Dit artikel maakt deel uit van de door ZonMw gesubsidieerde (nr. 31160012) multidisciplinaire stu... more Dit artikel maakt deel uit van de door ZonMw gesubsidieerde (nr. 31160012) multidisciplinaire studie 'Prevalence, treatment needs and new pharmacotherapeutic treatment options for crack dependent people in the Netherlands'.
Crack users in the Netherlands are an ageing and diverse population with longstanding criminal ca... more Crack users in the Netherlands are an ageing and diverse population with longstanding criminal careers. Our aim was to assess factors associated with current criminal involvement and specialization in selling drugs, property crime and violence. A sample of 1,039 frequent crack users was recruited in three major Dutch cities, combining respondent-driven sampling with random institutional sampling. Bivariate and logistic regression analyses were performed to find factors associated with current criminality. A total of 431 participants (41.5%) had engaged in crime in the past 30 days, mostly selling drugs (68.9%), followed by property crimes (34.4%) and a few cases of violent crime (9.7%). Younger age, homelessness, heavier patterns of use and a more prolific criminal justice history were associated with current criminality. Those receiving welfare benefits tended to be more likely to specialize only in selling drugs as opposed to (also) property crimes. Reducing drug use among crimina...
Veel heroïnegebruikers roken tegenwoordig ook basecoke. Wat er over basecokegebruikers gezegd en ... more Veel heroïnegebruikers roken tegenwoordig ook basecoke. Wat er over basecokegebruikers gezegd en geschreven wordt, komt meestal uit de drugshulpverlening. Misschien levert dat een vertekend beeld op en verschillen deze cliënten van de gebruikers buiten de verslavingszorg. Zijn ze bijvoorbeeld vaker allochtoon of nemen ze vaker geen heroïne? Om hier zicht op te krijgen moet je onderzoek doen buiten de muren van de drugshulpverlening. In Amsterdam interwiewden wij 439 basecokegebruikers: een veldsteekproef volgens de methodologie van 'respondent-driven sampling' (RDS), een variant van de sneeuwbalmethode, plus twee aselecte steekproeven van gebruikers uit respectievelijk de laagdrempelige verstrekking en bezoekers van gebruikersruimten. In dit artikel wordt vooral ingegaan op de praktijk van RDS. Ook schetsen we een profiel van de gebruikers die met de verschillende onderzoeksmethoden zijn bereikt. Met RDS blijken deels andere segmenten van de gebruikerspopulatie te worden bereikt, resulterend in een meer gevarieerd beeld van de Amsterdamse basecokegebruikers. Ruim een kwart van de RDS-respondenten heeft de laatste maand geen contact met verslavingszorg.
The aim of this study was to estimate the prevalence of crack dependence in the three largest Dut... more The aim of this study was to estimate the prevalence of crack dependence in the three largest Dutch cities (Amsterdam, Rotterdam, The Hague), stratified by gender and age. Three-sample capture-recapture, using data (collected between 2009 and 2011) from low threshold substitution treatment (n = 1,764), user rooms (n = 546), and a respondent-driven sample (n = 549), and applying log-linear modeling (covariates: gender, age, and city), provided a prevalence rate of 0.51% (95% CI: 0.46%-0.60%) for the population aged 15-64 years, with similar estimates for the three cities. Females (23.0% of total estimate) and younger crack users (12.8% aged <35 years) might be underrepresented in drug user treatment services.
Background/Aim: Respondent-driven sampling (RDS) is increasingly applied in social epidemiologica... more Background/Aim: Respondent-driven sampling (RDS) is increasingly applied in social epidemiological surveys among ‘hidden populations’ of hard drug users. The objective of the present study was to assess whether the profile of frequent crack users recruited through RDS differed from those surveyed in two random institutional samples, i.e. low-threshold opiate substitution treatment (ST) and user rooms (URs). Methods: A total of 1,039 crack users (mean age 45.1 ± 9.1 years; 81.5% males; 49.5% non-Western ethnicity) were interviewed in three Dutch cities, using each sampling strategy in each city. Characteristics of respondents in the three samples (per city and aggregated) were compared. Results: Crack users in the RDS sample were more likely to be younger and less likely to be poorly educated, have a long crack-using career (≥10 years), use opiates and attend ST than those in both of the other samples. The RDS and UR samples showed the most differences, with more female and Western c...
Background Opioids were implicated in approximately 88,000 fatal overdoses (OD) globally. However... more Background Opioids were implicated in approximately 88,000 fatal overdoses (OD) globally. However, in principle all opioid OD are reversible with the timely administration of naloxone hydrochloride. Despite the widespread availability of naloxone among people who use opioids (PWUO), many who suffer fatal OD use alone, without others present to administer the reversal agent. Recognising this key aspect of the challenge calls for innovations, a number of technological approaches have emerged which aim to connect OD victims with naloxone. However, the acceptability of OD response technologies to PWUO is of key concern. Methods Drawing on the Technology People Organisations Macroenvironment (TPOM) framework, this study sought to integrate acceptability-related findings in this space with primary research data from PWUO, affected family members and service providers to understand the factors involved in harm reduction technology acceptability. A qualitative study using a focus group methodology was conducted. The participant groups were people with lived experience of problem opioid use, affected family members and service providers. Data analysis followed a multistage approach to thematic analysis and utilised both inductive and deductive methods. Results Thirty individuals participated in one of six focus groups between November 2021 and September 2022. The analysis generated six major themes, three of which are reported in this article-selected for their close relevance to PWUO and their importance to developers of digital technologies for this group. 'Trust-in technologies, systems and people' was a major theme and was closely linked to data security, privacy and confidentiality. 'Balancing harm reduction, safety and ambivalence' reflects the delicate balance technological solutions must achieve to be acceptable to PWUO. Lastly, 'readiness-a double bind' encapsulates the perception shared across participant groups, that those at the highest risk, may be the least able to engage with interventions. Conclusion Effective digital strategies to prevent fatal OD must be sensitive to the complex relationships between technological, social/human, organisational and wider macroenvironmental factors which can enable or impede intervention delivery. Trust, readiness and performance are central to technology acceptability for PWUO. An augmented TPOM was developed (the TPOM-ODART).
Background Telemedicine-delivered medication for opioid use disorder (TMOUD) has become more prev... more Background Telemedicine-delivered medication for opioid use disorder (TMOUD) has become more prevalent during the COVID-19 pandemic, particularly in North America. This is considered a positive development as TMOUD has the potential to increase access to evidence-based treatment for a population heavily affected by the opioid crisis and consequent rising mortality and morbidity rates in relation to opioid use disorder. Despite the increase in the use of TMOUD, there are no established service- and process-focused models to guide the implementation of this intervention. Objective This study aims to develop a process- and service-focused implementation model in collaboration with key stakeholders and bring together peer-reviewed literature, practice-based knowledge, and expert opinions. Methods The simple rules for evidence translation in complex systems framework was applied to guide the development of a 6-step qualitative study. The steps were definition of the scope and objectives ...
Background Opioids were implicated in approximately 88,000 fatal overdoses (OD) globally. However... more Background Opioids were implicated in approximately 88,000 fatal overdoses (OD) globally. However, in principle all opioid OD are reversible with the timely administration of naloxone hydrochloride. Despite the widespread availability of naloxone among people who use opioids (PWUO), many who suffer fatal OD use alone, without others present to administer the reversal agent. Recognising this key aspect of the challenge calls for innovations, a number of technological approaches have emerged which aim to connect OD victims with naloxone. However, the acceptability of OD response technologies to PWUO is of key concern. Methods Drawing on the Technology People Organisations Macroenvironment (TPOM) framework, this study sought to integrate acceptability-related findings in this space with primary research data from PWUO, affected family members and service providers to understand the factors involved in harm reduction technology acceptability. A qualitative study using a focus group meth...
BACKGROUND The use of telemedicine to deliver medications for the treatment of opioid use disorde... more BACKGROUND The use of telemedicine to deliver medications for the treatment of opioid use disorder (TMOUD) has become more prevalent during the COVID-19 pandemic, particularly in North America. This is considered a positive development as TMOUD has the potential to increase access to evidence-based treatment for a population heavily impacted by the opioid crisis and consequent rising mortality and morbidity rates in relation to opioid use disorder. Despite the rise in the use of TMOUD, there is a lack of consensus on best practice regarding the design, delivery, and implementation of TMOUD interventions across different settings. OBJECTIVE This study was designed to produce consensus and evidence-based guidance for the implementation and delivery of TMOUD. METHODS The successful healthcare improvement from translating evidence framework for evidence translation in complex systems was applied. A three-level qualitatively modified Delphi process was implemented to obtain multi-stakeho...
Context: Acute toxicity caused by illicit substance use is a common reason for emergency departme... more Context: Acute toxicity caused by illicit substance use is a common reason for emergency department (ED) presentation. Knowledge of the substances involved is helpful for predicting and managing potential toxicity, but limited information is available about the accuracy of patient-reported substance exposure. This study assessed the accuracy of the history of exposure in those reporting use of a single substance by comparison with those identified by detailed toxicological analysis, focusing on synthetic cannabinoid receptor agonists (SCRA). Methods: Adults (!16 years) presenting between March 2015 and July 2021 to participating UK hospitals with toxicity after reporting use of a single illicit substance were included. Exposure details were documented from medical records and blood and/or urine samples analysed using high-resolution accurate mass liquid chromatography-mass spectrometry (HRAM LCMS). Sensitivity, specificity, and positive and negative predictive values of the exposure history were calculated by comparison with biological sample analysis ("gold standard"). Results: Single substance exposure was reported for 474 (median age 33 years, IQR: 18 range 16-75, 80% males) patients. Analysis commonly identified multiple substances (Median 3, IQR 2-5). A history of exposure was documented for 121 of 151 patients where a SCRA or metabolite was detected on analysis (sensitivity 80.1%, 95% CI 72.9, 86.2%). Corresponding proportions were lower for 3,4-methylenedioxymethamphetamine (MDMA, 44/70, 62.9%., 95% CI 50.5%, 74.1%), heroin 41/108 (38.0% 95% CI 28.8-47.8%) and cocaine (22/56, 31.3%, 95% CI 20.9, 43.6%). Conclusions: Multiple undeclared substances were detected analytically in most patients reporting single substance use. Clinicians should be alert to the potential presence and toxicity of unreported substances when managing patients presenting after substance misuse.
BACKGROUND Drug overdose deaths, particularly from opioids, are a major global burden, with 128,0... more BACKGROUND Drug overdose deaths, particularly from opioids, are a major global burden, with 128,000 deaths estimated in 2019. Opioid overdoses can be reversed through the timely administration of naloxone but only if responders are able to administer it. There is an emerging body of research and development in technologies that can detect the early signs of an overdose and facilitate timely responses. OBJECTIVE Our aim was to identify and classify overdose-specific digital technologies being developed, implemented, and evaluated. METHODS We conducted a “state-of-the-art review.” A systematic search was conducted in MEDLINE, Embase, Web of Science, Scopus, ACM, IEEE Xplore, and SciELO. We also searched references from articles and scanned the gray literature. The search included terms related to telehealth and digital technologies, drugs, and overdose and papers published since 2010. We classified our findings by type of technology and its function, year of publication, country of st...
Director, EMCDDA appreciate the input of EMCDDA Scientific Committee members Anne-Line Brettevill... more Director, EMCDDA appreciate the input of EMCDDA Scientific Committee members Anne-Line Bretteville Jensen and Dirk Korf for their input on the final draft. I Dark net markets and interventions Both demand reduction and supply reduction interventions on the surface web have been gathering pace (EMCDDA, 2013; Interpol, 2015). The deep web, however, has provided new opportunities and challenges ultimately ensure consumer safety. Reports suggest, however, that there are a sizeable number of illegitimate online pharmacies involved in the illicit supply of products. These sites are not registered with any recognised accreditation system and do not abide by regulations and professional standards; therefore, they are operating illegally. There is concern that illegitimate online pharmacies may have a role in the supply of drugs for misuse. This is an area explored in more detail in Chapter 11, drawing on the limited studies available in this area.
To assess key characteristics of the retail crack market and the role of users as buyers and sell... more To assess key characteristics of the retail crack market and the role of users as buyers and sellers, data from a survey inside and outside institutional setting among 1,039 crack users in the three largest Dutch cities were analyzed to explore their role in the crack market as buyers and sellers. Of the total number of users, 42.3% bought crack in public places, 39.6% through home delivery, and 13.9% at dealer’s addresses. Near one-third reported participating in selling drugs, defining themselves as “go-betweens” (21.4%) or “dealers” (9.2%). User-sellers and nonselling users did not differ with regard to gender and ethnicity. Cluster analysis resulted in three distinct types of user-sellers (freelancers, assistants, and amateurs), each characterized by time spent selling drugs, type of drugs sold, and earnings. Amateurs seem quite similar to what scholars have labeled “social dealers” in recreational drugs markets. This study suggests the need for a more differentiated law enforce...
To assess key characteristics of the retail crack market and the role of users as buyers and sell... more To assess key characteristics of the retail crack market and the role of users as buyers and sellers, data from a survey inside and outside institutional setting among 1,039 crack users in the three largest Dutch cities were analyzed to explore their role in the crack market as buyers and sellers. Of the total number of users, 42.3% bought crack in public places, 39.6% through home delivery, and 13.9% at dealer's addresses. Near one-third reported participating in selling drugs, defining themselves as "go-betweens" (21.4%) or "dealers" (9.2%). User-sellers and nonselling users did not differ with regard to gender and ethnicity. Cluster analysis resulted in three distinct types of user-sellers (freelancers, assistants, and amateurs), each characterized by time spent selling drugs, type of drugs sold, and earnings. Amateurs seem quite similar to what scholars have labeled "social dealers" in recreational drugs markets. This study suggests the need for a more differentiated law enforcement policy toward drug-selling users.
Dit artikel maakt deel uit van de door ZonMw gesubsidieerde (nr. 31160012) multidisciplinaire stu... more Dit artikel maakt deel uit van de door ZonMw gesubsidieerde (nr. 31160012) multidisciplinaire studie 'Prevalence, treatment needs and new pharmacotherapeutic treatment options for crack dependent people in the Netherlands'.
Crack users in the Netherlands are an ageing and diverse population with longstanding criminal ca... more Crack users in the Netherlands are an ageing and diverse population with longstanding criminal careers. Our aim was to assess factors associated with current criminal involvement and specialization in selling drugs, property crime and violence. A sample of 1,039 frequent crack users was recruited in three major Dutch cities, combining respondent-driven sampling with random institutional sampling. Bivariate and logistic regression analyses were performed to find factors associated with current criminality. A total of 431 participants (41.5%) had engaged in crime in the past 30 days, mostly selling drugs (68.9%), followed by property crimes (34.4%) and a few cases of violent crime (9.7%). Younger age, homelessness, heavier patterns of use and a more prolific criminal justice history were associated with current criminality. Those receiving welfare benefits tended to be more likely to specialize only in selling drugs as opposed to (also) property crimes. Reducing drug use among crimina...
Veel heroïnegebruikers roken tegenwoordig ook basecoke. Wat er over basecokegebruikers gezegd en ... more Veel heroïnegebruikers roken tegenwoordig ook basecoke. Wat er over basecokegebruikers gezegd en geschreven wordt, komt meestal uit de drugshulpverlening. Misschien levert dat een vertekend beeld op en verschillen deze cliënten van de gebruikers buiten de verslavingszorg. Zijn ze bijvoorbeeld vaker allochtoon of nemen ze vaker geen heroïne? Om hier zicht op te krijgen moet je onderzoek doen buiten de muren van de drugshulpverlening. In Amsterdam interwiewden wij 439 basecokegebruikers: een veldsteekproef volgens de methodologie van 'respondent-driven sampling' (RDS), een variant van de sneeuwbalmethode, plus twee aselecte steekproeven van gebruikers uit respectievelijk de laagdrempelige verstrekking en bezoekers van gebruikersruimten. In dit artikel wordt vooral ingegaan op de praktijk van RDS. Ook schetsen we een profiel van de gebruikers die met de verschillende onderzoeksmethoden zijn bereikt. Met RDS blijken deels andere segmenten van de gebruikerspopulatie te worden bereikt, resulterend in een meer gevarieerd beeld van de Amsterdamse basecokegebruikers. Ruim een kwart van de RDS-respondenten heeft de laatste maand geen contact met verslavingszorg.
The aim of this study was to estimate the prevalence of crack dependence in the three largest Dut... more The aim of this study was to estimate the prevalence of crack dependence in the three largest Dutch cities (Amsterdam, Rotterdam, The Hague), stratified by gender and age. Three-sample capture-recapture, using data (collected between 2009 and 2011) from low threshold substitution treatment (n = 1,764), user rooms (n = 546), and a respondent-driven sample (n = 549), and applying log-linear modeling (covariates: gender, age, and city), provided a prevalence rate of 0.51% (95% CI: 0.46%-0.60%) for the population aged 15-64 years, with similar estimates for the three cities. Females (23.0% of total estimate) and younger crack users (12.8% aged <35 years) might be underrepresented in drug user treatment services.
Background/Aim: Respondent-driven sampling (RDS) is increasingly applied in social epidemiologica... more Background/Aim: Respondent-driven sampling (RDS) is increasingly applied in social epidemiological surveys among ‘hidden populations’ of hard drug users. The objective of the present study was to assess whether the profile of frequent crack users recruited through RDS differed from those surveyed in two random institutional samples, i.e. low-threshold opiate substitution treatment (ST) and user rooms (URs). Methods: A total of 1,039 crack users (mean age 45.1 ± 9.1 years; 81.5% males; 49.5% non-Western ethnicity) were interviewed in three Dutch cities, using each sampling strategy in each city. Characteristics of respondents in the three samples (per city and aggregated) were compared. Results: Crack users in the RDS sample were more likely to be younger and less likely to be poorly educated, have a long crack-using career (≥10 years), use opiates and attend ST than those in both of the other samples. The RDS and UR samples showed the most differences, with more female and Western c...
Background Opioids were implicated in approximately 88,000 fatal overdoses (OD) globally. However... more Background Opioids were implicated in approximately 88,000 fatal overdoses (OD) globally. However, in principle all opioid OD are reversible with the timely administration of naloxone hydrochloride. Despite the widespread availability of naloxone among people who use opioids (PWUO), many who suffer fatal OD use alone, without others present to administer the reversal agent. Recognising this key aspect of the challenge calls for innovations, a number of technological approaches have emerged which aim to connect OD victims with naloxone. However, the acceptability of OD response technologies to PWUO is of key concern. Methods Drawing on the Technology People Organisations Macroenvironment (TPOM) framework, this study sought to integrate acceptability-related findings in this space with primary research data from PWUO, affected family members and service providers to understand the factors involved in harm reduction technology acceptability. A qualitative study using a focus group methodology was conducted. The participant groups were people with lived experience of problem opioid use, affected family members and service providers. Data analysis followed a multistage approach to thematic analysis and utilised both inductive and deductive methods. Results Thirty individuals participated in one of six focus groups between November 2021 and September 2022. The analysis generated six major themes, three of which are reported in this article-selected for their close relevance to PWUO and their importance to developers of digital technologies for this group. 'Trust-in technologies, systems and people' was a major theme and was closely linked to data security, privacy and confidentiality. 'Balancing harm reduction, safety and ambivalence' reflects the delicate balance technological solutions must achieve to be acceptable to PWUO. Lastly, 'readiness-a double bind' encapsulates the perception shared across participant groups, that those at the highest risk, may be the least able to engage with interventions. Conclusion Effective digital strategies to prevent fatal OD must be sensitive to the complex relationships between technological, social/human, organisational and wider macroenvironmental factors which can enable or impede intervention delivery. Trust, readiness and performance are central to technology acceptability for PWUO. An augmented TPOM was developed (the TPOM-ODART).
Background Telemedicine-delivered medication for opioid use disorder (TMOUD) has become more prev... more Background Telemedicine-delivered medication for opioid use disorder (TMOUD) has become more prevalent during the COVID-19 pandemic, particularly in North America. This is considered a positive development as TMOUD has the potential to increase access to evidence-based treatment for a population heavily affected by the opioid crisis and consequent rising mortality and morbidity rates in relation to opioid use disorder. Despite the increase in the use of TMOUD, there are no established service- and process-focused models to guide the implementation of this intervention. Objective This study aims to develop a process- and service-focused implementation model in collaboration with key stakeholders and bring together peer-reviewed literature, practice-based knowledge, and expert opinions. Methods The simple rules for evidence translation in complex systems framework was applied to guide the development of a 6-step qualitative study. The steps were definition of the scope and objectives ...
Background Opioids were implicated in approximately 88,000 fatal overdoses (OD) globally. However... more Background Opioids were implicated in approximately 88,000 fatal overdoses (OD) globally. However, in principle all opioid OD are reversible with the timely administration of naloxone hydrochloride. Despite the widespread availability of naloxone among people who use opioids (PWUO), many who suffer fatal OD use alone, without others present to administer the reversal agent. Recognising this key aspect of the challenge calls for innovations, a number of technological approaches have emerged which aim to connect OD victims with naloxone. However, the acceptability of OD response technologies to PWUO is of key concern. Methods Drawing on the Technology People Organisations Macroenvironment (TPOM) framework, this study sought to integrate acceptability-related findings in this space with primary research data from PWUO, affected family members and service providers to understand the factors involved in harm reduction technology acceptability. A qualitative study using a focus group meth...
BACKGROUND The use of telemedicine to deliver medications for the treatment of opioid use disorde... more BACKGROUND The use of telemedicine to deliver medications for the treatment of opioid use disorder (TMOUD) has become more prevalent during the COVID-19 pandemic, particularly in North America. This is considered a positive development as TMOUD has the potential to increase access to evidence-based treatment for a population heavily impacted by the opioid crisis and consequent rising mortality and morbidity rates in relation to opioid use disorder. Despite the rise in the use of TMOUD, there is a lack of consensus on best practice regarding the design, delivery, and implementation of TMOUD interventions across different settings. OBJECTIVE This study was designed to produce consensus and evidence-based guidance for the implementation and delivery of TMOUD. METHODS The successful healthcare improvement from translating evidence framework for evidence translation in complex systems was applied. A three-level qualitatively modified Delphi process was implemented to obtain multi-stakeho...
Context: Acute toxicity caused by illicit substance use is a common reason for emergency departme... more Context: Acute toxicity caused by illicit substance use is a common reason for emergency department (ED) presentation. Knowledge of the substances involved is helpful for predicting and managing potential toxicity, but limited information is available about the accuracy of patient-reported substance exposure. This study assessed the accuracy of the history of exposure in those reporting use of a single substance by comparison with those identified by detailed toxicological analysis, focusing on synthetic cannabinoid receptor agonists (SCRA). Methods: Adults (!16 years) presenting between March 2015 and July 2021 to participating UK hospitals with toxicity after reporting use of a single illicit substance were included. Exposure details were documented from medical records and blood and/or urine samples analysed using high-resolution accurate mass liquid chromatography-mass spectrometry (HRAM LCMS). Sensitivity, specificity, and positive and negative predictive values of the exposure history were calculated by comparison with biological sample analysis ("gold standard"). Results: Single substance exposure was reported for 474 (median age 33 years, IQR: 18 range 16-75, 80% males) patients. Analysis commonly identified multiple substances (Median 3, IQR 2-5). A history of exposure was documented for 121 of 151 patients where a SCRA or metabolite was detected on analysis (sensitivity 80.1%, 95% CI 72.9, 86.2%). Corresponding proportions were lower for 3,4-methylenedioxymethamphetamine (MDMA, 44/70, 62.9%., 95% CI 50.5%, 74.1%), heroin 41/108 (38.0% 95% CI 28.8-47.8%) and cocaine (22/56, 31.3%, 95% CI 20.9, 43.6%). Conclusions: Multiple undeclared substances were detected analytically in most patients reporting single substance use. Clinicians should be alert to the potential presence and toxicity of unreported substances when managing patients presenting after substance misuse.
BACKGROUND Drug overdose deaths, particularly from opioids, are a major global burden, with 128,0... more BACKGROUND Drug overdose deaths, particularly from opioids, are a major global burden, with 128,000 deaths estimated in 2019. Opioid overdoses can be reversed through the timely administration of naloxone but only if responders are able to administer it. There is an emerging body of research and development in technologies that can detect the early signs of an overdose and facilitate timely responses. OBJECTIVE Our aim was to identify and classify overdose-specific digital technologies being developed, implemented, and evaluated. METHODS We conducted a “state-of-the-art review.” A systematic search was conducted in MEDLINE, Embase, Web of Science, Scopus, ACM, IEEE Xplore, and SciELO. We also searched references from articles and scanned the gray literature. The search included terms related to telehealth and digital technologies, drugs, and overdose and papers published since 2010. We classified our findings by type of technology and its function, year of publication, country of st...
Director, EMCDDA appreciate the input of EMCDDA Scientific Committee members Anne-Line Brettevill... more Director, EMCDDA appreciate the input of EMCDDA Scientific Committee members Anne-Line Bretteville Jensen and Dirk Korf for their input on the final draft. I Dark net markets and interventions Both demand reduction and supply reduction interventions on the surface web have been gathering pace (EMCDDA, 2013; Interpol, 2015). The deep web, however, has provided new opportunities and challenges ultimately ensure consumer safety. Reports suggest, however, that there are a sizeable number of illegitimate online pharmacies involved in the illicit supply of products. These sites are not registered with any recognised accreditation system and do not abide by regulations and professional standards; therefore, they are operating illegally. There is concern that illegitimate online pharmacies may have a role in the supply of drugs for misuse. This is an area explored in more detail in Chapter 11, drawing on the limited studies available in this area.
To assess key characteristics of the retail crack market and the role of users as buyers and sell... more To assess key characteristics of the retail crack market and the role of users as buyers and sellers, data from a survey inside and outside institutional setting among 1,039 crack users in the three largest Dutch cities were analyzed to explore their role in the crack market as buyers and sellers. Of the total number of users, 42.3% bought crack in public places, 39.6% through home delivery, and 13.9% at dealer’s addresses. Near one-third reported participating in selling drugs, defining themselves as “go-betweens” (21.4%) or “dealers” (9.2%). User-sellers and nonselling users did not differ with regard to gender and ethnicity. Cluster analysis resulted in three distinct types of user-sellers (freelancers, assistants, and amateurs), each characterized by time spent selling drugs, type of drugs sold, and earnings. Amateurs seem quite similar to what scholars have labeled “social dealers” in recreational drugs markets. This study suggests the need for a more differentiated law enforce...
To assess key characteristics of the retail crack market and the role of users as buyers and sell... more To assess key characteristics of the retail crack market and the role of users as buyers and sellers, data from a survey inside and outside institutional setting among 1,039 crack users in the three largest Dutch cities were analyzed to explore their role in the crack market as buyers and sellers. Of the total number of users, 42.3% bought crack in public places, 39.6% through home delivery, and 13.9% at dealer's addresses. Near one-third reported participating in selling drugs, defining themselves as "go-betweens" (21.4%) or "dealers" (9.2%). User-sellers and nonselling users did not differ with regard to gender and ethnicity. Cluster analysis resulted in three distinct types of user-sellers (freelancers, assistants, and amateurs), each characterized by time spent selling drugs, type of drugs sold, and earnings. Amateurs seem quite similar to what scholars have labeled "social dealers" in recreational drugs markets. This study suggests the need for a more differentiated law enforcement policy toward drug-selling users.
Uploads
Papers by Alberto Oteo