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Home Health A New Strategy for Preventing Fentanyl Overdoses: Testing Drugs

A New Strategy for Preventing Fentanyl Overdoses: Testing Drugs

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Chapel Hill, North Carolina — A small tube of white powder was delivered one morning by FedEx to the basement offices of the University of North Carolina campus in Chapel Hill.

An anonymous drug user from Wilmington, N.C., wrote on the index-card-sized piece of paper that came with the tube, “Immediately OD, half a bag, strangely lethargic.” I had a hunch that it contained fentanyl, but feared the presence of xylazine, a dangerous animal tranquilizer that can leave oozing scars on your hands and feet.

Erin Tracy, a university chemist who specializes in drug testing, set out to find the answer. She aliquoted the samples into small vials and placed them in her $600,000 refrigerator-sized instrument known as a gas chromatograph-mass spectrometer. This instrument is commonly used in academic chemistry laboratories.Showed nearby computers result A line graph with a dramatic peak that is the fentanyl signal.

Only trace amounts of xylazine were left, the machine confirmed.

The research at the North Carolina lab is part of a strategy known as harm reduction, which provides tools for safe drug use rather than leading users to sobriety, preventing infections, injuries, and illnesses. The goal is to prevent death. President Biden was the first president to endorse the strategy, which medical experts say could change the way the United States fights drug use.

Testing of drug samples in laboratories and in a growing number of cities across the country is providing researchers and drug users with new insights into what is in their local drug supply. Know what’s in it before you use it, warn other users of possible dangers, or find out why a drug caused an overdose or other reaction . The Chapel Hill team also investigated a sample of the drug that caused the fatal overdose and relayed the results to the Harm Reduction Group.

Known as drug testing, testing efforts in places like North Carolina have become particularly important in recognizing fentanyl, a synthetic opioid and the main culprit in many overdose deaths in recent years. Other drugs such as cocaine and heroin are often mixed with fentanyl.

But the U.S. drug supply is increasingly contaminated by other substances, such as xylazine. Calls to invest in drug testing are growing.

Dr. Nora D. Folkow, director of the National Institute on Drug Abuse, a division of the National Institutes of Health, said people who have had fatal drug overdoses have died not just from fentanyl, but from other contaminants as well. I pointed out that

“We need to understand that, and we need technology that can inform us,” she said.

Although exact numbers are difficult to pin down, drug policy experts say there are health departments, academic labs, Herm, and others using drug-checking machines across the country, including cities like New York and Chicago. There are dozens of reduction groups. But experts say the work will require more funding, in part because of how difficult it is to scale.A test strip that can check for the presence of fentanyl in a sample typically costs $1, but drug-checking machines It comes with a price tag of tens of thousands and even hundreds of thousands of dollars.

Biden administration in 2022 national drug strategy aims to increase drug-checking services in its harm reduction program by 25% within three years. Policy experts say more money should be directed to groups that typically operate on meager budgets.

Drug testing has long been a feature of harm reduction efforts in Canada, Australia and Europe, including social settings such as nightclubs and music festivals. However, it is only in recent years that the practice has been picked up in the United States, reflecting the slow adoption of harm reduction measures. More than 10 states have outlawed even basic drug-checking tools like fentanyl test strips as drug paraphernalia.conservatives criticize convention As an allowance for drug use.

Due to the surge in opioid supplies in recent decades, drug testing is usually done by crime labs or drug enforcement agencies to look at drug seizures. Law enforcement agencies have long been reluctant to share results quickly or publicly with the goal of helping drug users learn more about local supplies.

Users often have an intuition of what to take based on the smell and appearance (such as lightness or darkness) of tablets and powders. Samples from the same drug dealer may contain different amounts of fentanyl, may be mixed with other substances, and may vary by dose. Effects may vary from batch to batch and may contain trace amounts of substances that can cause strange and surprising sensations.

Experts say the limited value of fentanyl test strips means that drug-testing tools are needed in some areas. core component On the Biden administration’s drug control strategy. Unlike some drug testers, the strip does not tell the user the type or amount of fentanyl in the sample. It’s just whether or not it contains drugs. Also, because fentanyl is so widespread, users often take the substance knowing it contains drugs.

Some harm reduction groups now use cheaper toaster-sized machines that perform less comprehensive checks than the Chapel Hill device, but are more portable. These machines allow healthcare workers in cities like New York, Chicago, San Francisco and Boston to test drug samples from vans and small rooms and report results to users within minutes.

“We have regular customers who come back every week,” said Lo Giuliano, who directs the syringe exchange program at the San Francisco AIDS Foundation. Use a small machine to check for drugs.

The Chapel Hill team has developed what some drug policy experts consider the most ambitious model. activities can extend beyond a single organization or community, including

The program does not know the identity of the user who submitted the drug for testing. Samples are typically routed through harm reduction organizations that have relationships with drug users and can communicate results to them.the result too Post onlineResearchers have so far tested drugs from 18 states and 51 clinics and programs.

To collect samples, the Chapel Hill team provides drug users with kits containing small vials containing chemical solutions that effectively neutralize the substance. Scientist Navarun Dasgupta, who oversees the program, said the move would avoid skepticism about the legality of the research.

Drug testing already benefits users in states with drug device laws. make drug testing more difficultAaron Ferguson is the leader of the Urban Survivors Union, a group representing harm reduction organizations and drug users. of heroin samples were collected and sent to Dr. Dasgupta’s team because they were suspected of containing fentanyl.

Ferguson said the drug check tool “creates an early warning system that never happens from the DEA’s drug seizures in the illegal drug supply.” I don’t know if it’s in.”

Dr. Dasgupta and his team found that among the approximately 600 samples the group has run to date, 100+ substancesOnly a handful of what he called “intended” drugs, including THC, cocaine, heroin, ketamine, MDMA, and methamphetamine. Many samples contain dizzying combinations of over a dozen substances.

Dr. Dasgupta recalled a sample submitted by a harm reduction group in western North Carolina. The group received samples from cross-border Tennessee drug users. Harm mitigation groups in the area were unaware that the samples contained metonitazen, a potentially dangerous opioid, he said.A few weeks later, the Centers for Disease Control and Prevention issued report This shows how drug checks can provide users with timely warnings.

In two other cases, researchers found xylazine in samples from users who were misdiagnosed with bacterial abscesses that sometimes required amputation. Some can be treated like burns, avoiding the need for more dramatic intervention. At least one of those users escaped amputation after the presence of xylazine was confirmed, he said.

Drug testing has already left its mark on health officials and members of law enforcement, according to drug policy experts. His Traci C. Green, an epidemiologist at Brandeis University, said: Massachusetts Drug Testing Program We collect samples from harm reduction groups and law enforcement agencies.

The drug supply is “not this gigantic, deadly, snarling beast,” Dr. Green said. “It’s what we live with.”

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