BACKGROUND: Research on drug checking services co-located within supervised consumption sites is limited. This multi-method study investigated the feasibility, acceptability and impacts of operating drug checking within the Uniting Medically Supervised Injecting Centre (MSIC), Sydney, Australia.

METHODS: Feasibility was assessed using documentation of approval processes and requirements, on-site chemical analysis, and off-site confirmatory testing. Acceptability was measured using client uptake rate and surveys. Impact was assessed via self-reported intended behaviours captured through surveys and case notes.

RESULTS: Following delays related to insurance, during 6 months in 2024, 65 people (74% male, median age 45 years) used the drug checking service, comprising 25% of the 256 MSIC clients on-site during drug checking service operation. On-site testing found that 61 of 77 samples contained only the expected substance, 11 contained the expected substance plus additional substance/s and 5 contained only unexpected substance/s. In seven samples, on-site results differed from off-site confirmatory analysis. For most samples (79%), participants reported having tried some of the batch prior to testing. While participants reported not having any more left following testing for 24% of the samples, for two thirds (68%) participants reported that they intended to use the drugs, including 5 who would use less and 6 who would carry naloxone. Almost half of participants (42%) sought further information about drug treatment and 20% were directly referred on.

CONCLUSION: These findings provide groundwork for the implementation of future drug checking services that are considered acceptable, trustworthy, and responsive to the needs of people who inject drugs.