Potential influences of the darknet on illicit drug diffusion

PURPOSE OF REVIEW: Darknet-hosted drug markets (‘cryptomarkets’) are an established model of illicit drug distribution which makes use of specialised online hosting and payment systems to link buyers and sellers remotely. Cryptomarkets appear to professionalise, gentrify and integrate drug markets. Therefore, they can be hypothesised to have effects on drug availability by allowing purchases by people who use drugs (PWUD) outside of face-to-face networks that have typified drug distribution. They may attract new buyers and may change use patterns by offering a greater range of higher-potency drugs. This paper examines the research on cryptomarkets’ potential impacts on drug availability. RECENT FINDINGS: 1. Cryptomarkets tend to address established PWUD who mainly already have access to existing distribution systems. Their greatest impact may be on what is available and the quantities available, and not the overall ease of access. 2. Cryptomarkets may provide new data sources which can inform our understanding of drug markets. 3. Cryptomarkets may define PWUD as consumers and contribute to reshaping their identities around principles of self-directed, informed consumption. 4. In terms of size, cryptomarkets are currently smaller than other modes of digital drug distribution such as through social media and messaging apps and should be seen as a specialist subset of that genre. 5. Users of cryptomarkets often integrate drug-purchase and consumption repertoires across multiple sites, online and offline, and cryptomarkets can be one element. SUMMARY: The cryptomarkets are of interest partly because they alter the practical calculus around drug diffusion and partly because they contribute to the formation of digitally enabled drug use which emphasises a consumer relationship between buyer and seller

The 'Risk Gradient' in policy on children of drug and alcohol users: Framing young people as risky

Parental drug and alcohol problems can have a profound impact on children. There is a growing policy and practice focus on this topic in the UK. Most is concerned with children of primary school age and younger. Older children tend to be neglected in the debate, and young people of age 16 and over are mostly absent from it. It is argued here that this reflects, and is reflected in, the construction of a ‘risk gradient’ in policy and practice. An analysis of Hidden Harm, the report of the Advisory Council on the Misuse of Drugs’ inquiry into the impact of parental drug misuse, and related documents is used to illustrate this. In the risk gradient, children are constructed as being at risk when younger, and becoming risky to themselves and others when older. The risk gradient stigmatises young people as manifesters of risk, diminishes ongoing difficulties they face, and denies their coping strategies. The definition of risk as manifesting in institutional settings and services underscores this. It encourages a focus on parent-child risk transfer, to the detriment of other difficulties the child or young person may be facing, and renders the young person invisible when they leave service contexts. Finally, the culturally and legally established distinction between illicit drugs and alcohol tends to isolate families with alcohol problems. Most of the response to parental substance use has focused on illicit drugs, rendering the difficulties of young people affected by alcohol problems less visible except as when they are manifesters of risk

The impact of COVID-19 on access to harm reduction, substance use treatment and recovery services in Scotland:A qualitative study

Introduction People who use drugs (PWUD) are considered vulnerable to COVID-19 exposure and the sequelae of infection due to their social circumstances, health conditions, drug purchasing, and substance use. They can depend on access to services that provide harm reduction, substance use treatment, recovery and support, and general healthcare. Social distancing measures and service restrictions posed significant challenges to the health and wellbeing of PWUD. Methods Ethical approvals were secured. PWUD were recruited from voluntary sector homeless and housing, harm reduction, and recovery organisations across central Scotland. Data was collected via semi-structured interviews and analysed using the Framework Method. Results Twenty nine PWUD participated and reported mixed experiences of the impacts of COVID-19 lockdown. Several benefitted from policy and practice developments designed to sustain or increase access to harm reduction services. Some PWUD reported improved access to substitute prescribing and/or appreciated being trusted to manage multiple take-home doses. Others noted the loss of regular in-person contact with treatment providers and dispensers. Access to recovery support was challenging for many, especially those unable to access or uncomfortable with online provision who experienced greater isolation. Lack of access to general healthcare services was common, and especially problematic for PWUD with chronic physical and mental health conditions. Conclusions This qualitative research describes the impacts of COVID-19 social and service restrictions on PWUD in Scotland. These impacts were anticipated by policy makers and service providers. Effective and acceptable developments were shown to maintain and even increase service provision for PWUD. Developments were geographically dependent and significant challenges remained for many people. The learning generated can inform responses to increase service access and uptake in post-pandemic times