'‘Why don’t we just build it in a square hole?': developing a multi-component drug outreach service for young people aged 16-25 in England (2026)

Background: In England, the rise in young people/adults' drug use coincides with a decline in specialist outreach and support services. Current substance use provision particularly neglects young adults. This paper traces the origins of the multi-component '1625 Outreach' model and how it was developed and refined by utilizing community engagement and co-production approaches.
Methods: The co-produced, qualitative research design included observations of outreach practitioners in different settings, focus groups with professionals and young people/adults, and semi-structured interviews with key informants.
Results: The multi-component model was found to be agile, innovative and responsive to local drug trends. This was facilitated by community partnerships and inter-agency collaboration and the involvement of young people in service development and delivery. Co-designed prevention messages on social media were effective in reaching a wide audience. It was important that the educator was viewed as relatable, trustworthy and knowledgeable, with honest harm reduction messages. Participants preferred strengths-based harm reduction discussions, allowing for exploration of the complexities of drug use.
Conclusion: The study highlights the importance of developing credible, strengths-based harm reduction messages co-designed by young people. A coherent multi-component delivery approach with stakeholder engagement can facilitate agile responses to the changing needs of local young people/adults. [Author's abstract]