Swaich Anmol, Ignatieff Delaney, Milloy M-J, Choi JinCheol, Kerr Thomas, Hayashi Kanna
British Columbia Centre on Substance Use, Vancouver, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
British Columbia Centre on Substance Use, Vancouver, Canada.
Int J Drug Policy. 2024 Dec;134:104633. doi: 10.1016/j.drugpo.2024.104633. Epub 2024 Oct 30.
Impacts of the COVID-19 pandemic on unregulated drug markets in North America have not been well characterized. We sought to estimate potential changes in the availability and retail price of unregulated drugs in Vancouver, Canada pre- vs. post-emergence of the COVID-19 pandemic.
We used self-report data from two prospective cohorts of people who use drugs in Vancouver. We employed interrupted time series analyses to identify changes in the monthly prevalence of immediate availability (i.e., within 10 minutes vs. any longer) and median retail price of crystal methamphetamine, powder cocaine, crack cocaine, and 'down' (the local term for unregulated opioids, e.g., heroin, fentanyl, etc), post-pandemic emergence (i.e. post-July 2020).
Between 2018 and 2022 among 739 participants, the monthly prevalence of immediate availability significantly decreased for all drugs immediately post- emergence of the pandemic (all p<0.05). The monthly prevalence of immediate availability of cocaine declined most (-18.1%, 95% confidence interval [CI]: -25.9, -10.4) and the immediate availability of 'down' declined least (-13.0%, 95% CI:-18.8, -7.3). In analyses of median price, the only significant change was in the price of cocaine, which increased by $3.46 per 0.5 grams (95% CI:1.0, 5.9) immediately post-emergence of the pandemic.
While more research is needed to investigate reasons for the observed trends, the stagnant price amidst decreased availability for all drugs examined in this study (save cocaine) may reflect decreased purity/increased contamination of unregulated drugs following the beginning of the pandemic in our study setting. These findings may have implications for drug policy and practice approaches, particularly in regions where synthetic psychoactive substances are increasingly dominating the unregulated drug supply.
新冠疫情对北美食药黑市的影响尚未得到充分描述。我们试图估计加拿大温哥华在新冠疫情出现前后，非管制药品的可得性和零售价格的潜在变化。
我们使用了来自温哥华两个吸毒者前瞻性队列的自我报告数据。我们采用中断时间序列分析来确定疫情出现后（即2020年7月之后），冰毒、可卡因粉、快克可卡因和“down”（当地对非管制阿片类药物的称呼，如海洛因、芬太尼等）即时可得性（即10分钟内可得与更长时间可得）的月度患病率以及零售价格中位数的变化。
在2018年至2022年期间的739名参与者中，疫情出现后所有药物的即时可得性月度患病率均显著下降（所有p<0.05）。可卡因即时可得性的月度患病率下降最多（-18.1%，95%置信区间[CI]：-25.9，-10.4），“down”的即时可得性下降最少（-13.0%，95%CI：-18.8，-7.3）。在中位数价格分析中，唯一显著的变化是可卡因价格，疫情出现后每0.5克上涨了3.46美元（95%CI：1.0，5.9）。
虽然需要更多研究来调查观察到的趋势的原因，但本研究中所研究的所有药物（除可卡因外）在可得性下降的情况下价格停滞不前，这可能反映了在我们的研究环境中疫情开始后非管制药物纯度降低/污染增加。这些发现可能对毒品政策和实践方法有影响，特别是在合成精神活性物质在非管制毒品供应中日益占主导地位的地区。
