This survey study (n=1530) examined the demographic profiles of people who made use of drug checking services in the Netherlands in 2018 and found that most participants who acquired this service had longstanding experience and a higher lifetime prevalence of using ecstasy/MDMA than the average Dutch citizen.
Abstract
“Background: Drug checking services (DCS) provide information about drug content and purity, alongside personalized feedback, to people who use drugs; however, the demographic and drug use characteristics of DCS clients are rarely reported. This paper describes these characteristics for clients of the Dutch DCS, the Drug Information and Monitoring System (DIMS).
Methods: 1,530 participants completed a pen-and-paper questionnaire at one of eight participating DCS in the Netherlands in 2018.
Results: The participants were mostly highly educated males in their twenties with no migration background. Experience with drugs prior to coming to the DCS was common. Only 0.7% indicated they had never used any of the twenty drugs studied. 93% of participants reported use of ecstasy or MDMA with an average of 6.3 years since first use.
Conclusions: These results indicate that drug checking can be a valuable tool for public health services as it facilitates access to more difficult-to-reach communities who use drugs. It is unlikely that DCS encourage drug initiation, since almost all people who visit the Dutch DCS already report experience with drugs. However, DCS should be aware that their services might not be easily accessible or attractive to all demographic groups.”
Authors: Raoul P. J. Koning, Annemieke Benschop, Camiel Wijffels & Judith Noijen
Summary
Introduction
The production of illegal drugs is at an all-time high, and people who use drugs do not know the dose or purity of the drug they have acquired. Drug checking services have been established in several European countries since the early 1990s.
The Dutch Drugs Information and Monitoring System (DIMS) consists of a coordinating office and 31 fixed-site DCS. PWUD can anonymously submit samples of their drugs for analysis during weekly consultation hours.
The DIMS DCS is used by 12,634 Dutch PWUD. Little is known about them as the most recent description was published nearly twenty years ago.
Drug checking is not without controversy. Critics worry that drug checking encourages drug use by creating a false sense of security and contributing to the normalization of drug use.
Recruitment
During March-December 2018, visitors of eight drug testing centers were invited to fill out a pen-and-paper questionnaire. The answers were not discussed during the private consultation and were collected through routine service provision and were exempt from specific ethical approval under Dutch law.
Measures
Demographics, education level, frequency of visiting nightlife venues, alcohol and tobacco use, drug use, and lifetime and last year prevalence of MDMA, amphetamine, cocaine, 4-FA, 2C-B, LSD, cannabis, nitrous oxide are reported.
Visitor profile
Participants were mostly males in their twenties, did not have a migration background, and were avid visitors of nightlife. They drank and smoked more on days out than on ‘normal’ days.
DIMS visitors had used cannabis and MDMA on average at least three years ago, and almost all had used drugs recently.
Drug use statistics were calculated for the total sample and six subsamples. The remaining 284 participants submitted a wide variety of other drugs, multiple different drugs, an unknown drug, or did not record the drug they submitted.
More than half of participants had never used amphetamine, cocaine, 4-FA, 2C-B or LSD, but most participants who submitted these drugs had previous experience with them.
Discussion
The DIMS is the largest and oldest of the DCS that are currently active worldwide. Its visitor profile is typically male, in his twenties, highly educated, doesn’t have a migration background and is a regular visitor of nightlife venues and music events.
Results show that people who are not highly educated or who have a migration background are underrepresented among the participants in the DCS. This indicates that efforts should be made to broaden the reach of the DCS among these populations in the Netherlands.
The participating DCS visitors had more experience with drugs than the average Dutch citizen, and often had already used the type of drug they submitted for testing.
Participants who submitted a sample of a drug they had never used before were not naive when it came to other drugs, and few to none had never used any of the twenty drugs listed in the questionnaire.
Limitations
The results of this study cannot be generalized to the total visitor population of the DIMS nationwide or the participating facilities, and the proportion and selectivity of visitors declining to participate are unknown.
Conclusion
In conclusion, drug checking can be a valuable tool for addiction care facilities to reach more difficult to reach PWUD, but should be aware that their services might not be easily accessible to all PWUD.
Ethics
This study is not subject to the Dutch Medical Research Involving Human Subjects Act (WMO), because participants were not exposed to interventions/procedures or required to behave in a particular way.