“Harm reduction” means different things to different people. Matt Bowden, for example, believes himself to be a pioneering figure in the field for his work developing safer chemicals in New Zealand. Even the Dark Web fentanyls dealer U4IA embraces the harm-reduction mantle, claiming that his cheaper products benefit society at large by reducing his clients’ costs and making it less likely they will have to rob or steal to feed their addictions.
I asked those I spoke with—including academics, activists, substance-abuse counselors, elected officials, law enforcement officers, drug manufacturers, traffickers, psychonauts, and chemists—what they believed to be the best methods for stopping NPS overdoses and limiting the deadly march of drugs like fentanyl. The majority spoke to the necessity of harm reduction, including a surprising number of law enforcement officers and drug dealers alike. Very few were prohibitionists; almost all had their eyes open and agreed that limiting the negative effects of NPS rather than imprisoning their users was the most important goal.
No matter how harm reduction is defined, it springs from the understanding that preventing the use of drugs is impossible and that making sure they are used as safely as possible is a necessity.
Most harm-reduction policies seem like common sense—and an easy way to save lives—but many governments don’t see them in that light. In November 2018, a Russian harm-reduction organization, the Andrey Rylkov Foundation—which provides clean needles and other services—was ordered by a court in Moscow to pay a fine of 800,000 rubles (US$12,000) for an article advising synthetic-cathinone users about how to take the drug safely.
In the United States, with the War on Drugs still looming large, few harm-reduction tactics have been attempted on a widespread scale. Organizations like DanceSafe and Drug Policy Alliance, while effective, operate on extremely limited budgets. In Europe, however, a number of efforts have made breakthroughs, including government programs providing heroin directly to addicted users. In Switzerland, for example, users can receive prescription-quality heroin from a clinic for free, as long as they are eighteen, have been addicted for two years, and have failed at more conventional treatments. They must use the heroin in the clinic, rather than taking it with them.
Taken in the proper quantity, heroin itself usually does not kill people—rather the killers are adulterants like fentanyl or dirty needles or other problems resulting from behaviors while high or violence resulting from street life. The Swiss program has led to drops in deaths, drug dealing, and crime in the country—since enrolled users no longer have to steal or deal to pay for their habits. Those in the heroin-prescription program committed 55 percent fewer auto thefts and 80 percent fewer burglaries and muggings, and were almost 95 percent less likely to sell drugs. This program has also been successful in the Netherlands, where heroin use by people under forty has fallen dramatically. It even has precedent in the United States: when the government banned heroin in 1914, the law still permitted doctors to administer it to people who were addicted; only after doctors were forced to stop doing so did crime rates and health problems begin to spiral upward.
In Europe, a number of groups are doing cutting-edge work in harm reduction, including the Netherlands’ Drug Information and Monitoring System, Switzerland’s Safer NightLife, and the Austrian organization CheckIt!, which boasts some of the most sophisticated drug-checking technology in the world. These programs provide a wide variety of services, including educating users about new drugs; providing clean needles, contraception, water, and other safety supplies; and sending out updates about adulterated drugs being sold locally, often in real time.
Spain in particular stands out for its creative, forward-thinking measures to stop drug overdoses, which combine government efforts with private ones. For instance, a Spanish harm-reduction group called Energy Control is allowed to order new drugs from vendors on the Dark Web for the purposes of analyzing them and understanding their potential to cause problems. In fact, when Adam Auctor and Bunk Police need to confirm that their sample of a new drug from China is “pure,” they send it to Energy Control.
“Energy Control is the best in the world,” according to Auctor. “They’re what DanceSafe could be if they didn’t have all kinds of regulations covering them.”
The scope of Energy Control’s operations, and what the group is legally permitted to do, is staggering. On an annual budget of 640,000 euros (US$720,000)—about 60 percent of which comes from regional and national government coffers, with most of the rest raised by the organization itself—it provides counsel and information to drug users and those who are curious. Working with state-of-the-art mass-spectrometry and gas-spectrometry equipment, the organization will test anyone’s drugs. The service is free for Spanish nationals. Others can pay for it, even Dark Web vendors, who are known to send in their wares and then post Energy Control’s analyses showing the purity on their vendor sites. The only comparable system is the website Ecstasydata.org, run by American drug-information database Erowid, which the DEA permits to receive drugs in the mail, test them, and post the results. But Energy Control is better funded and, according to the organization, processes results faster.
Energy Control’s outreach prowess is on display each year at the Own Spirit music festival, set in the Spanish countryside. Located an hour and a half from Barcelona by train and nestled in a rocky, forested area surrounded by mountains, the event is small by mega-rave standards, drawing perhaps a few thousand people. There are no superstar DJs or major corporate sponsorships. You can purchase beer only if you’ve got a reusable cup for it.
Occasional cops wander the premises. But because Spain—like its neighbor Portugal—has largely decriminalized recreational drugs, attendees are unafraid to light up a joint or deal chemicals. LSD is sold openly, ten euros per drop. Nobody seems out of control. However, nobody is assured that what’s purported to be LSD actually is LSD, and that’s where Energy Control comes in. For the festival’s April 2017 iteration, the group arrived just before sundown, setting up its black tent near a main stage. ENJOY THE PARTY, read its banner, in English, with the N composed of images of tablets, pills, and blotter papers.
The Energy Control crew attends parties or concerts every week. This night, as the festival began, it numbered about ten people, including both staff and volunteers. The drug checking was helmed by Energy Control’s twenty-six-year-old lab technician, Cristina Gil, a chemical analyst who had traded her white lab coat for a hoop through her nose and gray lipstick. She’s equally at home, she admitted, scrolling through gas-chromatography-analysis graphs at the lab and feeling the bass in her face. Of course, said bass doesn’t make for ideal lab conditions, but the group had jury-rigged a serviceable setup at the back of the tent, with a lab station made from a folding table, lit by floodlights powered by extension cords.
Almost immediately, people started queuing up. One young woman, wearing green and orange makeup, arrived with a small metal tin of various substances, asking for a test of what she believed was speed. She was followed by a British guy in a bright orange winter hat, who had purchased two ecstasy pills on the festival grounds. One was silver, while the other was stamped with the logo of Chupa Chups—a brand of Spanish lollipop. Both attendees were given numbers and told to return in about an hour for their results. A thirty-year-old man from France, wearing gauged earrings and a hooded sweatshirt, approached the tent cautiously, first asking whether the testing was authorized. Upon assurance, he removed three stashes from his camouflage-printed fanny pack: a dropper bottle of LSD, ketamine powder, and some cocaine. He was a dealer, he sheepishly admitted, adding that he was seeking Energy Control’s stamp of approval to help sell his wares at the festival. This revelation didn’t faze Energy Control’s staff. “As long as the overall purity and information is increasing, it’s a benefit,” said Rafael Sacramento, who was coordinating the group.
Energy Control used a technique called thin-layer chromatography. A volunteer helped scrape off a tiny fraction of a pill—or spooned a bit of the powder—into a small vial. Gil or her colleague then added a solvent, shook it up, and placed drops from the mixture onto a testing strip, followed by a small bit of the reagent. After the combined liquid spread across the test strip, they compared it with samples brought with them, of known drugs like MDMA, cocaine, amphetamine, and ketamine; and a host of adulterants, including N-bombs. Different drugs present different colors; MDMA turns dark purple, but some others are hard to track with the naked eye—for such cases Gil strapped on eye-protecting sunglasses to examine the samples under a UV light. There are limits to this type of testing, and she couldn’t identify everything. “In that case it’s better not to take it, since nobody knows what could happen,” she advised.
Later in the evening, the handwritten results of the first ten tests were posted to the tent’s wall, drawing an anxious crowd. The woman with the green and orange makeup had amphetamine, as she expected, although it was cut with caffeine, which is common. The British guy’s ecstasy pills were indeed MDMA. The dosages for these particular types of pills are often very strong, however, so Sacramento cautioned he might not want to take an entire pill at once. The drug dealer from France had legitimate LSD and ketamine. His cocaine, however, was cut with levamisole, an animal dewormer used by veterinarians, which produces an effect that weakly mimics cocaine. Relieved, he headed off into the night to hawk his wares.
“Everything is pretty normal,” Gil concluded, after completing a few more rounds of testing. “But that’s good.”
“Pretty normal” is typical at Spanish music festivals, where the ecstasy tends to be genuine. In fact, in an Energy Control study, about 80 percent of samples analyzed contained only MDMA. Though DanceSafe’s American study, by contrast, found only 60 percent of samples had any MDMA, and Bunk Police found even less than that.
With fewer large-scale safrole oil busts in recent years, and the emergence of a viable synthetic precursor called PMK-glycidate, which is often made in China, the pure-ecstasy supply has rebounded. Though American dealers still commonly attempt to pass off adulterated ecstasy, this is much less common in Spain, and the same is also true with LSD. Though Energy Control has seen some adulteration from drugs like 25I-NBOMe, aka N-bombs, those instances have been decreasing as well. “One of the reasons is that we have several drug-checking services around the country,” said Mireia Ventura, Energy Control’s coordinator of drug-checking services. “It’s the same in other countries that have them. It’s a type of quality control. We are totally sure that we have some influence in the market.” Logically, drug dealers are less likely to sell drugs that are filled with adulterants if they know their customers will be checking them.
Though many consider Dark Web drug markets a dangerous gathering place for the deviant and immoral, Ventura feels differently, noting that the marketplaces’ vendor ratings also serve as a form of quality control, as bad Dark Web reviews will quickly have an effect. Energy Control also works with a Madrid doctor named Fernando Caudevilla, who, as “DoctorX,” for years on various Dark Web sites has been candidly answering questions on recreational substances, ranging from how long MDMA is detectable in your system for a drug test (forty-eight to seventy-two hours) to how to store one’s amphetamines (“in a dry, dark place, out of direct sunlight”) and whether or not taking Advil will counteract memory loss from smoking too much marijuana (it will not).
Energy Control and other harm-reduction organizations believe in candid drug talk. “If you overemphasize the negative effects, they don’t believe you,” said Steve Mueller, director of the Vienna-based CheckIt! program. “We talk about the positives too.”
Though Energy Control can’t provide many statistics to validate its harm-reduction tactics, Spanish authorities believe in the organization’s work. Despite close association with drug users and even dealers, Energy Control isn’t controversial. Part of the reason has been its rapid response to emerging drug crises.
Stamped with the famous S logo and bearing a pink hue, the “Superman” pill was blamed for the deaths of four people in England during late December 2014 and early January, 2015. The users apparently thought it was ecstasy, but the pills were found to contain the toxic knockoff PMMA. The Superman pills continued to circulate, however, making their way around the European continent. Many feared they would continue wreaking havoc.
Nearly a week before the first of the British deaths, however, scientists at a Utrecht laboratory uncovered the actual contents of the pills, which were believed to have been manufactured in the Netherlands. The authorities organized a national, televised alert, which appears to have been successful—no one died in the Netherlands. The relevant English authorities received the information too, but tragically failed to sound the alarm, reportedly because they didn’t think the Superman pills had arrived in England.
Energy Control received the alert through the Trans-European Drug Information project, which pooled information supplied by drug-checking programs all over Europe. Energy Control acted quickly, asking users in its network to bring in for testing any Superman pills they came upon. Dozens did exactly that, and Energy Control determined the batch to indeed be toxic.
It immediately issued a “red warning,” sending out e-mail, Facebook, Twitter, and WhatsApp messages to anyone who might be at risk, targeting university groups, festival owners, hospitals, college students, and others. They also got the word to journalists, and soon stories on these dangerous Superman pills were all over the Internet, TV, and radio. In the end, there were no deaths in Spain, and the pills promptly vanished. “Some dealer was like, ‘Well, we can’t sell these in Spain!’” commented Núria Calzada, Energy Control’s national coordinator.
Since so many NPS—including N-bombs, fentanyl, and the more nefarious ecstasy substitutes—have potentially fatal effects, a key strategy is to convince people not to use them. And this is exactly what they’ve been able to do in Spain. Since Spanish users won’t get busted for using traditional drugs (which tend to be safer than NPS) most choose from among those options. “NPS is not an issue here,” said Mireia Ventura. “Most people prefer classic drugs.”
That’s not to say Spain doesn’t have its issues. It is located on major smuggling routes; cocaine from Colombia and hashish from Morocco have overwhelmed authorities in recent years, and drug traffickers in the southern part of the country have been known to attack police who try to seize their shipments. Rates of cocaine use, and trafficking arrests, have soared. But Spain boasts a very low rate of overdose deaths, only about 1 in 120,000 in 2015 (the most recent year for which statistics were available), one of the lowest rates in the world. That year in the United States, the number was about 1 in 6,100.
As shown by Energy Control and other organizations, some of the best solutions to the NPS crisis are coming out of the rave scene. But many of the services provided by Energy Control are illegal in the United States. Organizations that want to test drugs at raves aren’t showered with government funds—they’re sent home. Right now there doesn’t seem to be much political will to overturn the Rave Act, which threatens promoters of events where drugs are consumed. If the bill were changed, however, big raves would quickly become safer. “I definitely know that if we could do harm reduction, and it was allowed, we would do it,” said promoter Gary Richards, who puts on an enormous annual southern California electronic dance music event called Hard Summer. “I’ve been to other festivals in Canada where they do it, and I know they find all kinds of things in those pills. We would love to be able do that if we’re allowed to, but we can’t.”
The musicians performing at these festivals tend to feel the same way, even those who are sober, like Kaskade, a celebrity DJ who is also a devout Mormon. He emphasizes that these events can be enjoyed by teetotalers, but he’s not deluding himself. “I think a lot of kids are going to take drugs no matter what we say,” he said. “If you’re going to take stuff, have it checked. These guys can check this stuff out to make sure it’s not going to kill you.”
At the very least, just about everyone—from both sides of the political spectrum—agrees that disseminating information about NPS is critical and that users need to understand the dangers of NPS, even compared to traditional drugs. For kids who are experimenting, the educational aspect might be their only protection.
Suburban Dallas, an area where teenagers, including Montana Brown, have died from new drugs, has since found some success by getting the word out about them. Grace Raulston, a substance-abuse counselor from Collin County—which contains a section of Brown’s hometown of Frisco—said that the K2 menace in the area was significantly reduced after an information campaign about synthetic marijuana. “The biggest thing we’re fighting now is education. The majority of people out there—parents especially—do not have any idea the scope of the problem we’re dealing with today,” said Courtney Pero, the narcotics sergeant in nearby Plano, Texas. Parents need to believe that an overdose could happen to their kid, because it can happen to any kid.