Real time, on-site drug checking in low-threshold housing communities

Area of Science:

• Public Health
• Substance Use Research
• Harm Reduction

Background:

• Boston implemented harm reduction housing (HRH) to increase housing options and reduce overdose risk.
• HRH residents lack access to drug checking services, despite potential benefits for identifying adulterants and monitoring supply shifts.
• A pilot study integrated real-time drug checking into HRH sites, leveraging the Massachusetts Drug Supply Data Stream.

Purpose of the Study:

• To pilot real-time, on-site drug checking services within harm reduction housing (HRH) programs in Boston.
• To assess resident engagement and the utility of drug checking in identifying drug supply changes and informing harm reduction strategies.
• To explore the role of drug checking in complementing existing harm reduction services in transitional housing.

Main Methods:

• Administered surveys to 106 HRH residents and conducted longitudinal interviews with 28 participants.
• Implemented real-time drug checking using FTIR spectroscopy and immunoassay test strips at three HRH sites.
• Analyzed survey data, interview transcripts, and field notes to evaluate service provision and resident experiences.

Main Results:

• Fifty-five drug samples were collected across nine site visits over three months, indicating considerable resident engagement.
• Drug checking services increased xylazine awareness and provided opportunities to discuss concerns about the evolving drug market.
• Residents confirmed the need for on-site drug checking, expressing consensus on concerns regarding the local drug supply.

Conclusions:

• Real-time, on-site drug checking is a promising harm reduction strategy for low-barrier housing programs.
• This approach effectively detects shifts in the drug supply and complements transitional housing interventions.
• Residents utilize drug checking services to influence personal, community, and market-level norms regarding substance use.