Global review of drug checking services operating in 2017
Introduction
Drug checking services invite members of the public to anonymously submit psychoactive
drug samples for forensic analysis and then provide individualised feedback of results and
counselling as appropriate. These services are known under many names, including: drug
checking (services), street drug analysis, pill testing, adulterant screening, multi-agency safety
testing, and drug safety testing. Here, we use the term ‘drug checking services’, while
acknowledging that a lack of agreement about terminology persists.
The rationale for the operation of these services is to inform people who decide to use currently
illegal drugs or new psychoactive substances (NPS) about the content and purity of the
products, so they can make a more informed decision about whether to use them or how to
use them (Brunt et al., 2017). These services also monitor drug market changes and when
particularly dangerous drug samples are identified, they can issue tailored public alerts and
inform specific harm reduction interventions (Vidal Giné et al., 2017).
In recent times, we have seen the emergence of hundreds of NPS, as well as a rise in purity
of substances typically used in nightlife settings, including MDMA and cocaine. In parallel, we
have seen the emergence of drug checking services globally. The last time a substantive
review of drug checking services was undertaken was in 2001 (Kriener et al., 2001) and this
review only covered European countries. A brief updated report released by the EMCDDA
recently profiled some aspects of drug checking services, but it again covered the main
European services only (Brunt, 2017).
This bulletin is the first time a global perspective has been taken. This work sought to identify
and document the features of drug checking services operating across the globe as at 2017.
Methods
We developed a survey to be completed by drug checking services about the technologies
used, the setting of the service, aspects of the process of operation, its scale and length of
operation, funding models, and comments on its history and challenges to operation.
A list of contacts for known existing services was constructed that met our definition. We
emailed those contacts with an invitation to complete the survey, in English, German, and
French where appropriate. Within that invitation we also asked service providers to provide
additional contacts for services we did not yet have listed. The list was expanded through this
process, within each country and world region. The result of this iterative process is that we
feel confident that we have identified the existing services. 1 We followed up contacts to
encourage them to complete the survey, which ran from April to July 2017.
1
But we could be wrong, and we welcome new information about existing services we may have
missed that were operating during the sample data collection period April-July 2017.
NATIONAL DRUG AND ALCOHOL RESEARCH CENTRE
UNSW SYDNEY | NSW 2052 AUSTRALIA | T +61 (2) 9385 0333 | F +61 (2) 9385 0222
ABN 57 195 873 179 | CRICOS Provider Code 00098G
1
Following survey closure, the survey data were checked and cleaned. Some internal
inconsistencies were amended after checking with the agency contacts. Others updated the
data when profiles were provided back to them for checking in October 2017.
The response rate to the survey was high. However, service providers in Wales and Brazil did
not fully respond to our request for participation and a few projects were only mentioned after
we closed the data collection period (see profiles appendix).
Data were used in two ways:
1.
2.
a quantitative summary of the results across all services (this bulletin);
a narrative profile report, providing details of each service.
Results
Geographic reach
Service representatives from 20 countries completed the survey, representing 31 different
checking services (run by 29 separate organisations 2). Twenty-three of the 31 services were
operating within European countries: France (4) 3, Spain (4), Switzerland (3) 4, Austria (2),
Slovenia (2), Belgium (1), Hungary (1), Italy (1), Luxembourg (1), Netherlands (1), Poland (1),
Portugal (1), and the United Kingdom (1). Six of the 31 services were operating in the
Americas, including United States (2), Canada (1), Colombia (1), Mexico (1) and Uruguay (1).
Two of 31 services were operating in Australasia, including in Australia (1) and New Zealand
(1). Nine of 31 services reported that they analyse samples from people who live outside of
their own country, if they present to the service. Two of 3 postal services reported accepting
samples posted from any part of the world.
Figure 1: Number of drug checking services globally (see Figure 2 for Europe)
1
2
Two organisations ran two separate services.
In France, there were 5 laboratories and 38 projects, see profiles appendix.
4 In Switzerland, there was one additional service, see profiles appendix.
3
2
Figure 2: Number of drug checking services in European countries
Length of operation
The median number of years of operation was 11, range 1–25 years (see Figure 3). Thirteen
of 29 organisations running services had been doing so only since 2013.
Figure 3: Number of years since first operation (n=29 organisations providing drug checking)
Imaginario 9
DUCK
SIN Lab
KnowYourStuffNZ
Association Bus 31/32
Be Aware on Night Pleasure Safety (BAONPS)
Programa de Analisis de Sustancias (PAS)
dib+, raveitsafe.ch by Contact – Siftung für Suchthilfe
Drogenarbeit Z6 Drug Checking
ACT Investigation of Novel Substances Project
DÁT2 Psy Help
The Loop
Servicio de Analisis de Sustancias (Substance Analysis…
XBT program
Kosmicare Association (BOOM)
Testing Project; Lonja Laket Project; Punto Fijo
ANKORS Festival Harm Reduction
Jugendberatung Streetwork/ saferparty.ch
DrugsData/EcstasyData
SINTES
DrogArt
Energy Control
Dancesafe
Saferparty.ch; Raveitsafe.ch; Safer Dance Basel, Nuit…
checkit! - Suchthilfe Wien gGmbH
Modus Fiesta
Technoplus
Asociación Hegoak Elkartea
Drug Information and Monitoring System (DIMS)
0
5
10
15
20
25
3
Mode of submission
Three modes of submission were identified: on-site, fixed-site and postal. Twenty-three of 31
services reported conducting on-site setting, including at festivals, nightclubs and other mass
gatherings. Eighteen of 31 services reported operating in fixed-site settings, including offices
and outreach centres, and 2 of these services operated in hospital or emergency department
settings. Three services reported offering a postal submission service. Considering the
different combinations of modes of submission, 12 operated only on-site, 10 ran on-site and
fixed-site services, 6 operated only a fixed-site service, and single services reported operating
on-site/fixed-site/postal, fixed-site/postal and only postal.
The service modes of submission (on-site, fixed-site, postal) appear to be largely driven by
the regulatory environments where they operate, as well as the capacity of sites (e.g.,
nightclubs, festivals) to allow services on-site. That is, promoters may be willing to host a drug
checking service at their event, but to do so may reduce their chances of getting appropriate
approvals from government authorities, because, in some countries, hosting drug checking is
viewed as an acknowledgement that drug use is occurring at their event (Levy, 2004).
Drug analysis methods
Services provided a list of all the drug analysis methods that they used (see Figure 4). Fifteen
of 31 reported at least 1 mass spectrometry or liquid chromatography method (including GCMS, LC-MS, HPLC, UHPLC, IT-MS). 11 reported at least 1 spectroscopy method (including
FTIR, UV-Vis, Raman). TLC was utilised by 13 services. Sixteen of 31 services reported use
of reagent tests. A quarter (4 of 16) services who used reagent kits reported only using this
method: in most cases, reagent kits were combined with other analysis techniques.
Figure 4: Drug analysis methods employed by drug checking services
Raman Spectroscopy
Ion Trap-Mass Spectrometry
Ultra High-Performance Liquid Chromatography
Fourier Transform Infrared Spectroscopy
UltraViolet–Visible Spectroscopy
Liquid Chromatography Mass Spectrometry
High-Performance Liquid Chromatography
Thin Layer Chromatography
Gas Chromatography Mass Spectrometry
Reagent test kits
0
2
4
6
8
10
12
14
16
18
Note: Multiple responses were allowed. N=31 services responded to this question.
4
While Figure 4 only includes the techniques asked about in the survey, in the free-text ‘other’
category, responses included Nuclear Magnetic Resonance (NMR) (4), UV Lamp for LSD
identification (2), wet extraction (solvent washing) for MDMA purity in tablets (1), hemp test
(1), Liquid Chromatography/Quadrupole Time-of-flight Mass Spectrometry (LC/QToF/MS) (1)
and High Resolution Mass Spectrometry (HRMS) (1). Some services also described the
capacity to send samples they could not identify to other services where more advanced
equipment was available. Counting both the standard and ‘other’ category responses, services
reported use of a median of 3 different analysis methods (Range 1-8).
Of those services reporting the use of reagent kits (n=16), the most common reagent tests
used were Marquis (16), Mandelin (15), Mecke (14), Ehrlich (12) and Simon (10). Reagents
used by less than half were Liebermann (6), Froehde (6), Folin (6) and RobaTest or Ropadope
(4). Additional reagents reported as free-text ‘other’ responses included Scott (semiquantitative cocaine test) (5), Cocaine Cuts (cocaine additives test) (1) and Hoffman (DMT
and LSD test) (1). Counting both the standard and ‘other’ category responses for reagent
testing, services who reported use of reagent test kits reported use of a median of 6.5 different
reagent kit types (range 2–10).
Regarding the types of results received from testing, 14 of 31 services reported being
equipped to identify multiple substances as well as purity or dosage, 10 identified multiple
substances (but not purity or dosage), 5 identified one main substance only, and 2 identified
one main substance as well as the purity of that substance. Two of the services that identified
multiple substances as well as purity or dosage specified that purity analysis was only done
for specified compounds, including MDMA, cocaine and 2C-B.
For identification of substances in a pill, most services (22 of 31) only required a scraping of
the pill or none (in the case of 1 service that used Raman spectroscopy, which can be
conducted without the device touching the substance), while others used a quarter (5), a half
(1) or a whole pill (3). Some services mentioned that they would conduct testing on any
amount, such as a scraping, but could conduct more reliable testing on greater amounts, so
they sought them when possible. Additionally, access to the whole pill was preferred in order
to photograph, measure and weigh it for cataloguing. For the 15 services that conducted
quantitative analysis on pills, the minimum amount needed for this kind of analysis was a
scraping (4), a quarter pill (6), half a pill (1), a whole pill (3) and 5mg (1).
For identification of substances in a powder (n=25 responses), the median amount required
for testing was 10mg (range 0-50mg). The modal amount required was 10mg (8), then 5mg
(5). For quantitative analysis on powders (n=13 responses), the median amount required for
testing was 10mg (range 1-50). The mode was 10mg (4), then 5mg (2) and 50mg (2).
Service model aspects
The reported wait times for service users (how long they have to wait for results of the analysis
process) are shown in Figure 5 for on-site services (23) and fixed-site services (17). The
median wait time was 15–29 minutes for on-site services and 1–3 days for fixed-site services.
The three postal services reported a wait time of over 1 week.
5
Figure 5: Wait times for service users by service type
On-site services
Fixed-site services
7
6
6
5
5
4
4
3
3
2
2
1
1
0
0
<5 5-14 15-29 30-59 1-2 1-3 4-7 >1
mins mins mins mins hours days days week
<5 5-14 15-29 30-59 1-2 1-3 4-7 >1
mins mins mins mins hours days days week
Note: On-site service n=23; fixed-site services n=17
Almost every service (30 out of 31) provided a brief intervention (one-on-one session between
service user and service staff), 25 services provided harm reduction materials/leaflets, 11
services reported providing an ‘other’ response (e.g., counselling, medical assistance, referral
to other services), and one service provided no additional information or intervention. Nine
services also reported offering secure disposal facilities to service users to discard drug
samples safely.
Services were asked whether drug samples are provided back to service users by service
staff, as this practice may represent a legal risk in some jurisdictions. Only 1 service reported
that they did provide samples back to service users. The most common practice was to only
ask for the amount needed for the test (15 of 31). Some services reported that they never
provided drugs back even if only a part of the sample was used for the analysis (7), while the
remainder reported that returning drugs to service users was not relevant to them (6) because
service staff never handled the samples (e.g., service users were instructed by staff to place
substance in a tube) or their service did not interact directly with service users (e.g. postal
service).
Communication of analysis results
Services were asked to consider to whom and how they communicate their results, including
individual and aggregate test results and warnings/alerts. All services communicated results
directly to individual service users (as per the definition of a drug checking service), and more
than half of the services also alerted the public (24), health/welfare/outreach (21), researchers
(19) and promoters/event managers (16) of the test results (see Figure 6).
Methods of communication of results, regardless of type of person, were primarily in person
(27), public website (21), email (21), and reports using aggregate data (20) (see Figure 6).
6
Figure 6: Communication of test results
Types of people and
organisations
Communication methods
Via app
Registered members
Text message
Police
Website with code
Politicians/Media
Verbally (Phone call)
Promoters/Event…
Report
Researchers
Public website
Health/Welfare/Outre…
Email
The public/Anyone
In person
The individual service…
0
10
20
30
0
10
20
30
When services provided analysis results back to individual service users, they did so in person
(27), by phone call (11), email (10), website public (6), website with a code (4), report using
aggregate data (4), text message (2) and app (1).
A database of analysis results was maintained by 28 of 31 services. Most (17) of these
maintained a restricted access database, while 8 reported that the database could be
accessed upon request, and 3 that the database was open access.
Funding sources
Services were asked about the sources of funding received to conduct drug checking. Some
form of government funding was received by most services (21 of 31). The most commonly
reported was national funding (10), then state funding (9), city/municipality level funding (8),
and international funding (4). Fifteen services reported government funding from a single type;
6 reported funding from multiple government funding types. Of the services with a single
government funder, 5 reported receiving only national funding, 6 reported receiving only state
funding, 2 reported receiving only city/municipality level funding, and 2 received only
international funding, including European Union funding.
Eleven services reported relying on a variety of non-government funding sources, either from
promoters (7), service user co-payments (4), private or philanthropic foundations (2) or private
donations (2). However, only one service was funded solely by promoters, and just one other
solely by service user co-payments, with none being funded solely by other types of nongovernment funding source.
Four services reported that they receive no funding whatsoever. There was a high reliance
across the sample on in-kind support from volunteers and auspice organisations. That is, even
when government funding was received, it was not typically enough to fully fund the operations
of the service. Some services also commented that the inclusion of drug checking in their
service made them ineligible to seek formal funding from government sources in their country.
7
Evaluation
Most services (20 of 31) reported that there has been some type of evaluation of their service.
However, in the comments field, evaluation reports that were published and available to the
public were less commonly mentioned. Many evaluations were either in-house, unpublished
or currently underway. Others were not available in English. See individual service profiles for
lists of available evaluations.
Discussion
This global catalogue has demonstrated the wide reach of drug checking services, now
operating in 20 countries across Europe, the Americas and Australasia. It has also shown the
exponential increase in the number of organisations conducting drug checking, with almost
half of the organisations who responded to our survey beginning operations in the last five
years. These new organisations join a contingent of established services, many with decades
of experience. This catalogue shows that drug checking is certainly not a new phenomenon.
It has been occurring on-site at festivals and music events, at fixed sites including outreach
and treatment centres, and through postal services, for over 25 years.
What is new though is the breadth of available analytic techniques that are now being used to
identify and quantify the contents of drug samples (Harper, Powell, & Pijl, 2017). While older
techniques (TLC, reagent tests) are still being used (they are easy to administer and less
costly), spectroscopy methods are increasingly popular. Just under half of the services used
an advanced method including mass spectrometry methods. This level of technology use
means that the majority of services are capable of identifying multiple drugs, while just under
half of the services are capable of quantifying multiple drugs (that is, providing purity or dosage
information). Such technology provides a level of detail often not attributed to drug checking
services by their critics (Schneider, Galettis, Williams, Lucas, & Martin, 2016), who also argue
that service users would not be willing to wait for the results of more sophisticated analysis.
Our results on wait times indicate that a 30-minute wait on-site is the median with longer waits
also being reported.
Reagent kits have been criticised by many due to their limitations (Schneider, et al., 2016),
and the possibility that they may provide a false sense of security (Winstock, Wolff, & Ramsey,
2001). For example, MDMA adulterated with an NBOMe will likely test positive for MDMA
using a Marquis test. If only one test is used, the presence of the much more dangerous
NBOMe will be missed. In our sample, only four services used only reagent kits, and there
was no service that reported use of only a single reagent kit. This catalogue also shows that
more accurate and comprehensive analysis techniques are available and feasible for on-site
use, but usually only in countries where political and funding contexts support the costs
associated with these techniques.
In our sample, identification of substances typically required only a scraping of a pill or 10mg
of powder. Australian research indicates that the provision of a scraping is acceptable to
almost all festival goers surveyed (Barratt, Bruno, Ezard, & Ritter, 2018). Some have argued
that drug checking services would not be viable if people are required to ‘give up’ a sample of
their drugs for testing. In such situations, there are technologies available for substance
identification that do not require any substance donation (Raman spectroscopy and DARTMS) (see also Harper, et al., 2017).
8
Almost every service provided a brief intervention and most provided harm reduction
information alongside their feedback about the drug’s content (and purity in some cases). That
is, the analysis result is only the beginning of the conversation with the service provider: it
provides a ‘hook’ to attract an otherwise hidden population into the service (Hungerbuehler,
Buecheli, & Schaub, 2011).
While nine services reported offering secure disposal facilities for drugs to be discarded, the
majority did not. Such a practice assists service users in discarding safely, but also enables
counts of the discarded drugs as evidence of drug checking services removing the most
dangerous compounds from circulation (Royal Society for Public Health, 2017; Sage, 2015).
The drug checking services surveyed here typically communicated their results to a wide
variety of stakeholders, in addition to the service user themselves. While most services
maintained a public website, only three services reported hosting a database of their
substance testing that was open access. While only one service reported using an app to
communicate with service users, we expect app-based communication to increase in coming
years. For example, in 2016, an app called KnowDrugs was released that presents a
combined database of drug checking results.
Many drug checking services operate in difficult or restrictive funding settings. Most services
reported at least some form of government funding, while a third of services reported relying
on donations or payments from non-government sources, including promoters, service user
co-payments, and private donations. Many services reported that they used volunteers and
relied on in-kind support from other organisations. The precarious nature of funding for many
drug checking services is concerning. Lack of adequate funding limits their use of the most
accurate and comprehensive analysis techniques, which typically require a greater financial
outlay and greater ongoing operation costs. It also affects their capacity to conduct
evaluations, which require separate resourcing. This study has identified a definite need for
separate resourcing to evaluate the variety of service models currently operating (Vidal Giné,
et al., 2017).
Some limitations of this catalogue should be noted. We did not ask service providers to
describe the client group that they serve nor which drug types they typically analysed. These
questions are increasingly important with the emergence of illicit fentanyl analogues being
unknowingly consumed, typically as ‘heroin’ (Ciccarone, Ondocsin, & Mars, 2017) but also as
other psychoactive substances (Lysyshyn, Dohoo, Forsting, Kerr, & McNeil, 2017). This public
health threat has prompted many organisations to provide testing services for people who
inject drugs at outreach and treatment services, with the aim of identifying tainted heroin
before its consumption (Krieger et al., 2018; Lysyshyn, et al., 2017). Other limitations of this
catalogue include a limited number of languages used to request participation—including
other languages may increase the catalogue reach in future.
We already know that there are new services starting up in countries not covered in this
bulletin. We look forward to updating the bulletin to reflect these new services and
developments among the increasing number of drug checking services globally.
9
Summary of services in this bulletin
This table lists summary features of the 31 services who completed the survey.
Name of service, Country
Start
year
Mode of
Submission
Analysis
method(s)
Drug Information and Monitoring
System, Netherlands
1992
Fixed-site
GC-MS, LC-MS, ITMS, FTIR,
Reagents
Asociación Hegoak Elkartea, Spain
1994
On-site & fixedsite
TLC, Reagents
Technoplus, France
1995
On-site
TLC
Modus Fiesta, Belgium
1996
On-site
GCMS, TLC,
Reagents
checkit! - Suchthilfe Wien gGmbH
1997
On-site
HPLC-MS/MS,
UHPLC, MALDI-ITMS/MS, HRMS
Saferparty.ch; Raveitsafe.ch; Safer
Dance Basel, Nuit Blanche
1998
On-site
HPLC, GC-MS, LCMS, UV
Dancesafe, United States
1998
On-site
Reagents
SINTES, France
1999
On-site, fixed-site
& postal
HPLC, UHPLC,
GC-MS, LC-MS,
UV, FTIR
Energy Control, Spain
1999
Fixed site &
Postal
HPLC, GC-MS, UV,
TLC
Energy Control, Spain
1999
On-site
UV, TLC, Reagents
DrogArt, Slovenia
1999
Fixed-site
HPLC, GC-MS
DrogArt, Slovenia
1999
On-site & fixedsite
Reagents
Jugendberatung Streetwork/
saferparty.ch, Switzerland
2001
On-site & fixedsite
HPLC, GC-MS, LCMS
DrugsData/EcstasyData, United
States
2001
Postal
GC-MS, Reagents
ANKORS Festival Harm Reduction,
Canada
2002
On-site & fixedsite
Raman, TLC,
Reagents
Testing Project; Lonja Laket Project;
Punto Fijo, Spain
2002
On-site & fixedsite
GC-MS, TLC,
Reagents
10
Kosmicare Association- Integrated
Drug Checking Service at The Boom
Festival, Portugal
2006
On-site
TLC
XBT Program, France
2009
On-site & fixedsite
TLC
ACT Investigation of Novel
Substances Project, Australia
2013
Fixed-site:
Hospital
HPLC, UHPLC,
GC-MS, LC-MS,
FTIR, NMR
Servicio de Analisis de Sustancias
(Substance Analysis Service),
Colombia
2013
On-site & fixedsite
GC-MS, UV, TLC,
Reagents
The Loop, United Kingdom
2013
On-site
UV, FTIR,
Reagents
DAT2 Psy Help, Hungary
2013
On-site
Reagents
Drogenarbeit Z6 Drug Checking,
Austria
2014
Fixed-site
GC-MS, LC-MS
Programa de Analisis de Sustancias
(PAS), Mexico
2014
On-site & fixedsite
TLC, Reagents
dib+, raveitsafe.ch by Contact –
Siftung für Suchthilfe, Switzerland
2014
Fixed-site
HPLC, GC-MS, LCMS
KnowYourStuffNZ, New Zealand
2015
On-site
FTIR, Reagents
Association Bus 31/32, France
2015
On-site & fixedsite
TLC
Be Aware on Night Pleasure Safety
(BAONPS), Italy
2015
On-site
Raman
DUCK, Luxembourg
2016
On-site
GC-MS, LC-MS
SIN Lab, Poland
2016
On-site
Reagents
Imaginario 9, Uruguay
2016
On-site
TLC, Reagents
11
Suggested citation
This bulletin was prepared by Monica J. Barratt, Michala Kowalski, Larissa J. Maier, and Alison
Ritter. Please cite this bulletin as follows:
Barratt, M.J., Kowalski, M., Maier, L.J., & Ritter, A. (2018). Global review of drug checking
services operating in 2017. Drug Policy Modelling Program Bulletin No. 24. Sydney, Australia:
National Drug and Alcohol Research Centre, UNSW Sydney.
Acknowledgements
We would like to thank Leigh Coney for assistance with data cleaning, Samuel Banister and
Anton Luf for review of our glossary, Hans-Jörg Helmlin and Daniel Allemann for review of our
questionnaire, and Gregory Pfau for extra information about the French monitoring system.
We also thank all drug checking services for their time completing the survey and reviewing
the service profiles.
References
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12