People who use illegal drugs in New York City can now find out exactly what's in them

Overdose deaths have soared in recent years, in part to the rise of fentanyl. A pilot program uses spectrometry to tell users of illegal drugs what, exactly, is in the drugs they are planning to take.

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People who use illegal drugs in New York City can now find out exactly what's in them. That's thanks to a drug checking service being piloted by the city. Overdose deaths have soared in recent years, in part to the rise of fentanyl. But that isn't the only potentially dangerous or unexpected substance people might be consuming. WNYC Caroline Lewis takes us to one of the pilot sites. And just a warning, this story includes the sound of a person overdosing on drugs.

TAMMY HOGAN: I need help.

CAROLINE LEWIS, BYLINE: On a Tuesday afternoon, a woman walks into OnPoint NYC, a center for drug users in Harlem, and tells staff her husband is overdosing on the sidewalk outside.

UNIDENTIFIED PERSON #1: Go, go, go.

LEWIS: Staff rush through the crowded lounge to find the 65-year-old leaning on a lamp post, still conscious but struggling to walk.

UNIDENTIFIED PERSON #2: There we go. You see that condensation right there? That means he's breathing.

LEWIS: They get him in a comfortable chair with an oxygen mask and a pulse oximeter clipped to his finger. His wife, Tammy Hogan, is visibly shaken. She says he's been doing dope since he was a kid, but the drug supply has changed.

HOGAN: It's not heroin no more. There's something else in the drugs that they're cutting these drugs with. And I don't understand why they're doing that to people 'cause this is people's lives, man.

LEWIS: Hogan suspects her husband took fentanyl, but she wants to know for sure and wants to know the potency of the drugs he bought. Thanks to New York City's new drug checking program, that's easy to find out. This is just one of the services offered at this overdose prevention center, where people can also use illicit drugs under staff supervision.

YARELIX ESTRADA: So if you look at the sample here, the red is the drug that was brought in, and then the blue is a reference.

LEWIS: In a tiny room off the side of the lounge, Yarelix Estrada from the city health department is demonstrating how to find out the contents of a drug sample using an infrared spectrometry machine, a device you would typically find in a lab.

ESTRADA: Caffeine is often found inside of these samples. Quinine is often found inside of these samples because it gives a similar taste and feeling of itchiness as heroin.

LEWIS: Estrada said some clients still think their drugs contain heroin, but increasingly, they're getting the more powerful opioid fentanyl mixed with other chemicals. A basic test strip could tell someone whether their drugs contain any trace of fentanyl at all. But for opioid users, Estrada says, it's often more helpful to know how much.

ESTRADA: There's a lot of folks that are buying things off the street under the assumption that they know what's in it, but they actually don't know and then have adverse reactions because of it in some situations.

LEWIS: Fentanyl isn't the only concerning substance that pops up in the illicit drug supply. The drug checking program recently confirmed the presence of xylazine, an animal sedative that can be dangerous for humans. That discovery led the city health department to send out an alert to programs that serve drug users so they would know how to handle it. But the first priority is to inform individuals about what they're taking. Estrada recalled testing a bag of cocaine and finding that it was mixed with a pain reliever that has been outlawed in the U.S. because it's associated with kidney disease. She said the client already had kidney problems and was open to talking about their drug use.

ESTRADA: So being able to have that more in-depth conversation about, like, their long-term health goals and potentially changing the supply or things like that.

LEWIS: Studies of similar programs show that when someone finds out their drugs contain something unexpected, they're more likely to use less of it or change their behavior in some other way rather than throw the drugs out. But these programs can still play a role in making drug use safer. Terrence Jones, who works at OnPoint NYC, said even dealers have used the service on occasion.

TERRENCE JONES: I think people have just this notion that home drug dealers don't care. Drug dealers are trying to get money. They ain't trying to go to jail for homicide, you know what I'm saying?

LEWIS: Drug checking programs using sophisticated technology have recently started popping up in other parts of the U.S., including Massachusetts and North Carolina. Sheila Vakharia of the national Drug Policy Alliance said the biggest barriers to launching more of these programs are time and money. The machines used in New York cost about $40,000 and require significant training to use. But she also worried they could eventually face the type of backlash that has hampered some other harm reduction services, such as syringe exchanges.

SHEILA VAKHARIA: There are a lot of really challenging conversations happening, and the backlash is mounting.

LEWIS: But these programs are already starting to give public health officials and drug users themselves valuable insights into the rapidly changing drug supply.

For NPR News, I'm Caroline Lewis in New York.

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