• Services must be designed to first and foremost reduce harms associated with the consumption of drugs obtained through unregulated markets.
• Services should also provide harm reduction benefits to the broader community by generating anonymous real-time data that feeds into an early warning system.

• Services must be inclusive to all community members, recognising the diverse characteristics of people who use drugs. System design should include different ways of servicing populations with varying needs.
• There should be no demographic exclusions to service use, including young people and pregnant people.
• There should be no geographic exclusions to service use. State-wide accessibility should be facilitated with multiple drop-off points.
• To minimise financial barriers, there should be no monetary cost to service users.
• The early warning system should be open, transparent, and publicly available.

• Analytic technology should detect the widest range of drug types possible. This can be achieved by partnering with organisations with existing analytic capability.
• Procedures should facilitate rapid testing, to disseminate timely information to both service users and the early warning system.

• Service users must be anonymous, feel safe, and not be targeted by police.
• Police must play a supportive role by not patrolling surrounding areas of services.

Peer organisations that represent service users should be centred in the planning, design, implementation and evaluation of services and the early warning system.

Drug checking services and the early warning system should be fully evaluated, and their design adjusted in response to evaluation findings.

Globally: A 2022 review of harm reduction services around the world identified the existence of drug checking services in at least 28 countries⁸. In recent years, services have expanded significantly in countries around the world and particularly in North America (e.g. Toronto⁹ and Vancouver¹⁰) in response to soaring overdose rates arising from markets flooded with fentanyl-type substances.

In Australasia: Australia’s experience so far with government-sanctioned drug checking has included fixed-site and mobile drug checking trials in Canberra^11,12, and recently announced approval for drug checking services to be trialled in Queensland¹³. In 2021, New Zealand passed legislation to make drug checking services fully legal, with extensive guidance on suitable service implementation features required to obtain a drug checking license¹⁴. An interim report of the Canberra city-centre fixed-site service pilot has strongly supported its continuation, and development beyond the pilot period¹².

Globally: There is strong evidence that service users adjust their intended behaviour after accessing drug checking services¹⁵. Recent research from the UK¹⁶ and Portugal¹⁷ also demonstrates that service users change their behaviour after accessing drug checking services, particularly when test results are unexpected. Most service users (86% Portugal, 69% UK) who received test results indicating that the drug was different than expected did not go on to consume the substance. About half of service users (50% Portugal, 59% UK) whose test results indicated that their drugs were stronger than expected took a smaller dose than usual.

In Australia: An independent evaluation of Canberra’s mobile drug checking service trial found that all service users who were informed that their sample contained the novel substance n-ethyl-pentylone (an NPS known to have a particularly high-risk profile) discarded the drugs¹¹. The evaluation also found increases in self-reported drug harm reduction knowledge, trust in service providers, and behaviour change consistent with common harm reduction advice.

Early warning systems in action: The Dutch Drugs Information and Monitoring System¹⁸ quickly tailors public warnings to prompt avoidance of high-risk drug samples in the community. For example, in 2014, alerts were rapidly issued advising the public to avoid ‘Superman’ pills that contained an unexpected lethal dose of PMMA. No deaths were recorded in the Netherlands. In neighbouring UK where no warnings were issued, the same tablets were associated with several deaths¹⁹.

Individual harm reduction behaviours reduce individual risk of overdose: At a Canadian drug checking service located at a supervised injecting site, service users who unexpectedly found fentanyl in their drugs were more likely to reduce their dose¹⁰. Those who did reduce their dose were also significantly less likely to overdose.

Drug checking services around the world operate on the basis that drug consumption is never entirely safe or risk-free. However, as evidenced above, drug checking services do create safer conditions under which drugs are taken, by empowering service users with knowledge to make informed decisions. This has been demonstrated to lead to safer decision-making.

Evidence does not support claims that the implementation and availability of drug checking services lead to increased drug use. A recent Australian study²⁰ that surveyed festival-goers about drug checking scenarios found that the existence of a drug checking service (on-site at a festival or in a central fixed-site location) did not increase intention to use ecstasy, for both ecstasy-naive and ecstasy-initiated groups.

Drug checking is aligned with existing and emerging approaches to reducing drug-related harms endorsed by The Victorian Government. In fact, drug checking would work synergistically with existing initiatives that make crucial steps towards using drug content information to reduce harm. For example, the ‘Emerging Drugs Network of Australia – Victoria’ (EDNAV) system²¹ collects clinical and toxicological data from drug-related emergency department presentations. Public drug checking services would improve the efficiency, timeliness and effectiveness of the Victorian Department of Health’s current initiative of distributing drug alerts with information about adulterated substances that have been identified by EDNAV. Drug checking’s overdose prevention focus can also ease pressures on our emergency health system, reducing system burden and improving health outcomes for all Victorians.

Robust political discourse about drug checking has culminated in its public support. The majority of Australians support drug checking, as evidenced in two recent major surveys (the nationally representative ‘2019 Australian Election Study’²² and the Australian Institute of Health and Welfare’s ‘National Drug Strategy Household Survey 2019’²³). Younger people (including age groups with highest rates of use) are even more likely to support drug checking²⁴.