Drug checking (also known as pill testing or adulterant screening) allows people who use drugs to help identify the substance they intend on taking and therefore prevent harms associated with consuming an unknown substance. Simple identification methods, such as reagents and drug checking strips, can help prevent drug-related injury and overdose.
Drug checking services have been a part of Europe’s nightlife and music scene since the 1990’s. Organizations like DanceSafe have also brought drug checking services to music festivals and dance events in the United States. Both these movements have primarily targeted music event attendees using drugs such as MDMA and often rely upon on-site reagent drug checking methods.
Reagents (also known as spot or colorimetric tests) are liquid drops that can be applied to a small sample of a substance with minimal user training. A chemical interaction identifies the presence of certain substances contained in the sample based on color changes and corresponding codes.
Results take about 30 seconds and allow users to identify a variety of substances, including methamphetamine, opiates, MDMA, LSD, and cathinones (“bath salts”). DanceSafe also sells drug testing kits (costing between $20-$25 for 50 uses) to the public.
More recently, as fentanyl-related drug overdose deaths have increased dramatically, fentanyl checking strips, originally designed for urine drug tests, are now being used off label to test for the presence or absence of fentanyl and fentanyl analogs in the illegal drug supply. Drug checking strips allow users to dissolve a small sample of a drug into water, insert a test strip, and look for an indicator line alerting the user to the presence of fentanyl. Strips are single use and cost $1-2 per test.
A February 2018 John Hopkins University study showed that the testing strips could detect the presence of fentanyl nearly 100 percent of the time. In May 2017, the California Department of Public Health began paying for fentanyl checking strips that could be distributed to people who use drugs at syringe exchange programs. Similar programs have also popped up in New York, Ohio, Maryland, North Carolina, Massachusetts, and elsewhere.
Research shows that individuals want to know what is in their drug supply, and, in particular, if their drugs contain fentanyl. Of 335 people in one study, 256 people (76%) thought they had unknowingly consumed fentanyl. Of the whole sample, 85% responded that they want to know about the presence of fentanyl before using drugs and most participants wanted to know “the amount of fentanyl (86%) and the presence of other substances (87%).”
Awareness of fentanyl contamination reduces overdose risk by prompting individuals to not use the adulterated drugs, use more slowly, use with others who have naloxone, or to change purchasing behaviors.
Drug testing is also a common harm reduction strategy utilized by the nightlife, dance, and festival communities and ensures that people have an understanding of what they are consuming so they can better manage any potential negative consequences of consumption.
Making drug checking equipment and services available to the public would lower the number of deaths and hospitalizations and also allow for real-time tracking of local drug trends.
Reagent kits, fentanyl checking strips, and other drug checking equipment and supplies are arguably defined as drug paraphernalia and state legislatures and regulatory agencies should provide legal exemptions to ensure wide scale access to this life-saving intervention as well as dedicated funding.
The Drug Policy Alliance (DPA) is working to create access to drug checking equipment and was instrumental in recently amending DC and Maryland law to exempt drug checking supplies from the state paraphernalia code and in California to expand the definition of exempted harm reduction materials.
DPA’s #SaferPartying campaign explains various forms of drug checking to partygoers, connects them to sources to acquire reagent kits and testing strips, and advocates for festival producers to adopt drug checking into their events as part of a comprehensive harm reduction strategy.