Impact of Precursor Control on Drug Markets: An Expanded and Updated Systematic Review

Precursors are essential compounds for the production of illicit drugs. These substances play a critical role in making drugs like synthetic opioids and methamphetamines, as well as in producing semi-refined drugs such as heroin and cocaine. However, there is a lack of systematic knowledge regarding the impact of regulating these substances on the illicit drug market. The most recent systematic review, now 15 years old, focused primarily on methamphetamine in North America. Recent studies have begun to explore the broader impacts on drugs like cocaine and heroin. While these studies suggest potential effectiveness, they also reveal significant inconsistencies.

This paper evaluates the effectiveness of regulations on illicit drug precursors in disrupting illegal drug markets. Essentially, we aim to determine whether restricting access to substances used in the manufacture of illegal drugs can reduce drug use, trafficking, and related issues, such as overdoses. To address this question, we conducted a systematic review of 12 databases to identify studies that evaluated the impact of drug precursor regulations on the supply and use of illegal drugs. The guidelines of The Cochrane Collaboration were employed to select and assess the quality of the included study designs.

Despite some limitations in the evidence base, regulating precursors appears to be a promising strategy for reducing drug availability and its associated problems. This approach could offer a cost-effective solution to combat the increasing issue of synthetic opioids, like fentanyl, which are becoming more prevalent, not only in North America but also in Europe. In 2021, the United States reported an average of 220 deaths per day from opioid overdoses. Effective regulation of drug precursors could potentially save many of these lives.