Acceptability of implementing community-based drug checking services for people who use drugs in three United States cities: Baltimore, Boston and Providence

City checking: Piloting the UK's first community‐based drug safety testing (drug checking) service in 2 city centres

“…Valente and colleagues concluded that community‐based testing with problem drug use, opioid using and lower socio‐economic income groups has “more modest results” than testing in nightlife settings with higher socio‐economic groups engaged in recreational drug use . Sherman and colleagues found that older, homeless and nonwhite drug using groups reported being less likely to use testing services . Community‐based testing may also be more time sensitive to turnaround times: whilst a study of club and festival–goers found that 80% were willing to wait an hour for test results, this may be less attractive to opioid‐using service users anticipating or experiencing withdrawal, for example …”

“…This study supports the work of Valente and colleagues in Europe and Sherman and colleagues in Canada, suggesting that more modest aspirations may be appropriate for community‐based testing compared with event‐based testing, and concludes with a call to take into account different geographical, criminal justice and socio‐cultural contexts in service design, delivery and evaluation. For example, lower disposals at a community testing service could relate to different service user demographics and disparities in the perceived risk of having controlled drugs on one's person in urban and festival settings; retaining little or none of a substance of concern after a negative experience; the just in time purchase and consumption of single doses by lower income and marginalised drug users; or differential intention to consume a substance regardless of test result, particularly if anticipating or experiencing withdrawal.…”

“…Emergent findings also suggest that drug safety testing services may disproportionately attract younger, less experienced and female drug users and that they are more likely to engage positively in harm reduction behaviours afterwards. Conversely, engagement and outcomes may be lower for those with longer histories of drug use, higher scores on sensation seeking scales, previously having engaged with drug treatment services or having witnessed a fatal drugs overdose …”

“…Conversely, engagement and outcomes may be lower for those with longer histories of drug use, higher scores on sensation seeking scales, previously having engaged with drug treatment services or having witnessed a fatal drugs overdose. 22,23,30,38,39 The temporal and geographical distinctiveness of outdoor music festivals combined with onsite paramedical, welfare and security services have led them to be characterised as temporary autonomous zones 40 and have facilitated innovative local policy initiatives in areas such as policing, health, welfare and the environment. In UK music festivals, this included a drug policy shift from zero tolerance to the 3Ps (prevent, pursue, protect) from 2016 onwards, in parallel with and supporting the introduction of onsite drug safety testing.…”

“…35 Sherman and colleagues found that older, homeless and nonwhite drug using groups reported being less likely to use testing services. 23 Community-based testing may also be more time sensitive to turnaround times: whilst a study of club and festivalgoers found that 80% were willing to wait an hour for test results, this may be less attractive to opioid-using service users anticipating or experiencing withdrawal, for example. 47…”