"The most recent data shows that drug producers continue to create new substances to avoid legal controls, although the rate at which new psychoactive substances are now entering the market appears to be slowing. Between 2016 and 2022, typically around 50 new psychoactive substances appeared on the market for the first time each year; this fell to 26 in 2023. In addition, around 400 previously reported new substances are detected on the market each year."

"With the growing availability of AAS [Anabolic-Androgenic Steroids] through online platforms [71, 72] the traditional reliance on social networks and healthcare providers for access to injecting equipment and safer use information has diminished [73–76].

"Community pharmacies are essential healthcare destinations that serve as an optimal resource for addressing non-urgent inquiries, such as safe injecting practices, management of adverse drug reactions, and medication provision, thus reducing the burden on general practitioners (GPs) [1, 2].

"The final theme emanating from this exploration is the notable affordances and ‘malaffordances’ of both platforms that facilitate IPED supply. To first address the former of these, a fundamental capitalist logic undergirds the replication of mainstream marketing tactics in the social media IPED market.

"The market for image and performance enhancing drugs has undergone seismic changes in the last two decades and, as has been alluded to above, its partial digitisation has created something of a dual space of commerce (Gibbs, Forthcoming). Before presenting an overview of the supply-side of the market however, it is worth considering the production of IPEDs.

"A total of 142 unique CEs [Cognitive Enhancers] were identified by NPSfinder®. They were divided into 10 categories, including plants/herbs/products (29%), prescribed drugs (17%), image and performance enhancing drugs (IPEDs) (15%), psychostimulants (15%), miscellaneous (8%), Phenethylamines (6%), GABAergic drugs (5%), cannabimimetic (4%), tryptamines derivatives (0.5%), and piperazine derivatives (0.5%). A total of 105 chemically different substances were uniquely identified by NPSfinder®. Only one CE was uniquely identified by the EMCDDA; no CE was uniquely identified by the UNODC."

"NPSfinder® identified 35 molecules (out of the total of 4,204) that were described by psychonauts as having cognitive enhancing effects, such as improved memory, alertness, attention, and concentration. A further 107 molecules were previously described as CE (7–9), although psychonauts did not explicitly describe them as CE.

"Cognitive enhancement may be defined as “the amplification or extension of core capacities of the mind through improvement or augmentation of internal or external information processing systems” (1).

"In the medical field, insulin is predominantly recognised as a fundamental component of treatment for type 1 diabetes mellitus and frequently employed in managing type 2 and gestational diabetes mellitus [1].

"At midyear 2019, the highest percentage of confined persons receiving MAT was reported in jails in the Northeast (3%), followed by jails in the Midwest and West (1% each) and jails in the South (0.4%) (table 7). Jails in the South accounted for more than half (53%) of the confined jail population at midyear 2019 but nearly a quarter (24%) of jail inmates receiving MAT (not shown in tables). In comparison, jails in the Northeast accounted for 10% of confined persons but 32% of those receiving MAT (not shown in tables).