Drug checking to detect fentanyl and new psychoactive substances

Abstract

Introduction: Drug checking services invite drug consumers to anonymously submit drug samples for chemical analysis and provide feedback of results. Drugs are tested for strength/dose and/or presence of adulterants. Drug checking appears to be more common in recent years in response to increases in fentanyl-related deaths and the proliferation of new psychoactive substances (NPS). Purpose of review:We aim to provide information regarding the current state of drug checking in relation to analysis methods, adulteration rates, and behavioral responses to results. Recent findings:Various technologies are being used to detect the presence of fentanyl, its analogs, and other NPS in drug samples. Proxy drug-checking, which we define as biospecimen testing for drug exposure post-consumption, is also becoming common. However, there appears to a dichotomy between research focusing on populations at high risk for fentanyl exposure and to exposure to NPS such as synthetic cathinones.Summary: Drug checking research and services largely focus on opioid consumers and nightclub and dance festival attendees, but more focus may be needed on the general population. Drug checking results can inform surveillance efforts, and more research is needed to overcome barriers to drug checking and to focus on whether test results indeed affect behavior change.

Situating the Continuum of Overdose Risk in the Social Determinants of Health: A New Conceptual Framework

“…Drug checking programs enable PWUD, without the risk of arrest, to have their drugs chemically analyzed for the presence of substances like fentanyl and its analogues and for their purity, thereby allowing for more informed decisions about subsequent drug use. [169][170][171][172] These programs, which were pioneered in Europe and are inclusive of laboratory-based and point-of-care models, have the potential to promote product safety in the illicit drug supply in the United States, where its use has been limited to testing drugs at music festivals and some SSP and community-based organizations. Such services are needed in the context of a large unregulated illicit market in which the quantity and purity of illicit drugs (eg, heroin) remain uncertain.…”

COVID-19 restrictions and increased risk of overdose for street-based people with opioid dependence in South Africa

“…[13] The potential for poisoning from potent synthetic opioids, such as fentanyl and its analogues, in light of the changed drug market is unknown. [14] To mitigate the risk of overdose in the time of COVID-19, we recommend:…”

“…[13] The potential for poisoning from potent synthetic opioids, such as fentanyl and its analogues, in light of the changed drug market is unknown. [14] To mitigate the risk of overdose in the time of COVID-19, we recommend:• That government funds the scaling up and access to OST at all shelters in locations where the capacity for OST initiation exists through partnership with civil society and academic institutions. People initiated onto OST during lockdown should be linked to ongoing maintenance therapy with access to psychosocial services once released.…”

Shifts in Unintentional Exposure to Drugs Among People Who Use Ecstasy in the Electronic Dance Music Scene, 2016‐2019

“…The biggest barrier is that it is difficult to obtain approval from institutional review boards (IRBs) and from local and federal law enforcement to test illegal drugs. Since drug checking is often not feasible in US studies, some researchers have tested drug adulteration by proxy, post‐use, through testing of biological specimens 4 . Such testing provides not only an opportunity to detect unintentional exposure to drugs, but continued testing over time may allow us to examine trends in adulteration.…”