Crowdsourcing Black Market Prices For Prescription Opioids

Prescription opioid diversion and abuse are major public health issues in the United States and internationally. Street prices of diverted prescription opioids can provide an indicator of drug availability, demand, and abuse potential, but these data can be difficult to collect. Crowdsourcing is a rapid and cost-effective way to gather information about sales transactions. We sought to determine whether crowdsourcing can provide accurate measurements of the street price of diverted prescription opioid medications.

The object of this paper, published in the Journal of Medical Internet Research (JMIR) was to assess the possibility of crowdsourcing black market drug price data by cross-validation with law enforcement officer reports.

Through StreetRx, we collected data about the price that site visitors paid for diverted prescription opioid analgesics during the first half of 2012. These results were compared with a survey of law enforcement officers in the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) System, and actual transaction prices on a “dark Internet” marketplace (Silk Road).

We concluded that crowdsourced data (e.g., data collected through StreetRx) provide a valid estimate of the street price of diverted prescription opioids. The (ostensibly free) black market was able to accurately predict the relative pharmacologic potency of opioid molecules.

Big Pharma Company Jacks Up Price of Overdose Life Saver by 1100%: Now, More People Will Die

In 2008, one pharmaceutical company, Hospira, secured a monopoly on the production of naloxone, an antidote that reverses opiate overdose, and jacked up the prices by 1100%. The price increases have been detrimental to overdose prevention programs around the country.

StreetRx in the News

Some notable excerpts:

The website is one of several tools used by the Researched Abuse, Diversion and Addiction-Related Services system to track prescription drug usage for pharmaceutical companies and others who subscribe.

Prescription drugs prices are different from street drugs, such as heroin and cocaine,ecause sellers can control the purity. That means Percocet pills in Los Angeles don’t cost much more than Percocet pills in Chillicothe.

Because prices are relatively constant, any shift might indicate a change in supply or demand, which is important information for law enforcement.

Jessie Balmert
CentralOhio.com

In a recent NPR article, Mystery Man, a drug dealer in Albuquerque, NM, who sells Suboxone on the street was interviewed:

He sells each pill for $5. He uses the profit to pay himself and his bodyguards, and to invest in his next deal. He says he notices a difference in his customers. “People don’t overdose no more. They’re just mellow,” he says. “If you take it you won’t be stealing, you won’t be robbing, and you won’t be prostituting.”      …

The Center for Substance Abuse Research at the University of Maryland, College Park recently warned of an emerging buprenorphine misuse. But a survey of physicians who are certified to prescribe Suboxone underscores Mystery Man’s role. The majority believe patients who seek Suboxone on the street are doing so to self-medicate.

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‎”Interviews with patients who abused both formulations of OxyContin indicated a unanimous preference for the older version. Although 24% found a way to defeat the tamper-resistant properties of the abuse deterrent formulation, 66% indicated a switch to another opioid, with “heroin” the most common response. These changes appear to be causally linked, as typified by one response: “Most people that I know don’t use OxyContin to get high anymore. They have moved on to heroin [because] it is easier to use, much cheaper, and easily available.” It is important to note that there was no evidence that OxyContin abusers ceased their drug abuse as a result of the abuse-deterrent formulation. Rather, it appears that they simply shifted their drug of choice.”

Cicero, Theodore J., Matthew S. Ellis, and Hilary L. Surratt. “Effect of Abuse-Deterrent Formulation of OxyContin.” New England Journal of Medicine 367.2 (2012): 187-189.

Street-Level Value of Drugs Seized in Canada

from the Report on the Illicit Drug Situation in Canada – 2008

From the Economist:

THE street price of cocaine varies hugely across the world. No surprise that it is cheapest in Colombia, the world’s biggest producer of coca: at $2, a gram costs less than a Big Mac. Geography is an obvious price factor. The farther away a country from the main producers in South and Central America, and the more isolated it is, the higher the cost to traffick there. In far-flung New Zealand, a gram costs a wallet-busting $714.30. But there are some pricing anomalies. Although the street price in Japan is several times higher than in Israel, Germany and Britain, the wholesale price in the countries is similar, around $46.40. In Canada the wholesale price is 50% more than in America, but Canadians pay 40% less on the street. It could be that policing is more zealous in some countries, or that there is less competition among suppliers.

http://www.economist.com/node/9414607