Drug checking is hosted at harm reduction service providers throughout the state. Samples are provided voluntarily by members of the community concerned about what might be in the drug supply. At intake, technicians fill out an electronic form in collaboration with the community member to describe what is being tested. This includes questions about what the sample was sold or given to the person as, what it looks like, and whether the drug in question has been consumed and, if so, observations and consequences.
The person requesting testing may provide a sample of the drug itself (a fraction of a pill or small amount of powder or tar) or they may offer residue in a pipe or cooker after use. Most of our analyses on these pages concentrate on testing samples of the drug itself before use, as testing pipes, etc., brings up issues of cross-contamination (finding what might have been in that pipe last week) and positive results for substances that appear after use (metabolites) or after exposure to heat or light (degradants). We cannot rule out all cross-contamination, however, because the container a community member uses might be used multiple times: We might still detect a substance that was in the baggy or tin earlier, but was not actually sold with the item the person wants tested.
Local testing
Drug checking sites have an array of test strips, which can give an indication of whether the target substance (e.g., fentanyl) is present in the sample. Sites currently included in the data presented on these pages also have machines called Fourier-Transform Infrared spectroscopes that scan the samples producing a spectrum that can be compared to known chemical signatures.
Confirmatory testing
To facilitate training and gaining of expertise, samples are currently sent for confirmatory testing. Detailed chemical analysis is done on each sample using mass spectrometry by our testing partner at the Opioid Data Lab at the University of North Carolina (UNC) or the National Institute of Standards and Technologies (NIST). Shipping, lab processing, and compilation of results creates a lag of at least two weeks, often longer.
Data structure
Intake information, including key variables such as test material (what was tested, generally divided into the drug itself before use or something holding residue from use), form (e.g., pill versus powder), and what the item was sold as, are recorded in one dataset with one row per submission. Confirmatory testing results arrive with one row per substance results. A given sample can have many substance results: Samples sold as fentanyl or fentanyl analogues (also known as “fentalogs”), for example, often have multiple identified substances due to incomplete or imperfect synthesis of the target substance, so the results might indicate fentanyl specifically, one or more fentanyl analogues (e.g., para-fluorofentanyl), and one or more chemical precursors (chemicals involved in the synthesis, which are unlikely to be substantially psychoactive, such as 1-phenethyl-4-propionyloxypiperidine), in addition to any modifying agents (e.g., acetaminophen or xylazine) or bulking agents (e.g., sugars). In order to analyze sample results, these substances need to be coded to drug categories of interest and the data flattened to one row per submission.
Drug coding
Categorizing substance results to a useful taxonomy of drug categories is a difficult process, and inherently leaves out information in the interest of simplicity and summarizing. One person might be highly interested in the presence of 1-phenethyl-4-propionyloxypiperidine, others may simply wish to note the presence of all fentanyl precursors, and other may wish to simply include any psychoactive precursors in a broader fentanyl analogues category. ADAI has combined its experience coding and classifying similar testing results from state crime lab data with further input from chemical experts, drug checking sites, and people with lived experience to implement a categorization system used in these pages. This system combines codes that represent only one substance (e.g., fentanyl, cocaine, xylazine) and categories that group similar substances together (e.g., fentanyl analogues). Each category is then grouped into super-categories for purposes of summarizing the extent to which samples are testing positive for expected versus unexpected substances. These super-category labels--major, minor, other of interest, not of interest--have more to do with population-level health effects and in no way represent how you would feel if they showed up in your sample. Drug categories identified include:
Major drugs
Amphetamine, a stimulant
Benzodiazepines ("benzos") are divided into those legally available by prescription (Rx benzos) versus illicit or "designer" (non-Rx) benzodiazepines. Legal status here refers to whether the substance is legally available by prescription in the United States, not the status of the submitted sample itself.
Cocaine
Fentanyl itself
Other types of fentanyl, known as fentanyl analogues or fentalogs, including carfentanil, flourofentanyl, etc., which are functionally and structurally similar to fentanyl. The fentalogs may be weaker or stronger opioid agonists than fentanyl itself.
Sometimes we may call out the strong analogues (currently included in the larger analogue category):
Carfentanil: 30 to 100 times stronger than fentanyl, used for large animal anesthesia
Methylfentanyl: Some versions might be less potent than fentanyl, but some isomers are as much as 60 times stronger
Cyclopropyl fentanyl: Approximately 3 times as potent as fentanyl
Furanylfentanyl: Approximately 7 times more powerful
Heroin
Methamphetamine
Other novel synthetic opioids include non-prescription synthetics other than the fentanyls, such as the U series (U-47700, U-48800) and noramidopyrine. When we see nitazenes, they will be coded here.
Rx opioids includes all other opioid medications legally available by prescription (tramadol, oxycodone, etc.)
Xylazine
Xylazine is a tranquilizer, common in veterinary medicine, often added to augment the experience of fentanyl. We call it out as a separate category of unexpected drugs due to the health risks associated with xylazine in the drug supply.
Minor drugs
Cathinones are a class of drugs used for their stimulating and/or hallucinogenic effects. Often sold as "bath salts".
Depressants: Specifically, all other depressants not mentioned elsewhere (benzos, xylazine, etc.). Includes substances such as trazodone, carisoprodol, and gamma-hydroxybutyrate (GHB).
Ketamine & related: Ketamine itself and similar substances such as deschloroketamine. Ketamine is a dissociative anesthetic also used in pain management and, more recently, treatment of depression. At certain dosages, it may also create mild hallucinations.
Kratom refers to compounds present in the Mitragyna speciosa plant, commonly known as kratom. Individually or together, they can be both stimulative and similar in effect to opioids.
LSD & other tryptamines includes LSD itself as well as several other designer tryptamines such as DMT.
PCP & related included PCP itself and similar substances such as methoxy-PCP.
Phenethylamines
MDMA (methylenedioxymethamphetamine), known as "Ecstasy"
MDA (methylenedioxyamphetamine), sometimes known as "Sally"
Other phenthylamines includes related substances designed to have similar effects to MDMA/MDA, such as DMA, the 2C family, etc. Also includes mescaline, a natural phenethylamine.
Other of interest
Antidepressants
Buprenorphine, a medication mostly used to treat opioid use disorder.
Caffeine, often used as a bulking agent.
Cannabimimetics, synthetic drugs that imitate the effects of cannabis.
Cannabis, or specifically any cannabinoid
Hormonal agents: Presumably used as filler, substances such as clomiphene deserve some calling out.
Methadone is an opioid sometimes used to treat pain but most often to treat opioid use disorder.
MXE: Methoxetamine is a designer dissociative similar to ketamine but different enough that we have it in a separate category.
Other analgesics include acetaminophen (most often for fentanyl-positive cases), lidocaine, and phenacetin.
Other psychoactives includes other drugs, often novel substances with stimulant, dissociative, or hallucinogenic effects, that do not fit into other categories, such as phenibut, methamnetamine, isopropylphenidate and 4-fluoromethylphenidate, MXIPR, and phenylmorpholines/phenmetrazines such as 3-chlorophenmetrazine (3-CPM).
Steroids
Not of interest (in general)
Cuts & buffs includes other substances thought to have little health or psychoactive effects used to extend the mass of product or assist in forming pills. This category includes diverse substances such as glycerin, sugars, and melatonin. Not all of these are detectable by the chemical analyses used, so this represents an undercount. Other prominent cuts & buffs we sometimes mention:
Levamisole is sometimes used to cut cocaine. It is commonly sold as as a de-worming medication.
Methylsulfonylmethane (MSM), also known as dimethyl sulfone, is most commonly known as a dietary supplement and may be used to cut methamphetamine.
Fentanyl precursors refers to chemicals involved in the process of synthesizing fentanyl (or fentalogs). Their presence in the final product is common, and may reflect incomplete synthesis or merely unavoidable byproducts of the synthesis method used. Thus, "precursors" might not be accurate in describing chemicals that are technically byproducts or side-products in the given string of chemical reactions, but we use the general term precursors to indicate impurities arising from imperfect synthesis of fentanyls.
Impurities are chemicals that remain due to incomplete refinement or synthesis of the target substance (excluding those exclusive to synthesizing fentanyls). Although most are specific to a parent drug (e.g., papaverine is a component of the opium poppy often left over when heroin is produced), for analytical purposes we lump them together in one category. Also likely undercounted due to a combination of factors.
A new impurity associated with negative experiences with fentanyl in the summer of 2024 led us to create a new indicator for BTMPS (Bis[2,2,6,6-tetramethyl-4-piperidyl]sebacate)
separate from the other impurities.
Metabolites: Although our partner community drug checking sites try to test substances before use, cross-contamination may occur. In addition, exposure of substances to water or heat prior to use may also change their chemical compositions, creating new chemicals, which might be called degradants but which we include in the metabolites category. Also likely undercounted.
Using our interactive charts