Dasgupta, Nabarun and Figgatt, Mary C (2022) Invited commentary: Drug checking for novel insights into the unregulated drug supply. American Journal of Epidemiology, 191, (2), pp. 248-252. doi: 10.1093/aje/kwab233.
External website: https://academic.oup.com/aje/article/191/2/248/637...
Tobias et al. (Am J Epidemiol. 2022;191 (2):241-247) present a novel analysis of time trends in fentanyl concentrations in the unregulated drug supply in British Columbia, Canada. The preexisting knowledge about unregulated drugs had come from law-enforcement seizures and postmortem toxicology. As both of these data sources are subject to selection bias, large-scale drug-checking programs are poised to be a crucial component of the public health response to the unrelenting increase in overdose in North America. As programs expand, we offer 2 guiding principles. First, the primary purpose of these programs is to deliver timely results to people who use drugs to mitigate health risks. Second, innovation is needed to go beyond criminal justice paradigms in laboratory analysis for a more nuanced understanding of health concerns. We provide examples of the role adulterants play in our understanding of drug harms. We also describe the applications and limitations of common laboratory assays, with implications for epidemiologic surveillance. While the research and direct service teams in British Columbia have taken groundbreaking steps, there is still a need to establish best practices for communicating results to sample donors in an approachable yet nonalarmist tone.
B Substances > New (novel) psychoactive substances > Synthetic opioids
E Concepts in biomedical areas > Pharmacology and toxicology
E Concepts in biomedical areas > Pharmacology and toxicology > Purity / adulterant
HA Screening, identification, and diagnostic method > Physical / medical screening, assessment and diagnostic method
J Health care, prevention, harm reduction and treatment > Risk and needs assessment > Risk assessment
J Health care, prevention, harm reduction and treatment > Risk and needs assessment > Risk assessment > Early warning monitoring system
J Health care, prevention, harm reduction and treatment > Harm reduction > Substance use harm reduction
J Health care, prevention, harm reduction and treatment > Identification and screening > Identification and screening for substance use
J Health care, prevention, harm reduction and treatment > Identification and screening > Identification and screening for substance use > Drug checking / testing service
MM-MO Crime and law > Justice and enforcement system
N Communication, information and education > Information use and impact
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