Feasibility, acceptability, and impacts of a drug checking service within a supervised consumption site in Sydney, Australia

Background Research on drug checking services co-located within supervised consumption sites is limited. This multi-method study investigated the feasibility, acceptability and impacts of operating drug checking within the Uniting Medically Supervised Injecting Centre (MSIC), Sydney, Australia. Methods Feasibility was assessed using documentation of approval processes and requirements, on-site chemical analysis, and off-site confirmatory testing. Acceptability was measured using client uptake rate and surveys. Impact was assessed via self-reported intended behaviours captured through surveys and case notes. Results Following delays related to insurance, during 6 months in 2024, 65 people (74% male, median age 45 years) used the drug checking service, comprising 25% of the 256 MSIC clients on-site during drug checking service operation. On-site testing found that 61 of 77 samples contained only the expected substance, 11 contained the expected substance plus additional substance/s and 5 contained only unexpected substance/s. In seven samples, on-site results differed from off-site confirmatory analysis. For most samples (79%), participants reported having tried some of the batch prior to testing. While participants reported not having any more left following testing for 24% of the samples, for two thirds (68%) participants reported that they intended to use the drugs, including 5 who would use less and 6 who would carry naloxone. Almost half of participants (42%) sought further information about drug treatment and 20% were directly referred on. Conclusion These findings provide groundwork for the implementation of future drug checking services that are considered acceptable, trustworthy, and responsive to the needs of people who inject drugs.