Understanding Drug and Alcohol Staff Perspectives on the Barriers and Facilitators to Drug Checking: A Qualitative Study

Introduction

Drug checking (i.e., whereby members of the public submit a drug sample for pharmacological analysis of the drug content) is an evidence-based harm reduction tool. Despite this, the uptake of drug checking services by people who use drugs (PWUD) is often limited across different jurisdictions and types of services, highlighting the need for research examining barriers to drug checking uptake from the perspective of key stakeholders. This qualitative pre-implementation study explored the perspectives of staff employed by alcohol and other drug (AOD) organisations on drug checking, including barriers and facilitators to uptake.

Methods

Interviews were conducted with 23 AOD harm reduction and AOD treatment staff (14 female; mean age = 38.8 years, SD = 8.2). Qualitative data were analysed using iterative categorisation.

Results

Five themes were extracted from the data: (i) PWUD infrequently are most likely to access drug checking; (ii) Confidentiality and anonymity concerns are barriers to drug checking; (iii) Ease of use is integral to drug checking uptake; (iv) Safe, non-judgemental environments that include peer workers are critical; and (v) People who sell drugs will likely use drug checking.

Discussion and Conclusions

The following factors were identified as paramount to the uptake of drug checking services among PWUD: (i) confidentiality; (ii) agreements or memoranda of understanding that protect service clients from over-policing and criminalisation; (iii) mobile and fixed-site services that are accessible to PWUD; and (iv) a non-judgemental and safe environment that includes both health professionals and peer workers with lived experience.