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Record W3171719398 · doi:10.1097/cxa.0000000000000112

Identifying Cocaine Adulteration in the Unregulated Drug Supply in British Columbia, Canada

2021· article· en· W3171719398 on OpenAlex
Priya Patel, Sara Guzman, Mark Lysyshyn, Jane A. Buxton, Margot Kuo, Samuel Tobias, Jennifer Matthews, Jaime Arredondo, Lianping Ti

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
venuePublished in a venue whose home country is Canada.
aboutThe title or abstract carries a Canadian signal from the geographic lexicon.

Bibliographic record

VenueThe Canadian Journal of Addiction · 2021
Typearticle
Languageen
FieldPharmacology, Toxicology and Pharmaceutics
TopicForensic Toxicology and Drug Analysis
Canadian institutionsUniversity of British ColumbiaVancouver Coastal HealthBC Centre for Disease ControlBritish Columbia Centre on Substance Use
Fundersnot available
KeywordsFentanylMedicineDrugHarm reductionStimulantBenzoylecgoninePharmacologyHeroinToxicologyInternal medicineUrinePublic health

Abstract

fetched live from OpenAlex

ABSTRACT Objectives: In response to the opioid overdose crisis, driven largely by the emergence of illicitly manufactured fentanyl, various harm reduction approaches have been implemented. Among them, drug checking informs individuals about the content and purity of their drug samples. While the opioid supply has been highly adulterated with fentanyl, less is known about the adulteration of the stimulant supply. Methods: Drug checking with combination Fourier-transform infrared spectrometry and fentanyl test strips has been operating at supervised consumption sites and overdose prevention sites, in British Columbia, Canada. In this study, drug checking data were analyzed for samples expected (purchased or given as) by individuals to be cocaine in Vancouver, BC between November 2017 and December 2019. Results: Among the 505 cocaine samples presented during the study period (6.1% of all samples), there was a high concordance between individuals expecting cocaine and the sample containing any amount of cocaine (95%). While only 2 samples contained fentanyl, the most common pharmacologically active adulterants included phenacetin (6.7%), levamisole (2.2%), and caffeine (3.8%), whereas the most common diluents (fillers) included inositol (3.4%) and mannitol (2.0%). Conclusion: Fentanyl adulteration was found in very few cocaine samples over the study period. Of concern, phenacetin and levamisole were 2 commonly present adulterants, and are both known to cause serious negative health effects, including renal disease and agranulocytosis, respectively. These findings provide evidence of the presence of harmful adulterants in cocaine supporting drug checking as a valuable tool for reducing the risks associated with an unregulated drug supply. Objectifs: En réponse à la crise des surdoses d’opioïdes, due en grande partie à l’émergence du fentanyl fabriqué illicitement, diverses approches de réduction des méfaits ont été mises en œuvre. Parmi eux, le contrôle des médicaments informe les individus sur le contenu et la pureté de leurs échantillons de médicaments. Alors que l’approvisionnement en opioïdes a été fortement frelaté avec le fentanyl, on en sait moins sur l’adultération de l’approvisionnement en stimulants. Méthodes: Le contrôle des médicaments avec la spectrométrie infrarouge combinée à transformée de Fourier (FTIR) et les bandelettes de test de fentanyl est opérationnel dans des sites de consommation supervisée et des sites de prévention des surdoses, en Colombie-Britannique (BC), au Canada. Dans cette étude, les données de contrôle de la drogue ont été analysées sur des échantillons (achetés ou donnés tel quel par des individus) censés être de la cocaïne à Vancouver, en Colombie-Britannique entre novembre 2017 et décembre 2019. Résultats: Parmi les 505 échantillons de cocaïne présentés au cours de la période d’étude (6,1% de tous échantillons), il y avait une forte concordance entre les personnes qui s’attendaient à de la cocaïne et l’échantillon contenant n’importe quelle quantité de cocaïne (95%). Alors que seulement 2 échantillons contenaient du fentanyl, les adultérants pharmacologiquement actifs les plus courants comprenaient la phénacétine (6,7%), le lévamisole (2,2%) et la caféine (3,8%), tandis que les diluants les plus courants de remplissage comprenaient l’inositol (3,4%) et le mannitol (2,0%). Conclusion: L’adultération du fentanyl a été trouvée dans très peu d’échantillons de cocaïne au cours de la période d’étude. Fait préoccupant, la phénacétine et le lévamisole étaient deux adultérants couramment présents et sont tous deux connus pour causer de graves effets néfastes sur la santé, y compris une maladie rénale et une agranulocytose, respectivement. Ces résultats fournissent des preuves de la présence d’adultérants nocifs dans la cocaïne, soutenant le contrôle des drogues comme un outil précieux pour réduire les risques associés à un approvisionnement non réglementé.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.326
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.029
GPT teacher head0.311
Teacher spread0.282 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it