The relationship between cryptomarket drug purchase, social networks and adverse drug events: A cross-sectional study.

People who buy MDMA, cocaine, or LSD from cryptomarkets are more likely to have no drug-using social network and to report adverse events requiring medical treatment. Among over 23,000 respondents from more than 70 countries in the 2018 Global Drug Survey, adverse events were low overall (5.2%). After controlling for age, gender, and frequency of use, recent cryptomarket use was associated with a higher likelihood of having no drug-using network for each drug. It was also linked to increased odds of adverse events for cocaine (adjusted odds ratio 1.70) and LSD (adjusted odds ratio 1.58). For those with a network larger than one person, cryptomarket use was still associated with more adverse LSD events. The findings suggest cryptomarket use may increase drug-related harm, but the complex mechanisms require further study.

Study at a glance

Abstract

Drug use and trading are typically social activities; however, supply through cryptomarkets can occur without any in-person social contact. People who use drugs alone may be at higher risk of experiencing harms, for example, due to lack of others who may call for emergency assistance. Alternatively, cryptomarkets may be a source of harm reduction information and drugs with better-known content and dose, potentially reducing the risk of adverse events. This study examines relationships between cryptomarket use, drug-using social networks and adverse drug events for MDMA, cocaine and LSD. A subsample of 23,053 respondents from over 70 countries was collected in the 2018 Global Drug Survey. People who reported using MDMA, cocaine or LSD were asked about using cryptomarkets to purchase these drugs; any adverse drug events requiring medical treatment (combining seeking treatment and should have sought treatment but did not); and social networks who they had used the specific drug with. All measures referred to the last 12 months, hereon referred to as 'recent'. Binary logistic regressions examined relationships between cryptomarket use, drug-using social networks, and adverse drug events, controlling for age, gender, and frequency of drug use. Adverse events from any drug type were low (5.2%) and for each drug; MDMA (3.5%); cocaine (3.3%); and LSD (3.5%). After controlling for covariates, recent cryptomarket use was associated with increased likelihood of having no drug-using network for each drug type. People who recently used cryptomarkets were more likely to report adverse cocaine (AOR = 1.70 (1.22-2.37)) and LSD (AOR = 1.58 (1.12-2.09)) events. For those reporting a network size >1, network characteristics did not differ with recent cryptomarket use; however, those reporting recent cryptomarket use were more likely to report adverse LSD events (AOR = 1.86 (0.99-3.51)). People who reported purchasing drugs from cryptomarkets more commonly reported having no drug-using network, and cryptomarket purchase was associated with reported adverse events. Our results support the notion that cryptomarket use increases drug-related harm, but further disentanglement of multiple complex mechanisms is needed in future research.