Shifting Perspectives: Harm Reduction Staff Perceptions of Drug Checking Implementation

BACKGROUND: As the overdose crisis continues to devastate communities, expanding access to harm reduction services, such as drug checking, is essential. Drug checking services (DCS) enable people who use drugs (PWUD) to identify the likely active ingredients within their substances, supporting safer use and reducing overdose risk. However, implementing DCS in community settings may encounter barriers such as stigma, legal ambiguity, and organizational constraints. This study examines harm reduction staff perspectives on the implementation and delivery of a community-based DCS program in Michigan. METHODS: This study explored the perceptions of staff from a harm reduction organization before and after implementing Michigan's first community-based DCS using Fourier-Transform Infrared spectroscopy. Six focus groups, each composed of 2 to 5 staff members, were conducted before and after implementing DCS. Rapid qualitative methods, informed by the Consolidated Framework for Implementation Research, were used for analysis. RESULTS: Prior to implementation, staff anticipated that DCS would empower PWUD and provide crucial drug supply information to communities. Staff also believed that strong relationships with PWUD and effective service integration would facilitate uptake. Post-implementation, staff noted there was considerable engagement with DCS among PWUD, enhanced by dissemination via peer networks and strategic communication approaches. However, staff encountered several barriers to smooth implementation, including ongoing concerns about legal risks and criminalization, as well as organizational capacity constraints. CONCLUSION: Findings from this study highlight the need for legal protections, adequate staffing, and community support to sustain and expand drug checking programs.