Safer scoring? Cryptomarkets, social supply and drug market violence

Background: Cryptomarkets are digital platforms that use anonymising software (e.g. Tor) and cryptocurrencies (e.g. Bitcoin) to facilitate trade of goods and services, most notably illicit drugs. Cryptomarkets may reduce systemic violence compared with in-person drug trading because no face-to-face contact is required and disputes can be resolved through a neutral third party. In this paper, we describe the purchasing behaviour of cryptomarket users and then compare the self-reported experiences of threats, violence and other drug-market concerns when obtaining drugs from cryptomarkets with obtaining drugs through friends, known dealers and strangers. Methods: The Global Drug Survey was completed in late 2014 by a self-selected sample who reported accessing drugs through cryptomarkets in the last 12 months (N = 3794). Results: Their median age was 22 years and 82% were male. The drug types most commonly obtained through cryptomarkets were MDMA/Ecstasy (55%), cannabis (43%) and LSD (35%). Cryptomarket users reported using a median of 2 sources in addition to cryptomarkets to access drugs, the most common being in-person friendships (74%), in-person dealers (57%) and open markets/strangers (26%). When asked to nominate the main source they would use if cryptomarkets were unavailable, 49% nominated friends, 34% known dealers and 4% strangers. 'Threats to personal safety' (3%) and 'experiencing physical violence' (1%) were less often reported when using cryptomarkets compared with sourcing through friends (14%; 6%), known dealers (24%; 10%) or strangers (35%; 15%). Concerns about drug impurities and law enforcement were reported more often when using the alternative source, while loss of money, waiting too long and not receiving the product were more often reported when using cryptomarkets. Conclusion: Cryptomarkets are associated with substantially less threats and violence than alternative market types used by cryptomarket customers, even though a large majority of these alternatives were closed networks where violence should be relatively less common

What is drug checking, anyway?

Purpose The recent influx of interest in and the changing status of drug checking has led us to reconsider some fundamental questions about drug checking. This commentary aims to define drug checking. It proceeds in three parts: terminology, definitions and programmes that are excluded from the definition of drug checking that still have value for harm reduction. Design/methodology/approach To inform the commentary, an informal review of pertinent publications on the topic was conducted to extract relevant definitions and terminology. Findings Drug checking services (DCS) have five necessary features: (1) aim of reducing harm; (2) analyse samples directly from the public; (3) return results to the service user; (4) involve information exchange between service user and DCS; and (5) conduct a tailored intervention with the service user. Variable features include the populations served, setting, analysis methods, immediacy of results, nature of intervention, levels of engagement with other stakeholder groups, funding models, legal status and staff skillsets. Programmes that are not DCS but have some similarities to DCS include non-publicly accessible testing of drugs as well as testing of bodily fluids where results may inform drug alerts. Originality/value Drug checking remains a legally, politically and commercially sensitive health service. Reflecting on the history and evolution of drug checking, both as a term and as a harm reduction service, helps provide clarity in terms of what drug checking is and what it is not. This facilitates more effective framing of evaluations, in terms of what DCS aim to do and achieve. </jats:sec

“Coming Out”:Stigma, reflexivity and the drug researcher’s drug use

Some personal experience of illicit drug use undoubtedly exists within the population of academic drug researchers. But it is rarely acknowledged, and even more rarely reflected upon, in their published work. This is understandable: criminal, professional and social sanctions may follow public admission of illicit activities. However, to not “come out” seems contrary to some core academic principles, such as transparency in data collection and reflexivity in the research process. Coming out may present researchers with an opportunity for improving knowledge of, and policies toward, drug use. In this article, we identify reasons for and against the public disclosure of drug use and the impact of such disclosure across a range of spheres, including research, teaching, policy influence and private lives. Reasons against coming out include the risks of undermining professional reputations and hence the ability to contribute to academic and policy debates, the threat of criminal justice sanctions, and impacts on loved ones. However, coming out can have academic benefit (i.e., improving our understanding of drugs, of people who use drugs, and of drug research) and contribute to activist goals (e.g., de-stigmatization of drug use and demarginalization of people who use drugs). Both the risks and benefits of public drug use disclosure have implications for how research and researchers may influence drug policy. Two key themes, stigma and reflexivity, underpin the discussion. We do not conclude with clear recommendations for drug-using drug researchers; to come out or to not come out is a personal decision. However, we argue that there is clear merit to further open discussion on the role of disclosure and reflection on personal drug use experience among those working in drug research and drug policy—where such reflection is relevant and where such researchers feel able to do so

Exploring mortality among drug treatment clients: The relationship between treatment type and mortality

Aims: Studies consistently identify substance treatment populations as more likely to die prematurely compared with age-matched general population, with mortality risk higher out-of-treatment than in-treatment. While opioid-using pharmacotherapy cohorts have been studied extensively, less evidence exists regarding effects of other treatment types, and clients in treatment for other drugs. This paper examines mortality during and following treatment across treatment modalities. Methods: A retrospective seven-year cohort was utilised to examine mortality during and in the two years following treatment among clients from Victoria, Australia, recorded on the Alcohol and Drug Information Service database by linking with National Death Index. 18,686 clients over a 12-month period were included. Crude (CMRs) and standardised mortality rates (SMRs) were analysed in terms of treatment modality, and time in or out of treatment. Results: Higher risk of premature death was associated with residential withdrawal as the last type of treatment engagement, while mortality following counselling was significantly lower than all other treatment types in the year post-treatment. Both CMRs and SMRs were significantly higher in-treatment than post-treatment. Conclusion: Better understanding of factors contributing to elevated mortality risk for clients engaged in, and following treatment, is needed to ensure that treatment systems provide optimal outcomes during and after treatment

Constructive activism in the dark web: cryptomarkets and illicit drugs in the digital ‘demimonde’

This paper explores activism enacted through Silk Road, a now defunct cryptomarket where illicit drugs were sold in the dark web. Drawing on a digital ethnography of Silk Road, we develop the notion of constructive activism to extend the lexicon of concepts available to discuss forms of online activism. Monitoring of the cryptomarket took place between June 2011 and its closure in October 2013. Just before and after the closure of the marketplace we conducted anonymous online interviews with 17 people who reported buying drugs on Silk Road (1.0). These interviews were conducted synchronously and interactively through encrypted instant messaging. Participants discussed harnessing and developing the technological tools needed to access Silk Road and engage within the Silk Road community. For participants Silk Road was not just a market for trading drugs: it facilitated a shared experience of personal freedom within a libertarian philosophical framework, where open discussions about stigmatized behaviours were encouraged and supported. Tensions between public activism against drug prohibition and the need to hide one's identity as a drug user from public scrutiny were partially resolved through community actions that internalized these politics, rather than engaging in forms of online activism that are intended to have real-world political effects. Most aptly described through van de Sande's (2015) concept of prefigurative politics, they sought to transform their values into built environments that were designed to socially engineer a more permissive digital reality, which we refer to as constructive activism