1
|
Falzon D, Parkes T, Carver H, Masterton W, Wallace B, Craik V, Measham F, Sumnall H, Gittins R, Hunter C, Watson K, Mooney JD, Aston EV. "It would really support the wider harm reduction agenda across the board": A qualitative study of the potential impacts of drug checking service delivery in Scotland. PLoS One 2023; 18:e0292812. [PMID: 38096231 PMCID: PMC10721102 DOI: 10.1371/journal.pone.0292812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/28/2023] [Indexed: 12/17/2023] Open
Abstract
Drug checking services (DCS) enable individuals to voluntarily submit a small amount of a substance for analysis, providing information about the content of the substance along with tailored harm reduction support and advice. There is some evidence suggesting that DCS may lead to behaviour and system change, with impacts for people who use drugs, staff and services, and public health structures. The evidence base is still relatively nascent, however, and several evidence gaps persist. This paper reports on qualitative interviews with forty-three participants across three Scottish cities where the implementation of community-based DCS is being planned. Participants were drawn from three groups: professional participants; people with experience of drug use; and affected family members. Findings focus on perceived harm reduction impacts of DCS delivery in Scotland, with participants highlighting the potential for drug checking to impact a number of key groups including: individual service users; harm reduction services and staff; drug market monitoring structures and networks; and wider groups of people who use and sell drugs, in shaping their interactions with the drug market. Whilst continued evaluation of individual health behaviour outcomes is crucial to building the evidence base for DCS, the findings highlight the importance of extending evaluation beyond these outcomes. This would include evaluation of processes such as: information sharing across a range of parties; engagement with harm reduction and treatment services; knowledge building; and increased drug literacy. These broader dynamics may be particularly important for evaluations of community-based DCS serving individuals at higher-risk, given the complex relationship between information provision and health behaviour change which may be mediated by mental and physical health, stigma, criminalisation and the risk environment. This paper is of international relevance and adds to existing literature on the potential impact of DCS on individuals, organisations, and public health structures.
Collapse
Affiliation(s)
- Danilo Falzon
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, United Kingdom
| | - Tessa Parkes
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, United Kingdom
| | - Hannah Carver
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, United Kingdom
| | - Wendy Masterton
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, United Kingdom
| | - Bruce Wallace
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Vicki Craik
- Public Health Scotland, Glasgow, United Kingdom
| | - Fiona Measham
- Department of Sociology, Social Policy and Criminology, University of Liverpool, Liverpool, United Kingdom
- The Loop, Registered Charity, Manchester, United Kingdom
| | - Harry Sumnall
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom
| | | | - Carole Hunter
- Alcohol and Drug Services, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Kira Watson
- Scottish Ambulance Service, Edinburgh, United Kingdom
| | - John D. Mooney
- Public Health Directorate, NHS Grampian, Aberdeen, United Kingdom
| | - Elizabeth V. Aston
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| |
Collapse
|
2
|
Willeman T, Grundig N, Pochon C, Michels D, Charpentier N, Eysseric-Guérin H, Fouilhé Sam-Lai N, Stanke-Labesque F, Revol B. NPAideS: a drug-checking study among 3-methylmethcathinone (3-MMC) users. Harm Reduct J 2023; 20:96. [PMID: 37507699 PMCID: PMC10375651 DOI: 10.1186/s12954-023-00836-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND 3-methylmethcathinone (3-MMC) has been available on the European drug market for several years, but an increase in its availability seems to have occurred around 2020, associated with reports of harm and death. We aimed to analyze the composition of the supposed 3-MMC samples purchased and its concordance with the assumed composition of the drug. METHODS A prospective multicenter (n = 6) study was conducted between February 2021 and September 2021 in Auvergne-Rhone-Alpes, France. The inclusion criteria were: 3-MMC users over 18 years of age in contact with a community-based organization (CBO) called AIDES. Consumption was evaluated with an anonymized questionnaire and samples of 3-MMC powder were analyzed with a combination of qualitative (GC-MS) and quantitative methods (UPLC-MS/MS), to compare the assumed and real compositions of the products purchased. RESULTS We studied 45 samples provided by 33 users. The study population was predominantly male (91%), with a median age of 40 years, most were university graduates and regular users of 3-MMC. Intravenous drug use was reported by 15.2% of the population. Most of the users bought their 3-MMC online via the Clear Web. Drug testing was requested by 86% of the users, highlighting the need for this type of harm reduction strategy. The purity of the 3-MMC powder samples tested ranged from 21 to 98%. Other NPS drugs, such as 4-CEC (4-chloroethcathinone), 4-MMC, and 2-fluorodeschloroketamine (2-FDCK), supplied as methoxphenidine (MXP), were also detected. CONCLUSION This prospective study shows that 3-MMC purity and dose vary considerably. It also describes the characteristics of 3-MMC users and their expectations of a drug-checking program. Our data suggest that drug-checking services may be useful in this population. Health associations and laboratories should work together to help increase access to such programs.
Collapse
Affiliation(s)
- Théo Willeman
- Univ. Grenoble Alpes, Laboratoire de Pharmacologie, Pharmacogénétique, Toxicologie, CHU Grenoble Alpes, Grenoble, France
- Univ. Grenoble Alpes, Clinique de Médecine Légale, CHU Grenoble Alpes, Grenoble, France
| | - Nathan Grundig
- Univ. Grenoble Alpes, CEIP-Addictovigilance, CHU Grenoble Alpes, Grenoble Cedex 9, 38043, Grenoble, France
- CAARUD Pause Diabolo, Lyon, France
| | | | - David Michels
- AIDES, Pantin et Annemasse, Annemasse, France
- Laboratoire de Recherche Communautaire, Coalition PLUS, Pantin, France
| | - Nicolas Charpentier
- AIDES, Pantin et Annemasse, Annemasse, France
- Institute of Sociological Research (ISR), University of Geneva, Geneva, Switzerland
| | - Hélène Eysseric-Guérin
- Univ. Grenoble Alpes, Laboratoire de Pharmacologie, Pharmacogénétique, Toxicologie, CHU Grenoble Alpes, Grenoble, France
- Univ. Grenoble Alpes, Clinique de Médecine Légale, CHU Grenoble Alpes, Grenoble, France
| | - Nathalie Fouilhé Sam-Lai
- Univ. Grenoble Alpes, CEIP-Addictovigilance, CHU Grenoble Alpes, Grenoble Cedex 9, 38043, Grenoble, France
| | - Françoise Stanke-Labesque
- Univ. Grenoble Alpes, Laboratoire de Pharmacologie, Pharmacogénétique, Toxicologie, CHU Grenoble Alpes, Grenoble, France
- Univ. Grenoble Alpes, Laboratoire HP2 Inserm, U1300, Grenoble, France
| | - Bruno Revol
- Univ. Grenoble Alpes, CEIP-Addictovigilance, CHU Grenoble Alpes, Grenoble Cedex 9, 38043, Grenoble, France.
- Univ. Grenoble Alpes, Laboratoire HP2 Inserm, U1300, Grenoble, France.
| |
Collapse
|
3
|
Affiliation(s)
- David Love
- United States Drug Enforcement Administration, Special Testing and Research Laboratory, USA
| | - Nicole S. Jones
- RTI International, Applied Justice Research Division, Center for Forensic Sciences, 3040 E. Cornwallis Road, Research Triangle Park, NC, 22709-2194, USA,70113th Street, N.W., Suite 750, Washington, DC, 20005-3967, USA,Corresponding author. RTI International, Applied Justice Research Division, Center for Forensic Sciences, 3040 E. Cornwallis Road, Research Triangle Park, NC, 22709-2194, USA.
| |
Collapse
|