Objectives: Although the COVID-19 pandemic is believed to have impacted unregulated drug markets globally, precise impacts in North America have not been characterized. We sought to estimate potential changes in availability and price of unregulated drugs pre- vs. post-pandemic in Vancouver, Canada.
Methods: Data were derived from two prospective cohorts of people who use drugs in Vancouver from 2018-2022. We utilized interrupted time series analyses to identify changes in monthly prevalence of immediate availability (within 10 minutes) and median street price of crystal methamphetamine, cocaine, crack cocaine, and ‘down’ (unregulated opioids), post-pandemic (i.e. post-March 2020) among 739 participants.
Results: Monthly prevalence of immediate availability significantly decreased for all drugs immediately post-pandemic (all p<0.05). Cocaine declined most by -18.1% (95% confidence interval [CI]:-25.9, -10.4) and ‘down’ declined least by -13.0% (95% CI:-18.8, -7.3). There were no significant changes in trends of monthly prevalence of any drugs post-pandemic (all p>0.05). The only significant change in median street price was for cocaine which increased by $3.46 per 0.5 grams (95% CI:1.0, 5.9).
Discussion: For all drugs examined in this study, except for cocaine, the stagnant price amidst decreased availability may reflect increased contamination of unregulated drugs post-pandemic in our study setting. These findings may have implications for drug policy and practice approaches, particularly in regions where synthetic psychoactive substances are emerging in the drug supply.