Drug Checking

What is Drug Checking?

Drug checking services are an important component of harm reduction. These services can be used to determine whether drug samples contain the substance an individual wants to use, determine the purity level of a substance, identify toxic contaminants and unexpected substances, and track drug use patterns. Drug checking programs also have the potential to disrupt the drug market by exposing adulterated drugs, and by helping health and safety bodies to make public health alerts. 

Drug checking has been shown to support informed decision-making, reduce the amount of drugs that people take, and increase the likelihood that people will discard of unsafe drugs. 

Drug checking services have been available in much of Europe for over 25 years and are now available at supervised injection sites in Toronto and across Canada. However, there are still legal barriers to implementing drug-checking programs in certain settings.

Not All Drug Testing Methods are Equally Effective

Drug testing methods are not equally effective or convenient. While drug testing strips and reagent kits are a fast and affordable way to identify substances, they cannot determine how much of a substance is contained in a sample. There is also a small risk of false negatives with drug testing strips, meaning that someone could accidentally overdose on a drug that they believed was safe. Advanced drug testing methods such as gas chromatography and mass spectrometry are preferable because they are very accurate, but the machines can be expensive to own and operate.

Testing Your Drugs

Where can I get my drugs professionally tested?

You can now get your drugs checked at one of three supervised injection sites in Toronto: 

  • Parkdale Queen West CHC, 168 Bathurst St

  • South Riverdale CHC , 955 Queen St E

  • Toronto Public Health - The Works, 277 Victoria St

If you bring in your drugs, a very small sample of approx 10 mg will be prepared on-site and brought to St Michael’s Hospital and/or CAMH to be tested. Results will be communicated back to you and include what is in the sample and the strength of the compounds in the sample. 

As of November 2019, the turnaround time for results is approximately 48 hours. As the program continues, turnaround time is supposed to decrease to same-day results. 

How can I test my drugs at home? 

You can order drug testing reagent kits and testing strips online in order to test your drugs at home:

Follow instructions carefully and remember that DRUG TESTING DOES NOT MEAN THAT YOUR DRUGS ARE SAFE. This is because it is possible to get false negatives and you may not know what drugs or how much of a drug is in your sample. Drug testing should be paired with other harm reduction strategies, such as not using alone, staggering drug use with another person, starting low and going slow, and carrying naloxone.

Comparing Drug Testing Models in Canada

Models of drug checking services (DCS) in Canada differ in important ways, including targeted subpopulations of people who use drugs (who can access the service and when) and the technology used for analysis of samples (which impacts how long it takes to receive results and what information is available from the analysis). This resource aims to provide an overview of select DCS in Canada that are harmonizing research protocols and approaches for the purpose of ensuring nationwide comparability of collected evidence.

Ontario

Regional Health Authorities

DCS using fentanyl test strips are available to clients of SIS and OPS in Ontario through regional health authorities. 

Ottawa

DCS are available at the Sandy Hill Community Health Centre (SHCHC) in Ottawa to SIS clients. Clients prepare their injection in the SIS and a drop of their shot is inserted into a mobile mass spectrometer (portable ion scanner) for analysis prior to proceeding with their injection. Targeted qualitative information (instrument surveys against a list of common substances) is available in 20 seconds. 

Substances outside of this list can be looked for specifically with qualitative information available in 2-5 minutes. Qualitative capabilities are being expanded to capture a greater number of common substances in the targeted analysis. This technique is not intended to provide quantitative information on the potency of drug samples; however, estimations of potency are anticipated to be made available to clients. No offsite or confirmatory testing is undertaken. 

Toronto

DCS in Toronto are being centrally coordinated by the Centre on Drug Policy Evaluation (CDPE) at St. Michael’s Hospital and are being made available at three frontline harm reduction agencies also offering SIS, two of which are also a community health centre (CHC). Anyone can access DCS at these sites (i.e., services are not limited to SIS clients). Drug samples will be collected from clients onsite and transported for analysis offsite at partnering hospital laboratories using GC-MS and LC-MS, the gold standards in forensic drug analysis. It is anticipated that analysis results, including information on composition and potency (i.e., qualitative and quantitative), will be available to clients in approximately 2 hours.

British Columbia

Regional Health Authorities

DCS using fentanyl test strips are available to clients of most supervised injection services (SIS) and overdose prevention sites (OPS) in British Columbia through regional health authorities. 

Vancouver and Surrey

The BC Centre on Substance Use (BCCSU) offers DCS at two SIS and select music festivals and events using more advanced techniques. This program is located in the front entrance area of an SIS in Vancouver and an SIS in Surrey, and DCS are not limited to SIS clients. 

At music festivals and events, DCS are typically limited to event patrons. Drug samples are analyzed onsite using a Fourier-transform infrared (FTIR) spectrometer in combination with fentanyl test strips, a process that takes approximately 5 minutes for the client to receive qualitative information on the composition of their sample. FTIR can identify any substance in its library, although there are limitations to what can be qualitatively detected (e.g., substances present below the limit of detection of approximately 3-5% may not be detected). 

Fentanyl test strips are an important complementary technique – especially given current drug market trends – as this enables the detection of fentanyl at quantities that would not be detected by FTIR, though test strips are limited to targeted qualitative analysis (i.e., these provide information about the presence or absence of fentanyl and a limited number of fentanyl analogues). 

Neither of these onsite techniques are designed to provide quantitative (i.e., potency) information on drug samples; however, estimates can be made using FTIR spectroscopy. For example, FTIR provides some information on proportions depending on signal strength (i.e., peaks on the spectrograph), although the availability of this information varies by sample and skill of the operator, and the proportions are not exact. 

The BCCSU also provides the option to test samples offsite using quantitative nuclear magnetic resonance (qNMR), gas chromatography mass spectrometry (GC-MS), and liquid chromatography mass spectrometry (LC-MS) through partnerships with LifeLabs, Health Canada’s Drug Analysis Service labs, and Provincial Toxicology Centre labs. Precise information on composition and potency is made available to clients approximately 7 days after sample collection, although this is expected to decrease to 4 days. 

This data is primarily valuable for drug market monitoring and to confirm the accuracy of results provided at point-of-care through the use of FTIR and fentanyl test strips, as few clients currently access updated analysis results. The BCCSU expects to offer DCS outside of supervised consumption settings (i.e., at OPS designated for drug checking purposes only). 

Nelson

ANKORS (AIDS Network Kootenay Outreach and Support Society) offers DCS to clients at their office in Nelson. In addition to employing a FTIR spectrometer (provided through a partnership with BCCSU) and fentanyl test strips, ANKORS also uses reagent tests to complement these techniques in some cases (e.g., for LSD blotters). Different reagent tests detect different substances and, based on the colour and timing of the reaction, can provide insight into the composition of drug samples. Reagent tests provide some qualitative information, but do not provide any quantitative information. ANKORS also provides DCS using these techniques to patrons at select music festivals and events.