Intended for professionals who work in or provide ancillary services for public health and public safety, this “In-Brief” from the Forensic Technology Center of Excellence presents an overview of harm-reduction services for people who use illicit drugs (PWUD) in the United States, describes modes of drug checking within harm-reduction settings, and offers observations and lessons learned from emerging drug-checking needs.
Initially developed in the 1980s, harm reduction organizations offer products and services that educate PWUDs (and their family and friends) about safe drug use and help them make informed decisions without coercion, judgment, or threat of punitive action. With an increasingly unpredictable and dangerous drug supply, harm reduction sites have begun to offer products and services that help PWUD better understand what is in their drugs, referred to in this brief as “drug checking.” Drug checking can also serve the community when trends and insights from drug-checking promote products such as clean syringes and naloxone or health care services such as HIV testing. Studies indicate that PWUD are willing and interested in accessing drug checking with harm-reduction services. In a 2019 study of 334 PWUD in the Baltimore, Providence, and Boston areas, 89.5 percent indicated that drug- checking measures such as fentanyl strips (FTS) would “make them feel better about protecting themselves from overdose;” however, FTS only provides an indication of fentanyl presence and not confirmation of presence. Some instruments, such as Raman spectrometers, can scan the samples through a plastic bag, minimizing the need to handle the substance outside of its packaging.