4. A qualitative exploration of three hypothetical models of drug checking service delivery in a Scottish context

Scotland has the highest rates of drug related deaths in Europe. Drug checking, a harm reduction intervention, aims to reduce the risk of harms, including drug related deaths, to people who use drugs. They allow people to have their drugs tested and are then provided with information and advice. There are currently no drug checking services in Scotland. This research explored the suitability of different models of drug checking in a Scottish context. Forty-three semi-structured interviews were conducted with stakeholders across three Scottish cities. Stakeholders comprised of: people who use(d) drugs (PWUD); family members of PWUD; and professional stakeholders (NHS, third sector and police). Participants explored three hypothetical models of drug checking in a Scottish context. ‘Model one’ was a third sector fixed-site service, with a mobile van travelling to different locations; ‘Model two’ was a drug checking service in an NHS substance use service; and ‘Model three’ a drug checking service in a pharmacy. Model one was the most popular model, due to the pre-existing trust which PWUD often have with third-sector organisations. A mobile drug checking van was seen as a way of reaching PWUD who would not access fixed site services. However, participants acknowledged complex legal issues around the mobile aspect of the model. Model three was also a popular option due to pre-existing engagement by people accessing other harm reduction services. However, participants noted significant challenges around the space in pharmacies and its suitability for drug checking. Model two was relatively unpopular, due to the mistrust which PWUD often feel towards statutory services, presenting a potential barrier to engagement. However, the specialist staff, links with key services and exiting governance and protocols were all seen as potential advantages of such a setting, which could be drawn on to develop a mixed-model of provision.

This research addressed the knowledge-gap in relation to different models of drug checking and their suitability to different cultural, legal and drug market contexts. It identified potential models of service delivery for Scotland.