By checking for fentanyl and other deadly ingredients , researchers strive to save lives . BY CORRIE PIKUL
Adina Badea , Claire Macon , and Alexandra Collins , left to right , test drug samples in the toxicology lab of Rhode Island Hospital .
In a toxicology lab at Rhode Island Hospital , a team of Brown University researchers is testing samples labeled “ biohazard ” to discover the precise nature of their toxicity . The bags contain drug residue from discarded drug paraphernalia collected from harm reduction organizations in local communities .
Once samples are tested , the Rhode Island Department of Health shares the findings through print fliers , social media posts , and emails , and on PreventOverdoseRI . org , the state ’ s overdose dashboard developed through a partnership with the Brown School of Public Health . The team also contacts sample donors and tells them what was in the submitted residue . The results can be a surprise — to testers and donors alike .
This type of analysis is the cornerstone of TestRI , a two-year project and study led by Brown researchers and funded by the Foundation for Opioid Response Efforts . The need is urgent , the research team says : Rhode Island , like many parts of the country , is facing an overdose crisis , due largely to the presence of synthetic opioids like fentanyl in the drug supply . Fentanyl can cause overdose even in minuscule amounts , particularly for those who have never encountered it before . If a person doesn ’ t realize that fentanyl is present in a supply of cocaine or methamphetamines , they have a higher risk of accidentally overdosing .
Other surprise substances can be just as dangerous . One recent TestRI alert warned about the presence of xylazine , an animal tranquilizer , in tested samples and advised that not even an emergency treatment of overdose-reversing naloxone may be enough to save a life .
“ The drug supply across the US is continuing to change rapidly , and it has left a lot of unknowns ,” says Alexandra Collins , PhD , MSc , an assistant professor of epidemiology at Brown .
And those unknowns are often deadly . Rachel Wightman , MD , an
emergency physician at Rhode Island and The Miriam hospitals , has seen firsthand the dire effects of the changing drug supply , as she and her emergency department colleagues treat more and more patients for overdoses after using fentanyl-tainted drugs . In 2021 , more Rhode Islanders than ever before — 435 — died from accidental overdoses , and fentanyl accounted for about three-quarters of those deaths , the Department of Health reported .
Adina Badea , PhD , an assistant professor of pathology and laboratory medicine , says that after TestRI launched last May , test samples — which come from all over the state — started showing so many unexpected compounds that Badea worried she might be accidentally contaminating them .
“ In the beginning I was so paranoid , I cleaned my instrument and ran my samples again ,” says Badea , the director of toxicology at the Lifespan Academic Medical Center . But it wasn ’ t her ; it was the drugs themselves . “ It sometimes seems odd , but I have no reason not to trust the results . And after a number of samples tested , you start to see — oh , this is a trend , this is a pattern , this is real .”
The expense of toxicology testing limits how many samples that TestRI can process . Given the demand , the researchers hope to scale up the project in the future so they routinely test more samples .
Wightman , an assistant professor of emergency medicine , says that revealing to people the unexpected ingredients in their drugs can help them exercise more caution and take additional protective steps , like using in the presence of other people , instead of using alone ; taking smaller doses ; and making sure they have access to naloxone , which can reverse an overdose by blocking the brain ’ s opioid receptors . “ The end goal is to improve the well-being of people who use drugs by providing better support and care for the community ,” she says .
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