Street Drug Market Research Articles

Assessment of a Single Quadrupole Mass Spectrometer Combined with an Atmospheric Solids Analysis Probe for the On-Site Identification of Amnesty Bin Drugs.

The surging number of people who abuse drugs has a great impact on healthcare and law enforcement systems. Amnesty bin drug analysis helps monitor the "street drug market" and tailor the harm reduction advice. Therefore, rapid and accurate drug analysis methods are crucial for on-site work. An analytical method for the rapid identification of five commonly detected drugs ((3,4-methylenedioxymethamphetamine (MDMA), cocaine, ketamine, 4-bromo-2,5-dimethoxyphenethylamine, and chloromethcathinone)) at various summer festivals in the U.K. was developed and validated employing a single quadrupole mass spectrometer combined with an atmospheric pressure solids analysis probe (ASAP-MS). The results were confirmed on a benchtop gas chromatography-mass spectrometry instrument and included all samples that challenged the conventional spectroscopic techniques routinely employed on-site. Although the selectivity/specificity step of the validation assessment of the MS system proved a challenge, it still produced 93% (N = 279) and 92.5% (N = 87) correct results when tested on- and off-site, respectively. A few "partly correct" results showed some discrepancies between the results, with the MS-only unit missing some low intensity active ingredients (N-ethylpentylone, MDMA) and cutting agents (caffeine, paracetamol, and benzocaine) or detecting some when not present. The incorrect results were mainly based on library coverage. The study proved that the ASAP-MS instrument can successfully complement the spectroscopic techniques used for qualitative drug analysis on- and off-site. Although the validation testing highlighted some areas for improvement concerning selectivity/specificity for structurally similar compounds, this method has the potential to be used in trend monitoring and harm reduction.

Challenges with buprenorphine inductions in the context of the fentanyl overdose crisis: A case series.

North America is currently experiencing an epidemic of opioid overdose deaths, driven by the proliferation of fentanyl in the street drug market. Although buprenorphine/naloxone (BUP/NX) is an evidence-based, first-line opioid agonist for the management of opioid use disorder, a key challenge in its prescribing lies in the fact that it can precipitate opioid withdrawal during its initial induction process. At this time, there is minimal literature on the BUP/NX induction process in individuals who use illicit fentanyl regularly. A case series from a Vancouver, Canada addiction medicine clinic of three fentanyl-exposed patients who experienced unexpected, precipitated withdrawal when initiating BUP/NX. These cases describe incidents of precipitated opioid withdrawal occurring after unusually long periods of fentanyl abstention. Although fentanyl is experienced as a short-acting opioid, the drug persists much longer in the body's peripheral tissues. Here, we highlight the new challenges fentanyl may pose to current BUP/NX induction strategies, and explore the possibility of a long-acting pharmacokinetic effect of fentanyl in the setting of repeated illicit use.

Slow release oral morphine versus methadone for opioid use disorder in the fentanyl era (pRESTO): Protocol for a non-inferiority randomized clinical trial

BackgroundNorth America is facing an unprecedented public health crisis of opioid-related morbidity and mortality, increasingly as a result of the introduction of illicitly manufactured fentanyl into the street drug market. Although the treatment of opioid use disorder (OUD) is a key element in the response to the opioid overdose epidemic, currently available pharmacotherapies (e.g., methadone, buprenorphine) may not be acceptable to or effective in all patients. Available evidence suggests that slow-release oral morphine (SROM) has similar efficacy rates as methadone with respect to promoting abstinence, and with improvements in a number of patient-reported outcomes among persons using heroin. However, little is known about the relative effectiveness and acceptability of SROM compared to methadone in the context of fentanyl use. This study aims to address this research gap. MethodspRESTO is a 24-week, open-label, two arm, non-inferiority, randomized controlled trial comparing SROM versus methadone for the treatment of OUD. Participants will be 298 clinically stable, non-pregnant adults with OUD, recruited from outpatient clinics in Vancouver, Canada, where the majority of the illicit opioids are contaminated with fentanyl. The primary outcome is suppression of illicit opioid use, measured by bi-weekly urine drug screens. Secondary outcomes include: treatment retention, medication safety, overdose events, treatment satisfaction, psychological functioning, changes in drug-related problems, changes in quality of life, opioid cravings, other substance use, and cost-effectiveness. DiscussionpRESTO will be among the first studies to evaluate treatment options for individuals primarily using synthetic street opioids, providing important evidence to guide treatment strategies for this population.

Fatal overdoses involving carfentanil: A case series

Carfentanil, an ultrapotent analog of fentanyl, has invaded the street drug market, unbeknownst to many heroin users. About 10,000 times more potent than morphine, it was initially suspected that 20 μg of the substance was lethal. In this case series, we present 17 confirmed carfentanil overdoses in Michigan, with a primary focus on the concentration levels. Through a retrospective review, each public death reported in Oakland County, Michigan, with a subsequent toxicology report was investigated for suspected carfentanil use. To characterize each fatality, the autopsy results were collected, including the postmortem findings at scene and the decedent's medical and social history. Carfentanil levels were measured through liquid chromatography and tandem mass spectrometry (LC-MS-MS) by National Medical Services (NMS) Laboratories. Our case series found postmortem carfentanil concentrations as low as 10 ng/mL, with a mean concentration of 0.387 ng/mL. Ultimately, there are implications on law enforcement, first responders, and health care providers when dealing with this emerging illicit substance, and there is an alarmingly high mortality rate associated with the abuse of carfentanil.

Predicting opioid receptor binding affinity of pharmacologically unclassified designer substances using molecular docking.

Opioids represent a highly-abused and highly potent class of drugs that have become a significant threat to public safety. Often there are little to no pharmacological and toxicological data available for new, illicitly used and abused opioids, and this has resulted in a growing number of serious adverse events, including death. The large influx of new synthetic opioids permeating the street-drug market, including fentanyl and fentanyl analogs, has generated the need for a fast and effective method to evaluate the risk a substance poses to public safety. In response, the US FDA’s Center for Drug Evaluation and Research (CDER) has developed a rapidly-deployable, multi-pronged computational approach to assess a drug’s risk to public health. A key component of this approach is a molecular docking model to predict the binding affinity of biologically uncharacterized fentanyl analogs to the mu opioid receptor. The model was validated by correlating the docking scores of structurally diverse opioids with experimentally determined binding affinities. Fentanyl derivatives with sub-nanomolar binding affinity at the mu receptor (e.g. carfentanil and lofentanil) have significantly lower binding scores, while less potent fentanyl derivatives have increased binding scores. The strong correlation between the binding scores and the experimental binding affinities suggests that this approach can be used to accurately predict the binding strength of newly identified fentanyl analogs at the mu receptor in the absence of in vitro data and may assist in the temporary scheduling of those substances that pose a risk to public safety.

Effects of Prohibition and Decriminalization on Drug Market Conflict

Research SummaryTo reduce individual and social harms, most nations prohibit certain psychoactive drugs. Yet, prior scholarship has suggested that prohibition reduces illicit drug sellers’ access to law and thereby increases predation against and retaliation by them. No prior study, however, has directly tested that theory by comparing drug sellers of different legal statuses operating in a single place and time. This study analyzes rates of victimization, legal mobilization, and violent retaliation in three retail drug markets in Amsterdam, the Netherlands: the legally regulated alcohol trade of cafés, the decriminalized cannabis market of “coffeeshops,” and the illegal street drug market. Results from interviews conducted with 50 sellers in each market indicate, as expected, that illicit drug dealers have the highest rates of victimization and violent retaliation and the lowest rates of legal mobilization. Contrary to expectations, we find coffeeshops experience less victimization than cafés and have similar rates of violent retaliation and legal mobilization.Policy ImplicationsOur findings suggest that state regulation of drug markets affects victimization and conflict management of sellers, but the relationship does not seem to be linear. Prohibition undercuts the state's regulatory capacity by producing zones of virtual statelessness in which formal means of dispute resolution are unavailable, and thus, victimization and retaliation are more common. At the other extreme is laissez faire regulation, which may make sellers more likely to address problems only after they occur (instead of preventing their occurrence). The Dutch government originally instituted coffeeshops as a harm‐reduction method meant to separate the market for cannabis from that of hard drugs. The policy also seems to work well when it comes to reducing victimization, perhaps by encouraging the use of preventive measures by coffeeshop owners and employees. The Dutch experience offers lessons for drug policy reforms elsewhere.

Clinical Pharmacology of the Synthetic Cathinone Mephedrone.

4-Methyl-N-methylcathinone (mephedrone) is a popular new psychoactive substance (NPS) that is structurally related to the parent compound cathinone, the β-keto analogue of amphetamine. Mephedrone appeared on the street drug market as a substitute for 3,4-methylenedioxy-N-methylamphetamine (MDMA, ecstasy) and was subsequently banned due to the potential health risks associated with its use. Nevertheless, mephedrone continues to be widely consumed among specific populations, with unique patterns of misuse. To date, most information about the biological effects of mephedrone comes from user experiences, epidemiological data, clinical cases, toxicological findings, and animal studies, whilst there are very few data regarding its human pharmacodynamics and pharmacokinetics. This chapter reviews the available published data on patterns of mephedrone use, its acute and chronic effects, and its pharmacokinetic properties. More human research is needed to elucidate the safety, toxicity, and addiction potential of mephedrone and related NPS.

Systematic Observations of Neighborhood Order

A systematic pre- and postintervention neighborhood observation constituted one component of the evaluation of an initiative to eliminate a street-drug market. Analysis focused on multiple indicators of social and physical order and disorder, as well as physical decay. No noticeable changes were found, but variations in physical and social attributes between the market area and other segments of the neighborhood were revealed. These results suggest lessons that can be learned—and questions that should be considered—with regard to the application of the neighborhood observation methodology to an evaluation of this type of strategic, community-based initiative.

‘Heads Held High’: An Exploratory Study of Legal Highs in Pre-Legislation Ireland

The research aimed to present a unique ‘snapshot’ of legal psychoactive drug use prior to legislative control in Ireland, in relation to the types of products used; sourcings; consumptive practices and particular social settings for use; gauging of dosage; licit and illicit drug transitions, individualisation of drug decision-making and experiences; and future intentions regarding drug switching post legislation. Semi-structured in depth interviews (n = 32) were conducted with adults aged 18–33 years who had used legal highs in the 6 months prior to fieldwork. The findings indicate some support for ‘differentiated’ displacement consumptive patterns between illegal and legal drugs, with user pathways grounded in ‘legal high’ availability; perceived user effect, safety, legality, quality and price. Mephedrone emerged as most popular drug of choice. Internet sales, stockpiling and diversion of previously ‘legal highs’ onto the illegal street drug market remain of concern, against a background of emerging new designer drugs in Ireland.

‘The Sweet Taste of Sin’—A Muslim Drug Dealer in a Nordic Welfare State

Moa is a 22-year-old Muslim dealer selling drugs at a street drug market in Oslo. The main part of the paper consists of long interview extracts from three interviews with him. The aim is to capture some of the ambivalence and complexity that might otherwise be lost in traditional scholarly analysis. In short, Moa tells how he got into drug dealing in the first place, the help he received from a well-meaning welfare state apparatus, his feelings of remorse, guilt, and shame, and the attempts he made to break with the drug trade and its life-style. Moa's story highlights differences between street life in a benevolent welfare state with a penal system famous for its open-handedness, and street life under harder socio-economic and penal conditions. Even though Moa has more opportunities than offenders elsewhere, failing in a society where most others succeed is different from failing in a larger marginalized community. Moa's story also challenges the public view of Muslim offenders and questions established assumptions about the relationship between Islam and crime.

Gangster, victim or both? The interdiscursive construction of sameness and difference in self‐presentations

The paper conceptualizes two contradictory discourses, both used by ethnic minority drug dealers in a street drug market in Oslo, Norway. Oppression discourse includes personal narratives of unemployment, racism and psycho-social problems, often combined with stories about the government and city council being unwilling to help. Drug dealers use the discourse to justify drug dealing and violence, both for themselves and in meetings with welfare organizations. Gangster discourse, on the other hand, includes a series of personal narratives emphasizing how hard, smart, and sexually alluring the young men are. Drug dealers use this discourse to gain self-respect and respect from others, and it dominates interactions on the street. An important argument in this paper is that the discursive practice of criminals inspires theoretical perspectives on criminal practice. Oppression and gangster discourses have inspired, respectively, neutralization and subculture theory. When the same people use both discourses, however, the picture becomes more complicated. The 'bilingual' discursive practice of the street drug dealers reflects the ambivalent role of the researcher, and a Scandinavian institutional and social context where street drug dealers have extensive contact with a welfare state apparatus. The paper still suggests that similar interdiscursivity may have been sacrificed in previous research to produce more coherent theoretical frameworks.

Black Drug Dealers In A White Welfare State: Cannabis Dealing and Street Capital in Norway

This study is based upon ethnographic fieldwork and interviews with ethnic minority cannabis dealers at a street drug market in Oslo, Norway. Three dealers’ socio-biographies are presented and used to illustrate three groups of dealers, and three ideal-typical trajectories to street drug dealing. The first trajectory emerges from migration and early experiences in war-inflicted countries. The second emerges from an increasing drug habit and early socialization in established criminal networks, and the third from an alternative search for identity. The analysis is based on the concept ‘street capital’, inspired by Pierre Bourdieu. This theoretical framework highlights the embodied character of cultural knowledge, the importance of early socialization, and the practical rationality involved when young people start dealing illegal drugs.

Engagement, reciprocity and advocacy: ethical harm reduction practice in research with injecting drug users

In this paper, we contribute to the ethical challenges of harm reduction-based research by describing and reflecting on our experiences of initiating and maintaining relationships with research participants during an innovative neighbourhood-based study of the social and molecular epidemiology of the hepatitis C virus among injecting drug users over a 2-year period. We show through examples of our work how recruitment to our study had practical value for both researchers and study participants including advocacy and reciprocity. We argue that the recruitment process needed to be flexible, able to cope with the demands of the street drug market, and that we as researchers need to engage participants in their own environments as much as possible. We conclude with a series of recommendations for other researchers such as the need to employ appropriately skilled researchers who are flexible, innovative and comfortable in street settings, and for the setting of realistic time-frames for preliminary research, data collection and feedback and analysis.

Was this a result you were expecting?

Since 1996, The Burnet Institute has been developing a program of research into the drug-use patterns and associated risk behaviours among injecting drug users of Vietnamese ethnicity.1−4 Ethnic Vietnamese drug users have been important in the functioning of the street-based drug markets across Melbourne for at least a decade.5 Injecting drug users (IDUs) born in south-east Asia are over-represented in the HIV notification data inVictoria.6 Furthermore, between 1999 and March 2003, 11 out of 38 (41%)HIV notifications in Victoria with injecting drug use as their sole exposure category were born in Vietnam.7 Between February and September 2003, I was part of a Burnet Institute team investigating the prevalence of blood-borne viruses among ethnic Vietnamese injecting drug users. The institutional ethics committee of the Department of Human Services approved this cross-sectional study where ethnic Vietnamese illicit drug injectors were recruited using street-based snowball techniques from three areas across metropolitan Melbourne. Participants were interviewed about their drug-use patterns and risk behaviours and were offered preand post-test counselling for HIV, hepatitis C (HCV) and hepatitis B (HBV). We recruited 127 ethnic Vietnamese IDUs, over 60% of whom reported injecting heroin daily. Of the participants, 103 (80%) were HCV antibody positive, and three people (2.4%) tested positive to HIV. In this field note, I describe and reflect on my personal responses to the first time I told someone they were HIV positive. Footscray (one of the main recruitment sites for the study) is located in the inner west of Melbourne and is a diverse multicultural community with a significant ethnic Vietnamese population. On entering Footscray for the first time, one is struck by its distinctly Asian feel. The smells and sounds are those of south-east Asia. Large numbers of people come to Footscray every day to shop, just as they would have done in their neighbourhood markets in their country of origin. But the fresh food market is not all that attracts people. Footscray also serves as a busy commercial and administrative centre for thewestern suburbs and the regional office for Centrelink (the government income support department). It is a public transport hub for the western suburbs and there are many suburban buses as well as a tram and rail line in the middle of the shopping district. Much of the preand post-test training I received had emphasised that the recruitment of active injectors in streetbased settings was not the perfect way to do HIV testing, but our previous research experience had shown us that it was hard to encourage testing in other ways. The study had been running for 3 months when I received a telephone call informing me that one of the 60 participants had tested positive for HIV. I checked my field notes to see who it was. ‘Lam’ (not his real name) is a young man in his early 30s who was born in Vietnam and arrived in Australia ∼15 years ago with his father and other siblings. His mother was left inVietnamwith her brothers and sisters and has never lived in Australia. Lam is well connected to the street drug market and has a long and established history with the justice system in Victoria. He is currently living with his father, but in the few years that I have known him, I have visited him in squats, at other friends’ houses and even in prison. In some ways I knew this had to happen eventually because ethnic Vietnamese injectors have been evident in much of the surveillance data. Just on 40% of those who have an injecting history, and who tested HIV positive in Victoria between 1999 and 2003, were born in Vietnam. After all, this was the reason we had received funding for the study. But the prospect of actually telling someone they had HIV produced an unexpected emotional response in me. I was almost nauseous, my head was spinning with all the information we had been taught about how to deliver the positive HIV test result and I had done several role-plays acting out the scenario. I remembered being told to just come out and tell them straight, don’t go round in circles. Then less than an hour after I had learned that Lam was HIV positive he walked right past me in the street. I was busy in the street drug market looking for potential study participants. Giving Lam his positive result was never going to be easy. I knew him well and had run into him almost every time I had recruited people for our research over the years. Was

Fear of sense in the street heroin market

Open street drug markets in the western industrialized world often create fear and outrage in the community. Many arguments posited by resident groups and local businesses against the introduction of harm reduction initiatives, such as fixed site needle and syringe programmes (NSP) and supervised injecting facilities (SIF), are based on the fear that such facilities will attract street drug markets. In this paper, we explore the fear produced in a city's encounter with street heroin use. Through linking a Deleuzian ontology to spatial practices associated with the street drug market, we provide a deeper understanding of the fear of public drug use. After examining how fear is produced, we then connect fear with the flows of capital in street drug markets and to the political and economic outcomes from such encounters.

Quality of cocaine seized in 1997 in the street-drug market of São Paulo city, Brazil

Street drugs when in great demand in an illicit market become not only more expensive but are also subject to extensive adulteration and dilution. These fraudulent practices may also contribute to the amplification of toxic effects observed in the abuse of certain drugs including cocaine hydrochloride. The number of seizures reflects the increase of illicit use of cocaine in the city of S.Paulo, where the identity of the suspected drug is its hydrochloride form. Routine analytical procedures in enforcement laboratories in Brazil now comprise techniques involving thin layer chromatography for presumptive identification of the drug and eventually gas chromatography for its confirmation or quantification whenever required. The determination of cocaine content, adulterants and diluents in street samples is not only of clinical value but also important for enforcement activities, recognition of its geographical distribution and allocation. So, the aim of this study was to continue examining the quality of cocaine hydrochloride in the illicit market of the city of S.Paulo. Cocaine and adulterant contents were determined as well as the identification of several diluents in 389 out of 1958 samples of white powder seized in the city of Sao Paulo. Thin-layer and gas-liquid chromatography (FID) and GC-MS were used for the determination of cocaine and adulterant contents. Spot-tests and thin-layer chromatography were the techniques applied for the identification of diluents. The results were as follows: neither cocaine nor adulterants were detected in 17 samples (4.4%); of all positive samples (95.6 %) for cocaine, 14% consisted of no more than 200 mg/g; in 70% cocaine purity ranged from 201 to 550 mg/g and in 16% it was not greater than 700 mg/g. The local anesthetics lidocaine and procaine were detected in 19 samples (4,9%) in a range from 10 to 602 mg/g. Caffeine was present in only two samples (179 and 356 mg/g). The main diluents detected were carbonates and bicarbonates (19.2%); silicates (13.8%), sugars (9.59%); starch (5.6%), borate (3.8%) and sulphates(2.8%). Contaminants (secondary products) originated from coca paste refining or decomposition processes were not analysed.

“Slinging dope”: The role of gangs and gang members in drug sales

There are two competing views about the role of gangs and gang members in drug sales. The first argues that street gangs are well-organized purveyors of illegal drugs who reinvest the profits from drug sales into the gang. A second approach rejects this notion. Its proponents claim that drug sales by gangs are seldom well-organized and that gang members often act independently of the gang in selling drugs. We examine these two arguments in the context of findings from a three-year field study of street gangs in a large midwestern city. We find that gang members are involved extensively in the sale of drugs, but that sales are seldom well organized. These results are discussed in light of the organizational structure of the gang and the nature of the street drug market.

Criminal Justice Responses to Crack

The past few years have seen heightened concern about the spread of the use and sale of smokable cocaine (“crack”) and its effects on crime and public order. In particular, the criminal justice system has responded to these concerns with an unprecedented emphasis on apprehending street drug dealers and users in record numbers, overwhelming the courts and jails of many urban jurisdictions. The public perception that crack is a particularly dangerous and addictive drug, together with the growth of an unregulated street drug market, media accounts of crack-related violence, and the lack of treatment facilities, has placed pressure on the system to process crack arrests differently from other drug arrests. This study of the response of the New York City criminal justice system to the early stages of the crack “epidemic” is based on analyses of the 3,403 crack arrests that occurred between August and October 1986, including the characteristics of defendants, charges, case dispositions, and sentences. The comparison sample consisted of powdered cocaine arrests from 1983 to 1984. The results suggest that crack cases had a higher probability of pretrial detention, felony indictment, and jail sentence. Logit analyses of lower court disposition and the bail decision indicated that being charged with a crack-related offense was a relatively strong determinant of these case decisions compared to such traditional factors as prior criminal record.

Status of drug quality in the street-drug market--an update.

Status of drug quality in the street-drug market--an update.