Hot Spot Mapping and Size Estimation of Illicit Drug Users in Iran: A Pilot Study

Background: Mapping and size estimation of people who use (PWUD) or inject drugs (PWID) are important issues for control of drug use. The aim of this pilot study is to mapping and estimate the number of PWUD and PWID in Iran.Methods: We used the hotspot mapping and size estimation method to estimate the number of illicit drug users in four cities of Iran from December 2017 to January 2019. We identified hotspots by local knowledge of key informants. For size estimation in each hotspot, three estimates were made during hotspot visit: a) KAP-KI (Key Affected Population Key Informant) estimate (drug users met in the hotspot), b) Non-KAP KI estimate (e.g. taxi drivers, shopkeepers nearby the hotspot); c) estimation made by field observers. Locations of hotspots were recorded by the field team and ArcGIS software was used for mapping. Results: A total number of 335 hot spots were identified in four cities of them, 70 (20.9%) were in Ahvaz, 90 (26.9%) in Sari, 67 (20%) in Yazd and 108(32.2%) in district 2 of Tehran metropolitan. We identified nine high-density areas for PWUDs of them three were in Ahvaz, one in the south of Sari, two in district 2 of Tehran and three in Yazd. The total numbers of 1524 key informants were interviewed by the field team in 335 identified hot spots. Based on the median estimated number of PWUD, Ahvaz had the highest estimated number of PWUD (1242, range, 606-1285), followed by Sari (788, range, 373-1044), district 2 of Tehran (684, range, 642-728) and Yazd (123, range, 76-316). The median estimated number of PWID indicated that Ahvaz had the highest estimated number of PWID (843, range, 703-887), followed by Sari (346, range, 307-666), Yazd (228, range, 221-471) and Tehran (18, range, 18-34). Conclusions: Findings highlight the importance of geographical targeting of illicit drug users to provide harm reduction programs with a broader reach in Iran.

Covid-19, county lines and the seriously “left behind”

Purpose The purpose of this study is to suggest how the Covid-19 lockdown may affect illicit drug users and vulnerable children and young people who become involved in County lines drug dealing. Design/methodology/approach This is an “opinion piece” based on data released by central and local government departments and voluntary sector sources concerning the impact of the Covid-19 restrictions on illicit drug users and vulnerable children and young people. The data is augmented with information from recent discussions with police officers, youth workers and social workers in a London borough. Findings It appears that the Covid-19 restrictions have had, and will continue to have, a deleterious impact upon both illicit drug users and the young people caught up in County lines drug distribution. Originality/value The study’s originality lies in its attempt to use a range of sources to anticipate the consequences of the Covid-19 restrictions on illicit drug users and vulnerable children and young people.

Impacts of COVID-19 on the health of illicit substance users : Preliminary Analysis from Illicit Drug Transaction Data. (Preprint)

BACKGROUND While much attention has been given to how COVID-19 patients are treated (or fail to be treated), the impact of the pandemic on illicit drug users remains largely undiscussed. The consequences of COVID-19 on substance users and on the health care system are exposed. OBJECTIVE The aim of this short report is to understand the health issues that illicit drug users may be currently facing following the lockdowns due to the COVID-19 pandemic. METHODS We analysed 262 self-reported submissions of illicit drug transactions on the darkweb. The self-reports include the date of the transaction, the types of illicit drugs bought/sold, and whether the shipment of the illicit drugs succeeded, had issues (ex. unusually long delivery, an error in the type of drug shipped, quantity or concentration of the drug), or failed. RESULTS Between January 1st 2020 and March 21, 2020, deliveries of illicit drug on the darkweb were mostly successful (60% to 100%). Starting on March 21st, the number of shipments that had issues or failed to be delivered increased rapidly and represented a majority of all shipments (79%). CONCLUSIONS The flow of darkweb drugs has been disrupted at the same time as COVID-19 pandemic started to lead to lockdowns. This suggests that the lockdowns could have disrupted the sourcing of illicit drugs, thereby possibly impacting the health of illicit drug users.