Drug Checking
Drug checking is a harm reduction strategy that allows for the characterization of drug materials (i.e., pills, powders) based on individual drug components, including active drug ingredient(s), adulterant(s), diluent(s), and other substances. There are various tools and technologies used for drug checking, including in-the-field (e.g., fentanyl test strips, FTIR) and in-the-laboratory (e.g., GC-MS, LC-MS) equipment. Drug checking allows individuals to draw scientifically-backed opinions and understand complex drug data based on accurate and reliable testing protocols.
The CFSRE is collaborating with public health agencies and community organizations to collect up-to-date information regarding the drug supply in various cities and communities across the United States. Our leading team of toxicologists and chemists help acquire data and interpret results based on years of knowledge and experience. For more information about our drug checking initiatives, email our program manager at: npsdiscovery@cfsre.org.
Overview of Trends in the Illicit Drug Supply
Traditional drugs (e.g., fentanyl, cocaine, heroin, ketamine, and methamphetamine) are commonly identified among drug samples in cities across the United States, albeit at varying purities and in various combinations. Novel psychoactive substances (NPS) continue to appear within the drug supply, masked as traditional drugs or added to traditional drug preparations. Nationally, the drug supply remains a dynamic and evolving environment, with respect to the active drug components, cutting agents, and/or adulterants added to drug preparations. The drug supply and drug use trends can be different from city to city or even within a given community, requiring specific regional or local assessments. Accurate understanding of drug materials and the drug supply in real-time is imperative for effective public health and safety preparedness and response.
Top-10 Primary Drugs Identified in CFSRE's Tested Drug Samples
Exhibit 1 shows the 10 most frequently observed primary drug identified within the drug samples analyzed by CFSRE during from the selected regions over the selected Quarters/Years. Primary drug is determined by the most abundant drug from CFSRE's GCMS analysis. Note: For the visual to be most accurate, Exhibits 1 and 2 are intended to have the same filters applied.
Uncommon Primary Drugs Identified in CFSRE's Tested Drug Samples
Exhibit 2 shows the uncommonly [outside of the Top-10] observed primary drug identified within the drug samples analyzed by CFSRE during from the selected regions over the selected Quarters/Years. Primary drug is determined by the most abundant drug from CFSRE's GCMS analysis. Note: For the visual to be most accurate, Exhibits 1 and 2 are intended to have the same filters applied.
Trends in Drug Combinations and Adulteration
Drug products are increasingly challenging to describe because rather than a single substance, illicit drugs are frequently accompanied by other compounds; these co-occurring substances include not only benign diluents, but also potent synthetic drugs and toxic adulterants. The inclusion of active adulterants can dramatically amplify or unpredictably alter effects. These evolving mixtures introduce significant uncertainty and risk for people who use drugs, making it essential to monitor how substances are combined across regions and over time.
Common Adulterants Detected in Fentanyl Since 2024
This line graph displays temporal trends in the detection of common adulterants within fentanyl-containing samples since 2024. Monitoring these patterns highlights emerging substances, shifts in formulation, and changes that may increase toxicity and overdose risk.
Substance Co-Occurrence by Primary Drug and Quarter
This visualization shows how substances are found together within drug samples over time, grouped by primary drug classification. Higher intensities indicate more common combinations, which can help to identify common mixtures and emerging co-occurrence patterns.
Novel Psychoactive Substances - Trends and Findings
The following visuals depict trends in NPS observations by the NPS Discovery Program at CFSRE. These trends are among the samples tested at CFSRE and not meant to be reflective of the overall drug market.
NOVEL PSYCHOACTIVE SUBSTANCES (NPS) DETECTIONS
Exhibit 3 shows the observed NPS identified within drug samples analyzed by CFSRE's GCMS analysis during from the selected regions over the selected Quarters/Years. These are not necessarily the primary drug substance in the sample.
