Procurement pathways of illegal substances in Germany: A systematic review with implications for prevention, harm reduction, and drug policy (2025)

Purpose of Review: Illegal substance use is a global issue with significant health, social, and economic consequences, and Germany is no exception. This systematic review examines drug procurement methods in Germany, focusing on their mechanisms, market dynamics, and associated health risks, aiming to synthesize existing research on drug acquisition methods. By identifying key trends and gaps in the literature, this review provides a foundation for future research, and includes discussions of harm reduction strategies and policy interventions.
Recent Findings: A systematic search of MEDLINE, Embase, and Web of Science identified papers published in English or German between January 2009 and May 2024. Eleven studies (six qualitative, five quantitative) met the inclusion criteria, assessed using the Critical Appraisal Skills Program and Newcastle-Ottawa Quality Assessment Tool. Key findings revealed diverse procurement routes: cryptomarkets, street-based markets, self-cultivation, and social supply networks. Cryptomarkets, virtual marketplaces accessed via the Darknet and using cryptocurrency for transactions, ensure buyer anonymity and offer global reach with trust built through reviews and secure transactions. In contrast, street markets rely on interpersonal trust and geographic proximity. Social networks facilitate non-commercial sharing, especially of cannabis. Despite their potential, the role of social media in drug distribution remains underexplored in Germany. The COVID-19 pandemic highlighted market adaptability, with cryptomarkets navigating disruptions more effectively than street-based markets. Drug quality varied, with cryptomarkets often offering higher purity due to reputation-based incentives.
Summary: The procurement of illegal substances in Germany reflects a dynamic interplay of online and offline mechanisms. While cryptomarkets offer anonymity and quality control advantages, street markets continue to serve as vital supply points. Social supply networks and self-cultivation further diversify procurement routes. Despite these insights, the review identified significant research gaps, including gender-specific dynamics, the impact of cannabis legalization, and differences in drug quality across channels. This study underscores the complexity of Germany's drug markets, emphasizing the need for targeted research to address these gaps. Expanding knowledge in this area could inform harm reduction strategies and policy interventions tailored to Germany's unique drug procurement landscape. [Author's abstract]