Impact of having a regular drug dealer on obtaining drug checking results consistent with expectations during a drug toxicity crisis in a Canadian setting.

Abstract

The unregulated illicit drug supply is a key factor in Canada's ongoing drug crisis and a significant public health concern. This study explores whether having a regular drug dealer impacts the likelihood of obtaining drug checking results consistent with expectations (i.e., the drug the individual expected was detected using drug checking technology, irrespective of other substances present). Data were derived from a cross-sectional study, conducted between March 2020 and August 2023, across 22 harm reduction sites in British Columbia (BC), Canada. These sites operate drug checking services using Fourier-transform infrared spectroscopy (FTIR) and immuno-assay strips. Logistic regression analysis examined the relationship between having a regular dealer and obtaining drug checking results consistent with expectations. A total of 322 participants were included in the study: 268 (83.2 %) reported a regular drug dealer and 260 (80.7 %) obtained results consistent with their primary drug expectation. Among those with a regular dealer, 240 (74.8 %) obtained drugs from them 100 % of the time. After adjusting for confounders, multivariable logistic regression analysis found no significant association between having a regular dealer and obtaining expected drug checking results (adjusted odds ratio = 1.10; 95 % confidence interval: 0.48 - 2.52, p-value = 0.827). Despite assumptions that a regular dealer increases the likelihood of receiving results consistent with primary drug expectations, this study found no association. These findings support the importance of drug checking, education on the unpredictability of the unregulated drug supply, and other essential harm reduction services in addressing Canada's public health crisis.