To better understand the factors and circumstances that led patients into their offices, practitioners providing treatment for substance use disorders need to recognize the changes happening at the front of the supply chain, says Derek Osborn, CPS, CPM, founder and CEO of DrugUniversity.org.
At the virtual National Conference on Addiction Disorders, Osborn will present on developments with the dark web, cartels and other drug trends that practicing clinicians need to know. Ahead of his session at NCAD, he spoke with Addiction Professional about cartels’ changing business models, the impact of COVID-19, and new illicit substances available online.
Editor’s note: This interview has been edited for length and clarity.
What is the most noteworthy trend you have observed with regards to substance use disorder trends within the past year or two that you will address at NCAD?
We’re going to look quickly into a lot about the opioid epidemic from a different perspective. It won’t be typical information about opioids. A lot of this will be about replacements for traditional opioids, and how the cartel has changed their business model based on the wants and desires of the United States population and how the dark net plays into that—even some stuff you can buy in convenience stores right now. I don’t think a lot of people are aware of what is basically a hidden world that certain people want to stay hidden, because the more it stays hidden, the less legal actions are taken against them.
You said the cartel has changed its business model in response to the wants and desires of the U.S. population. What’s happening there?
One of the major things is when we really started tracking this opioid epidemic back in 2013 or so, that was about the time where many states decided they were going to legalize marijuana. What the cartels did—and they still deal plenty of marijuana, it’s just that our marijuana is a lot better than theirs—they had to rethink their business model. A lot of them dug up their marijuana crops and planted poppy. I have some slides that show what they did and how they did it and how they continue to progress now with synthetic opiates like fentanyl and those kinds of things. Plus, there has been the rise of meth and the resurfacing of cocaine.
What have developments have you seen in the past few months, particularly around the impact of COVID-19?
One of things we’ve seen and recognized is that the distribution network was hurt a little bit by it, but not as much as you might think. It has really given time for a lot of them to review their procedures and how they get things to where they want them to go. You would think it would have a major impact on the distribution channels and the fact that people are not getting out as much, but actually, it’s probably accelerated a bit because there are so many people sitting home with nothing to do. You see that in the data we look at that involves the increased use of alcohol and prescription medications. All these things feed into this epidemic.
What do practitioners need to know with regards to the dark web and the early part of the supply chain of illicit substances?
There are situations where you may have a client with opioid use disorder, and that may be a situation where they seem like they’re doing well without the use of medication-assisted treatment. But there are a lot of products unknown to clinicians that are available for purchase and can fill that void when the use of heroin or prescription medication stops. That’s where this comes into play. You may want to ask whether someone is using a particular substance or if they have heard of a particular substance that is not necessarily mainstream and a lot of people know about.