DECRIMINALIZE DRUGS
UQ leads the world’s largest drug survey
Researchers from The University of Queensland have launched the world’s biggest drug survey, to gain insight into drug use around the globe.
Researchers from The University of Queensland have launched the world’s biggest drug survey, to gain insight into drug use around the globe.
The Global Drug Survey was founded by Professor Adam Winstock from University College London and has been running annually since 2012.
This year the survey is led by Dr Cheneal Puljevic from UQ’s School of Public Health.
“The aim of the Global Drug Survey is to make drug use safer for people, regardless of the drug’s legality,” Dr Puljevic said.
“We hope to gain insight into drug use across the world, so we can inform individuals and organisations about what’s going on in their communities and how best to reduce harms from drug use.”
This year respondents will be asked about drug prices, decriminalisation, tobacco endgame policies, performance and image enhancing drugs, nitrous oxide use and drug use in nightlife and festival settings.
It will also be the first Global Drug Survey to ask questions about the use of illicit tobacco.
Dr Puljevic said there had been very little international research into the tobacco black market.
“Illegal tobacco use has exploded in the past year, with some tobacconists in Australia selling packets of cigarettes for as little as $5,” she said.
“But we don’t really know much about who’s using illicit tobacco or where they're getting it from.”
The 2024 survey also includes questions about how peoples’ drug use would change if drugs like MDMA and cocaine were decriminalised.
The anonymous online survey has been translated into 9 different languages and will be circulated worldwide.
It takes between 20 to 30 minutes to complete.
“The Global Drug Survey usually gets more than 100,000 respondents from more than 25 countries, so our goal is to exceed that this year,” Dr Puljevic said.
“We want as many diverse perspectives as possible, with respondents of all ages, genders and sexual orientations and from rural and urban areas.”
The Global Drug Survey 2024 will run until 30 April and can be completed here.
Dark web fentanyl-selling operations have grown rapidly, offer steep discounts
Study highlights the challenges of limiting supply by shuttering online purveyors
Overdose deaths in North America have skyrocketed, primarily because of the spread of illegally manufactured fentanyl. In a new study, researchers analyzed an early and prominent fentanyl-selling operation on the dark web. The organization sustained a significant growth rate, which allowed it to offer consumers steep discounts. In light of these findings, the authors conclude that it might be challenging to constrain supply by shuttering individual organizations since remaining organizations could grow rapidly to fill unmet demand.
The study was conducted by researchers at Carnegie Mellon University, the University of Arizona, Tucson, and the University of Maryland, College Park. It appears in Global Crime.
“Internet drug sales have the potential to become more prevalent,” explains Jonathan P. Caulkins, professor of operations research and public policy at Carnegie Mellon’s Heinz College, who led the study. “This raises the question of how they differ from traditional in-person distribution systems; to answer that, we examined how the organization operated, how profitable it was, and what its vulnerabilities were.”
For the first time, researchers used both detailed qualitative and large-scale transaction-level data to analyze more than 5,500 drug transactions involving more than 870,000 items sold for about $2.8 million through AlphaBay; the AlphaBay marketplace operated from 2014 to 2017 and was considered the largest dark web marketplace, with more than 200,000 users. Dark web marketplaces, like legal Internet marketplaces such as eBay and Amazon, allow vendors and buyers exchange currency for goods, with orders fulfilled primarily by contracting with parcel delivery services. However, dark web marketplaces (also called cryptomarkets) generally involve cryptocurrencies, which provide anonymity.
The study focused on a prominent organization based in Utah that primarily manufactured counterfeit prescription pills containing fentanyl and distributed them by U.S. mail. This organization is of particular interest because it allowed the researchers access to seller-level data, providing insights into organizational strategy. The study also analyzed court documents related to the prosecution of the organization. Operating at least between July 2015 and November 2016, the organization used the storefront name Pharma-Master. Most of Pharma-Master’s sales were of counterfeit oxycodone pills, which contained fentanyl but no oxycodone.
Pharma-Master sustained a sales growth rate of approximately 15% per week, the study found. Increasing order sizes by a factor of 10 reduced the price per pill by approximately 25% for oxycodone and 50% for Xanax, which the organization also sold. Those steep quantity discounts led to large price markups when selling further down the distribution chain.
The authors suggest that drug trafficking organizations’ high growth rates and price markups make it hard for law enforcement to shut down organizations quickly enough to prevent other organizations from expanding to fill unmet consumer demand. They also conclude that:
- Organizations selling via internet drug markets can share characteristics with legal firms (e.g., they are profit-making entities that regularly produce and sell products to customers, their staff has specialized roles, and ownership operates separately from workers), but differ from organizations that sell drugs in traditional drug markets (e.g., they may recruit employees from an inner circle of friends and acquaintances who lack prior criminal convictions or connections to drug distribution).
- Internet drug traffickers can expand rapidly, in part because they are not limited by geography.
- Online selling can be profitable because of low costs and the ability to reach many customers at multiple levels of the market without having to conduct in-person meetings, which can be risky.
Among the study’s limitations, the authors note that they are uncertain what proportion of Pharma-Master’s sales are represented in the data they analyzed, so these data may represent only about a quarter to a half of all the organization’s actual transactions. In addition, Pharma-Master may have been atypical: Most online vendors are small and short-lived. Finally, market conditions have changed since 2016, with most fentanyl now entering the United States from Mexico, not directly from China.
“Pharma-Master was just one drug-trafficking organization and while it was a successful one, it was not long-lived,” notes Philippe C. Schicker, who coauthored the study while he was a master’s student in public policy and data analytics at Carnegie Mellon’s Heinz College. “But there is still significant value in studying this organization because it contributed to the early rise in manufacturing counterfeit prescription drugs containing fentanyl, which has dominated drug overdose deaths in the United States and Canada for several years.”
JOURNAL
Global Crime
ARTICLE TITLE
A detailed study of a prominent dark web fentanyl trafficking organization
Nationwide study suggests link between medical cannabis for chronic pain and abnormal heart rhythm
IMAGE:
PORTRAIT PHOTO OF RESEARCHER DR ANDERS HOLT
view moreCREDIT: EUROPEAN HEART JOURNAL / ANDERS HOLT
People taking medical cannabis for chronic pain have a slightly increased risk of arrhythmia, according to research published in the European Heart Journal [1] today (Thursday). Arrhythmia is when the heart beats too slowly, too quickly or irregularly. It includes conditions like atrial fibrillation.
Recreational use of cannabis has been linked to cardiovascular disease but there has been very little research on the side effects of medical cannabis.
Researchers say the new study is important as a growing number of countries now permit medical cannabis as a treatment for chronic pain.
The study was led by Dr. Anders Holt from Copenhagen University Hospital – Herlev and Gentofte in Denmark. It included data on 5,391 Danish patients who had been prescribed cannabis for chronic pain. This included people with pain in their muscles, joints or bones, people with cancer and those suffering with nerve pain. Researchers compared this group with 26,941 patients who also had chronic pain but were not receiving cannabis as a treatment.
The data showed that patients receiving medical cannabis had a 0.8% risk of being diagnosed with arrhythmia that required monitoring and possible treatment within 180 days of receiving cannabis. This risk was more than twice the risk for patients with chronic pain who were not taking cannabis. The difference in risk between the two groups had become smaller when researchers looked at the first year of treatment.
Patients taking cannabis who were aged 60 and older and those already diagnosed with cancer or cardiometabolic disease, such as heart disease, stroke and diabetes, had the largest increases in their risk of arrhythmia.
The study did not show any link between taking medical cannabis and the risk of acute coronary syndrome, which includes a heart attack and unstable angina, stroke or heart failure.
Dr. Holt said: “Medical cannabis is now allowed as a treatment for chronic pain in 38 US states as well as several countries in Europe – such as Spain, Portugal, the Netherlands and the UK – and elsewhere around the world. This means more and more doctors will find themselves prescribing cannabis, despite a lack of evidence on its side effects.
“I don’t think this research should make patients with chronic pain refrain from trying medical cannabis if other treatment has been inadequate. However, these results do suggest some improved monitoring may be advisable initially, especially in patients who are already at increased risk of cardiovascular disease.”
Researchers say this is the first nationwide study of its kind investigating the cardiovascular effects of medical cannabis for chronic pain. However, they caution that this is an observational study. Dr. Holt explained: “Despite our best efforts to make a balanced comparison, it can never be assumed that patients prescribed medical cannabis do not differ from patients not prescribed medical cannabis, and this could influence the results.”
He added: “We need much more research in this area. Before concluding anything, results from this study should be replicated in other countries and settings. It would also be interesting to understand if there are any links between long-term cannabis use and heart failure, stroke, or acute coronary syndrome. This would be an important area to clarify since chronic pain can persist for many years.”
In an accompanying editorial [2], Prof. Robert L. Page from the University of Colorado, USA, said: “Close pharmacovigilance of cannabis, as well as its safety and efficacy, have been limited by decades of worldwide illegality and by the ongoing classification of cannabis as a Schedule 1 controlled substance in the USA. Nonetheless, with increased cannabis decriminalisation and legalisation across the globe, the association between cannabis exposure and incident cardiovascular events has emerged as an important safety signal.
“Therapeutically, these findings suggest that medical cannabis may not be a ‘one-size-fits-all’ therapeutic option for certain medical conditions and should be contextualised based on patient comorbidities and potential vulnerability to side effects.
“Cannabis is typically referred to as recreational and ‘medical’ or ‘medicinal’. This latter terminology has come under scrutiny as it includes both phytochemical-derived cannabis products and also those prescription cannabinoids approved in the EU. Additionally, the term ‘medical’ implies that the product may have some clinical monitoring along with safety and efficacy data, which is far from true with cannabis. To this end, I would argue that ‘cannabis for therapeutic use’ would be a more appropriate terminology rather than ‘medical’.”
JOURNAL
European Heart Journal
METHOD OF RESEARCH
Observational study
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Cannabis for chronic pain: cardiovascular safety in a nationwide Danish study
ARTICLE PUBLICATION DATE
11-Jan-2024
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