What you might do versus what you actually do: measuring participant drug behaviours in drug checking services

Background: CanTEST is the first fixed-site drug checking service in Australia, and one of the first globally to be independently evaluated. Conclusions regarding the effectiveness of services like CanTEST are hampered by an absence of studies on behaviour after the intervention. Most research has collected behavioural data at the time of intervention and may both underestimate the potential benefits of drug-checking services and fail to detect hazards. Follow-up of participants after accessing the intervention can provide important information on both efficacy and safety outcomes. This study has assessed behaviours through a novel follow-up of service users.  

Methods: Data were collected in the first six months of the CanTEST service. A follow-up survey was sent to participants one week subsequent to attending the service. Of the 299 service participants who consented to survey completion in the service, 82 also completed a follow-up survey around two weeks after using the service. While in the service, participants were asked about their intention to use the substance as well as to dispose of the substance. The follow-up survey asked participants if they did take the substance or dispose of it. These behavioural data were also linked to the participant's testing results, showing what they thought the drug was and what substances were identified in chemical analyses. 

Results: Compared with surveys completed in the service where participants were asked about intentions to use the drug, intended quantity of consumption and potential disposal of the drug, follow-up participants reported similar patterns. This suggests that decisions made about use of the tested drug in the service, do not appear to substantially differ in the weeks after attending the service. Trying to obtain more of the drug that was tested was also uncommon for follow-up respondents, which is an important finding given concerns around the potential for drug checking to encourage drug use. Given the small sample size, only limited analyses could be conducted on the retention of information provided in the service. For participants who expected ecstasy/MDMA in their sample, and ecstasy/MDMA was found in the sample, correct recall of information provided about the chemical contents of the substance was high (84%). Accurate recall of drug checking results was lower where there were inconclusive results (25%) and where a drug other than MDMA was detected (and no MDMA) (63%).

Conclusions: In a novel contribution to the field, this evaluation has compared behaviour change stated in the service and through follow-up after the intervention. While still self-reported data, the follow-up data suggests that service participants’ intentions and behaviours are not substantially different. Preliminary analyses of participants' recall of drug testing information suggest that accurate recall is variable. Further research on these communication outcomes are needed.