Drug checking: a potential solution to the opioid overdose epidemic?

Bardwell, Geoff

doi:10.1186/s13011-018-0156-3

Cited by 38 publications

(25 citation statements)

References 6 publications

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“…A 2017 evidence review of drug checking technologies and research concluded that communitywide drug checking may be instrumental as part of public health responses in British Columbia, and potentially a life-saving harm reduction service [12]. At the same time, caution is advised as "[I]mplementation in the absence of rigorous evaluation could result in the wasting of precious resources, and more importantly, more lost lives to fatal overdose" [13] (p. 2).…”

Section: Introductionmentioning

confidence: 99%

What is needed for implementing drug checking services in the context of the overdose crisis? A qualitative study to explore perspectives of potential service users

et al. 2020

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Background: The current illicit drug overdose crisis within North America and other countries requires expanded and new responses to address unpredictable and potentially lethal substances, including fentanyl analogues, in the unregulated drug market. Community-wide drug checking is being increasingly explored as one such public health response. We explored how drug checking could be implemented as a potential harm reduction response to the overdose crisis, from the perspective of potential service users. Methods: The research was guided by the Consolidated Framework for Implementation Research (CFIR). We conducted a qualitative, pre-implementation study to inform development and implementation of drug checking services that are acceptable to people who use substances and meet their needs. University and community researchers conducted 27 in-depth interviews with potential service users at prospective drug checking sites. We inductively developed emerging themes to inform the implementation of drug checking services within the five domains of the CFIR, and identified the most relevant constructs. Results: Implementing community drug checking faces significant challenges within the current context of criminalization and stigmatization of substance use and people who use/sell drugs, and trauma experienced by potential service users. Participants identified significant risks in accessing drug checking, and that confidential and anonymous services are critical to address these. Engaging people with lived experience in the service can help establish trust. The relative advantage of drug checking needs to outweigh risks through provision of accurate results conveyed in a respectful, non-judgemental way. Drug checking should provide knowledge relevant to using and/or selling drugs and informing one's own harm reduction.

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Section: Introductionmentioning

confidence: 99%

What is needed for implementing drug checking services in the context of the overdose crisis? A qualitative study to explore perspectives of potential service users

et al. 2020

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“…The public health response to the opioid overdose epidemic has been challenging, given the proliferation of illicit fentanyl and fentanyl-adulterated drugs across the continent (Ciccarone, 2017; Fairbairn, Coffin, & Walley, 2017). Given the reality of a poisoned illicit drug market, there has been a variety of public health interventions implemented in various settings to address the overdose crisis, including naloxone training and distribution (Bardwell, Fleming, Collins, Boyd, & McNeil, 2019; Sherman et al, 2009; Tobin, Clyde, Davey-Rothwell, & Latkin, 2018), drug checking programs (Bardwell & Kerr, 2018; Krieger et al, 2018; Peiper et al, 2019; Tupper, McCrae, Garber, Lysyshyn, & Wood, 2018), and supervised injection sites (Boyd et al, 2018; Kral & Davidson, 2017; Strike & Watson, 2019; Wallace, Pagan, & Pauly, 2019).…”

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confidence: 99%

The Opioid Overdose Epidemic and the Urgent Need for Effective Public Health Interventions That Address Men Who Use Drugs Alone

2019

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is amid an overdose crisis that is showing no signs of slowing down. In 2017, there were 10.9 opioid-related deaths per 100,000 individuals in the United States (Ahmad, Rossen, Spencer, Warner, & Sutton, 2018). In Canada, data from the first half of 2018 show a rate of 11.2 opioid-related deaths per 100,000 individuals (Government of Canada, 2018) and as high as 31 deaths per 100,000 individuals in the province of British Columbia (BC Coroners Service, 2019). The public health response to the opioid overdose epidemic has been challenging, given the proliferation of illicit fentanyl and fentanyl-adulterated drugs across the continent (Ciccarone, 2017;Fairbairn, Coffin, & Walley, 2017). Given the reality of a poisoned illicit drug market, there has been a variety of public health interventions implemented in various settings to address the overdose crisis, including naloxone training and distribution (Bardwell, Fleming, Collins,

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“…Drug checking services, wherein individuals can determine if there are contaminants, such as fentanyl, in the drugs they are planning to consume, have been recommended as one avenue to prevent poisonings [79, 80]. Various technologies are used for drug checking, including lower-cost options (e.g., fentanyl urine test strips) and more advanced laboratory techniques (e.g., mass spectrometry) [81].…”

Section: Resultsmentioning

confidence: 99%

Lessons learned from the opioid crisis across the pillars of the Canadian drugs and substances strategy

Taha

Maloney‐Hall

Buxton

2019

Subst Abuse Treat Prev Policy

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Background: Canada is facing an urgent challenge to reduce the harms associated with opioids: from January 2016 to December of 2018, more than 11,500 individuals lost their lives due to opioid related harms. This review examines responses to the opioid crisis thus far, the lessons learned from these initiatives and the knowledge gaps that still need to be addressed across the four pillar model adopted by the CDSS. Methods: A search of peer-reviewed literature was conducted in PubMed and PsycNet, and grey literature was retrieved from reputable substance use and health organizations to determine responses to the opioid crisis and related outcomes between 2013 and 2019. Findings related to actions, outcomes and unintended consequences across the categories of prevention, treatment, harm reduction, enforcement and the evidence base were included and synthesized into a narrative review on lessons learned. Results: The opioid crisis is a result of multiple, complex interrelated factors. Many physicians may not feel competent to appropriately treat pain and/or addiction. Pushes for opioid deprescribing have resulted in some individuals using illicit opioids as treatment. A range of effective and accessible pharmacological and psychological treatments are still required. When regulations are barriers, unsanctioned actions, such as overdose prevention sites, may be enacted by individuals to respond to urgent public health needs. A nimble response with evolving enforcement perspectives can aid individuals experiencing harms from opioid use. Conclusions: There is no one size fits all response to this crisis, and consideration should be given to the unique needs of different communities and populations, as well as the broader impact of harms on families, communities, and society. A situation so multifaceted requires both immediate and long-term strategies implemented concurrently in order to address the differing and ongoing needs of Canadians experiencing opioid harms. The expertise of individuals and families affected by the opioid crisis must be included in consultations and decisions related to different strategies, to ensure responses are not stigmatizing, that they will be effective and acceptable and that unintended consequences are quickly recognized and mitigated.

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Drug checking: a potential solution to the opioid overdose epidemic?

Cited by 38 publications

References 6 publications

What is needed for implementing drug checking services in the context of the overdose crisis? A qualitative study to explore perspectives of potential service users

What is needed for implementing drug checking services in the context of the overdose crisis? A qualitative study to explore perspectives of potential service users

The Opioid Overdose Epidemic and the Urgent Need for Effective Public Health Interventions That Address Men Who Use Drugs Alone

Lessons learned from the opioid crisis across the pillars of the Canadian drugs and substances strategy

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