How the World’s Oldest Drug Checking Service Makes High-Risk Pills “Unsellable”

    Don’t sit on your day job,” Daan van der Gouwe advised people who operate drug checking services. By which he meant, getting information out there greatly amplifies the public health benefit of what you’re doing.

    The Drugs Monitoring and Information System (DIMS) in the Netherlands can proudly claim to be the oldest drug checking service in the world. It began unauthorized operations back in 1989, a time when use of “club drugs” was increasing in the country, and was formalized in 1992.

    By 1999, it was receiving funding from national and local governments. Today, DIMS is operated by the Trimbos Institute, a government-funded agency, and runs over 30 offices around the country, serving tens of thousands of people every year.

    Its purpose is twofold: to protect the health of individual drug users by informing them about what they plan to take; and to compile information about Dutch illicit drug markets for wider protection of public health.

    “This specific tablet became completely unsellable. It was off the market almost immediately.”

    This is illustrated when DIMS issues “Red Alerts” to the nation about high-risk drug supplies—something that’s now done, among other means, through an app which sends push-up messages to people’s phones.

    Daan van der Gouwe, a drug researcher and sociologist at the Trimbos Institute, was closely involved in DIMS’ most recent “full-blown Red Alert” in December 2014. “We identified through our weekly system a pink tablet with a logo in the shape of Superman,” he told Filter at the International Harm Reduction conference in Porto, Portugal.

    Sold as ecstasy, this pill contained no MDMA; instead, it contained PMMA—a drug with higher toxicity—in a “lethal” concentration. “We also had intelligence that there was a huge amount of these pills already on the market.“

    DIMS sprang into action. “We went all-out to alert the public to this danger through the media,” van der Gouwe related. He himself appeared on national television, and many other media reported it. DIMS also conducted a large-scale social media campaign.

    This effort was astonishingly successful. “This specific tablet became completely unsellable in the Netherlands,” said van der Gouwe. “It was off the market almost immediately.”

    It was exactly the outcome that such national alerts—of which there have been 10 so far—were designed to produce.

    Unfortunately, few other countries enjoy such protection. A “huge batch” of the Superman pills had already been produced, according to van der Gouwe, and so their manufacturers, no longer able to find Dutch buyers, looked for an alternative market. “In the UK, at least three people died after taking exactly the same tablet, just days after we warned for this specific pill.”

    DIMS tests every kind of illicit drug, and shares its data—in aggregated form, so it’s not traceable to individuals—with the government. “Measuring is knowing,” said van der Gouwe. “It’s a win-win situation—for drug users because they gain knowledge about the substance they’re about to use, and for us researchers and prevention workers because it gives essential information.”

    While the Netherlands has its share of risky drug use, the landscape differs significantly from the US, van der Gouwe explained. “Use of ‘designer’ [“synthetic”] drugs in our country is very limited.” In addition, “there is still very little or even no fentanyl in the Dutch heroin supply,” although, given what’s happening in the US and Canada, “we are very alert to it.”


    Daan van der Gouwe


    An Office-Based Model

    DIMS differs from many other drug checking services in that it is entirely office-based. Until 2002 it operated at clubs and parties, but was then required by the government to switch over.

    While van der Gouwe said DIMS regarded this as a step backwards at the time, he pointed out that there are many advantages to the way it now operates. “We now think office-based testing is better.”

    Clearly, on-site checking services—such as those conducted at festivals and other events by organizations like the Zendo Project, The Loop and DanceSafe—are also essential and must be expanded. The International Harm Reduction Conference additionally heard from drug checking providers from Canada, Colombia, France and Ukraine, operating with different levels of political and law enforcement cooperation.

    “We are lucky; we have a very luxurious position funded by the government.”

    However, “a lot of [particularly on-site] services have to limit themselves, budget-wise, to simple reagent tests,” said van der Gouwe. DIMS offers a range of different forms of checking from its many locations, of which lab testing provides the most accurate and detailed information. If a pill contains nothing but MDMA, for example, but a dangerously high dose of it, lab testing will reveal that, whereas a reagent test would not. “We are lucky; we have a very luxurious position funded by the government.”

    The environment of DIMS offices is another factor. Van der Gouwe said that being able to have detailed conversations with service users about drug safety is important. He noted that people who bring their drugs to DIMS offices, unlike those who check their drugs at parties, are unlikely to have already been drinking or using other drugs, which facilitates careful decision-making.

    And although people typically have to wait a week to receive lab results, the fact that they’re not already at an event when they receive them means “they have time to buy something else; people at a club or party might not have that chance and some just take the drug anyway.”


    Takeaways From the DIMS Experience

    Van der Gouwe stressed several factors that are key to DIMS’ effectiveness. One is making certain that DIMS results can always be depended upon, and that Red Alerts are as specific and concise as possible. “We have to be seen as fully reliable.”

    Another is building broad support for DIMS—including from law enforcement, so that people can bring in their drugs without fear of reprisals; from the communities where DIMS operates; from media; and from politicians at all levels.

    This last aspect has been so successful in the Netherlands that van der Gouwe describes political support for DIMS as universal. “Recently, we were visited by our secretary of state, from the conservative Christian Union, and he was doing drug checking himself in our office. What more can I say?”

    Asked what he would say to people or governments who think that drug checking services “encourage” drug use, van der Gouwe took a deep breath.

    “Our 27 years of research and experience shows that there’s no sign of drug checking encouraging drug use at all. Most likely the opposite is true.” Van der Gouwe has been struck by just how many people are willing to throw away unsatisfactory drugs.

    He also emphasized, “We never say, ‘This drug is safe, please take it.’ Even, for example, a lab-tested pill containing nothing but a standard dose of MDMA, he pointed out, might have very different outcomes for different individuals.

    One of the many harms of prohibition is that illicit markets deny people information about the drugs they use. A great deal of evidence—of which DIMS’ experience forms an important part—shows that people who use drugs will protect their health if given the tools to do so.

    Photo by Erwan Hesry on Unsplash

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