Fostering Community: A Mixed Method Analysis of Kosmicare's Mobile Drug Checking Service in Lisbon, Portugal

Since 2019, Kosmicare has been at the forefront of addressing drug-related issues in Lisbon, Portugal, through its fixed Drug Checking Service (DCS). While successful in serving the middle- to high-class demographic, a noticeable gap existed in reaching the more vulnerable populations. In response to the global opioid crisis and the emergence of synthetic opioids in Europe, Kosmicare initiated a pioneering Mobile Drug Checking Service, operating from January to September 2022. A thorough needs assessment was conducted with PWUD, outreach workers, and community leaders. The necessity for a non-destructive analytical technique and providing the service at locations where people buy and use drugs, as well as integration with other community responses, emerged during the needs assessment.  Kosmicare's innovative pilot project involved partnerships with state and civil society organisations and a university. The mobile DCS operated weekly, strategically aligning with safe consumption and community spaces frequented by PWUD. To enhance its impact, Kosmicare facilitated the creation of a peer group, engaging individuals in various project activities based on their preferences and providing compensation for their contributions.

The project's outcomes were assessed through a mixed-methods evaluation, including surveys with service users and outreach workers, focus groups with peers, and interviews with neighbours and community leaders. 

The service reached over 500 people who use drugs (PWUD), mainly heroin, smoked cocaine and alcohol and facing severe social and economic vulnerabilities. Trained 120 outreach workers and health professionals and engaged over 50 residents in project activities

Results indicated a significant reduction in tensions between local communities and PWUD. The shared activities fostered recognition and belonging and strengthened peer social networks, supporting a culture of care in these marginalised territories.

The project successfully established a crucial link between its users, conventional health and social services, and other community resources. It promotes market monitoring and provides accurate information to design better responses for PWUD.

 Furthermore, the community-driven initiatives, such as neighbourhood clean-ups and assemblies, demonstrated tangible improvements, showcasing the project's broader positive impact. The study concludes that integrating drug-checking services within the community framework can bridge gaps, reduce stigma, and promote collective well-being among people in vulnerable situations.