Community Drug Checking

A statewide community drug checking program in Massachusetts that gathers timely information on the illicit drug supply to inform an effective response to the opioid crisis 

Community drug checking helps people who use drugs have a better idea of what substances are in the drugs they use. When people have a better idea of what’s in their drugs, they can make more informed choices about their use and can take steps to reduce harm.  Community drug checking can include the use of specific innovations like fentanyl test strips and more complex instruments used to test the components of a drug sample.  There are growing numbers of community organizations engaging in community drug checking, which, in the United States, started out in Chicago and Boston

The first statewide community drug checking program, the Massachusetts Drug Supply Data Stream (MADDS), launched in 2019. Its mission is to learn more about the local illicit drug supply to better inform public health and safety responses to the opioid overdose crisis. Street drug samples and paraphernalia obtained from community health and harm reduction organizations are tested for the presence of fentanyl and other substances. Some programs host and operate their own instruments for community drug checking.  Others partner with Brandeis University technical staff, who operate instruments that are brought to the sites. In all MADDS locations, arrangements to permit and support community drug checking are secured. In some locations, law enforcement also provides samples for drug checking to complement the community health and harm reduction organization data. Specifically, law enforcement allow the technical staff to test remnant drug samples otherwise meant for destruction (i.e., no criminal action).  Samples typically come from overdoses, found property, or controlled buys and, like the samples tested at community health and harm reduction organizations, do not contain personally identifying information. 

Once tested using the instruments on-site, samples are sent to an off-site laboratory for more complete testing. Initial and then updated complete results are compiled in real-time onto the website www.streetcheck.org where they can be viewed publicly (limited information) or by the sample submitter and registered users (all information). Streetcheck.org also serves as a portal for programs to launch a companion collector tool that streamlines the sample collection and data entry for community programs and labs. Testing results are communicated back to people who use drugs by the community health and harm reduction organizations, and trends are analyzed to inform treatment and harm reduction providers, law enforcement, and first responders.

Aggregated trend data are reported in public health alerts and bulletins in coordination with other drug surveillance programs. An interactive dashboard is also available for quick looks at trends by substance, geography, and other factors. An overview of the program, data reports from MADDS communities, and the interactive dashboard can be found here 

MADDS and StreetCheck are joint projects of the Opioid Policy Research Collaborative at Brandeis University and the Massachusetts Department of Public Health, and funded by the Commonwealth of Massachusetts and grants from CDC and SAMHSA. StreetCheck is available at no cost.  

In 2021, fentanyl was by far the most common active substance detected in drug samples. Fentanyl has been detected in cocaine, heroin, and counterfeit pills. 

Continuum of Care
Harm Reduction
Type of Evidence
Peer-reviewed
Response Approach
Overdose prevention
Peer-reviewed Article

Evidence of Program Effectiveness

An evaluation found that MADDS is a feasible approach to implementing a statewide drug checking program.  The benefit of community drug checking was clear in its ability to quickly detect new adulterants in the street drug supply that could pose increased risk of overdose and other negative health effects.

"CDCPs [community drug checking programs] can be collaboratively designed with public health, public safety, and protection of individuals' goals to generate critical health and safety information for PWUD [persons who use drugs] and the communities where they live. Information generated about the drug supply is relevant to the safety of PWUD, the programs that provide supportive services, and public safety efforts and contributes to more nuanced and impactful statewide initiatives.". - Greene, T. et al., 2022.