Needs & Modalities of Drug checking for Drug Users: Perspective of People with Lived Experience and Service Providers.

Drug checking (DC) services are incresingly being implemented and made available to tackle the overdose crisis and other drug-related harms. In many settings, we know little of DC services needs. This study aims to fill this gap in evaluating the perspective of individuals and organizations regarding the needs and modalities for the implementation of DC services for people who use drugs in Quebec. Two main objectives were pursued: 1- Identify the aspects that must be considered for potential DC to meet the needs of substance users, and 2- Identify facilitating factors and obstacles to the implementation of potential DC. Both quantitative and qualitative snowball sampling methodologies were employed with three target populations: Gay, bisexual and other men who have sex with men (MSM), People who inject drugs, and Party setting enthusiasts. Thematic qualitative analysis of interviews with service providers (N=59) was conducted by research professionals using NVivo software. In total, 157 people who use drugs filled out a questionnaire. The study underscores critical factors for implementing DC services. A simplified exemption process is vital, alongside recurrent funding for sustainability. Quality assurance, collaborative efforts with police, and targeted promotion by harm reduction organizations are emphasized. In organizing DC services, visibility and geographic coverage are crucial. Locations, including community organizations, festivals, and pharmacies, should offer essential tools. Operational hours aim for accessibility, aligning with organizational schedules. Guidelines for DC service provision prioritize confidentiality, discretion, and free services, integrating with existing services. Target populations include a broad reach, focusing on dealers and MSM. Human resources considerations favor community practitionners for analyses. Result types and delivery methods prioritize substance identification, quantity detection, and timely results. In-person and text message deliveries cater to diverse preferences. Lastly, data collected should be publicly disseminated, preserving anonymity. Results should be interpreted considering the time elapsed since data collection and the impact of the COVID-19 pandemic. The advisory committee couldn't be re-engaged for result validation. The survey analysis treated environments as mutually exclusive, and participants were categorized post hoc based on consumption and sexuality responses. Interviews were solely conducted with intervenors and managers, lacking perspectives from substance consumers. Including consumer interviews would have enhanced the study's validity. Interviews with managers and intervenors were limited to specific regions, neglecting vast and sparsely populated areas. For Party settings and MSM contexts, interview organizations were identified from two sources: co-researchers and service providers. This study has important public health implications for the implementation of DC services.