Massachusetts Drug Supply Data Stream: Implementing a Statewide Public Health and Public Safety Partnership to Check Drugs

The drug supply is highly variable, and recent increases in illicitly manufactured fentanyl are linked to unprecedented rates of fatal drug overdoses. New substances, contaminants, and unpredictable supply fluctuations add tremendous risk to people who use drugs (PWUD), their caregivers, and first responders. It is important to collect timely drug supply data and to share information with consumers and stakeholders, so that efforts can occur to avoid harmful substances, take preventive actions, and better target interventions.

This session will overview the Massachusetts Drug Supply Data Stream (MADDS), the country’s first statewide community drug-checking program, and describe its implementation, barriers, and facilitators. MADDS was piloted in 2019 and rapidly expanded to 12 sites with monthly sample donations from harm reduction agencies and police departments. Samples are reviewed by a medical toxicologist for potential health and safety concerns and communications are crafted for health and first-responder partners. MADDS collects drug “trash” (e.g., drug packaging, paraphernalia with residue) from PWUD and non-criminal samples from partnering police departments and tests them using simultaneous immunoassay fentanyl test strips, Fourier Transform Infrared (FTIR) spectrometry, and confirmatory testing by gas chromatography-mass spectrometry (GC/MS), which enables documentation of the presence of a sample’s inactive and active components. Results are accessible to community programs and municipalities, while trend analyses inform public health drug monitoring for cross-site alerts and informational bulletins. Presenters will share the importance of implementing community drug-checking programming to better understand the drug supply. Evidence and best practices developed through MADDS will be highlighted.