To combat the overdose crisis, expand drug control programs

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about the past two weeks, Minnesota and Vermont took steps to explicitly legalize, fund, and expand drug control resources. These are important developments for drug policy. Tools like mass spectrometers and fentanyl test strips give people real-time information about what’s in their medications, which can help them make more informed decisions and reduce the chance of an overdose. In addition, they help public health and harm reduction workers understand what is in the drug supply, a necessary prerequisite for them to respond to crises and reduce risk. More local legislators and organizations should follow in the footsteps of Minnesota and Vermont and implement policies that emphasize drug control as a harm reduction tool and expand its use as a community tool.

In addition to drug screening, we can find out what’s in the drug supply through drug supply surveillance. Most of this surveillance data is collected through drug seizures by law enforcement, drug screening in clinical settings or after death, and urine-based drug screening of individuals in treatment programs. of drugs. In short, this information is often collected through punitive measures. A positive urine drug test can result in loss of custody of a childdenial or loss of employment, and imprisonment. We have turned this discrimination into law with legislation like the Drug Free Workplace Act of 1988, which requires employers who receive federal contracts to drug test their employees. Some legislators have gone further, pushing for drug test people who receive government support such as food and housing stamps. And the choices about who to test are often discriminatory. A published study earlier this year, for example, it found that hospitals are more likely to drug test black women who are pregnant than white women, despite no difference in the positive test rates.

When you know what might be in your drug supply, you can be better prepared to reduce harm. You may choose to use smaller amounts, avoid mixing drugs, or not use them alone. I could start taking naloxone. But for this to be possible, we need timely and accurate communication about the local drug supply, which requires approaches that are neither punitive nor discriminatory.

Along with others at Brown University School of Medicine and Rhode Island Hospital, we run a pilot drug surveillance project called testRI, which takes donated samples of used drugs and paraphernalia from people across the state and Test using an integral machine in the hospital’s toxicology laboratory. This gives us a detailed list of all the substances that were in the sample and allows us to understand what is in the local drug supply. Then our test data is compiled, published onlineand distributed in the community, along with information on what substances were detected and how to reduce the risk. In MarchFor example, someone told us they thought they were buying fentanyl, but when we analyzed the sample we also found xylazine, a powerful animal tranquilizer. This drug can cause serious injury and cause prolonged sedation, which can complicate responses to overdose. Once we documented the presence of xylazine, we created and distributed a magazine to people in the community with information about what the drug is, how it manifests itself locally, and how people can care for the skin wounds it causes and respond to overdoses.

We’re not the only ones taking this kind of approach. TO laboratory at the University of North Carolina at Chapel Hill runs a drug-check-by-mail program, where people from all over the country can send in substances to be tested. And the NY The Department of Health and Mental Hygiene offers drug screening programs at three sites, allowing people to see what’s in the substances they have on hand and giving them tips on how to reduce risk.

Combining drug verification programs with comprehensive drug supply surveillance efforts is critical to quickly understanding and responding to changes in the supply. But for these efforts to be effective, they must be community-driven, with the goal of reaching people where they already are. When we work with local partners to publish on instagram and Twitter and distributing magazines and other printed materials, led to funding for wound care kits distributed by harm reduction agencies in the state, and additions to the state overdose dashboard.