The sad, simple fact is that all unregulated market substances, all of them, are prone to misrepresentation (when one substance is sold as another substance). Unregulated market substances are also subject to adulteration (when one substance is ‘cut’ with a separate material unknown to the buyer).
Although it is difficult to pull exact information from the publicly available data, it is clear that these two issues now represent the vast majority of so-called ‘drug overdose’ deaths. This makes misrepresented and adulterated substances among the leading causes of death for Americans, even in the midst of the Covid-19 crisis.
The ultimate solution to ending these deaths is the creation of legal, regulated marketplaces and safe-use facilities. But until we get to the point where we have a rational drug policy, it is up to individual consumers to be as safe as possible while using substances under prohibition.
Any drug can be misrepresented. ANY!
And look, I get it. You trust your source. Of course you trust your source, otherwise you probably wouldn’t buy substances from them. But drug misrepresentation and adulteration rarely happen at the retail level. These are issues endemic to unregulated markets, and happen WAY high up on the supply chain. So unless you, personally, have tested these substances, you just don’t know what it is you’re consuming. Your downstream provider is likely not testing their wares.
I’ll say that again. If you yourself don’t personally test a substance, you have no idea what it might be.
For misrepresentation, reagent testing is a wonderful tool. A reagent is simply a chemical or mixture that is used in chemical analysis. Harm reduction reagent test kits are easy to get online and allow users to check their substances to avoid ingesting unknown and potentially dangerous materials sold on the unregulated market. Our harm reduction organization, DanceSafe, sells reagent kits and supplies, but others do as well.
Reagents are very, very good at differentiating 25i-NBOMe from LSD for instance, or MXE from ketamine. Reagent tests are relatively easy to use and ‘read’ to get your results. You do need to read the instructions, since we’re talking about powerful chemistry and strong acids – but not the kind of strong acid the dude in that giant fire dome hooked you up with.
Although they are great for presumptive identification of the substance, these tests are not ‘positive identification.’ This means, for instance, that you can know with 100% certainty that a sample is NOT LSD if it doesn’t react with the Ehlich’s Reagent. But even if it does react, you do not know with 100% certainty that it IS LSD. There are other indole drugs that would trigger an identical reaction.
Reagents don’t detect potency or purity. They also aren’t great at identifying adulteration, since the ‘stronger’ reaction can often overpower the ‘weaker’ reaction. In a pill that is a combination of methamphetamine and MDMA, for instance, the MDMA reaction is likely to overpower the methamphetamine one, resulting in a person not realizing there is methamphetamine in the sample.
The ideal situation is to have on-site lab testing not just at events, but at community health clinics throughout the U.S. And I truly believe we’re heading in that direction. In the meantime, if you see DanceSafe at an event, there’s a pretty good chance we have advanced, laboratory analysis on site, so come ask! You can also submit samples for laboratory testing to our partner lab at DrugsData.org (what used to be called EcstasyData). This type of lab analysis is confirmatory. If the lab says a sample is MDMA…. It IS MDMA.
Test EVERYTHING you plan on consuming, and know the limitations of the kits.
For adulteration, immunoassay strips and laboratory testing are the only real options. The immunoassay strips, which test fluid samples, currently exist for fentanyl and a handful of other substances. DanceSafe has only performed the lab work confirming these results work as needed with the fentanyl test strips, so those are the only ones we use at this time.
Our goal is to eventually have a more robust toolkit of these methods in the hope that more on site adulteration analysis will be possible with an at-home kit. The reason we focus on the fentanyl adulteration strips is that the opioid fentanyl, and its related analogues, are killing tens of thousands of people per year. We are seeing fentanyl in substances sold as a wide, wide variety of drugs.
Fentanyl in samples sold as ‘heroin’ is incredibly common, and in some parts of the United States it has actually replaced heroin to a substantial degree. Fentanyl adulterated cocaine is a real issue and also killing people. I was hesitant to believe this for a long time, but it has now been confirmed by many independent researchers, and I have personally tested cocaine that was adulterated. We are in the midst of another wave of this particular adulteration, and anyone who uses cocaine should be in the habit of testing with the fentanyl test strips.
We have also confirmed fentanyl in samples sold as ketamine, MDMA, MDA, and we’ve even seen carfentanil (a very, very potent fentanyl analogue) being distributed on blotter paper that traditionally contains LSD. We believe this was being sold as an opiate blotter, since per-dose it’s more expensive than LSD. But if someone were to drop a ten strip of this on the ground, we all know what the person who found it would assume. The reality is, if you use ANY substance sourced on the unregulated market, you should assume that fentanyl adulteration is possible.
The Chocolate Chip Cookie Problem
The primary issue with fentanyl adulteration is that the fentanyl is very, very unlikely to be evenly distributed in a baggie. And since a single milligram would likely be fatal to a non opiate user using alone (yes, 1mg, or 1/1000th of a gram bag), it is incredibly important to test the ENTIRE sample you are planning on consuming. We call this the ‘chocolate chip cookie problem’, since a single ‘chocolate chip’ of fentanyl on a cookie the size of a dining room table would be enough to potentially kill someone. So when testing, you have to ‘find the chocolate chip’ in what you test. For this reason, the strips are actually a better technology than most laboratory analysis, since even in the most sophisticated lab might miss the fentanyl in that sample, unless they test the ENTIRE sample a person is planning on consuming.
This is, to be frank, sometimes a bit of a pain. Dissolving a gram of cocaine in water, testing the water, and then drying out the cocaine for later use sounds like a lot of work, and it is. But it’s far less problematic than dealing with accidental consumption of fentanyl. And since fentanyl adulteration is possible in any unregulated market substance, you have to take appropriate steps:
- Test anything you plan on consuming with fentanyl strips, and test the whole amount you plan on consuming.
- Know how to use Narcan, also known as Naloxone, and keep it on hand. Narcan is used to treat known or suspected opioid overdose.
- Never use ANY drug alone, since there will be no one to help if you need it.
I want to dispel a couple of the more common misconceptions around drug checking, and leave you with some final non-testing tips.
No one, and I mean no one, can identify a drug by sight, smell, taste, or other factors. I have seen some of the sneakiest misrepresentation designed explicitly to exploit this belief (including a bag of βk-MDEA that had been treated with root beer extract to make it smell like ‘Sass’). Without testing, you can not know what it is you’re taking. Period.
There is also this common public perception, even among drug users, that you don’t need Narcan if you don’t use opiates. This is not true. Fentanyl adulteration can happen to anyone, and anyone who uses anything should know how to use Narcan and always have it around. But Narcan doesn’t do anything if you don’t have someone there to administer it, so even with substances you are very, very familiar with you should never use alone.
The last little myth I would like to dispel is the idea that reagent test kits detect purity. As I talked about above, they do not. Anyone who says ‘this is really pure’ or ‘this is really strong’ based on a test kit reaction is fundamentally misunderstanding the nature of a reagent kit. Reagent kits are far better than consuming something without testing it, but they do not eliminate the risks of substance use.
Until the legislative changes happen that create legal, regulated markets for all drugs, it really is up to us as drug users to build the new models needed for safer use. In addition to always testing, I deeply believe everyone should learn to use Narcan, learn to trip-sit, and build the support networks needed so that communities can make substance use as safe as possible.
I also deeply hope that if you’re interested in policy change, you get involved in the multiple, ongoing fights to create a more rational drug policy. From Decrim Nature campaigns to safe use facilities, there is a lot going on in the U.S. right now, and we can use all the help we can get.
If you ever have any questions, please feel free to contact DanceSafe. We are a nonprofit which has been providing harm reduction services and advice for more than 20 years at events all over the world. Stay safe during your New Year’s celebrations. As The Teafaerie says in her incredible poem Mapping the Source:
Image: Adapted from Pirulaputa