A Realist Review of How Community-Based Drug Checking Services Could Be Designed and Implemented to Promote Engagement of People Who Use Drugs



Masterton W, Falzon D, Burton G, Carver H, Wallace B, Aston EV, Sumnall H, Measham F, Gittins R, Craik V, Schofield J, Little S & Parkes T (2022) A Realist Review of How Community-Based Drug Checking Services Could Be Designed and Implemented to Promote Engagement of People Who Use Drugs. International Journal of Environmental Research and Public Health, 19 (19), Art. No.: 11960.

With rising numbers of drug-related deaths in the UK and globally, exploration of interventions that seek to reduce drug-related harm is essential. Drug checking services (DCS) allow people to submit drug samples for chemical analysis and receive feedback about the sample, as well as harm reduction advice. The use of DCS is often linked to festival and/or nightlife settings and to so-called ‘recreational’ drug use, but research has also shown the potential of community-based DCS as an intervention serving more varied demographics of people who use drugs, including more marginalised individuals and those experiencing drug dependence. Whilst there is a growing evidence base on the effectiveness of drug checking as a harm reduction intervention, there is still limited evidence of the underlying mechanisms and processes within DCS which may aid implementation and subsequent engagement of people who use drugs. This presents a challenge to understanding why engagement differs across types of DCS, and how best to develop and deliver services across different contexts and for different populations. To explore the contexts and mechanisms which impact engagement in community-based DCS, a realist review was undertaken to synthesise the international evidence for the delivery and implementation of DCS. There were 133 sources included in the review. From these sources the underlying contexts, mechanisms, and outcomes relating to DCS implementation and engagement were developed and refined into seven programme theories. The findings of this review are theoretically novel and hold practical relevance for the design of DCS, with implications for optimisation, tailoring, and implementing services to reach individuals in different settings.

drug checking; harm reduction; substance use; drug intervention

International Journal of Environmental Research and Public Health: Volume 19, Issue 19

FundersCORRA Foundation
Publication date31/10/2022
Publication date online22/09/2022
Date accepted by journal15/09/2022

People (6)


Doctor Gillian Burton
Doctor Gillian Burton

PhD Researcher, Sociology, Social Policy & Criminology

Dr Hannah Carver
Dr Hannah Carver

Lecturer in Substance Use, Sociology, Social Policy & Criminology

Mr Danilo Falzon
Mr Danilo Falzon

Research Assistant, Faculty of Social Sciences

Dr Wendy Masterton
Dr Wendy Masterton

Lecturer in Criminology, Sociology, Social Policy & Criminology

Professor Tessa Parkes
Professor Tessa Parkes

Professor, Faculty of Social Sciences

Mr Joe Schofield
Mr Joe Schofield

Research Fellow, Faculty of Social Sciences

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