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Evaluating networked drug checking services in Toronto, Ontario: study protocol and rationale.

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Drug checking services (DCS) in Toronto help prevent opioid overdose by analyzing unregulated drug supplies and informing people who use drugs about risks. This study evaluates their impact on overdose behaviors and drug composition.

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Area of Science:

  • Public Health
  • Epidemiology
  • Harm Reduction

Background:

  • Canada faces a public health crisis due to fatal opioid overdoses, largely driven by potent adulterants like fentanyl in unregulated drugs.
  • Drug checking services (DCS) are a key overdose prevention strategy, with a network established in Toronto in 2019 using mass spectrometry.
  • These services are integrated with supervised consumption services (SCS) at harm reduction agencies.

Purpose of the Study:

  • To evaluate the impact of DCS access on overdose and related risk behaviors.
  • To assess the perceived effectiveness of DCS in overdose prevention.
  • To identify trends in the composition of Toronto's unregulated drug supply.

Main Methods:

  • A parallel-mixed-methods design utilizing diverse data sources.
  • Data includes chemical analysis of drugs, surveys, service records, and qualitative interviews.
  • A meta-inference process synthesizes findings from all analyses.

Main Results:

  • Toronto's DCS primarily targets marginalized people who use drugs accessing frontline services.
  • Explores optimal service delivery models and technologies for this population.
  • Provides insights into the unregulated drug supply and its impact on the risk environment.

Conclusions:

  • Addresses critical evidence gaps in overdose prevention strategies.
  • Generates evidence on a novel approach to reduce drug-related morbidity and mortality.
  • Offers insights applicable to Canada and other regions facing similar crises.