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Bern, A study commissioned by the FOPH shows that this service helps protect users from overdoses and adverse reactions to adulterants. The study also underlines the potential of drug checking for identifying vulnerable individuals at an early stage and for monitoring the drug market. In cities such as Basel, Bern, Geneva or Zurich, small quantities of drugs can now be submitted anonymously to a counselling centre for analysis. Such tests are also offered in certain clubs or at festivals. The feedback from the substance analysis is incorporated in a professional counselling session with the person concerned. In over half of the cases, the tested sample posed an increased risk to the user. The study shows that drug-checking services can raise the awareness of drug users concerning less risky drug use, even preventing fatalities in extreme cases. They can also enable the information to get to the harder-to-reach target group of occasional drug users. Accordingly, nine out of ten individuals interviewed in connection with the study stated that they had used less of, or even stopped using, the tested drugs after receiving a substance warning. A quarter of those affected forwarded the warning to other people. The most important warnings are also disseminated online, notably on the website infodrog. Thanks to the drug-checking services, moreover, vulnerable individuals can be identified at an early stage and referred to appropriate support agencies. Finally, a systematic analysis of the substance samples as part of the monitoring process can provide information about the drug market and reveal problematic developments. According to the study, these are all relevant functions that can be perfected and expanded in order to further improve the cost-benefit ratio of the service offering. As early as the s, Switzerland was one of the first countries to provide such services. Buyers do not usually know anything about the quality of drugs available on the black market. As a result, even those who use drugs occasionally are taking potentially fatal risks. Address for enquiries. Top of page. Homepage Main navigation Content area Sitemap Search. Contact information. Back to overview. Federal Office of Public Health Bern, Monitoring the drug market Thanks to the drug-checking services, moreover, vulnerable individuals can be identified at an early stage and referred to appropriate support agencies.

Drug-checking services: effective approach to harm reduction

Geneva buying MDMA pills

Official websites use. Share sensitive information only on official, secure websites. Sean Dolan developed the survey, collected and analyzed the data, and wrote the initial draft of the manuscript. Matthew Johnson secured funding for the study and contributed to the final draft of the manuscript. Both authors contributed to the experimental design of the study and have approved the final draft. Corresponding Author: Sean B. Dolan, sdolan8 jhmi. The current study aimed to evaluate the effectiveness of adulterant-related informational prompts in reducing Ecstasy use using a novel probability discounting task. Each prompt contained general, potential public-health information that was not specifically related to subsequent behavioral tasks. All participants then completed an identical Drug Purity Discounting Task, in which they indicated the likelihood of using a sample of Ecstasy across different probabilities of the sample being impure, and then completed a hypothetical Ecstasy purchasing task. Likelihood of Ecstasy use decreased as impurity probability increased across conditions. Ecstasy-use likelihood did not differ among conditions when the likelihood of sample impurity was 0. Ecstasy purchasing did not differ among groups. Inelastic purchasing was associated with greater likelihood of using potentially-impure Ecstasy. Altogether, these data highlight the necessity of education regarding pharmacologically-active, rather than inert, adulterants in Ecstasy, and suggest that increased access to drug checking kits and services may mitigate some of the harms associated with Ecstasy use. Ecstasy is commonly associated with 3,4-methylenedioxymethamphetamine MDMA , which produces prosocial, euphoric, and energizing effects de la Torre et al. Aside from the violations of informed consent posed by unintentional consumption of a drug, many Ecstasy adulterants have psychological and health-related consequences exceeding the severity of those posed by MDMA. Many of the synthetic cathinones found in Ecstasy are more potent Gatch et al. Additionally, adulterant pharmacokinetics may differ substantially from MDMA and potentially lead to redosing with faster pharmacokinetics, or delayed onset from slower pharmacokinetics, which is considered a driving factor in Ecstasy-related fatalities associated with para -methoxymethylamphetamine Kraner et al. Adulterated Ecstasy produces greater adverse subjective effects than MDMA, which can be highly-distressing, even in the absence of the threat of addiction or overdose Brunt, et al. Furthermore, individuals report reduced drug-use likelihood contingent upon an MDMA-negative or adulterant-positive reading in both real Saleemi et al. Drug-checking services can be highly-effective harm-reduction tools; however, novel approaches are necessary to understand drug-related decision-making processes to optimize strategies for increasing engagement in drug checking. Behavioral economics provides a theoretical framework for evaluating decision making under different constraints, and has been successfully utilized to assess drug use and dependence. Two frequently-used behavioral economic concepts for evaluating drug use are probability discounting and demand Bickel et al. Probability discounting classically refers to devaluation of a reinforcer as the probability of its receipt decreases Rachlin et al. Responding on these tasks is sensitive to framing conditions, such that condom-use likelihood increases when the hypothetical STI is considered more dangerous i. HIV vs. Demand, referring to changes in consumption as a function of cost, is commonly assessed using hypothetical purchase tasks, in which participants indicate how much of a commodity they would purchase across prices. Three studies have assessed hypothetical Ecstasy demand, albeit alongside other, simultaneously-available drugs, and demonstrated Ecstasy demand increases with perceived quality Sumnall et al. These data highlight that context can strongly influence decision-making processes. The current study aimed to utilize these principles to investigate how Ecstasy-use behaviors may be influenced by information related to adulteration. The survey was released in 3 waves between November and February Participants who met the aforementioned inclusion criteria were provided a link to the main survey, which took about 15 minutes to complete. Participants read a consent page describing the study and their rights as participants. Beginning the survey after reading this page was considered provision of consent. Participants provided demographic information age, gender, race, marital status, educational history, employment status and Ecstasy-use data, including use frequency and preferred formulation e. Probabilities were presented in random order and whether losses or gains were completed first was randomized. Participants were randomly assigned to one of four experimental framing conditions containing different Ecstasy-related prompts supplemental methods. This condition was designed to describe general aspects of MDMA likely known to recreational users. It was made explicit that these impurities did not produce any deleterious effects. Unlike the Inert Impurities frame, the Active Impurities frame explicated that these adulterants can cause serious harm. Following the prompt excluding No Frame , participants completed a brief, three-question quiz specific to their condition, and were not allowed to move on to the next section until they correctly answered each question. The quiz ensured participants were exposed to and understood the information in the prompt. All participants then completed an identical probability discounting task that was independent of any prompt condition. Participants used a sliding visual analog scale ranging from 0—, in one-point, whole-integer increments, to indicate their likelihood of using a sample of Ecstasy based on the probability that it contained an unspecified impurity. Each probability was presented sequentially on separate pages. Participants read a brief instructional set supplemental methods asking to imagine a typical month when they would use Ecstasy and to consider the following: the Ecstasy was of their normal quality; they could not get Ecstasy elsewhere; they could not use Ecstasy saved from previous use episodes; they could not spend more money than they actually had; they would consume all of the purchased Ecstasy in the next month; they should consider each price individually; and that one dose was defined as either one pressed tablet, capsule of powder, or small baggie of powder. The purchase task was not included in the initial release, but participants in waves 2 and 3 completed the task. Due to non-normality across variables, nonparametric statistical tests were used. Demographic variables were compared among groups to evaluate demographic matching. When possible, non-continuous demographic variables were dichotomized for statistical comparison. Continuous variables were analyzed using Kruskal-Wallis H tests, whereas categorical variables were analyzed using chi-squared analysis. PDQ scores h value were calculated the same way for gains and losses, as previously described Madden et al. Larger h values indicate greater probability discounting e. Individual h values were compared among groups using a Kruskal-Wallis H test. Datasets violating these criteria were excluded from analysis. Using these standardized data points, area under the curve AUC was calculated for each participant as previously described Myerson et al. Greater AUC indicates a greater drug-use likelihood. In the event of a significant group difference, pairwise comparisons using Mann-Whitney U tests were conducted to assess differences between each group. Datasets with consumption exceeding doses were excluded from analysis. To allow for log transformation, the first instance of 0 consumption was converted to 0. Observed O max maximum expenditure was determined by calculating the maximum money spent on Ecstasy at any single price for each participant. Money spent at each price was determined by multiplying the number of Ecstasy units purchased by the price per unit. Because model-fitting was not possible in such cases, datasets with 0 or unchanging consumption across prices were excluded from demand elasticity, but not intensity, analyses. Intensity and elasticity were compared among groups using a Kruskal-Wallis H test. Bivariate Spearman Rank correlational analyses were performed to determine relations between measures. In total, 22, people completed the screener, and 1. This is comparable to the prevalence of pastday Ecstasy use among persons aged 26—34 in the United States 0. Participant demographics are presented in Table 1. Demographics were comparable among conditions with a few exceptions. Participant demographics for the total sample and each framing condition. Drug purity discounting is illustrated in Figure 1. Discounting responses were generally orderly. Forty-five nonsystematic datasets Ecstasy Purity Discounting. Median standardized i. Ecstasy demand is illustrated in Figures 2 and 3. Because the purchase task was not included in the initial survey release, only participants completed it. Demand responses were generally orderly. Twenty-six datasets Hypothetical Ecstasy demand curves. Median hypothetical Ecstasy doses purchased across prices and best-fit demand curves for the No Frame white circles, solid line , Drug Effects filled circles, dotted line , Inert Impurities white squares, dashed line , and Active Impurities filled squares, dotted dashed line groups. Hypothetical Ecstasy demand metrics. Larger values indicate greater consumption. Larger values indicate greater expenditure. Larger values indicate greater price-sensitivity. Spearman correlations among measures are presented in Table 2. Bivariate correlations among task metrics and Ecstasy use measures. Spearman rho values are presented in each cell. These findings underscore the importance of information regarding Ecstasy sample purity in making informed decisions related to Ecstasy use. Although hypothetical, these data mirror reports in which individuals who test their Ecstasy samples and detect an impurity report decreased likelihood of using the tainted sample Day et al. Given the harms associated with pharmacologically-active adulterants, the growing literature demonstrating reduced use likelihood with knowledge of sample impurity highlight the public-health benefit of drug-checking services. These data also inform best practices for messaging about drug-checking services. Strategies to advocate drug-checking services could most-effectively promote drug-checking by emphasizing dangerous effects of pharmacologically-active adulterants in Ecstasy, or simply stressing the high incidence of adulteration, given the reduction in use likelihood without explicitly defining impurities. Conversely, focusing on pharmacologically-inert adulterants may be counterproductive for effective utilization of drug-checking services. These data contribute to the emerging framing-effects literature in behavioral economics. Individuals reading about dangers of pharmacologically-active adulterants responded similarly to individuals receiving no adulterant-related information. Conversely, those reading about inactive adulterants indicated a greater likelihood of using potentially-impure Ecstasy relative to the other conditions. Assessments of framing effects have demonstrated reduced delay discounting when delays are presented as dates rather than temporal distances e. When considered with the current data, the similar responding between unspecified and explicitly-injurious outcomes suggest individuals may default to worst-case scenarios when provided limited information about a potentially-harmful outcome. Simply assessing general Ecstasy use may have led us to conclude that adulterant-related information did not influence Ecstasy-use behaviors. Additionally, probability discounting for Ecstasy use and money showed near-zero correlation coefficients, indicating independent underlying probability-discounting processes for the two commodities. This study was the first to assess hypothetical purchasing of Ecstasy alone. Demand responses were generally orderly with monotonic decreases in consumption with increasing price, and suggests the utility of this approach for assessing Ecstasy demand. Although discounting differed among groups, hypothetical purchasing was similar among prompt conditions. The reason for the lack of framing effects on hypothetical demand is unclear. Because the purchasing task was not included in the initial survey release, the smaller sample size may have been insufficient for detecting significant group differences. The temporal distance between the framing prompt and the purchasing task, which were separated by the purity discounting task, may have diminished the salience of the prompt information. Additionally, the purchase task did not explicitly reference purity, whereas adulteration was the crux of the discounting task. Despite the lack of framing effects on purchasing, there were significant relations between Ecstasy demand, Ecstasy use, and Purity discounting. The negative relation between elasticity and AUC indicates that greater Ecstasy demand may be related to riskier Ecstasy use patterns, as individuals indicating more inelastic purchasing are more likely to use impure Ecstasy. Elasticity was negatively related to ESDS scores, suggesting that more inelastic purchasing patterns are also associated with greater dependence severity. Curiously, a similar relation between ESDS and AUC did not emerge, suggesting the greater impure sample use likelihood in inelastic purchasers was not necessarily reflective of greater dependence, but may be indicative of a stronger desire to use Ecstasy, regardless of price or purity. Similarly, alternative assessments of use, such as episodic consumption i. The reasons for this relation are not apparent. The most salient outcomes from this study should support harm-reduction education and public-health campaigns regarding Ecstasy adulteration and the benefits of drug-checking services. Narratives simply informing the public of the presence of adulterants may be as effective as emphasizing the potentially-dangerous compounds present in Ecstasy, given that purity discounting was comparable between the pharmacologically-active impurities framing condition and the two, impurity-nonspecific groups. Additionally, these data expand upon previous findings demonstrating that individuals will use information regarding Ecstasy sample purity to decide whether to use the drug Day et al. These numbers are higher than previous reports Day et al. Altogether, increased public awareness of the relative impurity of Ecstasy and its associated harms alongside increased access to drug-checking services has the potential to save lives by reducing the inadvertent use of tainted Ecstasy. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Drug Alcohol Depend. Published in final edited form as: Drug Alcohol Depend. Find articles by Sean B Dolan. Find articles by Matthew W Johnson. Contributors Sean Dolan developed the survey, collected and analyzed the data, and wrote the initial draft of the manuscript. Issue date Mar 1. PMC Copyright notice. The publisher's version of this article is available at Drug Alcohol Depend. Open in a new tab. Demand Intensity Consumption at lowest price. O max maximum observed expenditure. PastDay Ecstasy Use. Role of Funding Source: Nothing declared. Conflict of Interest: No conflict of interest declared. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Past 30 Day Ecstasy use days median, Q1—Q3.

Geneva buying MDMA pills