From lab innovation to street safety: scientists develop rapid drug testing device to combat overdose crisis

“It’s terrifying when we see drugs like Carfentanil in there which is 10,000 times more potent than morphine. Used in veterinary medicine as an elephant tranquilizer on animals that weigh several tons, then a 180-pound human uses it – even just a tiny amount will kill you. The illegal drug market is so heavily contaminated right now, there is no room for error,” says Dr. Dan Beriault. 

As Associate Professor in the Department of Laboratory Medicine and Pathobiology, and Head of Biochemistry at Unity Health Toronto, he co-leads a drug checking program in the Greater Toronto Area that was recently recognized by the Canadian Society of Clinical Chemists for ‘Innovation in Laboratory Medicine’. 

“We started this project in 2019 and have now analyzed over 10,000 drugs. It’s been an amazing project and it’s great to have the support from Health Canada who have just given us another two years of funding,” says Beriault. 

The aim of the project is harm reduction. According to Health Canada, 22 people die every day from opioids alone. Combined with a safe consumption site, users can come to the service at five locations across Toronto to take drugs in a safer environment, and while they are there, submit samples or drug paraphernalia to check what their drugs consist of. Beriault calls it a “gateway” service as users are exposed to social services, counselling, and information about safe housing. “If they’re on their own on the streets, no one is saving them. Sites like this can give support and help them make decisions to beat their addiction,” he explains. 

Samples are anonymous and there is no threat of prosecution when using the service. “We only need a tiny amount, the equivalent to a few grains of salt, or we can test their equipment for the residue. Using mass spectrometry means it is incredibly sensitive and we can provide a report from the tiniest of samples,” explains Beriault. 

Users of the service range from recreational users who want to check what’s in their supply for the weekend, to individuals with chronic drug dependence. “People who don’t have severe addictions then have a choice whether to take that drug once they know what is in it. For those who have a higher drug dependence, it gives them information that they can use to reduce harm. For example, use at a safe consumption site or have a naxolone kit handy when they take it. Or after the fact, to find out why they reacted poorly to a certain batch, and perhaps avoid a specific dealer because they cut their supply with something particularly dangerous”. This knowledge can help individuals make decisions that could, ultimately, save their life and hopefully encourage them to discontinue drug use. 

What the team finds in the samples can be frightening. “What has surprised me is just how much of the drug market has Fentanyl in it. The overall majority of the drugs we’re testing contain it and it is fifty times more potent than heroin”. Beriault has also been shocked at the presence of other substances that can cause real harm, like Xylazine which is commonly found in the unregulated drug supply. A horse tranquilizer, it can cause necrosis of the skin. “They call it the zombie drug because you develop lesions and open sores. It is not meant for human consumption, yet it is being cut into these drugs.” 

The information generated by the drug checking service not only helps individuals but provides insights for public health. “Previously the only illegal drugs being tested were those seized by police or border services. At that stage it is fairly pure. By the time that drug gets on the street, it's been mixed with so many other terrible things, no one actually knew what was in it and what was killing people. Once Fentanyl entered the market, particularly around 2016, we saw deaths increase so we had to start doing something different to tackle the overdose crisis.” 

One of the challenges is the turnaround time for testing. Using sophisticated technology that needs to be interpreted by a lab expert is the standard approach for drug testing, but it means the 100 samples they receive each week need around 24 hours to process. Not quick enough for some individuals.