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Background The use of psychoactive substances is a key public health issue due to its impact on mental, physical, and social health. Integrated drug checking is a well-known harm reduction and addiction prevention measure and is currently implemented in four federal states in Austria. The aim of this study is to investigate the prevalence of drug checking use among a web-survey sample of people who use drugs (PWUD) in Austria and to examine differences in socio-demographic and substance use characteristics between individuals with and without drug checking experience. In addition, reasons for not using these services are explored. Methods A secondary data analysis of the Austrian data from the European Web Survey on Drugs (EWSD), a targeted survey conducted between March and May 2021 was performed. Based on reported drug checking experience, the data set was divided into two groups - those with and without drug checking experience – and compared. Results In this web-survey sample of PWUD ( n  = 1113), 20.1% reported prior use of a drug checking service in Austria. The groups with drug checking experience ( n  = 224) and those without ( n  = 889) differed significantly in both univariate and multivariate analyses. Univariate analysis revealed significant differences in terms of age, household composition, highest level of education, employment status, region of residence, substance use prevalences and treatment experience. Participants who used cannabis only had significantly less experience with drug checking. No significant differences were found regarding gender and income. While logistic regression analysis showed a significant relationship between sociodemographic predictors and drug checking experience, this relationship was relatively weak. The main reasons for not having used the services yet included a high level of trust in the source of supply (68%), confidence in receiving high quality of substances (64%), and a lack of service availability near the place of residence (62%). Conclusions The results indicate that drug checking services are well-accepted and trusted but not equally accessed by and accessible to all PWUD. Specifically, people who use only cannabis and those residing with parents or in rural or small-town areas access services less. In conclusion, there is considerable potential for expanding the availability and accessibility of drug checking services in Austria, particularly to reach underserved groups of PWUD who could benefit from this intervention.

Local anesthetics (LAs) are frequently used as adulterants in cocaine sold on the illicit market, sometimes in higher quantities than cocaine itself. These agents can mimic cocaine's anesthetic effect, masking the products reduced purity. While reports suggest that LAs influence monoaminergic neurotransmission, systematic evidence remains limited. We examined three LAs commonly detected in cocaine samples submitted for drug checking from Vienna, Austriaprocaine, benzocaine, and lidocainefor their activity on uptake-1 monoamine transporters (DAT, NET, SERT) and uptake-2 organic cation transporters (OCT13). Transporter activity was measured in vitro, and computational docking was applied to explore molecular interactions with atomistic detail. Procaine and benzocaine inhibited DAT and NET at physiologically relevant concentrations, whereas neither compound affected SERT. Procaine also inhibited OCT1 and OCT2 with affinities comparable to or greater than cocaine, while benzocaine exhibited no OCT activity. Lidocaine had no significant effect on any transporter. Docking studies confirmed procaine binding within the DAT substrate pocket, consistent with its inhibitory profile. Although LAs modulate uptake-1 and uptake-2 transporters, their actions are insufficient to replicate cocaine's psychoactive effects. However, their impact on OCTs indicates potential health risks, highlighting the importance of accessible drug checking services for harm reduction.

PurposeThe purpose of this paper is to assess the relevance of cryptomarkets, characteristics of purchasers and possibilities for survey research by approaching users directly on cryptomarkets.Design/methodology/approachCross-country comparison of the results from the European Web Survey on Drugs (EWSD) and summarizing lessons learned during the data collection was carried out.FindingsPurchasers of drugs on cryptomarkets are still a rather small segment of all drug purchasers, and most people who use cryptomarkets also use other sources of supply to buy drugs. The percentage of people using cryptomarkets is unevenly distributed across countries and substances. Purchasers on cryptomarkets in most countries are more likely to be men and more likely, on average, to use more substances. Other characteristics such as age or place of residence do not show a consistent pattern across countries. Recruitment of respondents on cryptomarkets calls for specific techniques and procedures. Specific attention should be paid to build trust and guarantee credibility and anonymity.Research limitations/implicationsInterpretation of the quantitative results is limited by nonprobabilistic sampling and different recruitment strategies in different countries.Practical implicationsUsers of cryptomarkets show some specific characteristics, providing a challenge for research and prevention agencies to keep up with digital technology. Increasing knowledge about characteristics of users of cryptomarkets may help to create adequate responses for harm reduction measures in different supply settings. However, collecting self-reported data from users on cryptomarkets is limited owing to significant privacy concerns and requires specific skills and strategies.Originality/valueThe EWSD provides a rare opportunity for detailed analyses of consumption patterns and characteristics of active drug users across several European countries. Furthermore, experiences of a new recruitment strategy are discussed.

PurposeThe 3,4-methylenedioxymetamphetamine (MDMA) content in ecstasy tablets has increased enormously throughout Europe across the past decade. This study aims to determine whether this is caused by the production of “stronger” tablets (more mg MDMA per mg of tablet), or if tablets have simply been getting larger and heavier (more mg of tablet in total).Design/methodology/approachA data set of 31,716 ecstasy tablets obtained in 2012–2021 by 10 members of the Trans European Drug Information (TEDI) network was analysed.FindingsThe MDMA mass fraction in ecstasy tablets has remained virtually unchanged over the past 10 years, with increased MDMA contents being attributed almost exclusively to increased tablet weight. These trends seem to be uniform across Europe, despite varying sampling and analytical techniques being used by the TEDI participants. The study also shows that while tablet weight correlates perfectly with MDMA content on a yearly basis, wide variations in the MDMA mass fraction make such relations irrelevant for determining the MDMA content of individual tablets.Research limitations/implicationsThese results provide new opportunities for harm reduction, given that size is a tangible and apparently accurate characteristic to emphasise that one tablet does not simply equate to one dose. This is particularly useful for harm reduction services without the resources for in-house quantification of large numbers of ecstasy tablets, although the results of this study also show that chemical analysis remains crucial for accurate personalised harm reduction.Originality/valueThe findings are both new and pertinent, providing a novel insight into the market dynamics of ecstasy tablet production at a transnational level.