Thread by @mary_figgatt

🧵1/ Want to know what it takes to launch a #DrugChecking program?

The growing interest has been really exciting. So we wanted to share some tips to help others get started.

To catch your attention, here’s what an heroin spectrum on an FTIR looks like!

2/ But, first what are drug checking programs? These are cutting edge programs grounded in #PublicHealth and #HarmReduction

The purpose is simple: to provide drug testing services to people who use drugs so they can make informed decisions about what they put their body.

3/ To get started, read up on this topic. There is A LOT of useful information about there. A good place to start is @BBCSU. They have some amazing training resources here
drugcheckingbc.ca/resources/manu…

4/Main things that make a successful program: 1) it is a welcoming public health service, 2) people who use drugs are in decision making roles (and even better if trained as technicians), and 3) #harmreduction and science guide practice.

From @nabarund &I academic.oup.com/aje/advance-ar…

5/ Super important: start off with a strong team. For us, @WeezieBeale had the vision and was supported by @crazynangoldin

Our team came together to help keep our community safe. Respecting each other as equals, and honoring our community are central to our work.

6/ Public health orientation: Remember, this means we provide a service to people who use drugs. Y’all know our society’s view on drug use is ridiculous. So it is the responsibility of drug checking programs to create a safe space for people - free of judgment.

7/ That brings me to a word on criminal justice involvement in drug checking work:🚩🚩🚩NOPE.

We recognize the horrific harms of the drug war, particularly among communities of color. Criminal justice is at odds with what’s best for public health. Our firm requirement: no cops.

8/ There are many drug checking technologies out there.

This is a Fourier transfer infrared (FTIR) spectrometer. It’s compact, portable, and fast. It gets results in like 5-10 minutes. What else could ya ask for?

9/ Sounds straightforward, right? Well… as when starting anything new, we gotta sort through a few things first:

1. $$$
2. Technology has its limitations
3. Someone needs to get trained.
4. Figure out how you will report results.

10/💲: A typical FTIR can cost around $40k upfront. Also budget for training, salary, test strips, & supplies. Could be ~$100k+ to get things moving. That’s some💰 But it's mostly salary after buying the FTIR.

Pro tip: Don’t buy the FTIR with the touch screen. Not worth it!

11/ Limitations: FTIR is not going to detect small amounts of a drug. Quantities <5% are not picked up accurately, esp for for fentanyl and benzos. So always use fentanyl and benzo test strips, too!

Read more here: onlinelibrary.wiley.com/doi/10.1111/da…

12/ Limitations: You also need to have a way to do confirmatory testing (#GCMS/#LCMS) for complex samples, and to provide feedback for quality assurance.

Commercial and non-profit labs @erowid are available. University labs can be a more affordable option.

13/ Training: Do you need an advanced degree in chemistry? It helps, but anyone can learn.

What DO you need? Eagerness to learn, commitment, and the ability to effectively communicate results. Knowledge about #HarmReduction and drugs is important, too.🙂

14/ Training Part 2: Running an FTIR is an art. Based on what you communicate, people are going to make decisions that impact their health. So if you are unsure about a result, tell them!! There is no room for overconfidence here.

15/ Training Part 3: Put in the🕒You need to spend some quality time with your little machine. Learn how the software works. Figure out what parts of the spectrum are important. Eventually, you’ll get there. But always be learning-we gotta stay on top of the changing supply!

16/ Quant info (potency)📊is super useful. But it’s a little trickier and requires some special analyses. So it’s best to start your program by getting qualitative info. This is still VERY useful - we can tell people things like: "we're seeing more fent in this sample than usual"

17/ Reporting results: You need to have a process/platform for reporting results back to participants. This can be pretty informal.

Stay tuned though: we are building an open-source software tool to centralize records. That should be available in early 2022.

18/ Alright that’s all for now. Me and the team couldn’t have gotten here without some awesome people. @DianeW_Chem @veruka2 @samhatobias @zrsalazar and the ACDC crew. Y’all are amazing

19/ And a big shout out to the programs who have been paving the way: @Erowid @DanceSafe @BCCSU

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