Implementing an integrated multi‐technology platform for drug checking: Social, scientific, and technological considerations

Abstract

The illicit drug overdose crisis in North America continues to devastate communities with fentanyl detected in the majority of illicit drug overdose deaths. The COVID-19 pandemic has heightened concerns of even greater unpredictability in the drug supplies and unprecedented rates of overdoses. Portable drug-checking technologies are increasingly being integrated within overdose prevention strategies. These emerging responses are raising new questions about which technologies to pursue and what service models can respond to the current risks and contexts. In what has been referred to as the epicenter of the overdose crisis in Canada, a multi-technology platform for drug checking is being piloted in community settings using a suite of chemical analytical methods to provide real-time harm reduction. These include infrared absorption, Raman scattering, gas chromatography with mass spectrometry, and antibody-based test strips. In this Perspective, we illustrate some advantages and challenges of using multiple techniques for the analysis of the same sample, and provide an example of a data analysis and visualization platform that can unify the presentation of the results and enable deeper analysis of the results. We also highlight the implementation of a various service models that co-exist in a research setting, with particular emphasis on the way that drug checking technicians and harm reduction workers interact with service users. Finally, we provide a description of the challenges associated with data interpretation and the communication of results to a diverse audience.

Fentanyl detection and quantification using portable Raman spectroscopy in community drug checking

“…As a part of a harm reduction service operated as the Vancouver Island Drug Checking Project, [42] drug samples are presented by individuals for testing at several sites that have sanctioning from public health to provide overdose prevention services including drug checking. These samples are considered unknown in composition prior to testing with portable IR, Raman, GC-MS, and immunoassay fentanyl and benzodiazepine test strips.…”

The Bronze Age of drug checking: barriers and facilitators to implementing advanced drug checking amidst police violence and COVID-19

“…Recent analyses have explored the technical capacities of portable spectrometry devices, including limits of detection and the interpretation of spectrometry outputs [20,21]. Research on the participant uptake and analytical results of drug checking services through the use of chemical reagents (a strategy most often used for testing stimulants and other psychoactive substances commonly considered "club drugs") or portable spectroscopy devices at electronic music events has been carried out in European countries including Italy [22], Portugal [23] Slovenia [24], and the United Kingdom [25].…”

Third party drug checking: accessing harm reduction services on the behalf of others

“…Data were collected from a drug checking service in Victoria, Canada between November 10, 2018, and June 29, 2021, with ethical approval from the Health Research Ethics Board at the Island Health Authority (J2018-069). The service implements chemical analytical technologies, including fentanyl and benzodiazepine immunoassay test strips, Raman spectroscopy, infrared absorption spectroscopy, and paper spray–mass spectrometry [ 3 ]. Over time, the location of the service changed, but has always been established alongside community harm reduction sites and services, with origins in overdose prevention sites.…”

“…Increasingly, drug checking services are being explored as an intervention in the ongoing overdose epidemic [ 1 – 3 ]. Drug checking aims to provide information on the composition of illicit drugs from the unregulated market to reduce substance use related risks.…”