Global trends, local harms: availability of fentanyl-type drugs on the dark web and accidental overdoses in Ohio

  • Usha Lokala
  • Francois R. LamyEmail author
  • Raminta Daniulaityte
  • Amit Sheth
  • Ramzi W. Nahhas
  • Jason I. Roden
  • Shweta Yadav
  • Robert G. Carlson
S.I. : SBP-BRiMS 2018


As America’s opioid crisis has become an “epidemic of epidemics,” Ohio has been identified as one of the high burden states regarding fentanyl-related overdose mortality. This study aims to examine changes in the availability of fentanyl, fentanyl analogs, and other non-pharmaceutical opioids on cryptomarkets and assess relationship with the trends in unintentional overdoses in Ohio to provide timely information for epidemiologic surveillance. Cryptomarket data were collected at two distinct periods of time: (1) Agora data covered June 2014–September 2015 and were obtained from Grams archive; (2) Dream Market data from March–April 2018 were extracted using a dedicated crawler. A Named Entity Recognition algorithm was developed to identify and categorize the type of fentanyl and other synthetic opioids advertised on cryptomarkets. Time-lagged correlations were used to assess the relationship between the fentanyl, fentanyl analog and other synthetic opioid-related ads from cryptomarkets and overdose data from the Cincinnati Fire Department Emergency Responses and Montgomery County Coroner’s Office. Analysis from the cryptomarket data reveals increases in fentanyl-like drugs and changes in the types of fentanyl analogues and other synthetic opioids advertised in 2015 and 2018 with potent substances like carfentanil available during the second period. The time-lagged correlation was the largest when comparing Agora data to Cincinnati Emergency Responses 1 month later 0.84 (95% CI 0.45, 0.96). The time-lagged correlation between Agora data and Montgomery County drug overdoses was the largest when comparing synthetic opioid-related Agora ads to Montgomery County overdose deaths 7 months later 0.78 (95% CI 0.47, 0.92). Further investigations are required to establish the relationship between cryptomarket availability and unintentional overdose trends related to specific fentanyl analogs and/or other illicit synthetic opioids.


Fentanyl Fentanyl analogs Illicit synthetic opioids Cryptomarkets Opioid overdose Ohio 



Funding was provided by National Institute on Drug Abuse (Grant No. 5R21DA044518-02).


  1. Barratt MJ, Aldridge J (2016) Everything you always wanted to know about drug cryptomarkets* (*but were afraid to ask). Int J Drug Policy 35:1–6CrossRefGoogle Scholar
  2. Branwen G, Christin N, Décary-Hétu D, Munksgaard R, Presidente E (2015) Dark net market archives, 2011–2015. Retrieved August, 28Google Scholar
  3. Burns L, Roxburgh A, Bruno R, Van Buskirk J (2014) Monitoring drug markets in the internet age and the evolution of drug monitoring systems in Australia. Drug Test Anal 6(7–8):840–845CrossRefGoogle Scholar
  4. Cameron D, Smith GA, Daniulaityte R, Sheth AP, Dave D, Chen L, Anand G, Carlson R, Watkins KZ, Falck R (2013) PREDOSE: a semantic web platform for drug abuse epidemiology using social media. J Biomed Inform 46:985–997CrossRefGoogle Scholar
  5. Carlson R, Li L, Daniulaityte R (2017) Montgomery county poisoning death review, 2010–2016Google Scholar
  6. Ciccarone D (2017) Fentanyl in the US heroin supply: a rapidly changing risk environment. Int J Drug Policy 46:107–111CrossRefGoogle Scholar
  7. City of Cincinnati (2018) Heroin overdoses. Accessed 21 Aug 2018
  8. Cunliffe J, Martin J, Decary-Hetu D, Aldridge J (2017) An island apart? Risks and prices in the Australian cryptomarket drug trade. Int J Drug Policy 50:64–73CrossRefGoogle Scholar
  9. Daniulaityte R, Juhascik MP, Strayer KE, Sizemore IE, Harshbarger KE, Antonides HM, Carlson RR (2017a) Overdose deaths related to fentanyl and its analogs—Ohio, January–February 2017. MMWR Morb Mortal Wkly Rep 66:904–908CrossRefGoogle Scholar
  10. Daniulaityte R, Lamy FR, Smith GA, Nahhas RW, Carlson RG, Thirunarayan K, Martins SS, Boyer EW, Sheth A (2017b) “Retweet to pass the blunt”: analyzing geographic and content features of cannabis-related tweeting across the United States. J Stud Alcohol Drugs 78:910–915CrossRefGoogle Scholar
  11. Decary-Hetu D, Paquet-Clouston M, Aldridge J (2016) Going international? Risk taking by cryptomarket drug vendors. Int J Drug Policy 35:69–76CrossRefGoogle Scholar
  12. Fielding J, Teutsch S, Breslow L (2010) A framework for public health in the United States. Public Health Rev 174:176–177Google Scholar
  13. Gladden RM, Martinez P, Seth P (2016) Fentanyl law enforcement submissions and increases in synthetic opioid-involved overdose deaths—27 States, 2013–2014. MMWR Morb Mortal Wkly Rep 65:837–843CrossRefGoogle Scholar
  14. Greenberg A (2014) Drug market ‘Agora’ replaces the ‘silk road’ as king of the dark net. In: Wired. Accessed 21 Aug 2018
  15. Lamy FR, Daniulaityte R, Nahhas RW, Barratt MJ, Smith AG, Sheth A, Martins SS, Boyer EW, Carlson RG (2017) Increases in synthetic cannabinoids-related harms: results from a longitudinal web-based content analysis. Int J Drug Policy 44:121–129CrossRefGoogle Scholar
  16. O’Donnell JK, Halpin J, Mattson CL, Goldberger BA, Gladden RM (2017) Deaths involving fentanyl, fentanyl analogs, and U-47700—10 states, July-December 2016. MMWR Morb Mortal Wkly Rep 66:1197–1202CrossRefGoogle Scholar
  17. O’Donnell J, Gladden RM, Mattson CL, Kariisa M (2018) Notes from the field: overdose deaths with carfentanil and other fentanyl analogs detected—10 states, July 2016–June 2017. Morb Mortal Wkly Rep 67:767CrossRefGoogle Scholar
  18. Peterson AB, Gladden RM, Delcher C, Spies E, Garcia-Williams A, Wang Y, Halpin J, Zibbell J, McCarty CL, DeFiore-Hyrmer J, DiOrio M, Goldberger BA (2016) Increases in fentanyl-related overdose deaths—Florida and Ohio, 2013–2015. MMWR Morb Mortal Wkly Rep 65:844–849CrossRefGoogle Scholar
  19. Public Health Dayton & Montgomery County (2018) Accidental overdose death totals, Mongomery County, Ohio, 2017Google Scholar
  20. Rudd RA, Paulozzi LJ, Bauer MJ, Burleson RW, Carlson RE, Dao D, Davis JW, Dudek J, Eichler BA, Fernandes JC, Fondario A, Gabella B, Hume B, Huntamer T, Kariisa M, Largo TW, Miles J, Newmyer A, Nitcheva D, Perez BE, Proescholdbell SK, Sabel JC, Skiba J, Slavova S, Stone K, Tharp JM, Wendling T, Wright D, Zehner AM, Control Centers for Disease, and Prevention (2014) Increases in heroin overdose deaths—28 States, 2010 to 2012. MMWR Morb Mortal Wkly Rep 63:849–854Google Scholar
  21. Rudd RA, Aleshire N, Zibbell JE, Gladden RM (2016) Increases in drug and opioid overdose deaths—United States, 2000-2014. MMWR Morb Mortal Wkly Rep 64:1378–1382CrossRefGoogle Scholar
  22. Somerville NJ, O’Donnell J, Gladden RM, Zibbell JE, Green TC, Younkin M, Ruiz S, Babakhanlou-Chase H, Chan M, Callis BP, Kuramoto-Crawford J, Nields HM, Walley AY (2017) Characteristics of fentanyl overdose—Massachusetts, 2014-2016. MMWR Morb Mortal Wkly Rep 66:382–386CrossRefGoogle Scholar
  23. Suzuki J, El-Haddad S (2017) A review: fentanyl and non-pharmaceutical fentanyls. Drug Alcohol Depend 171:107–116CrossRefGoogle Scholar
  24. U.S. Drug Enforcement Administration (DEA) (2016) National Forensic Laboratory Information System: Midyear Report 2015. U.S. Drug Enforcement Administration, SpringfieldGoogle Scholar
  25. U.S. Drug Enforcement Administration (DEA) (2018) Emerging threat report, first quarter 2018. U.S. Drug Enforcement Administration, SpringfieldGoogle Scholar
  26. Van Buskirk J, Naicker S, Roxburgh A, Bruno R, Burns L (2016) Who sells what? Country specific differences in substance availability on the Agora cryptomarket. Int J Drug Policy 35:16–23CrossRefGoogle Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Computer Science and Engineering, Kno.e.sis CenterWright State UniversityDaytonUSA
  2. 2.Department of Society and Health, Faculty of Social Sciences and HumanitiesMahidol UniversityNakhon PathomThailand
  3. 3.Department of Population and Public Health Sciences, Center for Interventions, Treatment, and Addictions Research, Boonshoft School of MedicineWright State UniversityDaytonUSA
  4. 4.Department of Population and Public Health Sciences, Department of Psychiatry, Boonshoft School of MedicineWright State UniversityDaytonUSA

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