Drug checking refers to a service in which street-obtained drugs are chemically analyzed and information regarding their contents is shared with the person using the drug checking service. Drug checking can be conducted using multiple technologies either at an on-site location or at a laboratory where samples are dropped off or shipped for analysis. Drug checking services may include a brief counselling component and serve as an initial point of contact with health care and other services.379 

Drug checking services have recently expanded in BC in response to the increasing dominance of fentanyl in the unregulated drug market. A 2018 cross-sectional survey examining the uptake of drug checking services at Insite in Vancouver found that drugs were checked in nearly 1% of visits, with nearly 84.1% of drugs reported to be heroin testing positive for fentanyl.380 Similarly, data from a 2018 pilot program of two supervised consumption sites in Vancouver demonstrated that nearly 2% of clients utilized the drug checking services at the SCS between October 2017 and April 2018, with 90.6% of all samples believed to be heroin testing positive for fentanyl.381

Data from two 2018 observational studies indicate that people who use drugs are willing to use drug checking services.382,383 However, research on the impacts of drug checking on service users’ substance use behaviors or health outcomes is limited.384  Data from a 2018 survey suggest that people who receive a positive test result for fentanyl are significantly more likely to plan to reduce their drug use upon injecting (OR: 9.35, 95% CI: 4.25–20.65); however, they are not more likely to dispose of their drugs (OR: 1.60, 95% CI: 0.79–3.26).380 A 2022 systematic review (N=90 studies) also found that drug checking services influenced the behaviour of people who use drugs, particularly when drug checking results are unexpected.384 However, the authors noted significant limitations in the available literature, including the fact that the majority of studies were cross-sectional.384