NorWest CHC Case Study

About NorWest CHC

NorWest Community Health Centre delivers primary health care and health promotion programs to northwestern Ontario communities. Path 525 is a Consumption and Treatment Service (CTS) located at their Thunder Bay location. The CTS offers harm reduction education, supplies, overdose response, and drug consumption supervision by experienced CTS staff, including Registered Nurses.

The Northwestern Ontario drug supply, like most of North America, has grown more deadly over time. New additives like benzodiazepines and xylazine are the primary causes of increased overdoses due to opioid use. In 2022 there were 114 suspected drug-related deaths in Thunder Bay District Health Unit. Over the past few years, alongside drug-related deaths, reported overdoses have also climbed. At Path 525, zero deaths due to overdoses have occurred, a testament to the effectiveness of CTSs.

Amplifi ID

Amplifi ID is a point of care drug checking device that provides detailed breakdowns of sample components in 10 minutes or less. The device utilizes Raman spectroscopy to generate a “chemical fingerprint” of a sample and then uses machine learning models to identify the components of the drug mixture.

Amplifi ID’s software and sampling workflow has been designed to be easy to use, requiring only 3 hours of training to start testing. The results are delivered in plain language, removing the need for operator interpretation. The combination of bulk and trace scan provide a comprehensive method that can detect most high importance drugs and cutting agents at relevant concentrations. The detection capabilities of Amplifi ID are tied to the software which is updated regularly to respond to the shifting drug landscape.

NorWest Drug Checking Service

Prior to using the Amplifi ID, NorWest CHC had limited access to drug checking or information on the local drug supply. Test strips were used and distributed to clients to detect the presence of fentanyl, but the limited information and difficulty with result interpretation quickly led to the program being scaled down. The only access to detailed information on the local drug landscape was the toxicology data from coroner’s reports. These typically were not made available until weeks after a drug-related death and could not confirm if a mix of substances was from a single sample or multiple sources.

Impact of Amplifi ID

In August of 2022, Path 525 adopted the Amplifi ID device to implement a drug checking service. Since introducing drug checking, additional community members have accessed the site who had previously not used Path 525's services.

In October of 2022, Path 525 started tracking unique clients visiting the service. The number of unique clients that use the service has increased by over 300%. The frequency of drug checking has also increased, from 17 to 74 per month, attesting to the high demand for drug checking in the community. To help reach additional community members, NorWest CHC offers extended drug checking hours on Thursdays, after Path 525 has closed.

Site staff have observed and recorded notable changes in client behavior upon receiving drug checking results on their sample. This includes lowering the dosage they take which reduces the chance of an overdose.

The information that Amplifi ID provides has enabled Path 525 staff to better inform clients about the noteworthy substances in their sample. “It allows us to create awareness and also to specify substances in the drug alerts we send out from onsite overdoses. It also creates a great learning opportunity for clients. For example, when we see extreme/prolonged sedation from using fentanyl - it often comes back with benzodiazepine as an unexpected substance which makes sense of the sedation we see.” With test results happening in real time, Path 525 has also been able to rapidly issue alerts pertaining to particularly noteworthy drug samples that could pose a threat to the community.

Amplifi ID is able to provide overviews of the drug supply in more ways than one. Tracking presumptions (expected drug) can provide insights into the most commonly used drugs in the community. Fentanyl, methamphetamine and cocaine make up the majority of samples tested.

Conclusion

The overdose crisis is continuing to worsen with new and increasingly dangerous compounds being introduced into the drug supply. Prior to implementing drug checking, NorWest CHC was operating with limited information on what their clients were consuming.

Since implementing Amplifi ID, Path 525 has seen an increase in community engagement, with unique monthly clients rising by over 200%. "We have community members accessing the sites for drug checking services who have not accessed our site for consumption before. We are then able to offer additional wrap-around services to them." The drug checking results from Amplifi ID has allowed Path 525 to better understand their local drug supply to better educate and care for their clients.