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Nigeria grapples with a formidable public health concern, as approximately 14 million individuals partake in illicit drug use (IDU). This predicament significantly impacts psychiatric disorders, suicides, disability, and mortality rates. Despite previous investigations into predictors and remedies, the role of financial inclusion (FI) remains inadequately explored. Leveraging existing literature on FI and population health, this study asserts that bolstering FI could be instrumental in mitigating IDU prevalence in Nigeria. We employ spatial analysis to scrutinize the influence of FI and other social factors on IDU, revealing a 14.4 % national prevalence with spatial variations ranging from 7 % in Jigawa state to 33 % in Lagos state. Significant IDU hotspots were identified in the southwest states, while cold spots were observed in the Federal Capital Territory and Nassarawa. Multivariate spatial analysis indicates that FI, income, unemployment, and the proportion of the young population are pivotal predictors of IDU nationwide, explaining approximately 67 % of the spatial variance. Given these findings, the study advocates heightened levels of FI and underscores the need for intensified government initiatives to prevent and address illicit drug use., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Pandemic income support payments have been speculatively linked to an increased incidence of illicit drug poisoning (overdose). However, existing research is limited., Methods: Collating Canadian Emergency Response Benefit (CERB) payment data with data on paramedic attended overdose and illicit drug toxicity deaths for the province of British Columbia at the Local Health Area (LHA) level, we conducted a correlation analysis to compare overdose rates before, during and after active CERB disbursement., Results: There were 20,014,270 CERB-entitled weeks identified among residents of British Columbia for the duration of the pandemic response program. Approximately 52 % of all CERB entitled weeks in the study were among females and approximately 48 % were among males. Paramedic-attended overdoses increased uniformly across the pre-CERB, CERB and post-CERB periods, while illicit drug toxicity deaths sharply increased and then remained high over the period of the study. Correlation analyses between overdose and CERB-entitled weeks approached zero for both paramedic-attended overdoses and illicit drug toxicity deaths., Conclusions: These findings suggest that attributing the pandemic increase in overdose to income support payments is unfounded. Sustained levels of unacceptably high non-fatal and fatal drug poisonings that further increased at the start of the pandemic are reflective of complex pre-existing and pandemic-driven changes to overdose risk., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Despite thousands of licensed cannabis retail stores operating across Canada, there remains a significant illicit cannabis market. Some cannabis users continue to buy cannabis from dealers, illicit stores, and/or illicit online retailers., Methods: Data are from the 2021 British Columbia Cannabis Use Survey. Respondents (n = 8473) were 19 years or older, lived in British Columbia at the time of the survey, and reported using cannabis in the past 12 months., Results: Buying cannabis from all types of illicit sources was more common among younger cannabis users, those who use cannabis more frequently and started using cannabis before the age of 17 (vs. 19 or older), and among those who co-use cannabis with other drugs. Specifically, buying cannabis from a dealer was more common among men, those with lower educational attainment, and those who seek the lowest prices when buying cannabis. In contrast, those using cannabis for medical (vs. non-medical) purposes were more likely to report getting cannabis from illicit retail stores, while buying cannabis from illicit websites was more common among people who use edible cannabis products., Conclusion: Consistent with other studies, younger and more frequent cannabis users were more likely to report buying cannabis from illicit sources. However, these findings suggest there is significant heterogeneity among those who buy cannabis from different types of illicit sources, which should be carefully considered when developing policies and strategies aimed at encouraging consumers to transition to legal sources., Competing Interests: Declaration of competing interest The author declares that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

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., Competing Interests: Declarations of Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Background: Personal vaporisers are gaining popularity as an alternative route of administration for a range of substances. Online cryptomarkets are becoming increasingly popular among people who use substances due to their perceived anonymity, ease of use, and reduced risk of violence compared to traditional face-to-face dealers. We examined the diversity of substances marketed for use in a personal vaporiser on these marketplaces., Methods: Vaping related listings were extracted from three online cryptomarkets ('Agartha', 'Cryptonia', and 'Tochka') using The Onion Router browser. Data collection occurred between October and November 2019., Results: We identified 1929 listings from 201 unique sellers. The top product on Agartha, Cryptonia, and Tochka were vape cartridges prefilled with the e-liquid (70.4 %, 39.4 %, 52.3 % respectively). The most common substance in these products was cannabis oil (96.1 %, 82.1 %, 87.8 %), followed by synthetic cannabinoids (3.7 %, 9.7 %, 9.8 %) and psychedelic substances (0.2 %, 6.4 %, 1.2 %). Vendors were primarily from the USA. Many products offered worldwide shipping (96.3 %, 42.4 %, 51.2 %)., Conclusion: Vaping products listed on online cryptomarkets in 2019 primarily contained cannabis oils. Future studies should continue to examine cryptomarkets to identify emerging trends of substances that can be used in personal vaporisers., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Ecological momentary assessments (EMA) can improve data accuracy and be useful for understanding the real-time co-occurrence of drug use and harm reduction service utilization among people who inject drugs (PWID); however, feasibility and acceptability of EMA in this population is unknown., Methods: We conducted qualitative interviews (n = 45) and EMA surveys (n = 38) with PWID in cities and towns outside of Massachusetts' and Rhode Island's capital cities to 1) assess EMA feasibility and acceptability and 2) examine day-level correlations between drug use and harm reduction service utilization., Results: Qualitative and quantitative data demonstrated that a 14-day EMA study was both feasible and acceptable. Interviews identified housing instability and related disruptions in cellphone access as challenges to consistent EMA participation. In the 14-day EMA study, EMA completion was high (mean = 10.1 days,SD = 5.3). High completion was associated with higher education (p = 0.005), receiving EMA via SMS text (vs. email, p = 0.017), and not having injected crack in the past month (p = 0.026). Of those who responded (n = 29), 100 % reported willingness to participate in a similar future study. Past 24 -h use of harm reduction services was positively associated with past 24 -h injection drug use (p = 0.013), but not past 24 -h syringe sharing (p = 0.197)., Conclusion: Findings support the acceptability, feasibility, and potential utility of EMA for understanding daily experiences of PWID. Future studies should explore strategies to overcome structural barriers to maximize EMA participation, and assess how injection practices, syringe sharing, and use of harm reduction services interact to impact health risks in larger and diverse samples of PWID., Competing Interests: Declaration of Competing Interest No conflict declared., (Copyright © 2020 Elsevier B.V. All rights reserved.)

As recreational substances, synthetic cathinones started to be used at the beginning of the 21st century. There is still limited data on these compounds, introduced to the illicit drug market for the most part after 2009. Considering that synthetic cathinones are currently the second largest group of new psychoactive and dangerous substances among over 670 new psychoactive substances identified in Europe and monitored by the EMCDDA, research on them should be regarded as extremely important. This review focuses on the availability of synthetic cathinones on the illicit drug market, presentation of current trends in the use of these substances, and their mechanisms of action and toxicity. The authors discuss cases of intoxication with synthetic cathinones and post-mortem diagnostics as well as the problem of combined used of synthetic cathinones with other psychoactive substances. Literature as well as clinical and forensic data indicate the need for further research on the metabolism, toxicokinetics, toxicodynamics, clinical effects, and addictive potential of synthetic cathinones, especially in the context of potential threats caused by increased consumption of this group of drugs in future., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Introduction and Aims: There is little objective market data on the price or potency of legal and illegal cannabis products following recreational cannabis legalisation., Design and Methods: In the 2 months post-legalisation in Canada (November-December 2018), legal and illegal cannabis retailers were identified from government lists and online directories. The store location, price and Δ9-tetrahydrocannabinol (THC) and cannabidiol levels of dried herb and cannabis cookies were collected from retailer websites or Weedmaps., Results: We identified 185 legal retailers (22 online stores, 163 storefronts; 65 government-run stores, 120 private stores) and 944 illegal retailers (791 delivery-only services, 157 storefronts). Relative to legal dried herb, illegal dried herb was lower in price (1 g: $10.23 vs. $11.08, ⅛ oz: $9.37/g vs. $10.88/g, ½ oz: $8.18/g vs. $8.85/g; P < 0.05 for all) and higher in potency (THC: 20.5% vs. 16.1%, cannabidiol: 2.4% vs. 1.7%; P < 0.05 for both). Legal private stores had higher prices for dried herb than government-run stores (1 g: $13.08 vs. $10.89, ⅛ oz: $12.75/g vs. $10.45/g, ½ oz: $10.85/g vs. $8.71/g, 1 oz: $8.54/g vs. $7.22/g; P < 0.05 for all). On average, one cannabis cookie in the illegal market contained 96 mg of THC and cost $1.57 per 10 mg of THC., Discussion and Conclusions: In the 2 months post-legalisation, illegal cannabis was less expensive, with higher labelled THC content than legal cannabis, although the scope of these differences was more modest than estimates from other crowdsourced and self-reported data. Direct monitoring of cannabis price and potency from legal and illegal retailers is needed to examine the impact of legalisation over time., (© 2020 Australasian Professional Society on Alcohol and other Drugs.)

This systematic review attempts to understand how people keep secrets online, and in particular how people use the internet when engaging in covert behaviours and activities regarding the procurement and supply of illicit drugs. With the Internet and social media being part of everyday life for most people in western and non-western countries, there are ever-growing opportunities for individuals to engage in covert behaviours and activities online that may be considered illegal or unethical. A search strategy using Medical Subject Headings terms and relevant key words was developed. A comprehensive literature search of published and unpublished studies in electronic databases was conducted. Additional studies were identified from reference lists of previous studies and (systematic) reviews that had similar objectives as this search, and were included if they fulfilled our inclusion criteria. Two researchers independently screened abstracts and full-texts for study eligibility and evaluated the quality of included studies. Disagreements were resolved by a consensus procedure. The systematic review includes 33 qualitative studies and one cross-sectional study, published between 2006 and 2018. Five covert behaviours were identified: the use of communication channels; anonymity; visibility reduction; limited posts in public; following forum rules and recommendations. The same technologies that provide individuals with easy access to information, such as social networking sites and forums, digital devices, digital tools and services, also increase the prevalence of inaccurate information, loss of privacy, identity theft and disinhibited communication. This review takes a rigorous interdisciplinary approach to synthesising knowledge on the strategies adopted by people in keeping secrets online. Whilst the focus is on the procurement and supply of illicit drugs, this knowledge is transferrable to a range of contexts where people keep secrets online. It has particular significance for those who design online/social media applications, and for law enforcement and security agencies., (Copyright © 2019 The Author(s). Published by Elsevier B.V. All rights reserved.)

This study seeks to understand whether people substitute between recreational cannabis and conventional over-the-counter (OTC) sleep medications. UPC-level grocery store scanner data in a multivariable panel regression design were used to compare the change in the monthly market share of sleep aids with varying dispensary-based recreational cannabis access (existence, sales, and count) in Colorado counties between 12/2013 and 12/2014. We measured annually-differenced market shares for sleep aids as a portion of the overall OTC medication market, thus accounting for store-level demand shifts in OTC medication markets and seasonality, and used the monthly changes in stores' sleep aid market share to control for short-term trends. Relative to the overall OTC medication market, sleep aid market shares were growing prior to recreational cannabis availability. The trend reverses (a 236% decrease) with dispensary entry (-0.33 percentage points, 95% CI -0.43 to -0.24, p < 0.01) from a mean market share growth of 0.14 ± 0.97. The magnitude of the market share decline increases as more dispensaries enter a county and with higher county-level cannabis sales. The negative associations are driven by diphenhydramine- and doxylamine-based sleep aids rather than herbal sleep aids and melatonin. These findings support survey evidence that many individuals use cannabis to treat insomnia, although sleep disturbances are not a specific qualifying condition under any U.S. state-level medical cannabis law. Investigations designed to measure the relative effectiveness and side effect profiles of conventional OTC sleep aids and cannabis-based products are urgently needed to improve treatment of sleep disturbances while minimizing potentially serious negative side effects., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Introduction: Why aren't cryptomarkets more widely used? Researchers from a wide array of fields have attempted to answer this question by studying the size of drug cryptomarkets, the substances trafficked, and their structure. In this paper we address the potential acceptance of drug cryptomarkets by studying their perceived ease of use., Methods: This paper draws on observational data collected over 350 h of unstructured observation during an ethnographic study conducted in April-September 2016 of the two most prominent drug cryptomarkets at the time, in addition to seven face-to-face semi-structured qualitative interviews., Analysis: Use of cryptomarkets relies on specialised knowledge. The administrators of the cryptomarkets do not play a publicly visible role in facilitating or easing cryptomarket use while simultaneously expecting cryptomarket users to exhibit self-reliance. We argue that the current levels of complexity and obfuscation constructed in the cryptomarket environment act as a barrier to the widespread acceptance of this technology., Discussion: Through studying cryptomarkets' potential for widespread use we have shed light on current barriers to their growth requirement of specialised knowledge in order to use cryptomarkets and no public efforts to bridge the knowledge gap on behalf of cryptomarket administrators. As cryptomarkets continue to develop the ease of use of these platforms are bound to change, and with them the likelihood that cryptomarket usage may increase., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Illicitly manufactured fentanyl and its analogues are appearing in countries throughout the world, often disguised as heroin or counterfeit prescription pills, with resulting high overdose mortality. Possible explanations for this phenomenon include reduced costs and risks to heroin suppliers, heroin shortages, user preferences for a strong, fast-acting opioid and the emergence of Dark Web cryptomarkets. This paper addresses these potential causes and asks three questions: (1) can users identify fentanyl; (2) do users desire fentanyl; and (3) if users want fentanyl, can they express this demand in a way that influences the supply?, Argument/analysis: Existing evidence, while limited, suggests that some users can identify fentanyl, although not reliably, and some desire it, but because fentanyl is frequently marketed deceptively as other drugs, users lack information and choice to express demand effectively. Even when aware of fentanyl's presence, drug users may lack fentanyl-free alternatives. Cryptomarkets, while difficult to quantify, appear to offer buyers greater information and competition than offline markets. However, access barriers and patterns of fentanyl-related health consequences make cryptomarkets unlikely sources of user influence on the fentanyl supply. Market condition data indicate heroin supply shocks and shortages prior to the introduction of fentanyl in the United States and parts of Europe, but the much lower production cost of fentanyl compared with heroin may be a more significant factor CONCLUSION: Current evidence points to a supply-led addition of fentanyl to the drug market in response to heroin supply shocks and shortages, changing prescription opioid availability and/or reduced costs and risks to suppliers. Current drug users in affected regions of the United States, Canada and Europe appear largely to lack both concrete knowledge of fentanyl's presence in the drugs they buy and access to fentanyl-free alternatives., (© 2018 Society for the Study of Addiction.)

In the context of cannabis legalization, an important question among clinicians, policymakers, and the public is whether availability of legal cannabis will significantly reduce consumption (demand) of illegal cannabis. Using paradigms from behavioural economics, we tested the prediction that legal cannabis would be an asymmetrical substitute for illegal cannabis, with legal cannabis operating as a superior commodity based on its regulated status. In a sample of 289 adult cannabis users in Ontario, we found evidence of substitutability for both legal and illegal cannabis, but significantly lower substitutability of illegal for legal cannabis, a pattern that was also present for price elasticity (α) and P max . Thus, the data indicated asymmetric substitution such that the availability of legal cannabis substantially decreased demand for illegal cannabis, but a significantly smaller effect in reverse. These results suggest that the introduction of legal cannabis into the market may disrupt and reduce illegal purchases, contributing to the reduction of the potential harms associated with the illegal market. However, in revealing price windows in which legal cannabis is preferred over the contraband alternative, these data also have significant implications for pricing policies.

Introduction: This study sought to estimate the number of illicit retailers and the average price of cannabis in the largest municipality in each province and territory in Canada by obtaining information from retailers., Methods: Online search engines were used to identify retailers in each municipality. The advertised prices for various volumes of the least expensive, most expensive, and most popular dry herb were determined using the retailer's website, Weedmaps, or Leafly. Data was collected between October 2017 and May 2018, including two waves in Toronto to examine changes over a five-month period., Results: Across the 13 municipalities, 997 cannabis retailers were identified, including 215 physical storefronts. The average price per gram of cannabis was $10.02, $7.80, and $12.30 for the most popular, least expensive, and most expensive strains, respectively. The price-per-gram decreased as purchase volume increased: purchasing one-eighth of an ounce and one ounce of cannabis led to savings of up to 9% and 27%, respectively. Prices were consistent across municipalities, although the number of outlets varied greatly. Prices were similar between storefronts and delivery-only services; however, delivery services offered larger discounts for cannabis purchased by the ounce. The five-month comparison in Toronto revealed modest changes in the number of retailers and more pronounced changes in the price of the most popular and least expensive strains., Conclusion: The findings depict a well-established retail cannabis market in Canada in the year prior to legalization. The average advertised price of the most popular cannabis varieties was approximately $10, which aligns with the projected retail price of cannabis from licensed sources following legalization in Canada., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background and Aims: The evolving legal status of cannabis world-wide necessitates evidence-based regulatory policies to minimize risks associated with cannabis misuse. A prominent concern is the impact legalization may have on the illegal cannabis market, including whether illegal cannabis will serve as a substitute for legal cannabis. Empirical data on this issue are virtually non-existent. This study used behavioral economics to investigate substitutability of legal and illegal cannabis in legalized catchment areas in the United States., Design: A substitution-based marijuana purchase task assessed estimated cannabis consumption from concurrently available legal (a dispensary) and illegal (a dealer) sources. Prices of the two options were reciprocally either held constant ($10/gram) or escalated ($0-$60/gram)., Setting: US states with legalized recreational cannabis., Participants: Adult cannabis users who were at least 21 years old (n = 724; mean age = 34.13; 52% female; 74% Caucasian) were recruited using online crowdsourcing., Measurements: Mean consumption values were used in demand curve modeling to generate indices of price sensitivity and elasticity. Differences in demand indices were compared using extra sums-of-squares F-tests., Findings: Both legal and illegal fixed-price cannabis options had significant positive cross-price elasticities (Ps < 0.001), indicating that higher prices motivate substitution irrespective of legality. However, the presence of a legal alternative had a substantially greater effect on consumption and elasticity of illegal cannabis (∆ elasticity  = 0.0019; F (1,37)  = 160, P < 0.0001) than the presence of an illegal alternative on demand for legal cannabis (∆ elasticity  = 0.0002; F (1,37)  = 48, P < 0.0001), indicating asymmetric substitution. Demand for legal cannabis was significantly greater than for illegal cannabis (P < 0.0001)., Conclusions: Cannabis users treat legal cannabis as a superior commodity compared with illegal cannabis and exhibit asymmetric substitutability favoring legal product. Cannabis price policies that include somewhat higher consumer costs for legal cannabis relative to contraband (but not excessively higher costs) would not be expected to incentivize and expand the illegal market., (© 2018 Society for the Study of Addiction.)

Purpose: Diverted prescription opioids are significant contributors to drug overdose mortality. Street price has been suggested as an economic metric of the diverted prescription opioid black market. This study examined variables that may influence the street price of diverted oxycodone and oxymorphone., Methods: A cross-sectional study was conducted utilizing data from the previously validated, crowdsourcing website StreetRx. Street price reports of selected oxycodone and oxymorphone products, between August 22, 2014 and June 30, 2016, were considered for analysis. Geometric means and 95% confidence intervals were calculated comparing prices per milligram of drug in US dollars. Univariate and multivariable regressions were used to examine the influence of dosage strength, drug formulation, and bulk purchasing on street price., Results: A total of 5611 oxycodone and 1420 oxymorphone reports were analyzed. Across various dosages and formulations, geometric mean prices per milligram ranged between $0.12 and $1.07 for oxycodone and $0.73 and $2.90 for oxymorphone. For a 2-fold increase in dosage strength, there is a 24.0% (95% CI: -28.1%, -19.6%, P < 0.001) and a 22.5% (95% CI: -24.2%, -20.8%, P < 0.001) decrease on average in price per milligram for oxycodone and oxymorphone, respectively. Lower potency, high dosage strength, crush-resistant opioids, and those purchased in bulk were significantly cheaper., Conclusion: Street prices for diverted oxycodone and oxymorphone are influenced by multiple factors including potency, dosage, formulation, and bulk purchasing. Buyers who purchase large quantities of low potency, large dosage, crush-resistant formulation prescription opioids can expect to achieve the lowest price., (© 2018 John Wiley & Sons, Ltd.)

Background Crackdowns on urban sites with concentrated criminal activity are sometimes followed by geographical relocation of crime. Is this also the case in cyberspace, where illegal websites and online networks can be wiped clean, but also quickly rebuilt and replaced on new servers and URLs? Methods I address this question in three steps. First, I measure MDMA trade in a large digital market for drugs, before and after the arrest of a leading MDMA seller in the same market. Second, I count the number of available digital drug markets and vendor shops in the period February 2014-June 2018, to see if websites closed by police were replaced by new ones. Third, I track the digital movement and trading activities of individual drug sellers, before and after law enforcement shut down two large markets. Results After police arrested a leading MDMA seller, other MDMA sellers filled most - but not all - of the gap. A major law enforcement crackdown reduced the number of available markets, but new ones were created, and market counts eventually surpassed the previous peak. When law enforcement shut down two big markets, many of the sellers relocated to other e-commerce sites and continued high-earning operations there. Conclusion Arrests and market closures redirect digital drug trade to other sellers and markets. Hot spot policing in cyberspace might produce temporary results, but is arguably ineffective in the long run, as actors use information and communication technology's unique capacities to reorganize., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Informal recycling refers to the street-based collection of discarded materials for reuse, resale, or return to a recycling facility for money. While qualitative research has explored experiences and perceptions of informal recycling, little is known about the scope and exposures associated with informal recycling among people who use drugs (PWUD)., Methods: Using data from two prospective longitudinal cohorts of PWUD, we examined the prevalence of informal recycling and its association with social, structural and health risks, including criminal justice system involvement., Results: Between June 2010 and May 2015, of 1664 participants, 557 (33.5%) reported engaging in informal recycling during the study period. In multivariable generalised estimating equations (GEE) analyses, informal recycling was positively associated with injection drug use (Adjusted Odds Ratio (AOR) = 1.43, 95% Confidence Interval (CI) 1.21-1.68), public injection (AOR = 1.27, 95% CI 1.09-1.49), methamphetamine use (AOR = 1.35, 95% CI 1.05-1.72), difficulty finding harm reduction equipment (AOR = 1.16, 95% CI 1.02-1.32), and police interactions (AOR = 1.35, 95% CI 1.18-1.55). Sub-analyses revealed PWUD engaged in informal recycling were more likely to be told to move on, ticketed, stopped for jaywalking, and directed to services by police., Conclusions: These findings suggest informal recycling as a situated practice for PWUD, with potential indications for higher-risk drug use, experiencing greater surveillance, and difficulty accessing health and addiction treatment services. This research highlights the significance of the broader risk environment and the need for health-promoting policies for socioeconomically marginalised PWUD engaged in informal recycling., (Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective: To systematically review guidance documents for the estimation of the social cost of illegal drugs, and to define standards for this estimation., Method: A systematic literature search was conducted between April and May 2015 and updated in November 2015. Pubmed, Scopus, and Google Scholar were searched. Studies were included only if they provided indications of analytical methods for calculating the social cost of illegal drugs consumption., Results: A total of 21 papers were selected for a final review. Four main areas of discussion were identified: a) alternative theories for the framework design; b) basic concepts definition; c) theoretical issues in the application of the framework and; d) definition of the cost matrix and its elements. The review exercise enabled the definition of two analytical approaches, which are proposed as references for estimation in the field., Conclusions: although social cost is a well-established method in the literature, there is a lack of agreement on the most appropriate approaches in the area of estimation of the social cost of illegal drugs consumption. Moreover, the two analytical approaches proposed are aimed at promoting more research focused at sophisticating the methodology in the field., (Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Many efforts have been undertaken to construct an overview of various aspects of illicit drug distribution in the United Kingdom. Yet given that national, regional, and local differences can be profound, this has proven difficult, to the extent that Scotland has been largely excluded from the conversation. In addition, the level of supply being examined, the drug type, and the actors involved only add to confusion and vast differences between some findings., Method: The current study aims to provide a holistic account, as best as possible considering variations of illegal drug supply in illicit networks, by focusing in on a particular geographical context (Scotland) and addressing drug supply at all levels. It is informed by in-depth interviews with 42 offenders involved in drug distribution from retail to wholesale/middle market to importation levels., Results: Findings indicate Scotland's importation and distribution is evolving owing to increasingly adaptive risk mitigation by importers and distributors, and market diversification of both product and demand. While a hierarchical model still dominates the market, commuting or 'county lines' and increasing demand for drugs such as cannabis, but also anabolic steroids and psychoactive substances, means that home growing, online purchasing, and street-level dealership is common., Conclusion: The findings have the capacity to further inform police and practitioners about the diverse and evolving nature of drug distribution in Scotland (with a particular focus on the west of the country), so that they may become more effective in improving the safety and wellbeing of people, places and communities., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Technology provides new ways to access customers and suppliers while enhancing the security of off-line criminal activity. Since the first cryptomarket, Silk Road, in 2011, cryptomarkets have transformed the traditional drug sale by facilitating the creation of a global network of vendors and buyers. Due to the fragmented nature of traces that result from illegal activities, combining the results of concurrent processes based on traces of different nature should provide supplementary benefit to understand the drug market. This article compares the data of the Australian virtual market (in particular data extracted from cryptomarkets) to the data related to traditional market descriptors, namely national seizures and arrests, prevalence data, shipping countries of seized post shipments as well as outcomes of specific surveys targeting users' behaviour online. Results revealed the domestic nature of the online illicit drug trade in Australia which is dominated by amphetamine-type substances (ATS), in particular methylamphetamine and cannabis. These illicit drugs were also the most seized drugs on the physical market. This article shows that the combination of different information offers a broader perspective of the illicit drug market in Australia and thus provides stronger arguments for policy makers. It also highlights the links between the virtual and physical markets., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Interventions to tackle the supply of drugs are seen as standard components of illicit drug policies. Therefore drug market-related administrative data, such as seizures, price, purity and drug-related offending, are used in most countries for policy monitoring and assessment of the drug situation. International agencies, such as the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and the UN Office of Drugs and Crime, also monitor and report on the drug situation cross-nationally and therefore seek to collect and make available key data in a uniform manner from the countries they cover. However, these data are not primarily collected for this purpose, which makes interpretation and comparative analysis difficult. Examples of limitations of these data sources include: the extent to which they reflect operational priorities rather than market changes; question marks over the robustness of and consistency in data collection methods, and issues around the timeliness of data availability. Such problems are compounded by cultural, social and contextual differences between countries. Making sense of such data is therefore challenging and extreme care needs to be taken using it. Nevertheless, these data provide an important window on a hidden area, so improving the quality of the data collected and expanding its scope should be a priority for those seeking to understand or monitor drug markets and supply reduction. In addition to highlighting some of the potential pitfalls in using supply indicators for comparative analysis, this paper presents a selection of options for improvements based on the current EMCDDA programme of work to improve their supply-related monitoring and analysis. The conceptual framework developed to steer this work may have wider application. Adopting this approach has the potential to provide a richer picture of drug markets, at both national and international levels, and make it easier to compare data between countries., (Copyright © 2018 Elsevier B.V. All rights reserved.)

This essay argues that policies aimed at suppressing drug use exacerbate the nation's opioid problem. It neither endorses drug use nor advocates legalizing the consumption and sale of all substances in all circumstances. Instead, it contends that trying to suppress drug markets is the wrong goal, and in the midst of an addiction crisis it can be deadly. There is no single, correct drug policy; the right approach depends crucially on the substance at issue, the patterns of use and supply, and the jurisdiction's culture, institutions, and material resources. Decriminalization is no panacea for a nation's drug problems. Nevertheless, either de jure or de facto decriminalization of personal drug possession is a necessary condition for mitigating this crisis.

Introduction: Cryptomarkets operating on the darknet are a recent phenomenon that has gained importance only over the last couple of years (Barratt, 2012). However, they now constitute an evolving part of illicit drug markets. Although selling and buying a variety of psychoactive substances on the Internet has a long history, new technological developments enable systematic drug trading on the net.These technological innovations on the Internet allow users to proceed with (illicit) drug transactions with almost completely anonymous identities and locations. In this paper, we provide a systematic measurement analysis of structures and trends on the most popular anonymous drug marketplace, and discuss the role of cryptomarkets in drug distribution., Methods: Data collection and analysis include a long-term measurement of the cryptomarket 'AlphaBay', the most popular platform during the survey period. By developing and applying a web-scraping tool, market data was extracted from the marketplace on a daily basis during a period of twelve months between September 2015 and August 2016. The data was analysed by using business-intelligence software, which allows the linking of various data sets. We found 2188 unique vendors offering 11,925 drug items. The findings of our long-term monitoring and data analysis are compared over time and across marketplaces, offering a detailed understanding of the development of revenues generated, characterisation of countries of origin and destination, and distribution of vendors and customers over time., Results: We provide a nuanced and highly detailed longitudinal analysis of drug trading on the darknet marketplace 'AlphaBay', which was the largest cryptomarket in operation. 1) Total sales volumes for the 'drugs' section was estimated at approximately USD 94 million for the period from September 2015 to August 2016. 2) In addition, about 64% of all sales are made with cocaine-, cannabis-, heroin-, and ecstasy-related products. 3) Average selling prices increase over time for categories including cannabis and hashish, ecstasy, opioids, psychedelics and stimulants. 4) The five most frequent countries of origin as indicated by vendors are the United States, United Kingdom, Australia, the Netherlands and Germany. Moreover, it was demonstrated that drug distribution on cryptomarkets is conducted at a regional rather than global level. 6) Furthermore, 4.88% of vendors made over USD 200,000 and were responsible for 52.9% of total revenues generated over the period analysed. In contrast, 57.51% of vendors managed to sell drug items worth less than USD 10,000 within a period of twelve months. The findings suggest that 'AlphaBay' was a cryptomarket mainly from and for Western industrialised countries. In contrast, countries of the global South are neither among the main countries of origin nor destination countries., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: The importance of illicit drug price data and making appropriate adjustments for purity has been repeatedly highlighted for understanding illicit drug markets. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has been collecting retail price data for a number of drug types alongside drug-specific purity information for over 15 years. While these data are useful for a number of monitoring and analytical purposes, they are not without their limitations and there are circumstances where additional adjustment needs to be considered. This paper reviews some conceptual issues and measurement challenges relevant to the interpretation of price data. It also highlights the issues with between-country comparisons of drug prices and introduces the concept of affordability of drugs, going beyond purity-adjustment to account for varying national economies., Methods: Based on a 2015 European data set of price and purity data across the heroin and cocaine retail markets, the paper demonstrates a new model for drug market comparative analysis; calculation of drug affordability is achieved by applying to purity-adjusted prices 2015 Price Level Indices (PLI, Eurostat)., Results: Available data allowed retail heroin and cocaine market comparison for 27 European countries. The lowest and highest unadjusted prices per gram were observed for heroin: in Estonia, Belgium, Greece and Bulgaria (lowest) and Finland, Ireland, Sweden and Latvia (highest); for cocaine: the Netherlands, Belgium and the United Kingdom (lowest) and Turkey, Finland, Estonia and Romania (highest). The affordability per gram of heroin and cocaine when taking into account adjustment for both purity and economy demonstrates different patterns., Conclusion: It is argued that purity-adjusted price alone provides an incomplete comparison of retail price across countries. The proposed new method takes account of the differing economic conditions within European countries, thus providing a more sophisticated tool for cross-national comparisons of retail drug markets in Europe. Future work will need to examine other potential uses of the drug affordability tool., Limitations: The limitations of this measure reflect primarily the limitations of the constituent data; in addition to issues inherent in collecting accurate data on illicit markets, analysis that relies on data collected from multiple countries is susceptible to discrepancies in data collection practices from country to country., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Cryptomarkets, or illegal anonymizing online platforms that facilitate drug trade, have been analyzed in a rapidly growing body of research. Previous research has found that, despite increased risks, cryptomarket sellers are often willing to ship illegal drugs internationally. There is little to no information, however, about the extent to which uncertainty and risk related to geographic constraints shapes buyers' behavior and, in turn, the structure of the global online drug trade network. In this paper, we analyze the structure of a complete cryptomarket trade network with a focus on the role of geographic clustering of buyers and sellers., Methods: We use publicly available crawls of the cryptomarket Abraxas, encompassing market transactions between 463 sellers and 3542 buyers of drugs in 2015. We use descriptive social network analysis and Exponential Random Graph Models (ERGM) to analyze the structure of the trade network., Results: The structure of the online drug trade network is primarily shaped by geographical boundaries. Buyers are more likely to buy from multiple sellers within a single country, and avoid buying from sellers in different countries, which leads to strong geographic clustering. The effect is especially strong between continents and weaker for countries within Europe. A small fraction of buyers (10%) account for more than a half of all drug purchases, while most buyers only buy once., Conclusion: Online drug trade networks might still be heavily shaped by offline (geographic) constraints, despite their ability to provide access for end-users to large international supply. Cryptomarkets might be more "localized" and less international than thought before. We discuss potential explanations for such geographical clustering and implications of the findings., (Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Data on the prevalence and correlates of illegal drug use in Puerto Rico are now almost 20 years old., Objectives: This study sought to estimate the 12-month prevalence of illegal and non-prescribed medical drug use in San Juan, Puerto Rico and identify sociodemographic correlates of use., Methods: Data are from a random household sample of 1510 individuals, 18-64 years of age in San Juan, Puerto Rico., Results: The 12-month prevalence of any illegal or non-prescribed drug use was 16.5%. Prevalence among men (20.7%) was higher than among women (12.9%; chi 2  = 16.308; df = 1; p < .01). Prevalence for specific drugs ranged from 11.2% for marijuana to 0.2% for methadone., Results: of the multiple logistic regression analysis showed that male gender (OR = 1.67, 95CI = 1.21-2.3; p < .01), age 18-29 (OR = 2.39; 95CI = 1.35-4.23; p < .01), age 30-39 (OR = 1.93; 95CI = 1.01-3.69; p < .05), low (OR = 2.03; 95CI = 1.36-3.02; p < .001) and medium (OR = 1.50; 95CL = 1.01-2.23; p < .05) family cohesion/pride, and no religious preference (OR = 1.99; 95CI = 1.23-3.22; p < .01) increased the odds of drug use. Annual family income of $40,000-$60,000 (OR = 0.45; 95CI = 0.21-0.93; p < .05) and $60,001 and more (OR = 0.35; 95CI = 0.13-0.94; p > .05) were negatively associated with drug use compared to annual income up to $10,000., Conclusions: As in many other places in the U.S., drug use in San Juan, Puerto Rico is high, affecting about 1 in 6 adults in the population. The highest prevalence is for marijuana use, which cannot be medically prescribed and of which recreational use is illegal on the island., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Libya is facing a rapidly growing epidemic of illicit drug use and HIV. This situation is fueled by a complex array of factors, mainly the consequences of the political and military turmoil of the Arab Spring. Although it is extensively documented in other settings that young people are one of the most vulnerable groups to both HIV and illicit drug use, no study has explored this issue among young people in Libya. The current study addresses this research gap., Methods: This study is a qualitative study using in-depth interviews guided by a semi-structured questionnaire. We used a maximum variation, purposive sampling strategy to recruit male and female participants, aged 14-18 years, from schools, prisons, and community-based informal re-education and rehabilitation centers in Tripoli, Libya., Results: In total, 31 participants were recruited: 6 females and 25 males. Sixteen participants were prisoners and residents of community-based informal re-education and rehabilitation centers, and 15 were recruited in schools. Risk factors for drug use included peer influence, the increased availability and affordability of drugs, disruption of social life and healthy recreational activities, and the distress and casualties of the war. Protective factors were religious beliefs and practices, good parent-child connectedness, and high self-esteem and future aspiration. Risk factors for HIV were insufficient knowledge related to HIV transmission and unsafe injection practices, such as sharing needles and syringes., Conclusion: We found individual, interpersonal, family, and structural-level factors that interplayed to shape the vulnerability of young people to drug use and HIV infection in Tripoli, Libya. Structural factors, including the increased availability and affordability of drugs, provided the frame within which other factors, such as peer influence, insufficient knowledge of substance use, and HIV, operated to increase the vulnerability of young people to drugs and HIV, while religious beliefs and parent-child connectedness acted as protective factors. Multisectoral efforts and studies to quantitatively evaluate the magnitude and distribution of these problems are urgently needed., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: Australia has a reputation as an anomaly with regard to cryptomarket drug trading, with seemingly disproportionately high levels of activity given its relatively small size, high prices and anecdotal accounts of it being a destination where many foreign-based vendors will not sell. This paper aims to investigate these claims from a risk and prices perspective., Methods: By analysing data for over 60,000 drug products available for purchase from eight cryptomarkets in January 2016 this work builds a descriptive picture of the Australian online market in comparison to the rest of the world, before moving onto analyse the prices of drugs available to Australian consumers, both online and though conventional drug supply routes., Results: Results show that the Australian online illicit drugs market is of considerable size, internally isolated and with methamphetamine sales being particularly large by comparison to other countries. Australian cryptomarket vendors sell drugs at significantly higher prices than those listed by their foreign counterparts. Online prices are however broadly comparable to street prices, with the exception of methamphetamine where prices appear to be much lower online., Conclusions: These findings indicate that the perceived stringency of Australian border protection inadvertently increases the competitiveness and local market share of domestic cryptomarket vendors via a consumer side 'risk tariff', challenging the traditionally vendor-oriented drugs risk and prices framework., (Copyright © 2017 Elsevier B.V. All rights reserved.)

The social cost of drugs is the monetary cost of both the consequences of their trade and their consumption. In this paper, drugs considered are tobacco and alcohol, which are legal, plus those that are illegal. The social cost is the sum of the external cost: value of loss in quality of life, value of years of life lost and value of loss in productivity, plus public expenditure. Public expenditure consists of public spending on medical care, prevention, and law enforcement, minus savings from unpaid pensions and taxes levied on tobacco and alcohol. The parameters for the calculations have used the recommendations of a French governmental working group (2013) Quinet, L'évaluation socioéconomique des investissements publics [Internet], Centre d'Analyse Stratégique, 2013, http://www.strategie.gouv.fr/sites/strategie.gouv.fr/files/archives/CGSP&#95;Evaluation&#95;socioeconomique&#95;17092013.pdf , and the health data were derived from the scientific literature. The social costs are €122 billion for tobacco, €118 billion for alcohol, and €8.7 billion for illegal drugs. The largest fraction of the costs (53, 56, and 31 %, respectively) derives from the number of deaths, 79,000 for tobacco, 49,000 for alcohol, and 1600 for illegal drugs, given the high cost of a year of life lost (€115,000). The external cost corresponds to 86, 97, and 68 % of the social cost, respectively, for tobacco, alcohol, and illegal drugs. The annual drug-related net expenditure represents €13.9, €3.0, and €2.3 billion, respectively, for tobacco, alcohol, and illegal drugs. The tax revenues on tobacco and alcohol, €10.4 and €3.2 billion, represent less than half of the corresponding healthcare costs, which are €25.9 and €7.7 billion.

Issues: Drug use accounts for one of the main disease groups in Europe, with relevant consequences to society. There is an increasing need to evaluate the economic consequences of drug use in order to develop appropriate policies. Here, we review the social costs of illegal drugs, alcohol and tobacco in the European Union., Approach: A systematic search of relevant databases was conducted. Grey literature and previous systematic reviews were also searched. Studies reporting on social costs of illegal drugs, alcohol and tobacco were included. Methodology, cost components as well as costs were assessed from individual studies. To compare across studies, final costs were transformed to 2014 Euros., Key Findings: Forty-five studies reported in 43 papers met the inclusion criteria (11 for illegal drugs, 26 for alcohol and 8 for tobacco). While there was a constant inclusion of direct costs related to treatment of substance use and comorbidities, there was a high variability for the rest of cost components. Total costs showed also a great variability. Price per capita for the year 2014 ranged from €0.38 to €78 for illegal drugs, from €26 to €1500 for alcohol and from €10.55 to €391 for tobacco., Implications and Conclusions: Drug use imposes a heavy economic burden to Europe. However, given the high existing heterogeneity in methodologies, and in order to better assess the burden and thus to develop adequate policies, standardised methodological guidance is needed. [Barrio P, Reynolds J, García-Altés A, Gual A, Anderson P. Social costs of illegal drugs, alcohol and tobacco in the European Union: A systematic review. Drug Alcohol Rev 2017;00:000-000]., (© 2017 Australasian Professional Society on Alcohol and other Drugs.)

Cryptomarkets offer insight into the evolving interplay between online black markets and cartel-based distribution. The types and forms of heroin, fentanyl, and prescription drugs show wide diversification. In this commentary we describe changes in the conceptualizations, technologies and structures of drug supply chains in the 21st Century, with special attention to the role of cryptomarkets as tools, contexts, and drivers of innovation in public health research., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: New psychoactive substances (NPS) are on offer worldwide online, in order to shed light on the purity and price of these substances in the European Union, a research collaboration was set up involving France, United Kingdom (UK), the Netherlands, Czech Republic and Poland., Methods: Per country, around 10 different NPS were test purchased from different webshops. Then, chemical analysis of NPS was done with according reference standards to identify and quantify the contents., Results: In contrast to what is generally advertised on the webshops (>99%), purity varied considerably per test purchased NPS. Several NPS were mislabelled, some containing chemical analogues (e.g. 25B/C-NBOMe instead of 25I-NBOMe, pentedrone instead of 3,4-DMMC). But in some cases NPS differed substantially from what was advertised (e.g. pentedrone instead of AMT or 3-FMC instead of 5-MeO-DALT). Per gram, purity-adjusted prices of cathinones differed substantially between three countries of test purchase, with Poland being the least expensive. Synthetic cannabinoids were relatively the most expensive in the Czech Republic and least expensive in the UK., Conclusion: The current findings provides a snapshot of the price and chemical contents of NPS products purchased by different countries and in different webshops. There is a potential danger of mislabelling of NPS. The great variety in price and purity of the delivered products might be the result of the market dynamics of supply and demand and the role of law enforcement in different European countries., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: Legal and illegal drugs impose a considerable burden to the individual and to society. The misuse of addictive substances results in healthcare and law enforcement costs, loss of productivity and reduced quality of life., Methods: A social cost study was conducted to estimate the substance-attributable costs of alcohol, tobacco, illegal drugs and psychoactive medication to Belgian society in 2012. The cost-of-illness framework with prevalence-based and human capital approach was applied. Three cost components were considered: direct, indirect and intangible costs related to substance misuse., Results: The direct and indirect cost of addictive substances was estimated at 4.6 billion euros in Belgium (419 euros per capita or 1.19% of the GDP) and more than 515,000 healthy years are lost due to substance misuse. The Belgian social cost study reaffirms that alcohol and tobacco impose the highest cost to society compared to illegal drugs. Health problems are the main driver of the social cost of legal drugs. Law enforcement expenditure exceed the healthcare costs but only in the case of illegal drugs., Conclusion: Estimating social costs of addictive substances is complex because it is difficult to determine to what extent the societal harm is caused by substances. It can be argued that social cost studies take only a 'snapshot' of the monetary consequences of substance misuse. Nevertheless, the current study offers the most comprehensive analysis thus far of the social costs of substance misuse in Belgium., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: Illegal drugs consumption not only has a notable impact on the population's health, but also leads to major socio-economic costs. A significant characteristic of drug consumers is that the majority are of working age. The main aim of this study is to estimate the economic impact of drug consumption in Spain from a social perspective., Methods: A cost-of-illness methodology is carried out and a distinction is made between health-related and non-health related direct costs, as well as indirect costs. Among the direct health care costs included are hospitalisations, primary and emergency care, support programmes and HIV outpatient care. Expenditure on prevention, law enforcement and research was included as direct costs falling outside of health care. Productivity losses due to premature deaths attributed to substance abuse and patient hospitalisation formed part of indirect costs., Results: For 2012, the total social cost related to drug consumption in Spain was somewhere between 1,436 and 1,651 million euros. The minimum cost of this consumption represented 0.14% of Spain's GDP for that year., Conclusion: The present cost estimations provide a measure of the social burden that illegal drug consumption represents for the community. When it comes to allocating resources, the obtained results quantify the potential economic returns that could be achieved from effective policies and programmes aimed at reducing the consumption of illegal drugs., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objective: Nowadays, the web is rapidly spreading, playing a significant role in the marketing or sale or distribution of "quasi" legal drugs, hence facilitating continuous changes in drug scenarios. The easily renewable and anarchic online drug-market is gradually transforming indeed the drug market itself, from a "street" to a "virtual" one, with customers being able to shop with a relative anonymity in a 24-hr marketplace. The hidden "deep web" is facilitating this phenomenon. The paper aims at providing an overview to mental health's and addiction's professionals on current knowledge about prodrug activities on the deep web., Methods: A nonparticipant netnographic qualitative study of a list of prodrug websites (blogs, fora, and drug marketplaces) located into the surface web was here carried out. A systematic Internet search was conducted on Duckduckgo® and Google® whilst including the following keywords: "drugs" or "legal highs" or "Novel Psychoactive Substances" or "NPS" combined with the word deep web., Results: Four themes (e.g., "How to access into the deepweb"; "Darknet and the online drug trading sites"; "Grams-search engine for the deep web"; and "Cryptocurrencies") and 14 categories were here generated and properly discussed., Conclusions: This paper represents a complete or systematical guideline about the deep web, specifically focusing on practical information on online drug marketplaces, useful for addiction's professionals., (Copyright © 2017 John Wiley & Sons, Ltd.)

Objective: The hidden Web is used for the anonymous sale of drugs, and with the UK Psychoactive Substances Act, 2016, implemented on May 26th 2016; it could increase as a platform for obtaining new psychoactive substances (NPS). This study aims to describe the NPS market on the visible and hidden Web preban, and assess whether the hidden Web is a likely place for the sale of NPS postban., Methods: Data collection of 113 online shops took place in October 2015. Data collection of 22 cryptomarkets took place every 2 months from October 2015 to 2016 as part of the CASSANDRA project., Results: All online shops with a UK domain location sold NPS that were uncontrolled by the UK Misuse of Drugs Act, 1971, and closed after the ban. Of the cryptomarkets analysed, the total number of vendors selling NPS, number of substances, and listings advertised, all increased over the year. The majority of the NPS advertised on the hidden Web were phenethylamines and cathinones, yet the majority of uncontrolled NPS were synthetic cannabinoids., Conclusions: Vendors selling and availability of NPS increased over the 12 months of data collection. Potential displacement from the visible Web to hidden Web should be taken into consideration., (Copyright © 2017 John Wiley & Sons, Ltd.)

Objective: To examine the purchasing and supply patterns of new psychoactive substance (NPS) consumers in Australia., Method: Data were obtained from a self-selected sample of 296 past-year NPS consumers, with comparisons made across dimethyltryptamine (n = 104), 2C-x (n = 59), NBOMe (n = 27), and synthetic cannabinoid (n = 22) users., Results: Most consumers (58%) nominated a friend as their main NPS source, and almost half (46%) reported that they had supplied NPS to others in the past year (predominantly "social supply"). However, when comparisons were made across NPS, NBOMe users were more likely to nominate a dealer (30%) or online marketplace (22%) as their main source and to report: supplying NPS to others (63%); supplying to strangers (29%) and acquaintances (24%); and supplying NPS for cash profit (29%). Similarly, NPS consumers who nominated online markets as their main NPS source (9%; n = 26) were more likely to have supplied NPS to others (risk ratio [RR] 1.57); supplied to strangers (RR 6.05) and acquaintances (RR 12.11); sold NPS for cash profit (RR 4.36); and to have exchanged NPS for something else (RR 3.27) than those who reported alternative primary sources., Conclusion: NBOMe consumers and those who nominated online markets as their main NPS source reported greater engagement with for-profit supply; it is unclear if these individuals have "drifted" into dealing or if they were already engaged in such activities., (Copyright © 2017 John Wiley & Sons, Ltd.)

A range of information needs should be met in order to better understand and predict the longevity/existence of novel psychoactive substances (NPS). This conceptual paper argues that one way of assessing how long a molecule may be around is to document how the life cycles or natural histories of 'traditional' drugs and NPS evolve. The earliest indication of the possible appearance of a new substance might be evidenced on the DeepWeb. However, this means they are less visible, in line with the clandestine nature of drug use and supply. Therefore, monitoring discussion groups/fora needs the development of new methods compared to those used in the Surface Net. Issues needing consideration in establishing NPS life cycles are outlined here, together with the probable outcomes that could result. The approach advocated means that it should be easier to identify which NPS are likely to come up or are emerging in real time, and, therefore, pre-empt/prevent their supply., (Copyright © 2017 John Wiley & Sons, Ltd.)

Background and Aims: On-line drug markets flourish and consumers have high expectations of on-line quality and drug value. The aim of this study was to (i) describe on-line drug purchases and (ii) compare on-line with off-line purchased drugs regarding purity, adulteration and price., Design: Comparison of laboratory analyses of 32 663 drug consumer samples (stimulants and hallucinogens) purchased between January 2013 and January 2016, 928 of which were bought on-line., Setting: The Netherlands., Measurements: Primary outcome measures were (i) the percentage of samples purchased on-line and (ii) the chemical purity of powders (or dosage per tablet); adulteration; and the price per gram, blotter or tablet of drugs bought on-line compared with drugs bought off-line., Findings: The proportion of drug samples purchased on-line increased from 1.4% in 2013 to 4.1% in 2015. The frequency varied widely, from a maximum of 6% for controlled, traditional substances [ecstasy tablets, 3,4-methylenedioxy-methamphetamine (MDMA) powder, amphetamine powder, cocaine powder, 4-bromo-2,5-dimethoxyphenethylamine (2C-B) and lysergic acid diethylamide (LSD)] to more than a third for new psychoactive substances (NPS) [4-fluoroamphetamine (4-FA), 5/6-(2-aminopropyl)benzofuran (5/6-APB) and methoxetamine (MXE)]. There were no large differences in drug purity, yet small but statistically significant differences were found for 4-FA (on-line 59% versus off-line 52% purity for 4-FA on average, P = 0.001), MDMA powders (45 versus 61% purity for MDMA, P = 0.02), 2C-B tablets (21 versus 10 mg 2C-B/tablet dosage, P = 0.49) and ecstasy tablets (131 versus 121 mg MDMA/tablet dosage, P = 0.05). The proportion of adulterated samples purchased on-line and off-line did not differ, except for 4-FA powder, being less adulterated on-line (χ 2  = 8.3; P < 0.02). Drug prices were mainly higher on-line, ranging for various drugs from 10 to 23% higher than that of drugs purchased off-line (six of 10 substances: P < 0.05)., Conclusions: Dutch drug users increasingly purchase drugs on-line: new psychoactive substances in particular. Purity and adulteration do not vary considerably between drugs purchased on-line and off-line for most substances, while on-line prices are mostly higher than off-line prices., (© 2016 Society for the Study of Addiction.)

Supply-side interventions, which we define as laws, regulations, enforcement activities, and other measures that extend from drug production to dealing, feature prominently in drug policy and related expenditures internationally, but have undergone relatively little rigorous, empirical evaluation. We argue for filling the knowledge gap and highlight three areas of particular concern: first, the policy community knows less than it should about the efficacy of supply-side interventions; second, it lacks sufficient understanding of the scope, magnitude, and practical implications of adverse consequences that accompany such interventions; third, it lacks tools to gauge the balance of benefits and costs, both monetary and non-monetary. Our interest has been in developing a harm-based approach to address these concerns and we put forward a "harm assessment framework" for that purpose., (Copyright © 2017 Elsevier B.V. All rights reserved.)

We estimate a model of illicit drugs markets using data on purchases of crack cocaine. Buyers are searching for high-quality drugs, but they determine drugs' quality (i.e., their purity) only after consuming them. Hence, sellers can rip off first-time buyers or can offer higher-quality drugs to induce buyers to purchase from them again. In equilibrium, a distribution of qualities persists. The estimated model implies that if drugs were legalized, in which case purity could be regulated and hence observable, the average purity of drugs would increase by approximately 20 percent and the dispersion would decrease by approximately 80 percent. Moreover, increasing penalties may raise the purity and affordability of the drugs traded by increasing sellers’ relative profitability of targeting loyal buyers versus first-time buyers.

Background: Cryptomarkets represent an important drug market innovation by bringing buyers and sellers of illegal drugs together in a 'hidden' yet public online marketplace. We ask: How do cryptomarket drug sellers and buyers perceive the risks of detection and arrest, and attempt to limit them?, Methods: We analyse selected texts produced by vendors operating on the first major drug cryptomarket, Silk Road (N=600) alongside data extracted from the marketplace discussion forum that include buyer perspectives. We apply Fader's (2016) framework for understanding how drug dealers operating 'offline' attempt to reduce the risk of detection and arrest: visibility reduction, charge reduction and risk distribution., Results: We characterize drug transactions on cryptomarkets as 'stretched' across time, virtual and physical space, and handlers, changing the location and nature of risks faced by cryptomarket users. The key locations of risk of detection and arrest by law enforcement were found in 'offline' activities of cryptomarket vendors (packaging and delivery drop-offs) and buyers (receiving deliveries). Strategies in response involved either creating or disrupting routine activities in line with a non-offending identity. Use of encrypted communication was seen as 'good practice' but often not employed. 'Drop shipping' allowed some Silk Road vendors to sell illegal drugs without the necessity of handling them., Conclusion: Silk Road participants neither viewed themselves as immune to, nor passively accepting of, the risk of detection and arrest. Rational choice theorists have viewed offending decisions as constrained by limited access to relevant information. Cryptomarkets as 'illicit capital' sharing communities provide expanded and low-cost access to information enabling drug market participants to make more accurate assessments of the risk of apprehension. The abundance of drug market intelligence available to those on both sides of the law may function to speed up innovation in illegal drug markets, as well as necessitate and facilitate the development of law enforcement responses., (Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.)

The internet facilitates rapid and covert communication, knowledge transfer, and has the potential to disrupt and transform drug market models and associated consumption patterns. Innovation and new trends diffuse rapidly through this medium and new operational models are emerging. Although the online drug markets currently only account for a small share of all drug transactions, the potential of the surface and deep web to provide a new platform for drug sale and exchanges is considerable., (© 2016 American Society for Clinical Pharmacology and Therapeutics.)

Background: This paper explores the understudied phenomenon of performance and image enhancing drug (PIED) markets by examining the structure and formation of the market for PIEDs among bodybuilders in the Netherlands and Belgium. This article specifically seeks to account for individual reasons and motivations for dealing PIEDs within these bodybuilding subcultures. Understanding illicit PIED markets is important for policy decisions as knowledge on the production and distribution of these substances may assist in designing law enforcement efforts, harm reduction initiatives and treatment options., Methods: This article draws on two years of fieldwork in various bodybuilding settings, 47 semi-structured interviews with individuals who are directly or indirectly involved in the PIED market and 64 PIED dealing cases initiated by criminal justice agencies in the Netherlands and Belgium., Findings: The data indicates that PIED dealing groups and individuals are often driven by motivations stemming from their social and cultural embeddedness in the bodybuilding subculture. Specifically, these PIED dealers are 'over-socialized' into the structure and culture of bodybuilding and follow the cultural scripts that come with their group affiliation and organization. As a result of the cultural context in which these transactions occur, PIED dealing networks among bodybuilders in the Netherlands and Belgium are more likely to consist of friends or 'friends of friends' tied together by threads of collective meaning found within the bodybuilding subculture., Conclusion: We argue that efforts seeking to explain the structure, formation and motivations of illicit PIED dealing must learn to appreciate how culture mediates structural forces and thereby influences individual and collective action. Policy makers, health care professionals and other relevant parties should consider a plurality of factors (social, economic and cultural) when designing and evaluating PIED-related interventions such as law enforcement efforts, harm reduction initiatives and treatment options., (Copyright © 2016 Elsevier B.V. All rights reserved.)

The concepts behind current "designer drugs" are not new. For several centuries, chemical synthesis has made drugs more specific and more selective. However, headline designer drugs now are different and a serious public health problem because they are illicit unregulated chemical knockoffs of approved psychoactive stimulant, sedative, or perception-altering controlled substances., (© 2016 ASCPT.)

The impact of illicit drug markets on the occurrence of violence varies tremendously depending on many factors. Over the last years, Mexico and the USA have increased security border issues that included many aspects of drug-related trade and criminal activities. Mexico experienced only a small reduction in trauma deaths after the enforcement of severe crime reinforcement policies. This strategy in the war on drugs is shifting the drug market to other Central American countries. This phenomenon is called the ballooning effect, whereby the pressure to control illicit drug-related activities in one particular area forces a shift to other more vulnerable areas that leads to an increase in crime and violence. A human rights crisis characterized by suffering, injury, and death related to drug trafficking continues to expand, resulting in the exorbitant loss of lives and cost in productivity across the continent. The current climate of social violence in Central America and the illegal immigration to the USA may be partially related to this phenomenon of drug trafficking, gang violence, and crime. A health care initiative as an alternative to the current war approach may be one of the interventions needed to reduce this crisis., (© 2017 S. Karger AG, Basel.)