Drug checking via Syringe Vending Machines
Background: According to the European Web Survey on Drugs, last year prevalence of New Psychoactive Substances among Georgian adult study participants is 24% (EMCDDA, 2021). Furthermore, there has been a rise in overdoses since the onset of the COVID-19 epidemic (NDO, 2021). Our implementation study aimed to expand drug checking service by distributing Fentanyl strips and Marquis, Liebermann, Mecke reagents through Syringe Vending Machines (SVM) in Tbilisi, Georgia.
Methods: Within the implementation study, from June 2023 onwards, all transactions were tracked via unique identifier number (‘ID code’) consisting of 15-digits. Meanwhile, to capture the results of the drug checking, we incorporated brief questionnaire into the SVMs' touch screen: 1. Which drug did you test? 2. What was the outcome of testing?
Results: From June to December 2023, a total of 600 transactions (228 reagents and 372 Fentanyl strips) were made by 126 beneficiaries (4 females and 122 males), with an average age of 37 years. Additionally, 18 beneficiaries provided an outcome of the drug checking. Out of 35 analyzed samples, Cocaine (13%), Methamphetamine (9%), MDMA/Ecstasy (9%), Heroin/Sirets (9%), Alpha-PVP (9%) and Amphetamine (6%) were the most frequently tested drugs. The least contaminated substance was MDMA/Ecstasy and when contaminated, it was mixed with Methamphetamine. It was also common when tested stimulants were adulterated with opioids and vice versa. Heroin was detected in half of the tested Cocaine samples. Moreover, in all cases when Alpa-PVP was tested the results were unclear.
Conclusions: Study findings suggest that in our sample it is common practice when drugs with opposite effects are mixed which can lead to overdose. Therefore, delivering reagents and test strips through SVMs is a feasible and an innovative intervention to reduce overdoses among PWUD, especially hidden groups of young people who use drugs recreationally.
