Module Seven: Service Provision

The unintentional transfer of a compound from one object or place to another.

Needs-based syringe distribution provides people who inject drugs(PWID) access to the number of syringes they need to ensure that a new, sterile syringe is available for each injection. A needs-based approach provides sterile syringes with no restrictions, including no requirement to return used syringes. https://stacks.cdc.gov/view/cdc/112935

A community advisory board (CAB) is a collective group of community members and representatives that provide suggestions, feedback, and directives to an organization. They advocate for the preferences and desires of the community, and help to ensure that the services a program is offering actually meets the community's needs.

Next Distro Definition of Drug Users Unions:

Drug user unions band together for connection, protection, and to change systems that control and punish people who use drugs. They provide opportunities to make changes on social, legal, and health issues that impact drug users. Similar to labor unions, drug user unions work together to solve a problem that members of the group are facing.They can connect you to resources, provide a space to talk about your use, and opportunities for strengthening the rights of people who use drugs like you. Drug user unions recognize the expertise of people who use drugs and put the power in their hands.

https://nextdistro.org/resources-collection/fight-back-drug-user-unions-how-drug-users-are-working-together-for-their-rights

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Legality of Drug Checking Equipment in the United States
https://www.networkforphl.org/resources/legality-of-drug-checking-equipment-in-the-united-states/

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Characterization of Xylazine Test Strips for Drug Checking

https://www.cfsre.org/images/content/reports/drug_checking/CFSRE_Xylazine_Report-Rev-1-18-23.pdf

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WHP: Drugs of Abuse Testing
https://www.whpm.com/xylazine

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DanceSafe Xylazine Test Strips

https://dancesafe.org/xylazine-test-strips/

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Godkhindi, P., Nussey, L. & O’Shea, T. “They're causing more harm than good”: a qualitative study exploring racism in harm reduction through the experiences of racialized people who use drugs. Harm Reduct J19, 96 (2022). https://doi.org/10.1186/s12954-022-00672-y

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https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-022-00672-y

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Lopez, A. M., Thomann, M., Dhatt, Z., Ferrera, J., Al-Nassir, M., Ambrose, M., & Sullivan, S. (2022). Understanding racial inequities in the implementation of harm reduction initiatives. American journal of public health, 112(S2), S173-S181.

https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2022.306767

Dasgupta, N., & Figgatt, M. C. (2022). Invited commentary: drug checking for novel insights into the unregulated drug supply. American Journal of Epidemiology, 191(2), 248-252.

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McCrae, K., Tobias, S., Grant, C., Lysyshyn, M., Laing, R., Wood, E., & Ti, L. (2020). Assessing the limit of detection of Fourier‐transform infrared spectroscopy and immunoassay strips for fentanyl in a real‐world setting. Drug and alcohol review, 39(1), 98-102.

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Gozdzialski, L., Wallace, B., & Hore, D. (2023). Point-of-care community drug checking technologies: an insider look at the scientific principles and practical considerations. Harm Reduction Journal, 20(1), 39.

Brandeis University: Massachusetts Drug Supply Data Stream

https://heller.brandeis.edu/opioid-policy/community-resources/madds/index.html

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Washington State Community Drug Checking Network

https://adai.uw.edu/wordpress/wp-content/uploads/THE_DC_Network_Infosheet.pdf

To Combat the Opioid Crisis, Expand Drug Checking Programs
https://www.wired.com/story/to-combat-the-overdose-crisis-expand-drug-checking-programs/

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New York State Department of Health Announces Drug Checking Programs

https://www.health.ny.gov/press/releases/2023/2023-10-23_drug_checking_programs.htm

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British Columbia Centre on Substance Use: What is Drug Checking

https://drugcheckingbc.ca/what-is-drug-checking/

We Are the Loop: Our History

https://wearetheloop.org/our-history

Nixon Adviser Admits War on Drugs Was Designed to Criminalize Black People

https://eji.org/news/nixon-war-on-drugs-designed-to-criminalize-black-people/

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Race and the War on Drugs

https://www.nacdl.org/Content/Race-and-the-War-on-Drugs

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Otiashvili D, Mgebrishvili T, Beselia A, Vardanashvili I, Dumchev K, Kiriazova T, Kirtadze I. The impact of the COVID-19 pandemic on illicit drug supply, drug-related behaviour of people who use drugs and provision of drug related services in Georgia: results of a mixed methods prospective cohort study. Harm Reduct J. 2022 Mar 9;19(1):25. doi: 10.1186/s12954-022-00601-z. PMID: 35264181; PMCID: PMC8906357.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8906357/

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Emerging Drug Trends and Prevention

‍https://www.carnevaleassociates.com/our-work/emerging-drug-trends-prevention-issue-brief.html

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Ray, B., Korzeniewski, S. J., Mohler, G., Carroll, J. J., Del Pozo, B., Victor, G., ... & Hedden, B. J. (2023). Spatiotemporal analysis exploring the effect of law enforcement drug market disruptions on overdose, Indianapolis, Indiana, 2020–2021. American journal of public health, 113(7), 750-758.

‍‍https://ajph.aphapublications.org/doi/10.2105/AJPH.2023.307291

CDC Dashboard and Visualizations of Overdose Rates:

https://www.cdc.gov/overdose-prevention/data-research/facts-stats/index.html

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SAMHSA Overdose Prevention and Response Toolkit:

‍https://store.samhsa.gov/sites/default/files/overdose-prevention-response-kit-pep23-03-00-001.pdf

The War on Drugs Is Built On Racism. It's Time to Decolonise Drug Policies

https://idpc.net/blog/2020/06/the-war-on-drugs-is-built-on-racism-it-s-time-to-decolonise-drug-policies‍

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Race, Mass Incarceration, and the Disastrous War on Drugs

https://www.brennancenter.org/our-work/analysis-opinion/race-mass-incarceration-and-disastrous-war-drugs

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The War on Drugs as Structural Racism

https://ldi.upenn.edu/our-work/research-updates/the-war-on-drugs-as-structural-racism/

Also referred to as point-of-care drug checking, community based drug checking refers to drug checking that is cited within overdose prevention centers, SSPs, and other harm reduction or community health settings. Compared to nightlife or pop-up drug checking, community based drug checking is more likely to be accessed by people who are structurally vulnerable to the harms of the War on Drugs and may be experiencing homelessness, complex medical concerns, and more chaotic substance use.

Within the context of drug checking, cross-reactivity refers to when a test responds inappropriately to the presence of a secondary compound that is not the primary target substance. For example, the presence of diphenhydramine (the active ingredient in Benadryl) can cause a false-positive result on a fentanyl test strip.

A memorandum of understanding (MOU) is a non-binding agreement between two or more parties that outlines how they will work together. MOUs are also known as letters of intent (LOIs) or memorandums of agreement (MOAs), and sometimes are the first step towards a formal contract.

Immunoassay strips are used to identify the presence or absence of a particular compound. The use specific antibodies to bind to the compound of interest. Immunoassay strips only give a positive or negative answer and do not indicate anything about how much of a particular compound is present. Examples of immunoassay strips commonly used in drug checking include fentanyl test strips, xylazine test strips, and benzodiazepine test strips, although tests are available for many other types of drugs.

The lowest concentration that can be confidently detected by an analytical instrument or technique.

An analytical instrument used to identify different compounds. Infrared spectroscopy uses infrared light to scan a sample, and then measures how the infrared light interacts with the various compounds in the sample.

A local drug supply refers to the localized aspects of drug availability within a specific area, encompassing unique variations in available drugs, adulterants, and distribution methods. These are impacted by regional law enforcement dynamics, community relationships, and targeted policies or interventions specific to that area.

Overdose Data to Action (OD2A) supports jurisdictions in implementing prevention activities and in collecting accurate, comprehensive, and timely data on nonfatal and fatal overdoses and in using those data to enhance programmatic and surveillance efforts. OD2A focuses on understanding and tracking the complex and changing nature of the drug overdose crisis by seamlessly integrating data and prevention strategies.

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Following lawsuits against major pharmaceutical companies such as Perdue Pharma, opioid manufacturers and distributers are paying more than $54 billion in restitution for their role in the opioid overdose crisis. Much of this money has or will be given directly to state, county, or city governments but there is little guidance in how the money is to be spent.

An adulterant is a substance added to a drug to increase the bulk or weight of a drug, or to enhance the effects or the delivery of the drug in some way. Examples of common adulterants include xylazine, caffeine, diphenhydramine, and levamisole.

A method of determining the presence or absence of a specific compound using specific chemicals to elicit color changes within a solution. In drug checking, colorimetric analysis, also known as reagent testing, is used to assess for the presence or absence of a specific drug of interest. Results of the test are interpreted based on the observed color changes.