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Drug checking or pill testing is a way to reduce the harm from drug consumption by allowing users to find out the content and purity of substances that they intend to consume. This empowers users to make safer choices: to avoid more dangerous substances, to use smaller quantities, and to avoid dangerous combinations.
Drug checking services have developed over the last twenty-five years in twenty countries and are being considered in more countries,  although attempts to implement them in some countries have been hindered by local laws. Drug checking initially focused on MDMA users in electronic dance music events but the services have broadened as drug use has become more complex. These developments have been strongly affected by local laws and culture, resulting in a diverse range of services, both for mobile services that attend events and festivals and fixed sites in town centres and entertainment districts.
Understand how drugs work
For instance, staff may or may not be able to handle illegal substances, which limits the use of testing techniques to those where the staff are not legally in possession of those substances. People intending to take drugs provide a small sample to the testing service often less than a single dose. Test may be provided immediately, after a short waiting period, or later. Drug checking services use this time to discuss health risks and safe behaviour with the service users. The earliest reported drug checking activity began in Amsterdam in November with a group from the University Hospital of Amsterdam and samples obtained through psychiatrists working with people who used drugs.
Since the service has tested overdrug samples at a national network of twenty-three testing facilities. Service users receive within a week via phone or and the service publishes aggregated describing what substances are in use. DanceSafe have operated in the USA since providing reagent testing and harm reduction advice. On March 31, a coalition of drug safety organisations hosted the first-ever International Drug Checking Day to raise awareness of safer drug use.
Front-of-house testing  provides testing services to clients at events. It provides real-time, as-you-wait. An example is the testing at BOOM festival in Portugal where drug testers are legally allowed to handle samples.
Where testers are not allowed to handle samples, for fear of breaking laws around possession, clients themselves must handle the substance to be tested. Back-of-house testing  is more restrictive. The substances tested do not come directly from event participants. Instead, they may come from samples confiscated by Police or event security or samples that are disposed of into drug amnesty bins. The may not be available to event attendees.
Middle-of-house testing  is a new development, started by The Loop in the UK. Testing happens on-site but without face-to-face interaction with the public - samples from medical incidents are tested and alerts can be issued after multiple incidents with a trend are identified. Static testing sites provide testing services to clients at fixed locations away from events. Often these are in the entertainment districts of cities. Off-site testing occurs away from events and away from clients.
Pill testing service submit samples by post or at drop-off locations. Those samples are analysed and then the are publicised.
The UK's first trial of community-based drug safety testing was carried out in Bristol and Durham in in a church, a drugs service, and a youth and community centre. Users reported that they intended to carry out a range of harm reduction actions such as alerting friends and acquaintances, being more careful mixing substances, consuming lowered dosage, and disposing of substances. A range of analysis techniques are in use by drug checking services.
The most common are reagent testingfourier transform infrared spectroscopyultraviolet-visible spectroscopyraman spectroscopyand gas chromatography mass spectrometry.
Developing technologies include nuclear magnetic resonance spectroscopy and ion-trap mass spectrometry. Reagent testing uses chemical indicators that show a colour change in the presence of particular drugs. These tests are widely available and affordable. The use of several reagents is generally necessary to positively identify a substance with MarquisMandelinand Mecke reagents being used to detect MDMA and Ehrlich's reagent common for detecting LSD.
However, reagent testing only indicates the presence of a substance, not the absence of contaminants or other substances.
This can provide a false sense of security when illicit drugs are deliberately adulterated to fool reagent tests. The presence of specific drugs can also be detected through immunoassay testing strips.
How the service worked
Testing strips for fentanyl can detect a few tens of nanograms of the substance at a price of a few dollars per test. Fourier transform infrared spectroscopy is a rapid test using robust hardware that can be carried out in the field. It provides sample identification and mixture analysis, allowing the detection of impurities and adulterants.
It is highly sensitive and can carry out analysis using only a few milligrams of a sample. It is semi-quantitative and can provide an indication of purity. For these reasons, it is widely used by both fixed and mobile testing services and considered the best technology to use. Gas chromatography mass spectrometry provides very sensitive and quantified information about substances. However, the high price and delicate equipment generally limit the use of this technique to fixed sites. Drug checking has been shown to be an effective way Pill testing service reduce the harm from drug use through informing safer use, limiting use, and helping users avoid the most dangerous substances.
Evidence from research conducted by Austrian pill testing service CheckIt!
Academic research from the UK has found that one in five substances were not what they were expected to be and two-thirds of misrepresented samples were disposed of. Such on-site testing accesses otherwise hard-to-reach user groups to reduce the harms associated with drug use. Research that followed-up people who had used drug checking services in the UK revealed that those people acted upon the harm reduction advice that they received from the service.
Those people disposed of unwanted substances, reduced their dosage of wanted substances, and reduced their risk of overdose. People also followed those risk management practices after attending festivals, altered friends to the risks of drug use, and continued to follow that advice. Retrieved International Journal of Drug Policy. ISSN PMID The Lancet. Letters to the Editor: — The Loop.
Are Your Drugs Laced? Resident Advisor. British Journal of Clinical Pharmacology. PMC Scientific American. International Journal of Drug Policy : MDMA adulterants by product name and the impact of harm-reduction services at raves".
Does pill testing encourage drug use?
Journal of Psychopharmacology. S2CID : Drug culture Drug safety Drug testing reagents Harm reduction. Namespaces Article Talk. Views Read Edit View history. Help Learn to edit Community portal Recent changes file.
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