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Drug checking as a potential strategic overdose response in the fentanyl era.
Int J Drug Policy. 2018 12; 62:59-66.IJ

Abstract

Adulteration of illicit drug supplies with synthetic opioids such as fentanyl has contributed to a dramatic rise in overdose morbidity and mortality in North America. One promising response to this crisis is the implementation of "drug checking" services. Drug checking encompasses a range of interventions used to assess the constituents of illicit drug samples, such as colour-spot testing, gas or liquid chromatography, and various methods of spectroscopy. Testing may be performed on-site at events or harm reduction service locales, performed independently by consumers, or sent to a centralized lab for analysis. This information may then serve to inform individual decision-making, enhance harm reduction efforts and strengthen public health surveillance and response strategies to prevent harms associated with illicit drug use. Historical examples of drug checking services that emerged with the 1990s synthetic "party drug" movement in Europe provide a theoretical and practical basis for the adaptation of these services for use in context of the current opioid overdose crisis. Potential harm reduction benefits of drug checking for synthetic opioid adulterants include individuals being more likely to use drugs more safely or to dispose of drugs found to contain harmful adulterants. Public health benefits of drug checking may also include negative feedback on the illicit drug supply with decreased availability or consumption of drugs from sources adulterated with synthetic opioids following public health warning campaigns. As part of the response to the current synthetic opioid epidemic in BC, pilot efforts are being undertaken in Vancouver to determine the feasibility and effectiveness of drug checking as an overdose response strategy. Models of drug checking service delivery and comparison of differing technologies, including unique challenges and potential solutions related to access to these services, legal obstacles, and sensitivity and specificity of testing technologies, are explored, alongside suggestions for future research and directions.

Authors+Show Affiliations

Department of Medicine, University of British Columbia, Vancouver, BC, Canada; British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.Department of Medicine, University of British Columbia, Vancouver, BC, Canada; British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada. Electronic address: nadia.fairbairn@bccsu.ubc.ca.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30359874

Citation

Laing, Matthew K., et al. "Drug Checking as a Potential Strategic Overdose Response in the Fentanyl Era." The International Journal On Drug Policy, vol. 62, 2018, pp. 59-66.
Laing MK, Tupper KW, Fairbairn N. Drug checking as a potential strategic overdose response in the fentanyl era. Int J Drug Policy. 2018;62:59-66.
Laing, M. K., Tupper, K. W., & Fairbairn, N. (2018). Drug checking as a potential strategic overdose response in the fentanyl era. The International Journal On Drug Policy, 62, 59-66. https://doi.org/10.1016/j.drugpo.2018.10.001
Laing MK, Tupper KW, Fairbairn N. Drug Checking as a Potential Strategic Overdose Response in the Fentanyl Era. Int J Drug Policy. 2018;62:59-66. PubMed PMID: 30359874.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Drug checking as a potential strategic overdose response in the fentanyl era. AU - Laing,Matthew K, AU - Tupper,Kenneth W, AU - Fairbairn,Nadia, Y1 - 2018/10/22/ PY - 2018/04/27/received PY - 2018/10/01/revised PY - 2018/10/04/accepted PY - 2018/10/26/pubmed PY - 2019/11/7/medline PY - 2018/10/26/entrez KW - Drug checking KW - Drug testing KW - Fentanyl KW - Harm reduction KW - Opioid overdose KW - Overdose epidemic KW - Synthetic opioids SP - 59 EP - 66 JF - The International journal on drug policy JO - Int J Drug Policy VL - 62 N2 - Adulteration of illicit drug supplies with synthetic opioids such as fentanyl has contributed to a dramatic rise in overdose morbidity and mortality in North America. One promising response to this crisis is the implementation of "drug checking" services. Drug checking encompasses a range of interventions used to assess the constituents of illicit drug samples, such as colour-spot testing, gas or liquid chromatography, and various methods of spectroscopy. Testing may be performed on-site at events or harm reduction service locales, performed independently by consumers, or sent to a centralized lab for analysis. This information may then serve to inform individual decision-making, enhance harm reduction efforts and strengthen public health surveillance and response strategies to prevent harms associated with illicit drug use. Historical examples of drug checking services that emerged with the 1990s synthetic "party drug" movement in Europe provide a theoretical and practical basis for the adaptation of these services for use in context of the current opioid overdose crisis. Potential harm reduction benefits of drug checking for synthetic opioid adulterants include individuals being more likely to use drugs more safely or to dispose of drugs found to contain harmful adulterants. Public health benefits of drug checking may also include negative feedback on the illicit drug supply with decreased availability or consumption of drugs from sources adulterated with synthetic opioids following public health warning campaigns. As part of the response to the current synthetic opioid epidemic in BC, pilot efforts are being undertaken in Vancouver to determine the feasibility and effectiveness of drug checking as an overdose response strategy. Models of drug checking service delivery and comparison of differing technologies, including unique challenges and potential solutions related to access to these services, legal obstacles, and sensitivity and specificity of testing technologies, are explored, alongside suggestions for future research and directions. SN - 1873-4758 UR - https://www.unboundmedicine.com/medline/citation/30359874/Drug_checking_as_a_potential_strategic_overdose_response_in_the_fentanyl_era_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0955-3959(18)30257-3 DB - PRIME DP - Unbound Medicine ER -