A new EMCDDA Rapid Communication, published on 29 May, presents the results of an innovative project to gather information on the substances used by people who inject drugs, by chemically analysing the residual content of used syringes. The pilot study of the ESCAPE project (European Syringe Collection and Analysis Project Enterprise) collected syringes in 2017 from the bins of street automatic injection kit dispensers and at harm-reduction services in a network of six sentinel European cities: Amsterdam, Budapest, Glasgow, Helsinki, Lausanne and Paris.
The contents of 1 521 used syringes were analysed in five laboratories using chromatographic and spectroscopic methods.Among the findings were that traces of stimulants (cocaine, amphetamines and synthetic cathinones) were found in a high proportion of the syringes tested in each of the cities, which may indicate a high prevalence of stimulant use among people who inject drugs.
The project seeks to complement existing data on substances injected by users, by providinglocal and timely information that can be used for city-level monitoring and interventions. It complements existing monitoring tools (such as surveillance data from drug treatment centres) but does not replace them.
Well-designed observational studies, collecting behavioural data and qualitative information from interviews with drug users in low-threshold services or using respondent driven sampling, are still the best tools to obtain information on many aspects of injecting, including reuse and sharing. Nevertheless, the timely, laboratory-confirmed local data on injected substances and patterns of injection provided by the ESCAPE approach can help to guide local responses. By collecting injecting material from street bins, it potentially provides information on groups of people who inject drugs that are not reached by health services.
Future collection campaigns will further harmonise the sampling strategy, the type of syringes collected and the list of substances tested across cities. Future campaigns should also aim at collecting syringes from other settings and including more cities in order to provide a more representative picture of the European situation and to advance knowledge on local injecting practices. By analysing trends over time, the network will aim to detect changing patterns of injecting.