Carolina researchers developing warnings for tainted street drugs

Led by Nabarun Dasgupta, researchers from across the University will work with seven community-based harm reduction programs from all regions of North Carolina to conduct the first-ever street drug assessment focused on public health, backed by sophisticated machine learning techniques.

With new grant funding, Nabarun Dasgupta ’13 (Ph.D.), Gillings Innovation Fellow at the UNC-Chapel Hill Gillings School of Global Public Health and senior scientist at the UNC Injury Prevention Research Center, will work with colleagues across Carolina to develop systems to detect and issue public warnings about dangerous adulterants in street drugs.

The funding from the Foundation for Opioid Response Efforts, or FORE, will support his work to develop processes and guidelines for chemical drug testing along with systems to alert the public about potential dangers — an approach that he calls “underutilized.”

“Drug checking is an essential public health response to novel psychoactive substances and adulterants that are treacherous,” said Dasgupta. “Our team is bringing together advertising, epidemiology and chemistry to generate timely data to reduce overdose deaths.”

Punitive drug policies have coincided with an intensifying opioid and overdose crisis, but evidence increasingly points to the superior effectiveness of a harm reduction approach that protects people who use drugs from the worst health outcomes rather than punishing them. This approach also provides a platform to connect people to other services, such as syringe exchange or treatment for substance use disorder. The drug-checking work is co-led by Mary Figgatt, a doctoral student in the UNC Gillings Department of Epidemiology, and the Department of Chemistry Core Laboratory. Using state-of-the-art mass spectrometry machines, the Core Laboratory has collaborated with Dasgupta’s team for a year and a half to develop new methods to stay ahead of the ever-changing drug supply in North Carolina.

Together they will work with seven community-based harm reduction programs from all regions of North Carolina, to conduct the first-ever street drug assessment focused on public health, backed by sophisticated machine learning techniques. Dasgupta stresses the urgency of this work.

“It’s too late to help people make changes by the time that they die from an overdose,” he said. “We need new immediate solutions.”

The COVID-19 pandemic has obscured a worsening opioid overdose epidemic. The National Center for Health Statistics recorded more than 100,000 deaths from drug overdose in 2021. While projections indicate this number will keep rising, the problem is far broader than even this stark number suggests.

Many people who use drugs are hospitalized and treated for conditions linked with street drugs that are contaminated with other substances, including stronger drugs than the purchaser intends to use. A contaminated drug supply can contribute both to morbidity and mortality.

“We have had calls from doctors around the state with complex atypical cases of drug-related harm,” said Dasgupta. “With our insight into what’s actually in street drugs, we’ve been able to help inform clinical care.”

The team plans to release open-source chemistry lab protocols that will allow other university labs to test their local drug supply. Chemical insights into drug supply need to be returned to people who use drugs so they can make informed decisions to protect their health, Dasgupta and Figgatt recently wrote in a commentary for the American Journal of Epidemiology. They also work closely with the North Carolina Survivors Union in Greensboro.

All of this work aligns with FORE’s newly announced Innovation Program, which has three foci: education and training to address stigma, support for the transition from treatment to recovery, and generation of timely and actionable data, which Dasgupta’s research provides. A grant totaling nearly $600,000 will support this research.

To help ensure data are actionable, the study team includes Allison Lazard, E. Reese Felts Jr. Distinguished Associate Professor in the UNC Hussman School of Journalism and Media.

“The FORE Innovation Program grant will help us develop ways to deliver timely and actionable alerts about opioids and stimulants. Our hope is to promote positive behavior and avoid risk-seeking,” said Lazard. “Carolina is a research university that fosters interdisciplinary discovery. I’m pleased to be working with Nabarun Dasgupta at Carolina’s Opioid Data Lab to bring innovative evidence-based approaches for health communication to tackle some of the most challenging aspects of the opioid overdose crisis.”

The Opioid Data Lab is a collaborative effort of the University of North Carolina at Chapel Hill, University of Kentucky and University of Florida that centers the patient experience to study issues related to pain management, harm reduction and addiction treatment.

Unfortunately, warnings about “dangerous drugs” can have unintended adverse consequences if they lead people to believe a drug is particularly powerful — which some may perceive as a benefit. Much of Dasgupta and Lazard’s work with the lab has focused on effective health communication using illustrations as well as text and other conventional strategies, and they will use this experience to create effective drug warnings that avoid potential pitfalls. Working with artists around the country, they will create an open-source library of hand-drawn illustrations for drug warning posters and social media.

“By pairing novel data collection with cutting-edge communication guidance, we offer a comprehensive solution,” said Dasgupta. “These techniques empower people who use drugs to make informed choices and reduce harm.”

Learn more about the UNC Gillings School of Global Public Health