What About Drug Checking? Systematic Review and Netnographic Analysis of Social Media

Author(s): Amira Guirguis*, Isma Moosa, Rosalind Gittins, Fabrizio Schifano*

Journal Name: Current Neuropharmacology

Volume 18 , Issue 10 , 2020

Become EABM
Become Reviewer
Call for Editor

Graphical Abstract:


Drug checking services have been operating worldwide as a harm reduction tool in places like festivals and night clubs. A systematic review and netnographic analysis were conducted to explore the public’s perception of drug checking. Although public perceptions of drug checking had not previously been evaluated in the literature, some positive and negative perceptions were captured. From twitter, a total of 1316 tweets were initially identified. Following the removal of irrelevant tweets, 235 relevant tweets were identified, of which about 95% (n = 223) tweets were in favour, and about 5% (n = 12) were not in favour of drug checking as a harm reduction intervention. Tweets perceived the service as part of effective law reform, public health intervention that serves in raising awareness and countering the role of the internet, initiative to reduce drug related harms and/ or potentially deaths, help in identifying Novel drug trends related to drugs, enabling a scientific basis to capture data, reducing harm from risky drugs or risky consumption, reducing the economic and social burden on society and preventing young people from having criminal records and punitive fines. Drug checking was perceived to support engagement with treatment services and support individuals in making more informed decisions. Tweets against drug checking focussed on the concerns over the quality of drug checking, particularly with false-positive results, which may lead to punitive outcomes, discrimination, and prejudice. The present study showed that twitter can be a useful platform to capture people’s perceptions of drug checking.

Keywords: Drug checking, drug screening, drug testing, pill testing, harm reduction, twitter.

Groves, A. ‘Worth the test?’ Pragmatism, pill testing and drug policy in Australia. Harm Reduct. J., 2018, 15(1), 12.
[http://dx.doi.org/10.1186/s12954-018-0216-z ] [PMID: 29631613]
United Nations Office on Drugs and Crime (UNODC) World drug report 2018. Analysis of drug markets, 2018,. https://www.unodc.org/wdr2018/prelaunch/WDR18_Booklet_3_DRUG_MARKETS.pdf
Sherman, S.G.; Morales, K.B.; Park, J.N.; McKenzie, M.; Marshall, B.D.L.; Green, T.C. Acceptability of implementing community-based drug checking services for people who use drugs in three United States cities: Baltimore, Boston and Providence. Int. J. Drug Policy, 2019, 68, 46-53.
[http://dx.doi.org/10.1016/j.drugpo.2019.03.003 ] [PMID: 30991301]
Winstock, A.R.; Ramsey, J. Drug checking and pill testing – what it can and cannot do and why it matters. Global Drug Survey, https://www.globaldrugsurvey.com/past-findings/gds2017-launch/drug-checking-and-pill-testing-what-it-can-and-cannot-do-and-why-it-matters/
Barratt, M.; Kowalski, M.; Maier, L.; Alison, R. Global Review of Drug Checking Services. Drug Policy Model Progr Bull No 24, 2017.https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Global%20review%20of%20drug%20checking%20services%20operating%20in%202017.pdf
DanceSafe. About Us., https://dancesafe.org/about-us/
Measham, F.C. Drug safety testing, disposals and dealing in an English field: Exploring the operational and behavioural outcomes of the UK’s first onsite ‘drug checking’ service. Int. J. Drug Policy, 2019, 67, 102-107.
[http://dx.doi.org/10.1016/j.drugpo.2018.11.001 ] [PMID: 30541674]
Alcohol and Drug Foundation (ADF). Drug checking: a harm reduction strategy., https://adf.org.au/insights/drug-checking-a-harm-reduction-strategy/
Brunt, T. Drug checking as a harm reduction tool for recreational drug users: opportunities and challenges., http://www.emcdda.europa.eu/system/files/attachments/6339/EuropeanResponsesGuide2017_BackgroundPaper-Drug-checking-harm-reduction_0.pdf
Pill Testing Australia. TRANS TASMAN Charter for pill testing., https://pilltestingaustralia.com.au/trans-tasman-charter/
Welsh Emerging Drugs & Identification of Novel Substances Project (WEDINOS) WEDINOS About Us. http://www.wedinos.org/about_us.html
Sutcliffe Research Group. MANDRAKE-Manchester drug analysis and knowledge exchange., https://www.sutcliffe-research.org/mandrake/
Bardwell, G.; Kerr, T. Drug checking: a potential solution to the opioid overdose epidemic? Subst. Abuse Treat. Prev. Policy, 2018, 13(1), 20.
[http://dx.doi.org/10.1186/s13011-018-0156-3 ] [PMID: 29801458]
Bardwell, G.; Boyd, J.; Arredondo, J.; McNeil, R.; Kerr, T. Trusting the source: The potential role of drug dealers in reducing drug-related harms via drug checking. Drug Alcohol Depend., 2019, 198, 1-6.
[http://dx.doi.org/10.1016/j.drugalcdep.2019.01.035 ] [PMID: 30856370]
Barry, C.L. Fentanyl and the evolving opioid epidemic: what strategies should policy makers consider? Psychiatr. Serv., 2018, 69(1), 100-103.
[http://dx.doi.org/10.1176/appi.ps.201700235 ] [PMID: 28967324]
Laing, M.K.; Tupper, K.W.; Fairbairn, N. Drug checking as a potential strategic overdose response in the fentanyl era. Int. J. Drug Policy, 2018, 62, 59-66.
[http://dx.doi.org/10.1016/j.drugpo.2018.10.001 ] [PMID: 30359874]
Karamouzian, M.; Dohoo, C.; Forsting, S.; McNeil, R.; Kerr, T.; Lysyshyn, M. Evaluation of a fentanyl drug checking service for clients of a supervised injection facility, Vancouver, Canada. Harm Reduct. J., 2018, 15(1), 46.
[http://dx.doi.org/10.1186/s12954-018-0252-8 ] [PMID: 30200991]
Peiper, N.C.; Clarke, S.D.; Vincent, L.B.; Ciccarone, D.; Kral, A.H.; Zibbell, J.E. Fentanyl test strips as an opioid overdose prevention strategy: Findings from a syringe services program in the Southeastern United States. Int. J. Drug Policy, 2019, 63, 122-128.
[http://dx.doi.org/10.1016/j.drugpo.2018.08.007 ] [PMID: 30292493]
Barratt, M.J.; Kowalski, M.; Maier, L.J.; Ritter, A. Profiles of drug checking services. Drug Policy Model Progr Bull No 24, 2017.https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Profiles%20of%20drug%20checking%20services%20in%202017.pdf
European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and Europol Early-warning system on new psychoactive substances — operating guidelines, EMCDDA Risk assessments. Publications Office of the European Union, Luxembourg. 2007.http://www.emcdda.europa.eu/system/files/publications/449/EWSguidelines2_98082.pdf
Hungerbuehler, I.; Buecheli, A.; Schaub, M. Drug Checking: A prevention measure for a heterogeneous group with high consumption frequency and polydrug use - evaluation of zurich’s drug checking services. Harm Reduct. J., 2011, 8, 16.
[http://dx.doi.org/10.1186/1477-7517-8-16 ] [PMID: 21663618]
Tupper, K.W.; McCrae, K.; Garber, I.; Lysyshyn, M.; Wood, E. Initial results of a drug checking pilot program to detect fentanyl adulteration in a Canadian setting. Drug Alcohol Depend., 2018, 190, 242-245.
[http://dx.doi.org/10.1016/j.drugalcdep.2018.06.020 ] [PMID: 30064061]
The Pharmaceutical Journal (PJ). First Home Office-licensed street drug-testing clinic opens https://www.pharmaceutical-journal.com/news-and-analysis/news/first-home-office-licensed-street-drug-testing-clinic-opens/20206219.article
European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). An inventory of on-site pill-testing interventions in the EU in cooperation with. Lisbon., (Accessed March 23, 2020),
Butterfield, R.J.; Barratt, M.J.; Ezard, N.; Day, R.O. Drug checking to improve monitoring of new psychoactive substances in Australia. Med. J. Aust., 2016, 204(4), 144-145.
[http://dx.doi.org/10.5694/mja15.01058 ] [PMID: 26937663]
Lefkovits, Z.G. A Pill too Hard to Swallow? A Public Health and Legislative Consideration of Methods to Reduce Drug-Related Harm in the Victorian Party Scene: On-site Pill Testing, Market Monitoring and Publication of Publication of Police Drug Seizure Data, https://www.ncbi.nlm.nih.gov/pubmed/27469086
Camilleri, A.M.; Caldicott, D. Underground pill testing, down under. Forensic Sci. Int., 2005, 151(1), 53-58.
[http://dx.doi.org/10.1016/j.forsciint.2004.07.004 ] [PMID: 15935943]
Schroers, A. Drug checking: monitoring the contents of new synthetic drugs. J. Drug Issues, 2002, 32, 635-646.
Barratt, M.J.; Bruno, R.; Ezard, N.; Ritter, A. Pill testing or drug checking in Australia: Acceptability of service design features. Drug Alcohol Rev., 2018, 37(2), 226-236.
[http://dx.doi.org/10.1111/dar.12576 ] [PMID: 28635057]
Uitemark, J.; Cohen, P. A clash of policy approaches: The rise (and fall?) of Dutch harm reduction policies towards ecstasy consumption. Int. J. Drug Policy, 2005, 16, 65-72.
Kozinets, R.V. The field behind the screen: using netnography for marketing research in online communities. J. Mark. Res., 2002, 39, 61-72.
Paul, M.J.; Sarker, A.; Brownstein, J.S.; Nikfarjam, A.; Scotch, M.; Smith, K.L.; Gonzalez, G. Social media mining for public health monitoring and surveillance. Biocomputing 2016Proceedings of the Pacific symposium, United States2016, pp. 468-479.
Cameron, D.; Smith, G.A.; Daniulaityte, R.; Sheth, A.P.; Dave, D.; Chen, L.; Anand, G.; Carlson, R.; Watkins, K.Z.; Falck, R. PREDOSE: a semantic web platform for drug abuse epidemiology using social media. J. Biomed. Inform., 2013, 46(6), 985-997.
[http://dx.doi.org/10.1016/j.jbi.2013.07.007 ] [PMID: 23892295]
Chary, M.; Genes, N.; McKenzie, A.; Manini, A.F. Leveraging social networks for toxicovigilance. J. Med. Toxicol., 2013, 9(2), 184-191.
[http://dx.doi.org/10.1007/s13181-013-0299-6 ] [PMID: 23619711]
Cavazos-Rehg, P.A.; Krauss, M.; Fisher, S.L.; Salyer, P.; Grucza, R.A.; Bierut, L.J. Twitter chatter about marijuana. J. Adolesc. Health, 2015, 56(2), 139-145.
[http://dx.doi.org/10.1016/j.jadohealth.2014.10.270 ] [PMID: 25620299]
Hanson, C.L.; Cannon, B.; Burton, S.; Giraud-Carrier, C. An exploration of social circles and prescription drug abuse through Twitter. J. Med. Internet Res., 2013, 15(9) e189
[http://dx.doi.org/10.2196/jmir.2741 ] [PMID: 24014109]
Kalyanam, J.; Katsuki, T.; Lanckriet, G.R.; Mackey, T.K. Exploring trends of nonmedical use of prescription drugs and polydrug abuse in the Twittersphere using unsupervised machine learning., Addict. behave, 2017, 65, 289-295..
Katsuki, T.; Mackey, T.K.; Cuomo, R. Establishing a link between prescription drug abuse and illicit online pharmacies: analysis of Twitter data. J medl. J. Med. Internet Res., 2015, 17(12) e280
[http://dx.doi.org/10.2196/jmir.5144 ] [PMID: 26677966]
Sarker, A.; O’Connor, K.; Ginn, R.; Scotch, M.; Smith, K.; Malone, D.; Gonzalez, G. Social media mining for toxicovigilance: automatic monitoring of prescription medication abuse from Twitter. Drug Saf., 2016, 39(3), 231-240.
[http://dx.doi.org/10.1007/s40264-015-0379-4 ] [PMID: 26748505]
Scott, K.R.; Nelson, L.; Meisel, Z.; Perrone, J. Opportunities for exploring and reducing prescription drug abuse through social media. J. Addict. Dis., 2015, 34(2-3), 178-184.
[http://dx.doi.org/10.1080/10550887.2015.1059712 ] [PMID: 26075802]
Shutler, L.; Nelson, L.S.; Portelli, I.; Blachford, C.; Perrone, J. Drug use in the Twittersphere: a qualitative contextual analysis of tweets about prescription drugs. J. Addict. Dis., 2015, 34(4), 303-310.
[http://dx.doi.org/10.1080/10550887.2015.1074505 ] [PMID: 26364675]
Shutler, L.; Perrone, J.; Portelli, I.; Nelson, L.S.; Blachford, C.R. Prescription opioids in the Twittersphere: a contextual analysis of tweets about prescription drugs. Ann. Emerg. Med., 2013, 62, S122.
Thompson, L.; Rivara, F.P.; Whitehill, J.M. Prevalence of marijuana-related traffic on Twitter, 2012–2013: a content analysis. Cyberpsychol. Behav. Soc. Netw., 2015, 18(6), 311-319.
[http://dx.doi.org/10.1089/cyber.2014.0620 ] [PMID: 26075917]
Ahmed, W.; Bath, P.; Demartini, G. Using twitter as a data source: an overview of ethical, legal, and methodological challenges. The Ethics of Online Research. Advances in Research Ethics and Integrity (2); Woodfield, K., Ed.; Emerald: UK, 2017, pp. 79-107.
Omnicore. Twitter by the numbers: stats, demographics, & fun facts https://www.omnicoreagency.com/twitter-statistics/
Schultz, D.; Jolly, S. Automatic Tweet Hashtag Categorization., https://courses.media.mit.edu/2010fall/mas622j/Projects2010/SunnyJolly_DanSchultz.pdf
Moher, D.; Liberati, A.; Tetzlaff, J.; Altman, D.G. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med., 2009, 6(7) e1000097
[http://dx.doi.org/10.1371/journal.pmed.1000097 ] [PMID: 19621072]
Kerr, T.; Tupper, K. Drug checking as a harm reduction intervention: Evidence Review Report. Vancouver, https://www.bccsu.ca/wp-content/uploads/2017/12/Drug-Checking-Evidence-Review-Report.pdf
Makkai, T.; Macleod, M.; Vumbaca, G.; Hill, P.; Caldicott, D.; Noffs, M. Report on Canberra GTM Harm Reduction Service., https://www.drugsandalcohol.ie/29513/
Saleemi, S.; Pennybaker, S.J.; Wooldridge, M.; Johnson, M.W. Who is ‘Molly’? MDMA adulterants by product name and the impact of harm-reduction services at raves. J. Psychopharmacol. (Oxford), 2017, 31(8), 1056-1060.
[http://dx.doi.org/10.1177/0269881117715596 ] [PMID: 28693371]
Day, N.; Criss, J.; Griffiths, B.; Gujral, S.K.; John-Leader, F.; Johnston, J.; Pit, S. Music festival attendees’ illicit drug use, knowledge and practices regarding drug content and purity: a cross-sectional survey. Harm Reduct. J., 2018, 15(1), 1.
[http://dx.doi.org/10.1186/s12954-017-0205-7 ] [PMID: 29304871]
Byrne, S.; Gock, A.; Cowling, A.; Faunce, T.; Faunce, T. Australia’s first official illicit pill testing at canberra groovin’ the moo music festival: legal hurdles and future prospects. J. Law Med., 2018, 26(1), 54-60.
[PMID: 30302973]
Liu, B. Sentiment Analysis and Opinion Mining; Lang. Arts Discip, 2012, pp. 1-167.
The Guardian. Festival overdose victim took multiple pills before event 'to avoid police detection. https://www.theguardian.com/australia-news/2019/jul/08/festival-overdose-victim-took-multiple-pills-before-event-to-avoid-police-detection
Sande, M.; Šabić, S. The importance of drug checking outside the context of nightlife in Slovenia. Harm Reduct. J., 2018, 15(1), 2-9.
[http://dx.doi.org/10.1186/s12954-018-0208-z ] [PMID: 29329544]
Chinet, L.; Stéphan, P.; Zobel, F.; Halfon, O. Party drug use in techno nights: a field survey among French-speaking Swiss attendees. Pharmacol. Biochem. Behav., 2007, 86(2), 284-289.
[http://dx.doi.org/10.1016/j.pbb.2006.07.025 ] [PMID: 16934861]
Evans, M. Anti-drug campaigners slam plans to introduce drug testing tents at music festivals., https://www.telegraph.co.uk/news/2017/05/21/anti-drug-campaigners-slam-plans-introduce-drug-testing-tents/
Edwards, M. Inside the UK’s First City Centre Drug Testing Facility., https://www.vice.com/en_uk/article/59qdwb/inside-the-uks-first-city-centre-drug-testing-facility
Waldron, J.; Mokrysz, C.; Grabski, M.; Freeman, T.; Measham, F. Just say “know” to drugs: can testing facilities make festivals safer?, https://www.theguardian.com/science/sifting-the-evidence/2017/aug/10/just-say-know-to-drugs-can-testing-facilities-make-festivals-safer
The Conversation. Testing festival goers’ pills isn’t the only way to reduce overdoses. Here’s what else works, . https://theconversation.com/testing-festival-goers-pills-isnt-the-only-way-to-reduce-overdoses-heres-what-else-works-118827
Grahame, H. Inquest into the death of six patrons of NSW music festivals. Findings of Magistrate Harriet Grahame, Deputy State Coroner, http://www.coroners.justice.nsw.gov.au/Documents/Redacted%20findings%20in%20the%20joint%20inquest%20into%20deaths%20arising%20at%20music%20festivals%20including%20annexures%20-%208%20November%202019.pdf
Martín-Wanton, T.; Pons-Porrata, A.; Montoyo-Guijarro, A.; Balahur, A. Opinion Polarity Detection Using Word Sense Disambiguation to Determine the Polarity of Opinions., https://www.researchgate.net/publication/221539778_Opinion_Polarity_Detection_-_Using_Word_Sense_Disambiguation_to_Determine_the_Polarity_of_Opinions
Bindal, N.; Chatterjee, N. A Two-Step Method for Sentiment Analysis of Tweets Int. Conf. Inf. Technol., 2016, pp. 218-224.
Mohammad, S.M. Sentiment Analysis: Detecting valence, emotions, and other affectual states from text. Emotion measurement; Woodhead Publishing, 2016, pp. 201-237.
House of Commons; Health and Social Care Committee. 2019.Drugs policy., https://publications.parliament.uk/pa/cm201919/cmselect/cmhealth/143/143.pdf
Hendrie, D. Toxicologists throw support behind pill testing ahead of major festival weekend. newsGP, https://www1.racgp.org.au/newsgp/professional/toxicologists-throw-support-behind-pill-testing-ah
The Guardian. NSW's resistance to pill testing will drive dealers to sell 'more dangerous drugs', ACT warns.. https://www.theguardian.com/australia-news/2019/jan/23/nsws-resistance-to-pill-testing-will-drive-dealers-to-sell-more-dangerous-drugs-act-warns
Giné, C.V.; Vilamala, M.V.; Measham, F.; Brunt, T.M.; Bücheli, A.; Paulos, C.; Valente, H.; Martins, D.; Libois, B.; Tögel-Lins, K.; Jones, G.; Karden, A.; Barratt, M.J. The utility of drug checking services as monitoring tools and more: A response to Pirona et al. Int. J. Drug Policy, 2017, 45, 46-47.
[http://dx.doi.org/10.1016/j.drugpo.2017.05.018 ] [PMID: 28582668]
Ventura, M.; Noijen, J.; Bücheli, A.; Isvy, A.; van Huyck, C.; Martins, D. drug checking service good practice standards. Drug Checking Service Good Practice Standards. http://newip.safernightlife.org/pdfs/standards/NEWIP_D_standards-final_20.12-A4.pdf
Guirguis, A.; Corkery, J.M.; Stair, J.L.; Kirton, S.B.; Zloh, M.; Schifano, F. Intended and unintended use of cathinone mixtures. Hum. Psychopharmacol., 2017, 32(3), 1-17.
[http://dx.doi.org/10.1002/hup.2598 ] [PMID: 28657191]
Komesaroff, P.A.; Lloyd-Jones, D.M. Pill testing warrants assessment in careful pilot programmes. Intern. Med. J., 2019, 49(4), 419-421.
[http://dx.doi.org/10.1111/imj.14258 ] [PMID: 30957381]
European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Recent changes in Europe’s MDMA/ecstasy market. http://www.emcdda.europa.eu/system/files/publications/2473/TD0116348ENN.pdf
Harm Reduction International (HRI). Drug-checking service., 2019.
Daily, S. Class A – National drugs intelligence bulletin. Q3; LGC Group: Teddington, UK, 2018.
European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) European drug report 2019: trends and developments.. 2019.http://www.emcdda.europa.eu/system/files/publications/11364/20191724_TDAT19001ENN_PDF.pdf
Lancaster, K.; Ritter, A.; Matthew-Simmons, F. Young people’s opinion on alcohol and other drugs issues. Australian National Council on Drugs, https://ndarc.med.unsw.edu.au/sites/default/files/newsevents/events/RP27-young-peoples-opinions.pdf
Sage, C.; Michelow, W. Drug checking at music festivals: A how-to guide., ANKORS http://michelow.ca/drug-checking-guide/
Pharmaceutical Society of Australia. Minimising harm from illicit drug use through pill testing and drug checking position statement., https://www.psa.org.au/pharmacists-support-pill-testing/
Chan, B.; Lopez, A.; Sarkar, U. The canary in the coal mine tweets: Social media reveals public perceptions of non-medical use of opioids. PLoS One, 2015, 10(8) e0135072
[http://dx.doi.org/10.1371/journal.pone.0135072 ] [PMID: 26252774]
Rose, S.W.; Jo, C.L.; Binns, S.; Buenger, M.; Emery, S.; Ribisl, K.M. Perceptions of menthol cigarettes among twitter users: Content and sentiment analysis. J. Med. Internet Res., 2017, 19(2) e56
[http://dx.doi.org/10.2196/jmir.5694 ] [PMID: 28242592]
Glowacki, E.M.; Glowacki, J.B.; Wilcox, G.B. A text-mining analysis of the public’s reactions to the opioid crisis. Subst. Abus., 2018, 39(2), 129-133.
[http://dx.doi.org/10.1080/08897077.2017.1356795 ] [PMID: 28723265]

Rights & PermissionsPrintExport Cite as

Article Details

Year: 2020
Published on: 04 November, 2020
Page: [906 - 917]
Pages: 12
DOI: 10.2174/1570159X18666200413142632
Price: $65

Article Metrics

PDF: 21
PRC: 1