Drug safety testing with rapid feedback: Next steps for Australia

Transcription

1 Drug safety testing with rapid feedback: Next steps for Australia Monica J. Barratt, PhD 12 August 2016 Drug Policy Modelling Program

2 Outline Quality control in unregulated drug markets Why it matters and what we can do Illegal drug safety testing Defining and variable features Festival safety testing with rapid feedback Profiling the work of The Loop UK Understanding festival drug use How can different testing models affect outcomes of drug use? Preliminary data from Australian festivalgoers What are the next steps for Australia? 2

3 Quality control in unregulated markets Quality control is a problem in unregulated markets No manufacturing standards or labelling regulations Intentional adulteration with cheaper ingredients Unintentional adulteration through production errors Highly variable purity Proliferation of new/novel substances adds to the problem Fentanyl derivatives sold as heroin NBOMe sold as LSD MXE sold as ketamine Many things sold as ecstasy! 3

4 100 new NPS in 2015 (EMCDDA) In : 34 health alerts 7 risk assessment European Monitoring Centre for Drugs and Drug Addiction. (2016). EU Drug Markets Report. Lisbon: EMCDDA. 4

5 The effects of a lack of quality control Harms from variable dosages Harms from unexpected effects from unintended ingestion of unknown substances e.g. 173mg PMMA Superman Health responses may be confused or constrained through lack of information about what the patient has taken The quality control problem may also be a deterrent that is, some people may avoid illegal drug markets entirely due to the risks posed by lack of quality control. Those who remain in the market are at greater risk 5

6 x from an ad campaign in 2011

7 Responses to the quality control problem The problem would be (almost) solved through the regulation of drug supply The regulation of drug supply is not currently proposed, at least in Australia at this time In the context of unregulated drug supply, there have been programs and services over 40+ years where drugs are tested or analysed for safety purposes. 7

8 Street drug identification Drug safety testing Street drug analysis Pill testing Pill and powder testing Pill checking Drug checking Drug testing Adulterant screening Multi agency safety testing

9 What is (illegal drug) safety testing? Defining features The pharmacological composition of drugs is determined The results of these analyses are shared Aims to improve public health and safety Variable features The source of the drugs Level of interaction with end users of drugs Extent of information sharing/feedback with all stakeholders Lag times Setting of testing Type of analytic testing conducted Funding models 9

10 Different safety testing models UK s The Loop Spain s Energy Control Portugal CHECK!N Austria s ChEck it! Swiss Safer Party Dutch Drug Information Monitoring System US EcstasyData.org Welsh WEDINOS system (also Australia s ACTINOS) Canadian ANKORS (AIDS Network Kootenay Outreach and Support Society) drug checking service Luxembourg, Germany, Uruguay, New Zealand, etc.! 10

11 The Loop UK, Secret Garden Party, 2016

12 Profiling The Loop (UK) testing models Half-way Full Source of drugs Interaction with consumers Information sharing Lag times Setting Analytic testing methods Funding model Police, medical, amnesty bins, ground finds No direct individual interaction Community through noticeboard + stakeholders Results available within minutes On-site at festivals/clubs Direct from consumers, in addition Direct service provided to individuals Individualised tailored feedback, in addition Bruker Alpha Fourier Transform Infrared (FT-IR) spectrometer with reagents + purity test for MDMA Charity funded through donations 12

13 All Loop on-site testing at festivals & clubs is always fully supported by festival management, police, paramedics, welfare, public health & all agencies involved. This requires many meetings, policy documents, protocols & table top exercises to translate into practise! - Fiona Measham The Bruker Alpha FT-IR, 2016

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15 How can the half model reduce harm?

16 How can the full model reduce harm?

17 Next steps for Australia We have a framework for assessing outcomes We have models from UK and elsewhere to inform our own BUT We need to bring stakeholders together and agree on a model of testing to trial We need to highlight the critical need for this intervention, citing data on variable purity and mis-representation found through other testing services globally. NSW cross-parliamentary committee on harm minimisation held a summit yesterday highlighting the need for reform watch this space! 19

18 Acknowledgements MB is co-affiliated with NDRI/Curtin and Burnet MB is supported by an NHMRC Early Career Researcher Fellowship (APP ) Thank you to the participants of our survey and to my collaborators Alison Ritter, Bruno Raimondo and Nadine Ezard. Thanks to Fiona Measham/The Loop UK for providing information and images of them in action. Please contact Monica for further 20