Health Canada’s Drug Checking Technology Challenge
An innovative approach to the opioid crisis
Last week, through the Impact Canada Initiative, Health Canada launched a Challenge to improve on drug checking technology for the community of people who use drugs and those who support them.
I am very proud to be an active partner in the development and implementation of this initiative with my colleagues at Health Canada, the Impact and Innovation Unit of the Privy Council Office, and my fellow entrepreneurs (
and ).This challenge, in my opinion, is one of many examples of the Government of Canada’s commitment to a compassionate approach to addressing problematic substance use and it’s continued support of innovative harm reduction initiatives.
Harm reduction: measures that reduce the negative effects of drugs and substances on individuals and communities, without requiring abstinence
About Drug Checking & the Challenge
In the context of this challenge, ‘drug checking’ refers specifically to the harm reduction measure where people have their illegal drugs tested to find out what’s in them, including if they contain toxic substances or potent drugs like fentanyl.
Drug checking programs already exist in Canada. In fact, access to Drug checking Services has grown to 15 Health Canada-approved Supervised Consumption Sites (SCSs). Important work conducted by Insite in Vancouver B.C., using test strips and other technology, suggests that when people know their drugs contain fentanyl, they are 10 times more likely to reduce the dose. This could reduce their risk of an overdose. Another study carried out by Johns Hopkins Bloomberg School of Public Health found that when people knew that their drugs contained fentanyl, they were more likely to change their behaviour.
The objective of this challenge is to encourage innovation and development of accurate, easy to use, and low-cost solutions, requiring minimal training and sample preparation. The hope is that, as a result, we could further improve access and availability of drug checking services, allowing more people to more accurately determine the risks associated with their drugs. This could provide them with the opportunity to make an informed decision about:
- not consuming or reducing intended dosage of drugs
- not using drugs alone
- having naloxone on-hand
- visiting supervised consumption or overdose prevention sites
How did we get here?
Canada is in the midst of a crisis. The rate of overdoses and deaths as a result of problematic opioid use has risen dramatically in recent years. While it has affected all parts of this country, some regions have been hit harder than others.
In 2016, there were 3,005 apparent opioid-related deaths. Unfortunately, this number increased in 2017 to 3,996.
There have been more than 8,000 apparent opioid-related deaths in Canada since January 2016
Shockingly, opioids are now the leading cause of deaths among 30 to 39 year old males. Yes, it is now the leading cause of death among males 30 to 39 years of age.
An unpredictable illegal drug supply
The roots of this crisis are complex. Illegal drugs are unpredictable, with the dose, quality, and composition unknown and inconsistent between batches. Since 2016, fentanyl or fentanyl analogues are increasingly present in illegal drugs in Canada. From January to September 2017, 72% of apparent accidental opioid-related deaths involved fentanyl or fentanyl analogues, compared to 55% in 2016. People who use drugs often do not know whether or not they are being exposed to fentanyl. It cannot be seen, smelled, or tasted.
Fentanyl is also turning up in unexpected places. Recent drug checking results from Ottawa’s Sandy Hill Community Health Center suggest that besides popping up in almost all “heroin/fentanyl/down” samples, fentanyl is now often present in speed, crystal meth, and even cocaine.
Exploring opportunities for Innovation: 2018 Opioid Detection and Testing Workshop
Health Canada (HC), the National Research Council of Canada (NRC) and the Privy Council Office (PCO) convened a group of representatives from the federal government, law enforcement, emergency response services, people with lived and living experience, and community organizations for a workshop on the detection and testing of opioids on February 26, 2018.
The purpose of the workshop was to gain the perspective of various stakeholder groups on what technologies, if any, could be developed or improved, to:
- better protect first responders and others who are exposed to opioids, particularly fentanyl, in the course of performing their duties and to enable them to fulfill their responsibilities more effectively and efficiently;
- and better protect and reduce harm to people who use drugs, as per the Canadian Drugs and Substances Strategy and the Government’s commitment to harm reduction.
The discussion that took place helped us identify the need for new or improved detection and testing technologies for the purposes of drug checking. Currently, drug checking technologies come in different forms with varying levels of reliability and sensitivity. While fentanyl test strips have become increasingly popular (even dollar stores carry them now), they are not without limitations. This includes not being able to tell you just how much fentanyl is in a tested sample — and as fentanyl creeps into more unexpected places in the illegal drug supply, the less informative “yes/no” fentanyl test strips become.
Unfortunately, technologies that do provide relative quantity of opioids also tend to be very expensive and require specialized training (often a technician) to interpret the results. While there are several different types of devices and instruments currently being used for drug checking in Canada, none appear ideal for people who use drugs and those who support them.
Developing an Impact Canada Challenge
Without a clear solution in the marketplace (particularly one that has been tested for the purposes of drug checking), a challenge-based approach to encourage innovation was considered ideal. Fortunately, the Impact Canada Initiative provides a means for departments to accelerate the adoption of innovative funding approaches, particularly challenges. Besides facilitating the processes to set up a challenge-based funding mechanism, through the support of the Impact and Innovation Unit, we were also granted access to the internationally acclaimed NESTA Prize Challenge Centre. The guidance and expertise provided by both groups were invaluable to the development of the initial and current challenge design.
Refining the challenge: Open Consultation in July and August 2018
Beginning in July, a consultation phase was launched to encourage potential applicants and people who may benefit from drug checking technology to review our proposed challenge and send us feedback.
Given the urgency of the crisis, the consultation phase was carried out over only 2 months but featured a targeted approach to contact key stakeholders, including potential applicants, supervised consumption sites, people with lived or living experience, and researchers in the field of harm reduction and drug checking. We also used the Impact Canada web site to solicit input from the public.
Visiting a local supervised consumption site here in Ottawa provided a great opportunity for me and
to see first-hand how drug checking services are provided and hear from the tremendous staff that support people who use drugs everyday.The feedback received from the consultation phase helped us refine the design of the challenge, including the criteria on which potential solutions will be judged.
More than $1 million dollars up for grabs
The Challenge is now open to any for-profit and not-for-profit organizations such as companies, industry associations, Indigenous organizations and research associations, as well as post-secondary institutions. Selected semi-finalists will receive $25,000 and be eligible to compete for $100,000 to enter the pilot phase and, ultimately, the grand prize of $1,000,000.
We are now accepting applications. Apply Now! Can your innovative design win the grand prize of $1 million?
The application deadline is February 1st, 2019.
What now?
Now that the challenge has been launched, the focus is on doing everything we can to make sure that all of the innovators in this space have the opportunity to apply. Please consider sharing posts about the challenge and help to spread awareness of this initiative.
Questions about the challenge?
Visit the Drug Checking Challenge web site for more details, FAQs, and a contact form to get in touch with the team.
Considerations
There is no silver bullet
The Government of Canada has acknowledged that no one actor has the power to change the current course of events. This is why a well-rounded approach is needed to help address problematic substance use. This challenge is just one of many initiatives currently underway. For more information on the Federal Action on Opioids, I encourage you to visit the canada.ca site.
Innovation under current laws and restrictions
Under the Controlled Drugs and Substances Act (CDSA), the unauthorized handling, possession, production, transfer or transport of controlled substances is prohibited. By running this challenge, potential innovators who may have been previously deterred from developing technologies for drug checking, can leverage this opportunity to build partnerships with law enforcement, drug testing laboratories, or with supervised consumption sites or overdose prevention sites that are authorized by Health Canada to conduct drug checking activities on-site. The intent is also to provide finalists with the valuable opportunity to pilot their device or instrument in a real-world setting such as supervised consumption sites.
Promoting drug checking can help to address stigma
Even without a winner, just running this challenge can help to promote a compassionate approach to the crisis by supporting drug checking as a means of reducing harm. Supporting this and other harm reduction initiatives serve to maintain focus on the needs of the people affected by the crisis, and may lead to more courageous conversations on different approaches to the crisis.
It is unfortunate that at this point, most of us know someone affected by the crisis. Yet despite everything, people continue to feel stigmatized.This can have a major impact on the quality of life and prevent people from getting the help they need. There are ways we can all help reduce stigma and I encourage you to learn more.
Together, we can stop the cycle of stigma, and #StopOverdoses.
