Evidence map›Paper›PMID 40245047›Full record

ArticlePloS one2025

"Everyone says 'safe sex' but no one ever says 'safe drugs', you know?": Perspectives on the intersection of drug checking services, drug policy and the overdose crisis.

Jeff Ondocsin, Lissa Moran, Daniel Ciccarone, Simon Outram, Dan Werb, Nicole Holm, Emily A Arnold

Abstract read
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Interpol review of forensic drug chemistry, 2022-2025.Forensic science international. Synergy · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jeff OndocsinCenter for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, California, United States of America.ORCID 0000-0002-9954-7932
Lissa MoranCenter for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, California, United States of America.ORCID 0000-0003-2026-6095
Daniel CiccaroneFamily & Community Medicine, Department of Medicine, University of California, San Francisco, California, United States of America.
Simon OutramCenter for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, California, United States of America.
Dan WerbCentre on Drug Policy Evaluation, St. Michael's Hospital, Toronto, Ontario, Canada.
Nicole HolmFamily & Community Medicine, Department of Medicine, University of California, San Francisco, California, United States of America.
Emily A ArnoldCenter for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, California, United States of America.ORCID 0000-0003-3968-9100

Funding

Synthetics in Combination (SYNC)R01DA054190 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI DANIEL H CICCARONE · 2021 to 2026
$4.3M
NIDA NIH HHS R01 DA054190
6 · The paper itself

Abstract

backgroundOverdose deaths have continued to rise in the US despite heightened public attention and resources. Drug checking shows promise for integration into existing services for people who use drugs (PWUD) across North America. Amidst the backdrop of rising overdose deaths and emerging funds for harm reduction initiatives, this manuscript explores the landscape of drug checking services in North America and perspectives on improved integration with a diverse set of PWUD based in San Francisco and North American drug checking experts.

methodsTwo separate samples of drug checking stakeholders, 'providers' and 'clients' were recruited. Providers participated in in-depth semi-structured qualitative interviews over Zoom on their experiences advocating for and operating drug checking services in the US and Canada. Clients were people who used drugs and lived in or commuted to the San Francisco Bay Area and participated in semi-structured interviews in November 2022. Interviews were transcribed fully and analyzed using thematic analysis methods.

resultsProviders and clients identified ongoing instability in the North American drug supply that is exacerbating overdose risk while also identifying groups that would benefit from greater access to drug checking services. Both groups believed the paradoxical impacts of the fentanyl crisis at the core of drug checking services created barriers to the implementation and expansion of these services, hurting PWUD and their providers. Additionally, clients and providers reflected on the social and policy challenges to expansion and improvement of drug checking in their communities.

conclusionDrug checking remains underleveraged, particularly with respect to the most vulnerable PWUD. Clients and providers contended that these services must become more responsive to an ever changing and dangerous drug supply in North America.

Indexed as

Drug OverdoseAdultCanadaDrug UsersFemaleHarm ReductionHumansMaleMiddle AgedSan FranciscoUnited States

Identifiers

PMID40245047
PMCPMC12005539

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.