With growing international attention on the impacts and broad potential of drug checking services, a number of events at HR17 featured research findings and frontline experience with this harm reduction intervention.
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For the first time in its history, the 25th Harm Reduction International Conference (HR17) held in Montréal, Canada put drug checking – a harm reduction intervention that provides people who use drugs with information about purity, potency, and composition of their substances – front and centre on the agenda. Reflecting increasing international interest in implementing drug checking services, a pre-conference workshop, panel session, and press conference explored the impacts of drug checking on the health and wellbeing of people who use drugs in a variety of settings and across the spectrum of drug-using behaviour. As a harm reduction conference taking place against a backdrop of an opioid overdose crisis, drug checking in the form of fentanyl test strips were made available in the onsite medical room.
On May 14, 2017 prior to the official opening of HR17, members of a Canadian National Working Group on Drug Checking organized a “Drug Checking Services and Analysis Workshop.” A free and public event, the workshop was well attended by local and international stakeholders from a variety of disciplines with existing expertise and interest in further learning about drug checking fundamentals along with different models of research evaluation and service provision that are currently being used around the world. Speakers included Helena Valente (Porto University, Portugal), Brun Gonzalez (Programa de Análisis de Sustancias, Mexico), and Dr. Mireia Ventura (Energy Control, Spain). Attendees were treated to speakers’ unique perspectives on the rationale behind drug checking, effective methods in the field, and how to build upon and sustain existing programs. Speakers agreed that drug checking offers much more than test results – including education and support around drug use – and importantly, attracts people who use drugs who otherwise would not interact with health services about their drug use. Noting that the majority of harm reduction efforts have traditionally focused on people who inject drugs, Mr. Gonzalez described drug checking as essential to “full spectrum harm reduction,” an approach that provides appropriate services for all people who use drugs despite where they fall on the spectrum of drug use. Burgeoning evidence suggests that most people intend to change their behaviours (e.g., not take a drug, reduce their dosage, not use alone, etc.) if their drug checking results reveal some unexpected or unknown contents in the drugs they were planning to take. Ms. Valente stressed that although empirical evidence indicates that drug checking is a useful intervention, moving beyond research on behavioural intention will be an important step in establishing the evidence base to support scaling up these services. Dr. Ventura emphasized the value of drug checking in monitoring drug markets and equipping policymakers and health authorities with data to respond to dangerous trends, and noted that Energy Control is responsible for detecting about 65% of new substances to the government. Attendees left the workshop feeling energized and having expanded their international networks and knowledge on drug checking.
A concurrent panel session titled “Drug Checking: From Dance Clubs to the Dark Web” kept a focus on drug checking on May 15, 2017 and gave conference delegates a chance to learn about the evaluations of innovative drug checking programs. Dr. Mark Lysyshyn presented an important example from Vancouver – one of the cities across Canada experiencing a major opioid overdose crisis – where clients of a supervised injection facility (SIF), Insite, were offered test strips to check their drugs for fentanyl. Dr. Lysyshyn’s research found that offering fentanyl drug checking allowed clients to use the results to reduce harm through dose reduction and thereby decrease their risk of overdose, suggesting that drug checking could be a useful intervention to prevent overdose fatalities, including among people who use drugs accessing a SIF. The presenters also participated in a press conference earlier that day during which journalists were given the opportunity to ask targeted questions about their drug checking research. Julie-Soleil Meeson, a member of the Canadian National Working Group on Drug Checking, also made remarks at the press conference on the various efforts taking place across Canada to implement drug checking.
Beyond disseminating information on drug checking research, HR17 was also a likely diffusion point for fentanyl test strips, with some conference delegates bringing these back to their agencies in Canada and abroad. Although no results were collected, word of mouth indicated a noticeable amount of results from test strips were positive for the presence of fentanyl.
We hope the emphasis on drug checking at HR17 not only created a space to learn and share, but also inspired a continuation of efforts to create harm reduction strategies that meet the diverse needs of people who use drugs .
Written by: Tara Marie Watson, Caleb Chepesiuk, and Nazlee Maghsoudi, Members of Canadian National Working Group on Drug Checking
Special thanks to Julie-Soleil Meeson for translating this blog post into French!