Nonmedical drug use (NMPU) is one of the biggest health challenges facing the world today. The reasons for NMPU are highly variable, and to some extent differ according to the class of drug concerned, but the underlying cause is quite clear. The world is often not a happy place and consumers want easy access to drugs to help them feel happier. The top sellers on the dark net are all mood-altering drugs. The major groups either blunt emotions or heighten them.

Dark net consumers choose drug not by efficacy nor safety but by vendor trust and feedback from other e-customers.

The major categories of drugs in e-commerce on the dark net are: cannabis and cannabinoids; stimulants, e.g., crack; psychedelics, e.g., LSD; empathogens, e.g., MDMA, and opioids.

Dark net buyers, who may otherwise be respectable members of society, are reduced to operate from a position of enforced deviance. Buyers become compelled to accept their deviance and justify their behaviour (even if they don’t think it is deviant). Initially they rationalize their behaviour with the justification of careful management of their use to promote the semblance of adult control.

This control is rarely maintained. Rates of NMPU are increasing throughout the world, and resulting in increases in drug-related hospital attendances and deaths. In 2016, 21% of drug-related emergency hospital presentations were associated with the misuse of these drugs.

Buyers beware strenuously applies to the dark net.  Lack of control and regulation means purchasers don’t know what they’re getting and the products received may not only be ineffective but dangerous.

Dark net consumers currently have few resources to determine the quality of dark net products.  Dark net consumers choose their drug not by traditional measures of efficacy nor safety but by vendor trust and feedback from other e-customers. Monitoring these vendors is difficult. Short lifespan of the websites and proxy servers can obfuscate sellers and regulators.

The leading shipping countries, the US, UK, Germany, Netherlands, Canada Spain, China, Finland, Norway, Philippines, India, Australia, and Belgium, need to act decisively to prevent more deaths occurring.

Clearly the dark web cannot be stopped; nor happiness and excitement prescribed. Healthcare professionals, however, should routinely ask about the dark net as a potential source of procurement of both prescription and non-prescription drugs.

Education is also important: not just in schools and public awareness campaigns. These new forms of drug distribution need to be discussed and legitimised, not regulated.

In addition, consumer organisations need to embrace these new developments and start educating the public about efficacy, safety, safe purchasing and health protection just as they do about non -drug consumables.  Just as cars and refrigerators may be tested and ranked, so too light should be shone on the dark web.