How to monitor the illicit drug supply is an evolving science. New tools and technologies are emerging all the time, but these products are usually developed in labs, often tested by marketing teams, and rarely tried on “real-world” drug samples for validity and feasibility testing, let alone handled or reviewed by people who use drugs and programs supporting their health and wellness.

​

In the New England region, there is a strong network of community drug checking programs. These programs are supported by state initiatives, community groups, and foundation funding. We brought together  this network of sites–united by a common data collection platform, trained similarly and already gathering regularly in learning collaboratives–to serve as a laboratory for testing out drug-related innovations, tools, and technologies.

​

We're working with drug checking sites in four New England states (Massachusetts, Rhode Island, Connecticut, and Vermont) to test new technologies and methods as part of the Network 1 collaboration. The sites will work together, share resources, and help shape the study, ensuring everyone has a say in how things are done. The Network 1 sites all use StreetCheck and host on-site Bruker FTIR, test strip and related technologies. 

​

Formed and piloted in 2023 and launched in 2024, Network 1 has considered several protocols to advance the science and practice of drug checking:

​

Motivating Project: BTNX XTS Pilot Study

• Who: 10 community drug checking partners across New England 

• Aim: Test the sensitivity, specificity and usefulness of xylazine test strips for the detection of xylazine in the drug supply

• Why: Xylazine is increasing found in the drug supply in the Northeast but there are no test strips that have been used on actual community samples in the New England drug supply to see if they are valid and useful here.

• Findings:  Currently available xylazine test strips are specific (low false positive) but not sensitive (high false negative) and have too high of a level of detection to find the xylazine that is circulating in the New England drug supply. The amount of drug needed to test a sample to detect xylazine is substantially higher than what is needed for fentanyl test strips, which complicates training and distribution of test strips in the community.  If currently available xylazine test strips are to be used by drug checking program technicians, take care to concentrate the sample or use sufficient sample.  Risk of false negative (the test missing a true positive xylazine sample) is substantial and distribution of xylazine test strips should not be done without education on testing process (more drug needed to detect), warning on the probability of a negative result, and referrals for wound care and supports should they experience xylazine-suspected wounds. 

• View: Using Xylazine Test Strips for Drug Checking In The New England Region 

​

OPUS 9.0 Beta Project

• Who: 10 community drug checking partners across New England

• Aim: To help gather feedback on the newest version of OPUS while in beta to test software and provide feedback to Bruker to improve utility for FTIR drug checking technicians. The primary enhancement being tested in this version was the Autonomous Component Identifier (AID), which is an expansion upon a current feature called Mixture Analysis. 

• Why: New technology and updated features are not always able to be tested with actual community samples or developed specifically with community drug checking in mind. This provided an opportunity to test AID with "real world" samples and provide technician feedback to directly to Bruker. 

• Findings: Based on feedback conveyed to Bruker developers have incorporated notes on the Custom Result Feature to allow the operator to customize the weights of substances that will auto-adjust to add up to 100% for a composite spectrum. There is an option to increase or decrease the weights in small increments (0.1%), similar to the preexisting Manual Subtraction feature in regular OPUS. In the real-world sample scans we asked the technicians to review as part of this beta testing, it was reported that AID struggled to detect low lying components such as xylazine. These scans were shared with developers so the algorithm could be improved to detect xylazine in a low concentration. Feedback was heard in where seeing results for mixture samples reporting 6 or more substances can be confusing and misleading. This note was taken under consideration and now limits the composite spectra provided immediately to be limited to 5 or fewer component spectra.

• View: OPUS 9.0 for Drug Checking Feedback Report

​​

Multi-Lab Analysis Project

• Who: 10 lab partners from across U.S. who have been or are preparing to provide secondary testing for community-based drug checking using GC-MS, LC-QTOF-MS and other instruments.

• Aim: Each enrolled lab is sent the same series of 10 drug samples that are theoretically comparable in composition (approx. 10mg each).  Each lab will conduct the maximum level testing according to their regular procedures and report the results to the Network 1 team. The team will then conduct analysis on results between labs to determine their levels of comparability. These results will be used to promote discussion between labs for quality improvement and standardization purposes.

• Why: To assess the comparability of various toxicology labs that analyze unknown drug samples.  The labs will compare results across different testing methodologies to have more uniform testing results for participants and programs. 

• Findings: ​​​​​Laboratories involved in secondary testing for community-based drug checking consistently reported the same Major/Primary components, with newer labs just starting in this field showing the most variation. When examining dope, heroin, and fentanyl samples, the trace-level components can differ significantly. This variation is influenced by challenges and limitations like imperfect subsampling methods and differences in the technology ionization types and analysis methods used. Overall, there isn't a single best instrument or method for drug checking — it's a complex process. The constantly changing drug supply and the need for labs to tailor their sample preparation and analysis methods add to the difficulty. Collaboration between laboratories is crucial, and more research is needed to refine these practices. Future efforts could include another round of multi-laboratory analysis, potentially expanding to include international labs, to improve and standardize the process.   

​​

Wet Sample Project

• Who: 7 community drug checking partners across New England 

• Aim: To develop best practices to prepare wet samples for FTIR point-of-care testing and for laboratory analysis 

• Why: To expand the range of services provided by drug checking and improve work up procedures for different samples. Through this, there is potential to engage certain groups of people who use drugs who may not otherwise have been engaging in drug checking services.

• Findings: A total of 59 wet samples were collected across multiple categories (wet cookers/cottons, vape cartridges, hormones, gelatinous edibles, and miscellaneous). Across sites, technicians experimented with drying, diluting, or directly scanning wet samples, and results were compared to laboratory findings:

  • GHB-like drugs: FTIR testing worked well (direct drop or concentrated by evaporation). Results were consistent with lab findings for GHB, GBL, and 1,4-BDO. FTIR can be sufficient in many cases, with labs used for confirmation.

  • Hormones: FTIR could detect hormones but often misclassified ester types due to interference from carrier fluids. Lab testing was more reliable and needed when ester-specific identification was important.

  • Psychedelic carts: FTIR consistently detected LSD, and results were fully aligned with lab confirmation (n=3). Both methods were effective.

  • Wet cookers/cottons: Drying samples sometimes allowed FTIR to match lab results, but cellulose interference from cottons and dilution often obscured signals. Labs were required when water content was high or active components were too dilute.

  • Gelatinous samples (gummies, jellies, THC cartridge contents): FTIR was not effective, as the gelatin signal overwhelmed any active substances. Lab testing successfully identified substances (e.g., LSD, Delta-9). Future work may consider test strips or solvent extractions with this form.

  • Nicotine/THC cartridges: FTIR mostly detected carrier liquids and sometimes missed nicotine. Labs sometimes identified actives when FTIR could not, but struggled with a full analysis of carrier liquids and unknown substances not in their analyte library.

  • Miscellaneous samples: FTIR had mixed results. Poppers were difficult to identify clearly due to overlapping alcohol signals. Liquid ketamine tested well on FTIR and was confirmed by lab testing. Lab testing adds confidence for complex mixtures.

• Overall, the project demonstrated that FTIR testing of wet samples can be incorporated across a range of potential submissions. This can expand the scope of drug checking services, but careful sample preparation, access to appropriate FTIR reference libraries, and thorough technician training are essential. Laboratory testing remains a critical resource for confirmation and for complex or low-concentration samples; however, when the laboratory needed to acquire new reference standards, this added time and complexity to the testing process.
  For a more detailed summary, please reach out to MADDS@brandeis.edu
   

BTNX MTS/NTS Validation Study

• Who: 12 community drug checking partner sites across New England during Spring 2025 

• Aim: Evaluate the sensitivity, specificity and usefulness of BTNX medetomidine and nitazene test strips for the detection of these emergent drugs in the supply

• Why: Medetomidine and nitazenes are emergent substances in the drug supply. They are potent substances of concern with health effects even at low levels in a drug.  When drug checking, we often see them in low concentrations near or at the limit of detection of current drug checking technologies like FTIR. This project evaluates the accuracy and reliability of the test strips in real-world samples in New England, to see if they can be useful tools for drug checking. With practice using these strips, the Network One cohort will work together to come up with best practices if incorporating these new tools into drug checking procedures. 

• Findings: By the project end date of 6/30/25, laboratory results were available for 212 nitazene test strip samples and 85 medetomidine test strip samples. While prevalence (as reported by lab testing) in the New England drug supply for nitazenes has been low during this study (4.2%), the BTNX NTS demonstrate good sensitivity (80.0%) and specificity (95.5%). The BTNX medetomidine test strips (MTS) also performed well, whether considering the performance comparison of the more discriminating lab instrument (LC/QTOF: sensitivity 82.2% and specificity 98.0%, prevalence: 42.9%) or the less discriminating instrument (GC/MS: sensitivity 90.5% and specificity 81.3%, prevalence 25.9%). These results suggest that BNTX MTS are able to accurately detect low levels of medetomidine.
  
  Note that the amount of drug needed to accurately test using an MTS or NTS is substantially higher (10mg or 2 microscoops) in comparison to the amount needed to use fentanyl test strips (about the eye of a sewing needle or visible residue). This complicates utilization and distribution of MTS and NTS in the community. Individuals using MTS and NTS should be trained appropriately and be equipped to dispel myths surrounding these substances.  Harm reductionists should encourage using drugs with others around, emphasize using rescue breaths in the event of an overdose, and encourage drug checking when possible.
  Limitations: Caffeine may cross-react with NTS. Couple the use of NTS with FTIR when testing to be mindful of false positives. High costs of both medetomidine and nitazene test strips (>$2.50/strip) may also be a barrier to their uptake or may limit distribution much beyond drug checking services.

• View: MTS/NTS Protocol

​

Future Project Ideas: 

• We are taking suggestions! 

• Have an idea for a protocol for us to test out?

• What do you want to know about drug checking and the tools for drug checking?

​​