Results from a mobile drug checking pilot program using three technologies in Chicago, IL, USA

Karch, Lydia; Tobias, Samuel; Schmidt, Clare; Doe-Simkins, Maya; Carter, Nicole; Salisbury-Afshar, Elizabeth; Carlberg-Racich, Suzanne

doi:10.1016/j.drugalcdep.2021.108976

Cited by 33 publications

(37 citation statements)

References 12 publications

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“…These findings align with recent evidence that a high proportion of co-involved stimulant-opioid overdose occurs among individuals not intending to use opioids [ 38 ]. Rising rates of fentanyl adulteration and co-involved stimulant-opioid overdose [ 38 , 39 ] call for increased educational outreach about the risks of fentanyl in nonopioid substances [ 39 , 40 ] and wider access to robust drug checking services [ 41 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

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Characteristics and context of fentanyl test strip use among syringe service clients in southern Wisconsin

Tilhou

Birstler

Baltes³

et al. 2022

Harm Reduct J

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Background Fentanyl adulteration of illicit drugs is a major driver of opioid-involved overdose in the USA. Fentanyl test strips are increasingly used by people who use drugs to check for fentanyl. However, little is known about factors that influence test strip use in this population. Methods In this mixed-methods study employing semi-structured open-ended interviews (n = 29) and a structured survey (n = 341), we examined characteristics associated with test strip use, characteristics of test strip use, and situational, logistical and psychosocial factors influencing test strip use. Respondents were recruited from a syringe service program in southern Wisconsin. Bivariate tests of association and multivariable logistic regression examined the relationship between respondent characteristics and test strip use. Summary statistics were used to describe how situational, logistical and psychosocial factors impact test strip use. Results Most respondents were male (59.6%), non-Hispanic white (77.4%), young (mean 35.7 years), reported heroin as their primary drug (70.7%), injection as their primary route (87.9%), and use ≥ 3 times daily (78.6%). In multivariable models, site, race and ethnicity, drug of choice, and seeking fentanyl were associated with test strip use. Among test strip users, 36.5% use them most of the time or more and 80.6% get positive results half the time or more. Among individuals reporting heroin, fentanyl, methamphetamine, or cocaine or crack cocaine at least once per month, 99.1%, 56.8%, 42.2%, and 55.7% reported testing these drugs, respectively. Test strip use is supported by information from suppliers, regular transportation, diverse distribution locations, recommendations from harm reduction staff, and having a safe or private place to use. Conclusions We found that individuals who use fentanyl test strips are more often non-Hispanic white, use heroin, and seek drugs with fentanyl relative to individuals without test strip use. Findings confirm high fentanyl penetration in the Wisconsin drug supply. Low rates of stimulant testing suggest inadequate awareness of fentanyl penetration. Findings support outreach to key populations, increased diversity of distributing locations, efforts to correct misperceptions about drug wasting, emphasis on pre-consumption testing, and the importance of adjunct behaviors to prevent overdose given high rates of intentional fentanyl use.

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Section: Discussionmentioning

confidence: 99%

“…As such, a negative test result cannot guarantee the absence of analogs. Confusion and misunderstanding when interpreting FTS results could increase overdose risk and indicates a clear role for more robust drug checking services [ 41 , 42 ] and additional research exploring FTS analog detection in real world samples.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and context of fentanyl test strip use among syringe service clients in southern Wisconsin

Tilhou

Birstler

Baltes³

et al. 2022

Harm Reduct J

Self Cite

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“…These early warning signs provide an opportunity to implement strategies to reduce harm from fentanyl based on lessons learned from other states. As PWUD are navigating this volatile market, easily accessible avenues (e.g., point-of-care, mobile spaces, and direct to consumer) of drug checking devices (e.g., Ramon spectrometer, Fourier-transform infrared spectrometer device, fentanyl test strips) should be made available to identify fentanyl presence for consumers [26]. Information gathered from drug checking services may inform harm reduction behaviors, collect surveillance data, and improve drug supply knowledge, including emerging fentanyl analogs [27][28][29].…”

Section: Discussionmentioning

confidence: 99%

“It wasn’t here, and now it is. It’s everywhere": fentanyl’s rising presence in Oregon’s drug supply

Shin¹,

LaForge²,

Stack³

et al. 2022

Harm Reduct J

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Background Illicit fentanyl has contributed to a drastic increase in overdose drug deaths. While fentanyl has subsumed the drug supply in the Northeastern and Midwestern USA, it has more recently reached the Western USA. For this study, we explored perspectives of people who use drugs (PWUD) on the changing drug supply in Oregon, experiences of and response to fentanyl-involved overdose, and recommendations from PWUD to reduce overdose risk within the context of illicit fentanyl’s dramatic increase in the recreational drug supply over the past decade. Methods We conducted in-depth interviews by phone with 34 PWUD in Oregon from May to June of 2021. We used thematic analysis to analyze transcripts and construct themes. Results PWUD knew about fentanyl, expressed concern about fentanyl pills, and were aware of other illicit drugs containing fentanyl. Participants were aware of the increased risk of an overdose but remained reluctant to engage with professional first responders due to fear of arrest. Participants had recommendations for reducing fentanyl overdose risk, including increasing access to information, harm reduction supplies (e.g., naloxone, fentanyl test strips), and medications for opioid use disorder; establishing drug checking services and overdose prevention sites; legalizing and regulating the drug supply; and reducing stigma enacted by healthcare providers. Conclusion PWUD in Oregon are aware of the rise of fentanyl and fentanyl pills and desire access to tools to reduce harm from fentanyl. As states in the Western USA face an inflection point of fentanyl in the drug supply, public health staff, behavioral health providers, and first responders can take action identified by the needs of PWUD.

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“…Drug checking is a useful tool to prevent adverse health effects and monitor substances from unregulated markets in different countries (Betsos et al , 2021; Betzler et al , 2020; Day et al , 2018; Karch et al , 2021; Sande and Šabić, 2018; Sherman et al , 2019; Valente et al , 2019; Ventura et al , 2012). Drug checking studies in Europe and North America were performed with the availability of high-level technology such as Fourier transform infrared spectroscopy, GC/MS and LC/MS (Beaulieu et al , 2021; Fregonese et al , 2021; Harper et al , 2017; Hungerbuehler et al , 2011).…”

Section: Discussionmentioning

confidence: 99%

Échele Cabeza as a harm reduction project and activist movement in Colombia

Moreno¹,

Ayala²,

Estrada³

et al. 2022

DHS

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Purpose The purpose of this paper is to present the results and context of the drug checking service (DCS) performed by the harm reduction project Échele Cabeza (EC) in Colombia. Design/methodology/approach Data from several years are presented with a focus on data from 2021. In 2021, data were derived from 2,339 questionnaires filled out by DCS users and a total of 2,868 drug checking test results from samples collected at the fixed-site service in Bogotá and 30 music festivals in 8 cities nationwide. Findings The tusi phenomenon is gaining strength in Colombia revealing a problem associated with the changing makeup of tusi and, thus, polydrug use. MDMA adulteration and misrepresentations have increased in comparison to 2019. There is an increasing number of people who want to use the DCS in Colombia, which is encouraging but also exposes the limitations of the drug checking methods available to EC. Originality/value This paper offers the first publication of the pioneering drug checking organization EC in Latin America.

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Results from a mobile drug checking pilot program using three technologies in Chicago, IL, USA

Cited by 33 publications

References 12 publications

Characteristics and context of fentanyl test strip use among syringe service clients in southern Wisconsin

Characteristics and context of fentanyl test strip use among syringe service clients in southern Wisconsin

“It wasn’t here, and now it is. It’s everywhere": fentanyl’s rising presence in Oregon’s drug supply

Échele Cabeza as a harm reduction project and activist movement in Colombia

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