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Literature Review of Drug Checking in Nightlife – Methods, Services, and Effects

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Literature Review of Drug Checking in Nightlife – Methods, Services, and Effects Literature Review of Drug Checking in nightlife – Methods, Services, and Effects CENTER FOR RUSMIDDELFORSKNING PSYKOLOGISK INSTITUT AARHUS UNIVERSITET LITERATURE REVIEW OF DRUG CHECKING IN NIGHTLIFE – 2 METHODS, SERVICES, AND EFFECTS Colophon This report is the product of a collaboration between the Danish Health Authority and researchers from the Centre for Alcohol and Drug Research (CRF) at the University of Aarhus. The general study was managed and carried out by assistant professor, Jeppe Oute, CRF, University of Aarhus. Assistant professor, Maj Nygaard-Christensen, CRF, University of Aarhus assisted with the literature search and the write-up of this report. The review of testing equipment and the analysis processes related to drug checking was supervised by associate professor, Christian Lindholst, department head at the Institute of Forensic Medicine, University of Aarhus. Associate professor, Kristine Rømer Thomsen, assistant professor, Maj Nygaard- Christensen, scientific assistant, Line Boelskifte and trainee, ph.d. Else-Marie Elmholdt, CRF, University of Aarhus contributed to the quality assessment of the literature and the organization of the report. Finally, a monitoring group including associate professor, Morten Hesse and professor Torsten Kolind, CRF, provided ongoing feedback on the literature review, problems pertaining to specific topics, and the write-up of the report. LITERATURE REVIEW OF DRUG CHECKING IN NIGHTLIFE – 3 METHODS, SERVICES, AND EFFECTS List of Content 1.0 Reading Guidelines ....................................................................................... 4 2.0 Background .................................................................................................. 6 2.1/ Introduction ................................................................................................. 6 2.2/ The Research Questions of the Report ........................................................ 8 3.0 Methods ....................................................................................................... 9 3.1/ Literature Search.......................................................................................... 9 Scopus* (*Searched in Advanced search) ..................................... 10 Web of Science* (*searched in Advanced search) ........................ 10 PUBMED ........................................................................................ 10 3.2/ Summary of the literature Search ............................................................. 12 Methodological Considerations for the Database Search ............. 12 4.0 Quality Assessment of Articles and Reports ................................................. 13 Critical Comments to this Literature Review ................................. 14 Quality Assessment of Literature on Drug Checking: Critical Remarks ......................................................................................... 14 5.0 Results ........................................................................................................ 19 5.1/ Test Equipment and Analysis Processes .................................................... 19 Drug Testing Methods ................................................................... 19 5.2/ Content and Organization of Drug Checking Programs ............................. 23 Global Overview of Drug Checking Services .................................. 23 Status, Mobility, Monitoring, Harm Reducing Counseling and Required Competences .......................................................... 30 5.3/ Effects of Drug Checking Programs ............................................................ 31 Positive Effects: Harm Reduction and Monitoring ........................ 32 Harm Reduction ............................................................................. 34 6.0 Conclusion .................................................................................................. 36 7.0 References .................................................................................................. 38 8.0 Bilag 1: Schematic Overview of the Assessment of the Literature ................. 42 LITERATURE REVIEW OF DRUG CHECKING IN NIGHTLIFE – 4 METHODS, SERVICES, AND EFFECTS 1.0 Reading Guidelines To make it easier for the reader to navigate this report, this chapter gives a brief overview of the content of the individual chapters. Chapter 2: Background This chapter describes the aim and the background for this literature review of drug checking in nightlife. Additionally, drug checking is put into a broader historical context as the background for the report’s research question. Chapter 3: Methods This chapter describes the literature search in three databases, PubMed, Web of Science, and Scopus. Furthermore, a flowchart of the search process is presented, followed by a summary of the findings of the search process as well as some critical reflections about the precision and shortcomings of the search process. Chapter 4: Quality Assessment of Articles and Reports In this chapter, a quality assessment of the articles and reports identified through the literature search is conducted. Based on this, a number of critical statements are made about the methodological and empirical weaknesses of the literature as well as contextual shortcomings. Chapter 5: Findings The result chapter should be read with the quality assessment of the literature in mind (chapter 4). The chapter presents the results of the literature review in relation to the following three aspects: Testing equipment and analysis processes The question of which testing equipment and analysis processes assessed in the literature about drug checking in nightlife is highlighted. Furthermore, knowledge is provided about the most commonly used drug tests in nightlife and descriptions of their reliability and price. Content and Organization of Drug Checking Programs The question of the content of previous and current drug checking programs and the organization of the programs are highlighted. Positive and Negative Effects of Drug Checking Programs First, the findings from the literature on possible positive effects of drug checking programs are reviewed, including the evidence for reductions in the number of poisonings, behavioral changes among users, and counseling in relation to drug checking, and how the programs contribute to national and international monitoring of drugs. LITERATURE REVIEW OF DRUG CHECKING IN NIGHTLIFE – 5 METHODS, SERVICES, AND EFFECTS Next, the negative effects of drug checking programs as presented in the literature are described. Among other things, the question of whether drug checking contributes to the normalization of drug use is reviewed, including whether users consider their drugs ‘pure’ and hence, less dangerous, based on drug checking. Chapter 6: Conclusion The conclusion summarizes the general findings of the literature review, and conclusions on the three research questions are presented in a narrative form. The chapter concludes with some general perspectives on considerations and needs for further research based on this report. Appendix 1 A diagram is included as an appendix, documenting the quality assessment presented in chapter 4. The diagram consists of an overview of the different types of articles and reports that were identified in the literature search and reviewed in the report. The appendix should also contribute to enhancing the transparency of the critical reservations about the credibility of the results found in the literature. Furthermore, the diagram gives the reader the ability to see the specific assessment of the quality of the individual articles and reports by the author, including the study’s aim, methods, sample, main findings, and comments. It is recommended that the reader continuously consults the diagram when reading the quality assessment of the literature and the findings. 5.0 RESULTS LITERATURE REVIEW OF DRUG CHECKING IN NIGHTLIFE – 6 METHODS, SERVICES, AND EFFECTS 2.0 Background Although several drug checking programs in nightlife are in existence in a few European countries, Canada, and Australia there is only limited systematic scientific knowledge about the methods used, the organization of the drug checking services and the effects of drug checking, including unwanted negative effects (Pirona et al., 2017). Following a debate about drug checking in nightlife in the media as well as politically, the Danish Health Authority conducted a professional assessment of drug checking programs in nightlife concluding that from a precautionary standpoint such programs could not be recommended. The assessment presumes that initiation of new initiatives must always be founded on solid knowledge about the effect of the intervention, and that there are no negative or contrary effects (Danish Health Authority, 2018). On this background, the Danish Health Authority initiated a systematic review of the international research literature on drug checking among recreational drug users, including evaluations of such programs, documentation about the effects as well as a critical analysis of the quality of the documentation. This literature review will provide the basis for upcoming work by the Danish Health Authority on this issue. 2.1/ Introduction ‘Drug checking (services)’ or ‘pill testing’ includes testing drugs and giving the test results about the type of drug, purity, and concentration to the drug users. Drug checking has been used for some years in different European countries1 both as a harm reduction
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