Finland buying Heroin

__________________________

📍 Verified store!

📍 Guarantees! Quality! Reviews!

__________________________

▼▼ ▼▼ ▼▼ ▼▼ ▼▼ ▼▼ ▼▼

▲▲ ▲▲ ▲▲ ▲▲ ▲▲ ▲▲ ▲▲

Finland buying Heroin

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.

History of Heroin

Finland buying Heroin

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. Key findings and threat assessment. Global context. Trafficking and supply. Criminal networks. Prices, purities and offences. Retail markets. Actions to address current threats and increase preparedness. In most countries in the EU, it appears that the number of people who use heroin is relatively stable. In , the prevalence of high-risk opioid use among adults aged 15 to 64 is estimated to be around 1 million. The countries estimated to have the highest number of users per 1 inhabitants aged 15 to 64 are Finland at 7. Conceptually, there are two main strategies for assessing the size of the drug market, namely a demand-based or bottom-up approach and a supply-side or a top-down approach. The strengths and limitations of these strategies are reviewed in a background paper Udrisard et al. Using the methodology established by the EMCDDA , it is possible to estimate the size of the heroin retail market based on the number of users and their use patterns, including how much they use per year and the average price paid at retail level. While the overall prevalence of high-risk opioid use among adults aged 15 to 64 in was estimated to be around 1 million people in the EU, there was considerable variation between countries, and whereas some countries specified the main opioid used, others did not. As such, for some countries an estimate is available for high-risk heroin users rather than for high-risk opioid users. Where there is no estimate of high-risk heroin users available, this is imputed, based on high-risk opioid user estimates in combination with treatment data. Using the latest available data, the minimum estimated annual retail value of the heroin market is EUR 5. Estimates of amounts used suggest that about tonnes of heroin at retail-level purity range While this approach has a sound scientific basis, demand-based estimates are prone to underestimation due to misreporting and underreporting of prevalence and use, as self-reported data rarely reflect reality Udrisard et al. Obtaining information on the number of users and the amount of heroin they use is challenging. This is primarily because a large number of people who use heroin are dependent on the drug and may be living on the margins of society, and are thus unlikely to be included in surveys of the general population. Wastewater analysis, another source of information on drug use, cannot be performed for heroin because morphine, the most abundant metabolite of heroin, which can be used as a target residue to estimate heroin consumption, may also be an indicator of the commonly used medicines morphine and codeine. Many other potential indicators of heroin use have some time lag. For example, treatment indicators will detect opioid users only after approximately 13 years of use, and the number of opioid users entering treatment could be influenced by financial priorities and the availability and accessibility of services. Based on previous research, a ratio of 3. Further limitations include the lack of coverage of specific subgroups, such as prisoners, homeless people and other marginalised populations, in the current EU heroin market size estimate. This is due to a lack of data on the prevalence of drug use and the quantities used by these populations, which may be considerable. It would therefore be appropriate to consider these subpopulations specifically in demand-based estimates in the future Udrisard et al. It is also possible to produce an estimate of the size of the heroin market using a top-down approach. There are two main models that can be used for this, namely a production-based approach and a seizure-based approach. The first involves assessing the amount of heroin available for consumption in a given country or region by taking global production estimates, subtracting the amount seized by law enforcement authorities or otherwise lost spoiled, etc. The amount available can then be multiplied by the local price adjusted for purity, to account for adulteration to arrive at the retail market value. There are several challenges with this approach, such as the accuracy of global production estimates and global seizure data, and how the national and EU market share can be assessed. The seizure-based approach simply uses the amount of drug seizures and an estimated seizure rate to assess the quantities of drugs available on the market. However, no data are available that would allow an assessment of the seizure rate. An alternative supply-side approach is based on estimates of the number of dealers and the average number of doses they sell Rossi, Making such assessments may be possible. However, further studies are needed, initially at city level, to test this method and assess its suitability for use at national and EU level. In Europe, the opioid market is becoming increasingly complex, incorporating new potent synthetic opioids, prescription opioid medicines and mixtures see Section Synthetic opioid trafficking. While heroin remains by far the most common illicit opioid on the market at the EU level, this is not the case for all Member States. Ongoing monitoring and law enforcement action is needed to prevent further spread of synthetic opioids, some of which are relatively inexpensive and easy to manufacture or to divert from legitimate sources. While fentanyl and its derivatives, along with potent benzimidazole nitazene opioids, are still relatively niche in most places, they are increasingly available as part of the EU opioid market. Information on their use in Europe is limited, although existing evidence points to diverse national situations where there are signs of clusters of use limited to particular geographical locations. Historically, fentanyl and fentanyl derivatives have been the most common form of opioids used in Estonia. An increase in the availability of these substances was also observed in neighbouring markets, including Latvia, Lithuania and Sweden see Section Synthetic opioid trafficking. An important caveat is that current monitoring systems may not accurately document trends in synthetic opioid use, and this is therefore an area that needs improvement. Composite products, including heroin-fentanyl mixtures, have also been reported, as has the adulteration of illicit opioids with a range of potentially dangerous substances see Box Adulteration of illicit opioids with xylazine and new benzodiazepines. The availability of these products represents a significant change in the risk environment for users of opioids and people who inject drugs, posing additional challenges for health responses. While individual studies and monitoring data indicate that the misuse of prescription opioid medicines in the EU is limited, there is insufficient information to allow a more thorough assessment. For example, the diversion of methadone and buprenorphine from opioid agonist treatment is reported to be a significant problem in some countries see Section Synthetic opioid trafficking. There is also some evidence to suggest that the number of prescriptions for opioids used for pain management has been increasing. The same study assessed several proxies for misuse and identified a similar increasing trend. The number of opioid-related hospital admissions tripled from 2. Further, while opioid-related mortality remained stable between and , at 0. An increase in the use of prescription opioids affects the illicit market in a number of ways. For example, people who become dependent on opioid medications may turn to the illicit market to top up their medications or when their prescriptions expire. Also, an increase in the number of prescription opioids in circulation may provide new opportunities for diversion into the illicit market. Similar dynamics have been seen in the United States, where prescription opioids have fuelled the ongoing opioid epidemic. In addition to the diversion of opioids from legitimate sources, falsified and counterfeit opioid medicines are available, raising issues of their own. Reports and public notices have emerged in a number of EU Member States in recent years, alerting users about new opioids mis-sold as fake medicines, such as oxycodone tablets containing nitazenes. The EU is currently far from experiencing the opioid epidemic faced by the United States. Heroin is a central nervous system depressant. The immediate effects of heroin use include a rush of euphoria, a warm flushing of the skin, dry mouth and a heavy feeling in the limbs. However, these effects are short-lived, and the drug quickly leads to a state of drowsiness, slowed breathing and clouded mental function. It can also cause nausea, vomiting and severe itching. The long-term effects of heroin use are numerous and can be severe. These include physical and psychological dependence, overdose and death. Chronic heroin use can cause a range of physical and mental health problems, including liver disease, kidney disease, collapsed veins, chronic pneumonia, and infections of the heart lining and valves. In addition to the physical and mental health effects of heroin use, there are also a number of social and economic harms associated with the drug. These include increased crime rates, lost productivity, healthcare costs, and strained family and community relations. In particular, the broader social costs associated with long-term dependence on heroin include higher rates of homelessness and criminality, particularly acquisitive crime. The use of heroin is associated with a disproportionate amount of acute and chronic harm, and this is compounded by factors that include the properties of the drug, the route of administration, individual vulnerability and the social context in which heroin is consumed. Although the number of people reporting use of heroin in the EU is low compared with drugs such as cannabis and cocaine, a large proportion of people who use heroin are dependent on the drug. This means that they use it more frequently and in larger amounts than is the case for other drugs. In Europe, heroin is predominantly sold in the base form as brown powder, while white powder hydrochloride salt and black tar are rare. While the availability of various preparations of heroin may influence the mode of use, the drug is most frequently smoked or injected. Heroin that is smoked is usually in the base form, which is appreciably more volatile than the salt i. For injecting use, citric acid solution is added to prepare heroin base as it is poorly soluble in water. Injecting heroin is associated with many local and systemic complications, including increased risk of overdose, increased risk of infectious disease transmission such as HIV and hepatitis C via needle sharing , vein damage, skin abscesses and infections. Although heroin has historically been the main drug associated with injecting in Europe, this has been changing in recent years. Opioids are reported as the main injected drugs in 19 out of 24 countries for which data are available for clients entering treatment in While these data are not nationally representative, they can be viewed as indicative of local-level drug use dynamics. In this sample of used syringes, heroin was the most commonly detected drug in five out of the 12 participating cities. Overall, a third of syringes contained residues of two or more drug categories, often including both opioid and stimulant drugs. This indicates frequent polydrug use or reuse of injecting equipment. Recognising the increasing complexity of injecting practices in Europe and the prominence of polydrug consumption in this context is therefore likely to have important implications for both understanding the harms associated with this mode of administration and the interventions designed to reduce such harms. The most serious risk from overdose with opioids is rapid respiratory depression slow and shallow breathing , which can lead to death. With heroin, this risk may be increased by a number of individual as well as contextual, especially social, factors, including the following:. While the data available have limitations in respect of quality and coverage, the information available suggests that opioids, usually in combination with other substances, remain the group of substances that are most commonly implicated in drug-related deaths. Overall, trends in deaths where opioids are implicated appear stable. Meanwhile, in the north of Europe, less than one in six overdose deaths in Finland, Sweden and in the Baltic countries was reported to involve heroin in As such, while it remains the case that heroin is involved in a large proportion of opioid-related deaths, the data available increasingly suggest that other opioids are playing a more important role. Available data suggest that polydrug toxicity is the norm and that opioids other than heroin, including methadone and, to a much lesser extent, buprenorphine, with the exception of Finland and France , oxycodone and fentanyl, are associated with a substantial share of overdose deaths in some countries. In half of the 22 countries with post-mortem toxicological data available for , at least one in five drug-induced deaths involved methadone. In countries with available data, oxycodone was reported as being involved in drug-induced deaths between and , mainly in Denmark, Estonia, France and Finland EMCDDA, a. While available data indicate that fentanyl and fentanyl derivatives were linked to 49 deaths in Europe in , this excludes figures from Germany. With the inclusion of data from Germany, this number appears to be much higher, rising to a minimum estimate of deaths. Preliminary analysis, however, suggests that many of these fatalities might be associated with diverted fentanyl medicines rather than illicit fentanyl. Potent synthetic opioids, such as the fentanyl derivative carfentanil and benzimidazole nitazene opioids, consumed in the context of polydrug use, do not currently feature prominently in the data available at EU level but are observed to be causing an increasing number of deaths in the Baltic countries, including in Estonia and Lithuania in Preliminary data indicate that in , Estonia experienced an increase in drug overdose deaths involving isotonitazene, metonitazene and protonitazene. In Latvia, both the national statistics and the forensic registers have reported a three-fold increase in the number of drug-induced deaths in compared with Part of this reported increase relates to improved laboratory capacity in As such, the increase should be interpreted cautiously, although recent shifts in the opioid market are also likely to have played a role. Nitazenes appeared to be involved in a number of fatalities in and xylazine was identified in one case. Preliminary first-quarter data for from Latvia also suggest that benzimidazole opioids were involved in a number of drug-related deaths. The adulteration of heroin with fentanyl and isotonitazene, leading to fatal overdoses among users, has been reported to Europol by UK authorities since mid The UK Home Office is aiming to tighten controls on two other synthetic opioids, namely brorphine and metonitazene. Opioids were found in 20 of the 24 European hospitals participating in In contrast, small proportions of the presentations involved heroin in the hospitals in Belgium, the Netherlands, Estonia, Latvia and Lithuania and in the centres in Paris France and Barcelona Spain. Most presentations with heroin were among middle-aged men, and in 12 of the 20 centres no cases were aged less than 25 years. The use of heroin and other opioids during pregnancy has been linked to a number of neonatal complications, including opioid withdrawal, postnatal growth deficiency, neurobehavioural problems and a fold increase in sudden infant death syndrome Minozzi et al. Repeated use of heroin and withdrawal symptoms are associated with increased neonatal mortality Jansson et al. High rates of intrauterine growth retardation have also been reported in heroin-dependent mothers Binder and Vavrinkova, , in addition to elevated risk of low-birthweight infants from maternal heroin use compared to those from non-drug-using mothers, and prematurity and small-for-gestational-age babies Bell and Harvey-Dodds, ; Madgula et al. Among pregnant women who continue illicit intravenous heroin consumption, the risks of medical complications such as infectious diseases, endocarditis, abscesses and sexually transmitted diseases are also increased Winklbaur et al. There is a well-established, albeit complex, relationship between illicit opioid use and crime. Although high-risk opioid users are much more prevalent in the criminal justice system than in the general population, the relationship between opioid use and crime differs between individuals, and for the same individual over time. There is strong evidence that problem heroin use can amplify offending behaviour, particularly related to economic-compulsive crime, whereby users of heroin or other opioids engage in economically oriented crime to support a compulsive pattern of use Goldstein, A meta-analysis of studies on the relationship between drugs and crime concluded that the likelihood of committing crimes that were not drug possession offences is up to eight times greater for people who use drugs than for those who do not Bennett et al. Few opioid users resort to violence to acquire money for drugs, though some may engage in violent crime, such as assault, homicide or robbery. However, the extent to which opioid dependence is associated with these more serious forms of crime is less apparent White and Gorman, There is limited research examining the prevalence of drugs other than alcohol in penetrating injuries such as gunshots, explosive devices and stab wounds , and most of the published research originates from the United States Lau et al. Although heroin-using offenders have high rates of offending, they also have high rates of a range of other problems, such as homelessness, unemployment, low educational attainment and disrupted family backgrounds, making the relationship between drugs and crime more complex. The association between opioid use and crime highlights the importance of addressing use as a means of reducing criminal behaviour and improving public safety. Treatment for opioid-dependent individuals can help to reduce the demand for illicit drugs and decrease associated crime. Heroin can also be associated with an increased risk of being a victim of violence, due to altered perceptions and impaired judgement Gilbert et al. It is important to note that the risk of experiencing heroin-related violence is likely to be influenced by a range of situational factors, such as setting, socioeconomic status, other drug use, and a history of mental illness and trauma. Women involved in the sex trade have been identified as a sub-group who are particularly at risk of experiencing gender-based violence in the context of drug use, through engagement in the sex trade or in their intimate relationships EMCDDA, b. Many women who trade sex for drugs have limited power to practise safe sex or follow safe injecting practices and are at risk of experiencing violence and imprisonment. These women also face a greater degree of stigma, through both their drug use and their involvement in the sex trade EMCDDA, b. The available evidence strongly supports enrolment in opioid agonist treatment as a protective factor against opioid overdose and some other causes of death, with positive outcomes also found with regard to the use of illicit opioids and other drugs, reported risk behaviours, offending and drug-related harms EMCDDA, d, a; Mayet et al. In the EU, opioid users represent the largest group undergoing specialised drug treatment, mainly in the form of opioid agonist treatment, typically combined with psychosocial interventions EMCDDA, a. Overall, opioid agonist treatment was received by about half of all high-risk opioid users in the EU in , an estimated individuals. However, there are differences between countries. Trends from countries that consistently report data on clients receiving opioid agonist treatment between and show an overall stable trend of treatment levels during this period, with little fluctuation in the number of clients. This has important implications for service delivery, with services having to address a more complex set of healthcare needs in a population that is becoming more vulnerable due to other age-related health and social issues. Alongside opioid agonist treatment, needle and syringe exchange programmes and other harm reduction interventions were in place in all EU Member States and Norway in However, coverage and access to these programmes remains a challenge, with only five of the 17 EU countries with available data reaching the World Health Organization service provision targets in Currently, 15 countries report the provision of take-home naloxone to prevent overdose deaths and 10 countries report having at least one supervised drug consumption room. Naloxone works as a safe and effective antidote to reverse the respiratory depression caused by opioids Boyer, ; Britch and Walsh, ; Strang et al. However, coverage of these interventions remains uneven within and across countries in the EU. In addition, 12 countries have some type of drug checking service, which can help prevent harms by allowing users to find out what substances are present in the drug they have acquired and intend to consume. However, as with other drugs, opioids are also distributed across the EU via a range of digital channels, including darknet markets. The quantities offered online are typically small, and purchases are usually delivered using post and parcel services see Section Fluidity of routes, methods of transportation and modi operandi. In addition to parcel delivery, user-level distribution takes place by means of personal handover or by agreeing on a location where the drugs are left for pick-up. Although online retail distribution of heroin appears to remain marginal compared with other supply methods, it is important to understand its scope. A total of 2 listings sale offers of opioids excluding new opioids were identified based on data from eight major darknet markets, namely Versus , World , Dark0de Reborn , ASAP , Hermes 71 , Alphabay-v3 66 , Cypher 51 and Royal 23 ; these were reported as being shipped from an EU country. To put this in context, although not directly comparable, a similar scanning exercise conducted in found 13 listings for cannabis and 6 for amphetamine products For more information on the data source, see Section Overview of data and methods. The source data for this graphic is available in the source table on this page. Caution is needed in interpreting these data, as neither the number of individual sellers offering heroin on these marketplaces nor the number of transactions can be extrapolated from the number of listings alone. Nonetheless, the number of listings has been used as a valid indicator of the scope of activity on darknet markets. However, these findings should be viewed with caution due to an absence of forensic testing and evidence on the actual substances sold in these listings. In addition, heroin-fentanyl combinations appear to be available on darknet markets. An example of this can be found in a listing reportedly shipping from the Netherlands see Screenshot Fentanyl-heroin mixture listed on a darknet market, shipping from the Netherlands. The availability of such products represents a significant change in the risk environment for people who inject drugs. New benzimidazole nitazene opioids, including isotonitazene, etazene, etomethazene, metonitazene and protonitazene, also appear to be available on darknet drug markets. Listings for these substances have been associated with several EU Member States Czechia, France, Germany, Hungary, Poland and Sweden , which were noted as shipping origins on major darknet markets in Of particular concern is the online marketing of new opioids mis-sold as falsified fake medicines. In recent years, reports and public notices have been issued in a number of EU Member States to alert people about new opioids mis-sold as fake medicines, such as oxycodone tablets containing new opioids. The criminal use of the online environment to trade synthetic opioids, or medicines containing or adulterated with such compounds, could further increase in the EU as criminals act upon new opportunities, such as an increased demand for these products see Box Operation Earphones disrupts the trafficking of fentanyl into Italy. In addition to falsified medicines, there is also an online market for opioid medicines diverted from legitimate pharmacy supplies and sold on the surface web see Box Poland-based online market supplying illegally diverted opioid medicines to the United States and the United Kingdom. Consult the list of references used in this module. 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. Table of contents Search within the book. Introduction Introduction Key findings and threat assessment Key findings and threat assessment Global context Global context Production Production Trafficking and supply Trafficking and supply Criminal networks Criminal networks Prices, purities and offences Prices, purities and offences Retail markets Retail markets Actions to address current threats and increase preparedness Actions to address current threats and increase preparedness. Search within the book Operator Any match. Exact term match only. Main subject. Target audience. Publication type. EU Drug Market: Heroin and other opioids — main page. On this page.

Finland buying Heroin