Katinka van de Ven

The Internet and lifestyle drugs: an analysis of demographic characteristics, methods, and motives of online purchasers of illicit lifestyle drugs in the Netherlands

Abstract Aims: The Internet has marked a revolution in the supply of illegal drugs, while at the same time, new types of illegal and semilegal drugs increasingly are becoming available. In order to deepen our understanding of the demand and supply of these new drugs on the Internet, this study focuses on the demographic characteristics, methods and preferences of people who purchase ‘lifestyle drugs’ through the surface web. Methods: Data were obtained through the following two surveys: a prevalence study of 50,848 Dutch respondents and an in-depth study of 153 people who have purchased lifestyle drugs online. Findings: At least 10.2% of the Dutch adult population has bought medicines online; the majority being lifestyle drugs (5.2%). In addition, an estimated 1.6% of the Dutch population has purchased medicines illicitly, with the majority of products concerning lifestyle drugs (0.9%). Illicit lifestyle drugs are primarily purchased through e-commerce sites and online pharmacies, and users report high satisfaction rates. Conclusion: Purchasing lifestyle drugs is characterised by specific online dynamics, as the drugs are often openly accessible and the boundaries between legal and illegal sale blurred. As new types of drugs become available, it is important to further monitor customers’ preferences and experiences.

Alcohol and other drug treatment commissioning and purchasing: Is it health care or social-welfare?: Commentary

‘[I]n recognition of the social determinants of alcohol, tobacco and other drug problems and that the age and stage of life issues associated with substance use can result in different risks and harms require integrated, holistic and systems based partnerships. This includes partnerships between both government and non-government agencies in areas such as education, treatment and services, primary health care, justice, child protection, social welfare, fiscal policy, trade, consumer policy, road safety and employment’. [1]

Health risk and health seeking behaviours among people who inject performance and image enhancing drugs who access needle syringe programs in Australia: PIEDs injection: Health risk behaviours

INTRODUCTION AND AIMS People who use performance and image enhancing drugs (PIED) are a growing population in needle syringe programs (NSP) in Australia. Previous international research has identified heterogeneity among the PIED-using population. This study investigated health behaviours among NSP attendees who had recently (last 12 months) injected PIEDs and examined differences among this group according to recent psychoactive drug use. DESIGN AND METHODS The Australian Needle and Syringe Program Survey is an annually repeated cross-sectional survey conducted at approximately 50 NSPs nationally. In 2015, respondents provided information on their demographic characteristics, health risk and health monitoring behaviours, and provided a capillary dried blood spot for HIV and hepatitis C virus antibody testing. Univariable and multivariable logistic regressions assessed factors associated with recent (last 12 months) use (all routes of administration) of psychoactive drugs. RESULTS Among recent PIED injectors (n = 156), 59% had recently used psychoactive substances. Those who had recently used psychoactive drugs were significantly younger, less educated and more likely to have experienced redness at an injection site in the previous 12 months but were more likely to report recent HIV/hepatitis C virus testing. DISCUSSION AND CONCLUSIONS This study identified significant differences in demographic characteristics, risk and health seeking behaviour among PIED users who did and did not also use psychoactive substances. There is a need to enhance and tailor harm reduction efforts and to build the capacity of NSP staff to better meet the needs of this diverse group.

Illicit Performance and Image Enhancing Drug Markets

This chapter explores the illicit production and supply of performance and image enhancing drug (PIED) markets in Belgium and the Netherlands. In recent years, the widespread availability of drugs with the potential to enhance image and performance, such as muscle drugs, tanning products and weight-loss drugs, has generated a new and growing group of users. Aside from the potential health risks, a major concern is that the majority of PIEDs are not legally obtained through a physician, by means of a prescription, but instead are illegally purchased on the black market. Importantly, sport officials and state authorities suggest that economically motivated individuals and dangerous groups are driving the illicit market for PIEDs; and ‘mafia-type’ organized crime specifically is considered to be the main culprit. Despite these concerns, little empirical research exists on the production and supply of PIEDs. However, understanding illicit drug markets is important for policy decisions as it may assist in designing and evaluating law enforcement efforts, prevention, harm reduction initiatives and other measures. This chapter provides a historical account of the development of PIED markets in Belgium and the Netherlands. In addition, the general characteristics of PIED dealers, such as their legal professions and gender, will be discussed in more detail. This will be followed with an examination of the methods and motives of PIED dealers, using bodybuilding as a case study. In the final section, the link between the illicit PIED market, organized crime, and professional sport is critically explored. The chapter concludes with a discussion of the overall findings.