A Systematized Review of Drug-checking and Related Considerations for Implementation as A Harm Reduction Intervention

Giulini, Francesca; Keenan, Eamon; Killeen, Nicki; Ivers, Jo-Hanna

doi:10.1080/02791072.2022.2028203

Cited by 23 publications

(23 citation statements)

References 33 publications

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“…If affordable (and politically/legally feasible [16,53]) offering a range of DCS technologies seems the best possible model at present. [24,54] Regardless of the technologies available however, the rapidly changing street drug market and the seemingly constant evolution and availability of new analog synthetic opioids will present continued challenges to any testing technology used to provide DCS to street drug users [17]. Drug checking technologies will have to also be capable of rapidly evolving to detect newly synthesized drugs as they are added to the illegal drug supply.…”

Section: Discussionmentioning

confidence: 99%

Current Attitudes Toward Drug Checking Services and a Comparison of Expected with Actual Drugs Present in Street Drug Samples Collected from Opioid Users

Swartz¹,

Lieberman

Jimenez³

et al. 2022

Preprint

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Background: The opioid epidemic continues to cause high numbers of fatalities in the US and other countries, driven mainly by the inclusion of potent synthetic opioids in street drugs. Drug checking by means of various technologies is being increasingly implemented as a harm reduction strategy to inform users about constituent drugs in their street samples. We assessed how valued drug checking services (DCS) would be for opioid street drug users given the ubiquity of fentanyl and related analogs in the drug supply, the information they would most value from drug checking, and compared expected versus actual constituent drugs in collected samples. Methods: A convenience sample of opioid street drug users (N = 118) was recruited from two syringe service exchange programs in Chicago between 2021-2022. We administered brief surveys asking about overdose history, fentanyl preference, and interest in DCS. We also collected drug samples and asked participants what drug(s) they expected were in the sample. Provided samples were analyzed using LC-MS technology and the results compared to their expected drugs. Results: Participants reported an average of 4.4 lifetime ODs (SD=4.8, range=0-20) and 1.1 (SD=1.8, range=0-10) past-year ODs. A majority (92.1%) believed they had recently used drugs containing fentanyl. Opinions about the desirability of fentanyl were mixed with 56.1% indicating they did not and 38.0 % indicating they did prefer fentanyl. Attitudes towards DCS indicated a general but not uniform receptiveness with a majority indicating interest in DCS though sizeable minorities believed DCS was ”too much trouble” (25.2%) or there was “no point” in testing (35.4%). Participants were especially poor at identifying common cutting agents and potentiating drugs such as diphenhydramine in their samples. They reported having quantitative information on drug concentrations and identification of all constituent drugs present in a sample would be especially valuable. Conclusions: Results affirmed street drug users remain interested in using DCS to monitor their drugs and such services should be more widely available. Advanced checking technologies that provide information on the relative quantities and the different drugs present in a given sample available at point-of-care, would be most valuable but remain challenging to implement.

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Section: Discussionmentioning

confidence: 99%

Current Attitudes Toward Drug Checking Services and a Comparison of Expected with Actual Drugs Present in Street Drug Samples Collected from Opioid Users

Swartz¹,

Lieberman

Jimenez³

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…According to multiple contributions to this special issue, test results do not match purchase intent for approximately 12%–17% of tested substances of concern (Barratt et al , 2022; Díaz Moreno et al , 2022; Kaskela et al , 2022; Kushakov et al , 2022; Measham and Simmons, 2022; Valente et al , 2022). When tested substances of concern do not match expectations, a robust and growing body of research (Measham, 2019; Valente et al , 2019; for a review, see Giulini et al , 2022; Maghsoudi et al , 2021) finds that service users discard these substances. This finding was replicated in two contributions to this special issue with comparable methods (Barratt et al , 2022; Measham and Simmons, 2022).…”

Section: Past and Present Resistance And Challengesmentioning

confidence: 99%

“…Is advocating for the legalisation and regulation of psychoactive drugs not more efficient? Firstly, if a test result does not match purchase intent, there is a robust and growing evidence base concurring that the majority of service users throw away substances of concern (for reviews, see Giulini et al , 2022; Maghsoudi et al , 2021). What is currently lacking, however, are analyses of existing independent public health data to show that discarding substances of concern could be correlated with a reduction in drug-related incidents at local or national level as a consequence, over the period that DCS were in operation.…”

Section: Recommendationsmentioning

confidence: 99%

Challenges, policy and politics in drug checking: reflections of the TEDItorial team

Linden

Koning

Gouwe

et al. 2022

DHS

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Purpose The purpose of this paper is to present some of the continued resistance and challenges faced by drug checking services (DCS) and review how the existing literature and the contributions to the special issue address them, with a view to making recommendations. Design/methodology/approach The existing literature and the contributions to the special issue are reviewed. Findings Drug checking cannot be equated with quality control. With the appropriate equipment and chemistry staff, DCS can provide quantitative analysis and reliable results. When the product does not match expectations, service users discard the tested substance of concern. To more easily compare the results of different studies and better evaluate drug checking, standardisation of measures is desirable. Uptake of drug checking, notably in festivals, is low and depends in part on the capacity of DCS. Drug checking has added value in monitoring drug markets and is complementary with chemical (forensic) analysis. Originality/value This paper interrogates in a relatively comprehensive way the continued resistance to drug checking in light of theoretical and empirical research to derive recommendations that are specific to drug checking and that are addressed to health professionals, researchers and also to policymakers.

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“…More than a decade later, DCS reached Europe. In the past 30 years, these services have been disseminated worldwide (Brunt, 2017; Barratt et al , 2018) and, until recently, mainly served partygoers (Kriener et al , 2001; Maghsoudi et al , 2021; Giulini et al , 2022).…”

Section: Introductionmentioning

confidence: 99%

Drug use patterns, harm reduction strategies and use of drug checking services in boom festival patrons

Valente

Martins²,

Pinto³

et al. 2022

DHS

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Purpose Recent studies have shown that people who attend electronic dance music events and use drug checking services (DCS) are a predominantly white male, highly educated middle-class population. However, there is still a lack of data beyond sociodemographic characteristics that must be addressed. This paper aims to describe the drug use patterns and protective behavior strategies (PBS) used by testers and nontesters at Boom Festival 2018 and analyze the relationship between these behaviors and the decision to use the DCS. Design/methodology/approach This is an exploratory research based on a cross-sectional design using baseline data collected at the Boom Festival from testers (N = 343) and nontesters (N = 115). Findings Nontesters presented, in general, slightly higher frequencies of use for most drugs, whereas testers tended to adopt PBS more frequently. Moreover, testers planned their drug use more often than nontesters and set more limits on the amount of drugs they used in one session. Both of these behaviors work as predictors for using the DCS. Practical implications Our data suggest that DCS might not be easily accessible to all people who use drugs, reaching almost exclusively highly educated people that already apply several harm reduction strategies. Actions should be taken to promote service accessibility. Originality/value To the best of the authors’ knowledge, this paper is the first to compare the demographics, drug use and PBS adoption of DCS users with nonusers who attended the same festival.

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A Systematized Review of Drug-checking and Related Considerations for Implementation as A Harm Reduction Intervention

Cited by 23 publications

References 33 publications

Current Attitudes Toward Drug Checking Services and a Comparison of Expected with Actual Drugs Present in Street Drug Samples Collected from Opioid Users

Current Attitudes Toward Drug Checking Services and a Comparison of Expected with Actual Drugs Present in Street Drug Samples Collected from Opioid Users

Challenges, policy and politics in drug checking: reflections of the TEDItorial team

Drug use patterns, harm reduction strategies and use of drug checking services in boom festival patrons

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