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Official websites use. Share sensitive information only on official, secure websites. Correspondence should be sent to Marcus A. In , an Australian television reporter asked science fiction writer Arthur C. Clarke what the year might be like for his young son. It has transformed our routines of buying and selling goods and services, displacing brick-and-mortar stores, and rendering the suburban mall a near anachronism. Like virtually all commercial venues in human history, the Internet also has become a means to buy and sell contraband—namely, drugs. The rise of online pharmacies advertising controlled substances to the public without a prescription termed illicit online pharmacies was documented in a series of reports from the early s. However, the reality was quite different, with many orders never arriving or yielding tablets containing entirely different ingredients from those expected. Recognizing the threat to public health and safety, law enforcement agencies have engaged in large-scale operations to shut down illicit online pharmacies. Coordinated by INTERPOL and now involving more than countries globally, Operation Pangea is an annual campaign to seize illicit and counterfeit pills and take down illicit online pharmacy Web sites. Since that time, the volume of illicit and counterfeit pills seized has only grown. However, despite such enforcement activities, illicit online pharmacies persist. From these tweets, the investigators then reviewed those linking to external Web sites and found seven unique Web sites offering opioid analgesics for sale without a prescription. Previous studies relied on manual review of links from Internet search engines, an extremely time-consuming and imprecise method. Years of enforcement activity have forced illicit online pharmacies to find new ways of advertising, so big data analytics approaches such as this one are valuable. More broadly, the study by Mackey et al. Several natural extensions of the work by Mackey et al. In a prominent example, Lazer et al. Although their approach was appealing, the numerous search terms examined likely yielded spurious correlations, and the volume of search terms was subject to external forces such as media attention. Twitter presents some similar challenges because the types of people using it and their modes of expression are constantly changing. The findings by Mackey et al. Currently, because enforcement activities have targeted illicit online pharmacies, the market has adapted, namely, through cryptomarkets. Cryptomarkets are online venues for the purchase of drugs and other contraband protected by technology allowing for anonymous communication e. These markets often have fully developed systems of customer feedback and dispute resolution. Although illicit online pharmacies traded in pharmaceuticals, cryptomarkets offer access to a broader range of drugs, including cannabis products, 3,4-methylenedioxymethamphetamine MDMA , cocaine, and amphetamines. What do cryptomarkets mean for the future of drug use? In a recent review, Aldridge et al. However, cryptomarkets may provide benefits as well, with preliminary evidence suggesting a higher purity of cryptomarket-obtained drugs relative to those obtained offline possibly resulting from pressure on sellers to sell high-purity products because systems can track and report customer feedback. Given that people will continue to buy drugs, cryptomarkets may offer several personal and public health advantages over offline purchases. When faced with an emerging venue for illicit drug sales, our impulse is to focus on law enforcement. Indeed, there have been large-scale operations against cryptomarkets, but data suggest that effects are only temporary. Whereas physical drug markets are typically hidden, making it difficult to intervene at the point of sale, digital drug markets are often open and broadly accessible to the public. What if we could harness these venues to promote health? Interventions could potentially broadcast health-oriented messages or even connect soon-to-be customers with resources such as harm reduction advice or services or even substance use disorder treatment. Some of this work is already ongoing; for example, in , a Spanish nongovernmental organization implemented a drug content and purity testing service aimed at people using cryptomarkets. Historically, the proportion of people obtaining drugs via the Internet has been small, but it will almost certainly grow. We are only beginning to understand the hazards and benefits of this shift. Online drug commerce and social media offer unprecedented opportunities to understand and quantify drug markets as well as the behavior and social networks of people who use drugs. Analytic techniques like the one described by Mackey et al. As a library, NLM provides access to scientific literature. Raina M. Find articles by Marcus A Bachhuber. Find articles by Raina M Merchant. Accepted Sep 9; Issue date Dec. See also Mackey et al. 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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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. People who inject drugs are at risk of contracting infections through the sharing of drug use paraphernalia. On this page, you can find the latest analysis of drug-related infectious diseases in Europe, including key data on infections with HIV and hepatitis B and C viruses. European Drug Report — home. The drug situation in Europe up to Drug supply, production and precursors. Synthetic stimulants. Heroin and other opioids. New psychoactive substances. Other drugs. Injecting drug use in Europe. Drug-related infectious diseases. Drug-induced deaths. Opioid agonist treatment. Harm reduction. People who inject drugs are at risk of contracting infections such as viral hepatitis B and C HBV and HCV, respectively and the human immunodeficiency virus HIV through the sharing of drug use paraphernalia. These infections can cause chronic diseases that may result in severe health-related harms, including death. While long-term trends in new HIV infections associated with drug injection have been falling in Europe, the risk of HIV transmission among people who inject drugs remains higher than for the general population, and transmission rates attributable to injecting are also still elevated in some countries. Concern exists that the low number of new HIV infections observed in may reflect, in part at least, a delay in diagnosis due to a disruption of testing caused by the pandemic, rather than a decline in transmission see the figure New HIV notifications linked to injecting drug use in the European Union, to , below. Local HIV outbreaks associated with stimulant injecting have been a recurrent problem in Europe in the last decade, with city-level outbreaks in Luxembourg —16 , Dublin —15 , Munich , Cologne , Thessaloniki and Helsinki highlighting the need for adequate treatment and harm reduction coverage see the figure Most-recent HIV outbreaks in Europe among people who inject drugs: number of cases and the associated injected substance, to Most-recent HIV outbreaks in Europe among people who inject drugs: number of cases and the associated injected substance, to This is a concern, as those with a late HIV diagnosis are at increased risk of HIV-related morbidity and mortality and may have a poorer response to antiretroviral treatment. Harm reduction approaches, particularly the provision of sterile injecting equipment, are now regarded as an important component of reducing HIV transmission among people who inject drugs. However, coverage and access to needle and syringe provision remain insufficient in many countries, with only 5 of the 17 EU countries with available data achieving the WHO service provision targets in see the figure Number of sterile syringes distributed per person who injects drugs per year, or latest data. Obtaining secure funding for harm reduction services working with people who inject drugs can be challenging in some countries. NGOs in Bulgaria and Romania, for example, have experienced funding and procurement difficulties over the last few years that led to a reduction in provision. In Europe, people injecting substances also have a high burden of viral hepatitis, and injecting drugs remains the most common risk factor for new HCV diagnoses. There is also evidence that harm reduction services, such as needle and syringe programmes, as well as the provision of opioid agonist treatment, can reduce the risk of HCV transmission. As noted earlier, the coverage of and access to these interventions vary considerably between European countries see the figure Availability of needle and syringe programmes in Europe at the regional level, or the most recent year available , below. In addressing the harms associated with HCV infection, it is particularly important to identify individuals who remain chronically infected with the virus, as they are at risk of cirrhosis and cancer, and can transmit the virus to others through the sharing of any injecting paraphernalia that has been in contact with their blood. However, barriers to the uptake of HCV testing and treatment exist in many countries, and this can mean many HCV infections go undiagnosed and untreated. Positively, more European countries are now making efforts to gather data about HCV linked to injecting, whether through ad hoc studies or routine surveillance systems. This information, together with the establishment of effective referral pathways to specialist health services, can contribute to a more systematic approach to providing the continuum of care needed for people who inject drugs and have acquired HCV infection. Not available Available No information. Data are at NUTS levels 2 or 3. The lack of data at NUTS levels 2 or 3 does not mean that the intervention is not available within a country. European policymakers have made a commitment to the WHO global health sector strategies to end AIDS and the epidemics of viral hepatitis and sexually transmitted infections by Achieving these objectives, however, still requires greater investment to enhance harm reduction services, testing and linkage to treatment, as the provision in many countries remains insufficient. Greater efforts therefore are still needed to prevent future outbreaks and reduce transmission and thereby reduce the burden of disease linked to HIV, HCV and other infections among people who inject drugs. Low evidence Moderate evidence. Show source tables. Back to list of tables. 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. This make take up to a minute. Once the PDF is ready it will appear in this tab. Sorry, the download of the PDF failed. A more recent version of this page exists: Drug-related infectious diseases — the current situation in Europe European Drug Report Table of contents Search within the book. Search within the book Operator Any match. Exact term match only. List of tables Table 1 new HIV notifications linked to injecting drug use in the European Union, to Table 2 most-recent HIV outbreaks in Europe among people who inject drugs: number of cases and the associated injected substance, to Table 3 number of sterile syringes distributed per person who injects drugs per year, or latest data Table 4 availability of needle and syringe programmes in Europe at the regional level, or the most recent year available Table 5 drug-related infectious diseases Table 6 prevalence of active HCV infection among people who inject drugs, by country, or latest available data Table 1. New HIV notifications linked to injecting drug use in the European Union, to Year Notifications per million population 3. Table 2. Most-recent HIV outbreaks in Europe among people who inject drugs: number of cases and the associated injected substance, to City Country Associated drug lat,lon Dublin Ireland Synthetic cathinones Table 3. Number of sterile syringes distributed per person who injects drugs per year, or latest data Country Lower estimate Central estimate Upper estimate Belgium Table 4. Antwerpen Prov. Limburg BE Prov. Oost-Vlaanderen Prov. Vlaams-Brabant Prov. West-Vlaanderen Prov. Brabant Wallon Prov. Hainaut Prov. Luxembourg BE Prov. Namur Prov. Aisch-Bad Windsheim Neustadt a. Gallen St. Neumarkt i. Waldnaab Neustadt a. Fichtelgebirge Wunsiedel i. Ilm Pfaffenhofen a. Opf, Kreisfreie Stadt Weiden i. Brussel-Hoofdstad Arr. Antwerpen Arr. Mechelen Arr. Turnhout Arr. Hasselt Arr. Maaseik Arr. Tongeren Arr. Aalst Arr. Dendermonde Arr. Eeklo Arr. Gent Arr. Oudenaarde Arr. Sint-Niklaas Arr. Halle-Vilvoorde Arr. Leuven Arr. Brugge Arr. Diksmuide Arr. Ieper Arr. Kortrijk Arr. Oostende Arr. Roeselare Arr. Tielt Arr. Veurne Arr. Nivelles Arr. Ath Arr. Charleroi Arr. Mons Arr. Tournai-Mouscron Arr. Soignies Arr. Thuin Arr. Huy Arr. Waremme Arr. Verviers — communes francophones Arr. Arlon Arr. Bastogne Arr. Marche-en-Famenne Arr. Virton Arr. Dinant Arr. Namur Arr. Philippeville Arr. Wendel St. Donau Dillingen a. Table 5. Table 5c. Trends in drug-related HIV: EU and selected countries cases per million population Country Bulgaria 5. Table 5d. Table 6. Prevalence of active HCV infection among people who inject drugs, by country, or latest available data Country Prevalence percent Level of evidence Colour coding for chart Austria Main subject. Target audience. Publication type. European Drug Report main page. On this page.

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