Capturing key regulatory events to inform assessment of black-market opioid pricing patterns using an online, real-time, crowd-sourced platform

Olya Ryjenko, Daniel T. Winter, Benjamin C. Riordan, Carolyn A. Day, Amanda Roxburgh

Background: Within the last decade, Australia observed marked increases in prescription opioid harms, including mortality. In response, regulatory measures have been implemented to restrict prescribing, availability and use of these medicines. StreetRx is a novel, online platform that allows users to anonymously submit prices paid for illicitly purchased prescription medicines and other drugs. This platform has the potential for use as a new tool for monitoring the Australian illicit drug market.

Aims: The aims of this study were (a) to examine the possible impacts of opioid restrictions on black market pricing over the last decade, and (b) to construct a protocol to assess the utility of the StreetRx data contributed by Australians.

Methods: Australian government and non-government websites were searched to identify regulatory activities to restrict pharmaceutical opioid use between 2010 to 2021. A literature review was conducted to investigate the impacts of these restrictions on opioid supply, use and harms. Where significant impacts were observed, it was hypothesised that black market opioid pricing may also be influenced. A protocol was established to analyse the Australian StreetRx dataset against the timeline of regulations.

Results: Restricting supply of prescription opioids has changed their use and harms in Australia. A number of key regulatory activities have potentially contributed to driving pricing patterns in the illicit drug market.

Conclusions: Regulatory changes are likely to influence prices paid for illicitly purchased pharmaceutical opioids in Australia.