Availability of nitazenes via cryptomarkets and surface web shops: An observational study

Abstract Aims To identify: (i) availability of nitazenes for purchase on international cryptomarkets and surface web shops, (ii) country of origin and country of destination of advertised products and (iii) types and forms of nitazenes available. We also identified shifts in market characteristics over time where possible. Methods Observational study of cryptomarkets and surface web marketplaces selling drugs and specifically nitazenes. Data comprised: (i) all drug listings on 34 cryptomarkets, collected twice monthly from October 2021 to September 2024, and from which nitazene listings were identified and (ii) all nitazene listings on 10 surface web shops, identified in April 2024 via search query on purchasing nitazenes in Australia on a common search engine. The former were analysed using Joinpoint regression; the latter descriptively. Results While nitazene listings comprised a small proportion of total drug listings across the cryptomarkets (0.16%), the proportion of nitazene listings had a small and fluctuating increase over the 3 years [average monthly percent change (MPC) = 1.7%; 95% confidence interval (CI) = 0.4%, 2.4%]. Overall, 78.9% of listings were reported as available for delivery to Australia, decreasing from 90.4% in October 2022 to 67.7% in September 2024 (MPC = −2.1%; 95% CI = −2.8%, −1.6%). The proportion reported as originating from Asia decreased from August 2023 (52.8%) to September 2024 (12.1%) (MPC = −11.7%; 95% CI = −16.3%, −8.9%), while listings originating from North America increased from April 2023 (19.3%) to September 2024 (82.8%) (MPC = 9.0%; 95% CI = 7.3%, 11.2%). Isotonitazene, protonitazene and metonitazene were most frequently identified, with proportion of isotonitazene and protonitazene listings increasing over the 3 years (average MPC = 2.1%; 95% CI = 1.5%, 2.8% and average MPC = 4.1%; 95% CI = 2.8%, 5.4%) and metonitazene declining (average MPC = −3.5%; 95% CI = −4.2%, −2.7%). Powder was the predominant form (87.2%), although the proportion of pills statistically significantly increased between October 2021 (0.0%) and September 2024 (20.2%) (MPC = 11.8%; 95% CI = 7.7%, 16.5%). Seven out of 10 surface web shops sold nitazenes for Australian delivery. Ten types of nitazene were identified on surface web shops. Powder was also the main form listed, followed by nasal sprays. Conclusions From October 2021 to September 2024, nitazenes were listed across a range of cryptomarkets and surface web shops, with shifts in the types available and their reported country of origin. These market insights show the importance of ongoing digital trace monitoring and reinforce the need for comprehensive harm reduction strategies and strong public health risk communication frameworks.