultats concrets obtenus par les services de la police cynophile dans le cadre de la stratégie institutionnelle 2030 « Pour des communautés sûres et en paix ¼.

En el marco de la cooperación nacional e internacional contra el sistema del narcotráfico, la policía nacional de Colombia (PNC) establece una sinergia operacional institucional contra los grupos armados organizados (GAO). Para ello, emplea binomios (guía-perro), distribuidos en forma de 75 unidades caninas por todo el territorio colombiano, especializadas en diferentes tareas del servicio. La contribución de los equipos caninos consiste en contrarrestar las acciones que afectan a la convivencia y seguridad ciudadana, controlando sustancias explosivas alrededor de los cultivos de cocaína, marihuana y amapola, en los cuales se ha logrado hallar un 16% de artefactos explosivos improvisados, minas antipersona y munición sin explotar (fusiles y granadas convencionales) de un total de 12 500 kg incautados por la PNC (año 2016). Además, los perros han detectado un 19% del total de las incautaciones de sustancias controladas (cocaína, marihuana, heroína, bazuco y drogas sintéticas) en puertos, aeropuertos, terminales terrestres y carreteras, golpeando así las estructuras narcotraficantes desde los cultivos ilícitos, la producción, la distribución, la comercialización y el consumo, y contrarrestando el microtráfico y los factores asociados a la descomposición social de las drogas. Son responsabilidad de la Escuela de Guías y Adiestramiento Canino de la institución los esfuerzos académicos y avances tecnológicos que propenden a lograr roles estratégicos definidos para los binomios, para los cuales son necesarios la selección genética, la cría, los perros detectores aspirantes, la evaluación, la formación, el manejo comportamental operativo, la discriminación de olores durante la búsqueda, la certificación, la relación guía perro, su hábitat, y el manejo sanitario, zootécnico y relativo al bienestar animal. Todo lo anterior va destinado a lograr resultados efectivos, eficientes y eficaces en el servicio de policía con caninos en el marco de la visión institucional 2030 «Comunidades Seguras y en Paz¼.

Effect of restricting the legal supply of prescription opioids on buying through online illicit marketplaces: interrupted time series analysis.

OBJECTIVE: To examine the effect on the trade in opioids through online illicit markets ("cryptomarkets") of the US Drug Enforcement Administration's ruling in 2014 to reschedule hydrocodone combination products. DESIGN: Interrupted time series analysis. SETTING: 31 of the world's largest cryptomarkets operating from October 2013 to July 2016. MAIN OUTCOME MEASURES: The proportion of total transactions, advertised and active listings for prescription opioids, prescription sedatives, prescription steroids, prescription stimulants, and illicit opioids, and the composition of the prescription opioid market between the US and elsewhere. RESULTS: The sale of prescription opioids through US cryptomarkets increased after the schedule change, with no statistically significant changes in sales of prescription sedatives, prescription steroids, prescription stimulants, or illicit opioids. In July 2016 sales of opioids through US cryptomarkets represented 13.7% of all drug sales (95% confidence interval 11.5% to 16.0%) compared with a modelled estimate of 6.7% of all sales (3.7% to 9.6%) had the new schedule not been introduced. This corresponds to a 4 percentage point yearly increase in the amount of trade that prescription opioids represent in the US market, set against no corresponding changes for comparable products or for prescription opioids sold outside the US. This change was first observed for sales, and later observed for product availability. There was also a change in the composition of the prescription opioid market: fentanyl was the least purchased product during July to September 2014, then the second most frequently purchased by July 2016. CONCLUSIONS: The scheduling change in hydrocodone combination products coincided with a statistically significant, sustained increase in illicit trading of opioids through online US cryptomarkets. These changes were not observed for other drug groups or in other countries. A subsequent move was observed towards the purchase of more potent forms of prescription opioids, particularly oxycodone and fentanyl.

Oncology drugs in the crosshairs of pharmaceutical crime.

Oncology drugs clearly have become a target for pharmaceutical crime. In 2016, falsified oncology drugs ranked fifth in the most commonly falsified drug category among the reports received by the Pharmaceutical Security Institute. Although the prevalence of illicit oncology drugs in the legal supply chains appears to be small, these drugs are difficult to detect, particularly in clinical practice. Forthcoming countermeasures to detect illicit drugs in high-income countries include compulsory antitampering devices and product verification technology for a risk-based selection of medicines. Health-care professionals must implement these new procedures into their workflow and remain vigilant about those medicines that are not selected. Although countermeasures should firmly tighten supply chain security, there are concerns about how quickly pharmaceutical crime will adapt to these protections. Because patients and health-care professionals have shown a lenient attitude towards purchasing medicines from unreliable sources, measures against the highly accessible illegal medicine supply chain remain necessary. To improve detectability in clinical practice, reporting of ineffectiveness and unusual drug effects as adverse events or adverse drug reactions is essential.

Kingpin approaches to fighting crime and community violence: Evidence from Mexico's drug war.

This study considers the effects of the kingpin strategy, an approach to fighting organized crime in which law-enforcement efforts focus on capturing the leaders of criminal organizations, on community violence in the context of Mexico's drug war. Newly constructed historical data on drug-trafficking organizations' areas of operation at the municipality level and monthly homicide data allow us to control for a rich set of fixed effects and to leverage variation in the timing of kingpin captures to estimate their effects. This analysis indicates that kingpin captures cause large and sustained increases to the homicide rate in the municipality of capture and smaller but significant effects on other municipalities where the kingpin's organization has a presence, supporting the notion that removing kingpins can have destabilizing effects throughout an organization that are accompanied by escalations in violence. We also find reductions in homicides in municipalities surrounding the municipality where kingpins are captured.

A qualitative examination of the effects of international counter-drug interdictions.

BACKGROUND: The purpose of this study is to utilize unique qualitative data to determine the effects of sporadic international drug interdictions on drug trafficking, and to assess whether the responses of drug traffickers align with rational choice theory. METHODS: Qualitative data obtained from 23 high-level United States Drug Enforcement Administration (DEA) informants, who are embedded in international drug trafficking groups, are examined to identify common responses to drug interdiction operations. RESULTS: The findings indicate that sporadic counter-drug interdictions do not a have permanent deterrent effect on transnational drug smuggling operations. However, these types of law enforcement operations produce temporary alterations in drug trafficking, as traffickers adopted a variety of methods to thwart the efforts of law enforcement-often by relying on information acquired from corrupt local law enforcement. The results also indicate that while interdiction operations displaced trafficking activities (temporally, spatially, and methodological), there is little evidence that drug traffickers responded to such operations by moving into new areas (i.e., malign spatial displacement). CONCLUSION: Sporadic international drug interdiction programs do little to deter drug trafficking organizations (DTOs) from engaging in their illicit trade. Instead, DTOs adjust in a calculating manner to these operations to ensure that their illegal products reach consumer marketplaces, which is congruent with the rational choice theoretical perspective.

[securPharm e. V. - a protective shield against falsified medicines]. / securPharm e. V. ­ der Schutzschild gegen gefälschte Arzneimittel.

It is the declared objective of the Falsified Medicines Directive 2011/62/EU to further improve the protection of patients from falsified pharmaceuticals. Therefore, it stipulates measures based on which falsified medicines in the supply chain can be more easily identified. This is the European legislature's reaction to an increase in falsified medicines. The EU Falsified Medicines Directive aims to create a uniform, standardized solution for protection from falsified drugs. From 9 February 2019 onward (according to the EU Regulation No. 2016/161), manufacturers may only release prescription drugs bearing two safety features into circulation and pharmacies may only dispense these drugs to patients following a successful authentication.The EU legislature demands that each EU member state establish a non-profit national medicines verification organisation (NMVO) that sets up and operates a national medicines verification system (NMVS) for the authentication of pharmaceuticals. In Germany, this is securPharm e. V., an alliance of the pharmaceutical industry, wholesalers and pharmacies. securPharm e. V. was established in 2011. Since 2013, pharmaceutical companies, wholesalers and pharmacies have been able to use the securPharm system for testing purposes. This article provides an overview of the current project progress of securPharm e. V. as of June 2017.

Secondary harm mitigation: A more humanitarian framework for international drug law enforcement.

This article introduces the concept of 'secondary harm mitigation' as a framework for improving the humanitarian credentials of international drug law enforcement agencies. The concept is rooted in a critical analysis of the compatibility of the harm reduction philosophy with Australia's international drug law enforcement practices. On a utilitarian level, the net benefits of international drug law enforcement are determined to be, at best inconclusive, arguably counterproductive and in most cases, incalculable. On a humanitarian level, international drug law enforcement is also determined to be problematic from a criminological standpoint because it generates secondary harms and it is indifferent to the vulnerability of individuals who participate in illicit drug trafficking. Accordingly, the article concludes that a philosophy of harm reduction grounded in the public health perspective is inadequate for mitigating secondary harms arising from Australia's efforts to combat international illicit drug trafficking. A tentative list of secondary harm mitigation principles is presented and the article argues that secondary harm mitigation should replace supply reduction as a core tenet of Australia's National Drug Strategy. The article also concludes that secondary harm mitigation may provide a viable framework for stimulating a productive dialogue between those who advocate prohibition and those who call for decriminalisation at the global level.