Pubdate: Sat, 12 Aug 2017
Source: Vancouver Sun (CN BC)
Copyright: 2017 Postmedia Network Inc.
Author: Kenneth Tupper
Page: B2


Quality checks of illicit drugs is one way, writes Kenneth Tupper.

In recent years across B.C., a public-health tragedy has resulted in
thousands of preventable deaths from street drugs containing powerful
opioids such as fentanyl or its analogs.

Toxicity from adulteration has occurred not just in the heroin supply,
but also in stimulants, club drugs and counterfeit pills. Border
agents and police have tried to reduce or disrupt the supply, but they
have had little success in stemming the tide of illicit drug
importation and consequent deaths.

A public health emergency relating to the drug overdose situation was
declared by Provincial Health Officer Dr. Perry Kendall in April 2016,
and more than a year later the deaths continue on a daily basis.

In response, a range of harm-reduction interventions have been scaled
up - including public education, take-home naloxone kits (an antidote
to opioids that can revive someone who has overdosed) and supervised
consumption services. These measures have undoubtedly saved lives, yet
the toxicity of the drug supply hasn't diminished.

However, there is one approach that might help to reduce the risk of 
overdoses, but hasn't been rigorously tried yet in Canada: drug-checking.

Drug-checking refers to a service where individuals are able to
anonymously submit samples of street drugs to have them analyzed to
determine their chemical constituents. As with many harm-reduction
interventions, drug-checking is not new: it exists in a range of
settings in a number of European countries.

It has been tried in a very limited way at Insite, Vancouver's
flagship supervised injection service, and at the Shambhala Music
Festival in the Kootenays, but not yet with the scale and rigour that
might help significantly reduce the risk of death.

There are a variety of different kinds of technologies that can be
used for drug-checking, but the basic concept is to provide
information to consumers of street drugs about what is in them. This
information may then in turn allow them to make different choices
about where, how much, with whom or even whether to use them.

Drug-checking also gives health and other service-providers a means to
collect and assess information about what is circulating in illegal
drug markets, the monitoring and surveillance of which are otherwise
notoriously difficult.

Drug-checking is grounded firmly in the overlapping terrains of public
health and consumer safety. In the history of modern public health,
after clean drinking water and vaccinations, perhaps the most
important contributor to improved population health outcomes was the
passage of pure food and drugs legislation in the late-19th and
early-20th centuries. Before this, as a consumer you took your life
into your hands if you bought a sandwich at a restaurant, a drink at a
bar or a patent medicine at the pharmacy. Illness or death from
contaminated foods and drugs was common, and conventional wisdom at
the time was to blame the victim: "Too bad - you ought to be more
careful about where you get your meals or medications."

However, public health officials and legislators came to realize that
to protect consumers, quality-control standards could be imposed on
the producers and distributors of products that can potentially be

This consumer safety principle is now applied to a wide assortment of
goods and services: not just foods, beverages, and pharmaceuticals,
but also automobiles, children's toys and hang-gliding equipment. We
understand people have a right to be assured that products - sometimes
inherently risky products - sold by retailers are manufactured to
certain quality standards and that they're what they're purported to
be - with one glaring exception: psychoactive drugs used for
non-medical purposes.

Due to the erroneous belief that prohibition and law enforcement could
eradicate their use, psychoactive drugs such as cocaine, heroin and
MDMA were excluded from consumer safety regulations, so these
commodities were relegated to uncontrolled black markets.

As the likelihood of regulation and control over currently illegal
drugs is politically remote at present, a viable harm-reduction
approach to consumer safety is to offer drug-checking services.
Drug-checking provides valuable - potentially life-saving - feedback
to people who use drugs, allowing them to make better informed
decisions, which contributes to improved self-determination. A street
drug-testing service that provides timely feedback to clients creates
a level of accountability between the consumers of street drugs and
those who supply them.

When consumers of street drugs are able to have their drugs analyzed
for purity and quantity, they're empowered to boycott those dealers
who sell poor-quality or heavily adulterated products. In the midst of
an unprecedented public health crisis of overdose deaths from
adulterated street drugs, an innovative, public health-based service
such as drug-checking - along with rigorous scientific evaluation of
its impacts - is urgently needed.

Kenneth Tupper is director of implementation and partnerships at the 
B.C. Centre on Substance Use and adjunct professor in the School of 
Population and Public Health at the University of B.C.
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