Interview with Doctor X: Shaping the Darknet and Promoting Harm Reduction

DoctorX interviewed in Deep Web

Doctor X

We brought to the surface from the depths of the deep web the recent interview with Fernando Caudevilla, better known as Doctor X in the underworld.

This interview was originally published on the Pygmalion Shop blog, a darknet drug store. In it, Pygmalion (a popular and highly active vendor in darknet forums) interviews Dr. Fernando Caudevilla, better known as DoctorX

Dear Community,

When Doctor X contacted me on Telegram, I was rather excited.
He is one of the old heroes of the DN, that shaped the philosophy and culture as we find it today a lot with his harm reduction efforts. He is a physician who offered harm reduction advice on Silk Road and he was a key member of the Energy Control lab that tests drugs in Spain until 2019. He reached out to me because had been off the Darknet for a long time and was looking for ways to reconnect. Dread was not fully back up and only in beta mode. Of course I helped him out with a private Dread link so he could re-join our community.

It’s my hobby to do interviews with interesting DN personalities and I am grateful that Dr. X was so kind to answer some of my questions. Here we go.

Pygmalion: DrX, thank you for the opportunity to interview you. How are you?

Doctor X: Very well, thanks!

Pygmalion: Would you kindly explain who you are and what you are doing on the Darknet?

Doctor X: My name is Fernando Caudevilla, I am a family doctor and I live in Madrid with my husband and a crazy parrot. My personal interests include Japanese cuisine, fantastic B-movies from the 50s and 70s, electronic music and rave culture, ufology and boxing. One of the great things about Family Medicine is that it gives you a base from which to specialize in whatever you want. In my case I chose drugs, which have always interested me both personally and professionally. The traditional moralistic approach does not interest me at all, but the risk reduction/responsible use approach seems to me to be a very interesting and unexplored field by health professionals. In the last 20 years I have been involved in different activities related to training, research or direct care in areas such as risk reduction in recreational settings, therapeutic use of cannabis, new psychoactive substances, responsible use of steroids or chemsex. For example, between 2016-2019 I directed and coordinated the first chemsex website in Spanish ( The intersection of the Internet and drugs, the possibilities that opens for harm reduction and intervention has been a field of particular interest to me.

My early academic contributions centered around MDMA and the Internet. My friends started calling me “DoctorX”, a nickname that resonated with me due to its superhero-like quality. I embraced the pseudonym and used it for my popular articles, participation in drug-related internet forums, and as a medical advisor for Energy Control, a leading Spanish NGO dedicated to minimizing risks associated with recreational drug use. I have developed a significant part of my career (2001-2019) with this NGO. Well, now I am supposed to tell all the story about Silk Road, the marketplaces, Ross trial, Energy Control International….but it is all here. We can discuss the details you want.

Pygmalion: You used to be famous on the Darknet in Silk Road to Evolution times. Then you vanished. What happened?

Doctor X with Nice People Take Drugs t-shirt

Doctor X: Well, I have been off a long time indeed. I declared in Ross Ulbritch trial as a witness in 2015. The Federal Judge in charge of the case shamelessly manipulated my written testimony. In the final verdict against Ross, there are eight pages dedicated to insulting me, defaming me, and taking my words out of context. This circumstance, along with a series of subsequent events worthy of a crime novel, made me proceed with more caution, even though from the very beginning, Doctor X has been publicly linked to my real identity and no one has ever been able to accuse me of any illegal activity. Then we started the Energy Control International service. My last public show was in Vienna, at the 63rd session of the Commission on Narcotic Drugs.

It was so exciting to be in the zero zone of prohibitionism to talk about cryptomarkets and administrators as potential harm reduction agents. The last days we heard rumours about problems in airports due to a strange new disease….and we laughed thinking that maybe we could not come back to Spain. Then, one week later, the apocalypse was unleashed. I had to give up all my activities to work in a primary care center in chaotic and precarious conditions. My generation has been very fortunate to not have experienced a war in first person. The circumstances made the work as close as possible to a battlefield as I can imagine. Then I became ill and… well, we can simply say that the Spanish Health System has not behaved very well with its professionals. Then on the other hand, things at Energy Control International did not work well. I think we did an excellent job and I humbly believe that much of the credit goes to me. Let me just put it like this: It is horrible that after a break up, people can spend the whole day railing against their ex-partner. Things just stopped working out and between that and COVID, I was out of action for a couple of years.

Pygmalion: Thank you for providing the court material of Dread Pirate Robert’s case. I studied it. His lawyer argued that DPR made significant contributions to the harm reduction for drug users. To give the reader an inkling about the arguments used:

”The Silk Road web site provided features, including physician counseling, ratings of vendors, and improved accountability and trasparency, as well, conversely, an anonymous forum in which drug users and abusers could be candid about their drug use and abuse and seek advice not only about drug use, but also about drug safety, use reduction, and even ceasing such activity altogether.”

“Dr. Fernando Caudevilla [..] was also a critical part of the harm reduction ethos of the site. As Dr. Caudevilla affirms [..] [he] sent more than 450 messages to Silk Road users in response to requests for advice and assistance. [He] also spent up to two to three hours a day on the forum during that time frame providing expert advice as to drugs and health. [His] advice ranged from information as to safe dosage and administration of particular drugs as well as the risks attendant to the use of certain drugs, information as to where to find reliable and credible information about various substances on the internet, proper methods of drug administration, adverse effects, pharmacological interactions, advice as towhether particular combinations of drugs (both legal and illegal) should be avoided, advice as to how to stop use of particular drugs or drugs generally, to general medical and psychiatric advice related to drugs.”

“Dr. Caudevilla further explains that his contact with and assistance to Silk Road users was in part possible because ‘the administrator of the Silkroad site, Dread Pirate Roberts, was aware of [his] presence on Silk Road and was supportive of [his] role infurthering the harm reduction ethos of the site.”

“Dr. Caudevilla notes that he provided weekly reports to DPR which documented the topics [he] had discussed in [his forum] thread] [entitled ‘Ask a Drug Expert Physician About Drugs &Health’] during the previous week.”

“Dread Pirate Roberts never censored my views or advice in any way, even when I espoused views that Silk Road users should not use or buy certain drugs sold on the site …, discouraged drug use, or helped customers to reduce or cease drug use entirely.”

“In fact,, when the demand for Dr. Caudevilla’s advice became a burden because of the time it consumed in Dr.Caudevilla’s day, DPR even offered to pay Dr. Caudevilla $500 a week to continue to provide advice to site users.”

“As Dr. Caudevilla attests, ‘as a result of his personal experiences working with customers on the site, and monitoring the site’s drug safety forums,’ he has first hand knowledge that SilkRoad provided site users with the tools to take drugs in a safer and more informed manner, espoused a harm reduction ethos which was reflected in the individual buyer-seller transactions on the site and in the community created on the site’s forum, and enabled some site participants to actually reduce, if not entirely eliminate, their drug use. For example, some heroin users were drawn to Silk Road because it provided them access to methadone, a drug utilized in many countries, and administered by physicians, to enable heroin users to end their addictions. For many Silk Road users methadone was illegal or unavailable in their home countries. Accordingly, they would likely not have had access to the resources necessary to reduce their heroin use without the Silk Road.”

The judge, however, saw things differently.

“The Court notes that there is the presence of Dr. X who deserves special mention in his particularly despicable — that he has been pointed to as a big part of the harm reduction. I have read each and every post of Dr. X and I was blown away and infuriated by it. A doctor who wants to sell Fentanyl patches? Expired Fentanyl patches? So, it is absolutely clear that Dr. X is part of the problem, he is not part of the solution and, again, it is magicial thinking to think so. So, let’s talk about Dr. X because he is an absolute enabler. He is a positive marketing event to get people to use drugs. Does that mean he never ever helped people discuss how to titrate down oncertain drugs? No. I’m not suggesting he didn’t do that. I’m suggesting that havings omebody there who can also say ‘Hey, yeah, ecstasy is not a bad thing, here is how you do it. That’s fine.’ That’s enabling.

The first post of Dr. X on Exhibit 4 in Ms Lewis’ affidavit is an example of the problem. He is told that an individual has never done MDMA — ecstasy — but is interested in exploring it. –market expanding — The individual discloses that he has Type 1 Diabetes. Dr. X states that MDMA would be okay nonetheless.”

“In another post he glibly advises that ‘all drugs are absolutely harmless. They won’t, in his words, assault you or rape you.”“To an 18-year old who states he is concerned that he has a developing brain Dr. X advises: ‘but given how you’re on Silk Road and your mannerism of speaking, be careful, and I feel you’ll be fine. Stick to psychedelics’.

Doctor X at Boom Festival

So it is therefore clear that the judge came from an entirely different philosophical background and believes that recreational drug use is not something that should be done and that advocating that safe use is possible is automatically evil, or as he calls it“market expanding”, thus calling Dr. X efforts “despicable”. That is the essence of the war on drugs. People on one side would like to enjoy their right to do with their own bodies as they want freely without oppression. On the other side we have paternalistic leaders who want to push their own personal views on drugs on other people using guns, violence, and prison cells.

Doctor X: The issue of the $500/week in BTC that DPR offered me was highlighted in many media outlets. There is nothing surprising about this as I was the one who provided the court with this information during my deposition. In any case, most of my work was funded by anonymous donations. DPR enters the story when he decided to advertise my work not only on the SR forums but on the website itself was when I wrote to him saying “Hey, man…I appreciate you considering my work but I’m already putting in 2-3 hours a day on this and I can’t take on any more extra work”. Then and now, I am not looking for any specific “offer”. It is safer to work with anonymous donations.

Pygmalion: What brings you back now?

Doctor X: The time I spend now on DW activities is much more limited. I periodically post a series of comprehensive guides on harm reduction and drugs on the Dread forum, which in my view is the most significant meeting point for the narcocrypto community. I also answer questions about drugs and health there, both in public and through private messages. The time I can dedicate is limited and depends on the donations I receive. In this “second season” in which I have only been working for six months the capital raised amounts to 1 XMR, which does not make it easy for me to give up time from work in the real world to dedicate to the Deep Web. I am not waiting for an specific offer as in Silk Road times and, in fact, I prefer annonymous donations. And I am not here just for the money (in that case I would have tried as a vendor). But, obviously I could dedicate more time to my work in Deep Web with some financing. Some events have happened that have encouraged me to come back. The most significant one has to do with a Canadian girl who is positively crazy. One day, she showed up at my office in Madrid in 2018. She had done some research on Dr. X. I have published a lot on the Internet. She said that I have an amazing story to tell about my work. It could be the subject of a novel, a film or a documentary. I told her everything I could off my chest.

She has kept nagging and hounding me for the last three years until I finally said “OK, let’s do it”. So with a Spanish novelist we are working on the novel “DoctorX: the Darknet Physician”. I still think the Canadian is crazy and that no multinational publisher is going to buy it, though I admit the prospect gives me a strange mixture of excitement and dread. And that precipitated my return to the Deep Web. If in 2013 it was the Silk Road forum that was the hub of activity, now it’s Dread. So with the help of the Pygmalion, whom I first contacted via Telegram, I was able to get back on Dread back to work. I still believe that cryptomarkets forums are an ideal place to interact with users, vendors and administrators to provide knowledge and tools to protect their health. It is curious that in the real world almost nobody dares to talk to their doctor about drugs for fear of moralistic attitudes and value judgements. However, DoctorX always has two or three queries in his mailbox about aspects that, in an ideal world, should be discussed naturally in a doctor’s office.

Pygmalion: Regarding the “63rd session ofthe Commission on Narcotic Drugs” in Vienna that you mentioned earlier. How was your acceptance among your academic peers there, considering their research is basically opposing your own interests?

Doctor X: I do not agree with the idea that academic research is opposed to harm reduction. There are lines of work in this direction being developed by scientific societies, peer-reviewed scientific journals and university working groups. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), the European Union’s official body on drugs, supports this line of work and in fact they counted on me for the first monograph on cryptomarkets that was published in 2016.

In this sense, I have had the good fortune to work with some of the world’sleading researchers, such as Judith Aldrigde (University of Manchester) and Monica Barratt (University of New South Wales). It is true that the impact of this line of work is limited compared to the dominant drug policies imposed by uncivilised countries such as the UnitedS tates, Russia or China.

Pygmalion: Can you quickly summarize the final outcome of that commission? Are the people on the DN going to benefit from it or is it harmful for the community?

Doctor X: Well, I explained to them that crypto markets have a lot of potential for harm reduction. In five years, we analysed close to 6 thousand samples. Notably, at a certain point in time, we detected 10 fentanyl samples. We decided to publish immediately because it was the first time this happened in Europe. We had clear and irrefutable evidence about the vendors. I contacted them. The administrator. And then the vendor was banned immediately.

Key to note that take downs are strongly linked to innovations. Making the next time you need to infiltrate more difficult on yourself. Requires more resources, skills, and time. Imagine an ever increasing circle with the need to put in huge resources to find vendors of low scale. What if those same skills were deployed to combat guns or child porn? Should consider where best to deploy resources, against a system that has positive harm reduction capacity or against those that are clearly wrong? What are we driving cryptomarkets towards? If we continue to crackdown, push people towards total lack of centralization with no oversight mechanism, and cause more people to be scammed. Think about what direction we are policing towards. People buying on Telegram and closed Facebook routes is increasing. Hard to get to those dealers. It is the wild west on Telegram. Unintended consequences of taking down crypto markets is that they move to areas with no supervision by anyone.

I believe the impact can be positive, but it is not direct or short term. I think that just being able to explain that NDs are not necessarily the Gates of Mordor in front of the main actors of global drug policy is already a good thing. Current policies have turned out to be a disaster (even more so in the case of Deep Webcrypto-markets). Isolated intervention will not bring about major changes, but little by little we will have no choice but to look for more rational alternatives.

Drug cryptomarkets in the 2020s: policy, enforcement, harm, and resilience

See the side event  

Drug cryptomarkets in the 2020s: policy, enforcement, harm, and resilience
(part I and II).

Pygmalion: It’s a shame people cannot consult their own physicians about their drug habits. What are good resources for people to educate themselves about safe drug use?

Doctor X: Drug use should be seen as a human behaviour in which potential positive (pleasure) and negative (risks) consequences are at stake. The same is true for sexuality, sports or travel. Unfortunately, there is still a moral high ground in this respect. At the international level, Erowid still seems to me to be the most important resource. I think AI can be a very interesting resource in the near future although ChatGPT is still poorly trained in this respect.

Pygmalion: Is there a good mainstream media source for your mission right now? Has a broadcast channel depicted you in a way that you agree with?

Doctor X: No, although in that sense I am in open recruitment. Regarding my image in the media, whenever you expose yourself publicly you take a risk. Especially when it has to do with doctors, drugs and cryptomarkets. In that sense, I have had experiences that I have found more or less agreeable. But that’s OK too. There’s no need to make a big deal out of these things. By the way, a few months ago I was proposed a very crazy idea. A novel about DoctorX and his adventures in the cryptomarkets. I am aware that, as a doctor, I’ve had some strange things happen to me . But being the character of a novel is, without a doubt, the most bizarre. In any case, in October 2024, the novel “DoctorX: The Darknet Physician” will be released. It is written by Jose Angel Mañas (a prestigious writer, his novel “Historias del Kronen” is known all over Spain) and will be published by one of the main publishers in the country. We are looking forward for an English and French edition.

Pygmalion: What books have influenced youmost in your life?

Doctor X: History of Drugs (Antonio Escohotado, 1986), Manufacturing Consent (Adam Chomsky, 1988), Sex (Madonna,1993), The Doors of Perception (Aldous Huxley, 1954), Acid Dreams (Martin Lee,1985).

Pygmalion: What would you recommend influential DN people do next to improve the infrastructure, quality, whatever?

Doctor X: I believe that shared strategies could be established between market administrators, vendors, significant forum administrators (currently Dread) and the professionals, teams and programs working on Harm Reduction. I am not only referring to economic funding. Drug cryptomarkets could be an ideal environment to launch activities and programs specifically targeted at drug users.

Pygmalion: Do you have a good youtube music recommendation for an MDMA trip with friends? 

Doctor X: I can’t think of a specific list…if some recommendations…anything by Orbital or The Chemical Brothers (there are some DJ sets on Youtube). The Goa-psy trance genre also seems appropriate (X-Dream, Astrix, Juno Reactor, Infected Mushrooms…). In a calmer style, some Moby tracks (Bowie´s “Heroes”, “We are all made of stars”…) sound great under the effects of MDMA.

Pygmalion: Would you like to give some shout outs to people who you like? 

Doctor X: YESSS….I love it….I want to say hello to all my little friends in the real world (especially Irene and Concha).Also to my friends and fans in the virtual worlds. I also greet the President of the United States to ask him to commute the disproportionate and inhumane life sentence imposed on Ross Ulbritch. And to Madonna, to wish her a speedy recovery from her health problems.

Pygmalion: Dr. X, thank you for sharing so much of your time with us and being so open about yourself and what you do. I learned a lot about the history of DPR, the founder of the modern Darknet as it is today and it has been so exciting to read a lot of the philosophical foundation that still influences the community greatly today. DPR wasn’t only a capitalist, but also a practicioner of his libertarian values that he shared and discussed publicly with the community and that we continue today. While he made some moral errors,as we all do, he got some things right and by studying his life we can benefit from both. Your harm reduction contributions are still very present today and shaped the quality of Dread’s own /d/Harmreduction. Thank you for that.

Thank you for reading.

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