Ondocsin Jeff, Moran Lissa, Ciccarone Daniel, Outram Simon, Werb Dan, Holm Nicole, Arnold Emily A
Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, California, United States of America.
Family & Community Medicine, Department of Medicine, University of California, San Francisco, California, United States of America.
PLoS One. 2025 Apr 17;20(4):e0321574. doi: 10.1371/journal.pone.0321574. eCollection 2025.
Overdose deaths have continued to rise in the US despite heightened public attention and resources. Drug checking shows promise for integration into existing services for people who use drugs (PWUD) across North America. Amidst the backdrop of rising overdose deaths and emerging funds for harm reduction initiatives, this manuscript explores the landscape of drug checking services in North America and perspectives on improved integration with a diverse set of PWUD based in San Francisco and North American drug checking experts.
Two separate samples of drug checking stakeholders, 'providers' and 'clients' were recruited. Providers participated in in-depth semi-structured qualitative interviews over Zoom on their experiences advocating for and operating drug checking services in the US and Canada. Clients were people who used drugs and lived in or commuted to the San Francisco Bay Area and participated in semi-structured interviews in November 2022. Interviews were transcribed fully and analyzed using thematic analysis methods.
Providers and clients identified ongoing instability in the North American drug supply that is exacerbating overdose risk while also identifying groups that would benefit from greater access to drug checking services. Both groups believed the paradoxical impacts of the fentanyl crisis at the core of drug checking services created barriers to the implementation and expansion of these services, hurting PWUD and their providers. Additionally, clients and providers reflected on the social and policy challenges to expansion and improvement of drug checking in their communities.
Drug checking remains underleveraged, particularly with respect to the most vulnerable PWUD. Clients and providers contended that these services must become more responsive to an ever changing and dangerous drug supply in North America.
尽管公众关注度和资源投入有所提高，但美国的过量用药死亡人数仍在持续上升。药物检测有望融入北美现有的针对吸毒者（PWUD）的服务中。在过量用药死亡人数不断上升以及减少伤害倡议的新资金不断涌现的背景下，本文探讨了北美药物检测服务的现状，以及旧金山不同类型的吸毒者和北美药物检测专家对改善整合的看法。
招募了两个独立的药物检测利益相关者样本，即“提供者”和“客户”。提供者通过Zoom参加了深入的半结构化定性访谈，分享他们在美国和加拿大倡导及运营药物检测服务的经验。客户为居住在旧金山湾区或通勤至该地区的吸毒者，并于2022年11月参加了半结构化访谈。访谈内容被全部转录，并采用主题分析方法进行分析。
提供者和客户都指出北美毒品供应持续不稳定，这加剧了过量用药风险，同时也确定了哪些群体将从更多的药物检测服务中受益。两组人员都认为，芬太尼危机对药物检测服务的矛盾影响是这些服务实施和扩展的障碍，对吸毒者及其服务提供者造成了伤害。此外，客户和提供者还反思了社区中药物检测扩展和改进所面临的社会和政策挑战。
药物检测的作用仍未得到充分发挥，尤其是对最脆弱的吸毒者而言。客户和提供者认为，这些服务必须更好地应对北美不断变化且危险的毒品供应情况。
