Auras of Detection: Power and Knowledge in Drug Prohibition

2021 ◽  
pp. 009145092110354
Author(s):  
Jennifer J. Carroll
Keyword(s):  
Law Enforcement ◽  
Knowledge Production ◽  
Illicit Drug ◽  
Drug Market ◽  
Epistemic Authority ◽  
People Who Use Drugs ◽  
Drug Supply ◽  
Political Implications ◽  
Starting Point ◽  
Drug Checking

Drug checking is an evidence-based strategy for overdose prevention that continues to operate (where it operates) in a legal “gray zone” due to the legal classification of some drug checking tools as drug paraphernalia—the purview of law enforcement, not public health. This article takes the emergence of fentanyl in the U.S. drug supply as a starting point for examining two closely related questions about drug checking and drug market expertise. First, how is the epistemic authority of law enforcement over the material realities of the drug market produced? Second, in the context of that authority, what are the socio-political implications of technologically advanced drug checking instruments in the hands of people who use drugs? The expertise that people who use drugs maintain about the nature of illicit drug market and how to navigate the illicit drug supply has long been discounted as untrustworthy, irrational, or otherwise invalid. Yet, increased access to drug checking tools has the potential to afford the knowledge produced by people who use drugs a technological validity it has never before enjoyed. In this article, I engage with theories of knowledge production and ontological standpoint from the field of science, technology, and society studies to examine how law enforcement produces and maintains epistemic authority over the illicit drug market and to explore how drug checking technologies enable new forms of knowledge production. I argue that drug checking be viewed as a form of social resistance against law enforcement’s epistemological authority and as a refuge against the harms produced by drug criminalization.

scholarly journals Factors associated with drug checking service utilization among people who use drugs in a Canadian setting

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Viseth Long ◽  
Jaime Arredondo ◽  
Lianping Ti ◽  
Cameron Grant ◽  
Kora DeBeck ◽  
...  
Keyword(s):  
Drug Market ◽  
The United States ◽  
People Who Use Drugs ◽  
Opioid Overdose ◽  
Urine Drug Screen ◽  
Opioid Use ◽  
Drug Dealing ◽  
Factors Associated ◽  
Urine Drug ◽  
Drug Checking

Abstract Background The United States and Canada are amidst an opioid overdose crisis, with the Canadian province of British Columbia (BC) among the hardest hit. In response, drug checking services (DCS) have been introduced in this setting as a novel pilot harm reduction intervention though little is known about usage rates. Therefore, we sought to identify factors associated with drug checking uptake among people who use drugs (PWUD) in Vancouver, BC. Methods Data were derived from three ongoing prospective cohort studies of PWUD in Vancouver between June and November 2018. Multivariable logistic regression was used to determine factors associated with self-reported DCS utilization in the past 6 months among participants at high risk of fentanyl exposure (i.e., those self-reporting illicit opioid use or testing positive for fentanyl via urine drug screen). Results Among 828 eligible participants, including 451 (55%) males, 176 (21%) reported recent use of DCS. In multivariable analyses, factors significantly associated with DCS utilization included: homelessness (Adjusted Odds Ratio [AOR] 1.47; 95% Confidence Interval [CI] 1.01–2.13) and involvement in drug dealing (AOR 1.59; 95% CI 1.05–2.39). Conclusions In our sample of PWUD, uptake of DCS was low, although those who were homeless, a sub-population known to be at a heightened risk of overdose, were more likely to use the services. Those involved in drug dealing were also more likely to use the services, which may imply potential for improving drug market safety. Further evaluation of drug checking is warranted.

scholarly journals Diverse psychotropic substances detected in drug and drug administration equipment samples submitted to drug checking services in Toronto, Ontario, Canada, October 2019–April 2020

2022 ◽  
Vol 19 (1) ◽  
Author(s):  
Kristy M. Scarfone ◽  
Nazlee Maghsoudi ◽  
Karen McDonald ◽  
Cristiana Stefan ◽  
Daniel R. Beriault ◽  
...  
Keyword(s):  
Drug Administration ◽  
Synthetic Cannabinoids ◽  
Drug Market ◽  
Pilot Project ◽  
Gas Chromatography Mass Spectrometry ◽  
People Who Use Drugs ◽  
High Potency ◽  
Psychotropic Substances ◽  
Market Monitoring ◽  
Drug Checking

Abstract Background The overdose crisis has generated innovative harm reduction and drug market monitoring strategies. In Toronto, Ontario, Canada, a multi-site drug checking service (DCS) pilot project was launched in October 2019. The project provides people who use drugs with information on the chemical composition of their substances, thereby increasing their capacity to make more informed decisions about their drug use and avoid overdose. DCS also provides real-time market monitoring to identify trends in the unregulated drug supply. Methods Sample data were obtained through analyses of drug and used drug administration equipment samples submitted anonymously and free of charge to DCS in downtown Toronto from October 10, 2019, to April 9, 2020, representing the first six months of DCS implementation. Analyses were conducted in clinical laboratories using liquid chromatography- and/or gas chromatography-mass spectrometry (LC–MS, GC–MS) techniques. Results Overall, 555 samples were submitted, with 49% (271) of samples that were found to contain high-potency opioids, of which 87% (235) also contained stimulants. Benzodiazepine-type drugs were found in 21% (116) of all samples, and synthetic cannabinoids in 1% (7) of all samples. Negative effects (including overdose, adverse health events, and extreme sedation) were reported for 11% (59) of samples submitted for analysis. Conclusions Toronto’s DCS identified a range of high-potency opioids with stimulants, benzodiazepine-type drugs, and a synthetic cannabinoid, AMB-FUBINACA. This information can inform a range of evidence-informed overdose prevention efforts.

scholarly journals Drug Checking for Novel Insights into the Unregulated Drug Supply

2021 ◽  
Author(s):  
Nabarun Dasgupta ◽  
Mary C Figgatt
Keyword(s):  
British Columbia ◽  
Large Scale ◽  
People Who Use Drugs ◽  
Drug Supply ◽  
Public Health Response ◽  
Epidemiologic Surveillance ◽  
Crucial Component ◽  
Health Response ◽  
Drug Checking ◽  
Nuanced Understanding

Abstract Tobias et al. (Am J Epidemiol. XXXX;XXX(XX):XXXX–XXXX) present a novel analysis of time trends in fentanyl concentrations in the unregulated drug supply in British Columbia, Canada. The pre-existing knowledge about unregulated drugs had previously come from law enforcement seizures and post-mortem toxicology. As both of these data sources are subject to selection bias, large scale drug checking programs are poised to be a crucial component of the public health response to the unrelenting increase in overdose in North America. As programs expand, we offer two guiding principles. First, the primary purpose of these programs is to deliver timely results to people who use drugs to mitigate health risks. Second, innovation is needed to go beyond criminal justice paradigms in laboratory analysis for a more nuanced understanding of health concerns. We provide examples of the role adulterants play in our understanding of drug harms. We also describe the applications and limitations of common laboratory assays, with implications for epidemiologic surveillance. While the research and direct service teams in British Columbia have taken groundbreaking steps, there is still a need to establish best practices for communicating results to sample donors in an approachable yet non-alarmist tone.

The DUMA Drug Market Indicator Framework: methamphetamine

2021 ◽  
Author(s):  
Isabella Voce ◽  
Alexandra Voce
Keyword(s):  
Drug Use ◽  
Illicit Drug ◽  
Drug Market ◽  
Drug Markets ◽  
Drug Supply ◽  
Criminal Offending ◽  
Methamphetamine Use ◽  
Indicator Framework ◽  
The Impact ◽  
Market Indicator

In this paper, we introduce the Drug Use Monitoring in Australia (DUMA) Drug Market Indicator Framework. We use the framework to examine Australian trends in methamphetamine supply, demand and related harms between 2013 and 2019 to provide a baseline for measuring the impact of the COVID-19 pandemic. There were consistent increases in the prevalence, frequency and quantity of methamphetamine use, and corresponding increases in dependence, overdose and methamphetamine-related criminal offending. A brief but substantial decrease in methamphetamine availability occurred during 2017. Despite this, the methamphetamine market quickly recovered and continued to strengthen into 2019. This paper highlights the importance of monitoring indicators relating to drug supply, demand and harm to understand the dynamics of illicit drug markets during the COVID-19 pandemic and beyond.

Summary and conclusions

2018 ◽  
Author(s):  
Thomas F. Babor ◽  
Jonathan Caulkins ◽  
Benedikt Fischer ◽  
David Foxcroft ◽  
Keith Humphreys ◽  
...  
Keyword(s):  
International Organizations ◽  
Drug Policy ◽  
Drug Users ◽  
Illicit Drug ◽  
Supply And Demand ◽  
Unintended Consequences ◽  
Public Health Approach ◽  
Drug Supply ◽  
The Public ◽  
Balanced Approach

Among the 47 options reviewed in this book, most show some evidence of effectiveness in at least one country, but the evidence is less than definitive for many others, either because the interventions are ineffective, or the research is inadequate. Unfortunately, policies that have shown little or no evidence of effectiveness continue to be the preferred options of many countries and international organizations. The evidence reviewed in this book supports two overarching conclusions. First, an integrated and balanced approach to evidence-informed drug policy is more likely to benefit the public good than uncoordinated efforts to reduce drug supply and demand. Second, by shifting the emphasis toward a public health approach, it may be possible to reduce the extent of illicit drug use, prevent the escalation of new epidemics, and avoid the unintended consequences arising from the marginalization of drug users through severe criminal penalties.

scholarly journals “We're actually more of a likely ally than an unlikely ally”: relationships between syringe services programs and law enforcement

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Carol Y. Franco ◽  
Angela E. Lee-Winn ◽  
Sara Brandspigel ◽  
Musheng L. Alishahi ◽  
Ashley Brooks-Russell
Keyword(s):  
Law Enforcement ◽  
Police Officers ◽  
Wound Care ◽  
Phenomenological Approach ◽  
Treatment Programs ◽  
People Who Use Drugs ◽  
Positive Relationships ◽  
Structured Interviews ◽  
Program Staff ◽  
Compliance With The Law

Abstract Background Syringe services programs provide sterile injection supplies and a range of health services (e.g., HIV and HEP-C testing, overdose prevention education, provision of naloxone) to a hard-to-reach population, including people who use drugs, aiming to prevent the transmission of infectious diseases. Methods We performed a qualitative needs assessment of existing syringe services programs in the state of Colorado in 2018–2019 to describe—their activities, needs, and barriers. Using a phenomenological approach, we performed semi-structured interviews with key program staff of syringe services programs (n = 11). All interviews were digitally recorded, transcribed, and validated. A data-driven iterative approach was used by researchers to develop a coding scheme to organize the data into major themes found across interviews. Memos were written to synthesize main themes. Results Nearly all the syringe program staff discussed their relationships with law enforcement at length. All syringe program staff viewed having a positive relationship with law enforcement as critical to the success of their program. Main factors that influence the quality of relationships between syringe services programs and law enforcement included: (1) alignment in agency culture, (2) support from law enforcement leadership, (3) police officers’ participation and compliance with the Law Enforcement Assisted Diversion (LEAD) program, which provides intensive case management for low-level drug offenders, and (4) implementation of the “Needle-Stick Prevention Law” and Drug Paraphernalia Law Exemption. All syringe program staff expressed a strong desire to have positive relationships with law enforcement and described how a collaborative working relationship was critical to the success of their programs. Conclusions Our findings reveal effective strategies to foster relationships between syringe services programs and law enforcement as well as key barriers to address. The need exists for both syringe services programs and law enforcement to devote time and resources to build a strong, positive partnership. Having such positive relationships with law enforcement has positive implications for syringe services program clients, including law enforcement being less likely to ticket persons for having used syringes, and encourage people who use drugs to seek services from syringe services programs, which can then lead them to other resources, such as housing, wound care, and substance use treatment programs.

Confirmed reports of bupropion sold as crack cocaine in the illicit drug supply

2021 ◽  
pp. 1-2
Author(s):  
Rachel S. Wightman ◽  
Earth Erowid ◽  
Fire Erowid ◽  
Sylvia Thyssen ◽  
Mary Wheeler ◽  
...  
Keyword(s):  
Crack Cocaine ◽  
Illicit Drug ◽  
Drug Supply

The Evolving Overdose Epidemic: Synthetic Opioids And Rising Stimulant-Related Harms

2020 ◽  
Author(s):  
Christopher M Jones ◽  
Faraah Bekheet ◽  
Ju Nyeong Park ◽  
G Caleb Alexander
Keyword(s):  
Illicit Drug ◽  
Opioid Overdose ◽  
Prescription Opioids ◽  
Drug Supply ◽  
Synthetic Opioids ◽  
Key Stakeholders ◽  
Public Health Challenges ◽  
Concomitant Exposure ◽  
Over Time ◽  
Key Questions

Abstract The opioid overdose epidemic is typically described as having occurred in three waves, with morbidity and mortality accruing over time principally from prescription opioids (1999-2010), heroin (2011-2013) and illicit fentanyl and other synthetic opioids (2014-present). However, the increasing presence of synthetic opioids mixed into the illicit drug supply, including with stimulants such as cocaine and methamphetamine, as well as rising stimulant-related deaths, reflects the rapidly evolving nature of the overdose epidemic posing urgent and novel public health challenges. We synthesize the evidence underlying these trends, consider key questions such as where and how concomitant exposure to fentanyl and stimulants is occurring, and identify actions for key stakeholders regarding how these emerging threats, and continued evolution of the overdose epidemic, can best be addressed.

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