Monica J. Barratt

Synthetic cannabis: A comparison of patterns of use and effect profile with natural cannabis in a large global sample

BACKGROUND The last decade has seen the appearance of myriad novel psychoactive substances with diverse effect profiles. Synthetic cannabinoids are among the most recently identified but least researched of these substances. METHODS An anonymous online survey was conducted in 2011 using a quantitative structured research tool. Missing data (median 2%) were treated by available-case analysis. RESULTS Of 14,966 participants, 2513 (17%) reported use of synthetic cannabis. Of these, 980 (41% of 2417) reported its use in the last 12 months. Almost all recent synthetic cannabis users (99% of 975) reported ever use of natural cannabis. Synthetic cannabis reportedly had both a shorter duration of action (z=17.82, p<.001) and quicker time to peak onset of effect (z=-9.44, p<.001) than natural cannabis. Natural cannabis was preferred to synthetic cannabis by 93% of users, with natural cannabis rated as having greater pleasurable effects when high (t(930)=-37.1, p<.001, d=-1.22) and being more able to function after use (t(884)=-13.3, p<.001, d=-0.45). Synthetic cannabis was associated with more negative effects (t(859)=18.7, p<.001, d=0.64), hangover effects (t(854)=6.45, p<.001, d=0.22) and greater paranoia (t(889)=7.91, p<.001, d=0.27). CONCLUSIONS Users report a strong preference for natural over synthetic cannabis. The latter has a less desirable effect profile. Further research is required to determine longer term consequences of use and comparative dependence potential.

SILK ROAD: EBAY FOR DRUGS

Internet and digital technologies have been discussed recently by Addiction contributors in relation to the delivery of efficient computer-delivered brief interventions, online methodologies for recruiting and surveying illicit drug users and the internets role in facilitating the spread of information and sale of emerging drugs such as mephedrone and synthetic cannabinoids. Here, I introduce readers to a novel use of the internet in the drugs field. The anonymous online drug market-place Silk Road was first revealed in June 2011. Silk Road is accessible only to people who are using Tor anonymizing software. Tor uses encryption to make it impossible for anyone to trace IP addresses (the electronic code assigned to each computer on the internet). The front page of Silk Road looks a great deal like the front page of eBay. Goods and services for sale are categorized and all manner of drugs are available under the following categories: ecstasy, cannabis, dissociatives, psychedelics, opioids, stimulants, benzodiazepines and other. Sellers receive ratings from buyers and comments about the quality of their products, how fast they ship and the level of professionalism and discretion of the transaction. Trust in sellers is built on reputation. Silk Road traders use the anonymous currency Bitcoin. This decentralized international currency operates through peer-to-peer technologies. At the time of writing (October 2011), Silk Road is still online and continuing to expand. Facilitated by a combination of the internet and encryption technologies, buying and selling illegal products is now possible and may increase dramatically in the future. What may stop an exponential increase in the use of anonymous online drug market-places is the hurdle of delivery. At the end of the transaction, the physical product still needs to be sent to the buyer. Sending products between countries allows law enforcement the opportunity to intercept packages and potentially attempt to arrest the would-be importer. Sending products within the same country may make arrest less likely. There are also numerous barriers to entry for people who might want to use Silk Road. Installing and using Tor, buying and using Bitcoins in a secure way and taking the risk of fraud or arrest upon delivery may deter the majority of would-be users. Nevertheless, for the minority who master these concerns and are willing to take the risk, Silk Road has revolutionized how the internet can be used to source drugs. After all, buying drugs in the real world also involves considerable risk. For some, the online equivalent may prove more convenient and secure than arranging a standard deal. There are many unanswered questions about Silk Road. The extent to which law enforcement can stop and disband a site such as this is yet to be seen. The extent to which drug users will use this new technology is also unknown. Needless to say, if anonymous online drug markets do end up expanding into mainstream drug markets, they will pose a real challenge to existing drug laws and policies. Language: en

Use of Silk Road, the online drug marketplace, in the United Kingdom, Australia and the United States

AIMS To investigate the prevalence of awareness of the online illicit drug marketplace Silk Road (SR), consumption of drugs purchased from SR and reasons for use and non-use of SR. DESIGN AND SETTING Global Drug Survey: purposive sample collected in late 2012. PARTICIPANTS The base sample (n = 9470) reported recent drug purchase and resided in the United Kingdom (n = 4315, median age 24, 76% male), Australia (n = 2761, median age 32, 76% male) or the United States (n = 2394, median age 21, 80% male). MEASUREMENTS Online questionnaire. FINDINGS A total of 65% of US, 53% of Australian and 40% of UK respondents had heard of SR; 18% of US, 10% of UK and 7% of Australian respondents had consumed drugs purchased through SR. Across the three countries, 3,4-methylenedioxy-N-methylamphetamine (MDMA) was the most commonly purchased drug (53-60%), followed by cannabis (34-51%), lysergic acid diethylamide (LSD) (29-45%) and the 2C family (16%-27%). The most common reasons for purchasing from SR were wider range (75-89%), better quality (72-77%), greater convenience (67-69%) and the use of vendor rating systems (60-65%). The most common reasons for avoiding SR purchase were adequate drug access (63-68%) and fear of being caught (41-53%). Logistic regressions found that, compared with people from the UK, Australians [odds ratio (OR) = 3.37; 95% confidence interval (CI) = 2.29, 4.97) and Americans (OR = 1.46; 95% CI = 1.10, 1.94) were more likely to use SR due to lower prices; and to avoid SR purchase due to fear of being caught (Australia: OR = 1.65; 95% CI = 1.39, 1.96; USA: OR = 1.62; 95% CI = 1.37, 1.92). CONCLUSIONS While reasons for Silk Road use accord with broader online commerce trends (range, quality, convenience, ratings), its appeal to drug purchasers is moderated by country-specific deterrents and market characteristics.

The NBOMe hallucinogenic drug series: Patterns of use, characteristics of users and self-reported effects in a large international sample

The NBOMe compounds are a novel series of hallucinogenic drugs that are potent agonists of the 5-HT2A receptor, have a short history of human consumption and are available to buy online, in most countries. In this study, we sought to investigate the patterns of use, characteristics of users and self-reported effects. A cross-sectional anonymous online survey exploring the patterns of drug use was conducted in 2012 (n = 22,289), including questions about the use of 25B-NBOMe, 25C-NBOMe, and 25I-NBOMe and comparison drugs. We found that 2.6% of respondents (n = 582) reported having ever tried one of the three NBOMe drugs and that at 2.0%, 25I-NBOMe was the most popular (n = 442). Almost all (93.5%) respondents whose last new drug tried was a NBOMe drug, tried it in 2012, and 81.2% of this group administered the drug orally or sublingually/buccally. Subjective effects were similar to comparison serotonergic hallucinogens, though higher ‘negative effects while high’ and greater ‘value for money’ were reported. The most common (41.7%) drug source was via a website. The NBOMe drugs have emerged recently, are frequently bought using the internet and have similar effects to other hallucinogenic drugs; however, they may pose larger risks, due to the limited knowledge about them, their relatively low price and availability via the internet.

Diverging trends in alcohol consumption and alcohol‐related harm in Victoria

Objective: To examine recent trends in alcohol‐related harm and risky drinking in Victoria, Australia.

The 12-month prevalence and nature of adverse experiences resulting in emergency medical presentations associated with the use of synthetic cannabinoid products

A wide range of synthetic cannabinoid products have recently become available through the Internet and shop fronts across the globe. Concerns about the consequences of their use have been prompted by increasing reports of emergency department presentations.

Everything you always wanted to know about drug cryptomarkets* (*but were afraid to ask)

For some drug policy scholars, including us, the online marketplace Silk Road and its successors are inherently fascinating. When we first discovered Silk Road in 2011, on opposite sides of the globe, we could not believe it was real: people were buying illegal drugs anonymously through a global marketplace that resembled eBay or Amazon. We were instantly hooked. Rather than addressing our fellow cryptomarket-obsessed colleagues who will no doubt already be devouring the 12 articles in the issue, we would like to address the remaining readership of the journal, who may not know much at all about cryptomarkets and may wonder what relevance cryptomarkets have to broader drug policy scholarship. We believe that there are at least five reasons that the broader drug policy scholarly community should pay attention to drug cryptomarkets. First, cryptomarkets provide us with arguably the first opportunity to analyse the supply side of a drug market in its totality: not using small and often partial samples, but as a near complete population. Second, cryptomarkets are not isolated from broader drug markets: drugs flow into and out of cryptomarkets into broader social and commercial drug supply chains. Third, cryptomarkets provide a new way of monitoring emerging drug trends. Fourth, cryptomarkets offer an illustration of criminal innovation in drug supply as a response to law enforcement efforts. Fifth, cryptomarkets have become a location in which the needs and preferences of drug users are at least partially met: a wide repertoire of available drugs, information and advice, all within a community-based regulatory system that has more or less effectively bypassed state regulation. These marketplaces may therefore provide us with lessons we can usefully apply in a possible post-prohibition world. In this editorial, we aim to demonstrate why the journal readers should care about cryptomarkets. What are cryptomarkets and how do they work? How do the papers in this special issue contribute to mapping the innovation of cryptomarkets? What are the novel methodological opportunities and ethical issues that arise in conducting these kinds of studies? And what can we say about the future of cryptomarkets?

Internet content regulation, public drug websites and the growth in hidden Internet services

Governments have traditionally censored drug-related information, both in traditional media and, in recent years, in online media. We explore Internet content regulation from a drug-policy perspective by describing the likely impacts of censoring drug websites and the parallel growth in hidden Internet services. Australia proposes a compulsory Internet filtering regime that would block websites that ‘depict, express or otherwise deal with matters of… drug misuse or addiction’ and/or ‘promote, incite or instruct in matters of crime’. In this article, we present findings from a mixed-methods study of online drug discussion. Our research found that websites dealing with drugs, that would likely be blocked by the filter, in fact contributed positively to harm reduction. Such sites helped people access more comprehensive and relevant information than was available elsewhere. Blocking these websites would likely drive drug discussion underground at a time when corporate-controlled ‘walled gardens’ (e.g. Facebook) and proprietary operating systems on mobile devices may also limit open drug discussion. At the same time, hidden Internet services, such as Silk Road, have emerged that are not affected by Internet filtering. The inability for any government to regulate Tor websites and the crypto-currency Bitcoin poses a unique challenge to drug prohibition policies.

Hidden Populations, Online Purposive Sampling, and External Validity Taking off the Blindfold

Online purposive samples have unknown biases and may not strictly be used to make inferences about wider populations, yet such inferences continue to occur. We compared the demographic and drug use characteristics of Australian ecstasy users from a probability (National Drug Strategy Household Survey, n = 726) and purposive sample (online survey conducted as part of a mixed-methods study of online drug discussion, n = 753) using nonparametric (bootstrap) and meta-analysis techniques. We found significant differences in demographics and drug use prevalence. Ideally, online purposive samples of hidden populations should be interpreted in conjunction with probability samples and ethnographic fieldwork.

NBOMe - a very different kettle of fish . . .

NBOMe — a very different kettle of fish . . . TO THE EDITOR: We are concerned that recent media reports about a 17-year-old Sydney boy who died after allegedly consuming 25Bor 25I-NBOMe might lead to an increase in the incidence of NBOMe toxicity among patients presenting to emergency departments. NBOMe was reported to be available online for as little as