1

2

3

[click] this is, when it comes to Identifying Emerging Drug Use Trends, where we want to be.

4

5

6

7

8

9

[click] Traditionally, new drug trends had their origins in cultural capitals and harbour cities before gradually spreading to towns and villages. In short, this relied primarily on human contact; people from different geographical locations and networks meet in specific, shared spaces, where they get initiated into a new drug. Subsequently, they go back to their own communities and network and the process is repeated [click] Here we see an impression of the diffusion of heroin in the Netherlands, starting in 1972; all in all, a process of some 10 to 15 years.

10

[click] Here we see an impression of the diffusion of krokodil in Russia and Ukraine… [click] However, in 2011 krokodil suddenly surfaced in Georgia, where in the past 10+ years local markets in injectable drugs were dominated by heroin and (subsequently) buprenorphine. Within a year krokodil diffused deep into the networks of Georgian PWID, as did homemade methamphetamine. Between 2011 and 2013, between 89% and 72% of PWID visiting harm reduction services in Georgia had injected krokodil and between 82% and 25% had injected homemade stimulants. The pace of diffusion of krokodil injecting in Georgia can most likely not be explained without considering the role of the internet.

11

12

13

14

15

16

17

John Black was a late 19th century/early 20th century hobo and professional burglar, living out the dying age of the Wild West. He wrote You Can't Win (Macmillan, 1926) a memoir or sketched autobiography describing his days on the road and life as an outlaw. Black's book was written as an anti-crime book urging criminals to go straight but is also his statement of belief in the futility of prisons and the criminal justice system, hence the title of the book. Jack Black was writing from experience, having spent thirty years (fifteen of which were spent in various prisons) as a traveling criminal and offers tales of being a cross-country stick-up man, home burglar, petty thief, and opium fiend.

18

19

20

21

When you want to detect the prevalence estimation

http://leansoftwareengineering.com/2007/06/05/the-capture-recapture-code-

inspection/

GPS ČR 2008 22

23

24

25

Since the rise of the internet traditional explanations and models of drug diffusion have become less reliable in describing new drug trends. In the last 10-15 years comprehending the epidemiology and diffusion of new drug trends has become increasingly complex. The social and technological environment of the diffusion of drug trends is changing rapidly and theories that previously aptly explained the diffusion of drug use patterns may no longer offer valid explanations. New drug trends have emerged (and disappeared) at a much faster pace with the rise of the internet and patterns of e.g. geographic diffusion are much harder to distinguish (where did it start, where did it move to, via what channels/(overlapping) networks…?).

26

27

In 2013, 81 new synthetic drugs were detected in the EU (EMCDDA, 2014). Up from 14 in 2005.

28

Potential merging of different trends: home production and NPS Sisa (homemade, smokable methampthetamine) in Greece GHB in the Netherlands Self-produced methcathinone (Jeff) in Krakow, Poland

29

When thinking about the role of the internet in the diffusion of new drug trends, I think that at this point we can distinguish two crucial developments: On the demand side we see that during the 1990s access to information on mind altering substances became available to an increasingly larger audience, in particular with the launch of Windows in 1995. This effectively ended the monopoly on information about drugs – consumers have access to an ever-increasing body of online information that competes with “official” drug information from governments or NGOs.

30

Some ten years later, the emergence of e-Commerce started changing the rules of the game of drug trafficking. The online marketplace is an increasingly important platform where buyers and sellers of drugs meet. in particular of unscheduled drugs (NPS), but not exclusively.

31

Darknet based trading places, such as the (revamped, after the original was shut down by the DEA) Silk road, Agora, Evolution, Pandora, Blue Sky, Hydra, Cloud Nine or Andromeda. The Darknet still has a rather high geek level – at this point you need to be quite computer savvy to access it, although I am sure that, given the pace of IT diffusion, that will soon be as simple as installing an app on your phone. Drug trading via twitter, Instagram? check…

32

33

The combination of e-Commerce and NPS is a genuine Game Changer and NPS can be purchased 24/7 from virtually any location. As a result, new trends involving NPS can rapidly emerge in municipalities, large or small, urban or rural. In turn, this means new trends will be less predictable and less uniform. This present enormous challenges to public health, epidemiology and drug policy.

34

35

36

37

38

39

40