Across the United States, as COVID restrictions ease and concert venues and clubs reopen, millions of people are making a surreal transition from quarantine to nightlife. For those who use drugs, partying now may come with increased risks.

The emotional and physical transition could push some people past their pre-pandemic comfort zones, said Dr. Sheila Vakharia, deputy director of Drug Policy Alliance’s Department of Research and Academic Engagement. Many may use drugs they’re not familiar with, or quantities they’d normally avoid or be better prepared to tolerate.

“We think about drugs as ‘set and setting,’” Vakharia said. “We’re still in a pandemic! People are still dying of COVID … you may not be in as great of a headspace to get high the way you used to.”

Lockdowns and travel restrictions have also likely increased the prevalence of adulterants in most types of unregulated drugs. According to Vakharia, this is both because many people’s access to their regular sellers has been disrupted, and because the supply itself has been more complicated to transport, which incentivizes sellers to stretch their products as far as possible.

While fentanyl has been prevalent in the heroin supply for a decade, it is increasingly found in non-opioid drugs that are more regularly associated with nightlife and partying, like powder cocaine. And the pandemic appears to have exacerbated the risk—in New York City, fentanyl-involved cocaine overdose increased 30 percent between October 2019 and October 2020. Many people who use nightlife drugs don’t have opioid tolerance, adding to their vulnerability to overdose.

“I’m going to really stick to the scene where everyone knows each other, because I trust them and feel safer that way,” Alex told Filter. “There’s a mutual aid element to LES’s underground punk scene where everyone kind of looks out for each other. A lot of us even carry Narcan! I’m much more diligent now about really doing drug-checking in every way that I can. A good friend of mine uses cocaine when she’s out, but [during the pandemic] she tested a batch that came up positive for fentanyl.”

“If you go six months between buying drugs, something else may be in it. The market is changing so quickly.”

Research suggests that use of nightlife-associated drugs like MDMA and powder cocaine has decreased during the pandemic. Reasons include less contact with peers, fewer occasions to use these types of drugs and not enjoying using them at home alone. This in itself is grounds for caution when resuming use.

Another factor that many drug users might not be considering as they re-enter the nightlife scene is the proliferation of Novel Psychoactive Substances (NPS), like isotonitazine and etizolam, in unregulated supplies.

“Now, NPS opioids are coming and going in cycles of three to six months,” Alex Krotulski, the associate director for Center for Forensic Science Research & Education (CFSRE), told Filter. If “you go six months between buying drugs, something else may be in it. The drug market is changing so quickly.”

Follow basic harm reduction advice when getting back into nightlife this summer, advised Stefanie Jones, DPA’s interim managing director of communications and former director of its #SaferPartying campaign. “Go slow. Use with people that you know. Be in an environment [where] you feel safe. It’s going to be important to remind people of that, because they haven’t been thinking about these things for several months.”

Drug-Checking and Its Limitations

A large portion of people who use traditional party drugs are aware that they don’t fully know what they’re taking. According to the 2020 Global Drug Survey, nearly half the people who reported taking MDMA pills between October 2019 and October 2020 did so without knowing much actual MDMA their pills contained. This is where drug-checking can help.

Yuna Blair, a regular in San Diego’s underground EDM/rave scene, has been using drug-checking kits since 2016. At first, she only used one type of testing reagent. Then came a negative experience with what she thought was an MDMA pill.

“I’m still not quite sure what was in there,” Blair said. “I wish I didn’t take it, it wasn’t a good time … if you’re expecting one thing, and you get something else, it’s destabilizing.” These days, she uses three to five different reagents on every sample.

Organizations such as DanceSafe offer multiple types of reagent kits. But these are considered “drug paraphernalia,” and thus criminalized, in all US states except Alaska, California, Colorado, Nebraska, New York, South Carolina and Wyoming, as well as the District of Columbia.  

Mohawk Greene, director of DanceSafe’s New York chapter, said that even in a state where drug-checking kits are legal, like New York, venue managers often object to their presence.

“What’s the real use of giving [people] drug education info and talking about the importance of drug-checking,” Greene asked, “if they don’t have the tools themselves?”

Reagent kits also have functional limitations. They can only detect whether a given number of substances—like fentanyl—are present or not, and they give no indication of how much is present; just if it’s there at all.

“Drug-checking is an imperfect solution to an unregulated drug supply,” Dr. Vakharia said. “Even fentanyl testing strips—they’re great but they’re a dollar each, which can add up.”

“If we had a regulated drug supply, we wouldn’t need to check what’s in it.”

Nonetheless, valuable services do operate across North America. In Toronto, partying-focused harm reduction group the Trip! Project runs booths at local events. It’s staffed by outreach volunteers who offer drug-checking, safer use supplies and educational materials. It also works with emergency medical services to facilitate safer experiences.

“If someone’s vomiting or having a seizure and what not, it’s way easier for us to be able to bring them to the medical tents than for their friends to try to drag them there themselves,” project coordinator Lori Kufner told Filter. “So we really are working under the health and safety umbrella.”

Trip! Project works with Toronto’s Drug Checking Service which, similar to CFSRE, uses mass-spectrometry to reveal sample compositions, which are then made publicly accessible.

Safe consumption sites (SCS) have taken Canada’s drug-checking capacity to a new level, since they can often perform the service onsite. Results are recorded and provided to Health Canada for publication, and samples can be sent to designated laboratories with mass-spectrometry for evaluation.

“The mass-spec is the best checking there is, because we want to do it right and catch the analogs,” Kufner said. “I would really press cities or countries to allow SCS.”

If sellers had increased access to technology like mass-spectrometry, they’d be able to make more informed decisions about their product, as well as share that information with their buyers. But ultimately, the only way to remove dangerous adulterants from the supply is to regulate that supply.

“When I go to the store and buy lotion, a box of cereal, liquor, I know what’s in it so I don’t need to check it,” Vakharia said. “If we had a regulated drug supply, we wouldn’t need to check what’s in it.”

Photograph via Flickr/Creative Commons 2.0

* Name has been changed at source’s request

DPA previously provided a restricted grant to The Influence Foundation, which operates Filter, to support a Drug War Journalism Diversity Fellowship. Dr. Vakharia is a member of the board of directors of The Influence Foundation.

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