Key Takeaways:
There are three categories of drug checking services: take-home kits, point-of-care testing and lab testing
Lab testing provides the most detailed results, but suffers from high costs and long wait times
Point-of-care testing can provide the best rapid testing results, but needs to be enhanced with a trace method to overcome limits of detection
The ideal approach for drug checking is to provide multiple options that utilize the strengths of different methods
Drug checking is quickly becoming a popular harm reduction program to help combat the worsening drug poisoning crisis in North America. With an unregulated supply there is no guarantee as to what cocktail of substances can be found in a drug sample. Government agencies and non-profit organizations have implemented a variety of drug checking strategies and technologies to help people check to see the ingredients of their sample. There are three kinds of drug checking programs: take home tests, point-of-care (POC) testing and laboratory testing. This quick guide will provide the pros and cons of each method.
Take Home Tests/Test Strips
Take home tests, while the most limited in terms of the information they provide, are the most convenient due to their ease of use and ability to test from anywhere. Test strips are the most common type of take home test. Conducting a test requires taking a small sample of the substance and diluting it in water. The test strip is then dunked in the solution and set aside for the reaction to occur. They are relatively inexpensive and can provide results within a few minutes. As mentioned, however, test strips do have some limitations. The accuracy of the results can be impacted by a variety of factors, such as the quality of the sample and the presence of interfering substances. Additionally, test strips vary in sensitivity depending on the type of drug its testing for and may not detect smaller amounts of drugs or contaminants.
It is also important to note that test strips do not provide a detailed analysis of the substances present in a sample, and the results may be subjective and open to interpretation. For immunoassay test strips, results are usually displayed in the form of red lines that become visible on the strip, similar to a COVID-19 test. The interpretation of whether a result is positive can result in operator error.
Point-of-Care Devices
Point-of-care (POC) methods of drug testing, use specialized equipment at harm reduction and healthcare sites to deliver higher quality results that bridge the gap between take home tests and laboratory testing.
Fourier Transform Infrared Spectroscopy (FTIR) is one of the most popular POC methods for drug checking, as it was one of the first methods adopted by harm reduction providers. One of the main advantages of FTIR is that it can identify various substances in a sample, including cutting agents. Another advantage is that FTIR does not require the destruction of the sample, allowing for the preservation of the original material for further testing. However, FTIR also has some disadvantages. The cost of the equipment and maintenance can be high, and the interpretation of results requires specialized training and expertise. Additionally, FTIR is not as sensitive as other methods, meaning that it may not detect small amounts of certain drugs or contaminants. Typically, along with the FTIR, organizations will use test strips to detect fentanyl at trace concentrations to overcome the device's limit of detection.
Raman Spectroscopy is another POC method that is like FTIR in its ability to detect various substances with its non-destructive bulk scan method. At the same time, in its unenhanced form, it has the same short comings when it comes to detecting trace amounts of drug in a sample. The key difference between the two is that Raman has a unique additional method known as Surface Enhanced Raman Scattering (SERS). SERS requires specialized nanotechnology embedded into a test kit which uses a similar easy to use sample preparation technique to test strips. SERS enables the Raman to overcome its detection limitations and can detect trace amounts of a substance. Raman and SERS collect a spectrum which can be fed through a machine learning model to predict the substances present. At Spectra Plasmonics, our Amplifi ID system uses a combination of Raman (bulk scan) and SERS (trace scan) to generate highly detailed drug checking results. Our library is purpose built for harm reduction, and constantly evolves to adjust to the ever-changing drug supply.
Lab Testing
Lab testing is the final type of drug checking service/technology and provides the most accurate and detailed results possible. The most common devices used for this kind of testing are Mass Spectrometers. Mass Spectrometers are considered the “gold-standard” method due to their high accuracy both from a detection and quantification standpoint. Unfortunately, lab testing is the most expensive option available with one sample costing several hundred dollars to run. This is due to the high upfront cost of the devices alongside the cost of a specialized lab technician required to run a sample. Another limitation is the time between sampling and receiving results. Lab testing programs usually take between 1-2 business days to produce results, and this would be on the faster end in terms of turn-around.
What This All Means For Your Drug Checking Service
A combination of different drug checking services and technologies can provide a comprehensive approach to fighting the overdose crisis. Take home tests can be offered for when someone does not have access to a harm reduction site. POC tests can be used by sites that don’t have access to or budget for a lab testing facility. Lab testing can provide more insights and will even work with problematic samples that require a more thorough analysis if it contains rare or new psychoactive compounds. By leveraging the strengths of each method, a multi-faceted drug checking strategy can ensure a higher level of accuracy and reliability in identifying harmful substances.
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