testRI releases preliminary results of drug surveillance study

What our results say so far about RI’s drug supply

Download a .pdf of this release here.

PROVIDENCE, RI — testRI (Toxicological and Ethnographic Drug Surveillance Testing in Rhode Island) is today releasing preliminary results from its two year study to find out what is in the local drug supply in Rhode Island. The 90 samples analyzed provide key insights into the local drug supply in Rhode Island and how this may affect the ongoing overdose crisis.

One of the study’s main goals is to see how drug supply changes impact people who use drugs in our community. This study tests used equipment, like pipes and syringes. Equipment is collected from the community and donations from individuals or local organizations. Samples are processed using advanced confirmatory toxicology testing (LC-QTOF-MS) at Rhode Island Hospital.

Of the 90 samples tested to date:

• 52% were from Providence (47 samples)
• 14% were from Pawtucket (13 samples)
• 9% were from West Warwick (8 samples)
• The remaining 25% were from: West Warwick, Coventry, Rumford, East Providence, Central Falls, North Kingstown, Cumberland, Woonsocket and East Greenwich

Out of the 90 samples tested:

• 47% of the samples were sold as fentanyl (42 samples)
• 31% of the samples were sold as stimulants (cocaine, methamphetamine) (28 samples)
• 8% of the samples were sold as pressed pills (Percocets, Xanax) (7 samples)

Upon testing:

• 44% of all samples tested contained xylazine
• Among the stimulant samples (28), 39% (11 samples) contained opioids like fentanyl and fentanyl analogs and tramadol. In addition to fentanyl, 11% (3 samples) also contained xylazine
• Amongst the pressed pill samples (7), 86% (6 samples) contained fentanyl and xylazine. 1 sample contained a designer benzodiazepine

Implications for the overdose crisis in the state of Rhode Island:

• The drug supply is changing and it is important to use harm reduction steps even if you are not using opioids.
• Xylazine is a new tranquilizer being found in the drug supply. The additional symptoms it can cause are concerning.
• Fentanyl is being found in some meth and cocaine samples.
• Only a few pressed pills were tested, but a majority of them contained fentanyl and xylazine.

The preliminary results of our study illustrate the unpredictability of the drug supply. A changing drug supply means that people may not know what is in their drugs before using them — this can increase the risk of overdose.

Xylazine is of particular concern as an active cut and showed up in more than half of the samples tested to date. Xylazine is a veterinary tranquilizer and can cause increased sedation complicating overdose events. Naloxone has not been documented to reverse xylazine adverse effects. Xylazine exposure is associated with development of wounds and withdrawal symptoms. You can read more about xylazine here.

Fentanyl continues to be a concern in the local drug supply in Rhode Island. While it is a drug that is purchased for use by some, it is also showing up in stimulants in some of the samples we tested. Therefore, it is important that those who use stimulants like crystal meth and cocaine follow harm reduction practices to mitigate the risk of overdose. These include: not using alone, having naloxone, going slow, and testing your drugs with fentanyl test strips. Those buying prescription pills from sources other than a pharmacy should be mindful that these may contain fentanyl and fentanyl analogs as well.

testRI is a joint initiative of the People, Place and Health Collective at the Brown University School of Public Health and the Department of Emergency Medicine at the Alpert Medical School of Brown University. It is funded by the Foundation for Opioid Response Efforts (FORE). Principal investigators are Dr. Alexandra Collins, Assistant Professor of Epidemiology at Brown University, and Dr. Rachel Wightman, Assistant Professor of Emergency Medicine at Alpert Medical School of Brown University.

Media contact:

Alexandra Collins, PhD

Alexandra_collins1@brown.edu

Rachel Wightman, MD FACMT

rachel_wightman@brown.edu