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These datasets underpin the analysis presented in the agency's work. Most data may be viewed interactively on screen and downloaded in Excel format. All countries. Topics A-Z. The content in this section is aimed at anyone involved in planning, implementing or making decisions about health and social responses. Best practice. We have developed a systemic approach that brings together the human networks, processes and scientific tools necessary for collecting, analysing and reporting on the many aspects of the European drugs phenomenon. Explore our wide range of publications, videos and infographics on the drugs problem and how Europe is responding to it. All publications. More events. More news. We are your source of drug-related expertise in Europe. We prepare and share independent, scientifically validated knowledge, alerts and recommendations. About the EUDA. The content of this summary does not necessarily reflect the official opinion of the European Union, nor the official opinion of the Republic of Kyrgyzstan, and should be seen as the product of CADAP 5. The study involved a total of schools from the five countries, including 25 schools from the Kyrgyz Republic. A total of 1 students from Kyrgyzstan participated; Among schoolchildren in the 5th—7th grades, 0. The proportion of high school students who had used drugs was 1. On average, the age of first drug use was 10— It found that 2. It was noted that It was also found that It is presented in a form of small green balls with specific smell and taste. Nasvay is used by applying small amounts of it between a lower lip and a gum. Consequences of its sue are similar to intoxication with nicotine: mild local burning of a mucous mouth and headaches. The Ministry of Education and Science of the Kyrgyz Republic has implemented the Healthy Generation project with the support of international organisations. In the project conducted three training seminars for teachers from secondary schools and institutions of higher education to train them in the techniques of forming and maintaining a healthy way of life for adolescents and young adults. A summer camp was held for students of pedagogical institutions of higher education in order to teach them the innovative technologies and interactive methods of training on the prevention of HIV infection and drug addiction Ministry of Education and Science of the Kyrgyz Republic, An electronic interactive course on improving knowledge of HIV and AIDS for education specialists was designed, and 1 copies were printed. Together with the Ministry of Health and the Ministry of Education, a Kyrgyz—Finnish pilot project for the prevention of tobacco use among school students was implemented in the schools of the Chui region. In the governmental, international and non-governmental organisations conducted mass events and activities aimed at raising awareness among adolescents and young people about the negative consequences of drug use, developing the life skills of responsible behaviour and promoting a healthy lifestyle. These included:. In a month-long programme of events were arranged to coincide with the International Day Against Drug Abuse and Illegal Trafficking. The Ministry of Health, represented by the National Addiction Centre and together with the Ministry of Education of the Kyrgyz Republic, has implemented a number of preventive measures in the format of seminars, lectures, workshops, meetings, discussions and events among students and school activists, in secondary and higher educational institutions. Participants have included teaching staff of educational institutions, healthcare workers working with the general population, employees of the House Committee, municipal governments, educators, social care, justice, and law enforcement officers, and the judicial department and local authorities, including police officers, teachers and psychologists working at the Centre for Rehabilitation and Adaptation. In the Kyrgyz Republic problem drug use is defined as the injecting of drugs opiates or the long-term and regular use of opiates. The average age of first injection was Some The study found that The estimated number of injecting drug users in Kyrgyzstan, based on the bio-behavioural surveillance survey BBS , was 18 in and 30 in In there were 3 patients receiving treatment for problem drug use This is The number of people admitted for treatment for the first time in their life was 1 Of these, were treated in hospital; received outpatient treatment; 1 participated in opioid substitution treatment OST with methadone; and 1 participated in rehabilitation programmes. Among the people A total of clients in inpatient treatment were receiving treatment for the first time in their life in 9. Among the clients who received inpatient care, two adolescents 0. The predominant age groups were 25—34 years Outpatient treatment other than OST was provided to people in in , which represents 3. On an outpatient basis, clients received detoxification therapy and short-term psychotherapy. A total of In there were 1 people treated in OST programmes As of April , OST programmes with methadone had been implemented in 20 facilities. The total number of clients admitted to the methadone maintenance treatment MMT programme in —11 was 3 , or In the number receiving substitution therapy 1 represented In there were only 1 people in the programmes of medical and social rehabilitation, of whom were female 1 people including 98 females in ; the figures included those who received in-patient treatment people, of whom 10 were female. In young people with problematic use of psychoactive substances received medical consultations in special clinics for under-aged clients. Psychological examinations were undergone by under-age clients, of whom had problems connected with psychoactive substance use. Psychological counselling was carried out with 56 adolescents. During the year, the Department for the Prevention of PAS Consumption by Minors participated in meetings of the regional and city commissions for minors in Bishkek; 31 meetings were held in In a survey conducted among clients treated in the cities of Bishkek and Osh within the framework of the Global Assessment Programme on Drug Abuse it was found that were treated in Bishkek in , while were treated in Osh. The average age of the clients in the cities that were monitored during was The age of first use of the primary drug was At the end of some people using drugs were compulsory treated in the Addiction Centre of the Central Hospital in institution number 47 of the correctional system; clients were admitted and discharged in In the Atlantis rehabilitation centres in penitentiary institutions the rehabilitation of people addicted to alcohol and drugs was conducted on the basis of self-help work and peer-to-peer mutual aid. There were clients in these centres at the beginning of During some contracts were made with clients, and clients exited the programme, among them that had completed the treatment. By the end of the number of clients was There were 31 patients in the Centre for Rehabilitation and Social Adaptation at establishment number 31, Clean Zone, at the beginning of Twenty-eight contracts with clients were conducted in and 25 clients dropped out during the year. At the end of the number of patients was Further information is based on analysis of data from a compulsory registration According to Order No. There was an 8. With regard to the type of drug consumption among the new cases, It should be noted that, as in the case of the incidence of opiate dependence in , the proportion of people with a newly diagnosed dependence on opiates particularly heroin tends to increase within a year. The proportion of women among those newly diagnosed with an addiction to psychoactive substances was similar to the previous year at 7. As in the past year, the proportion of people under 18 years of age in was 0. The predominance of injecting drug use Of the reported cases of HIV infection, There were 3 cases of HIV infection registered as of 1 January , including 3 among citizens of Kyrgyzstan. Injecting drug users represented 2 , including citizens of the Kyrgyz Republic, who numbered 2 The number of patients with AIDS was It should be noted that the number of imprisoned PLHIV is increasing: in ; in ; in ; in ; in ; in ; in The smallest proportion of cases occurred in the northern regions of the country. In the country registered new cases of HIV infection males, females, among whom were citizens of the country , including those with AIDS, who numbered 95 21 females, 74 males ; the remaining five cases were foreign nationals three females, two males. IDUs represented cases Antiretroviral therapy had been assigned to patients as of 1 January , among whom received the therapy, including adults males, females , and children males, 55 females. The number of people who refused to undergo treatment was Some clients died while receiving the treatment, and 13 were intolerant to the medication. HIV testing of IDUs, together with pre-test counselling and obtaining the informed consent of the patient, is carried out in accordance with the orders of the Ministry of Health of the Kyrgyz Republic at the time of admission to drug treatment clinics, prisons and other institutions of law enforcement and public health including drop-in centres, friendly clinics, centres for the prevention and control of AIDS, and other places. Each population group has its own code for testing. There are more than 50 codes according to the approved N4 reporting form ; injecting drug users are tested under code However, injecting drug users can be tested for HIV under other codes, such as code A bio-behavioural surveillance survey BBS has been conducted among vulnerable groups in the Republic of Kyrgyzstan since In surveys were conducted among IDUs at eight sites. In and in serological studies were not performed. Ten people with viral hepatitis were identified in the State penitentiary system of the Kyrgyz Republic SPS at the end of , which is 0. The prevalence of viral hepatitis in the prison system of the Kyrgyz Republic is not known due to the difficulties to conduct seroprevalence studies in this setting. A total of died, including from TB and 66 from other causes. The current system of registration of drug-related deaths has significant drawbacks that do not allow any conclusions to be drawn about the situation on a national scale. In there were 64 fatal overdoses registered 84 in , including 4 women 6. In most cases of death, the cause of the overdose was an unspecified type of drug According to the National Health Information Centre, deceased persons were removed from dispensary registration in in , which accounted for 1. Analysis comparing the mortality rate among drug users removed from dispensary registration because of death, with the mortality of the general population of the same gender and age standardised mortality ratio — SMR found a death rate among drug users that was 1. Among male drug users the death rates are four times higher in the 20—24 age group compared with the same age group in the general population. Among female drug users the highest SMR 3. These programmes are implemented in both outpatient and inpatient settings, with different scopes. Outpatient programmes are mainly oriented towards motivation and continuation of treatment and the prevention of relapse. The main objectives of drug-free inpatient treatment programmes are to achieve stable remission or complete abstinence from drug use. Standards for the provision of healthcare services for injecting drug users were approved for the comprehensive treatment of drug addiction and its health consequences, including a standard for the detoxification therapy of withdrawal from opioids in the inpatient department of the Republican Addiction Centre of the Ministry of Health of the Kyrgyz Republic, a standard for the prevention of overdoses on opioids using naloxone and a standard for rehabilitation measures for people with opioid dependence Ministry of Health of the Kyrgyz Republic, Additionally, by an order of the Ministry of Health, the clinical protocols for opioid substitution treatment during the syndrome of opioid dependence were approved in Currently, the following types of treatment and services are suggested to patients in the country:. At the beginning of a clinic for the detoxification of people with an addiction to the opiate drug methadone was opened. The centre provides assistance to minors in the area of the treatment, rehabilitation, and prevention of the use of psychoactive substances. MMT was introduced in the Kyrgyz Republic in Since then the programme of substitution therapy has been expanded and by 1 January it was being provided at 20 facilities located in the Republican Centre of Addiction, in three centres of primary healthcare in Bishkek, in the cities of Tokmok, Kant, and Kara-Balt, the Alamedinsk, Sokuluk, and Moscow districts of the Chui regions, and at two facilities in Osh, Kara-Suysk, Uzgensk districts of the Osh regions, Dzhalal Abad and Kyzyl Kia Batken regions. MMT is also successfully implemented in three penitentiary institutions: penal colony number 47, detention centre number 1 Bishkek , and detention centre number 5 Osh. By 1 January the programme involved patients. Additionally, motivational and psychosocial counselling, HIV testing and testing for infections, including sexually transmitted infections, and pre-test and post-test counselling are provided in prisons. In the Bureau of Social Support, services of social support are provided to the individuals in prison who are living with HIV and drug addicts, and legal, psychological and social assistance is provided to prepare individuals for release and transfer to the civilian sector. Strategy and harm reduction programmes started to be implemented in Kyrgyzstan in In in Bishkek, Jalal-Abad, and Osh, and in areas of the Chui, Jalal-Abad and Osh regions 46 ONEs were operating, including 15 for syringe exchange in prisons 10 in correctional facilities and two in detention centres. In the Chui region, The non-governmental sector has, with the support of international organisations, taken an active part in the implementation of harm reduction programmes in the Kyrgyz Republic. In , two Associations continued to work actively on harm-reduction programmes. Issues such as a change in the principal recipient of the grant and transfer from the old to the new principal recipient took several months and resulted in problems with the continuity of funding, the timely supply of medical products to syringe exchange points, and the supply of food and soap detergent to social institutions. This affected both the coverage and the number of instruments and paraphernalia distributed to injecting drug users. For example, from 1 January to 31 August NSPs and social programmes reached 10 clients, while from September to December this number dropped to 7 Males represented the majority of clients In , with the support of the GFATM, a hour free helpline for drug addicts and their families continued to work in the Socium public association. The total number of clients who used the telephone hotline was 1 The largest number of helpline customers belonged to the age group 26— The gender composition was females and males. The Kyrgyz Republic borders with the Republic of Tajikistan, the total length of the border being around 1 kilometres, and Tajikistan, in turn, has a common border with Afghanistan. Most of the border between the Kyrgyz Republic and Tajikistan is a mountain range with numerous horse trails. Drugs are smuggled into the Kyrgyz Republic, and beyond to countries of the Commonwealth of Independent States and to Europe, through the many mountain passes. Drug traffickers use a variety of transportation methods, from horse-drawn vehicles in the border areas to air transportation. In the drug situation in the country was characterised by an intensification of international drug groups using the country as a drug transit corridor to Russia and the countries of the European Union. The trafficking of Afghan drugs and their transit through the territory of Tajikistan continue to be a major focus of drug abuse in the country. During law enforcement agencies of the Kyrgyz Republic uncovered 1 drug-law offences, In the law enforcement agencies of the Kyrgyz Republic seized 45 tons kilograms of narcotic drugs, psychotropic substances and precursors from illicit traffickers. Drugs of the cannabis group are produced in the Kyrgyz Republic itself. The local population uses it to make marijuana and hashish, which are distributed both locally and regionally through illegal markets. Ephedra also grows within the territory of the country; this is the raw material for the manufacture of the amphetamine-type stimulant methcathinone ephedrone. Drug prices have remained stable over the past three years and there have been almost no changes in the retail component. For example, the retail price for 1 gram of opium is fixed at around USD 1. According to the legislation of the Kyrgyz Republic, no chemical analysis of the purity of drugs seized in the country is performed, and the composition of a narcotic substance is not analysed; therefore, data on the composition and purity of drugs seized in criminal cases are not available. Accordingly, court decisions in criminal cases do not depend on a qualitative analysis of the purity of the drugs seized. Currently, the legislation concerning drugs in the Kyrgyz Republic is contained in 11 articles of the Criminal Code and two articles of the Administrative Code of the Kyrgyz Republic. Possession storage is an offence, depending on the quantity seized when the suspect is arrested. For example, if the detention of a suspect is accompanied by a seizure of heroin weighing less than 1 gram it is an administrative offence, and if the quantity is 1 gram or more it is subject to criminal prosecution. In accordance with Article of the Criminal Code of the Kyrgyz Republic, the illegal manufacture, acquisition, possession, transportation or shipment of narcotic drugs or psychotropic substances in small amounts without intent to sell, committed within one year of the application of administrative penalties for the same act, is punishable by community service of — hours, or a fine of up to 50 calculation units 1 , the restraint of liberty for a term not exceeding two years, or imprisonment. The same act committed by a person who has previously committed any other drug-law offence is punishable by a fine of up to calculation units, correctional labour for up to two years, the restraint of liberty for a term not exceeding three years, or imprisonment for a term of one to three years. Under the national law, a person who commits an offence under this Article and voluntarily surrenders narcotic drugs, psychotropic substances or their analogues and actively contributes to the disclosure or suppression of crimes related to illicit trafficking in narcotic drugs, psychotropic substances or their analogues, the exposure of the persons who committed these crimes, or the discovery of property obtained by criminal means, is exempted from criminal responsibility for the crime. In accordance with Article of the Criminal Code of the Kyrgyz Republic, the illegal manufacture, acquisition, possession, transportation, transfer with intent to sell and illicit production or distribution of narcotic drugs, psychotropic substances or their analogues or precursors shall be punished by imprisonment for four to eight years. In addition, according to the list of narcotic drugs, psychotropic substances and precursors subjected to control in the Kyrgyz Republic, hashish or cannabis resin separated resin, treated or untreated, or a mixture of resin and crushed particles of cannabis plants are subject to control on the territory of the Kyrgyz Republic and their trafficking implies unconditional administrative or criminal liability identical to that for other illicit drugs. In —11 the State Service of the Kyrgyz Republic on Drug Control, as the coordinator of the national anti-drug policy, together with the ministries and departments of the republic and experts from non-governmental and international organisations, developed a policy document on the concept of the anti-drug policy of the Kyrgyz Republic and the plan for its implementation until The matrix of measures for the implementation of the anti-drug concept is structured into 61 points with specification of activities, actors and the timing of the expected results. Structurally, the data points are divided into seven main sections:. This anti-drug concept of the Kyrgyz Republic aims to: establish effective governmental and social control over the drug situation in the country; reduce the drug-using population and drug-related crime; ensure the mobilisation and coordination of the anti-drug activities of state authorities, local authorities and voluntary organisations; and improve the legal framework to combat drug use and drug trafficking. It incorporates the tasks that are of a strategic and tactical nature, the key areas of public policy of drug prevention, reduction in the demand for drugs, and the fight against illicit drug production. It is the law enforcement and executive body that conducts the joint policy in the field of combating the trafficking of narcotic drugs and psychotropic substances and precursors, countering illicit trafficking and coordinating the activities of other executive bodies of the Kyrgyz Republic in this field including the provision of treatment for prevention and harm reduction. The Headquarters of the SDCS of the Kyrgyz Republic act as the national coordination centre for the collection of non-confidential information on drugs and drug addiction. Homepage Quick links Quick links. GO Results hosted on duckduckgo. Main navigation Data Open related submenu Data. Latest data Prevalence of drug use Drug-induced deaths Infectious diseases Problem drug use Treatment demand Seizures of drugs Price, purity and potency. Drug use and prison Drug law offences Health and social responses Drug checking Hospital emergencies data Syringe residues data Wastewater analysis Data catalogue. Selected topics Alternatives to coercive sanctions Cannabis Cannabis policy Cocaine Darknet markets Drug checking Drug consumption facilities Drug markets Drug-related deaths Drug-related infectious diseases. Recently published Findings from a scoping literature…. Penalties at a glance. Frequently asked questions FAQ : drug…. FAQ: therapeutic use of psychedelic…. Viral hepatitis elimination barometer…. EU Drug Market: New psychoactive…. EU Drug Market: Drivers and facilitators. Statistical Bulletin home. Quick links Search news Subscribe newsletter for recent news Subscribe to news releases. Breadcrumb Home Publications Kyrgyzstan. Kyrgyzstan country overview. No studies on the prevalence of problem drug use in the population were conducted in — Currently, the following types of treatment and services are suggested to patients in the country: Detoxification, on an inpatient and outpatient basis, which is conducted in all public institutions. These are located in 42 district family medicine centre FMC drug clinics, in three clinics in Bishkek, Osh and Jalal-Abad, and in five combined regional hospitals. Motivation for access to and continuation of treatment and the prevention of relapse and overdoses on an outpatient basis. The implementation of syringe exchange programmes. Harm reduction programmes include the following components: needle and syringe programmes NSPs and other protection, and the work of outreach workers; methadone maintenance therapy; outreach and educational activities; consultation with specialists; somatic healthcare; advocacy for drug addicts; detoxification for drug addicts. The regulatory framework for detoxification treatment with methadone in hospital was set up in During the department for the detoxification of people with a dependence on methadone started functioning; provision of medical care and an enhanced package of services in large NGOs, with the inclusion of social services, psychological orientation and consultation with experts from specialised agencies infectious diseases, TB, surgeon, venerology and others. Structurally, the data points are divided into seven main sections: Conducting targeted prevention of drug abuse and related offences. The introduction of new methods and treatment, and the medical and psycho-social rehabilitation of drug addicts. Reducing the availability of drugs. The concentration of law enforcement efforts on combating illicit drug trafficking. International cooperation in the fight against drug trafficking. Harm reduction. A reduction in the number of drug-related deaths.

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Official websites use. Share sensitive information only on official, secure websites. Elsevier hereby grants permission to make all its COVIDrelated research that is available on the COVID resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. Changes to drug markets can affect drug use and related harms. We aimed to describe market trends of heroin, methamphetamine, cocaine and ecstasy in Australia following the introduction of COVID pandemic-associated restrictions. We used self-reported market indicators price, availability, and purity for heroin, crystal methamphetamine, cocaine, and ecstasy crystal to estimate generalised additive models. Observations from the surveys were used to establish the pre-pandemic trend; , and observations were considered immediate, short-term and longer-term changes since the introduction of pandemic restrictions. There was no longer evidence for change in or relative to the trend. There were distinct disruptions to illicit drug markets in Australia after the COVID pandemic began; the timing and magnitude varied by drug. Drug markets are a known determinant of drug use and harms Hughes et al. For example, an abrupt change in heroin availability in Australia in the early s was marked by decreased frequency of heroin injection and rates of opioid-related fatal and non-fatal overdose but also increased use of other drugs and higher-risk injecting practices among some people Degenhardt et al. Likewise, a global ecstasy shortage in the early s was accompanied by proliferation of new psychoactive substances, some of which have been associated with elevated risk of acute harm Peacock et al. Monitoring changes in drug markets is thus critical to pre-empt and understand potential shifts in drug use and harms. With the onset of the COVID pandemic and associated border closures and restrictions on movement in early , disruption to illicit drug markets was predicted based on historical periods of economic, political and environmental upheaval Zolopa et al. To date, several studies using data collected in interviews with people who use drugs have described increased price, reduced availability and lower purity of illicit drugs in the initial months of the pandemic. Specifically, increases in price of cannabis and tranquilizers were reported in Norway Welle-Strand et al. In contrast, other studies reported limited impact to drug markets in Germany Namli, and Switzerland Gaume et al. These studies typically relied on participants reporting perceived changes in drug markets early in the pandemic. More rigorous inquiry would require comparison with indicators collected prior to the pandemic. Given the known resilience of drug markets Bouchard, , it is important to monitor responses to market disruptions over extended periods. However, studies of the market situation beyond the first year of the pandemic are limited in number and scope. Drug seizure data have been interpreted as a recovery for some drug markets, including methamphetamine in the US and Europe, in late and after initial supply disruptions European Monitoring Centre for Drugs and Drug Addiction, ; Palamar et al. With no land borders and a reliance on international importation for most drugs Australian Criminal Intelligence Commission, , Australia's illicit drug supply was thought to be particularly vulnerable to COVID associated border restrictions. Using annual cross-sectional data collected from people who regularly use illicit drugs in Australia from , the aim of this study was to investigate the immediate , short-term and longer-term changes in price, perceived purity, and perceived availability of heroin, methamphetamine, cocaine and ecstasy since COVID restrictions were introduced relative to the preceding trend IDRS participants were recruited through needle-syringe programs and treatment agencies and via word-of-mouth; EDRS participants were recruited via social media and word-of-mouth. From November , after Australia reach high vaccination coverage, international borders were opened and there were no further lockdowns. We analysed drug market data for the two illicit drugs most commonly injected among the IDRS sample heroin and crystal methamphetamine and used among the EDRS sample ecstasy and cocaine. Although questions regarding these drugs are asked in both surveys, small numbers report using or injecting the drugs chosen for analysis in the alternate survey. Furthermore, survey timing and recruitment methods differ between studies, so to maintain internal validity, we did not pool data between studies. We focused on ecstasy crystal in the main analysis as market indicator data for pills and capsules were combined from Use of all three indicators provides a better insight than one in isolation. In , participants reported which month this purchase occurred, which enabled exclusion of pre-pandemic restriction observations in we assumed that the timing of perceived availability and purity corresponded with last purchase. Analysis was undertaken in R version 4. The availability of only eight annual time points precluded use of traditional time series analysis. Instead, generalised additive models GAM were estimated using the mgcv package Wood, to model trends in market indicators, with thin plate spline functions for year of interview, allowing for non-linear relationships between predictor s and outcome. Six years of data pre-pandemic were included to elucidate trends prior to pandemic-related restrictions was the earliest year ecstasy crystal market indicator data were collected. Previous analyses suggest that market indicator data for heroin, crystal methamphetamine and cocaine were generally consistent in the years preceding Man et al. To allow for known differences in illicit drug markets by Australian jurisdiction, we considered three models: Model 1 where spline functions for year were fitted by jurisdiction i. The number of knots was chosen using the generalised cross validation criterion, whereby parsimony is balanced with explanatory power. To evaluate the suitability of GAMs, we also compared the fit of a generalised linear model with year as a linear covariate to assess linearity and potential overfitting. Seasonality was controlled for by incorporating month of interview in the model. As market indicator data were self-reported and may be subject to individual variability, models were adjusted for individual characteristics that may influence illicit drug access: age, gender, and drug use frequency Dave, ; Maher, ; McAdam et al. To assess changes in market indicators since the introduction of COVID restrictions in , three dummy variables corresponding to those years were included in the model. This is a common technique used in time series analyses to measure the effect of an event on an outcome e. For the purposes of visualisation, we fit a simple GAM with year of interview the only predictor. Results for perceived purity and availability of ecstasy pills and capsules are presented descriptively as there were insufficient data points pre-COVID to generate a trend line. Although repeat participation in annual cross-sectional studies is unlikely to affect population-level inferences Agius et al. In a second sensitivity analysis, we re-estimated price models without inflation adjustment. The nature of these analyses meant the model for each market indicator was limited to non-missing outcome observations. Then, for each market indicator, we assessed the nature of missingness for the covariates. Little's test suggested data were missing completely at random across all indicators Little, Therefore, we utilised a complete case approach. Sample characteristics remained mostly consistent across the samples. Detailed data regarding annual number of observations per market indicator, model selection, and model results are available in Appendices E, F, and G, respectively. Model 1 was selected for price inclusion of an interaction term between year and jurisdiction ; Model 2 was selected for availability and purity jurisdiction included as fixed effect only. Heroin market trends, IDRS samples In each figure the relationship between year and outcome is modelled using a generalised additive model. A The distribution of individual price observations is summarised as a smoothed density plot; the grey dots represent individual observations; the red line indicates the median price. Results of generalised additive models for illicit drug price, perceived availability, and perceived purity. Coefficients were estimated using generalized additive models. For availability and purity, coefficients are plotted on the log scale. Exact values for coefficients and corresponding confidence intervals are provided in Appendix G. However, we observed a decrease in perceived availability in and compared to In there was no longer evidence for change compared to the pre-pandemic trend aOR: 0. Cocaine market trends, EDRS samples A Last reported price per gram. The number of IDRS participants reporting heroin as high in purity increased from , albeit with some fluctuation Fig. However, there was no evidence for any change in purity in aOR: 0. Model 1 was selected for price and Model 2 was selected for availability and purity. There was a significant decrease in perceived availability observed in compared to the pre-pandemic trend aOR: 0. Crystal methamphetamine market trends, IDRS samples A Last reported price per point. The model suggested that perceived purity significantly decreased in compared to the pre-pandemic trend aOR: 0. Model 2 was selected for price and purity and Model 1 was selected for availability. Perceived availability of cocaine remained stable from to before increasing steadily until Fig. There was no evidence for any changes in perceived availability in , or relative to the existing trend Fig. There was no evidence for change in perceived purity of cocaine in compared to the existing trend Fig. Model 1 was selected for all three market indicators. Ecstasy crystal market trends, EDRS samples The perceived availability of ecstasy crystal increased with some fluctuation from to Fig. In , it increased again with no evidence for change compared to the existing trend aOR: 0. Similar trends were visually observed for ecstasy capsule and pill forms Appendices H and I. All results observed in the main models were similar when repeat participants were excluded Appendix J , except the change in heroin price observed in was no longer statistically significant. All results were replicated when prices were not adjusted for inflation Appendix K. Using nine years of annual survey data with cross-sectional samples of people who regularly inject drugs and people who regularly use illicit stimulants, we assessed changes to illicit drug markets after the introduction of COVID pandemic restrictions in Australia. We observed immediate disruptions to heroin and methamphetamine markets and delayed disruptions to cocaine and ecstasy markets. By , there was no longer evidence for any substantial disruption to heroin and methamphetamine market indicators compared to the pre-pandemic trend. Overall, the effect sizes observed were modest, which may be a result of small numbers of observations per jurisdiction. Given Australia's geographic isolation and reliance on importation of drugs, the initial shifts we observed in heroin and methamphetamine market indicators were not unexpected. The immediate changes to methamphetamine markets we observed were consistent with two jurisdictional surveys that took place in Perth and Melbourne in , which reported an increase in methamphetamine price Kasun, ; Voce et al. Previous drug shortages have been accompanied by increased reports of diluted or adulterated drugs e. Drug markets are known to be resilient to external forces Bouchard, , and we observed a return toward pre-pandemic price, perceived availability and purity for heroin and methamphetamine in Data from European drug markets suggested that while there was some reduction in drug trafficking between countries, localised decreases in drug availability were linked to areas with more stringent COVIDrelated restrictions European Monitoring Centre for Drugs and Drug Addiction and Europol, In Australia, wastewater analyses of methamphetamine support this notion: there were significant impacts between April and August when Australia's only nationwide lockdown occurred and between April and August when the two most populous states, New South Wales and Victoria, experienced extensive lockdowns Australian Criminal Intelligence Commission, a. Between these periods and since October when restrictions subsided, methamphetamine markets showed signs of recovery. Wastewater analyses of heroin consumption displayed similar, yet less pronounced, fluctuation. Our data were largely consistent with these findings for both heroin and methamphetamine, but as our survey period mostly occurred prior to the lockdowns, we did not observe the same impacts on market indicators in In contrast, disruptions to cocaine and ecstasy market indicators only became apparent in While it is possible that this is a result of EDRS interviews occurring immediately after the introduction of restrictions in and earlier than IDRS interviews , there are other plausible explanations. Compared to heroin and methamphetamine use in the IDRS sample, use of cocaine and ecstasy among the EDRS sample is less frequent and more likely to be used in nightlife or festival settings Uporova et al. It is possible that decreased demand for these drugs in delayed effects upon price, availability, and purity. The effects we observed on cocaine markets were less pronounced than those on the ecstasy markets. Wastewater data suggest consumption of cocaine has fluctuated since the onset of the pandemic and is yet to return to pre-pandemic levels Australian Criminal Intelligence Commission, b. However, unlike ecstasy, global production of cocaine is at a record high United Nations Office on Drugs and Crime, With international borders open and COVID public health restrictions now lifted in Australia, it is possible that demand and supply for these drugs will increase, necessitating continued monitoring of use and harms. We are not aware of other studies that have directly compared the magnitude of immediate and longer-term effects of the pandemic on drug markets using panel data as we have done. Therefore, while international organisations have generally reported that pandemic impacts to illicit drug markets were short-lived European Monitoring Centre for Drugs and Drug Addiction, ; United Nations Office on Drugs and Crime, , we cannot directly compare our findings to those of other countries. Given the variation in length and stringency of pandemic-associated border closures and restrictions globally, future comparisons will further elucidate the responsiveness of illicit drug markets to disruption. The main strength of this study is the long data series, which enabled testing of COVID pandemic effects while taking prior trends into account, rather than reliance on year-on-year comparisons. This study also has some limitations. The data used in this study were collected from sentinel samples, so should not be considered representative of the drug market experiences of all people who use or inject drugs in Australia. However, given the consistent recruitment methodology, we can be more confident in trends observed within the samples. The use of annual datapoints may have masked more granular fluctuations as illicit drug markets respond quickly to external forces Bouchard, We were unable to adjust for purity in our price models and given the perceived decrease in purity of drugs, we may have underestimated the change in purity-adjusted price Scott et al. While beyond the scope of this study, we were unable to investigate the impact of market disruptions to drug use behaviours e. Finally, our data are subject to recall bias, although self-report of drug related indicators among people who use drugs has been shown to be sufficiently reliable and valid Darke, The COVID pandemic is unprecedented in its potential to affect global illicit drug supply chains and local markets. We observed an immediate impact on Australian heroin and crystal methamphetamine markets in , followed by a rebound towards pre-pandemic levels in and For ecstasy and cocaine, effects on market indicators were slower to be seen, potentially due to reduced demand for these drugs during lockdown, but persisted in AP has received untied educational grant from Seqirus and Mundipharma for study of opioid medications. RB has received untied educational grant from Mundipharma and Indivior for study of opioid medications. LD has received untied educational grant from Seqirus, Indivior, and Mundipharma for study of opioid medications. All other authors have no conflicts of interest to declare. We also thank the thousands of participants who have shared their experiences and expertise with us over the years. Data Availability Statement: Data were collected during interviews with consenting participants. The data are not publicly available due to ethical constraints. Supplementary material associated with this article can be found, in the online version, at doi: This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Int J Drug Policy. Find articles by Olivia Price. Find articles by Nicola Man. Find articles by Rachel Sutherland. Find articles by Raimondo Bruno. Find articles by Paul Dietze. Find articles by Caroline Salom. Find articles by Seraina Agramunt. Find articles by Jodie Grigg. Find articles by Louisa Degenhardt. Find articles by Amy Peacock. Issue date Mar. Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.

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