'It’s not going to be a one size fits all': a qualitative exploration of the potential utility of three drug checking service models in Scotland

Abstract

Background Scotland currently has the highest rates of drug-related deaths in Europe, so drug checking services are being explored due to their potential role in reducing these deaths and related harms. Drug checking services allow individuals to submit presumed psychoactive drug samples for analysis, and then receive individualised feedback and counselling. This paper explores participants’ views on the advantages and challenges of three hypothetical service models, to inform future service delivery in Scotland. Methods Semi-structured interviews were conducted with 43 people: 27 professional stakeholders, 11 people with experience of drug use, and five family members across three cities. Vignettes were used to provide short descriptions of three hypothetical service models during the interviews. Interviews were audio-recorded, transcribed and analysed using thematic analysis. Results Participants identified advantages and challenges for each of the three potential service models. The third sector (not-for-profit) model was favoured overall by participants, and the NHS substance use treatment service was the least popular. Participants also noted that multiple drug checking sites within one city, along with outreach models would be advantageous, to meet the diverse needs of different groups of people who use drugs. Conclusions Drug checking services need to be tailored to local context and needs, with a range of service models being possible, in order to meet the needs of a heterogeneous group of people who use drugs. Addressing issues around stigma, accessibility, and concerns about the potential impact of accessing drug checking on access to and outcomes of drug treatment, are essential for successful service delivery.

Planning and implementing community-based drug checking services in Scotland: a qualitative exploration using the consolidated framework for implementation research

“…Demographic details are presented in Table 1 . Further detail on participant demographics has been reported elsewhere [ 45 ].…”

“…Additionally, the suitability of a site was said to differ according to the demographic/target population which the service aims to attract. See paper published from the same data set for extensive discussion of such issues [ 45 ]. Scale of service (adaptable) Participants noted that the scale of the service may vary, describing potential for drug checking across numerous sites and outreach checking or sample collection See paper published from the same data set for extensive discussion of such issues [ 45 ].…”

“… See paper published from the same data set for extensive discussion of such issues [ 45 ]. Scale of service (adaptable) Participants noted that the scale of the service may vary, describing potential for drug checking across numerous sites and outreach checking or sample collection See paper published from the same data set for extensive discussion of such issues [ 45 ]. Confirmatory testing options (adaptable) Discussions with local implementation groups and key stakeholders highlighted the potential for individuals to be offered more detailed results through confirmatory lab-based testing, meaning these more detailed results would be available within a longer period of time.…”

“…For professional stakeholders, participants held a range of roles, including both managerial and frontline, across a variety of organisations. Recruitment methods and processes have been described in detail elsewhere [ 45 ].…”

Recommendations from people who use drugs in Philadelphia, PA about structuring point-of-care drug checking

“…Similar to findings from a recent scoping review and two formative studies, participants in this study named convenient locations and hours of operation, along with privacy, as key considerations for a person-centered intervention [ 11 , 27 ]. The desire to have a service operated through a trusted harm reduction partner, especially if staffed by people with lived and living experiences of drug use, is noted in some qualitative studies with potential service consumers in Scotland and service providers in the United States [ 7 , 12 ].…”