Syringe residue analysis reveals polydrug use patterns and emerging trends in Barcelona
Abstract
Background: Syringe residue analysis is an objective method to monitor substances used by people who inject drugs (PWID), introduced by the ESCAPE network in 2017. Within the SYDRES project (2023–2025), it was applied in Barcelona to characterize consumption patterns, detect emerging substances, and complement surveillance systems
Methods: A total of 304 used syringes were collected from harm reduction services (supervised consumption rooms and outreach programs). Samples were analyzed using liquid chromatography–high-resolution mass spectrometry following ESCAPE protocols. A spectral library (>200 compounds) enabled identification of drugs, metabolites, and adulterants. Sociodemographic (self-reported gender) and contextual data (including chemsex) were included
Results: Cocaine was the most frequently detected substance (88%), often combined with heroin and other opioids, indicating widespread polydrug use. Around two-thirds of samples contained ≥3 substances. Gender differences were observed: samples from women showed higher prevalence of amphetamines and more complex combinations, while those from men more often contained cocaine–opioid combinations (p = 0.017). In chemsex-related samples, stimulants predominated, especially amphetamines and synthetic cathinones. Temporal trends suggested a decrease in opioid-based combinations and an increase in stimulant-related patterns in 2025. Adulterants such as piracetam and dextromethorphan were also identified
Conclusions: Syringe residue analysis confirms the central role of cocaine and highlights polydrug use as a key feature of injecting practices in Barcelona. It enables early detection of emerging substances and evolving patterns, including chemsex-related use. Incorporating gender perspectives and strengthening harm reduction responses are essential. This approach is a valuable tool for public health surveillance
Key messages: • Syringe residue analysis detects emerging drugs and widespread polydrug use, strengthening rapid public health surveillance and early warning systems.
• Integrating syringe monitoring into harm reduction improves early alerts and supports gender-responsive responses.
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BibTeX
@article{barbaglia2026syringe,
title = {{Syringe residue analysis reveals polydrug use patterns and emerging trends in Barcelona}},
author = {MG Barbaglia and A Garrido and JI Mestre-Pintó and C Pernas-Fraguela and X Ortiz and N Cabrera and S Aguelo and M González and J Netchaiev Rodríguez de Cárdena and RM Montes},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.235},
url = {https://doi.org/10.1093/eurpub/ckag169.235},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Syringe residue analysis reveals polydrug use patterns and emerging trends in Barcelona
AU - MG Barbaglia
AU - A Garrido
AU - JI Mestre-Pintó
AU - C Pernas-Fraguela
AU - X Ortiz
AU - N Cabrera
AU - S Aguelo
AU - M González
AU - J Netchaiev Rodríguez de Cárdena
AU - RM Montes
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.235
UR - https://doi.org/10.1093/eurpub/ckag169.235
AB - Background: Syringe residue analysis is an objective method to monitor substances used by people who inject drugs (PWID), introduced by the ESCAPE network in 2017. Within the SYDRES project (2023–2025), it was applied in Barcelona to characterize consumption patterns, detect emerging substances, and complement surveillance systems Methods: A total of 304 used syringes were collected from harm reduction services (supervised consumption rooms and outreach programs). Samples were analyzed using liquid chromatography–high-resolution mass spectrometry following ESCAPE protocols. A spectral library (>200 compounds) enabled identification of drugs, metabolites, and adulterants. Sociodemographic (self-reported gender) and contextual data (including chemsex) were included Results: Cocaine was the most frequently detected substance (88%), often combined with heroin and other opioids, indicating widespread polydrug use. Around two-thirds of samples contained ≥3 substances. Gender differences were observed: samples from women showed higher prevalence of amphetamines and more complex combinations, while those from men more often contained cocaine–opioid combinations (p = 0.017). In chemsex-related samples, stimulants predominated, especially amphetamines and synthetic cathinones. Temporal trends suggested a decrease in opioid-based combinations and an increase in stimulant-related patterns in 2025. Adulterants such as piracetam and dextromethorphan were also identified Conclusions: Syringe residue analysis confirms the central role of cocaine and highlights polydrug use as a key feature of injecting practices in Barcelona. It enables early detection of emerging substances and evolving patterns, including chemsex-related use. Incorporating gender perspectives and strengthening harm reduction responses are essential. This approach is a valuable tool for public health surveillance Key messages: • Syringe residue analysis detects emerging drugs and widespread polydrug use, strengthening rapid public health surveillance and early warning systems. • Integrating syringe monitoring into harm reduction improves early alerts and supports gender-responsive responses.
SN - 1101-1262
SN - 1464-360X
ER -