Considering the prevailing policy-environment, where the unknown purity, adulteration, contamination, and deliberate or accidental misselling of drugs can compound the inherent dangers associated with drug use, safety models such The Loop’s Multi Agency Safety Testing are of vital necessity. Such services are an indispensable resource for those who use drugs across society; at festival and nightlife venues, at home, in drug consumption rooms, and other environments. They are also invaluable to service providers for detecting, monitoring and responding to newly evolving trends.
Drugs may contain from 0-100% of an active substance. You might experience no effect from one batch and you could overdose from the next. There can also be significant differences within batches. As Kevin Flemen notes in this article:
“Crush – dab – wait has become a key message about starting with low doses of MDMA. Developed by the Loop, it is a field-appropriate method of taking a smaller drug dose on a moistened finger and waiting for one to two hours before taking further doses. In practice it can be hard to crush dense tablets in festival settings and if the drug in question is highly potent (such as a SCRA or a fentanyl) even dabbing could be a risk”.
Drug purity can, and does, vary wildly from batch-to-batch and within batches. Last year, The Loop analysed ‘ecstasy’ pills which were found to be 100% concrete. Conversely, ecstasy pills with potentially lethal doses of MDMA have been detected throughout Europe. These wild inconsistencies are also commonplace in cocaine, amphetamine and heroin markets.
Adulteration, contamination and misselling
- The European Monitoring Centre on Drugs and Drug Addiction has detected over 600 New Psychoactive Substances (NPSs) which may be present in any given drug sample. Recently, one of these substances (ADM-FUBICA) was sold as MDMA and led to a number of hospitalisations in Manchester.
- A recent study by John Hopkins University based on DanceSafe data found that only 60% of analysed substances sold as MDMA contained MDMA or the closely related MDA. The majority of adulterants detected were methylone and other cathinones whose safety profiles are not well understood. Three samples contained the extremely harmful PMMA.
- A Swiss study found that 97% of cocaine samples were adulterated. The adulterant levamiscole was detected in approximately 65% of cases. This adulterant is associated with a number of serious side effects, including skin lesions and renal dysfunction.
- In Canada, British Columbia has recently seen a dramatic increase in overdoses. Between January and April 2017, approximately 72% of these overdoses involved fetanyl. Vancouver Coastal Health -which tested for fetanyl at InSite– found that 83% of heroin, 82% of crystal meth, and 40% of cocaine samples tested positive for fetanyl. Reagent Tests UK sell a test kit which tests for fetanyl and DanceSafe’s kit tests for fetanyl and a number of analogues.
Multi Agency Safety Testing (MAST)
MAST allows people who use drugs to submit samples for analysis by trained professionals. Results are communicated to service users by trained drug workers as part of brief interventions. The service is also provided to agencies on-site. Similar services such as the Austrian ChEck It, the Swiss SaferParty, the Spanish EnergyControl, and the Dutch Jellinek, have been operating for approximately two decades. MAST can occur either through ‘front of house’ or ‘back of house’ testing and “ we should aim for a gold standard testing system that includes both, in order to maximise public health benefits and minimise drug-related harm”.
‘Front of House’ Testing:
- Fixed-lab-based drug safety testing services allow people to come in and drop off a sample for testing, e.g. ChEckIt, SaferParty, Jellinek and EnergyControl;
- At-event testing, e.g. The Loop, ChEckIt, SaferParty, CHECK!N, and DanceSafe;
- On-site testing in Drug Consumption Rooms happens in Canada, Spain and Denmark. The Vancouver-based InSite is conducting fetanyl screening on-site, CAS-Baluard provides testing in Spain, and the drug consumption room in Copenhagen has just started providing a drug checking service.
‘Back of House’ Testing:
- WEDINOS (Welsh Emerging Drugs and Identification of Novel Substances), allows Welsh people to send in samples for laboratory analysis for free;
- Spanish-based EnergyControl and US-based EcstasyData allow anyone to send in samples to analyse for a fee.
Benefits of MAST:
Provides information on the quality and purity of drugs to the people using them;
Provides a point of contact for brief interventions with people who use drugs, around their drug use;
Generally leads to safer consumption patterns (for example, when NPSs are detected, drugs are often discarded);
Can greatly enhance information gathering of substance use in given areas, and increase the responsivity of emergency services to newly emerging trends e.g. WEDINOS has detected several previously unidentified NPSs, the Trans-European Drug Information Project (TEDI) monitors trends through-out the European region and the Nightlife Harm Reduction Network of the Americas is developing similar capacities.