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Atte Oksanen 1 , Bryan L. Drugs are sold on both dark web services and on social media, but research investigating these drug purchases online is still emerging. The aim of this study is to analyze risk factors associated with buying drugs online. Utilizing theories of criminology and addiction research, it was hypothesized that social bonds, low levels of self-control, and poor mental health are associated with buying drugs online. Additionally, it was predicted that purchases of drugs online would mediate the relationship between low self-control and regular drug use. Measures of impulsivity, a sense of mastery, social belonging, psychological distress, excessive behaviors drinking, gambling and internet use were utilized to predict purchasing drugs online. Two percent of the U. Results from multinomial logistic regression, penalized maximum-likelihood logistic regression, and binary mediation regression models indicated that buying drugs online was associated with lower self-control, higher psychological distress, and excessive gambling behavior and excessive Internet use. Having online friends was not a risk factor, but having strong social bonds with offline friends served as a protective factor. Additionally, buying drugs online mediated the relationship between low self-control and regular use of drugs. Results indicate that more focus should be placed on mainstream social media services as sources of drug acquisition as online drug buyers have multiple self-control and mental health problems. Este estudio tiene como objetivo examinar los factores de riesgo vinculados a la compra de drogas online. Cite this article as: Oksanen, A. Illegal drug use and trade are persistent public health and safety issues with serious consequences for individuals and societies. The strategies and contexts for the purchase of drugs evolved greatly in the past decade. Nowadays, the Internet offers easy access to legal and illegal activities taking place on open social media services and encrypted services that use, for example, the Tor network. Online drug dealing first caught public attention with the rise of the Silk Road, an online cryptomarket, which operated in Tor, in Barratt et al. Although the Internet is now a popular context for drug trade, research on this topic is still in its very early stages. It is crucial to discover if buying drugs online is prevalent and to describe risk and protective factors that can potentially be addressed to prevent this emerging problem behavior. Studies have shown that users of cryptomarkets are most commonly males in their 20s. Users of cryptomarkets prioritize them over street markets for quality reasons and personal safety Barratt et al. Cryptomarket buyers have been considered a technological drug subculture that practices online activism and libertarian ideology Maddox et al. Despite much of the focus on cryptomarkets, some indications show that people might use mainstream social media sites, such as Instagram, to buy drugs Marsh, Recently, a Nordic project used qualitative interviews and a digital ethnographic approach to analyze the phenomenon in Denmark, Finland, Iceland, Norway, and Sweden. Currently, the literature lacks studies using national datasets and our study aims to fill this gap by investigating buying drugs online from a cross-national perspective. Investigating this phenomenon is important due to the potential of online drug markets for easier access to drugs, which can amplify the various risks that substance use has for young people. Moreover, risk and protective factors for buying drugs online still need to be discovered. We argue that a combination of theories from criminology and addiction research could help researchers to understand the psychological and social risk factors related to buying drugs online. These perspectives include self-control, social bonds, and mental health. Thus, we expect that easy access to social media sources for acquiring drugs could lead to more opportunities to engage in daily use of drugs in individuals with low self-control. Furthermore, we expect that buying drugs online would mediate the relationship between low self-control and regular drug use. Learning takes place in different environments, including friendships of differing quality, frequency, and intensity. Perceived closeness or belonging to friends can have an influence on deviant behaviors. This is particularly the case on the Internet, where it is very easy to get access to harmful and deviant content and form social contacts with like-minded peers Keipi et al. However, strong ties with offline friends have been shown to buffer risky online behavior Kaakinen, Keipi, et al. Mental health refers to psychological, emotional, and social stability and wellbeing of individuals. Addiction research widely recognizes that mental health problems coexist and develop with excessive drug use Orford, One example of these problems is psychological distress i. Issues with mental health are also manifested in other types of addictive behaviors, which could further influence drug use. Drug use has high comorbidity with excessive alcohol consumption Grant et al. All these excessive behaviors are relatively prevalent among young people. In this study, we focused on factors related to buying drugs online, an understudied and emerging problem behavior among young people. Our first aim was to evaluate the prevalence of social media drug acquisition in a population of the United States and Spanish young people. These countries were selected due to their high percentage of drug use among young people ESPAD, ; Savolainen, These countries are otherwise comparable in the usage of Internet among young people Savolainen et al, and provide a good starting point for comparative research on buying drugs online. Our second aim was to investigate how drug acquisition online is associated with self-control, social bonds, and issues with mental health. We predicted that strong social bonds online, low self-control, and mental health issues such as psychological distress and excessive behavior, including excessive drinking, gambling and internet use, would be associated with drug use and buying drugs online. We also expected strong bonds offline to function as a protective factor against drug use and buying drugs online. The participants of the study were year-olds from the U. We recruited the U. Using such panels has become commonplace in social sciences and they are considered a good alternative due to the difficulty of recruiting participants by traditional means. The limitation of such datasets is that they are mostly restricted to people using the Internet Lehdonvirta et al. However, research panels have the benefit of getting access to hard-to-reach populations such as emerging adults in many countries. In our case, the data were collected using similar procedure via Dynata in both countries to guarantee the comparability of data samples. Comparisons of the country datasets to the U. Both samples were part of a larger international comparative project on young people and addictions. A survey designed in English and translated into Spanish included validated measures that have been widely used in comparative research. Additional items were translated by proficient English and Spanish speakers. The accuracy and comparability of items was guaranteed by the back-translation process in December The surveys were pre-tested with university students and mechanical Turk respondents. The surveys were conducted with LimeSurvey software that was run on the Tampere University server. Survey format and layout was identical for all respondents and optimized for both computers and mobile devices. Median response time for the survey was minutes in the U. Participation was anonymous, voluntary, and participants were informed about their right to withdraw from the survey at any time. The participants were informed about the project web page including all the necessary information in case the participants had any concerns regarding the study. The participants gave consent to make data open access and available for research purposes. All the participants that finalized the survey were included in the study and there were no missing data on the items used in the study. Drug use. We then asked to specify the types of drugs used and the frequency of the use. Drug types included 1 cannabis, 2 synthetic cannabinoids, LSD, magic mushrooms, or other comparable hallucinogens, 3 amphetamines, ecstasy, cocaine or other stimulants, 4 opiates, 6 pharmaceutical opioids, 7 gamma, GBL, and other similar drugs, and 8 other pharmaceuticals. The user types were then categorized into regular cannabis users and regular users of other drugs e. Drug purchases online. Next, respondents were asked to identify different online resources for purchasing drugs, including darknet marketplaces and various social media platforms such as Facebook, Instagram, online dating services, and general discussion forums. Self-control was measured with two different scales. Response options were in 4-point Likert scale giving scores from 1 to 4 per each item. Response options were EIS were no 0 and yes 1 in all questions. However, omega for impulsivity in Spain was only. All regression models are adjusted for age, gender, social media activity and country. Social bonds. We used belonging to friends online and offline as measures of social bonds. We asked respondents three questions about how strongly they felt they belonged to friendship groups, groups of school or work friends, or online communities. The scale was from 1 not at all to 10 very strongly. Question on belonging to online communities was used as a single item for online friends. These questions have been previously validated in studies on deviant online behavior Minkkinen et al. Additionally, we used the nine-item Identity Bubble Reinforcement scale IBRS-9 to measure perceived similarity and identification with other social media users Kaakinen, Sirola, et al. Mental health. We measured psychological distress with the item General Health Questionnaire GHQ , which has been widely used in general population studies Goldberg et al. All of these scales had good inter-item reliability see Table 1. Control factors. We used gender, age, and social media activity as controls. We measured social media activity with a set of 12 questions involving how often respondents used the most popular social media sites. Analyses for this study were run with Stata A multinomial regression analysis was carried out to examine the associations among the covariates, drug use, and buying drugs online. We used an aggregated U. The group of people who had not used drugs was set as the reference category for those who had used drugs but not bought them online and for those who had also bought them online. Table 3 reports additional analyses that were run including only the participants who had experimented with drugs U. These analyses were conducted by using penalized maximum likelihood logistic regression i. Using the Firth method provides more robust findings in cases when either sample size or events are low. Despite this, we aimed to keep the estimation strategy as robust as possible and utilized the Firth method. The analyses were run with the Firthlogit-command Coveney, and age, gender, and social media activity were used as controls. We also report chi-square tests for categorical variables and mean comparison based on Kruskal-Wallis test. OR s are based on penalized maximum likelihood logistic regression models. All regression models are adjusted for age, gender and social media activity. Mediation analysis Figures 1 and 2 was conducted with binary mediation command with a replication bootstrap. We used aggregated US-Spain data here due to the low number of people buying drugs online. Impulsivity and sense of mastery were independent variables, buying drugs online was the mediating variable, and regular drug use was the dependent variable. Mediation analysis included age and gender as controls. Of the respondents, about every fifth Cannabis was clearly the drug most experimented with by respondents with fewer respondents reporting use of other types of drugs. Out of the United States young people, 7. In Spain the numbers were slightly lower with respective figures of 6. In the U. Additionally, respondents were given the opportunity to indicate several services where they purchased drugs online. About half of all the respondents in both the U. Multinomial logistic regression analysis revealed that those buying drugs online reported more self-control issues a lower sense of mastery and higher impulsivity compared with non-users as well as those who had used drugs but not bought them online Table 2. Buying drugs online was associated with psychological distress and excessive forms of drinking, gambling, and Internet use. Additional analyses were conducted in order to check the robustness of the results. Table 3 shows the descriptive statistics comparing those who have bought drugs online and those who have only experimented with drugs. These results further confirm the findings shown in Table 2 , comparing only the participants who experimented with drugs with the participants who reported buying drugs online. Self-control factors were only statistically significant in the U. In Spain, belonging to online friends was associated with buying drugs online. All mental health factors remained significant in the descriptive findings Kruskal-Wallis test and in penalized maximum likelihood logistic regression models. The last part of the analysis investigated buying drugs online as a mediator between the relationship of low self-control and regular drug use see Figures 1 and 2. Statistically significant mediation was found. Figure 1 presents the coefficients when treating impulsivity as an independent variable. The indirect effect was statistically significant p Figure 2 presents the coefficients when treating sense of mastery as an independent variable. The indirect effect was statistically significant p This study analyzed the behavior of buying drugs online among young people in the U. Still, on average every tenth person who had experience using drugs had bought them online. Thus, a low percentage of users purchasing drugs online could represent a more developed drug trade, especially given that current research on online buying indicates that a large share is intended for reselling Demant et al. The most remarkable finding is that mainstream social media services, such as Facebook and Instagram, were used for buying drugs in both countries. The results underline that research on online drugs sales should not only focus on darknet services. From a broader perspective, the results are in line with current social media and cybercrime research underlining that mainstream public Internet platforms give easy access to varying types of illicit and harmful content Keipi et al. In addition to drugs, communities and contents that promote other forms of harmful or addictive behaviors, such as problem gambling, disordered eating, or self-harm, are easily accessible and among the most visited social media sites by youth Keipi et al. In our study, both impulsivity and a low sense of mastery were associated with both drug use and buying drugs online, especially in the U. This result highlights that researchers should continue investigating impulsivity in an online setting. This could partially explain why our results were stronger in the U. Also, results indicated that online drug purchases mediated the relationship between low self-control and regular drug use. These results are an important contribution to the literature, as previous studies described online buyers as technologically savvy users who can regulate themselves Barratt et al. In contrast to these studies, our results indicate that existing self-control problems can lead to spontaneous drug purchases that may later on worsen the potential problems with regular use of drugs. Social norms and group processes within online social networks could be important in many ways. However, in our study we did not find results related to the potential influence of friend groups online. The only exception was the result from Spain indicating that those who bought drugs online expressed higher belonging to online friends. Due to this difference from the U. For example, scholarship on online cliques and bubbles has shown that they vary culturally and topically Keipi et al. We found, however, evidence that strong offline social ties were a protective factor against both drug use and buying drugs online. This finding is in line with previous studies showing that positive offline social ties can buffer potential risks encountered online Kaakinen, Keipi, et al. These findings are also consistent with social control aspects noted in criminology LaFree et al. Those buying drugs online had multiple mental health problems, as they reported psychological distress as well as excessive forms of gambling and Internet use. These findings confirmed previous research results on the associations of drug use in general Edlund et al. Therefore, it would be misleading to portray users of online drug markets as only a technologically savvy and a self-controlled sub-culture. Our results indicate that these youth may have many mental health issues and comorbidity of different addictions. Our analysis was cross-sectional and limited to two countries. Future studies should continue investigating this phenomenon in other countries as well. Although our models included risk and protective factors, and a mediation analysis, on a strong theoretical basis, causal relations need to be confirmed in future longitudinal studies. Additionally, stronger measures of impulsivity should be explored. The strength of the study was that it used two nationwide samples, but additional studies in other cultures and contexts are needed. This is one of the first studies focused on buying drugs online, an emerging problem behavior that might be especially harmful given that it is very difficult to control online behaviors. Online drug buyers have multiple self-control and mental health problems, and drug availability online might worsen their situations. Impulsive decisions are especially easy to make on social media. In light of this, more focus should be placed on youth behavior on mainstream social media services. Implications for policy and practice underline the need to work with youth on their social media use, since young people spend a considerable amount of time online. Social media platforms are linked to a wide variety of deviant behavior Nasaescu et al. The wide availability of illicit drugs is a larger problem area that needs to be tackled through legal enforcement efforts, especially online. Most importantly, the results suggest that there is a need to provide therapeutic interventions and support for those youth buying drugs online. As strong offline social ties could help protect from drug-related risks and harms, it is necessary to promote face-to-face interactions among young people. Comprehensive school-based interventions against substance use should include components related to buying drugs online, increasing its protective factors and decreasing risks. Social media and access to drugs online: A nationwide study in the United states and Spain among adolescents and young adults. Akers, R. Social learning and social structure: A general theory of crime and deviance. Northeastern University Press. The empirical status of social learning theory of crime and deviance: The past, present, and future. Cullen, J. Blevins Eds. Transaction Publishers. Bakken, S. International Journal of Drug Policy, Barratt, M. Addiction, 5 , International Journal of Drug Policy, 35 , Baumeister, R. Self-regulation failure: An overview. Psychological Inquiry, 7 1 , The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin, 3 , Bendayan, R. Psicothema, 31 2 , Bush, K. Archives of Internal Medicine, 16 , Coveney, J. Longitudinal effects of parenting mediated by deviant peers on violent and non-violent antisocial behaviour and substance use in adolescence. Demant, J. Drug dealing on Facebook, Snapchat, and Instagram: A qualitative analysis of novel drug markets in the Nordic countries. Drug and Alcohol Review, 38 4 , Trends in Organized Crime, 21 1 , De Ridder, D. Taking stock of self-control: A meta-analysis of how trait self-control relates to a wide range of behaviors. In Self-regulation and self-control pp. Dussault, F. Longitudinal links between impulsivity, gambling problems and depressive symptoms: A transactional model from adolescence to early adulthood. Journal of Child Psychology and Psychiatry, 52 2 , Edlund, M. Opioid abuse and depression in adolescents: Results from the national survey on drug use and health. Drug and Alcohol Dependence, , Eysenck, S. Impulsiveness and venturesomeness: Their position in a dimensional system of personality description. Psychological Reports, 43 suppl 3 , Farrington, D. Criminal, penal and life histories of chronic offenders: Risk and protective factors and early identification. Criminal Behaviour and Mental Health, 3 4 , Firth, D. Bias reduction of maximum likelihood estimates. Biometrika, 80 1 , Fisoun, V. Internet addiction as an important predictor in early detection of adolescent drug use experience - Implications for research and practice. Journal of Addiction Medicine, 6 1 , Forrest, W. Development of impulsivity and risk-seeking: Implications for the dimensionality and stability of self-control. Criminology, 57 3 , Goldberg, D. Psychological Medicine, 27 1 , Gottfredson, M. A general theory of crime. Stanford University Press. Grant, B. Epidemiology of DSM-5 alcohol use disorder. JAMA Psychiatry, 72 8 , Greenland, S. Penalization, bias reduction, and default priors in logistic and related categorical and survival regressions. Statistics in Medicine, 34 23 , Henson, B. Deviant Behavior, 38 7 , Holt-Lunstad, J. Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, 7 7. Kaakinen, M. Cybercrime victimization and subjective well-being: An examination of the buffering effect hypothesis among adolescents and young adults. Cyberpsychology, Behavior, and Social Networking, 21 2 , Shared identity and shared information in social media: Development and validation of the identity bubble reinforcement scale. Media Psychology, 23 1 , Keipi, T. Online hate and harmful content: Cross-national perspectives. King, G. Logistic regression in rare events data. Political Analysis, 9 2 , Koivula, A. Lafree, G. Correlates of violent political extremism in the United States. Criminology, 56 2 , Lai, H. Prevalence of comorbid substance use, anxiety and mood disorders in epidemiological surveys, A systematic review and meta-analysis. Lehdonvirta, V. Social media, web, and panel surveys: Using non- probability samples in social and policy research. Advance online publication. Lesieur, H. American Journal of Psychiatry, 9 , Maddox, A. Marsh, S. Youth workers warn of rise in drugs purchases through social media. Martin, J. Drugs on the dark net: How cryptomarkets are transforming the global trade in illicit drugs. Palgrave Macmillan. Polydrug use trajectories and differences in impulsivity among adolescents. International Journal of Clinical and Health Psychology, 18 3 , Meerkerk, G. Minkkinen, J. Moyle, L. International Journal of Drug Policy, 63 , Munksgaard, R. Mixing politics and crime — The prevalence and decline of political discourse on the cryptomarket. Nasaescu, E. Longitudinal patterns of antisocial behaviors in early adolescence: A latent class and latent transition analysis. Oksanen, A. Harm Reduction Journal, 15 Proanorexia communities on social media. Pediatrics, 1 , e Glamorizing rampage online: School shooting fan communities on YouTube. Technology in Society, 39 , Pearlin, L. The structure of coping. Journal of Health and Social Behavior, 19 1 , Peters, E. Relationship of gambling with tobacco, alcohol, and illicit drug use among adolescents in the USA: Review of the literature The American Journal on Addictions, 24 3 , Pevalin, D. Multiple applications of the GHQ in a general population sample: An investigation of long-term retest effects. Social Psychiatry and Psychiatric Epidemiology, 35 11 , Pratt, T. The empirical status of Gottfredson and Hirschis general theory of crime: A meta-analysis. Criminology, 38 3 , The empirical status of social learning theory: A meta-analysis. Justice Quarterly, 27 6 , Reyns, B. Digital deviance: Low self-control and opportunity as explanations of sexting among college students. Sociological Spectrum, 34 3 , Savolainen, I. Addiction by identification: A social psychological perspective on youth addictive behaviors. Tampere University, Finland. Online relationships and social media interaction in youth problem gambling: A four-country study. Peer group identification as determinant of youth behavior and the role of perceived social support in problem gambling. Journal of Gambling Studies, 35 1 , Schieman, S. Religiosity, socioeconomic status, and the sense of mastery. Social Psychology Quarterly, 66 3 , Slatcher, R. A social psychological perspective on the links between close relationships and health. Current Directions in Psychological Science, 26 1 , Van Hout, M. International Journal of Drug Policy, 24 6 , Vazsonyi, A. Its time: A meta-analysis on the self-control-deviance link. Journal of Criminal Justice, 48 , Your request has been saved. The data we compile is analysed to improve the website and to offer more personalized services. By continuing to browse, you are agreeing to our use of cookies. For more information, see our cookies policy. January Pages 29 - Abstract Drugs are sold on both dark web services and on social media, but research investigating these drug purchases online is still emerging. Introduction Illegal drug use and trade are persistent public health and safety issues with serious consequences for individuals and societies. Mental Health Mental health refers to psychological, emotional, and social stability and wellbeing of individuals. This Study In this study, we focused on factors related to buying drugs online, an understudied and emerging problem behavior among young people. Method Participants The participants of the study were year-olds from the U. Table 1 Descriptive Statistics. Conflict of Interest The authors of this article declare no conflict of interest. References Akers, R. Orford, J. Excessive appetites: A psychological view of addictions. Introduction Method Results Discussion. Go top. PlumX Metrics. Your request has been saved Notify me when a new issue is online I have read and accept the information about Privacy. For more information, see our cookies policy Aceptar. Table 1 Descriptive Statistics Note. Procedure Both samples were part of a larger international comparative project on young people and addictions. Instruments Drug use. Data Analysis Analyses for this study were run with Stata Results Of the respondents, about every fifth The indirect effect was statistically significant p Discussion This study analyzed the behavior of buying drugs online among young people in the U.

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Absence of hepatitis C infection among illegal drug users in Bucaramanga, Colombia. Bucaramanga, Colombia. October 10 to 12, The aim of this study was to estimate the prevalence of hepatitis C virus HCV and identify risk factors associated with the transmission this virus among drug users. In we performed a cross-sectional study at three facilities handling cases of drug addiction and in one prison. Anti-HCV antibodies were identified with two different immunoassays. HCV prevalence was lower than reported in previous studies of drug users in Latin-America. However, we identified risk factors that would facilitate HCV infection once the virus is introduced in this population. The hepatitis C virus HCV is the leading cause of morbidity and mortality associated with chronic hepatic disease, cirrhosis and hepatocellular carcinoma 1. The risk factors for HCV transmission have been studied extensively, allowing the categorization of the groups among which transmission occurs most frequently. IV drug users IVDU are most frequently infected, followed by hemophiliacs and then hemodialysis and poly transfused patients Transmission is also related to intranasal cocaine use, tattoos, unprotected sex, accidents with contaminated needles and sharing personal hygiene elements such as razors and electric shavers machines 7,8. It has been said that upon ingesting these substances, lesions are produced in the oral and nasal mucous. These lesions favor transmission of the virus when inhalation devices contaminated with infected blood are used In this group, sharing infected needles to administer IV drugs such as heroin is considered to be the main risk factor related to HCV transmission. Drug addiction is considered to be a public health problem in Colombia. Each year the number of users increases, primarily in the adolescent population In the year , an investigation in the city of Cali found that However, the Colombian university population has the lowest percentage of consumers found among epidemiological studies in South America 10 allowing one to infer that the proportion of illegal drug users is higher than has been reported in Colombia. Information regarding at-risk groups is scarce, and completely absent in the case of illegal drug users. Taking HCV transmission among risk groups in Colombia as a reference, it is necessary to perform an active search for cases among other groups such as illegal drug users. Due to the high cost and frequent complications of treating chronic hepatitis C, infected individuals must be identified so that action can be taken to decrease the transmission and impact of the disease. Developing epidemiological knowledge of HCV infections among at-risk groups is critical for developing for prevention programs and adequate care A cross sectional study using a non-probability sample was conducted during the first semester of Patient and prisoner participation was voluntary through a signed informed consent form, previously approved by the ethics committee of the University of Santander UDES. Individuals of any gender or age, who mentioned parenteral, oral or nasal drug abuse for three months or more, were included. Socio-demographic information including age, gender, level of education and health insurance and pension were obtained through interviews. Other additional risk factors associated with HCV transmission inquired about included specification of illegal drugs, duration of use, method of administration, sexual behavior, tattoos and piercings. Variables previously described by G. Quaglio et al. Once the interview was complete a 7ml blood sample was taken in tubes without anticoagulant. The size of the sample population was represented by individuals. Central tendency and dispersion measures were taken and position measurements or percentages were calculated according to the nature and distribution of the variables to characterize the population. The final sample was composed of individuals between 13 and 56 years of age The age group which consumes illegal drugs the most, with a prevalence of They are followed by people between the ages of 19 and 25, with a prevalence of Table 1. Socio-demographic characteristics of the sample studied. Most of the population said they consumed more than one type of drug. Heroin was used by 3. The frequency of other substances such as glue and hallucinatory mushrooms are shown in Table 2. Other important factors such as tattoos Table 2. Risk factors for Hepatitis C Virus infection among illegal drug in the Bucaramanga metropolitan area. Despite using a sample of convenience, the sample size used was representative if a prevalence among IVDUs and NIVDUs below that reported in nearby countries is assumed 10, These results could be associated with the low frequency in our population of intravenous use of illegal drugs 4. HCV transmission among IV drug addicts is still controversial. It has been stated that sharing non-injection devices is a possible channel for HCV transmission. Other studies suggest tattoos, age and having friends with HCV as important factors related to the transmission of the virus 32, 29, A systematic review of the literature concluded that there is not enough evidence to relate behaviors associated with drug use among NIVDUs with HCV infection Taking into account that most publications on the subject are descriptive, it has not been possible to define the specific risk factors present among NIVDUs that facilitate HCV transmission. On the other hand, it has been proven that, because of sharing needles contaminated with the virus, intravenous use is the most efficient route for HCV transmission among drug users 17, 18, Despite the absence of HCV infection in the analyzed population, several risk factors were found which were previously described among illegal drug users. In a recent study by CL Lopez et al. This was apparently due to greater lifetime exposure to the virus In the present study, Hepatitis C among male drug users is more frequent than among female drug users because of the higher proportion of drug users among males. In Colombia, according to a University study from Cali, The type of illegal drug is an indicator for method of administration and thus for the risk associated with HCV transmission. Heroin is administered intravenously more than any other substance. In our population 3. Similar results were described in Cali where the prevalence of heroin use was 4. Marijuana, cocaine, bazuco and other substances reported in this study showed no associations with HCV infections when compared with the literature taking into account that these substances are mainly consumed by non-IV methods. Whether tattoos and piercings are risk factors is controversial 35, It is probable that a small amount of inoculated virus in the skin during these cosmetic procedures develops on an asymptomatic course that is hard to detect. Nonetheless, this association has been described 35, 9 , In this study It is currently known that HCV transmission through sexual encounters is very unusual, and it is most often associated with drug use, especially intravenous drug use No HCV infections were found among the population of illegal drug users in Bucaramanga. This allows one to conclude that prevalence is lower than those reported in other Latin American countries except Venezuela. Risk factors that could result in HCV transmission once it has been introduced into the population were found. These factors were tattoos, piercings, age of drug using population and intravenous drug use. The possibility exists that other infectious agents such as HIV, HBV and syphilis that impact public health are circulating among drug users. Therefore new studies are required to look for these pathogens. The authors would like to thank the directors of Casa Shalom de Paz, Hogares Crea and Renovarse rehabilitation centers and the Palogordo prison for granting access to the participants. Wasley A, Alter MJ. Epidemiology of hepatitis C: geographic differences and temporal trends. Semin Liver Dis ; Epidemiology of hepatitis B and C viruses: a global overview. Clin Liver Dis ; High incidence of hepatitis C virus infection in hemodialysis patients in units with high prevalence. J Clin Microbiol ; Risk factors for hepatitis B and C in multi-transfused patients in Uruguay. J Clin Viro ; 34 Suppl 2: S Hepatitis C virus infection in female sexual workers from northern Lima. J Med Virol ; Incidence and risk for acute hepatitis C infection during imprisonment in Australia. Eur J Epidemiol ; Tattooing in prisons--not such a pretty picture. Am J Infect Control ; High prevalence of hepatitis C virus infection among noninjecting drug users: association with sharing the inhalation implements of crack. Liver Int ; Multiple infections and associated risk factors among non-injecting cocaine users in Argentina. Non-injection drug use and Hepatitis C Virus: a systematic review. Drug Alcohol Depend ; Risk behaviors and antibody hepatitis B and C prevalence among injecting drug users in south-western Sydney, Australia. J Gastroenterol Hepatol ; High HIV, hepatitis C and sexual risks among drug-using men who have sex with men in northern Thailand. AIDS ; High seroprevalence of blood borne viruses among street-recruited injection drug users from Buenos Aires, Argentina. Clin Infect Dis ; 37 Suppl 5: S Braz J Med Biol Res ; Rev Esp Enf Dig ; Estudio Nacional de Salud Mental Colombia Univ Phsychol ; 5: Hepatitis C virus seroprevalence in multi-transfused patients in Colombia. J Clin Virol ; 34 Suppl 2: S Serological markers and risk factors for hepatitis B and C viruses in patients infected with human immunodeficiency virus. Luque R. Iatreia ; 17 Suppl: Estimating future hepatitis C morbidity, mortality, and costs in the United States. Am J Public Health ; Factors associated with hepatitis C virus infection in injection and noninjection drug users in Italy. Clin Infect Dis ; Prevalence, risk factors and genotypes of hepatitis C virus infection among drug users, Central-Western Brazil. Rev Saude Publica ; 43 Suppl 1: Risk correlates of prevalent HIV, hepatitis B virus, and hepatitis C virus infections among noninjecting heroin users. J Acquir Immune Defic Syndr ; Hepatitis C virus infection in Chicago women with or at risk for HIV infection: evidence for sexual transmission. Sex Transm Dis ; Association of sex, hygiene and drug equipment sharing with hepatitis C virus infection among non-injecting drug users in New York City. Sharing of noninjection drug-use implements as a risk factor for hepatitis C. Subst Use Misuse ; The importance of preventing hepatitis C virus infection among injection drug users in the United States. Relationship of cosmetic procedures and drug use to hepatitis C and hepatitis B virus infections in a low-risk population. Hepatology ; The tattooing paradox: are studies of acute hepatitis adequate to identify routes of transmission of subclinical hepatitis C infection? Arch Intern Med ; Is sexual contact a major mode of hepatitis C virus transmission? Bruguera M, Forns X. Hepatitis C in Spain. Med Clin Barc ; Special focus: hepatitis C. Services on Demand Journal. Received: Accepted: Abstract The aim of this study was to estimate the prevalence of hepatitis C virus HCV and identify risk factors associated with the transmission this virus among drug users. Key words Hepatitis C, drug user, antibodies, prevalence, risk factors. Acknowledgment The authors would like to thank the directors of Casa Shalom de Paz, Hogares Crea and Renovarse rehabilitation centers and the Palogordo prison for granting access to the participants. All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. How to cite this article.

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