A scoping review of home-produced heroin and amphetamine-type stimulant substitutes: implications for prevention, treatment, and policy.
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.
School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland. ehearne@wit.ie.
Evelyn
E
Hearne
Department of Addictology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.|CVO - Addiction Research Centre, Utrecht, The Netherlands.|Freudenthal Institute for Science and Mathematics Education, Utrecht University, Utrecht, The Netherlands.
Jean-Paul Cornelius
JP
Grund
School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland.
Marie Claire
MC
Van Hout
Centre for Public Health, Liverpool John Moores University, Liverpool, UK.
Jim
J
McVeigh
D019969:Amphetamine-Related Disorders / Q000453:epidemiology*; D000662:Amphetamines / Q000138:chemical synthesis*; D000697:Central Nervous System Stimulants / Q000138:chemical synthesis*; D003932:Heroin / Q000138:chemical synthesis*; D006556:Heroin Dependence / Q000453:epidemiology*; D006801:Humans; D013287:Illicit Drugs; D020407:Internet
D000662:Amphetamines; D000697:Central Nervous System Stimulants; D013287:Illicit Drugs; D003932:Heroin
Homemade drugs; Internet; Kitchen chemistry; Krokodil; Scoping studies