Drug Checking Won't Save Us
Especially If It's Led By Non-Harm Reductionist, Non-Activist, Capitalist "Saviors"
About a week ago, I was informed about an Indiegogo product that was raising money to build a low cost "consumer friendly" raman spectroscopy drug checking device. It's hard to know where to begin when discussing this topic, as this is nowhere near the first, nor the last, group of folks completely uninvolved in any harm reduction or drug policy reform work inserting themselves into delicate affairs, thinking they've got the sure-fire solution to helping people who use drugs.
People don’t understand how harmful this truly is. I don’t care if you’re a brilliant scientist in your respective field in healthcare. The fact of the matter is, if you’ve never worked with spectroscopy or drug checking in the context of illicit drug supply analysis—especially hyper adulterated and stepped-on-to-filth substances, you don’t know any more than the average schmuck on the street.
From the perspective of people who use drugs, it would actually be GREAT to be able to quality test our own products, so that we can be responsible for our own supply, especially when the healthcare system has failed us in some way. However, framing drug checking as the tool that “saves us from ourselves” is delusional. Our drug use is not actually the problem here!
I do think a tool that could accurately identify substances without the stigmatizing lens would be extremely helpful. Based on their backstory, I unfortunately believe they're not being entirely forthcoming about the intention of their product. They were inspired to do something after a friend of theirs OD'd at an event. It's unclear what their friend ingested or why, but the lack of details around it is sus to me.
Was this friend knowingly using opioids already? If so, would an identification device as such have prevented the loss of a "junkie's" life? Was it another opioid that wasn't fentanyl? A combination of substances that potentiated the sedative effects to a deadly degree? Or, was this someone who was "recreationally" using something like benzos or cocaine, and OD'd from an opioid (likely fentanyl, based on their original product name which was the Snowflake FentScan), which could have been tested with a fentanyl test strip? It feels to me as if they're using "opioid" interchangeably with fentanyl in their product description in a way that assumes that nobody wants fentanyl or other opioids at all, or that they're dangerous or undesirable in any amounts, which is problematic.
Even as an "identification" device detached from judgements, the scaled down level of analysis they're pitching simply won't work. Folks have already run into these issues with the TruNarc, which is a raman spectrometer as well. There's just not enough information given by these devices, if the information we can get is reliable AT ALL.
These devices are usually just looking for the "problem" substance in the context of law enforcement (or other quality control regulation that is not based in harm reduction), all they really need to know is if there’s a narcotic present to be like "GOTCHA, BITCH!". It doesn't help anyone evaluate ratios of the ingredients, if it's even any good at picking them up with absolute certainty to begin with (some drug checking technicians use the language major, minor, and trace, and others will give approximate percentages/ratios of diluents, adulterants, artifacts, and/or contaminants). It requires a level of evaluation that really only a trained technician that has access to other technologies (like GCMS, HPLC, or LCMS) for secondary or testing can achieve at this time.
When testing for substances that are heavily contaminated (usually the opioid supply), fentanyl is hardly the only concern, especially when fentanyl is expected at this point for most—or some people want or “don’t mind” fentanyl in some tolerable amount. Some areas are seeing "fentless dope", which appear to have no detectable opioid, and are majority Xylazine (and possible other non-opioid sedatives), so would a device like this deem the drug "safe" simply because it finds no opioid? Would this device be able to access the latest libraries for emerging substances like all the various nitazines and research chemicals that are coming up for some of us, like 2-Oxo-PCE?
I just have SO many questions and concerns. There are far too many folks who have never done harm reduction work a day in their lives, nor have any lived experience besides a friend or family member OD'ing at most, thinking they can storm in like a knight in shining armor with the ultimate technology solution that will solve the overdose crisis after 1 month of "research", as if everyone else who's been dedicated to this movement for months, years, or decades even, just haven't been clever enough to have a similar idea or seek out solutions. Not to mention the ever changing drug supply and [legal, social, systemic] barriers when doing this work.
They're moving the goal posts from fentanyl detection to all opioid/drug detection without any understanding of how complex the issue actually is, and any understanding of how limited a single piece of drug technology is. It is highly likely to give unreliable results--and people don't even use the test strips and reagents correctly. We have enough hysteria debunking to deal with on this front, imagine what will happen when a raman spectrometer keeps throwing out inaccurate or incomplete information because it’s scaled down for “ease of use”, and everyone believes it. It's also predicated on the idea that every PWUD will simply throw out their substances when they find a contaminant or drug they don't like/didn't expect, simply because they don’t understand drugs or people who use drugs. Look at what happens when an inadequately trained technician or the media takes FTIR information at face value.
A fentanyl precursor, ecstasy, and Vyvanse: all drugs found in both vapes. Thanks to the spectrometer. - What is the precursor? Some of these are not active, or not opioids lol. Ecstasy, as in MDMA? Why would that even be there? And Vyvanse? Lisdexamfetamine—another highly unlikely ingredient or adulterant. Testing any liquid on the spectrometer gives extremely touchy results. Liquids absorb infrared light, and therefor weaken the signal for just about everything else after the signal for the liquid has been removed. Just about every tincture in my experience, the FTIR swears that the liquid is licorice or Johnson and Johnson baby oil (when the pharmaceutical libraries are turned on). We know that shit is NOT in there. Also, it’s my understanding that a second FTIR technician with more knowledge of the machine looked at the scan file, and said that there’s no confidence that the amphetamine (or possibly the other substances) were in that sample and has “no idea why this was reported”. I was late to the meeting when this story was being discussed, but I can say that everyone was appalled that this information was circulating.
“It is a small compact machine that uses infrared light to determine the components of the substance and it can give us results in a couple of minutes!” - It takes at least 10 minutes from the background scan to the end of the analysis, and that’s only if it’s a relatively clean substance and easy scan.
“the spectrometer only needs a drug sample the size of half a grain of rice.” - That is not true. The FTIR spectrometer needs a sample roughly the size of this emoji square (◾️), even though at times it can work with less (sometimes we don’t have a choice), but the FTIR does have a detection limit, meaning if the sample is too small it may not pick up enough of the signal of certain drugs at all, which is why we still use immunoassay strips to look for fentanyl and benzos. There have been many cases where the strip could detect the substance, but the FTIR missed it entirely, or misidentified it because the signal was too weak from there not being enough of the substance for it to get a good read.
The best spectrometers for that level of identification are far too complex to fit into an Easy Bake Oven, and far too expensive to manufacture and maintain at a $200-300 price point. Unless a machine like this can make or reliably wash my cocaine (with a name like Snowflake), they should find another pet project.
When I went through the FTIR training at Brandeis University in October 2023, it was an opportunity for me to get “up to speed” in ways that those formally doing the work are, even though I’ve been using the technology and drug checking in many ways since 2019 and beyond. I had also quite literally returned from Phoenix only 1 day prior, where I was pulling a couple of drug checking shifts with other harm reduction technicians equally familiar or more familiar with this task. Other than the instructors (Cole Jarczyk, Traci Green, Jamie Davis, and remote assistance from Ivy Sabal who was employed with Tapestry Health at the time), nobody else knew ANYTHING.
And it’s no shade, everyone was there trying their best and many picked up on the intense amount of nuance fairly quickly, but realistically you simply can’t throw random people into a 2 day or even 2 week training and think they’re going to understand very complex issues around drug checking and advising participants about harm reduction practices based on their analysis. Some people even started to ask me questions about drugs, because I was the only person with extensive background coming to the training. They were given a “cheat sheet” that tells them some tell-tale signs of xylazine or other common drug use, because there’s so many details to understand about drugs and the supply when you’re testing substances in a harm reduction context.
Considering that the vape had already been used, there was actually no rush to report preliminary results to the media. They could have taken their time to send that out to a lab and get accurate results. The only time we usually go off the FTIR and strips alone is when advising participants more real time, or shortly before they intend to use, as other lab analysis often takes up to 2 weeks, maybe more if there are a lot of samples for them to turnaround (there are only 2 or 3 that almost all of us in the US use for this purpose—Drugs Data, NCU Chapel Hill, and CSFRE).
There is NO easy fix to this problem, especially with the current state of the drug war. We need more people giving a shit about drug policy reform and human rights—not just “saving lives”, which is often thinly veiled purity politics and recovery industrial complex mindsets, making [this specific type of] drug use out to be the “problem”. Framing it as the “problem” creates more stigma and fuels harmful rhetoric and further perpetuates these issues we’re trying to solve, whether that is intended or not. Making more testing supplies and saturating consumers and health departments with flawed, inadequate technology or trying to train up technicians who have no prior exposure to this work certainly isn’t helping.