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.

中文翻译：

---

全球趋势，局部危害：俄亥俄州的深色网上有芬太尼类药物的供应和俄亥俄州的意外过量

由于美国的阿片类药物危机已成为“流行病的流行病”，俄亥俄州已被确定为与芬太尼相关的过量用药死亡率高负担的州之一。这项研究旨在检查加密市场上芬太尼，芬太尼类似物和其他非药物类阿片类药物的供应变化，并评估与俄亥俄州无意识用药过量趋势之间的关系，以便为流行病学监测提供及时的信息。加密市场数据是在两个不同的时间段收集的：（1）2014年6月至2015年9月的Agora数据是从Grams档案库中获得的；（2）使用专用搜寻器提取了2018年3月至4月的Dream Market数据。开发了一种命名实体识别算法，以识别和分类在加密市场上宣传的芬太尼和其他合成阿片类药物的类型。时滞相关性用于评估来自加密市场的芬太尼，芬太尼类似物和其他合成类阿片相关广告之间的关系，以及辛辛那提消防局紧急响应和蒙哥马利县验尸官办公室的过量数据。加密市场数据的分析表明，芬太尼类药物的增加以及芬太尼类似物和其他合成阿片类药物的类型在2015年和2018年投放广告，第二阶段可利用有效成分如芬太尼。将Agora数据与1个月后的辛辛那提紧急响应进行比较时，时滞相关性最大，为0.84（95％CI 0.45，0.96）。当将合成类阿片相关的集市广告与7个月后的蒙哥马利县药物过量死亡进行比较时，集市数据与蒙哥马利县药物过量之间的时间滞后相关性最大，为0.78（95％CI 0.47，0.92）。需要进行进一步的调查以建立密码市场的可用性与与特定芬太尼类似物和/或其他非法合成阿片类药物有关的无意用药过量趋势之间的关系。