Putting an Ecstasy Test Kit to the Test: Harm Reduction or Harm Induction?

Murray, Rebecca A.; Doering, Paul L.; Boothby, Lisa A.; Merves, Michele L.; McCusker, Rachel R.; Chronister, Chris W.; Goldberger, Bruce A.

doi:10.1592/phco.23.12.1238.32704

Cited by 31 publications

(24 citation statements)

References 21 publications

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“…Much has been written on strategies people use to minimize the potential risks associated with use of other drugs, especially MDMA/Ecstasy (Allott & Redman, 2006; Carlson et al, 2004; Carlson, Falck, McCaughan, & Siegal, 2004; Kelly, 2005; Murray et al, 2003; Rosenbaum, 2002). Since pain pill use more commonly occurs in private settings as opposed to public venues, has a less-well defined “subculture” of use, and because of the different nature of the drugs involved, risk minimization activities among pain pill users are unlikely to develop into an “indigenous” movement similar to the ones observed among MDMA/Ecstasy users.…”

Section: Discussionmentioning

confidence: 99%

“I’m not afraid of those ones just ‘cause they’ve been prescribed”: Perceptions of risk among illicit users of pharmaceutical opioids

Daniulaityte

Falck

Carlson

2012

International Journal of Drug Policy

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Background There has been a rise in the illicit use of pharmaceutical opioids (”pain pills”) in the United States. Conducted with young adult non-medical users of pharmaceutical opioids, this study uses qualitative methods and cultural consensus analysis to describe risk perceptions associated with pharmaceutical opioids and to determine patterns of cultural sharing and intra-cultural variation of these views. Methods The qualitative sub-sample (n=47) was selected from a larger sample of 396 young adults (18–23 years old), who were participating in a natural history study of illicit pharmaceutical opioid use. Qualitative life history interviews, drug ranking task, and cultural consensus analysis were used to elicit participant views about risks and harms associated with pain pills and other drugs, as well as alcohol and tobacco. Results Cultural consensus analysis revealed that the participants shared a single cultural model of drug risks, but the level of agreement decreased with the increasing range of drugs ever used. Further, those with more extensive drug use histories differed from less “experienced” users in their views about OxyContin and some other drugs. Overall, pain pills were viewed as addicting and potentially deadly substances, but these properties were linked to the patterns and methods of use, as well as characteristics of an individual user. Further, risks associated with pharmaceutical opioids were further curtailed because they “came from the doctor,” and thus had a legitimate aspect to their use. Conclusions This study highlights potential problems with universal approaches to substance use prevention and intervention among young people since such approaches ignore the fact that substance use education messages may be experienced differently depending on an individual’s drug use history and his/her perceptions of drug risks. Findings reported here may be useful in the development of prevention and intervention programs aimed at reducing the harm associated with illicit use of pain pills.

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Section: Discussionmentioning

confidence: 99%

“I’m not afraid of those ones just ‘cause they’ve been prescribed”: Perceptions of risk among illicit users of pharmaceutical opioids

Daniulaityte

Falck

Carlson

2012

International Journal of Drug Policy

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“…In attempts to reduce harms associated with the use of psychoactive drugs at dance parties, many organizations are providing presumptive color test kits for users to test their drugs. Murray evaluated screening kits for MDMA testing and concluded they should not be used by the public to give a false sense of security as pure and adulterated forms cannot be distinguished. A recent review in the Harm Reduction Journal compared methods of drug analysis for suitability in point‐of‐care services and found color tests to be the best lower technology option due to lower costs, ease of use and rapid results afforded .…”

Section: Current Situationmentioning

confidence: 99%

“…85 In attempts to reduce harms associated with the use of psychoactive drugs at dance parties, many organizations are providing presumptive color test kits for users to test their drugs. Murray 86 Reduction Journal compared methods of drug analysis for suitability FIGURE 4 Chemical reactions of common color spot tests that are selective toward a drug class. DuquenoisLevine reagent for cannabinoids (a); Mecke reagent for opium alkaloids (b); Scott's reagent for cocaine (c); Dille-Koppanyi reagent for barbiturates (d); Chen-Kao reagent for ephedrine/norephedrine (e); Ehrlich's reagent for ergot alkaloids (and LSD) (f); fast blue BB reagent for cannabinoids (g); and Zwikker reagent for barbiturates (h) in point-of-care services and found color tests to be the best lower technology option due to lower costs, ease of use and rapid results afforded.…”

Section: Harm Reductionmentioning

confidence: 99%

A review of chemical ‘spot’ tests: A presumptive illicit drug identification technique

Philp

2017

Drug Testing and Analysis

107

121

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Chemical 'spot' tests are a presumptive illicit drug identification technique commonly used by law enforcement, border security personnel, and forensic laboratories. The simplicity, low cost, and rapid results afforded by these tests make them particularly attractive for presumptive identification globally. In this paper, we review the development of these long-established methods and discuss color test recommendations and guidelines. A search of the scientific literature revealed the chemical reactions occurring in many color tests are either not actively investigated or reported as unknown.Today, color tests face many challenges, from the appearance of new psychoactive substances to concerns regarding selectivity, sensitivity, and safety. Advances in technology have seen color test reagents used in digital image color analysis, solid sensors, and microfluidic devices for illicit drug detection. This summarizes current research and suggests the future of presumptive color testing. KEYWORDScolor spot test, illicit drugs, new psychoactive substances, presumptive identification, seized material

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“…Field‐based drug identification tends to be limited to colourimetric reagent tests, spectroscopic methods, eg, infra‐red (IR), Fourier transform IR (FTIR), and Raman spectroscopy, and occasionally thin layer chromatography (TLC). Whilst these methods are cheap, rapid, and easily carried out without the need for elaborate laboratory infrastructure, colourimetric reagent tests are highly subjective, and there are limitations of spectroscopic methods in both sensitivity and specificity (particularly for tablets and powders containing mixtures of compounds or for very low concentration adulterants) . Further, the results produced by spectroscopic methods are dependent on (a) up‐to‐date libraries to include the latest substances, and (b) complex in‐built identification algorithms for the analysis of mixtures.…”

Section: Discussionmentioning

confidence: 99%

Variability in content and dissolution profiles of MDMA tablets collected in the UK between 2001 and 2018 – A potential risk to users?

Couchman

Frinculescu

Sobreira

et al. 2019

Drug Testing and Analysis

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3,4‐Methylenedioxymethamphetamine (MDMA, Ecstasy) tablets are widely used recreationally, and not only vary in appearance, but also in MDMA content. Recently, the prevalence of high‐content tablets is of concern to public health authorities. To compare UK data with other countries, we evaluated MDMA content of 412 tablets collected from the UK, 2001–2018, and investigated within‐batch content variability for a sub‐set of these samples. In addition, we investigated dissolution profiles of tablets using pharmaceutical industry‐standard dissolution experiments on 247 tablets. All analyses were carried out using liquid chromatography−tandem mass spectrometry (LC–MS/MS). Our data supported other studies, in that recent samples (2016–2018) tend to have higher MDMA content compared to earlier years. In 2018, the median MDMA content exceeded 100 mg free‐base for the first time. Dramatic within‐batch content variability (up to 136 mg difference) was also demonstrated. Statistical evaluation of dissolution profiles at 15‐minutes allowed tablets to be categorized as fast‐, intermediate‐, or slow‐releasing, but no tablet characteristics correlated with dissolution classification. Hence, there would be no way of users knowing a priori whether a tablet is more likely to be fast or slow‐releasing. Further, within‐batch variation in dissolution rate was observed. Rapid assessment of MDMA content alone provides important data for harm reduction, but does not account for variability in (a) the remainder of tablets in a batch, or (b) MDMA dissolution profiles. Clinical manifestations of MDMA toxicity, especially for high‐content, slow‐releasing tablets, may be delayed or prolonged, and there is a significant risk of users re‐dosing if absorption is delayed.

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Putting an Ecstasy Test Kit to the Test: Harm Reduction or Harm Induction?

Cited by 31 publications

References 21 publications

“I’m not afraid of those ones just ‘cause they’ve been prescribed”: Perceptions of risk among illicit users of pharmaceutical opioids

“I’m not afraid of those ones just ‘cause they’ve been prescribed”: Perceptions of risk among illicit users of pharmaceutical opioids

A review of chemical ‘spot’ tests: A presumptive illicit drug identification technique

Variability in content and dissolution profiles of MDMA tablets collected in the UK between 2001 and 2018 – A potential risk to users?

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