The unregulated drug supply is constantly evolving, and recent increases in illicitly manufactured fentanyl, counterfeit pills and xylazine are linked to severe and complex health consequences. Timely localized drug supply data are being scaled up across the Americas to inform public health efforts and intervene upon the harmful physical and psychological effects of addiction. Unlike traditional forensic and toxicology drug surveillance programs, drug checking services (DCS) allow voluntary submissions of drug samples by the community for “real-time” testing and communication of results. Our aim is to present emerging epidemiologic and economic research on drug checking services in the Americas and discuss the legal and policy challenges being faced by these programs.
To fully realize the potential benefits of DCS globally, we call upon governments and international agencies to consider developing and implementing new policies to support DCS staff and service users, in collaboration with DCS staff and service users:
1. Legal protections for DCS organizations and service users with regards to suspected drug sample and DCS equipment possession, distribution, transport and mailing.
2. Federal/regulatory warnings or bans on the selling and marketing of drug checking equipment that are falsely advertised, inaccurate, or perform suboptimally in DCS environments.
3. Funding and technical assistance for point-of-care instruments that are suitable for DCS.
4. Funding and technical assistance for harm reduction organizations that offer DCS.
5. Workforce development opportunities for people with lived and living experience to work in service delivery.