How can public health alerts help mitigate health risks associated with adulterated or poor-quality heroin in BNSSG?

Funding

BNSSG ICB Research Capability Funding.

What is the research question?

How can public health alerts help mitigate health risks associated with adulterated or poor-quality heroin in BNSSG?

What is the problem?

Illicit drug markets can be unpredictable, with substances varying in strength and quality. Sometimes, harmful substances can be added to batches of street drugs to increase their effects or quantity (a process known as ‘adulteration’). Recently, strong synthetic opioids have been detected in batches of heroin in England, including in the Bristol, North Somerset and South Gloucestershire (BNSSG) region. This means that people who inject drugs (PWID) are at an increased risk of harm because they are often unaware of what substances they are consuming.

Public health officials and drug and alcohol services can issue ‘drug alerts’ – often through posters or on social media – when strong or adulterated substances are identified. These can help warn people about the risks of using these substances and what they can do to reduce the chances of harm. However, although these can be important in raising awareness, we do not know (a) how PWID respond to drug alerts, and (b) what communication strategies and messages are the most effective in alerting PWID to adulterated substances.

What is the aim of the research?

The aim of the project is to co-produce messaging and alerts with PWID to help reduce drug-related harms (including overdose) in the event of either strong, contaminated or adulterated batches of heroin circulating in BNSSG.

How will this be achieved?

We will conduct interviews with PWID and stakeholders working in the drug and alcohol field in the BNSSG area to identify the preferred content and design of drug alerts and warnings, including language and tone, and how best to deliver these messages. We will also review existing evidence on drug alerts and messages.

We will use this evidence to co-produce an acceptable and feasible package of materials (including posters and social media messages) that can be piloted and further refined in the event of either strong, contaminated or adulterated batches of heroin circulating in BNSSG. This work will help determine a future study exploring how PWID respond to drug alerts and warnings, and whether they are an effective harm reduction method.

Who is leading the research?

Dr Tom May, Research Fellow, NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol.

Further information:

For more information or to get involved with this project, please contact bnssg.research@nhs.net.