Shedding light on the traces of illicit drugs

Accidental drug overdoses took the lives of 1,768 Australians in 2023, more than were lost on our roads. Almost three-quarters of these deaths can be traced back to opioids and stimulants including methamphetamine.

With dangerous new synthetic opioids gaining a foothold, public health and law enforcement agencies are battling to reduce the harms associated with drug use.

Scientists at the UTS Centre for Forensic Science have joined the cause by using innovative testing technology to detect traces of drugs in used syringes.

Working closely with partners at the Australian Federal Police, NSW Ministry of Health and Uniting Medically Supervised Injecting Centre (MSIC), the team has embarked on an ambitious research program to save lives in the community.

“Forensic science is the study of traces and can help improve our understanding of complex societal problems such as the drugs people are injecting,” said Associate Professor Marie Mc Nerney (Morelato), who led the research.

“Different data sources can help us understand this complexity. Each provides us with a different perspective on illicit drug use.”

At this point, Harry Fursman, a PhD candidate in forensic science, joined the team. He saw the value of testing technology working alongside the collection of used syringes to better understand the Australian illicit drug market. 

“By analysing the drugs in a lot of used syringes across a wide geographical area, we could work up a comprehensive picture of the drugs being injected,” Harry Fursman said.

“At the same time as optimising the MicroNIR for rapid drug detection, we were mapping and better understanding the patterns of drug use across the Sydney from a strategic point of view.”

Detecting traces of killer drugs

Through a detailed testing program, the team analysed the drugs found in more than 2,000 syringe samples collected over a six-year period across six locations in Sydney.

The largest study of its kind that had been conducted in Australia at the time, the analysis followed the traces to detect a number of patterns in the drugs being injected across the city.

“People tend to use either heroin or methamphetamine, and which one is more common varies depending on availability and price,” he said.

“Different populations would inject different drugs in different locations. In most suburbs, methamphetamine was more commonly used. For example, in some areas, there was contamination of fentanyl in heroin syringes for samples taken during 2023.”

Fentanyl is a drug of particular concern to public health and law enforcement agencies. It is 50 times stronger than heroin and the source of a significant number of overdoses in countries like the United States but have never really taken off in Australia.

Meanwhile, the surveillance program caught the eye of public health officials at NSW Ministry of Health.

In early 2024, through their relationship with the NSW Users and AIDS Association (NUAA), they became aware of a spike in the number of people who use opioids being hospitalised for opioid overdoses in an area of Sydney.

Jared Brown, who was Manager within the Centre for Alcohol and Other Drugs at NSW Ministry of Health at the time, was working on tracking the source of the overdoses.

“We were aware of the work being done at UTS and so we called in Marie, Harry and the team to help us investigate based on the contents of used syringes in the area,” he said.

“Within two weeks, we had detected a particularly nasty type of synthetic opioid in the residue from discarded syringes. Protonitazene is a substance 200 times the potency of morphine.”

Moving quickly, NSW Minstry of Health confirmed the result with NSW Health Pathology and issued a state-wide health alert around nitazenes in the area, in partnership with the NUAA. 

No further overdoses associated with nitazenes were reported in the region in the period after the alert was issued.

Enabling informed decisions to reduce harm

Having optimised MicroNIR for use in Australia, the next stage in the project involves using the technology to help people who use drugs make informed decisions around their drug use under a harm reduction lens within a drug checking trial.

“Traditional drug and forensic testing can take a while to get results. By the time you get them, you’ve missed your chance for intervention,” Harry Fursman said.

“This technology shows results in seconds and can be used practically anywhere. It can be used to give a healthcare worker the chance to inform an individual about what they’re going to inject and have a conversation about how they go about it.”

Building on a partnership with Uniting MSIC, a pilot study will explore making potentially life-saving interventions at MSIC in Sydney’s King’s Cross. 

As part of the trial, clients using the MSIC will have their drugs analysed on-the-spot using the MicroNIR as well as using a more traditional drug testing technique for comparison.

That information will then be given to a healthcare or harm reduction worker who can explain the results to the client and counsel them on their next steps, particularly if the results of the tests are unexpected.

“This has been an amazing collaboration between law enforcement, public health and academic researchers,” said Marie Mc Nerney.

“Getting everyone working together is how we get the best healthcare outcomes and also how we’re most disruptive to the illicit drug supply. We all want the most effective strategies that are most relevant and get the best for the community.”

“This is the future of forensic science. We’re following traces and gathering information to find solutions to some of the biggest societal challenges we face.”