Drug Testing, Drug Checking and their effects on reducing the risk of drug harm

The Loop CEO, Katy Porter

UK drug checking charity, The Loop, is dedicated to reducing drug harm. We asked their recently appointed CEO, Katy Porter, along with The Loop Colleagues to update us on the research and data that underpins their service.

Music festivals are leisure environments where larger numbers of people take larger quantities of legal and illegal drugs, spread across longer time periods than in everyday life. For example, in terms of recent use, 11.4% of young adults aged 16-24 in England and Wales report having had an illicit drug in the last month (Home Office, 2020), by comparison with over two thirds (67.8%) of English festival-goers (Measham & Simmons, 2022). Despite some events still adopting a “zero tolerance” approach to drug use, many festivals are implementing alternative policies to reduce the harms of drug use on-site. Two approaches, which have been developed onsite in recent years, both in the UK and internationally, are the use of non-publicly accessible drug testing and publicly accessible drug checking.

Drug testing can be characterised by the placement of mobile labs to test substances of concern submitted to amnesty bins, confiscated by police and security, and particularly in medical emergencies, where knowing the content and strength of substances in circulation can inform onsite and offsite stakeholders and drug-using communities and can help to inform service delivery and harm reduction messaging (Pascoe et al, 2022).

Drug checking, takes this service one step further. First introduced in 1965 in California, drug checking is a public health intervention which has the primary aim of reducing drug-related harm by directly engaging with people who use drugs. Members of the public submit substances of concern to The Loop for rapid laboratory analysis. Teams of chemists then determine the content and strength of submitted substances. The results of these analyses are delivered to service users embedded in individually tailored healthcare consultations delivered by multidisciplinary teams of experienced health professionals. In both cases, the results of testing are also disseminated to stakeholders and emergency services. Alerts about substances of concern in circulation can be shared through public health surveillance networks, early warning systems, the media and social media to reach at-risk communities, practitioners and other interested parties. The Loop is currently able to offer drug testing at music festivals.

The Loop’s laboratory has identified a number of new psychoactive substances (NPS)  missold as illicit drugs which have caused harm on-site at events. In recent years The Loop has identified a number of different cathinones missold as MDMA, for example. Prior to the pandemic, The Loop tested dozens of samples of N-ethylpentylone mis-sold as MDMA. After events resumed after Covid-19, The Loop was one of the first organisations to identify an increase in prevalence of a number of new cathinones missold as MDMA, such as 4-CMC and 3-MMC (Pascoe et al., 2022). The Loop is able to test and identify these adulterants in a matter of minutes, with the results circulated to key stakeholders including event management, ensuring that all onsite agencies can have a clear picture of what substances are in circulation and what their relative risk is of causing harm. At many of the events The Loop tests at, we are able to send real time drug alerts to attendees via festival apps, ensuring blanket coverage and  maximum awareness of high risk substances of concern, what the symptoms of an adverse reaction are and how to seek help if unwell. This reduces the risk of attendees coming to drug-related harm.

There is a developing evidence base that drug checking, by reducing drug related harm on-site, has beneficial effects to other on-site services such as by decreasing the number of drug-related medical incidents (Measham and Simmons, 2022). This in turn, reduces the number of hospital admissions and strain on NHS resources which increasingly is likely to be raised as a licensing concern due to the pressures the NHS is facing.

Additionally, The Loop’s drug checking service has identified a substantially increased risk of adulteration when people purchase drugs from on-site festival dealers in comparison to off-site neighbourhood dealers. This increased risk of someone consuming a missold substance bought at the festival can inform your festival’s drug policy. While extensive searching and sniffer dogs are implemented with the best intentions, there is a risk that the deterrent effect means that some young people buy drugs onsite instead. Consequently extensive security can displace drug transactions from offsite to the higher risk of missold substances bought on-site (Measham and Turnbull, 2021). This can be a difficult area for festivals to navigate, but as highlighted in Bristol’s new harm reduction campaign and the good work of many UK festivals already, events can adopt a harm reduction approach to drugs so long as they do not ‘knowingly permit’ drug use on-site.

Drug checking has been shown to decrease the quantities of drugs consumed and to reduce the likelihood of them engaging in higher risk drug taking behaviours such as polydrug use. Furthermore, these behaviour changes have been shown to persist, with nearly a third of The Loop’s service users continuing to engage in risk reduction behaviour 3 months after using our service. The Loop’s service is much more comprehensive that just drug testing and drug checking, however, with our team of health and media professionals regularly crafting risk reduction materials to help attendees stay safe at events. Furthermore, we offer a comprehensive package of drug training courses, including a course specifically designed for festival staff, which helps to equip event staff with a better understanding of the risks and effects of illicit drug use and gives them the skills to respond effectively to a drug-related emergency. The Loop has a robust in-house research and evaluation programme, publishing 9 peer-reviewed papers last year, which helps stakeholders have a better understanding of the evidence base behind our services and wider patterns of drug use.

If you are interested in the services of The Loop, from training to having drug testing at your festival then contact us (https://wearetheloop.org/contact-us) and we will be happy to discuss how we can work together. Even if drug testing isn’t something you’re in a position to consider this year, we can offer training or provide consultancy on harm reduction communications to your staff and customers.

We are passionate about what we do and committed to the health and wellbeing of all.

Additional credit: Professor Fiona Measham and Adam Waugh, The Loop