In reference to the severity of the impact of synthetic drug markets, of the 193 states reviewed for the Index a total of 22 were given a score of between 8 and 10.9 These are shown in red in Figure 1. [...] Synthetics have infiltrated and established domestic markets to varying degrees of criminal influence and harm in 187 of the 193 countries assessed in the Index.13 In the context of considering the presence of synthetic drug markets glob- ally with the generally perceived ubiquity of heroin (178/193), cocaine (192/193) and ILLICIT SyNTHETIC dRuG MARKETS: GLOBAL OVERVIEW 7 Criminal influence of dom. [...] This can be demonstrated in a review of five patterns and features: the opioid crises; the decentralization of production and diversity of actors; the democratization of information, technology and commerce; the emergence of potent poly-substances; and the vastness of what we still don’t know. [...] We see this in the increased levels of local production of meth, MdMA and methaqualone in southern African markets;109 the growth in fentanyl and meth production in the western provinces of Canada, and its shipment to Australia and the Pacific islands;110 and in the rapid escalation in the number of new actors and local labs tackling alpha-PVP production in ukraine following the Russian invasion.1. [...] How do we anticipate and prepare to respond to an extended synthetic drug-related health crisis within the vast, largely unknown market spaces of the 187 synthetic drug market countries of the world – particularly when the response to the original opioid crisis itself has been so muted, and mostly unsuccessful? SCANNING THE HORIZON 37 SYNTHETIC DRUGS THE PRESENT AND THE FUTURE Synthetic drugs are.
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