RESUMO
Artificial intelligence (AI) research and regulation seek to balance the benefits of innovation against any potential harms and disruption. However, one unintended consequence of the recent surge in AI research is the potential re-orientation of AI technologies to facilitate criminal acts, term in this article AI-Crime (AIC). AIC is theoretically feasible thanks to published experiments in automating fraud targeted at social media users, as well as demonstrations of AI-driven manipulation of simulated markets. However, because AIC is still a relatively young and inherently interdisciplinary area-spanning socio-legal studies to formal science-there is little certainty of what an AIC future might look like. This article offers the first systematic, interdisciplinary literature analysis of the foreseeable threats of AIC, providing ethicists, policy-makers, and law enforcement organisations with a synthesis of the current problems, and a possible solution space.
Assuntos
Inteligência Artificial/tendências , Crime/tendências , Mídias Sociais , Comércio/legislação & jurisprudência , Comércio/tendências , Tráfico de Drogas/legislação & jurisprudência , Tráfico de Drogas/tendências , Previsões , Fraude/legislação & jurisprudência , Fraude/tendências , Humanos , Pesquisa Interdisciplinar , Responsabilidade Legal , Delitos Sexuais/legislação & jurisprudência , Delitos Sexuais/tendênciasRESUMO
Illicit heroin and fentanyl are infecting North Carolina's communities, and causing an increasing number of overdose deaths. These trends in drug trafficking and opioid misuse represent a dramatic shift, necessitating a new and coordinated law enforcement response. The North Carolina Attorney General's Office is committed to working toward increased enforcement, prevention, and treatment to address this epidemic.
Assuntos
Analgésicos Opioides , Tráfico de Drogas/tendências , Epidemias , Fentanila , Heroína , Aplicação da Lei , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Humanos , North Carolina/epidemiologiaAssuntos
Analgésicos Opioides/provisão & distribuição , Analgésicos Opioides/uso terapêutico , Tráfico de Drogas/legislação & jurisprudência , Dor/tratamento farmacológico , Cuidados Paliativos , Política Pública , Tráfico de Drogas/tendências , Feminino , Política de Saúde/tendências , Humanos , Índia , Morfina/provisão & distribuição , Morfina/uso terapêutico , Política Pública/tendências , Medição de Risco , Fatores de Tempo , Estados Unidos , VietnãRESUMO
Heroin abuse as an outcome of the prior use of painkillers increased rapidly over the past decade. This "new epidemic" is unique because the new heroin users are primarily young White Americans in rural areas of virtually every state. This commentary argues that the painkiller-to-heroin transition could not be the only cause of heroin use on such a scale and that the new and old heroin epidemics are linked. The social marketing that so successfully drove the old heroin epidemic has innovated and expanded due to the use of cell-phones, text messaging and the "dark web" which requires a Tor browser, and software that allows one to communicate with encrypted sites without detection. Central city gentrification has forced traffickers to take advantage of larger and more lucrative markets. A second outcome is that urban black and Latino communities are no longer needed as heroin stages areas for suburban and exurban illicit drug distribution. Drug dealing can be done directly in predominantly white suburbs and rural areas without the accompanying violence associated with the old epidemic. Denial of the link between the new and old heroin epidemics racially segregates heroin users and more proactive prevention and treatment in the new epidemic than in the old. It also cuts off a half-century of knowledge about the supply-side of heroin drug dealing and the inevitable public policy measures that will have to be implemented to effectively slow and stop both the old and new epidemic.
Assuntos
Tráfico de Drogas , Dependência de Heroína , Abuso de Substâncias por Via Intravenosa , Demografia , Tráfico de Drogas/prevenção & controle , Tráfico de Drogas/tendências , Usuários de Drogas/estatística & dados numéricos , Dependência de Heroína/epidemiologia , Dependência de Heroína/etnologia , Dependência de Heroína/prevenção & controle , Humanos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Abuso de Substâncias por Via Intravenosa/etnologia , Abuso de Substâncias por Via Intravenosa/prevenção & controle , Estados Unidos/epidemiologiaRESUMO
The objective of the present study was to examine trends and correlates of handgun carrying among adolescents ages 12-17 in the United States. Data was derived from the National Survey on Drug Use and Health (NSDUH) involving non-Hispanic White, African American, and Hispanic respondents ages 12-17 (n=197,313) and spanning the years 2002-2013. Logistic regression was used to examine significance of trend year and correlates of previous 12-month handgun carrying. The overall self-reported prevalence of handgun carrying was 3.4%. The prevalence of handgun carrying during 2004-2005 was significantly higher for African-Americans (4.39%) compared to non-Hispanic Whites (3.03%). However, by 2012-2013, non-Hispanic Whites (4.08%) completely diverged and reported carrying handguns significantly more than both African-American (2.96%) and Hispanic (2.82%) youth. Male gender and a number of externalizing behaviors were significant correlates of handgun carrying; however, we also found evidence of differential correlates with regard to such factors as drug selling, parental affirmation, and income by race/ethnicity. To our knowledge, this is the largest study of handgun carrying among youth in the United States. Findings indicate that although at historically low levels handgun carrying is on the rise but only among non-Hispanic Whites. Differential correlates among racial/ethnic groups suggest prevention programming and policies may need modifications depending on group and geographic locale targeted.
Assuntos
Comportamento do Adolescente/etnologia , Etnicidade/estatística & dados numéricos , Armas de Fogo/estatística & dados numéricos , Adolescente , Criança , Tráfico de Drogas/tendências , Feminino , Humanos , Masculino , Prevalência , Autorrelato , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos , População UrbanaRESUMO
BACKGROUND: The spread of illicitly manufactured fentanyl is driving steep increases in US overdose deaths. Fentanyl seizures are correlated with state-level opioid-related mortality; however, more granular seizure surveillance information has the potential to better inform overdose prevention and harm reduction efforts. METHODS: Using data on fentanyl pill and powder seizures from High Intensity Drug Trafficking Areas (HIDTA), we tested associations between seizure prevalence and overdose mortality, from 2013 to 2020. The primary exposure-seizure burden-was constructed by identifying counties having high (above the median) prevalence of pill, powder, or combined pill/powder seizure burden per 100,000 population. Poisson models accounted for county demographic, law enforcement and time trends. RESULTS: During the timeframe, there were 13,842 fentanyl seizures in 606 US counties. In adjusted models, counties with a high burden of pill or powder fentanyl seizures, or both (combined pills/powder) exhibited higher total overdose mortality than non-high burden counties (pills adjusted prevalence ratio [aPR]: 1.10 [95 % confidence interval [CI]: 1.08, 1.12]; powder aPR 1.12 [CI: 1.11, 1.13]; combined pills/powder aPR: 1.27 [CI: 1.25, 1.29]). A similar pattern of associations with fentanyl seizure burden was noted for overdose deaths involving synthetic opioids (pills [aPR]: 0.99 [CI: 0.96, 1.02]; powder aPR 1.29 [CI: 1.27, 1.30]; combined pills/powder aPR 1.55 [CI: 1.52, 1.58]). CONCLUSIONS: Law enforcement data on fentanyl seizures predicts drug overdose mortality at the county-level. Integrating these data with more traditional epidemiologic surveillance approaches has the potential to inform community overdose response efforts.
Assuntos
Overdose de Drogas , Fentanila , Aplicação da Lei , Humanos , Fentanila/intoxicação , Overdose de Drogas/mortalidade , Overdose de Drogas/epidemiologia , Estados Unidos/epidemiologia , Masculino , Analgésicos Opioides/intoxicação , Feminino , Tráfico de Drogas/tendências , Adulto , PrevalênciaRESUMO
Cocaine is a naturally occurring psychostimulant drug available worldwide. Drug trafficking networks adulterate pure cocaine with cutting agents to increase their earnings. This study presents a descriptive statistical analysis of the cutting agents found in 2118 cocaine samples that were seized in the Northern Region of Colombia (in the period 2015-2017). The data used in this study was drawn from the GC-MS analytical reports of the National Institute of Legal Medicine and Forensic Sciences -Colombia, Northern Region. Results showed diverse cutting agents in seized cocaine samples, from which the most commonly used are caffeine, phenacetin, lidocaine, imidazole and levamisole. In addition, cocaine samples showed different mixtures of the above cutting agents, predominantly caffeine/phenacetin and caffeine/lidocaine/phenacetin mixtures.
Assuntos
Cocaína/química , Contaminação de Medicamentos , Tráfico de Drogas/tendências , Aporfinas/análise , Cafeína/análise , Codeína/análise , Colômbia , Humanos , Imidazóis/análise , Levamisol/análise , Lidocaína/análise , Fenacetina/análise , Análise Espaço-Temporal , Tetramizol/análiseRESUMO
BACKGROUND: Little is known regarding how the COVID-19 pandemic has affected patterns of drug use in the United States. Because drug seizures can serve as a proxy for drug availability, we examined shifts in drug seizures in the US during the pandemic. METHODS: We examined trends in seizures of marijuana, cocaine, methamphetamine, heroin, and fentanyl within five High Intensity Drug Trafficking Areas-Washington/Baltimore, Chicago, Ohio, New Mexico, and North Florida. Trends were examined for number and total weight of seizures from March 2019 through September 2020 using Joinpoint regression. RESULTS: Significant decreases in seizures involving marijuana (ß = -0.03, P = 0.005) and methamphetamine (ß = -0.02, P = 0.026) were detected through April 2020, and then seizures of marijuana (ß = 0.10, P = 0.028) and methamphetamine (ß = 0.11, P = 0.010) significantly increased through September 2020. The number of seizures involving marijuana and methamphetamine peaked in August 2020, exceeding the highest pre-COVID-19 number of seizures. Fentanyl seizures increased overall (ß = 0.05, P < .001), but did not significantly drop during the start of COVID-19, and significant changes were not detected for cocaine or heroin. We also detected a significant increase in weight of marijuana seized from April through September 2020 (ß = 0.40, P = .001). The weight of marijuana seized in August 2020 exceeded the highest pre-COVID-19 weight. CONCLUSION: The COVID-19 pandemic was associated with an immediate decrease in marijuana and methamphetamine seizures, and then increases throughout 2020 with some months exceeding the number (and weights) of seizures from the previous year. More research is warranted to determine the extent to which these seizures reflect changes in drug use.
Assuntos
Tráfico de Drogas/tendências , Drogas Ilícitas/provisão & distribuição , Aplicação da Lei , Baltimore , COVID-19/epidemiologia , Cannabis , Chicago , Cocaína/provisão & distribuição , District of Columbia , Fentanila/provisão & distribuição , Florida , Heroína/provisão & distribuição , Humanos , Metanfetamina/provisão & distribuição , New Mexico , OhioRESUMO
Over the past decade, synthetic cannabinoids have inundated the global market and now form the largest category of new psychoactive substances. Once these chemicals are available on the global market, they can be applied to plant material in a clandestine environment to create an end-product that is smoked by the user. The synthetic cannabinoids AMB-FUBINACA and 5F-ADB were most frequently detected between 2017 and the beginning of 2019. More recently, these two appear to have been replaced by different synthetic cannabinoids. This investigation summarises the recent trends in synthetic cannabinoids detected in New Zealand between 2017 and 2020 and outlines the potential factors influencing these trends.
Assuntos
Canabinoides , Tráfico de Drogas/tendências , Drogas Ilícitas , Medicamentos Sintéticos , Humanos , Nova ZelândiaRESUMO
BACKGROUND: To quantify the extent to which methamphetamine use is associated with increases in crime net of any premorbid risk of criminality among people who use the drug. METHODS: Four one-month data panels from 469 participants dependent on methamphetamine were drawn from the MATES cohort (N = 501). Odds ratios for within-person effects were extracted from a random intercept logistic regression model for crime during periods of methamphetamine use compared to no use. Effects were adjusted for time-varying measures of age, other substance use, and socio-economic disadvantage (income, unemployment and unstable accommodation). Involvement in crime (property crime, drug dealing, fraud, violent crime) and days of methamphetamine in the past month were assessed using the Opiate Treatment Index. RESULTS: Crime was more likely during months when participants used methamphetamine compared to when they did not (OR 13.2 95% CI 8.5-20.6; AOR 4.7 95% CI 2.8-8.0), this reflecting more property crime (OR 10.6 95% CI 6.3-18.0; AOR 5.5 95% CI 2.8-10.8), violent crime (OR 8.2 95% CI 4.2-15.9; AOR 3.4 95% CI 1.5-8.0), fraud (OR 3.4, 95% CI 2.0-5.8; AOR 1.7 95% CI 0.8-3.3) and dealing drugs (OR 18.2 95% CI 10.2-32.5; AOR 5.9 95% CI 3.0-11.9), although the adjusted relationship for fraud was not significant. Effects were dose related. CONCLUSIONS: The use of methamphetamine was associated with significant increases in crime beyond premorbid risk for criminality. Crime is a likely social consequence of methamphetamine use and efforts are needed to reduce this impact.
Assuntos
Transtornos Relacionados ao Uso de Anfetaminas/epidemiologia , Transtornos Relacionados ao Uso de Anfetaminas/psicologia , Crime/psicologia , Análise de Dados , Metanfetamina/efeitos adversos , Adulto , Transtornos Relacionados ao Uso de Anfetaminas/diagnóstico , Austrália/epidemiologia , Estudos de Coortes , Crime/tendências , Tráfico de Drogas/psicologia , Tráfico de Drogas/tendências , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto JovemRESUMO
BACKGROUND: Personal vaporisers are gaining popularity as an alternative route of administration for a range of substances. Online cryptomarkets are becoming increasingly popular among people who use substances due to their perceived anonymity, ease of use, and reduced risk of violence compared to traditional face-to-face dealers. We examined the diversity of substances marketed for use in a personal vaporiser on these marketplaces. METHODS: Vaping related listings were extracted from three online cryptomarkets ('Agartha', 'Cryptonia', and 'Tochka') using The Onion Router browser. Data collection occurred between October and November 2019. RESULTS: We identified 1929 listings from 201 unique sellers. The top product on Agartha, Cryptonia, and Tochka were vape cartridges prefilled with the e-liquid (70.4 %, 39.4 %, 52.3 % respectively). The most common substance in these products was cannabis oil (96.1 %, 82.1 %, 87.8 %), followed by synthetic cannabinoids (3.7 %, 9.7 %, 9.8 %) and psychedelic substances (0.2 %, 6.4 %, 1.2 %). Vendors were primarily from the USA. Many products offered worldwide shipping (96.3 %, 42.4 %, 51.2 %). CONCLUSION: Vaping products listed on online cryptomarkets in 2019 primarily contained cannabis oils. Future studies should continue to examine cryptomarkets to identify emerging trends of substances that can be used in personal vaporisers.
Assuntos
Comércio/economia , Sistemas Eletrônicos de Liberação de Nicotina/economia , Fumar Maconha/economia , Nebulizadores e Vaporizadores/economia , Vaping/economia , Navegador/economia , Comércio/tendências , Coleta de Dados/tendências , Tráfico de Drogas/economia , Tráfico de Drogas/tendências , Alucinógenos/administração & dosagem , Alucinógenos/economia , Humanos , Drogas Ilícitas/economia , Fumar Maconha/tendências , Marketing/economia , Marketing/tendências , Nebulizadores e Vaporizadores/tendências , Navegador/tendênciasRESUMO
: The COVID-19 pandemic and the response to have resulted in an increase in sales activity levels on darknet markets during the first 3 months of 2020, mainly related to cannabis products. One key question is whether more people will become used to this form of purchasing their drugs and will they continue with it post COVID-19 lockdown. As one-to-one encrypted communication services or social media apps are increasingly being used, monitoring and interdiction will become much more challenging.
Assuntos
Cannabis , Infecções por Coronavirus/epidemiologia , Uso Indevido de Medicamentos , Tráfico de Drogas/tendências , Internet , Abuso de Maconha , Pneumonia Viral/epidemiologia , Betacoronavirus , COVID-19 , Uso Indevido de Medicamentos/economia , Uso Indevido de Medicamentos/tendências , Previsões , Saúde Global , Humanos , Abuso de Maconha/economia , Abuso de Maconha/epidemiologia , Abuso de Maconha/psicologia , Marketing , Pandemias , SARS-CoV-2RESUMO
BACKGROUND: Illegal drug dealers no longer compete for customers only through the quality of their products, but also in convenience and speed of delivery. This article investigates "ring and bring" drug dealing, and argues that a focus on dealers' use of mobile phones is useful for exploring current changes within retail level drug markets. METHODS: The article is based on 21 face-to-face in-depth interviews with active drug dealers in Denmark all of whom were involved in the delivery of drugs (mainly cannabis and cocaine) often to buyers' homes. RESULTS: Contrary to studies emphasising how drug dealers often take up new communication technologies with enthusiasm, the dealers in this study displayed a technological conservatist stance. Moreover, mobile phones have become key to dealers' construction of in-group hierarchies, and have led to retail level drug selling becoming more flexible, individualised and more of a service on par with other services in the consumer society. Finally, the increasing use of mobile phones has also created a situation where portfolios of drug customers, held on cell phone SIM cards, are today traded and sold alongside other commodities in the drug economy. CONCLUSION: We show how a social constructivist approach to technology can provide a more detailed and nuanced account of the socio-technical ensemble and the meaning-making processes giving shape to retail level "delivery dealing."
Assuntos
Tráfico de Drogas/psicologia , Tráfico de Drogas/tendências , Telefone Celular , Comportamento de Escolha , Dinamarca , Humanos , Entrevista Psicológica , Meio Social , TecnologiaRESUMO
In last years, international and national Institutions have been completely focused on the new psychoactive substances (NPS) phenomenon. Many contrast policies have been planned in order to control their spread. Even scientific entities, such as our Forensic Toxicology Division, have spent time and resources for NPS identification in biological (from clinical and forensic caseworks) and non-biological (seized material) samples. Last reports show a low prevalence of NPS across the Europe and Italy, while the classical drugs are still the main cause of drug-related deaths. In particular, a worrisome datum is represented by the increasing number of deaths due to heroin. Seen these statistics, is the NPS phenomenon overestimated? Is the interest in classical drugs decreased? Were we diverted by NPS?
Assuntos
Tráfico de Drogas/tendências , Psicotrópicos/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Drogas Desenhadas/efeitos adversos , Toxicologia Forense , Humanos , Drogas Ilícitas/efeitos adversosRESUMO
This article explores recent developments within the U.K. drug market: that is, the commuting of gang members from major cities to small rural urban areas for the purpose of enhancing their profit from drug distribution. Such practice has come to be known as working "County Lines." We present findings drawn from qualitative research with practitioners working to address serious and organized crime and participants involved in street gangs and illicit drug supply in both Glasgow and Merseyside, United Kingdom. We find evidence of Child Criminal Exploitation (CCE) in County Lines activity, often as a result of debt bondage; but also, cases of young people working the lines of their own volition to obtain financial and status rewards. In conclusion, we put forward a series of recommendations which are aimed at informing police strategy, practitioner intervention, and wider governmental policy to effectively address this growing, and highly problematic, phenomenon.
Assuntos
Criminosos , Tráfico de Drogas/economia , Tráfico de Drogas/tendências , Menores de Idade , Problemas Sociais/tendências , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pesquisa Qualitativa , População Rural , Problemas Sociais/classificação , Reino Unido , Populações Vulneráveis , Adulto JovemRESUMO
Background Crackdowns on urban sites with concentrated criminal activity are sometimes followed by geographical relocation of crime. Is this also the case in cyberspace, where illegal websites and online networks can be wiped clean, but also quickly rebuilt and replaced on new servers and URLs? Methods I address this question in three steps. First, I measure MDMA trade in a large digital market for drugs, before and after the arrest of a leading MDMA seller in the same market. Second, I count the number of available digital drug markets and vendor shops in the period February 2014-June 2018, to see if websites closed by police were replaced by new ones. Third, I track the digital movement and trading activities of individual drug sellers, before and after law enforcement shut down two large markets. Results After police arrested a leading MDMA seller, other MDMA sellers filled most - but not all - of the gap. A major law enforcement crackdown reduced the number of available markets, but new ones were created, and market counts eventually surpassed the previous peak. When law enforcement shut down two big markets, many of the sellers relocated to other e-commerce sites and continued high-earning operations there. Conclusion Arrests and market closures redirect digital drug trade to other sellers and markets. Hot spot policing in cyberspace might produce temporary results, but is arguably ineffective in the long run, as actors use information and communication technology's unique capacities to reorganize.
Assuntos
Crime , Tráfico de Drogas/economia , Tráfico de Drogas/estatística & dados numéricos , Drogas Ilícitas/economia , Comércio/tendências , Tráfico de Drogas/tendências , Humanos , Drogas Ilícitas/provisão & distribuição , Internet/economia , Aplicação da LeiRESUMO
BACKGROUND: Illicitly manufactured fentanyl and its analogues are appearing in countries throughout the world, often disguised as heroin or counterfeit prescription pills, with resulting high overdose mortality. Possible explanations for this phenomenon include reduced costs and risks to heroin suppliers, heroin shortages, user preferences for a strong, fast-acting opioid and the emergence of Dark Web cryptomarkets. This paper addresses these potential causes and asks three questions: (1) can users identify fentanyl; (2) do users desire fentanyl; and (3) if users want fentanyl, can they express this demand in a way that influences the supply? ARGUMENT/ANALYSIS: Existing evidence, while limited, suggests that some users can identify fentanyl, although not reliably, and some desire it, but because fentanyl is frequently marketed deceptively as other drugs, users lack information and choice to express demand effectively. Even when aware of fentanyl's presence, drug users may lack fentanyl-free alternatives. Cryptomarkets, while difficult to quantify, appear to offer buyers greater information and competition than offline markets. However, access barriers and patterns of fentanyl-related health consequences make cryptomarkets unlikely sources of user influence on the fentanyl supply. Market condition data indicate heroin supply shocks and shortages prior to the introduction of fentanyl in the United States and parts of Europe, but the much lower production cost of fentanyl compared with heroin may be a more significant factor CONCLUSION: Current evidence points to a supply-led addition of fentanyl to the drug market in response to heroin supply shocks and shortages, changing prescription opioid availability and/or reduced costs and risks to suppliers. Current drug users in affected regions of the United States, Canada and Europe appear largely to lack both concrete knowledge of fentanyl's presence in the drugs they buy and access to fentanyl-free alternatives.
Assuntos
Fentanila , Drogas Ilícitas , Custos e Análise de Custo , Medicamentos Falsificados/efeitos adversos , Medicamentos Falsificados/economia , Relação Dose-Resposta a Droga , Custos de Medicamentos/tendências , Overdose de Drogas/mortalidade , Tráfico de Drogas/economia , Tráfico de Drogas/tendências , Fentanila/efeitos adversos , Fentanila/análogos & derivados , Fentanila/economia , Fentanila/provisão & distribuição , Heroína/efeitos adversos , Heroína/economia , Heroína/provisão & distribuição , Humanos , Drogas Ilícitas/efeitos adversos , Drogas Ilícitas/economia , Drogas Ilícitas/provisão & distribuição , Estados UnidosRESUMO
BACKGROUND: Many efforts have been undertaken to construct an overview of various aspects of illicit drug distribution in the United Kingdom. Yet given that national, regional, and local differences can be profound, this has proven difficult, to the extent that Scotland has been largely excluded from the conversation. In addition, the level of supply being examined, the drug type, and the actors involved only add to confusion and vast differences between some findings. METHOD: The current study aims to provide a holistic account, as best as possible considering variations of illegal drug supply in illicit networks, by focusing in on a particular geographical context (Scotland) and addressing drug supply at all levels. It is informed by in-depth interviews with 42 offenders involved in drug distribution from retail to wholesale/middle market to importation levels. RESULTS: Findings indicate Scotland's importation and distribution is evolving owing to increasingly adaptive risk mitigation by importers and distributors, and market diversification of both product and demand. While a hierarchical model still dominates the market, commuting or 'county lines' and increasing demand for drugs such as cannabis, but also anabolic steroids and psychoactive substances, means that home growing, online purchasing, and street-level dealership is common. CONCLUSION: The findings have the capacity to further inform police and practitioners about the diverse and evolving nature of drug distribution in Scotland (with a particular focus on the west of the country), so that they may become more effective in improving the safety and wellbeing of people, places and communities.
Assuntos
Comércio/métodos , Tráfico de Drogas/economia , Tráfico de Drogas/tendências , Drogas Ilícitas/economia , Drogas Ilícitas/provisão & distribuição , Humanos , EscóciaRESUMO
Fentanyl is a potent synthetic opioid used as a narcotic analgesic supplement in general and regional anesthesia as well as in management of persistent, severe chronic pain. Alarming epidemiological and forensic medicine reports, accumulated mainly during the last two decades, point to a growing increase in illicit use of fentanyl, mainly in North America and Europe. Toxicological data indicates that fentanyl use is inextricably linked with polydrug use. There are two main sources of fentanyl on the "recreational" drug market. First, the most common, combines illicitly manufactured fentanyl from clandestine sources. The drug is often mixed up with heroin ("fake heroin") to increase its potency at a little cost, or included in cocaine products. It can also be mixed into and sold as oxycodone-, hydrocodone- or alprazolam-containing tablets. The other way to gain fentanyl is through the diversion of fentanyl-containing medicines, especially transdermal patches (FTPs). Fentanyl extracted from FTP can be administered intravenously, insufflated or inhaled after volatilization. The drug can also be delivered by oral or transmucosal application of the whole patch, or by rectal insertion. The most common overdose symptoms are coma, lethargy, respiratory depression and arrest. Although naloxone, an opioid receptor antagonist, is the standard drug for fentanyl overdose rescue, attempts to revive patients with naloxone could be unsuccessful, due to the rapid onset of fentanyl's action. As the fentanyl problem is constantly growing, there is an urgent need for new, effective harm-reduction strategies and technologies, as well as overdose maintenance.
Assuntos
Analgésicos Opioides/efeitos adversos , Fentanila/efeitos adversos , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Formas de Dosagem , Contaminação de Medicamentos , Overdose de Drogas/tratamento farmacológico , Tráfico de Drogas/tendências , Humanos , Drogas Ilícitas/efeitos adversos , Naloxona/uso terapêutico , Antagonistas de Entorpecentes/uso terapêutico , Adesivo TransdérmicoRESUMO
INTRODUCTION: The link between drug selling and other delinquent behaviors in adolescence is well established. Less is known regarding the trends in drug selling among youth in the US and whether they are consistent with the recently observed decline in problem behaviors among this population. METHODS: Data were collected between 2002 and 2015 as part of the National Survey on Drug Use and Health (NSDUH). Participants included 233,435 US youth aged 12-17. The primary variable of interest was self-reported past year drug-selling. Logistic regression assessed trends in drug-selling among male and female subgroups. RESULTS: Between 2002 and 2015, the prevalence of drug-selling decreased significantly across all youth (AORâ¯=â¯0.970, pâ¯<â¯.001). Analysis of gender differences revealed that the rate of drug-selling decreased significantly among boys (AORâ¯=â¯0.962, pâ¯<â¯.001), however, the trend remained stable for girls (AORâ¯=â¯0.987, pâ¯>â¯.05). The decrease in drug-selling was observed for nearly all male subgroups, African-American girls (0.946, pâ¯<â¯.01) and girls reporting no illegal substance use in the past year (0.960, pâ¯<â¯.05). CONCLUSIONS: The prevalence of past year drug-selling among youth in the US is declining significantly, especially for boys.