Background: Amid the opioid overdose crisis, communities have formed around darknet markets to reduce the risks of darknet drug trade, including the harms of substance use. However, the nature and quality of harm reduction efforts by darknet market operators, drug vendors and substance users have not yet been examined.
Objectives: The aim of this research was to gain a deeper understanding and to evaluate this community-based peer-to-peer harm reduction activity.
Methods: A mixed-methods study was conducted to first explore the harm reduction topic of a darknet forum through qualitative content analysis, and then to further evaluate the results through focus group interviews involving harm reduction practitioners from Budapest, Hungary and Vancouver, Canada.
Results: The results showed that peer harm reduction among darknet operators, drug vendors and substance users is supported by both experts and professional organisations present in the darknet forum. The main theme of the darknet forum was drug testing, the availability of which depends on national legislation and the resources of local harm reduction organisations.
Implications: These findings highlight transnational variations in the role of global darknet markets in harm reduction and call on decision and policy makers to increase the cross-border availability of harm reduction programmes, the resources of harm reduction organisations and re-evaluate local drug policies.