Market design in the September Econometrica

The September Econometrica contains two very different market design papers.

Research Design Meets Market Design: Using Centralized Assignment for Impact Evaluation

DOI: 10.3982/ECTA13925
p. 1373-1432

Atila Abdulkadiroğlu, Joshua D. Angrist, Yusuke Narita, Parag A. Pathak

A growing number of school districts use centralized assignment mechanisms to allocate school seats in a manner that reflects student preferences and school priorities. Many of these assignment schemes use lotteries to ration seats when schools are oversubscribed. The resulting random assignment opens the door to credible quasi‐experimental research designs for the evaluation of school effectiveness. Yet the question of how best to separate the lottery‐generated randomization integral to such designs from non‐random preferences and priorities remains open. This paper develops easily‐implemented empirical strategies that fully exploit the random assignment embedded in a wide class of mechanisms, while also revealing why seats are randomized at one school but not another. We use these methods to evaluate charter schools in Denver, one of a growing number of districts that combine charter and traditional public schools in a unified assignment system. The resulting estimates show large achievement gains from charter school attendance. Our approach generates efficiency gains over ad hoc methods, such as those that focus on schools ranked first, while also identifying a more representative average causal effect. We also show how to use centralized assignment mechanisms to identify causal effects in models with multiple school sectors. 
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Dual-Donor Organ Exchange

DOI: 10.3982/ECTA13971
p. 1645-1671

Haluk Ergin, Tayfun Sönmez, M. Utku Ünver

Owing to the worldwide shortage of deceased‐donor organs for transplantation, living donations have become a significant source of transplant organs. However, not all willing donors can donate to their intended recipients because of medical incompatibilities. These incompatibilities can be overcome by an exchange of donors between patients. For kidneys, such exchanges have become widespread in the last decade with the introduction of optimization and market design techniques to kidney exchange. A small but growing number of liver exchanges have also been conducted. Over the last two decades, a number of transplantation procedures emerged where organs from two living donors are transplanted to a single patient. Prominent examples include dual‐graft liver transplantation, lobar lung transplantation, and simultaneous liver‐kidney transplantation. Exchange, however, has been neither practiced nor introduced in this context. We introduce dual‐donor organ exchange as a novel transplantation modality, and through simulations show that living‐donor transplants can be significantly increased through such exchanges. We also provide a simple theoretical model for dual‐donor organ exchange and introduce optimal exchange mechanisms under various logistical constraints. 

Market design, redesigned (in startups and university labs)

Market design is evolving, and new ways of organizing it are being explored. 

In my post yesterday, I talked about the early work on school choice that Atila Abdulkadiroglu, Parag Pathak, Tayfun Sonmez and I did under the auspices of Boston schools Superintendent Tom Payzant. The market design by economists in Boston, as with the earlier successful effort in New York City, was conducted as part of our research work as professors.  Not a penny changed hands, and we all felt good about that.

But if there was a flaw in that working arrangement, it was that no contracts were signed, and so as staff turnover took place in school districts, and the individuals we had dealt with departed, the district's institutional memory eroded, and they didn't always remember to turn to us when difficulties arose that we could have helped them with. Partly to address that, and to have at least one person able to devote time to approaching school districts, Parag and Atila and I supported Neil Dorosin in founding the non-profit  Institute for Innovation in Public School Choice, which during its lifetime helped school choice in a number of American cities, including Denver, New Orleans, and Washington D.C.

Parag and Atila went on to be founding members of MIT's School Effectiveness and Inequality Intiative, which just this week was "relaunched" with a different team as MIT Blueprint Labs, which aims to build on MIT's strengths not just in school choice but in a much wider area of market design and policy analysis, and to be a lab with a large staff and extensive fundraising:

Launch announcement of MIT Blueprint Labs

Featuring

Professor Parag Pathak Faculty Director MIT SEII / Blueprint Labs Research spotlight: K-12 education

Professor Joshua Angrist Faculty Director MIT SEII / Blueprint Labs Research spotlight: Higher education and the workforce

Professor Nikhil Agarwal Faculty Director, Health Care MIT SEII / Blueprint Labs Research spotlight: Health care

Eryn Heying Executive Director MIT SEII / Blueprint Labs

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Update: and here's the Blueprint Labs new (announced Aug. 11) website: https://blueprintlabs.mit.edu/

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In a related development, Parag has cofounded a new for-profit Ed-tech startup called Avela, that plans to spread the technologies he's helped pioneer.  A for-profit firm has some funding, employment and investing opportunities that aren't available to non-profits or university labs, let alone to teams of professors organized informally. And as in the Blueprint Lab, they hope that the tools they will develop will be readily applicable to quite a broad range of matching markets and market designs.

***************

These various efforts look to me like design experiments themselves, in the search for sustainable ways of making market design a permanent part of not only the research that economists do, but of the practical effects we hope to foster.

Observing all this from the West Coast, and over several decades, I can't help noticing that these institutional changes have been accompanied by team changes, and shifting collaborations among market designers.  

There are also a growing number of different kinds of economists (and computer scientists, operations researchers and businesses) involved in designing and assessing markets, and market design has not only changed markets, but changed the way economists work, in many small and large ways.  Econometricians and development economists have led the way in organizing large labs, and market design may be heading in that direction as well. Big and small tech firms have also started to think of market design as among their core competencies, and as a discipline they should be hiring.

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Here in California, I'd be remiss if I didn't mention that my colleague Paul Milgrom has for a long time engaged in auction design through his for-profit company Auctionomics.

And Susan Athey is the faculty director of a big lab at Stanford using different technologies in other areas of market design:  the Golub Capital Social Impact Lab, which describes itself this way:

"We use digital technology and social science research to improve the effectiveness of leading social sector organizations.

"Based out of Stanford GSB, the lab is a research initiative of affiliated academics and staff, as well as researchers and students, who are passionate about conducting research that guides and improves the process of innovation.

"Research Approach

We collaborate with a wide range of organizations, from large firms to smaller startups, for-profits to nonprofits, and NGOs to governments, to conduct research. Then, we apply and disseminate our insights to achieve social impact at large scale."

New Orleans School Choice in the WSJ

 School choice in New Orleans is the subject of this WSJ story, which focuses on the search for good school places, and how choice helps...

Inside the Nation's Biggest Experiment in School Choice

"Denver, Chicago and Cleveland have embraced school choice on a smaller scale, but none give as much freedom—to parents and campuses—as New Orleans does: About 84% of its 42,000 public school students attend charters, the largest share of any district in the U.S."

School Choice as a national goal

Both the NY Times and the Wall Street Journal report on a report from the Council on Foreign Relations that emphasize the importance of school choice.

The NY Times: Panel Says Schools’ Failings Could Threaten Economy and National Security

"The panel made three main recommendations:

¶ Common Core standards should be adopted and expanded to include science, technology and foreign languages.

¶ Students, especially those in poor schools, should have more choices in where they go to school.

¶ Governors, working with the federal government, should develop a national security readiness audit, to judge whether schools are meeting targets."
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The WSJ: School Reform's Establishment Turn: The Council on Foreign Relations endorses choice and competition.

"But the real story is how much progress the reform movement has made when pillars of the establishment are willing to endorse a choice movement that would have been too controversial even a few years ago."
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From the vantage point of the work we're doing with school districts around the country at the Institute for Innovation in Public School Choice (IIPSC), I would have to say that the cutting edge is combining charter and regular district-administered schools in one system, as in Denver (and underway in Chicago)

The Brookings school choice index

Brookings has released their school choice index:

The 2016 Education and Choice Competition Index

Denver won the top spot for large districts for second year in a row in the 2016 Education Choice and Competition Index (ECCI). The Recovery District serving New Orleans came in second. Denver and the Recovery District were the only two districts in the ECCI that receive grades of A on school choice.

Here are the top 12, of 112.

. 

Many of the school districts in the top 12 spots have had help from economists, including the top 5.  Much of that help has lately been organized through IIPSC, the Institute for Innovation in Public School Choice.

Universal enrollment--embracing both district and charter schools--was once on the agenda in NYC

One cause of congestion in school choice systems is that if some students receive multiple offers of admissions, other students must wait for admission to a school they want, particularly if the system is so decentralized that a student is only discovered to have rejected an admissions offer after he or she doesn't show up for the first week of class. So a lot of the school choice work that Atila Abdulkadiroglu, Parag Pathak, Neil Dorosin and I have done through IIPSC is aimed at 'universal' enrollment systems, in which all schools take part.

This hasn't happened yet in NYC. So it is interesting that a lawsuit has brought to light emails which suggest that universal enrollment was as one point seriously considered by the city.

Chalkbeat has the story:

Mayor de Blasio almost proposed a universal enrollment system for district and charter schools, emails show  BY ALEX ZIMMERMAN

"Common — sometimes known as “universal” — enrollment systems exist in cities from Newark to Indianapolis. Backers of the approach argue it can simplify the often complex and time-intensive process required to apply to either district or charter schools in cities that allow parents to choose among both. Streamlining the process can put parents on equal footing instead of allowing those with more time, knowledge or resources from automatically getting a leg up
...
"Common enrollment systems have gained traction in recent years as some cities have embraced a “portfolio model” of schools, a new way of organizing school districts that has developed strong backing. This enrollment approach is central in New Orleans and Denver, which received input from Neil Dorosin, who created and once ran New York City’s high-school application system."

Update on school choice in Newark

The WSJ has the story:
Charters Catch On Fast in Newark: Parents Increasingly Look Outside District Schools By LESLIE BRODY

"In the debut of a system that lets families apply to charter schools and district schools at the same time, Newark got an eye-opening lesson: More than half of the applicants for kindergarten through eighth grade ranked charters as their first choice.

The application numbers, supplied by the state-operated district, show the popularity of charters at a time when Superintendent Cami Anderson's One Newark reorganization plan faces heated opposition from some residents.

One part of the complex plan aims to make it easier for children to sign up for schools outside their neighborhoods. Ms. Anderson said the application data show many families want greater choice.

"Universal enrollment is giving us a real sense of demand and allowing families of all learners, including those who struggle, more options," she said. Some critics, meanwhile, say the superintendent's push to consolidate, overhaul and restaff many district schools has created such uncertainty that it hastened a flight to charters.

Newark is among a handful of cities experimenting with universal enrollment systems, including Denver, New Orleans and Washington. Nina Rees, president of the National Alliance for Public Charter Schools, said she hoped other cities would follow suit."


Learning Curve
Recent student numbers for kindergarten through 12th grade in Newark
Newark district-school enrollment for fall 2014: 34,800 students
Newark charter-school enrollment for fall 2014: 12,200
Newark district-school enrollment for fall 2013: 35,567
Newark charter-school enrollment for fall 2013: 10,869
(Source: Newark Public Schools)

School choice around the U.S.: some short video interviews

Northwestern's journalism school has a project on school choice that allows you to click on a map of the U.S. and see very short (1 minute) clips of video interviews they did about school choice in the indicated cities:
 One size does not fit all

You can glimpse my filing system for journals in the background of interviews they did with me and Neil Dorosin of IIPSC about Boston, New York, and Denver...

Thomas Toch on school choice and the presidential campaigns

Toch: School Choice Is Here to Stay. But How to Make It Fair and Equitable for All Families? High-Tech Common-Enrollment System Can Help

"The leading Democratic presidential candidates — liberals Elizabeth Warren and Bernie Sanders, but also moderates Joe Biden and Pete Buttigieg — have derided publicly funded charter schools as a threat to traditional public schools. But charter schools and the new, more consumer-oriented public education landscape they represent are here to stay.
...
"In this climate, the policy question is not whether we should have public-sector choice. Instead, we should be asking how to make choice systems in public education efficient and fair for all families. One promising answer: common-enrollment systems that allow families to select traditional public schools or charters through a single, centralized selection process powered by algorithms that match as many students as possible to their top choices.
...
"But taking advantage of expanding public options traditionally meant navigating myriad application timelines and deadlines without information to make clear comparisons.

"It meant oversubscribed schools pulling names out of paper bags, families pitching tents on sidewalks — or paying others to camp out for them — to get to the front of waiting-list lines and schools cherry-picking applicants to get the most attractive students. It was a system favoring the well-educated, the wealthy and the well-connected.

"For schools, that system made planning almost impossible. Many students were admitted to multiple schools but didn’t let schools know their plans, causing thousands of waitlisted students to change schools even after the start of classes, leaving administrators guessing about revenue and staffing, and disrupting instruction.

"But in recent years, the District of Columbia, Denver, New Orleans and a handful of other cities have launched a new way of matching students to schools that addresses these problems."
********

In the manner of journalists with space limitations, Toch goes on to attribute these advances to "Alvin Roth and colleagues."  Of course, prominent among those colleagues are the two leaders in the modern school choice revolution, Atila Abdulkadiroglu and Parag Pathak.

Report of the economics Job Market Committee in the May AER

The Report of Ad Hoc Committee on the Job Market in the May 2011 AER (pp 744-6) has four sections:

I. Signaling;
"The number of participating job candidates held steady at roughly 1,000 signalers per year. About two-thirds of those in the job market signal each year."
...
"We note that at least a small number of ads in JOE this season solicit signals (e.g., “Candidates will be interviewed at ASSA (Denver) and are encouraged to use AEA signaling”).

II. Scramble;
"Survey results indicate that about half of the employers who register for the scramble initiate an interview as a result of the scramble. It is difficult to count the number of job placements initiated by the scramble. For the 2009–2010 job market, it appears that there were at least 15 job placements facilitated by the scramble."

III. Letters of Reference;
"The Committee is keeping an eye on the proliferation of websites to which letters of reference for new PhDs have to be uploaded, with many universities having their own sites."
...
"The Job Market Committee has considered whether the AEA ought to recommend a short list of application service providers and suggest that departments use one of just a few Internet portals, eschewing the unique url approach that is so costly. However, economics departments may not always be in a position to override their human resources departments, which seek other advantages by having all the jobs offered by their university handled on the same software. In this case it might be useful to press for common interfaces, so that centralized job market services that provide efficiencies to letter writers could upload letters to centralized university-specific services (many of which depend on only a small numberof software providers).

IV. Applications to Ph.D. programs
"There is a related issue not pertaining to the job market that affects a broader group of economics departments than just those that produce PhDs. It is the PhD admission process.
...
"The problem, even more than in the job market, is that the graduate school admission process usually is not under the control of the economics department. Often the platform and application apply to all PhD programs in the graduate school. The process stands in contrast to law schools and medical schools, which have centralized admissions forms and recommendation procedures. It is ironic that electronic processing of graduate school and job applications has increased the time required to apply and write letters in support of applicants."
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Here's our original report:
Peter Coles, John Cawley, Phillip B. Levine, Muriel Niederle, Alvin E. Roth, and John J. Siegfried , " The Job Market for New Economists: A Market Design Perspective," Journal of Economic Perspectives, 24,4 (Fall) 2010, 187-206.

Incentives in matching markets: Counting and comparing manipulating agents by Bonkoungou and Nesterov

 Here's a paper that caught my eye in the current issue of Theoretical Economics, Volume 18, Issue 3 (July 2023)

Incentives in matching markets: Counting and comparing manipulating agents by Somouaoga Bonkoungou and Alexander Nesterov

Abstract: Manipulability is a threat to the successful design of centralized matching markets. However, in many applications some manipulation is inevitable and the designer wants to compare manipulable mechanisms to select the best among them.  We count the number of agents with an incentive to manipulate and rank mechanisms by their level of manipulability. This ranking sheds a new light on practical design decisions such as the design of the entry-level medical labor market in the United States, and school admissions systems in New York, Chicago, Denver, and many cities in Ghana and the United Kingdom.

"First, we consider the college admissions problem where both students and schools are strategic agents (Gale and Shapley (1962)) and schools can misreport their preferences as well as their capacities. We show that when all manipulations (by students as well as by schools) are considered, the student-proposing Gale–Shapley (GS) mechanism has the smallest number of manipulating agents among all stable matching mechanisms (Theorem 1). Dubins and Freedman (1981) and Roth (1982) show that this mechanism is not manipulable by students. This result was one of the main arguments in favor of its choice for the NRMP. However, it also has the largest number of manipulating schools among all stable mechanisms (Pathak and Sönmez (2013)). Our result still supports its choice when all strategic agents are considered. What is more, it is still the best choice even when schools can only misreport their capacities, but not their preferences. All these conclusions carry over to the general model where, in addition, students face ranking constraints: although the student-proposing GS mechanism is now manipulable by students, it is still the least manipulable mechanism.

"Second, we consider the school choice problem (Abdulkadiroglu and Sönmez ˘ (2003)) where students are the only strategic agents and also face ranking constraints. Historically, many school choice systems have used the constrained immediate acceptance (Boston) mechanism, but over time shifted toward the constrained student proposing GS mechanisms and relaxing the constraint. We demonstrate that the number of manipulating students (Theorem 2) weakly decreased as a result of these changes."

School choice in Denver: communication, communication, and communication

Shannon Fitzgerald, director of choice and enrollment services for Denver Public Schools, explains what parents need to know about a strategy proof system:

“All you have to put on the form is what you really want for your kid. There is no strategy that you can really employ … All parents needs to do is tell us is what they really want.”

I speak to Stanford alums in LA this evening: Market Design as Economic Engineering

Event Details

Register

Date/Time:

Wed, March 19, 2014
06:30PM - 09:00PM

Venue:

Skirball Cultural Center

Location:

2701 N. Sepulveda Blvd., Los Angeles CA 90049
Map address

Registration Period:

01/29/2014-03/13/2014

Contact:

Kelly Lanter

klanter@stanford.edu

650-724-3549

Join us for an evening with Nobel Prize winner and Stanford Professor Alvin Roth at Skirball on Wednesday, March 19.

Professor Roth will be speaking on Market Design as Economic Engineering: Using Economics to Assign Doctors, Get Kids Into High School and Save Lives

Alvin Roth is a pioneer in game theory and experimental economics and in their application to the design of new economic institutions. His work on the theory of matching markets includes redesigning mechanisms for selecting medical residents; multistep kidney exchanges; and school choice in New York City, Boston, Denver and New Orleans. Professor Roth shared the 2012 Nobel Memorial Prize in Economics for his work on market design. He is a fellow of the American Academy of Arts and Sciences and the Econometric Society, and a member of the National Academy of Science. He has also been a Guggenheim and Sloan fellow.

Schedule of Events
6:30 -7:30 p.m.: Reception with cash bar
7:30 -9:30 p.m.: Presentation and Q&A

Registration will open on Tuesday, February 4. This event includes light hors d'oeuvres, non-alcoholic beverages and a cash bar.

In the event this event does't sell-out prior to registration closing on March 13, registrations will be available at the door for the increased cost of $30 general admission and $20 young alumni (undergrads '04-'13, grads '09-'13).

Event Activities

Professor Roth at Skirball 
Wednesday, March 19, 2014 @ 6:30 PM

Understanding Markets Can Save Lives: Congressional Briefing and Reception, April 18

The Consortium of Social Science Associations (COSSA), of which the American Economic Association is a member, is sponsoring a Congressional Briefing on April 18. If you're in Washington next Tuesday you could come and cheer on those Congress folks who are interested in supporting science.

WHY SOCIAL SCIENCE? Because Understanding Markets Can Save Lives: Congressional Briefing and Reception

April 18 @ 3:00 pm - 6:00 pm

Discussion with Alvin Roth, Winner of the 2012 Nobel Prize in Economics

Tuesday April 18, 2017
3:00 pm – 4:30 pm
Reception from 4:30 – 6:00 pm
2167 Rayburn House Office Building

RSVP by April 13.

Dr. Alvin Roth is the Craig and Susan McCaw Professor of Economics at Stanford University, and the George Gund Professor Emeritus of Economics and Business Administration at Harvard University. Dr. Roth’s fundamental research in market design has revolutionized kidney exchanges, allowing incompatible patient-donor pairs to find compatible kidneys for transplantation. Dr. Roth’s matching theories have also been applied to school matching systems used in New York City, Boston, Denver, New Orleans, and several other cities, among other applications.

Come learn how social science can have real, significant impacts on our everyday lives, often in unexpected ways.

This widely attended event is made possible with support from Representative Eddie Bernice Johnson and SAGE Publishing.

Prostitution in America

Yesterday's NY Times writes about a report from the Urban Institute, funded by the Department of Justice, on prostitution in eight U.S. cities.

Here's the NY Times article: In-Depth Report Details Economics of Sex Trade

Here's the full (pdf) paper: Estimating the Size and Structure of the Underground Commercial Sex Economy in Eight Major US Cities 

Here's an abstract of the paper on the Urban Institute web site:
Estimating the Size and Structure of the Underground Commercial Sex Economy in Eight Major US Cities
Meredith Dank, Bilal Khan, P. Mitchell Downey, Cybele Kotonias, Debbie Mayer, Colleen Owens, Laura Pacifici, Lilly Yu

"Abstract
The underground commercial sex economy (UCSE) generates millions of dollars annually, yet investigation and data collection remain under resourced. Our study aimed to unveil the scale of the UCSE in eight major US cities: Atlanta, Dallas, Denver, Kansas City, Miami, Seattle, San Diego, and Washington, DC. Across cities, the UCSE's worth was estimated between $39.9 and $290 million in 2007, but decreased since 2003 in all but two cities. Interviews with pimps, traffickers, sex workers, child pornographers, and law enforcement revealed the dynamics central to the underground commercial sex trade?and shaped the policy suggestions to combat it.

Underground Commercial Sex Economy Key Findings

"Sex sells" does little to explain the multimillion-dollar profits generated by the underground commercial sex economy. From high-end escort services to high school "sneaker pimps," the sex trade leaves no demographic unrepresented and circuits almost every major US city. What we know about the underground commercial sex economy is likely just the tip of the iceberg, but our study attempts to unveil its size and structure while documenting the experiences of offenders and law enforcement.

Our study focused on eight US cities— Atlanta, Dallas, Denver, Kansas City, Miami, Seattle, San Diego, and Washington, DC. Across cities, the 2007 underground sex economy’s worth was estimated between $39.9 and $290 million. While almost all types of commercial sex venues—massage parlors, brothels, escort services, and street- and internet-based prostitution—existed in each city, regional and demographic differences influenced their markets.

Pimps and traffickers interviewed for the study took home between $5,000 and $32,833 a week. These actors form a notoriously difficult population to reach because of the criminal nature of their work. Our study presents data from interviews with 73 individuals charged and convicted for crimes including compelling prostitution, human trafficking and engaging in a business relationship with sex workers.

Pimps claimed inaccuracy in media portrayals. 
Most pimps believed that the media portrayals exaggerated violence. Some even saw the term "pimp" as derogatory, despite admitting to occasional use of physical abuse for punishment. Although pimps may have underreported the use of physical violence, they did cite frequent use of psychological coercion to maintain control over their employees.

Pimps manipulate women into sex work. 
From discouraging "having sex for free" to feigning romantic interest, pimps used a variety of tactics to recruit and retain employees. Some even credited their entry into pimping with a natural capacity for manipulation. Rarely, however, were pimps the sole influence for an individual’s entry into the sex trade.

Women, family, and friends facilitate entry into sex work. 
Female sex workers sometimes solicited protection from friends and acquaintances, eventually asking them to act as pimps. Some pimps and sex workers had family members or friends who exposed them to the sex trade at a young age, normalizing their decision to participate. Their involvement in the underground commercial sex economy, then extends the network of those co-engaged in the market even further.

Unexpected parties benefit from the commercial sex economy. 
Pimps, brothels, and escort services often employed drivers, secretaries, nannies, and other non-sex workers to keep operations running smoothly. Hotel managers and law enforcement agents sometimes helped offenders evade prosecution in exchange for money or services. Law enforcement in one city reported that erotic Asian massage parlors would purchase the names of licensed acupuncturists to fake legitimacy. Even feuding gang members occasionally joined forces in the sex trade, prioritizing profit over turf wars. The most valuable network in the underground sex economy, however, may be the Internet.

The Internet is changing the limitations of the trade.
Prostitution is decreasing on the street, but thriving online. Pimps and sex workers advertise on social media and sites like Craigslist.com and Backpage.com to attract customers and new employees, and to gauge business opportunities in other cities. An increasing online presence makes it both easier for law enforcement to track activity in the underground sex economy and for an offender to promote and provide access to the trade.

Child pornography is escalating.
Explicit content of younger victims is becoming increasingly available and graphic. Online child pornography communities frequently trade content for free and reinforce behavior. Offenders often consider their participation a "victimless crime."

The underground sex economy is perceived as low risk.
Pimps, traffickers, and child pornography offenders believed that their crimes were low-risk despite some fears of prosecution. Those who got caught for child pornography generally had low technological know-how, and multiple pimp offenders expressed that "no one actually gets locked up for pimping," despite their own incarcerations.

Policy and practice changes can help combat trafficking and prostitution.

• Cross-train drug, sex, and weapons trade investigators to better understand circuits and overlaps.
• Continue using federal and local partnerships to disrupt travel circuits and identify pimps.
• Offer law enforcement trainings for both victim and offender interview techniques, including identifying signs of psychological manipulation.
• Increase awareness among school officials and the general public about the realities of sex trafficking to deter victimization and entry.
• Consistently enforce the laws for offenders to diminish low-risk perception.
• Impose more fines for ad host websites."

Opioids and harm reduction: drug checking and Safe Injection Facilities

From Mason Marks writing on the Bill of Health blog at Harvard Law School:

The Opioid Crisis Requires Evidence-Based Solutions, Part III: How the President’s Commission on Combating Drug Addiction Dismissed Harm Reduction Strategies

" it is noteworthy that the Commission ignored harm reduction strategies such as drug checking, which could reduce deaths due to consumption of contaminated opioids. Many countries including Austria, Belgium, Switzerland, Portugal, Spain, Switzerland, and the Netherlands offer free and confidential drug checking (also known as pill testing) to drug users. Drug checking could reduce consumption of adulterated drugs and provides opportunities to support and counsel users who may otherwise receive no contact with medical or public health professionals. Drug checking is also a valuable source of information about drug use such as pricing, availability, effects, and composition of street drugs. This information can be used to further our understanding of drug use and its effects.

Some experts argue that drug dealers will be less likely to add dangerous adulterants to their products if they know that consumers have a mechanism to test their contents. The identification of drug contents can alert authorities to the presence of synthetic opioids, which can lead to public warnings and announcements that may further drive dealers to withdraw deadly additives from the market. The practice can also improve law enforcement efforts to reduce the illegal importation and sale of synthetic opioids. Dr. Carl Hart, Chair of the Department of Psychology at Columbia University, supports the use of free and anonymous drug checking in the United States. In a Scientific American article, heargues that the opioid crisis is a distinctly American problem. According to Hart, “Throughout Europe and other regions where opioids are readily available, people are not dying at comparable rates as those in the U.S., largely because addiction is not treated as a crime but as a public health problem.” Drug checking is one example of how European countries approach drug abuse from a public health angle rather than a punitive law enforcement perspective.

Critics of drug checking argue that it could normalize drug use or “send the wrong message” to potential users. For instance, the practice could create the appearance of safety when in fact the drugs being consumed are dangerous. ...

"Supervised injection facilities (SIFs), arguably a more controversial option than drug checking, were also ignored by the President’s Opioid Commission. SIFs provide a place for people to inject drugs under professional supervision to minimize the risk of HIV and hepatitis C infection, drug overdose, and death. They are primarily used in Switzerland, Canada, and Australia. However, the City of Denver is taking steps to become the first U.S. city to offer SIFs. In November, a plan for a pilot program won unanimous approval from a bipartisan ten-member legislative committee. However, the City’s General Assembly must approve the plan in January 2018 for it to move forward. Seattle and San Francisco are considering similar proposals. The State of Vermont is also considering using SIFs. On November 29, 2017, a commission of health and law enforcement professionals, led by State’s Attorney General Sarah George, recommended that Vermont make SIFs a part of its opioid strategy. However, the Vermont Commissioner of Public Safety and the Vermont Association of Police Chiefs disagree. The Commissioner stated, “Facilitating the ongoing use of heroin through SIFs sends the wrong message, at the wrong time, to the wrong people.”

...

"A 2014 review published in the journal Drug and Alcohol Dependence, examined the outcome of 75 studies and concluded that SIFs are an effective harm-reduction strategy not associated with increased drug use or crime. In early 2017, the Massachusetts Medical Society published its analysis of SIFs. It found that peer-reviewed research published in leading academic journals, such as JAMA and the New England Journal of Medicine, supports the conclusion that SIFs produce positive outcomes such as reduced mortality and increased access to drug treatment.

...

"Admittedly, there could be an “ick factor” associated with SIFs, and overly zealous drug control advocates could find them repugnant. However, when thousands of lives are at stake, emotional reactions to SIFs must be weighed against the scientific evidence. If the evidence suggests that SIFs are effective, then lawmakers must be courageous and allow their decisions to be guided by science rather than emotions such as disgust."