Disruption to Australian Heroin, Methamphetamine, Cocaine and Ecstasy Markets with the COVID-19 Pandemic and Associated Restrictions

Overview

Journal Int J Drug Policy

Publisher Elsevier

Specialties Psychiatry
Public Health

Date 2023 Feb 23

PMID 36822010

Authors

Olivia Price

Nicola Man

Rachel Sutherland

Raimondo Bruno

Paul Dietze

Caroline Salom

Seraina Agramunt

Jodie Grigg

Louisa Degenhardt

Amy Peacock

Affiliations

Soon will be listed here.

Abstract

Background: Changes to drug markets can affect drug use and related harms. We aimed to describe market trends of heroin, methamphetamine, cocaine and ecstasy in Australia following the introduction of COVID-19 pandemic-associated restrictions.

Methods: Australians residing in capital cities who regularly inject drugs (n ∼= 900 each year) or regularly use ecstasy and/or other illicit stimulants (n ∼= 800 each year) participated in annual interviews 2014-2022. We used self-reported market indicators (price, availability, and purity) for heroin, crystal methamphetamine, cocaine, and ecstasy crystal to estimate generalised additive models. Observations from the 2014-2019 surveys were used to establish the pre-pandemic trend; 2020, 2021 and 2022 observations were considered immediate, short-term and longer-term changes since the introduction of pandemic restrictions.

Results: Immediate impacts on market indicators were observed for heroin and methamphetamine in 2020 relative to the 2014-2019 trend; price per cap/point increased (β: A$9.69, 95% confidence interval [CI]: 2.25-17.1 and β: A$40.3, 95% CI: 33.1-47.5, respectively), while perceived availability (adjusted odds ratio [aOR] for 'easy'/'very easy' to obtain: 0.38, 95% CI: 0.24-0.59 and aOR: 0.08, 95% CI: 0.03-0.25, respectively) and perceived purity (aOR for 'high' purity: 0.36, 95% CI: 0.23-0.54 and aOR: 0.33, 95% CI: 0.20-0.54, respectively) decreased. There was no longer evidence for change in 2021 or 2022 relative to the 2014-2019 trend. Changes to ecstasy and cocaine markets were most evident in 2022 relative to the pre-pandemic trend: price per gram increased (β: A$92.8, 95% CI: 61.6-124 and β: A$24.3, 95% CI: 7.93-40.6, respectively) and perceived purity decreased (aOR for 'high purity': 0.18, 95% CI: 0.09-0.35 and 0.57, 95% CI: 0.36-0.90, respectively), while ecstasy was also perceived as less easy to obtain (aOR: 0.18, 95% CI: 0.09-0.35).

Conclusion: There were distinct disruptions to illicit drug markets in Australia after the COVID-19 pandemic began; the timing and magnitude varied by drug.

Citing Articles

Trends and characteristics in ketamine use among US adults with and without depression, 2015-2022.

Yang K, Kepner W, Cleland C, Palamar J J Affect Disord. 2025; 373:345-352.

PMID: 39746553 PMC: 11794009. DOI: 10.1016/j.jad.2024.12.108.

Historical and theoretical roots of the big events framework.

Friedman S, Rossi D, Perlman D Int J Drug Policy. 2024; 133:104606.

PMID: 39378779 PMC: 11540725. DOI: 10.1016/j.drugpo.2024.104606.

Changes in the rates and characteristics of gamma hydroxybutyrate (GHB)-related death in Australia, 2001-2023.

Darke S, Duflou J, Chrzanowska A, Farrell M, Lappin J, Peacock A Drug Alcohol Rev. 2024; 44(1):366-375.

PMID: 39238184 PMC: 11743235. DOI: 10.1111/dar.13940.

Trends in reported and biologically confirmed drug use among people who use ecstasy in the nightclub/festival-attending population, 2016-2022.

Palamar J, Salomone A, Massano M, Cleland C Drug Alcohol Depend Rep. 2023; 9:100198.

PMID: 38023341 PMC: 10665664. DOI: 10.1016/j.dadr.2023.100198.

Shifting drug markets in North America - a global crisis in the making?.

Meyer M, Westenberg J, Jang K, Choi F, Schreiter S, Mathew N Int J Ment Health Syst. 2023; 17(1):36.

PMID: 37880722 PMC: 10598952. DOI: 10.1186/s13033-023-00601-x.

References

Weatherburn D, Jones C, Freeman K, Makkai T . Supply control and harm reduction: lessons from the Australian heroin 'drought'. Addiction. 2002; 98(1):83-91. DOI: 10.1046/j.1360-0443.2003.00248.x. View

Scott N, Caulkins J, Ritter A, Quinn C, Dietze P . High-frequency drug purity and price series as tools for explaining drug trends and harms in Victoria, Australia. Addiction. 2014; 110(1):120-8. DOI: 10.1111/add.12740. View

Harris M, Forseth K, Rhodes T . "It's Russian roulette": adulteration, adverse effects and drug use transitions during the 2010/2011 United Kingdom heroin shortage. Int J Drug Policy. 2014; 26(1):51-8. DOI: 10.1016/j.drugpo.2014.09.009. View

Darke S . Self-report among injecting drug users: a review. Drug Alcohol Depend. 1998; 51(3):253-63; discussion 267-8. DOI: 10.1016/s0376-8716(98)00028-3. View

Dietze P, Peacock A . Illicit drug use and harms in Australia in the context of COVID-19 and associated restrictions: Anticipated consequences and initial responses. Drug Alcohol Rev. 2020; 39(4):297-300. PMC: 7283853. DOI: 10.1111/dar.13079. View

Price O, Man N, Bruno R, Dietze P, Salom C, Lenton S . Changes in illicit drug use and markets with the COVID-19 pandemic and associated restrictions: findings from the Ecstasy and Related Drugs Reporting System, 2016-20. Addiction. 2021; 117(1):182-194. PMC: 8441814. DOI: 10.1111/add.15620. View

Evrard I, Legleye S, Cadet-Tairou A . Composition, purity and perceived quality of street cocaine in France. Int J Drug Policy. 2010; 21(5):399-406. DOI: 10.1016/j.drugpo.2010.03.004. View

Man N, Sisson S, McKetin R, Chrzanowska A, Bruno R, Dietze P . Trends in methamphetamine use, markets and harms in Australia, 2003-2019. Drug Alcohol Rev. 2022; 41(5):1041-1052. DOI: 10.1111/dar.13468. View

Man N, Chrzanowska A, Price O, Bruno R, Dietze P, Sisson S . Trends in cocaine use, markets and harms in Australia, 2003-2019. Drug Alcohol Rev. 2021; 40(6):946-956. DOI: 10.1111/dar.13252. View

10.

Narayan P, Phan D, Liu G . COVID-19 lockdowns, stimulus packages, travel bans, and stock returns. Financ Res Lett. 2020; 38:101732. PMC: 7440077. DOI: 10.1016/j.frl.2020.101732. View

11.

Giommoni L . Why we should all be more careful in drawing conclusions about how COVID-19 is changing drug markets. Int J Drug Policy. 2020; 83:102834. PMC: 7332913. DOI: 10.1016/j.drugpo.2020.102834. View

12.

Gaume J, Schmutz E, Daeppen J, Zobel F . Evolution of the Illegal Substances Market and Substance Users' Social Situation and Health during the COVID-19 Pandemic. Int J Environ Res Public Health. 2021; 18(9). PMC: 8125553. DOI: 10.3390/ijerph18094960. View

13.

Otiashvili D, Mgebrishvili T, Beselia A, Vardanashvili I, Dumchev K, Kiriazova T . The impact of the COVID-19 pandemic on illicit drug supply, drug-related behaviour of people who use drugs and provision of drug related services in Georgia: results of a mixed methods prospective cohort study. Harm Reduct J. 2022; 19(1):25. PMC: 8906357. DOI: 10.1186/s12954-022-00601-z. View

14.

Peacock A, Bruno R, Gisev N, Degenhardt L, Hall W, Sedefov R . New psychoactive substances: challenges for drug surveillance, control, and public health responses. Lancet. 2019; 394(10209):1668-1684. DOI: 10.1016/S0140-6736(19)32231-7. View

15.

McAdam E, Hayashi K, Dong H, Cui Z, Sedgemore K, Dietze P . Factors associated with perceived decline in the quality of drugs during the COVID-19 pandemic: Evidence from community-recruited cohorts of people who use drugs in Vancouver, Canada. Drug Alcohol Depend. 2022; 236:109471. PMC: 9043624. DOI: 10.1016/j.drugalcdep.2022.109471. View

16.

Agius P, Aitken C, Breen C, Dietze P . Repeat participation in annual cross-sectional surveys of drug users and its implications for analysis. BMC Res Notes. 2018; 11(1):349. PMC: 5987568. DOI: 10.1186/s13104-018-3454-y. View

17.

Zolopa C, Hoj S, Bruneau J, Meeson J, Minoyan N, Raynault M . A rapid review of the impacts of "Big Events " on risks, harms, and service delivery among people who use drugs: Implications for responding to COVID-19. Int J Drug Policy. 2021; 92:103127. PMC: 7816610. DOI: 10.1016/j.drugpo.2021.103127. View

18.

Welle-Strand G, Skurtveit S, Clausen T, Sundal C, Gjersing L . COVID-19 survey among people who use drugs in three cities in Norway. Drug Alcohol Depend. 2020; 217:108302. PMC: 7500397. DOI: 10.1016/j.drugalcdep.2020.108302. View

19.

Arya S, Ghosh A, Mishra S, Swami M, Prasad S, Somani A . Impact of COVID-19 lockdown on substance availability, accessibility, pricing, and quality: A multicenter study from India. Indian J Psychiatry. 2022; 64(5):466-472. PMC: 9707667. DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_864_21. View

20.

Greenland S, Mansournia M, Altman D . Sparse data bias: a problem hiding in plain sight. BMJ. 2016; 352:i1981. DOI: 10.1136/bmj.i1981. View