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A scoping review of home-produced heroin and amphetamine-type stimulant substitutes: implications for prevention, treatment, and policy.

Hearne E, Grund JP, Van Hout MC, McVeigh J - Harm Reduct J (2016)

Bottom Line: The resulting physical health consequences of injecting these crude substances are very severe in comparison to heroin or amphetamine acquired in black markets.Due to this fact and the increased mortality associated with these substances, professionals in the area of prevention, treatment, and policy development need to be cognisant of the presentation, harms, and the dangers associated with home-produced substances globally.The Internet underpins the facilitation of this practice as recipes, and diverted pharmaceutical sales are available widely online, and currently, ease of access to the Internet is evident worldwide.

View Article: PubMed Central - PubMed

Affiliation: School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland. ehearne@wit.ie.

ABSTRACT
Several home-produced substances such as krokodil and boltushka are prevalent in many Eastern European countries. Anecdotal reports of its use have been circulating in Germany and Norway; however, this has not been confirmed. Its use has also been reported by the media in the USA, although only one confirmed report of its use exists. Home-produced drugs are associated with high levels of morbidity and a number of complex health issues such as the spread of blood borne viruses, gangrene, and internal organ damage. The high incidence of HIV rates amongst people who inject home-produced substances is a public health concern. The resulting physical health consequences of injecting these crude substances are very severe in comparison to heroin or amphetamine acquired in black markets. Due to this fact and the increased mortality associated with these substances, professionals in the area of prevention, treatment, and policy development need to be cognisant of the presentation, harms, and the dangers associated with home-produced substances globally. This scoping review aimed to examine existing literature on the subject of home-produced heroin and amphetamine-type stimulant substitutes. The review discussed the many implications such research may have in the areas of policy and practice. Data were gathered through the use of qualitative secondary resources such as journal articles, reports, reviews, case studies, and media reports. The home production of these substances relies on the utilisation of precursor drugs such as less potent stimulants, tranquillizers, analgesics, and sedatives or natural plant ingredients. The Internet underpins the facilitation of this practice as recipes, and diverted pharmaceutical sales are available widely online, and currently, ease of access to the Internet is evident worldwide. This review highlights the necessity of prevention, education, and also harm reduction related to home-produced drugs and also recommends consistent monitoring of online drug fora, online drug marketplaces, and unregulated pharmacies.

No MeSH data available.


Related in: MedlinePlus

Flow diagram charting inclusion and exclusion criteria for this study
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Fig1: Flow diagram charting inclusion and exclusion criteria for this study

Mentions: Scoping studies are gradually being encouraged for the extensive searching of literature on specific subjects. They are primarily used to emphasise the gaps and key issues in the current evidence base and to find areas that require further research, practical, and policy interventions [15, 27–29]. It is important to acknowledge the limitations of a scoping study. As the quantity of data generated in a scoping study is sometimes considerable, the decision to include all material available versus a more detailed analysis of a smaller number of studies can be difficult. Scoping studies do not appraise the evidence quality in the primary research papers, and as a result, scoping studies simply offer a descriptive or narrative interpretation of available research [16, 27]. This scoping review employed qualitative secondary sources together with peer reviewed journal articles, reports, reviews, case studies, and some media accounts. A thorough list using many different search terms was used to perform a literature search. These terms included “homemade drugs”, “kitchen chemistry”, “krokodil”, “desomorphine”, “boltushka”, “drug formulation tampering”, and “online drug markets”. To guarantee all articles relevant to the study were included, a broad search was conducted using many databases: EBSCO Host, Science Direct, PubMed, PsycINFO, and MEDLINE. A set of criteria for inclusion and exclusion in the study were put in place. Inclusion criteria consisted of home-produced substances limited to ATS and heroin substitutes and full-text access. Exclusion criteria consisted of incomprehensible language, animal studies, and insignificance to the scoping review (see Fig. 1 and Table 1).Fig. 1


A scoping review of home-produced heroin and amphetamine-type stimulant substitutes: implications for prevention, treatment, and policy.

Hearne E, Grund JP, Van Hout MC, McVeigh J - Harm Reduct J (2016)

Flow diagram charting inclusion and exclusion criteria for this study
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837500&req=5

Fig1: Flow diagram charting inclusion and exclusion criteria for this study
Mentions: Scoping studies are gradually being encouraged for the extensive searching of literature on specific subjects. They are primarily used to emphasise the gaps and key issues in the current evidence base and to find areas that require further research, practical, and policy interventions [15, 27–29]. It is important to acknowledge the limitations of a scoping study. As the quantity of data generated in a scoping study is sometimes considerable, the decision to include all material available versus a more detailed analysis of a smaller number of studies can be difficult. Scoping studies do not appraise the evidence quality in the primary research papers, and as a result, scoping studies simply offer a descriptive or narrative interpretation of available research [16, 27]. This scoping review employed qualitative secondary sources together with peer reviewed journal articles, reports, reviews, case studies, and some media accounts. A thorough list using many different search terms was used to perform a literature search. These terms included “homemade drugs”, “kitchen chemistry”, “krokodil”, “desomorphine”, “boltushka”, “drug formulation tampering”, and “online drug markets”. To guarantee all articles relevant to the study were included, a broad search was conducted using many databases: EBSCO Host, Science Direct, PubMed, PsycINFO, and MEDLINE. A set of criteria for inclusion and exclusion in the study were put in place. Inclusion criteria consisted of home-produced substances limited to ATS and heroin substitutes and full-text access. Exclusion criteria consisted of incomprehensible language, animal studies, and insignificance to the scoping review (see Fig. 1 and Table 1).Fig. 1

Bottom Line: The resulting physical health consequences of injecting these crude substances are very severe in comparison to heroin or amphetamine acquired in black markets.Due to this fact and the increased mortality associated with these substances, professionals in the area of prevention, treatment, and policy development need to be cognisant of the presentation, harms, and the dangers associated with home-produced substances globally.The Internet underpins the facilitation of this practice as recipes, and diverted pharmaceutical sales are available widely online, and currently, ease of access to the Internet is evident worldwide.

View Article: PubMed Central - PubMed

Affiliation: School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland. ehearne@wit.ie.

ABSTRACT
Several home-produced substances such as krokodil and boltushka are prevalent in many Eastern European countries. Anecdotal reports of its use have been circulating in Germany and Norway; however, this has not been confirmed. Its use has also been reported by the media in the USA, although only one confirmed report of its use exists. Home-produced drugs are associated with high levels of morbidity and a number of complex health issues such as the spread of blood borne viruses, gangrene, and internal organ damage. The high incidence of HIV rates amongst people who inject home-produced substances is a public health concern. The resulting physical health consequences of injecting these crude substances are very severe in comparison to heroin or amphetamine acquired in black markets. Due to this fact and the increased mortality associated with these substances, professionals in the area of prevention, treatment, and policy development need to be cognisant of the presentation, harms, and the dangers associated with home-produced substances globally. This scoping review aimed to examine existing literature on the subject of home-produced heroin and amphetamine-type stimulant substitutes. The review discussed the many implications such research may have in the areas of policy and practice. Data were gathered through the use of qualitative secondary resources such as journal articles, reports, reviews, case studies, and media reports. The home production of these substances relies on the utilisation of precursor drugs such as less potent stimulants, tranquillizers, analgesics, and sedatives or natural plant ingredients. The Internet underpins the facilitation of this practice as recipes, and diverted pharmaceutical sales are available widely online, and currently, ease of access to the Internet is evident worldwide. This review highlights the necessity of prevention, education, and also harm reduction related to home-produced drugs and also recommends consistent monitoring of online drug fora, online drug marketplaces, and unregulated pharmacies.

No MeSH data available.


Related in: MedlinePlus