Young adults' sourcing and supply of opioids in a changing drug market.

BACKGROUND

In Denmark, rising concern over young people's non-prescribed use of opioids such as tramadol and oxycodone has fueled media narratives invoking predatory suppliers and vulnerable youth, with a key emphasis on kiosks and social media as venues that make opioids immediately accessible to young people. To inform effective policy responses, more nuanced, empirically grounded understandings of youth opioid sourcing are needed.

METHODS

The article draws on qualitative data from a Danish study on non-prescribed use of tramadol and oxycodone among treatment-enrolled young adults and stakeholders in prevention and treatment. We analyze interviews with 30 young adults (20 male, 10 female, aged 18-32, median age 24.2) enrolled in municipal opioid agonist treatment (OAT) across eight municipalities. Interviews explored pathways into use, treatment experiences, and sourcing practices. This analysis centers on data related to acquisition, with attention to the role of social networks in facilitating access to non-prescribed opioids.

RESULTS

Participants were predominantly young adults with prior experience of illegal drug use, often involving early initiation and poly-drug experimentation. The majority were introduced to opioids by friends or acquaintances and continued sourcing opioids through social networks, in addition to kiosks, online platforms, and prescriptions. Several participants had also engaged in small-scale sales or smuggling, often through existing relationships or to support their own use. Fluid boundaries between use and supply were common.

CONCLUSION

The study shows that young adults access opioids from a variety of sources that often start with sourcing opioids through social networks, especially during the early stages of use. These insights call for nuanced prevention strategies that move beyond individual consumer models and address the complex social dynamics of non-prescribed opioid access and use.