Comparison of strength and adulteration between illicit drugs obtained from cryptomarkets versus off-line.

BACKGROUND AND AIMS: Drugs sold on cryptomarkets are thought to have lower levels of adulteration and higher strength compared with those sourced off-line. The present study aimed to determine whether cryptomarket and off-line-sourced 3,4-methylenedioxy-N-methamphetamine (MDMA), cocaine, amphetamine, methamphetamine and lysergic acid diethylamide (LSD) differed in adulteration and strength. DESIGN AND SETTING: A between-groups design was used to compare cryptomarket versus off-line-sourced drugs. Regression analyses controlling for year and service were conducted. Drug-checking services were conducted in Spain (Energy Control) and the Netherlands (Drugs Information and Monitoring System). CASES: The cases comprised drug samples that underwent drug checking between 2016 and 2021 and were expected to contain MDMA (tablets; n = 36 065; powder: n = 6179), cocaine (n = 11 419), amphetamine (n = 6823), methamphetamine (n = 293) and LSD (n = 1817). MEASUREMENTS: Drugs were measured for (1) matching the advertised substance (i.e. containing any amount of the expected substance); (2) strength; (3) presence of adulteration; and (4) number of adulterants. FINDINGS: The expected drug was more likely to be identified when sourced from cryptomarkets versus off-line for MDMA tablets [adjusted odds ratio (AOR) = 2.10, 95% confidence interval (CI) = 1.28-3.43], MDMA powder (AOR = 2.64, CI = 1.55-4.51), cocaine (AOR = 3.65, CI = 1.98-6.71) and LSD (AOR = 1.75, CI = 1.13-2.72). Cryptomarket-sourced MDMA powder (ß = 0.03, P = 0.012), cocaine (ß = 0.08, P < 0.001) and methamphetamine (ß = 0.15, P = 0.028) were statistically significantly higher in strength than substances from off-line sources. Conversely, MDMA tablets (ß = -0.01, P = 0.043) and amphetamine (ß = -0.07, P < 0.001) from cryptomarkets were statistically significantly lower in strength than from off-line sources. MDMA powder (AOR = 0.53, CI = 0.33-0.86) and cocaine (AOR = 0.66, CI = 0.55-0.79) were statistically significantly less likely to be adulterated if sourced from cryptomarkets. However, amphetamine (AOR = 1.54, CI = 1.25-1.90) and LSD (AOR = 1.31, CI = 1.00-1.71) were found to be more likely to be adulterated when purchased from cryptomarkets. Cocaine from cryptomarkets exhibited fewer adulterants (incidence rate ratio = 0.71, CI = 0.60-0.85). CONCLUSION: The relationship between on-line drug market-places and substance quality varies depending on both the specific substance and the dynamics of the cryptomarket.

Hybrid drug dealing: Merging on- and offline spheres when dealing drugs via social media.

BACKGROUND: Research exploring online mediated drug dealing has gained momentum in recent years. Much existing research is characterized by a primary focus on the "online" aspects of drug sales facilitated by social media, resulting in a divide between "on"- and "offline" drug dealing. We wish to bridge this gap, by focusing on the hybridity of dealing drugs via social media and by arguing for a more holistic understanding of contemporary drug dealing. METHODS: This article is based on in-depth digitally facilitated oral interviews with 25 individuals with experience of dealing drugs via social media platforms and encrypted messaging apps and on observational data from different apps and platforms. RESULTS: We found that many sellers start by dealing offline and gradually drift into sales using social media technology. While the internet offers drug sellers new opportunities to expand their business, many sellers are not technological exclusionists but rather adopt a multichannel approach where they sell both via social media and occasionally or regularly also through in-person and technologically analogue means. Additionally, many sellers do not draw clear cut distinctions between whether they use social media, SMS or encrypted apps, but rather see their "drug sales phone" as one medium for all sales related communication. Findings also show that local offline power dynamics continue to influence sellers' ability to build and expand their online business, and that offline as well as online networks play a crucial role in sellers' hiring of helpers and in their bulk drug sourcing. CONCLUSION: We discuss how our findings have analytical, conceptual, and methodological implications for the development of a more nuanced and holistic approach in the study of drug sales involving online technologies.

Global patterns in small-scale cannabis growers' distribution practices: Exploring the grower-distributor nexus.

BACKGROUND: While the supply of cannabis is commonly assumed to be dominated by criminal gangs, a sizable share of the domestic cannabis supply is provided by small-scale growers. This article examines the nature and scope of small-scale growers' distribution practices, with a particular focus on cross-country differences and variations between different types of grower-distributors, i.e., "non-suppliers", "exclusive social suppliers", "sharers and sellers" and "exclusive sellers". METHODS: Based on a large convenience web survey sample of predominantly small-scale cannabis growers from 18 countries, this article draws on data from two subsamples. The first subsample includes past-year growers in all 18 countries who answered questions regarding their market participation (n = 8,812). The second subsample includes past-year growers in 13 countries, who answered additional questions about their supply practices (n = 2,296). RESULTS: The majority of the cannabis growers engaged in distribution of surplus products, making them in effect "grower-distributors". Importantly, many did so as a secondary consequence of growing, and social supply (e.g., sharing and gifting) is much more common than selling. While growers who both shared and sold ("sharers and sellers"), and especially those who only sold ("exclusive sellers"), grew a higher number of plants and were most likely to grow due to a wish to sell for profits, the majority of these are best described as small-scale sellers. That is, the profit motive for growing was often secondary to non-financial motives and most sold to a limited number of persons in their close social network. CONCLUSION: We discuss the implications of the findings on the structural process of import-substitution in low-end cannabis markets, including a growing normalization of cannabis supply.

The Baltic and Nordic responses to the first Taliban poppy ban: Implications for Europe & synthetic opioids today.

The 2000-2001 and the 2022-2023 Taliban opium bans were and could be two of the largest ever disruptions to a major illegal drug market. To help understand potential implications of the current ban for Europe, this paper analyzes how opioid markets in seven Baltic and Nordic countries responded to the earlier ban, using literature review, key informant interviews, and secondary data analysis. The seven nations' markets responded in diverse ways, including rebounding with the same drug (heroin in Norway), substitution to a more potent opioid (fentanyl replacing heroin in Estonia), and substitution to one with lower risk of overdose (buprenorphine replacing heroin in Finland). The responses were not instantaneous, but rather evolved, sometimes over several years. This variety suggests that it can be hard to predict how drug markets will respond to disruptions, but two extreme views can be challenged. It would be naive to imagine that drug markets will not adapt to shocks, but also unduly nihilistic to presume that they will always just bounce back with no lasting effects. Substitution to another way of meeting demand is possible, but that does not always negate fully the benefits of disrupting the original market. Nonetheless, there is historical precedent for a European country's opioid market switching to synthetic opioids when heroin supplies were disrupted. Given how much that switch has increased overdose rates in Canada and the United States, that is a serious concern for Europe at present. A period of reduced opioid supply may be a particularly propitious time to expand treatment services (as Norway did in the early 2000s).

Characterizing prescription opioid, heroin, and fentanyl initiation trajectories: A qualitative study.

We understand the current crisis of overdose deaths to be driven by widespread opioid use, characterized by distinct 'waves' of drug use. The first wave was driven by prescription opioids, the second by heroin, and the third by illicit, non-pharmaceutical fentanyl and fentanyl analogues (henceforth, fentanyl). The purpose of this study is to describe opioid initiation within each of the three waves from the perspective of people who use illicit opioids, with a focus on emerging pathways into fentanyl use. The authors recruited sixty people reporting past-30-day illicit opioid use in Dayton, Ohio. Participants completed a brief survey and a semi-structured in-depth qualitative interview, conducted from March to November 2020 with a total of 13 in-person and 47 virtual interviews. The qualitative interviews were transcribed in their entirety and analyzed thematically using NVivo 12. We noted supply-side changes as influencing trajectories in all three waves. However, we also noted differences in the experiences of prescription opioid and heroin initiation, with these trajectories influenced by pharmacological effects, pain management, curiosity, intergenerational use, pricing, and peers. In comparison, most participants were unaware that they were initiating fentanyl, and many reported overdosing with their first use of fentanyl. We identified a trajectory into fentanyl with limited to no prior heroin use among a few participants. The increased risk of overdose with initiation into fentanyl use further emphasizes the need for an expansion of naloxone distribution and the implementation of more comprehensive measures, such as overdose prevention centers, drug testing, and a safer supply. Further research on the dynamics of the ongoing overdose death crisis in the era of fentanyl and the 4th wave of the overdose crisis is critical in developing responsive prevention and intervention strategies.

Conflict and social control among cannabis growers.

AIMS: Illegal drug markets are often assumed to be violent and predatory due to the absence of third-party enforcement. While cannabis markets are generally considered to be relatively more peaceful, there has been little investigation of the levels of conflict and victimization among small-scale cannabis growers, particularly under different cannabis policy and enforcement settings. This paper explores prevalence and predictors of conflict and social control among small-scale cannabis growers. METHODS: The data were obtained from an online convenience survey of small-scale cannabis growers from 13 countries (Austria, Canada, Denmark, Finland, France, Germany, Israel, New Zealand, Portugal, Switzerland, United Kingdom, United States, and Uruguay) from August 2020 to September 2021 (N = 5667). Key measures collected included the types of victimization due to cannabis growing, the perpetrators of these predatory actions, reasons for the conflict, and the grower's response to being victimized. Multivariate logistic regression models were used to identify predictors of different types of victimization and social control responses among cannabis cultivators. RESULTS: Most growers (76 %) never directly experienced violence or other victimization related to their cannabis cultivation. However, about one-quarter of growers had been victimized at some point, mostly involving theft, with physical violence rare. Growing outdoors, growing with others, growing more plants, and being a more seasoned grower increased the risk of victimization. Growers who were motivated by profit were more susceptible to theft. Surprisingly, growers in legal recreational jurisdictions experienced greater levels of theft and violent victimization than growers in illegal jurisdictions. Nonviolent social control responses predominated among the growers, mostly characterized by toleration but also avoidance and negotiation. CONCLUSION: While most growers reported no victimization, a substantial minority did so, largely theft rather than violence, and typically did not report employing retaliatory violence. Social control responses were mostly nonviolent. These findings varied under different cannabis policy and enforcement environments. Cannabis legalization does not eliminate opportunities for theft and violence related to cannabis cultivation.

Understanding the rise in overdose deaths involving opioids and non-opioid prescription drugs in the United States.

BACKGROUND: Previous studies demonstrate that the reformulation of OxyContin in the U.S. in 2010 induced substitution to illicit opioids, causing illicit opioid markets to grow disproportionately fast in states more exposed to the reformulation. In this paper, we examine if this shift to the illicit market also led to a rise in polysubstance overdose deaths involving non-opioid prescription drugs, including gabapentinoids and "Z-drugs" and, separately, benzodiazepines. METHODS: Using a difference-in-differences framework, the relationship between exposure to reformulation and overdose death rates including specific substances was studied in each year from 1999 to 2020 while accounting for fixed differences across states, common nationwide shocks, and state-level differences in pain reliever misuse prior to reformulation. Exposure to reformulation was measured as the pre-reformulation rate of OxyContin misuse. RESULTS: Exposure to reformulation predicted growth in overdose deaths involving gabapentinoids and Z-drugs. There is less evidence that it predicted growth in overdose deaths involving benzodiazepines. However, for all substances, there is strong evidence that pre-reformulation OxyContin misuse rates predicted post-reformulation growth in overdose deaths concurrently involving synthetic opioids. DISCUSSION: The opioid crisis has changed in radical ways. This study links a major supply-side intervention to the increase in polysubstance overdose deaths involving non-opioid prescription drugs, specifically gabapentinoids and Z-drugs.

Trends in overdose deaths involving gabapentinoids and Z-drugs in the United States.

INTRODUCTION: As policies have been implemented to limit access to prescription opioids, other drugs have been prescribed off-label, sometimes concurrently with opioids, to manage pain. There are concerns about the use of gabapentinoids and "Z-drugs" with opioids. As the opioid crisis transitions to illicit opioids and polysubstance use, little work quantifies the concurrent involvement of non-opioid prescription drugs and illicit opioids in overdose deaths. METHODS: Data from the census of deaths in the United States for 1999-2020 were used to understand trends in deaths involving gabapentinoids/Z-drugs and opioid co-involvement. These trends were studied overall and by sex, race, age, and education. RESULTS: Per capita overdose deaths involving gabapentinoids/Z-drugs increased almost continuously since 1999, averaging 15.8% annual growth. This rate increased to 32% in 2020, primarily due to overdoses involving synthetic opioids. Women typically had higher rates of overdose deaths involving both opioids and gabapentinoids/Z-drugs, though this disparity disappeared in 2020. White Americans and American Indians/Alaskan Natives historically had higher rates than other racial groups; however, Black Americans experienced over 60% annual growth in recent years. Low education groups have been disproportionately impacted. The age incidence tends to be older than overdoses involving opioids more generally. CONCLUSION: Overdose deaths involving opioids and gabapentinoids/Z-drugs have tended to disproportionately affect women and older age groups compared to all opioid-involved overdoses. As deaths involving synthetic opioids likely reflect use of illicitly-obtained opioids, there may be less of a role for policies targeting the concurrent prescribing of gabapentinoids/Z-drugs with opioids to reduce these deaths.

What's in Stock? Drug drought anticipation during COVID-19 among people who use drugs and service providers.

BACKGROUND: As with other areas of life, drug markets have been impacted by the COVID-19 pandemic and related restrictions. This article examines how structurally vulnerable people who use drugs (PWUD) experienced and adapted to changes in street drug markets caused by lockdown measures. METHODS: The article builds on ethnographic fieldwork in two Danish cities in 2020, including in-depth interviews with 22 PWUD, and interviews with 20 service providers, including low-threshold service providers and outreach workers. RESULTS: The most consistently reported effect of lockdown measures on local drug markets related to increases in cannabis prices. Accounts of changes in drug availability varied greatly, with some participants reporting changing availability while others described the situation as similar to pre-lockdown conditions. Rather than a long-term drug shortage, changes reported by participants related to the anticipated disruption of local markets and drug scarcity, restrictions in access to cash and sellers seeking to capitalize on the crisis. CONCLUSION: Although no long-term drug scarcity was seen, the anticipation of a shortage was sufficient to impact on local drug market dynamics. Heterogeneity in PWUDs' experiences of access to drug markets during lockdown can to some degree be explained in terms of their varied embeddedness in social networks. While local markets proved resilient to lockdown measures, PWUD less embedded in social networks were more vulnerable to shifts in drug availability and to sellers' over-pricing of drugs.

Liminal spaces, seasonal faces: Challenging drug market assumptions via an exploration of naturally occurring magic mushroom markets in rural Kent.

BACKGROUND: This article presents an exploration of naturally occurring Class-A magic mushroom markets in the UK. It aims to challenge some of the mainstream narratives about drug markets and to identify features of this specific market, which will extend our understanding of how illegal drug markets operate and are structured more generally. METHODS: The research presented comprises a three year ethnography of sites of magic mushroom production in rural Kent. Observations were conducted at 5 research sites over three consecutive magic mushroom seasons and interviews were conducted with 10 (8 male; 2 female) key informants. RESULTS: It finds that naturally occurring magic mushroom sites are reluctant and liminal sites of drug production, distinct from other Class-A drug production sites due to their: open and accessible nature; lack of invested ownership or evidence of purposeful cultivation; and lack of law enforcement disruption efforts, violence or organised crime involvement. Seasonal magic mushroom picker participants were found to be a sociable group, often acting in a cooperative nature, and without evidence of territoriality or violent dispute resolution. These findings have wider application in challenging the dominant narrative that the most harmful (Class-A) drug markets are homogenous in their violent, profit driven, hierarchical nature, and most Class-A drug producers/suppliers are morally corrupt, financially motivated and organised. CONCLUSION: A greater understanding of the variety of Class-A drug markets in operation can challenge archetypes and discrimination in understanding drug market involvement, will allow the development of more nuanced policing and policy strategies, and contributes to the presentation of a fluidity of drug market structure that permeates beyond bottom level street markets or social supply.

Disruption to Australian heroin, methamphetamine, cocaine and ecstasy markets with the COVID-19 pandemic and associated restrictions.

BACKGROUND: Changes to drug markets can affect drug use and related harms. We aimed to describe market trends of heroin, methamphetamine, cocaine and ecstasy in Australia following the introduction of COVID-19 pandemic-associated restrictions. METHODS: Australians residing in capital cities who regularly inject drugs (n ∼= 900 each year) or regularly use ecstasy and/or other illicit stimulants (n ∼= 800 each year) participated in annual interviews 2014-2022. We used self-reported market indicators (price, availability, and purity) for heroin, crystal methamphetamine, cocaine, and ecstasy crystal to estimate generalised additive models. Observations from the 2014-2019 surveys were used to establish the pre-pandemic trend; 2020, 2021 and 2022 observations were considered immediate, short-term and longer-term changes since the introduction of pandemic restrictions. RESULTS: Immediate impacts on market indicators were observed for heroin and methamphetamine in 2020 relative to the 2014-2019 trend; price per cap/point increased (ß: A$9.69, 95% confidence interval [CI]: 2.25-17.1 and ß: A$40.3, 95% CI: 33.1-47.5, respectively), while perceived availability (adjusted odds ratio [aOR] for 'easy'/'very easy' to obtain: 0.38, 95% CI: 0.24-0.59 and aOR: 0.08, 95% CI: 0.03-0.25, respectively) and perceived purity (aOR for 'high' purity: 0.36, 95% CI: 0.23-0.54 and aOR: 0.33, 95% CI: 0.20-0.54, respectively) decreased. There was no longer evidence for change in 2021 or 2022 relative to the 2014-2019 trend. Changes to ecstasy and cocaine markets were most evident in 2022 relative to the pre-pandemic trend: price per gram increased (ß: A$92.8, 95% CI: 61.6-124 and ß: A$24.3, 95% CI: 7.93-40.6, respectively) and perceived purity decreased (aOR for 'high purity': 0.18, 95% CI: 0.09-0.35 and 0.57, 95% CI: 0.36-0.90, respectively), while ecstasy was also perceived as less easy to obtain (aOR: 0.18, 95% CI: 0.09-0.35). CONCLUSION: There were distinct disruptions to illicit drug markets in Australia after the COVID-19 pandemic began; the timing and magnitude varied by drug.

"The Drug Sellers Were Better Organized than the Government": A Qualitative Study of Participants' Views of Drug Markets during COVID-19 and Other Big Events.

"Big events", such as wars, economic crises, pandemics, or natural disasters, affect the risk environment in which people use drugs. While the impact of big events on injection risk behaviors and access to drug-treatment services is well documented, less is known about the effects of big events on drug markets. Based on self-reporting data on drug availability among people who use drugs (PWUD) in the aftermath of Hurricane Maria in Puerto Rico and during the COVID-19 lockdown in a Midwestern US state, this study aims to document the effects of big events on drug markets. Qualitative data on the effects of Hurricane Maria on drug markets are based on participants' self-reporting (N = 31). Data collection started after the hurricane and ended in 2020. Data on changes to the drug supply during the COVID-19 lockdown were collected based on semi-structured interviews with PWUD (N = 40) in a Midwestern US state. Findings show that while the drug markets might have initially been affected by big events, most effects were temporary. Drug availability, pricing, and quality might have suffered some initial fluctuations but stabilized as the drug markets absorbed the initial shocks caused by the hurricane and the lockdown measures. In preparation for increasingly more frequent and virulent pandemics and natural disasters, health infrastructures should be strengthened to prevent not only overdose episodes and deaths but also drug-related harms.

Developing Prioritization Criteria to Identify Target Drugs for CalRx, the California Generic Drugs Initiative.

OBJECTIVES: This study aimed to establish criteria to identify priority drugs for CalRx, a California-sponsored initiative to support the manufacture and distribution of affordable generic drugs. METHODS: A web-based ranking exercise was implemented with key stakeholders in August 2020, using pricing, spending, and public health criteria identified through a review of academic literature and public health agency reports. A total of 39 of 40 invited stakeholders in 4 different categories-patient advocates, healthcare providers, health insurers, and health policy and economic experts-participated in this study (98% response rate). RESULTS: Drugs that treat large populations, drugs that represent high cost to payors, and drugs that represent high cost to consumers were ranked a priority, receiving > 10% of ranking weights. Drugs that treat conditions with high morbidity or mortality, drugs without therapeutic alternatives, and drugs treating vulnerable populations represented criteria of further interest (9%-10% of weights). Shortage risk and curative effect (8%-9% of the weights), high price increases, communicable disease treatments, and high unit prices (< 8% of the weights) represented the bottom of the priority distribution. CONCLUSIONS: This study suggests that drugs that treat large populations, drugs that represent large costs to payors, and drugs that represent large costs to consumers should be the priority for California's CalRx generic drug initiative. A prioritizing algorithm will assist California in determining top drugs to target from a public health and spending perspective as it plans the rollout of the CalRx initiative and negotiates with drug manufacturers.

Changes in Online Illegal Drug Buying during COVID-19: Assessing Effects due to a Changing Market or Changes in Strain using a Longitudinal Sample Design.

This research uses longitudinal data to investigate if illegal online drug purchases changed over time during the COVID-19 pandemic, and if these changes were primarily driven by users adjusting to market conditions or by a heightened level of pandemic-induced strain that could drive a greater demand for drugs. Data were collected across four waves between fall 2019 and fall 2021 using an online survey. Data showed an increase in reported online drug purchases across the waves, but the online drug purchases remained consistent for the first year of the pandemic, but increased by approximately 44% between the fall 2020 and fall 2021 when over 13 percent of the sample admitted to buying illegal drugs online. Strain was also related to buying illegal drugs online as those respondents who made illegal online purchased had an average of 5.2 strain events in the past 12 months compared to only 2.4 events among those who did not report purchasing illegal drugs online. However, the influence of strain on online purchases remained consistent across time. These results suggest that the increase in online drug purchases was primarily driven by users adapting to changing market conditions rather than the cumulative strains associated with the pandemic producing a greater effect on purchases. Policy implications are also discussed.

Most recent, modal, or median heroin purchase: Does it matter when estimating market size?

BACKGROUND: Assessing the size of illicit drug markets is an important activity of many government agencies; however, the expenditure-based method for estimating market size relies on the relatively untested assumption that the cash value of the most recent purchase is representative of the average purchase amount. Using panel data, we test the representativeness of the most recent, modal and median purchase compared to the average purchase amount. METHODS: Data were drawn from a prior study that collected daily transaction-level purchase data from a sample of 120 people who were using heroin regularly. The same study participants completed two distinct two-week waves of data collection, separated by six months. T-tests and bootstrapping were used to detect differences within each wave between the average cash value of participant heroin purchases and the cash value of their most recent, modal and median heroin purchases. RESULTS: In both waves, we found (a) no evidence that the expected value of the most recent purchase differs from the expected value of the average purchase, and (b) the expected values of the modal and median purchases are smaller than the expected value of the average purchase. These results imply that estimates of total market size based on the modal or median purchase will suffer from a significant downward bias, but that estimates based on the most recent purchase will be unbiased. CONCLUSIONS: We provide evidence in support of using the most recent (but not the modal or the median) purchase to estimate market size for heroin.

'Choice' of social media platform or encrypted messaging app to buy and sell illegal drugs.

Social media is increasingly being utilized to facilitate the buying and selling of illegal drugs, particularly by young people. However, the range of social media and messaging platforms means people must make 'choices' around which platforms they will use to conduct drug transactions. Polymedia theory suggests that people use different media to manage their social relationships, 'choosing' appropriate channels or platforms based on platform features and the social context of the relationship. This paper uses polymedia theory to explore how buyers and sellers navigate platform 'choice' for drug trading, and how this bears similarities to the ways in which they move between different platforms in their daily lives. We conducted anonymous online interviews with thirty-three people who buy and/or sell drugs via social media and encrypted messaging apps in New Zealand to explore the factors shaping their selection of platforms for drug transactions. Our findings highlight the importance of the relationship between the buyer and seller in shaping how interviewees weighted the relative importance of platform security and convenience. Though more commercial drug sellers exercised considerable influence in directing buyers of drugs towards a given platform, this pattern was less characteristic of how platform 'choice' was navigated in contexts of drug supply between friends. In social supply contexts, platform 'choices' were often not explicitly made, but rather exchanges were channelled through platforms already in use within the social group. We highlight the tensions that arise between seller preferences for a more secure platform and buyer preferences for greater convenience in contexts of friendship. Our findings highlight the importance of understanding social media drug market engagement as shaped by broader patterns of social media engagement, and the distinctions between different social contexts and personal relationships, consistent with polymedia theory.

Ordinary people, criminals, addicts and recreational users: Swedish court of law descriptions of persons sentenced for online drug purchases.

Background: The aim of this study was to analyze how Swedish courts describe persons sentenced for purchasing illicit drugs online. Methods: Qualitative analysis of naturally occurring data through 201 sentences that included 248 individuals sentenced for having purchased drugs online between January 1 2010 and January 1 2020. Results: The analysis resulted in the construction of four ideal types regarding the described characteristics of the sentenced persons; the ordinary person, the recreational user, the addict and the criminal. The courts operate with a notable dichotomy between traditional drug markets and online drug markets, that can be understood in relation to descriptions of Bourdieusian capital forms, specifically street capital and digital capital. Conclusion: Descriptions relating to street capital were of larger interest to the courts compared to digital capital, although there were examples of when the courts argued that uses of digital capital should be viewed as an aggravating circumstance. The courts largely held a dichotomous view of online and offline drug markets that focus on street-based criminality, which may have implications for how emerging digital drug markets are responded to by drug law enforcement and judicial systems.

Self-reported impacts of the COVID-19 pandemic among people who use drugs: a rapid assessment study in Montreal, Canada.

BACKGROUND: People who use drugs (PWUD) are at high risk of experiencing indirect harms of measures implemented to curb the spread of COVID-19, given high reliance on services and social networks. This study aimed to document short-term changes in behaviours and health-related indicators among PWUD in Montreal, Canada following declaration of a provincial health emergency in Quebec. METHODS: We administered a structured rapid assessment questionnaire to members of an existing cohort of PWUD and individuals reporting past-year illicit drug use recruited via community services. Telephone and in-person interviews were conducted in May-June and September-December 2020. Participants were asked to report on events and changes since the start of the health emergency (March 13, 2020). Descriptive analyses were performed. RESULTS: A total of 227 participants were included (77% male, median age = 46, 81% Caucasian). 83% and 41% reported past six-month illicit drug use and injection drug use, respectively. 70% of unstably housed participants reported increased difficulty finding shelter since the start of the health emergency. 48% of opioid agonist treatment recipients had discussed strategies to avoid treatment disruptions with providers; 22% had missed at least one dose. Many participants perceived increased difficulty accessing non-addiction health care services. Adverse changes were also noted in indicators pertaining to income, drug markets, drug use frequency, and exposure to violence; however, many participants reported no changes in these areas. Among persons reporting past six-month injection drug use, 79% tried to access needle-syringe programmes during the health emergency; 93% of those obtained services. 45% tried to access supervised injection sites, of whom 71% gained entry. CONCLUSIONS: This snapshot suggests mixed impacts of the COVID-19 pandemic on PWUD in Montreal in the months following declaration of a provincial health emergency. There were signals of increased exposure to high-risk environments as well as deteriorations in access to health services. Pandemic-related measures may have lasting impacts among vulnerable subgroups; continued monitoring is warranted.

Deal or no-deal? Using administrative data to explore buyer motivation in online drug purchases and its association with community risk factors in Scotland.

BACKGROUND: The expansion of online drugs markets has widened opportunities to purchase drugs, for both personal use and wider distribution, thus creating new potential public health risks. However, there is little research on the motivation of online drug purchasers or the level of risk that such transactions pose to different communities. Greater insights into the intended use of drug parcels arriving by post, and how this varies across communities could help law enforcement and health services develop more effective policies and better allocate resources to reduce drug-related harms. METHODS: We use Scottish administrative data about illegal drug parcels seized by the UK Border Force to create a new classification of 'buyer motivation' (based on type of drug, estimated number of doses purchased, and patterns of drug consumption). We identify three potential types of buyer motivation: personal consumption, heavy use or social dealing, and wholesale dealing; and examine the extent to which each type is associated with a range of drug-related community risk factors, thereby identifying potential variation in levels of public health risk. RESULTS: Communities to which drug parcels were destined differed significantly from the Scottish average across a range of factors; however, this varied by buyer motivation. Parcels thought to be purchased for heavy use or social dealing appeared to pose a greater risk within communities characterised by general deprivation, but especially health-related deprivation, with a high youth population but low unemployment rates; whereas those purchased for wholesale dealing appear most likely to pose a risk in communities with higher crime and unemployment rates. CONCLUSIONS: Administrative data about intercepted drug parcels could be helpful in classifying the motivation of online drug purchasers and monitoring patterns of variation in potential public health risks at a community level. This could support law enforcement and public health agencies to develop more targeted drug-harm reduction strategies.

How much demand for money laundering services does drug selling create? Identifying the key parameters.

BACKGROUND: The illegal drug trade is often, and plausibly, asserted to be the largest illegal market, globally and in many individual countries. It is also claimed that a large share of its revenues is laundered, though there are no estimates of that volume. We provide rough estimates of that proportion and its primary determinants. METHODS AND DATA: This paper presents a model of a multi-tiered drug distribution network that is parameterized with data based on one typical, well-studied case, namely British Colombia's market for illegal opioids, supplemented by a corresponding economic interpretation of what determines the share of drug trade revenues that need to be laundered. Sensitivity with respect to key parameters is analyzed. FINDINGS: We suggest that less than half and perhaps no more than a quarter of revenues from established drug markets need laundering. Key parameters governing this proportion include the price mark-up across distribution levels, transaction volumes at each market level, and the capacity of market participants to spend cash on daily living expenses. CONCLUSION: This model permits estimation of the scale of money laundering associated with a particular drug market. It suggests that there are limits on money laundering controls as a way of reducing drug supply - although money laundering investigations may still be an effective way to identify and investigate high-level drug traffickers.