Drug checking services for people who use drugs: a systematic review

Abstract

Background and Aims Drug checking services provide people who use drugs with chemical analysis results of their drug samples while simultaneously monitoring the unregulated drug market. We sought to identify and synthesize literature on the following domains: (a) the influence of drug checking services on the behaviour of people who use drugs; (b) monitoring of drug markets by drug checking services; and (c) outcomes related to models of drug checking services. Methods Systematic review. A systematic literature search was conducted in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PsycINFO, Scopus, Web of Science and Dissertations and Theses Global. Eligible studies were peer‐reviewed articles and conference abstracts or grey literature, published in any language since 1990 and including original data on the domains. We assessed risk of bias for quantitative peer‐reviewed articles reporting on behaviour or models of drug checking services using National Institutes of Health tools. Results We screened 2463 titles and abstracts and 156 full texts, with 90 studies meeting inclusion criteria. Most (n = 65, 72.2%) were from Europe and used cross‐sectional designs (n = 79, 87.7%). Monitoring of drug markets by drug checking services (n = 63, 70%) was the most reported domain, followed by the influence of drug checking services on behaviour (n = 31, 34.4%), including intent to use, actual use and disposal of the drug, and outcomes related to models of drug checking services (n = 17, 18.9%). The most common outcome measures were detection of unexpected substances (n = 50, 55.6%), expected substances (n = 44, 48.9%), new psychoactive substances (n = 40, 44.4%) and drugs of concern (n = 32, 36.5%) by drug checking services. Conclusions Drug checking services appear to influence behavioural intentions and the behaviour of people who use drugs, particularly when results from drug checking services are unexpected or drugs of concern. Monitoring of drug markets by drug checking services is well established in Europe, and increasingly in North America. Concerns about drug contents and negative health consequences facilitate the use of drug checking services; lack of concern; trust in drug sellers; lack of accessibility of drug checking services; and legal and privacy concerns are barriers to use.

Predictors of Frequent Emergency Department Use and Hospitalization among Patients with Substance-Related Disorders Recruited in Addiction Treatment Centers

“…Higher risk of frequent ED use among patients with drug-related disorders other than cannabis only may result in greater risk of intoxication or exposure to overdose from these drugs [ 40 , 41 ] given their popularity in recreational contexts and their appeal for improving energy or performance, but this also leads to accidents or aggressive behavior [ 42 ]. Increased implementation of harm reduction strategies such as drug checking [ 43 ], safer supply services [ 44 ] and supervised injection sites [ 45 ] may help diminish these adverse outcomes. As for higher risk of hospitalization among patients with alcohol-related disorders exclusively, compared to those with cannabis-related disorder only, this may be explained by the high prevalence of co-occurring chronic physical illnesses for these patients [ 46 ].…”

A distributed model to expand the reach of drug checking

“…j DRUGS, HABITS AND SOCIAL POLICY j Overall, there is a need to address the implementation barriers that are hindering its scale and reach (Wallace et al, 2021a). Notably, drug checking is showing benefits for those who access these services (Maghsoudi et al, 2021). But drug checking is not accessible for most people, particularly those beyond the reach of urban health services and those less likely to access current harm reduction services.…”

Fake anabolic androgenic steroids on the black market – a systematic review and meta-analysis on qualitative and quantitative analytical results found within the literature

“…‘Drug checking’ allows people who consume illegal and legal drugs acquired from unregulated drug markets to submit samples for chemical analysis and receive feedback on the quantity, quality, and purity of those substances. Commonly this approach is embedded in a wider prevention approach that includes counselling services and other short interventions [ 63 , 64 ]. Drug testing services can be an effective harm reduction service that may strengthen surveillance of the black-market drugs that are used and can accurately inform users about the quality and quantity of black market AAS prior to use [ 65 ].…”