Pharmaceutical leakage: The porous interplay between legal and illegal opioid markets

Anne M. Lovell and Nancy D. Campbell

Chapter 32 in Handbook of Pharmaceutical Science and Technology Studies, 2026, pp 523-537 from Edward Elgar Publishing

Abstract: This chapter examines pharmaceutical leakage among the sociotechnical systems and regulatory processes that govern opioid drug development for the treatment of Opioid Use Disorder (OUD) and/or opioid-based Substance Use Disorder. It follows the developmental pathways of two such drugs, methadone and buprenorphine, within the broader map of opioid medication development rooted in the search for a non-addictive analgesic. To date, the US Food and Drug Administration has approved only three drugs for clinical treatment of opioid related disorders, known as Medications for OUD (MOUDs). Methadone and buprenorphine illustrate contrasting, non-linear trajectories of pharmaceutical development-to-deployment and the multiple local, regional, and global actors involved in these processes. This chapter connects MOUD development to the pharmaceutical and nonpharmaceutical opioid overdose epidemics in the United States, from the 19th century to OxyContin™ in the 1990s and street fentanyl in the 2010s. Paradoxical impacts of MOUDs are examined in the US, France, India, Malaysia, West Africa, and elsewhere in the Global South. In conclusion, new sociotechnical infrastructures for analyzing global drug development and delivery are considered.

Keywords: Addiction trajectories; Medications for Opioid Use Disorder (MOUDs); Opioid markets; Pharmaceutical leakage; Socio-technical systems; Technological fix (search for similar items in EconPapers)
Date: 2026
ISBN: 9781035338443
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