By Martin Purbrick  

The report provides an analysis of variable Betting Duty (tax) rates on racing and sports betting operators to assess the impact on legal markets of higher rates and the related impact on betting turnover in the illegal betting markets. The economic impact of excessive Betting Duty in the Internet age is to drive consumers to the illegal betting market.

  • The highest rate of Betting Duty noted is in Hong Kong, at 75% of GGR. • The lowest rate of Betting Duty noted is in South Africa, at 6% of GGR. • The median rate of Betting Duty noted is in France, at 37.7% of GGR. • The highest Betting Duty rate in Hong Kong exists with an estimated illegal market of USD 257 per head of population, with lessening illegal markets per head of population with correspondingly lower Betting Duty rates of USD 61 in Singapore (25% Betting Duty), USD 59 per head in South Africa (6.5%), USD30 in Australia (10% to 20%), and USD 11.44 in the USA (6.75% to 51%). • Betting Duty rates have an impact on the turnover in betting markets, causing customers to potentially move from legal (licensed) to illegal (unlicensed) betting channels. • Higher Betting Duty rates lead to an increased theoretical margin to betting odds (which betting operators build in to ensure a profit margin), consequent increases to the takeout rate of the operator, increased prices for the customer, and inevitably drive customers to illegal betting markets where odds are better value because of no take out rate. • Illegal betting operators pay no Betting Duty or any other taxes and hence have no theoretical margin relating to taxation costs. There is hence a permanent price differential between the legal and illegal betting markets, with illegal markets consequently offering better odds (prices) to consumers. Betting customers, like the consumers of most products, are price sensitive and all things being equal prefer a cheaper betting product. • Higher Betting Duty rates also have increasingly less impact on consumer protection (when intended to discourage betting and gambling in society) as raising rates has the impact of migrating customers from the more expensive legal to the less expensive illegal betting market.  Government policy makers and gambling regulators should seek a commercially reasonable and stable Betting Duty rate that provides a balance between channelling gambling demand to the legal betting sector and allowing licensed betting operators to effectively compete with the illegal market.  
Hong Kong: Asian Racing Federation Council on Anti-Illegal Betting & Related Financial Crime, 2023. 30p.

By Oluwaseun Kugbayi and Adeleke Adegbami

Many towns and villages in Nigeria have been experiencing bandits activities, vis-à-vis kidnapping, armed robbery, murder, rape, cattle-rustling, and violent actions in recent years. These activities have continued to escalate despite the presence of security agencies such as – the Nigerian Army, the Nigerian Navy, the Nigerian Air Force, the Nigerian Police, the State Security Service, the National Intelligence Agency, and the Defence Intelligence among others. The unabated bandits' activities in part of the country depict a picture of ungoverned spaces, which suggests that there are territories that are experiencing a vacuum of political order. The study for that reason examines the connections between banditry and the ungoverned spaces, as well as, analyses the effects of bandits' activities on Nigeria and Nigerians. Using the discourse analysis that relies on secondary sources, the paper argues that the inability to govern some territories adequately in Nigeria has created a vacuum for bandits’ activities to thrive.
Law Research Review Quarterly, (4), 399-418. https://doi.org/10.15294/lrrq.v9i4.71054

By Sara Mariella Lambertini

The Orinoco Mining Arc (OMA) is in the south of Venezuela, a region rich in minerals and natural resources with a particular social, economic, and security dynamic. Due to its remoteness and difficult access, different actors have found a privileged space to conduct criminal activities. Venezuela has ratified the international conventions against transnational organized crime, trafficking in persons, and illicit drug trafficking. It also has national legislation criminalizing all these illicit activities. However, factors such as corruption and government inefficiency have led to impunity and a lack of implementation of legislation. Moreover, the complex social and economic situation in the country has forced part of the population to yield to the pressure of criminal groups operating in the mining sector. The research exposes the consolidation of organized crime groups in the OMA and their control of illicit activities in the area, such as illegal mining, human trafficking, and drug trafficking, among others. A documentary investigation is conducted to review the reports prepared by international organizations, academic institutions, and non-governmental organizations on Venezuela, as well as the Venezuelan legal framework and the official information issued by national authorities. The results indicate that organized crime has taken root in the OMA, generating an overlap between national and foreign actors. These actors lead the perpetration of a variety of illegal activities thanks to a criminal network, state corruption, and the vulnerability of the region’s inhabitants.

Journal of Illicit Economies and Development, 5 (1). 22 - 33. ISSN 2516-7227

By Abel Basutu, Jane Marie Ogola Ongolo

African countries have been experiencing an upsurge in public health problems as a result of the increased availability and use of psychoactive substances trafficked into the continent and also produced locally. However, mounting effective policy and programme interventions have been impeded by a lack of reliable data on various aspects of drug use and the harms associated with drugs. To address this challenge, the African Union started an ambitious programme aimed at improving the capacity of African Union member states to respond effectively to drug demand reduction challenges through strengthening research and data collection capabilities. The programme entails the establishment and operationalisation of a continent-wide drug surveillance sentinel with a public health orientation for the systematic collection and dissemination of comparable data on drug use and related problems in Africa. A key finding of the surveillance system, which draws data from national networks, has been the increase in the number of young drug users in the context of inadequate comprehensive treatment and care services, which threatens harnessing the continent’s demographic dividend. Sprouting evidence on drug use patterns and trends has aided shifts in policies and programmes towards addressing drug addictions and related health challenges at the national level.

Journal of Illicit Economies and Development, 5(3): pp. 60–69.2024.

By Ediomo-Ubong Ekpo Nelson

The production, distribution, and consumption of drugs has long been seen as a threat to social and economic development. On the other hand, conditions of unemployment and poverty foster expansion of illegal drug markets. In this study, I offer a nuanced view of the drugs/development connection where poverty and unemployment incentivise participation in the illegal drug market as a response to the failure of state-led development. The study is based on 31 in-depth interviews with male retail drug dealers in Nigeria. Findings revealed various ways the participants framed retail drug trade in connection to development. This includes, drug dealing as a pathway to social and economic mobility, drug dealing as way of mitigating youth crime, drug dealing as a response to failed development promises, and drug dealing as a means of capital formation for legitimate investment. The complex relationship between drugs and development revealed in these accounts troubles the narrow emphasis on counter-narcotics that dominate Nigerian drug policies. They indicate a need to view illegal drug trade, especially low-level distribution, as grassroots dissent from exclusionary development. Social policies designed to provide skills and opportunities for legitimate, gainful employment for at-risk youths offer scope for curbing involvement in retail drug trade.

Journal of Illicit Economies and Development, 5(3): pp. 47–59. 2024.

By John Sunday Ojo, Samuel Oyewole & Folahanmi Aina

Nigeria has confronted several security conundrums in recent years, including armed banditry, which poses a severe threat to the north-west and the entire nation. North-west Nigeria has been hit by an unprecedented wave of kidnappings, maiming, killings, population displacements, cattle rustling, and disruption of socio-economic activities due to the rise of armed bandits in the region. These events have created a climate of uncertainty that has become a cause for concern for the government and the citizenry. Relying on secondary sources of data, this article examines the causes, manifestations, and dimensions of armed banditry in north-west Nigeria, and its security implications. It provides a survey of both the visible and less-visible actors in the conflict. The article argues that armed banditry in the north-west and other parts of Nigeria transcends pastoralist insurgency, as evident in the dominant narratives, considering the multiplicity of complexly connected causal factors, actors, manifestations, and dimensions that are present in the threats posed by this development. The article also shows the negative impacts of armed banditry on human and national security in the region.

Democracy and Security, Volume 19, 2023 - Issue 4

By John Aloysius, Ankur Arora, and Viswanath Venkatesh

Purpose: Retailers are implementing technology-enabled mobile checkout processes in their stores to improve service quality, decrease labor costs and gain operational efficiency. These new checkout processes have increased customer convenience primarily by providing them autonomy in sales transactions in that store employee interventions play a reduced role. However, this autonomy has the unintended consequence of altering the checks and balances inherent in a traditional employee-assisted checkout process. Retailers, already grappling with shoplifting, with an estimated annual cost of billions of dollars, fear that the problem may be exacerbated by mobile checkout and concomitant customer autonomy. The purpose of this paper is to understand the effect of mobile checkout processes in retail stores on cybercrime in the form of shoplifting enabled by a technology transformed the retail environment.

Design/methodology/approach The authors conducted an online survey of a US sample recruited from a crowdsourced platform. The authors test a research model that aims to understand the factors that influence the intention to shoplift in three different mobile checkout settings − namely, smartphone checkout settings, store-provided mobile device checkout settings, and employee-assisted mobile checkout settings − and compare it with a traditional fixed location checkout setting.

Findings The authors found that, in a smartphone checkout setting, intention to shoplift was driven by experiential beliefs and peer influence, and experiential beliefs and peer influence had a stronger effect for prospective shoplifters when compared to experienced shoplifters; in a store-provided mobile devices checkout setting, experiential beliefs had a negative effect on shoplifters’ intention to shoplift and the effect was weaker for prospective shoplifters when compared to experienced shoplifters. The results also indicated that in an employee-assisted mobile checkout setting, intention to shoplift was driven by experiential beliefs and peer influence, and experiential beliefs had a stronger effect for prospective shoplifters when compared to experienced shoplifters.

Originality/value This study is the among the first, if not first, to examine shoplifters’ intention to shoplift in mobile checkout settings. We provide insights into how those who may not have considered shoplifting in less favorable criminogenic settings may change their behavior due to the autonomy provided by mobile checkout settings and also provide an understanding of the shoplifting intention for both prospective and experienced shoplifters in different mobile checkout settings.

Information Technology and People 32(5):1234-1261 , April 2019, p 39

WORLD ECONOMIC FORUM; MARSH & MCLENNAN COMPANIES; ZURICH INSURANCE GROUP

From the document: "The 'Global Risks Report 2024' presents the findings of the Global Risks Perception Survey (GRPS), which captures insights from nearly 1,500 global experts. The report analyses global risks through three time frames to support decision-makers in balancing current crises and longer-term priorities. Chapter 1 explores the most severe current risks, and those ranked highest by survey respondents, over a two-year period, analysing in depth the three risks that have rapidly accelerated into the top 10 rankings over the two-year horizon. Chapter 2 focuses on the top risks emerging over the next decade against a backdrop of geostrategic, climate, technological and demographic shifts, diving deeper into four specific risk outlooks. The report concludes by considering approaches for addressing complex and non-linear aspects of global risks during this period of global fragmentation."

WORLD ECONOMIC FORUM; MARSH & MCLENNAN COMPANIES; ZURICH INSURANCE GROUP

By Global Commission on Drug Policy 

Illegal drug markets provide an immense source of power and revenue for organized criminal groups. That has remained the case despite the vast investment of political, financial, social, and military capital into the global “war on drugs,” which has also generated a vast and tragic human cost. Far from curtailing drug markets, which are in fact expanding in scale and complexity worldwide, repressive criminal justice and military responses to drug trafficking have exacerbated the already profound impacts of drug-related organized crime, from prolific violence in certain states to increased corruption, and undermined political and economic stability. Deep-seated schisms continue in international debates on drug policy. Despite renewed commitment to the prohibitionist approach at the March 2019 Ministerial Declaration of the United Nations (UN) Commission on Narcotic Drugs (CND), there is increasing acknowledgement within the UN system of the harms of the current drug control regime, and the need to pursue options such as decriminalization of use and possession for personal use. Countries are increasingly adopting decriminalization models, and the legalization and regulation of cannabis for recreational use is becoming a reality in a number of jurisdictions. Yet at the same time, other countries have moved in the opposite direction, redoubling efforts to eradicate drug use through punitive approaches which harm health and human rights. Given this highly polarized context, the need for reform-minded states to advocate for evidence-based responses to organized crime and drug trafficking is greater than ever. This report supports this effort by building on the five key pathways towards improving drug policy as outlined in the Global Commission’s 2014 report. Alongside strategies to ensure the health and safety of those using drugs, this coherent five-fold program advocates for refocused enforcement responses to drug trafficking and organized crime as an essential part of drug policy reform. This report provides an overview of how the global “war on drugs” has, counter to its ostensible aims, fed and empowered transnational organized crime. More effective responses to transnational organized crime and drug trafficking – through both targeted and measured law enforcement approaches and development strategies which counter the root causes of organized crime – are possible and may be enacted even while markets remain illegal. The legal regulation of drugs offers an unprecedented opportunity to move drugs markets out of criminal control, as the Global Commission stated last year, but also presents new challenges for countering organized crime. This report explores lessons learned both in a context of prohibition and of a legally regulated market. Implementation of more progressive drug policies has often been held back by the international control regime; through a lack of coherence among UN entities, between regional bodies, and the deep-seated conservatism in the international regime. As such, this report considers the past record of the international drug control regime with respect to the fight against drug trafficking, and how more effective coordination could be achieved in the future, if political will is to be found. 

Geneva: The Global Commission, 2020. 52p.

By Beau Kilmer | Bryce Pardo | Toyya A. Pujol | Jonathan P. Caulkins

Background and aims: Synthetic opioids, mostly illegally manufactured fentanyl (IMF), were mentioned in 60% of United States (US) drug overdose deaths in 2020, with dramatic variation across states that mirrors variation in IMF supply. However, little is known about IMF markets in the United States and how they are changing. Researchers have previously used data from undercover cocaine, heroin, and methamphetamine purchases and seizures to examine how their use and related harms respond to changes in price and availability. This analysis used US Drug Enforcement Administration (DEA) data to address two questions: (i) “To what extent does IMF supply vary over time and geography?” and (ii) “What has happened to the purity-adjusted price of IMF?” Methods: We developed descriptive statistics and visualizations using data from 66 713 observations mentioning IMF and/or heroin from the DEA’s System to Retrieve Information from Drug Evidence (STRIDE; now STARLIMS) from 2013 to 2021. Price regressions were estimated with city-level fixed effects examining IMF-only powder observations with purity and price information at the low-to-medium wholesale level (>1 g to ≤100 g; n = 964). Results: From 2013 to 2021, the share of heroin and/or IMF observations mentioning IMF grew from near zero to more than two-thirds. The share of heroin observations also containing IMF grew from <1% to 40%. There is important geographic variation: in California, most IMF seizures involved counterfeit tablets, whereas New York and Massachusetts largely involved powder formulation. The median price per pure gram of IMF powder sold at the >10 to ≤100 g level fell by more than 50% from 2016 to 2021; regression analyses suggested an average annual decline of 17% (P < 0.001). However, this price decline appears to have been driven by observations from the Northeast. Conclusions: Since 2013, the illegally manufactured fentanyl problem in the United States has become more deadly and more diverse. 

Addiction. 2022;117:2745–2749. 

By Julia A Dilley, Susan M Richardson, Beau Kilmer, Rosalie Liccardo Pacula, Mary B Segawa, Magdalena Cerdá

Methods| The Washington Healthy Youth Survey (HYS) 2 is an anonymous, school-based survey of 8th, 10th, and 12th graders and the state’s primary source of information about health behavior among youths. The HYS has been implemented in the fall of even-numbered years since 2002, using a simple random sample of public schools to generate a state-representative sample. Response rates (incorporating school and student response) in 2016 were 80% for 8th grade, 69% for 10th grade, and 49% for 12th grade. The study was approved by the Washington State Institutional Review Board, whose general policy waives informed patient consent when data are de-identified. We Generated Covariate-adjusted prevalence estimates, modeling as closely as possible to Cerdá et al. Prevalence was based on modeled estimates (ie, SUDAAN predMARG [RTI International] postestimation command). Because the the MTF is not designed to provide state-representative estimates, the article generated covariate-adjusted modeled prevalence estimates for each state. The article suggested complex association between legalization and cannabis use among youths: increases in prevalence among Washington 8th and 10th graders, but not among 12th graders, relative to use in states without legalization of recreational marijuana.

The authors noted that, “the sample design may lead to discrepancies between MTF results and those found in other large-scale surveillance efforts.”1(p148) The purpose of the present study was to assess whether trends in cannabis use prevalence among youths from Washington’s state-based youth survey are consistent with findings from the MTF.

JAMA pediatrics, 173(2) 2019

By Bridget E. Weller,  Stephen Magura,  Dawn R. Smith, Matthew M. Saxton, Piyadarsha Amaratunga

  Background: Drug monitoring by drug testing of individuals under arrest provides an opportunity to detect drug use patterns within geographic areas. However, women have been omitted from large-scale monitoring efforts in criminal justice populations. The purpose of this study was to examine whether gender differences exist in drug use indicated by oral fluid collected in one U.S. jail. Methods: The study analyzed data collected in 2019-2020 from individuals under arrest (N = 191). Twenty-four percent of the sample identified as female. Oral fluid specimens were collected and then analyzed with enzyme-linked immunosorbent assay and liquid chromatography/tandem mass spectrometry. Logit regression models examined gender differences. Results: Women were more likely to test positive for methamphetamines than men (41% versus 22%, OR = 0.42, 95% CI 0.21-0.84). Significant gender differences were not found for other substances (marijuana, cocaine, and opioids), legality of drugs, or overall drug use. Conclusions: Because the National Institute on Drug Abuse aims to promote health equity, future drug monitoring in criminal justice populations should employ sampling approaches representing both women and men. This research would identify possible gender-based patterns of drug use and inform gender-based policies and clinical practices to prevent and treat drug misuse.

J Subst Use. 2023 ; 28(4): 541–544. 

By Karamoja–Turkana and the Community Research Team 

Ipoln the Karamoja and Turkana border regions of Uganda and Kenya, there is widespread violence including armed robbery, rape, and human rights abuses, yet community complaints about failures of governance remain largely unaddressed. This Policy Briefing highlights how different insecurities reinforce one another in ways exacerbated by the international border. It stresses the need for fulfilment of the two governments’ commitments to cross-border solutions, and suggests that international policy actors can help communities gain leverage with governments towards building trustworthy and effective peace and security institutions.

IDS Policy Briefing 214,

Brighton, UK: Institute of Development Studies, 2023. 4p.

By Alessia Rossi

Organised crime is one of the most important threats to the functioning of the rule of law and democracy. This research will analyse why the ‘ndrangheta, with its structure, ranks among the most powerful mafias. Specifically, consideration will be paid to cocaine trafficking, which is their most profitable supply channel. One of their main strengths is having ‘ndrine located all over the world, especially in Latin America. There, brokers manage to contract with key organisations, such as the Urabeños. Moreover, to carry out operations mainly via containers, they have trusted corrupt accomplices in the ports. In the latter, the ‘ndrangheta may not only have influence but even be embedded, as in the case of the port of Gioia Tauro. Finally, it will be examined not only the transnational approach but also the need for a national response of increasing port security in limiting the infiltration of the Calabrian mafia.  

Fiesole FI, Italy:  Transnational Governance of the European University Institute, 2023. 43p.

By David Bright and Simone J Deegan 

Outlaw motorcycle gangs (OMCGs) are often reported to be disproportionately involved in crime. Debate continues about the relationship between the organisational structure of these groups and the extent and types of criminal activities undertaken by group members. A systematic review of the existing literature was conducted to examine the organisational structures that underpin the criminal activity of OMCGs. The available empirical research, though scant, supports the notion that, at least in some clubs or chapters, the structure of OMCGs facilitates criminal activities by individuals or small cliques, sometimes in collaboration with non-members. 

Australia.. Australian Institute of Criminology. Trends & issues in crime and criminal justice no. 621. March 2021. 16p

By Robby Roks & Lieselot Bisschop & Richard Staring

As an important gateway to Europe, the Port of Rotterdam is known for its high-quality facilities and efficiency, but also attracts organised crime groups who use the transatlantic legal trade flows to traffic cocaine. Based on a qualitative study, consisting of 73 interviews with public and private actors, an analysis of 10 criminal investigations and field visits to public and private organisations in the port, this article examines how organised crime groups involved in cocaine trafficking take advantage of or adapt to the socio-spatial relations in the Port of Rotterdam. First, we pay attention to which physical spaces in the port of Rotterdam provide opportunities for cocaine trafficking. Second, we examine how the occupational and legal environment in which people, private companies and law enforcement agencies in the port work and interact provide opportunities for cocaine trafficking. Our findings demonstrate that increased security measures by both public and private actors directed at physical spaces result in a displacement to new spaces in and around the port of Rotterdam. Furthermore, the current socio-spatial relations in the port of Rotterdam also make the role of people on the inside – referring to a whole range of public and private employees – increasingly indispensable. 

Trends in Organized Crime (2021) 24:171–188 

By Sarah S. Shin, Kate LaForge, Erin Stack, Justine Pope, Gillian Leichtling, Jessica E. Larsen, Judith M. Leahy, Andrew Seaman, Daniel Hoover, Laura Chisholm, Christopher Blazes, Robin Baker, Mikaela Byers, Katie Branson & P. Todd Korthuis

Background

Illicit fentanyl has contributed to a drastic increase in overdose drug deaths. While fentanyl has subsumed the drug supply in the Northeastern and Midwestern USA, it has more recently reached the Western USA. For this study, we explored perspectives of people who use drugs (PWUD) on the changing drug supply in Oregon, experiences of and response to fentanyl-involved overdose, and recommendations from PWUD to reduce overdose risk within the context of illicit fentanyl’s dramatic increase in the recreational drug supply over the past decade.

Methods

We conducted in-depth interviews by phone with 34 PWUD in Oregon from May to June of 2021. We used thematic analysis to analyze transcripts and construct themes.

Results

PWUD knew about fentanyl, expressed concern about fentanyl pills, and were aware of other illicit drugs containing fentanyl. Participants were aware of the increased risk of an overdose but remained reluctant to engage with professional first responders due to fear of arrest. Participants had recommendations for reducing fentanyl overdose risk, including increasing access to information, harm reduction supplies (e.g., naloxone, fentanyl test strips), and medications for opioid use disorder; establishing drug checking services and overdose prevention sites; legalizing and regulating the drug supply; and reducing stigma enacted by healthcare providers.

Conclusion

PWUD in Oregon are aware of the rise of fentanyl and fentanyl pills and desire access to tools to reduce harm from fentanyl. As states in the Western USA face an inflection point of fentanyl in the drug supply, public health staff, behavioral health providers, and first responders can take action identified by the needs of PWUD.

Harm Reduction Journal volume 19, Article number: 76 (2022)

By C.J. Valaseka , Samantha A. Streuli a, Heather A. Pines , Steffanie A. Strathdeec , Annick Borquez , Philippe Bourgois , Tara Stamos-Buesige , Carlos F. Verac , Alicia Harvey-Verac , Angela R. Bazzi

Background: People who use drugs (PWUD) in the San Diego, USA and Tijuana, Mexico metroplex face high overdose risk related to historic methamphetamine use and relatively recent fentanyl introduction into local drug supplies. The personal overdose experiences of PWUD in this region are understudied, however, and may have been influenced by the COVID pandemic. Methods: From September-November 2021, we conducted 28 qualitative interviews among PWUD ≥18 years old sampled from an ongoing cohort study in the San Diego-Tijuana metroplex. Interviews explored overdose experiences and changes in the drug supply. Thematic analysis of coded interview transcripts explored overdose experiences, perspectives on drug supply changes, interactions with harm reduction services, and naloxone access. Results: Among 28 participants, 13 had experienced an overdose. Participants discussed rising levels of fentanyl in local drug supplies and increasing overdose incidents in their social networks. Participants discussed a general shift from injecting heroin to smoking fentanyl in their networks. Participants’ most common concerns included having consistent access to a safe and potent drug supply and naloxone. Conclusion: Participants prioritized adapting to drug supply changes and preventing overdose compared to other health concerns, such as HIV and COVID-19. Efforts to address overdose in this region could benefit from drug checking services and expanded, equitable delivery of naloxone.

Volume 7, June 2023, 100154, Drug and Alcohol Dependence Reports

By Lauren J. Tanz, R. Matt Gladden, Amanda T. Dinwiddie, Kimberly D. Miller, Dita Broz, Eliot Spector, Julie O’Donnell

Summary

What is already known about this topic?

More than 109,000 drug overdose deaths occurred in the United States in 2022; nearly 70% involved illegally manufactured fentanyls (IMFs). Data from the western United States suggested a transition from injecting heroin to smoking IMFs.

What is added by this report?

From January–June 2020 to July–December 2022, the percentage of overdose deaths with evidence of smoking increased 73.7%, and the percentage with evidence of injection decreased 29.1%; similar changes were observed in all U.S. regions. Changes were most pronounced in deaths with IMFs detected, with or without stimulant detection.

What are the implications for public health practice?

Strengthening and expanding public health and harm reduction services to address overdose risk with smoking and other noninjection routes might reduce deaths.

Preliminary reports indicate that more than 109,000 drug overdose deaths occurred in the United States in 2022; nearly 70% of these involved synthetic opioids other than methadone, primarily illegally manufactured fentanyl and fentanyl analogs (IMFs). Data from the western United States suggested a transition from injecting heroin to smoking IMFs. CDC analyzed data from the State Unintentional Drug Overdose Reporting System to describe trends in routes of drug use in 27 states and the District of Columbia among overdose deaths that occurred during January 2020–December 2022, overall and by region and drugs detected. From January–June 2020 to July–December 2022, the percentage of overdose deaths with evidence of injection decreased 29.1%, from 22.7% to 16.1%, whereas the percentage with evidence of smoking increased 73.7%, from 13.3% to 23.1%. The number of deaths with evidence of smoking increased 109.1%, from 2,794 to 5,843, and by 2022, smoking was the most commonly documented route of use in overdose deaths. Trends were similar in all U.S. regions. Among deaths with only IMFs detected, the percentage with evidence of injection decreased 41.6%, from 20.9% during January–June 2020 to 12.2% during July–December 2022, whereas the percentage with evidence of smoking increased 78.9%, from 10.9% to 19.5%. Similar trends were observed among deaths with both IMFs and stimulants detected. Strengthening public health and harm reduction services to address overdose risk related to diverse routes of drug use, including smoking and other non-injection routes, might reduce drug overdose deaths.

Morbidity and Mortality Weekly Report; February 15, 2024

By R. Santamarina  D. Caldicott , J. Fitzgerald , J.L. Schumann 

Background : Illicit drug use is overrepresented in music festival attendees compared with the general population. Drug use often involves a wide range of substances with the potential to cause drug toxicity. Law enforcement-centred strategies intended to deter drug use and supply at these mass gatherings have been implemented throughout Australia. However, many have been criticised for their lack of effectiveness, with evidence suggesting that they can inadvertently increase the risk of drug harm. Drug deaths are often multifactorial, providing added challenges in the development of prevention strategies. This study aimed to determine the frequency of deaths involving alcohol and other drugs at music festivals in Australia and to identify potential risk factors that may inform future harm reduction strategies.

Methods : A descriptive case series study was conducted using the National Coronial Information System (NCIS) to investigate drug-related deaths at music festivals throughout Australia between 1 July 2000 (Queensland from 1 January 2001) and 31 December 2019, using a list of keywords comprising music festival names and terms.

Results : There were 64 deaths, of which most involved males (73.4%) aged in their mid-20s (range 15-50 years). Drug toxicity was the most common primary cause of death (46.9%) followed by external injuries (37.5%). The drug most commonly detected or reported as being used was MDMA (65.6%), followed by alcohol (46.9%) and cannabis (17.2%), with most cases reporting the use of two or more drugs (including alcohol) and 36% reporting a history of drug misuse in the coroner's findings. Most deaths were unintentional, with less than a fifth of cases (17.2%) involving intentional self-harm. Clinical intervention was involved in 64.1% of cases and most festivals occurred in inner city locations (59.4%).

Conclusions : The findings suggest that drug-related deaths at music festivals in Australia typically involve young people using multiple illicit substances in combination with alcohol. Most are unintentional and could potentially be prevented through the implementation of a range of harm reduction strategies, including mobile medical care, drug checking services, and increased consumer education and awareness.

International Journal of Drug Policy Volume 123, January 2024, 104274