Drug safety testing, disposals and dealing in an English field: Exploring the operational and behavioural outcomes of the UK’s first onsite ‘drug checking’ service

Abstract

Background In a year when UK drug-related deaths and festival drug-related deaths reached their highest on record, a pilot festival drug safety testing service was introduced with the aim of reducing drugrelated harm. This paper describes the operational and behavioural outcomes of this pilot and explores the relationship between drug use, supply and policing within festival grounds. Methods Chemists in a temporary laboratory analysed 247 substances submitted by the public to a free, confidential testing service across four days at a UK festival in July 2016. Test results were returned to service users embedded in 230 healthcare consultations delivered to approximately 900 festivalgoers (one in five drug using festival-goers) that included harm reduction advice and the opportunity to use a disposal service for further substances of concern. Consultation data were collected at point of care, matched with test results, coded and analysed using SPSS. Results Test results revealed that one in five substances was not as sold or acquired. One in five service users utilised the disposal service for further substances of concern in their possession and another one in six moderated their consumption. Two thirds of those whose sample was missold disposed of further substances, compared with under one in ten whose sample was as sold. Service users who acquired substances onsite at the festival were more than twice as likely to have been missold them as those acquired offsite, were nearly twice as likely to use the disposal service and were on average two years younger. Women were more likely to be using the drug for the first time and more likely to use the disposal service. Test results were shared with emergency services; alerts issued across site and an unanticipated feedback loop occurred to some drug suppliers. Conclusion This pilot suggests that festival-goers engage productively with onsite drug safety testing services when given the opportunity, such services can access harder-to-reach and new user groups and can play a part in reducing drug-related harm by identifying and informing service users, emergency services and offsite drug using communities about substances of concern. Disposals to the testing service for onward police destruction provide an externally corroborated measure of impact, reducing harm to the individual and others by removing such substances from site. Evidence of differential dealing onsite and its potential negative consequences has implications for future research and policing.

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

“…Drug safety testing disposal rates vary widely depending on composition profiles and adulteration rates identified by forensic analyses, with a review suggesting that disposal rates for testing services ranged from 4–76% and subsequent studies suggesting that the range is even wider. Furthermore, distinctions have been made between intended disposals, actual disposals to a testing service, and verified disposals to an external agency . For example, a Portuguese festival testing service found that almost all service users intended not to take a substance when contents were identified as other than expected (94.3%, n = 86), whereas almost all intended to take it when as expected (98%, n = 370) .…”

“…A New Zealand festival testing service survey of 288 respondents found that 62% intended not to take the substance when it was other than expected . The UK's first pilot in 2016 found that over 3/4 (77.8%) of service users whose sample was identified as other than expected intended not to take the substance, with 85.7% of these handing over further substances to the testing service for onwards police destruction …”

“…Along with disposals, other micro–level harm reduction outcomes from drug safety testing include reported intentions to lower dosage, to take over an extended time period, to take more care in mixing substances, and to alert friends and acquaintances . 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.…”

“…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 …”

Testing of illicit drugs in the Netherlands could be a model for the UK

“…Chris Ford, clinical director of International Doctors for Healthier Drug Policies and for 30 years a London GP, argues that the existing evidence in the UK and internationally suggests that testing policies don’t encourage drug use but do reduce drug related harms, such as those from contaminants, and that they save lives by reducing overdoses 67. She believes that drug testing is a very useful strategy for harm reduction which, if introduced in the UK, would “categorically save lives.”…”