Rhode Island Hospital, Providence, RI, United States; Warren Alpert Medical School, Brown University, Providence, RI, United States.
Rhode Island Hospital, Providence, RI, United States.
Int J Drug Policy. 2023 Nov;121:104206. doi: 10.1016/j.drugpo.2023.104206. Epub 2023 Oct 3.
Drug overdose deaths have reached record-breaking levels in North America. Drug checking services (DCS) provide localized information on the contents of drugs to individuals and communities. Depending on the design, individuals can submit drug samples for onsite "real-time" testing or offsite testing. The results can shed light on emerging drugs in the community and support ongoing prevention and surveillance efforts. We sought to describe and report aggregate outcomes of DCS operating in North America.
The North American Drug Checking Survey was launched in 2022 to characterize and monitor DCS operating in the region. Sixteen organizations from the US (n = 9), Canada (n = 5), and Mexico (n = 2) responded to the survey. Each organization reported on their program's operations and provided service delivery outcomes (site- or program-level) in the aggregate.
Participating organizations reported testing a total of 49,786 drug samples between 2014 and 2022. DCS were run by community-led organizations (44%), health departments (25%), universities (19%), or clinical/private laboratories (19%). The types of samples tested differed between programs (e.g., solids vs. liquids, drug paraphernalia accepted). While most organizations tested onsite using fentanyl test strips (88%) and Fourier-transform infrared (FTIR) spectroscopy (63%), many sent samples offsite for confirmatory testing (63%), most often with mass spectrometry. Common facilitators of operating a DCS included: interest of clients (69%), interest of service providers (63%), and receiving external technical assistance (63%). Barriers included: the lack of funding (81%) or staff (50%), gaps in technical expertise (38%), as well as laws banning the possession and/or distribution of illicit drug samples, drug paraphernalia, or drug checking equipment (38%).
DCS are scaling up in North America. Given the evolving and localized nature of illicit drug supplies, supporting the establishment and operations of DCS could enhance the public's understanding of local drug supplies to reduce drug-related harms over time.
在北美，药物过量死亡人数已达到创纪录水平。药物检测服务（DCS）为个人和社区提供有关药物内容的本地信息。根据设计，个人可以提交药物样本进行现场“实时”检测或场外检测。检测结果可以揭示社区中新兴的药物，并支持正在进行的预防和监测工作。我们旨在描述和报告在北美运营的 DCS 的综合结果。
2022 年启动了北美药物检测调查，以描述和监测该地区的 DCS 运营情况。来自美国（n=9）、加拿大（n=5）和墨西哥（n=2）的 16 个组织对该调查做出了回应。每个组织都报告了其项目的运营情况，并提供了汇总的服务提供结果（地点或项目级别）。
参与组织报告称，2014 年至 2022 年间共检测了 49786 个药物样本。DCS 由社区主导的组织（44%）、卫生部门（25%）、大学（19%）或临床/私人实验室（19%）运营。测试的样本类型因项目而异（例如，固体与液体，接受药物用具）。虽然大多数组织使用芬太尼检测条（88%）和傅里叶变换红外（FTIR）光谱（63%）进行现场测试，但许多组织将样本送到场外进行确认测试（63%），最常见的是使用质谱。运营 DCS 的常见促进因素包括：客户的兴趣（69%）、服务提供者的兴趣（63%）和接受外部技术援助（63%）。障碍包括：缺乏资金（81%）或人员（50%）、技术专业知识的差距（38%），以及禁止拥有和/或分发非法药物样本、药物用具或药物检测设备的法律（38%）。
DCS 在北美正在扩大规模。鉴于非法药物供应的不断发展和本地化性质，支持 DCS 的建立和运营可以提高公众对当地药物供应的了解，从而随着时间的推移减少与药物相关的伤害。
