Kenneth W Tupper1, Karen McCrae2, Ian Garber2, Mark Lysyshyn3, Evan Wood4. 1. British Columbia Centre on Substance Use, #400 - 1045 Howe St., Vancouver, British Columbia, V6Z 2A9, Canada; School of Population and Public Health, University of British Columbia, 2206 E. Mall, Vancouver, British Columbia, V6T 1Z3, Canada. Electronic address: kenneth.tupper@bccsu.ubc.ca. 2. British Columbia Centre on Substance Use, #400 - 1045 Howe St., Vancouver, British Columbia, V6Z 2A9, Canada. 3. School of Population and Public Health, University of British Columbia, 2206 E. Mall, Vancouver, British Columbia, V6T 1Z3, Canada; Vancouver Coastal Health Authority, 5th floor, 132 West Esplanade, North Vancouver, British Columbia, V7M 1A2, Canada. 4. British Columbia Centre on Substance Use, #400 - 1045 Howe St., Vancouver, British Columbia, V6Z 2A9, Canada; Department of Medicine, University of British Columbia, 2775 Laurel St., 10th Floor, Vancouver, British Columbia, V5Z 1M9, Canada.
Abstract
BACKGROUND: Opioid overdose deaths in North America have been rising largely as a result of fentanyl adulteration in the illegal drug supply. Drug checking is an established harm reduction intervention in some European settings but has not been broadly implemented or evaluated in North America. We are evaluating a pilot program offering drug checking for people who use street drugs in Vancouver, British Columbia. METHODS: Drug checking services were implemented at two locations in Vancouver between November 2017 and April 2018 using a Fourier transform infrared (FTIR) spectrometer and fentanyl immunoassay strips. We report on the findings generated by this technological combination during the study period. RESULTS: During the study period, a total of 1714 samples were tested. Of 907 samples expected to be heroin, only 160 (17.6%) contained the expected substance, and 822 (90.6%) tested positive for fentanyl. Of 256 samples expected to be speed or crystal meth, 225 (87.9%) contained amphetamine or methamphetamine, and 15 (5.9%) tested positive for fentanyl. The FTIR also found unexpected and potentially dangerous substances and adulterants other than fentanyl. CONCLUSIONS: This pilot program has demonstrated the feasibility of drug checking for identifying individual drug samples containing unexpected or hazardous substances, including fentanyl. By identifying the range of adulterants and diluents and giving an estimate of their prevalence in different drug types, it has also provided information about the composition of the illicit drug supply in an urban North American setting.
BACKGROUND: Opioid overdose deaths in North America have been rising largely as a result of fentanyl adulteration in the illegal drug supply. Drug checking is an established harm reduction intervention in some European settings but has not been broadly implemented or evaluated in North America. We are evaluating a pilot program offering drug checking for people who use street drugs in Vancouver, British Columbia. METHODS: Drug checking services were implemented at two locations in Vancouver between November 2017 and April 2018 using a Fourier transform infrared (FTIR) spectrometer and fentanyl immunoassay strips. We report on the findings generated by this technological combination during the study period. RESULTS: During the study period, a total of 1714 samples were tested. Of 907 samples expected to be heroin, only 160 (17.6%) contained the expected substance, and 822 (90.6%) tested positive for fentanyl. Of 256 samples expected to be speed or crystal meth, 225 (87.9%) contained amphetamine or methamphetamine, and 15 (5.9%) tested positive for fentanyl. The FTIR also found unexpected and potentially dangerous substances and adulterants other than fentanyl. CONCLUSIONS: This pilot program has demonstrated the feasibility of drug checking for identifying individual drug samples containing unexpected or hazardous substances, including fentanyl. By identifying the range of adulterants and diluents and giving an estimate of their prevalence in different drug types, it has also provided information about the composition of the illicit drug supply in an urban North American setting.
Authors: Joseph J Palamar; Alberto Salomone; Rachele Bigiarini; Marco Vincenti; Patricia Acosta; Babak Tofighi Journal: Am J Drug Alcohol Abuse Date: 2019-01-02 Impact factor: 3.829