 Good morning, everybody. Can you hear me okay? Welcome to this press conference. My name is a muscle bus Mac for short I am director at mainland foundation in the Netherlands and I have the honor to chair this press conference today This press conference intends to address some of the key issues and new science that is you know in in the harm reduction fields relevant in our harm reduction field now And today the topic is drug testing, which is a much contested topic within the harm reduction field And this press conference is being live streams. So welcome to all those that are watching from the From their couch at home Before I introduce all my colleagues here, I would just like to address very briefly that drug testing has been yeah, but part of the of the Heavy debate in some of the countries where our presenters are from in the last year For example the UK and Australia there's been a lot of debates public debates about drug testing and it's actually led to Government sanctioned pill testing in those countries, which I think is really good The debate really centers around the testing of ecstasy pills in the party setting a lot I feel that's The discussion should also be about expanding that to testing other type of substances. For example heroin which is a of course a very dangerous drug of being Contaminated with other stronger substances like fentanyl and drug testing can really play a role in reducing those risks So in terms of harm reduction, I think it's important not to only focus on ecstasy testing but also on other drugs Let me start with a few Small remind a small housekeeping announcements We will hear a few brief remarks from all the presenters. They only have five minutes each So they have to be very very quick And after they've they all finish their speeches or their presentations There's room for questions from all the journalists here in the room and After the press conference there's room to address all the speakers one-on-one Arrange an interview if you like and go into more depth about their work and their presentations So without further ado, I'll introduce our first speaker, which is my colleague from the Netherlands Dan van der Kouen He's a researcher at DIMMS the drug information and monitoring system in the Netherlands centered in Trimbos Institute And he has a lot of experience in the drug testing field so Dan you can have the floor Thank you, Machteld I am representing the oldest drug checking service in the world DIMMS drugs information monitoring system We started off as an unofficial Service back in 87 already of the last century. We formalized in 1992 and Ever since 1999 we have been subsidized by the Ministry of Health at the national level and also By local authorities we have 31 testing locations throughout the country and we are mainly testing recreational drugs so ecstasy amphetamines also new drugs and In the afternoon, I will speak more about how we do this work Now I would like to focus for a few minutes on the lessons learned in all those years of drug checking in our country The first lesson that we have learned is that it's very essential to build trust trust initially From drug users because without users you will have no service and you have no data But equally important is also to build trust with Politicians because at the national level they are the ones who will decide about you know Whether or not to continue your work and whether or not to subsidize your work Equally important is local communities local authorities and Also working with the media is very essential because in case of warning for extra dangerous drugs you need to have the support of Media and you need to have the understanding of media as well They have to know exactly what you're doing and why you are doing the things that you are doing another lessons learned is That you have to give reliable information and if you don't have reliable information don't give anything at all Reliable it means that you know when you issue a warning on a specific tablet It has to be as specific as possible as concise as possible Not just warning for drugs in general because nobody will listen especially drug user They will not listen, but if you warn for a specific tablet for instance a pink Superman Containing no MDMA, but only PMMA it makes sense And you will have full coverage and the full cooperation also of the media We have done this several times and it has proven to be very effective and So this is a very important as well another main thing is that Don't sit on your data as a drug service. Don't keep it to yourself, but share it as widely as possible This is why we use Social media and other channels as well to spread the word when something contagious is on the market To finalize my short talk is that drug checking is not about saving lives It's basically about minimization of of harms, but you could never exclude people dying from Even a tested ecstasy tablet because it could happen to anyone, but at least it contributes to a safer world and We believe strongly that by doing our work the many years that we do it really has Reduced drug-related incidents. Thank you Thank you, Dan I'll introduce the next speaker which who is Julian Quintero. I hope I pronounced it right I practiced He is director of action technique a social in Colombia And Julian will give some insight into some of the interesting work That's being done as a festival to music festivals in his country. Go ahead Hi Morning, and my name is Julian Quintero. I'm from Bogota. I know speak English please for my pronunciation Sorry, I read for them little past the information for the afternoon is As long the presentation Okay drug checking in Colombia Reduction in drug poisoning in Bogota and drug checking service Okay, the data We have analyzes more the 60,000 drug samples signs February 2030 drugs give voluntary big consumer because they seek health care We have been to more that 119 festivals in 10 years serving more the 78,000 people directly impacting more that for 30,000 people per year We have published 48 early warnings more that 30 millions people have seen or Heard and read use lasted tweets in the last 10 years The two more 200 press releases they have been published in formal media the drug observatory of Colombia has Discovery 52 NPS in Colombia in the last 10 years 12 in this new drugs have been provided by us Just want a go go just want go a go for example 187,000 people saw our messaging of harm reduction of the screen of the most important music festival in Colombia That is all these every years for five years Stereo picnic is a one of the festival with less intoxication and without mortality in South America We are one of the few organization in Colombia which focus of the Reduction of drug intoxication and its admissions to the emergency Service of hospitals the other program seeks prevention and abandonment of consumption some evaluation data to user people and my program 96 percent confidence in the people who care in our tent 18 9 percent consider that the project information has been useful to change their consumption attitudes 83 percent said they have not used the substance when the result was negative 70 70 percent have reduced the mixed stories and drugs 18 5 begins with the low dose 95 percent Worry about in noting the quality of the substance 18 6 percent look for the early warning information 82 percent talk to your friends about the harm reduction the data psychedelics for example and 2016 2005 to case in Bogota and 2018 2000 24 case in Bogota in cocaine and 23 year 2030 years and 35 case and 28 years 24 case and ETS ecstasy's and MDMA for example and 22 Okay, sorry five five five five five four case and 20000 and and 2018 32 case Mixed drugs for example in 2030 to 100 case and 2018 1 36 case is some more okay, and and the star project in the 2010 the start drug checking and 2030 and the final support major of Bogota 2050 and 2060 the NPS arrived Colombia and Catino's for example Thank you Thank you union very interesting to hear an example from Colombia and next speakers are doing adjoins a presentation They are laurine collard and Jeffrey foul Laura is a senior project manager at the Federation addiction in France and she will reflect on the French experience of drug checking and Jeffrey foul from medicine de Monde will make some brief comments from his perspective Go ahead Thank you very much. Hello everyone. I'm from Federation addiction. It's a National professional network in France. It's we are based in Paris so We're here together with the Gregory to talk to you about that the the challenge of scaling up truck truck checking services in France and the link that we promote with the health monitoring systems Both in France and at European level So first things that you have to know is that during decades checking illicit drugs in France was not recognized as a health and arm reduction measure All all organizations that were promoting arm reduction struggled with the law of course in France as in lots of country in the world But organizations such as doctors of the world has been experiencing drug-checking services in nightlife settings and in using context and In the meantime health agencies developed monitoring systems to Check and monitor what was on the market in the early 2000s Well the beginning the early 2000s. So those two systems grew together and now since 2016 we had the Change in legislation and we had a change in what is recognized as health and arm reduction missions and measures to be provided by service providers as well as community-based organizations and Drug-checking illicit drug-checking has been recognized by the law So now we are facing a challenge of scaling up what has been experimenting by certain organizations to have a very strong network system of drug-checking between organizations who would collect because they are acting in settings where drug use is active and all the organizations who have labs on-site labs or mobile labs to To allow to have a very quick qualitative and quantitative approach of drug-checking So this is the challenge that we are facing This scaling up process is done with the support of networks such as federation addiction and in a very strong relation with Health monitoring agency the French monitoring center for drug and drug addictions Which is also developing monitoring system to To be able to tell what are the trends of the black market in France So the challenge is Starting to to be effective and now we have 50 services involved in this process and We have a strong link with the French monitoring system In a health perspective to share the data's and the database as Every opportunity allows so now I'm gonna give the photo Gregory to speak about His perspective on that. Thank you. Thank you. Thank you everybody. Thank you Lauren I'm gonna add just a few things because you you presented quite well, I guess The rest of the program I represent here the XBT program from Doctors of the World Which supports access to drug-checking as a harm-reduction tools since 1999 and we support empowerment of people and defend a wide access to health programs and We we defend that the fact that health programs for drug users include a drug-checking service We know that people who use drugs are really concerned by the content of the drug that by and we identify it it as positive behavior for their health and We also identified that Because of the prohibition the contents of the drugs are Exactly unknown. So we have to to face it To face this problem also in France and we ask now the government to support our network Which is complementary to health monitoring system, but it's it's not yet well recognized and We don't have yet a full support of our government so that that what we ask today. Thank you Next speaker is Slava Kuzhakov from Ukraine he is senior advisor with the Alliance for Public Health in Ukraine and They've recently undertaken quite some interesting moves in the party scene in Ukraine You have the floor Several years behind. That's why we don't have much Scientific findings to present, but I will tell you about the program in April 2018 the Alliance for Public Health in Ukraine with support from Elton John AIDS Foundation Launched the online counseling services and the nightlife safety program For experimenting young people for us. It's a new era in the development of harm reduction Which will address Experimental and recreational drug use and also build more conscious relationship with psychoactive substances There is a real likelihood of transition from experimental or recreational drug use to problem use to dependency severe disorders criminal engagement HIV late detection of HIV and late start of treatment The causes of these transit transitions are not Necessarily linked to the substances themselves But they are linked to the lack of objective information lack of conscious attitude to the consumption of substances That is caused by taboos and stigma criminalization and punitive policies We have now unique opportunities for early detection of potential problems Which is only possible in the context of trust and open conversation anonymity and protection against judgment and oppression the services we offer are based on the concept of smart pleasure and They cover a range of themes of interest to young people while also introducing health related subjects such as safer substance use harm reduction sexual and reproductive health Promotion and early detection and treatment of HIV and viral hepatitis mental health and also safeguards from violence and human rights violations We work online and we work at music music events music festivals There is the online resource which is called drugstore org ua And it offers online counseling risk screening and referrals informative blog Frequently asked questions Associated social media channels and the mobile application free to ask which is designed to facilitate access to online counseling In one year the resource was visited by 50,000 people 2000 took the screening test and more than thousand people also tested for HIV and other infections As far as the festivals are concerned so far we worked in about seven events In seven events in the capital of Ukraine But more importantly in August 2018. We launched the first drug checking service in Ukraine We are using rapid colorimetric tests And we use them so far during the brave factory festival and the written bureau festival These are large electronic music festivals in Kiev We distributed four hundred and thirty tests and people use this test at their convenience people have met the service with great enthusiasm and appreciation and They considered it to be a miracle similar to the miracle of needle and syringe programs that people faced 25 years ago in Ukraine So many of the people actually agreed to tell us about the results and we receive pictures of the process and we receive the actual Information on the test so we started collecting the data that will enable us to Address the policy changes that are required Currently, we are also field testing immunosay tests We are also working with lawyers who advise us on the relatively safe degree of Experimentation that we can allow ourselves with the drug checking In the current legal environment. We are also preparing proposals and will push for legislative changes required To enable receiving samples from clients in order to be able to use more reliable methods of Analysis as the ones that the colleagues are using in other countries So we plan to collect more data to inform policy work We negotiate the introduction of nightmare as well Who would offer us extra protection of the stigma free and violence free territory both online and at the use events Today at music festivals the only type of violence that people experience is violence from law enforcement From people who are actually supposed to protect us from the violence So the drug checking services still a semi-underground program law enforcement remains skeptical And they propose alternative ways to approach the issue of recreational drug use for example to Check urine in schools or teach parents how to use this kind of type of testing so the the exact method that actually Failed many years ago and will only lead to stigma will only lead to oppression and violence so Essentially checking of say co-active substances should not be controversial It is designed to protect people who do not have dependency Substance use disorders or other significant problems unless they are inadequately treated by law enforcement and Controversy and conservative radical communities one in nine people who use drugs will never develop problem use or severe disorders Provided that they have access to objective information on substances Their classifications associated effects and risks interactions and precautions to take in order to avoid them Provided that they do not get prosecuted for getting and possessing substances that are unlikely to harm them Provided that they do not face stigma and ostracism from families and communities and Thank you very much. I encourage you to attend the session on drug checking at 3 where we will give a little bit more detail And also provide some pictures Thank you very much Thank you Slava and our final speaker is mr. Jeff Bartwell from Canada He is a postdoctoral research fellow at the BC Center on substance use and the Faculty of Medicine at the University of British Columbia in Vancouver, Canada And Jeff will give us a brief overview of the new technologies that are available in drug testing. Okay, great. Thank you So as we've heard on this panel drug checking has been offered in various settings for people who use drugs Recreationally, but how it may reduce harms for those who use drugs frequently Particularly people who inject drugs people are living in poverty is less known So drug checking was recently introduced in the province of British Columbia where Vancouver is in Canada as a harm reduction Intervention in response to our overdose crisis that we're currently experiencing which is largely driven by a fentanyl adulterated drugs So for example last year fentanyl was detected in more than 80% of our overdose deaths So early implementation of drug checking services was targeted in the inner city Primarily for people who inject drugs and those that are living in poverty However, a low percentage of people actually use these services and when they were first rolled out only 1% of clients were using them So we interviewed people who inject drugs in Vancouver to try to Get an understanding of what their perspectives are on drug checking and what might be some barriers preventing them from accessing these services So I'm going to talk briefly about four of our findings So we found that there's several social and structural barriers as well as technological barriers that are preventing people Who use drugs and those experiencing poverty from accessing these services? So the first one I would like to talk about is time dedication. And so this is really People saw time as a barrier So this is the either the time waiting in line to use a service or the time required to wait to have The results reported to you and so particularly when we're thinking about people who are going through withdrawal symptoms or dope sickness People needed to consume their drugs immediately. And so the idea of waiting was not was seen as a barrier So secondly people talked about the sophistication of results. So there's a variety of different technologies And so some technologies can provide results more quickly, but we learned that people were less interested in ones that said Either a positive or negative result for fentanyl and they were more interested in a percentage breakdown Additionally, there's some technologies that don't provide a low concentration They're unable to measure low concentrations of some substances And so for example, if you think of someone who's using a stimulant such as cocaine and there's a low Amount of an opioid in it that may be of greater concern for them And so if that if that technology isn't unable to detect low concentrations, that's an issue Third barrier was providing a sample So the idea of no matter how small of a amount of drug you need to provide When you're living in poverty and you do not have enough money to buy your drugs and you're hustling and you're working hard Every day to get the drugs that you need the idea of giving up even a little amount of your drugs was Discussed as a barrier and then lastly a lot of people that we interviewed talked about their drug dealers and how they trust their drug dealers They might have longer relationships. They might be getting a consistent supply. So they saw drug checking as futile Because they had more trust in their dealers. So in conclusions Our findings suggest that there's a lot of barriers that are largely driven by poverty and criminalization For people accessing drug checking particularly those living in poverty and those who are injecting drugs daily But there are some Areas for improvement and opportunities that we found so one would be technological improvements So if we can focus on technologies that can provide a greater detail So the percentage of what are the contents of the drugs this may increase the Benefits and the uptake of these services and additionally having these come out in a Timely fashion rather than waiting half an hour or 15 minutes or whatnot because time was a barrier and secondly is working with drug dealers so a lot of harm reduction interventions really target people who are using drugs and so You know if drug checking programs can actually engage with drug dealers. You're moving drug checking up the supply chain so Drug dealers can provide information about the drugs that they are selling to their customers And so this will allow people who use drugs to make more informed choices about what drugs they're buying and how they're going to use them Thank you Thank you so much So Those were all our speakers very interesting I think we've all seen now based on their Experiences that there's quite a demand for this service that it can potentially also extend to other types of drugs Then just party drugs And that there's a huge potential to reduce harms because of alter the adulteration of drugs But that it can also lead to behavior change for example in terms of taking less being more responsible with what you take We are very happy to take your questions If you go up, we don't have a mic in a room So please stand up state your name states the media outlet that you're working for And who you direct the question to and I'll repeat your question in the mic I see a question there in the room. Go ahead The question is about the conflicts with law enforcement that you might encounter in the fields I didn't get your name and the media outlets from your great Elena It's a question to all speakers. So what are your experiences with law enforcement? Maybe I can just start What I try to mention in my short talk is that it's essential to have To have understanding from law enforcement. If you don't have it, it will really make your work very difficult to do We managed to have a relationship with law enforcement with police at a local and a national level In order to do the work that we do Firstly because we work with illicit drugs, you know So you need to have a regulation that allows you to work with these drugs, but even more important It's that users of drugs they feel safe and content to actually Visit your service because they have if whenever they have a slightest feeling that they will be arrested No, but nobody will visit your service So it's essential that you first before you do your first testing that you have arranged these Relationship with police and we have managed that in our country. Thank you Anyone else? Okay, and in Colombia is permative the people take the drugs the minimal dose for the law and my organization and the The Okay, it's remember and the five five years before the Relations of the police is bad is now is very nice relation and the change this information. I am the a product the Substance for the police the analysis and the the police is very impossible and content the more drugs and and and My project and the police is in in this moment. It's no problem Drug-checking services exist particularly the more advanced Technologies they actually exist at supervised consumption spaces and so Those are protected people can legally use drugs at those sites So there aren't issues with police police can't go into those sites and they can't make arrests in those sites however We have seen not just in Vancouver and in other jurisdictions in Canada that Once someone leaves a drug consumption room You know, it's what they're doing on at the street level They might get picked up or arrested or harassed by police and that's that does happen so Secondly when I was talking about engaging drug dealers If people who are using drugs Might not be targeted for possession by police But those who are trafficking drugs are especially targeted by police So the criminalization of drugs and particularly people who are selling drugs may be a barrier for people to Accessing this service because you know if you're bringing your drugs to a location where it's safe But then walking there and also leaving there. It's not safe. So there's some issues there. So experience from Ukraine or friends In Ukraine, we only worked at the seven events so so far We did not have luckily any interaction with the police at the events itself But but the client do tell us about the interaction with police and there are different kinds of interactions Individual as well as kind of mass interaction There were a couple of cases of raids in the nightclubs where people were arrested and and also violence was also there But in kind of most events are tolerated also police actually knows that the recreational drug use happening in certain Places, but you know, it's not every day. They use they do the rights, but we talked to the police at central level as I said, they are not completely ready to actually support the drug checking services, but we are working on this and also The drug checking services not hugely publicized so far. We only publicized through social media We don't want to put big boards telling the police and you know telling the Concerned parents about our services necessarily. Thank you Thank you Elements from the French situation. So in France, we had bad Experiences with the law enforcement regarding especially the regent test a few years back and it late left some Heritage as the perspective of the law enforcement regarding drug checking now I mentioned that the 2016 health law Recognized drug checking as an armored action missions, but still the product still is illicit and you can still Be at risk. So it's a bit of a hypocrisy that activists and workers are stuck with So what we do is to inform local authorities. That's key as my colleagues also mentioned to to ensure that everything is out in the open and that we know what we do and Also, there's a measure in the 2016 health law that protects our reduction Workers, even if they are not professional workers From being persecuted prosecuted, but you would still have to go to court to prove your case So it's still a bit of a hypocrisy Situation, but we are more protected than we were before Regarding checking. That's why we are scaling up now just Just adding just a thing Now the law in France is Not clear enough about what is considered as a drug checking service and we have to to define it more like a quality chart for example and As Laurence at the law starts to protect Homerdiction staffs But don't protect at all people who use drugs So when they they need to have access to that kind of service, they are not predicted at all So we have to change it also Thank you. Are there any other questions? Yeah, go ahead Yeah, this was a question from Diana in Colombia and she is interested in hearing from you the methodology on how you collect your data And how you use that to convince governments to adopt this method For the whole panel. Shall we start at the other end Jeff? You maybe want to start? Okay, so Mine is a bit different because So there there have been studies done on drug checking That are engaging people that are using the service So those are studies that are looking at what percentage of people are using them. What are the reasons they're using them for? We've found a lot of quantitative studies that are on willingness to use Have really high numbers really high percentages But then when it was actually rolled out in Vancouver when only 1% of clients were actually using the service There's a clear discrepancy between willingness to use and what was at actual use So I'm a qualitative researcher and so we did interviews with people to kind of unpack What are the reasons why? people may not be using these services and So qualitative research is a really useful method to Really probe at these discrepancies in larger quantitative studies because you can Rather than saying would you use the services why and check these boxes we can really ask okay? You're not using this service You've mentioned that you use crystal meth every day And you're living in poverty you can really start to actually understand their day-to-day experiences Which is something that's harder to capture in a larger quantitative study. So that's how we did our work Maybe a couple of words in terms of data the We only starting but you know the data will be collected and presented to the government and relevant authorities For now, it's difficult because the only statistical data on drug use for example We have from school surveys where there is significant bias and underestimation of the prevalence And also there is limited access to statistics on overdose or kind of health events related to the recreational drug use but the What we are building now is a powerful instrument for data collection and we are planning to use our online access to People who use drugs recreationally to obtain this data So we are starting to build the surveys that we will be put in place very soon. Thank you Friends we are at us. Thanks to Protected that base so we can protect the the whole system and guarantee to users total Anonymous service anonymity service, you know and We that's a strong point that strong point that we We we defend, you know, it's really important to to have a protected database for the people and Talking about working with our government that was the second part of your question, I guess We are trying to fit a rate a maximum of actor a harm-addiction Facilities maximum of actors in in France to ask the same thing to our government Which is interested by? Knowing better what we are doing describing what we are doing. So they started to Give us some financial support to describe our practices and we ask now with them to work on an impact evaluation to know better what is Positive for people and what can be better for in our practices and just to complete a very short element then the linkage with the health monitoring center is key here because the The French monitoring Center for drug and drug addiction has a whole monitoring in Spanish and From the beginning we are evaluating since the first time we did it ten years ago Each substance has a juicy life sheet We have been inspired in other projects in the world The energy control of other projects that as they have done We evaluate the impact on the change of behavior of people every three years It's a poco como ellos han apropiado y le hemos apuntado a un indicador especialmente Y es la reducción de la intoxicación por drogas el ingreso a los hospital es Pero más importante que todos estos indicadores está en que todos los días creo que cada semana hablamos con ellos Entonces tenemos un diálogo directo con la policía como que salió nuevo que es lo que hay que ya viste esta Sustancia nos intercambiamos lo mismo con el ministerio de salud lo mismo con el ministerio de justicia entonces creo que no tanto los datos sino una conversación constante con ellos 6,100 hojas de vida más o menos de cada sustancia Existe have to find a remarks. I will speak and that's no sorry I believe that you know in our country this drug checking is a win-win situation It's a win situation for drug users because they gain knowledge about the substance they have bought and they are about to use But for us for scientists and also for the government it gives a lot of additional information about what's actually going on on the market So it's a very essential monitoring tool to monitor the market for existing drugs the purity prices and so on But also for emerging new drugs as we have been doing this work for so many years We have for instance seen the emergence of all these new designer drugs and we always say measuring is knowing without Measuring you don't really know what's going on and based on our work We are very confident to say that for instance these use of designer drugs in our country is very limited We can see it through our samples and so the government We inform them about the results of our work. We have 12,000 samples every year. It's in aggregated form So it's not directed to a single person But we give proper information about what's going on in the drug market and they are quite happy with that Thank you. This is all the time we have. Thank you to all the speakers. Thank you to the press that was here Feel free to approach the speakers now for a one-on-one interview or additional questions There's also a session on drug checking this afternoon at two for those that are present at the conference So feel free to join and the presenters will give a bit more detail about their work Thank you on behalf of the conference and I wish you a nice day