Who uses drug checking services? Assessing uptake and outcomes at English festivals in 2018

Abstract

Purpose This study aims to assess service user characteristics, uptake and outcomes for drug checking services offered to over 250,000 English festival-goers in summer 2018 and to compare findings with earlier years, wider festival-goers and the general population. Design/methodology/approach A total of 2,672 substances of concern were submitted by the public and tested by chemists in mobile laboratories on 24 show days at seven festivals. Results were embedded in 2,043 individually tailored brief interventions (BI) delivered by health professionals to 4,240 service users. Comparative data were collected through anonymous self-report surveys with 1,291 respondents at five of the same festivals. Findings Three percent of drug-using festival-goers received BI, 95% of whom had not previously accessed health services regarding their alcohol or other drug use. Drug checking service users were significantly more likely to be younger, male and past month polydrug users with a wider range of drugs consumed in the last month compared with the general festival population. For samples matching purchase intent, nearly half intended to reduce dosage, with younger and female service users significantly more likely to reduce dosage. For substances identified as other than expected, nearly two thirds disposed of them. Social implications Festivals are potential sites to deliver innovative health interventions and to monitor their outcomes, reduce the risk of poisoning and overdose, and facilitate access to follow-up support services. Originality/value This study suggests that there is value in event-based services that provide risk reduction communications directly to young adults engaged in higher risk drug use compared with wider event and general populations.

Challenges, policy and politics in drug checking: reflections of the TEDItorial team

“…When tested substances of concern do not match expectations, a robust and growing body of research (Measham, 2019;Valente et al, 2019; for a review, see Giulini et al, 2022;Maghsoudi et al, 2021) finds that service users discard these substances. This finding was replicated in two contributions to this special issue with comparable methods Measham and Simmons, 2022). Furthermore, the effect size, as estimated by a mini-meta-analysis (Goh et al, 2016) of the results of the two concerned studies, is large (r = 0.53) [4], both in an absolute sense (Cohen, 1988) and relative to the median effect size found in behavioural research (Cafri et al, 2010).…”

“…This means that there is a greater chance that harm reduction measures will be implemented immediately. Research also suggests that festivals are sites of additional risk, at least at some English festivals, due to the significantly greater misselling of drugs acquired onsite compared with those acquired offsite (Measham and Simmons, 2022). Moreover, drug checking is not only supported by PWUD but is also actively requested and sometimes even becomes a criterion for festival selection (Measham and Turnbull, 2021).…”

What is drug checking, anyway?

“…Although substances of concern submitted to DCS are of unknown content and a minority may be non-psychoactive (e.g. 7% of substances submitted to UK DCS in 2018, Measham and Simmons, 2022), once confirmed as controlled drugs, the handling of them is prohibited in most parts of the world. A license to handle controlled drugs may be issued by the appropriate authorities to laboratory staff to cover this aspect of the DCS.…”

“…Presently, pills are only one of many forms of drugs present in recreational drug settings, so the term “pill testing” does not accurately describe the testing of drugs in the current context, although the use of the term persists, particularly in Australia (Ritter, 2019). For example, in the UK festival context, ecstasy pills make up about one quarter of submissions to festival DCS (Measham and Simmons, 2022). Even in Australia where the term persists, MDMA is more commonly consumed in capsule form rather than tablet form (Sutherland et al , 2021).…”

“…Although substances of concern submitted to DCS are of unknown content and a minority may be non-psychoactive (e.g. 7% of substances submitted to UK DCS in 2018, Measham and Simmons, 2022), once confirmed as controlled drugs, the handling of them is prohibited in most parts of the world. A license to handle controlled drugs may be issued by the appropriate authorities to laboratory staff to cover this aspect of the DCS. Thirdly, staff delivering consultations may be legally constrained regarding how they frame their harm reduction advice about controlled drugs, appropriate to legislation regarding assisting or abetting a future criminal offence by advising about future drug use. These legal complexities have led to a number of responses by DCS.…”