Insights from Drug Checking Programs: Practicing Bootstrap Public Health Whilst Tailoring to Local Drug User Needs.

Area of Science:

• Public Health
• Addiction Medicine
• Community Health

Background:

• The overdose crisis in 2021, exacerbated by COVID-19 pandemic stress and fentanyl proliferation, necessitates innovative harm reduction services.
• Street-based drug checking programs provide crucial information on substance composition, averting accidental overdoses and connecting individuals to treatment.
• Existing harm reduction efforts require enhancement to address the escalating overdose epidemic effectively.

Purpose of the Study:

• To capture service provider perspectives on best practices for community-based drug checking programs.
• To identify facilitators and barriers to implementing and sustaining drug checking initiatives.
• To explore the integration potential of drug checking with other health promotion and harm reduction services.

Main Methods:

• Conducted 11 in-depth interviews with harm reduction service providers from June to November 2022.
• Utilized Zoom for remote interviews lasting 45-60 minutes, with all sessions recorded and transcribed.
• Employed thematic analysis by a team of trained analysts to interpret interview data.

Main Results:

• Key themes include the instability of drug markets and dangerous drug supplies.
• Successful implementation requires dynamic service delivery adapting to community needs.
• Essential elements for sustainability include comprehensive training, capacity building, and integration with existing services.

Conclusions:

• Drug checking programs present a significant opportunity to reduce overdose deaths amidst evolving drug markets.
• Challenges remain in effective implementation and long-term sustainability due to policy contexts and program paradoxes.
• Integrating drug checking services into a broader harm reduction framework is crucial for maximizing impact and scalability.