Intentions, actions and outcomes: A follow up survey on harm reduction practices after using an English festival drug checking service

Background
Drug checking is a health service whose behavioural outcomes have been assessed primarily through reported intentions of service users after receiving healthcare consultations or brief interventions (BIs). This study contributes to the evidence base through utilising a follow-up design to compare outcomes of risk communications on risk management and harm reduction practices both at and after attending drug checking services at three English music festivals in 2017.

Methods
Data were collected and analysed from: (i) 1,482 self-complete questionnaires at sample drop-off; (ii) 1,482 nominated primary service users at 1,482 face-to-face BIs; and (iii) an anonymous online self-report follow-up survey completed by a sub-sample of 130 primary service users (one quarter of legible, functioning email addresses received) followed up three months later. Ten measures (one verified action and nine intentions) were recorded at point of BI and compared with retrospectively reported outcomes and ongoing changes post-BI.

Results
Outcomes at follow-up were correlated with actions and intentions at BI for nine of the ten measures, including over half of service users disposing of samples identified as other than expected and two in five reporting reduced dosage for samples identified as expected. One in five reported alerting their friends to substances of concern.

Conclusion
Event-based drug checking services can access and engage productively with young adults earlier in drug taking careers and not in touch with health services, through tailored polydrug BIs. Rapid identification of substances of concern, dissemination of test results and associated risk communications during and after events through friendship networks, support services and early warning systems suggest that the benefits of drug checking can extend beyond service users and point of BI and can increase strategies and behaviours to reduce drug-related harm such as poisoning and overdose.