Drug trafficking and illegal drug use is a problem that for long has been harassing societies in many developed and underdeveloped countries. In Europe, the sector of illicit drug market seems to be growing in complexity with cocaine being on rise in different countries (1) while in the United States opioid overdose deaths escalate reaching alarming proportions (2). Drug trafficking generates enormous amounts of money that is often used to support other areas of organized criminality such as gunrunning and human trafficking for sexual exploitation. Organization of illegal drug distribution follows a hierarchical structure (3) in which openly operating markets are on the bottom of such hierarchies. Open drug markets represent a huge challenge for police and local authorities because they disrupt the public order and violent crimes are more likely to concentrate around such places (4).
During the spring of 2017 we had the opportunity to analyze an open drug market in Sundsvall, a medium-sized city situated 400 km north of Stockholm. We came to the conclusion that it operates as any other market in base of providers who supply and clients who buy drugs. The merchandise (i.e. illicit drugs) is exchanged in a specific place, the local bus station crowded in many hours of the day by citizens who commute to arrive to their work places/homes and by adolescents who use this transportation mean to arrive to school in the morning and to go back to their homes in the afternoon. An important part of the market was being supplied not only of illicit drugs such as cannabis, heroine, metamphetamine or extasis but mainly of opioids medical prescribed such as Tramadol®, Subutex® and Suboxone®. Obeying to market laws of demand and supply we observed that the largest proportion of the market was due to these medical prescribed drugs and cannabis since they were cheaper. The users could not afford more expensive drugs (e.g. heroin) because of their low socio-economic status or being economically dependent from parents. Overdoses required emergency medical assistance with result of death in at least one occasion during the time of our study. Although the concentration of violent crimes was not higher than in other parts of the city, pedestrians and the general population pointed out the spot as the place where they felt more unsafe.
With the preliminary results of the study in our minds we started to unveil the best intervention that could shut down this market. Two approaches are possible. The traditional approach would point out the police as the first responsible for ‘cleaning the streets’ of users and providers through arrests and bring them to the justice system. However, after years and years working with such strategy we foresee that would inevitably fail. The law enforcement and the justice system will never be able to put out of circulation all drug providers and users. The drug market would likely be relocated in another part of the town if not in the same place short time after. Therefore, is imperative to take a more rational approach. We hypothesized that if it is possible to individualize treatment for heavy users in a way that covers physical, mental health, family, social and economic necessities and continue with aftercare treatment it would make it more attractive and would have a strong impact on relapse rates. On the other hand, if effective early drug prevention programs are introduced in schools it would avert the incorporation of new users to the market. In a short/medium term the market would run empty of clients, and markets empty of clients naturally disappear.
European Monitoring Centre for Drugs and Drug Addiction (2017). European drug report 2017: Trends and developments. Luxembourg: Publication Office of the European Union.
Rudd RA, Seth P, David F, Scholl L. (2016). Increases in drug and opioid-involved overdose deaths – United States 2010-2015. Morbidity and Mortality Weekly Report (MMWR). ePub: 16 December 2016.
Johnson BD (2003). Patterns of drug distribution: Implications and issues. Substance Use and Misuse, 38 (11-13), 1789-1806.
Weisburd, D., & Mazerolle, L.G. (2000). Crime and Disorder in Drug Hotspots: Implications for theory and Practice in Policing. Police Quarterly, 3(3), 331-349.