Low-threshold methadone treatment, heroin price, police activity and incidence of heroin use: The Zurich experience

Nordt, Carlos; Stohler, Rudolf

doi:10.1016/j.drugpo.2009.02.009

Cited by 12 publications

(7 citation statements)

References 4 publications

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“…City description was based on Bless [2], Uchtenhagen [33–35], Klingemann [36], Falcato [18], Fuchs [5], Huber [9], Stohler [37, 38], Hertzig [39], Conolly [19], Waal [20]. …”

Section: Resultsmentioning

confidence: 99%

Open drug scenes: responses of five European cities

Waal

Clausen

Gjersing³

et al. 2014

BMC Public Health

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BackgroundOpen drug scenes are gatherings of drug users who publicly consume and deal drugs. The authors conducted a study of five European cities that have met such scenes constructively. The aim was to investigate shared and non-shared interventions and strategies in order to increase the understanding of this type of problem.MethodsFirst a description was made for the cities of Amsterdam, Frankfurt, Vienna, Zürich and Lisbon. These descriptions were sent to contact persons in each city prior to visit by the researchers. The methods and strategies in each city were discussed and core choices and efforts extracted. A report was sent to the contact group for corrections and clarifications. The paper analyses shared and non-shared traits and strategies.ResultsAll of the cities had initially a period with conflict between liberal and restrictive policies. A political consensus seems to be a prerequisite for effective action. A core shared characteristic was that drug dependence was met as a health problem and drug use behaviour as a public nuisance problem. Low threshold health services including opioid maintenance treatment were combined with outreach social work and effective policing.ConclusionPrevention, harm reduction and treatment should be combined with law enforcement based on cooperation between police, health care and social services. The aim should be “coexistence” between society and users of illegal substances and the strategy based on several years planning and conjoint efforts. The solutions are found in appropriate combinations of harm reduction and restrictive measures.

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“…City description was based on Bless [2], Uchtenhagen [33–35], Klingemann [36], Falcato [18], Fuchs [5], Huber [9], Stohler [37, 38], Hertzig [39], Conolly [19], Waal [20]. …”

Section: Resultsmentioning

confidence: 99%

Open drug scenes: responses of five European cities

Waal

Clausen

Gjersing³

et al. 2014

BMC Public Health

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“…On a policy level, the Drug Enforcement Administration cited street price data to justify assigning buprenorphine to Schedule III, a lesser category of regulation than methadone, oxycodone, and morphine [5]. Street prices for cocaine and heroin have been used as indicators of intervention impact in public policy [6,7], including as inputs for modeling the impact of policy decisions, understanding the profits and risks in the drug trade [8,9], informing debates on prohibition [10], evaluating the impact of interdiction, informing the timing of public health efforts [11,12], and understanding the impact of globalization and economic recession on drug street prices [13-15]. Behavioral economic studies in controlled settings have been used extensively in the last decade to explain and predict human behaviors associated with addictive disorders, focusing on impulse control (discounting) and the relative likeability of substances [16,17].…”

Section: Introductionmentioning

confidence: 99%

Crowdsourcing Black Market Prices For Prescription Opioids

Dasgupta¹,

Freifeld²,

Brownstein³

et al. 2013

J Med Internet Res

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BackgroundPrescription opioid diversion and abuse are major public health issues in the United States and internationally. Street prices of diverted prescription opioids can provide an indicator of drug availability, demand, and abuse potential, but these data can be difficult to collect. Crowdsourcing is a rapid and cost-effective way to gather information about sales transactions. We sought to determine whether crowdsourcing can provide accurate measurements of the street price of diverted prescription opioid medications.ObjectiveTo assess the possibility of crowdsourcing black market drug price data by cross-validation with law enforcement officer reports.MethodsUsing a crowdsourcing research website (StreetRx), we solicited data about the price that site visitors paid for diverted prescription opioid analgesics during the first half of 2012. These results were compared with a survey of law enforcement officers in the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) System, and actual transaction prices on a “dark Internet” marketplace (Silk Road). Geometric means and 95% confidence intervals were calculated for comparing prices per milligram of drug in US dollars. In a secondary analysis, we compared prices per milligram of morphine equivalent using standard equianalgesic dosing conversions.ResultsA total of 954 price reports were obtained from crowdsourcing, 737 from law enforcement, and 147 from the online marketplace. Correlations between the 3 data sources were highly linear, with Spearman rho of 0.93 (P<.001) between crowdsourced and law enforcement, and 0.98 (P<.001) between crowdsourced and online marketplace. On StreetRx, the mean prices per milligram were US$3.29 hydromorphone, US$2.13 buprenorphine, US$1.57 oxymorphone, US$0.97 oxycodone, US$0.96 methadone, US$0.81 hydrocodone, US$0.52 morphine, and US$0.05 tramadol. The only significant difference between data sources was morphine, with a Drug Diversion price of US$0.67/mg (95% CI 0.59-0.75) and a Silk Road price of US$0.42/mg (95% CI 0.37-0.48). Street prices generally followed clinical equianalgesic potency.ConclusionsCrowdsourced data provide a valid estimate of the street price of diverted prescription opioids. The (ostensibly free) black market was able to accurately predict the relative pharmacologic potency of opioid molecules.

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“…Similarly, an interpretivist paradigm is considered in this study20 because, according to previous research,3 the level of tolerance and perception towards PWUDs and drug-related activities in a community is a key element in understanding DRCIs. In this paradigm, the researchers assume multiple subjective realities instead of a single reality (positivist or postpositivist) and thus will design a study to describe these multiple realities 17…”

Section: Methodsmentioning

confidence: 99%

“…The authorities are now at loss to respond to DRCIs. The lack of knowledge on the characteristics and dynamics of DRCIs is considered one main problem in this respect 17. Although similar studies are conducted in other countries using a specific method, to the best of our knowledge, the only study on open drug scenes of Tehran is about typology 7.…”

Section: Introductionmentioning

confidence: 99%

Drug-related community issues and the required interventions in open drug scenes in Tehran, Iran: a qualitative study protocol

et al. 2019

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Background and objectivesMany low-income and middle-income countries experience problems with open drug scenes and drug-related community issues (DRCIs). These experiences occur in settings with varying levels of health and law enforcement initiatives, and accordingly a range of approaches are implemented to curb the problem. Most of the published literature stems from Western and high-income societies. With this concern, the present study aims to describe a planned project to explore DRCIs in the open drug scenes of Tehran, including its typology, and predisposing and reinforcing factors. In addition, the study attempts to investigate the perceptions with respect to the required interventions and barriers to their accessibility.MethodsTo this end, the current study focuses on the Farahzad drug scene due to its structure and the difficult access to the scene by harm reduction providers. Data collection techniques encompass field observation, indepth interview and focus group discussion. Further, semistructured interviews are conducted with people who use drugs and other key informants who are engaged at this drug scene, including business, community, voluntary and statutory stakeholders, for an average of 90 min (average of 45 min for each part of the study). Furthermore, as a complementary method, field observation is performed regarding the themes of DRCIs at this scene. Then, focus group discussions are held to further describe the themes of DRCIs as well as to explore the required interventions, for an average of 90 min. Finally, the results are evaluated using qualitative content analysis.Ethics and disseminationEthical approval for the study was obtained from the Ethics Committee of Iran University of Medical Sciences, Iran. Additionally, participants are to provide written informed consent. The findings of the study are expected to play a role in promoting the current intervention.

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Low-threshold methadone treatment, heroin price, police activity and incidence of heroin use: The Zurich experience

Cited by 12 publications

References 4 publications

Open drug scenes: responses of five European cities

Open drug scenes: responses of five European cities

Crowdsourcing Black Market Prices For Prescription Opioids

Drug-related community issues and the required interventions in open drug scenes in Tehran, Iran: a qualitative study protocol

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