The consensus view presented offers practical and realistic guidance for policy-makers and community pharmacists on the sale of OTC products. It reflects the best evidence to date of expert views in this area and accords with current UK guidelines. The effective implementation of these strategies can only be achieved with improved communication and coordination at local and national level.
Aims.To establish the existence of needle fixation and provide a theoretical explanation for the phenomenon. Method. By searching published literature using electronic searches, consulting a National Drug Library (ISDD) and snowballing from reference lists in publications related to addiction. Findings. Needle fixation as a phenomenon has been mentioned in the literature since at least 1929 but there is only one published paper devoted to it. Needle fixation is a conditioned response but with a number of different secondary gains which maintain the practice. These include ritual, substitution of non psychoactive substances in the absence of drugs, pain, sexual pleasure and status. Conclusions. Needle fixation should be taken seriously because of the concern about blood borne viruses among injecting drug users and the need to reduce the practice of injecting. A greater understanding of the problem will help in treatment of injecting drug users.
Issues conveniently considered together as needle fixation are current among injecting drug users and may be relevant to the inability of some drug users to change from injecting drug use.
Background
We conducted a scoping review focused on various forms of substance use amid the pandemic, looking at both the impact of substance use on COVID-19 infection, severity, and vaccine uptake, as well as the impact that COVID-19 has had on substance use treatment and rates.
Methods
A scoping review, compiling both peer-reviewed and grey literature, focusing on substance use and COVID-19 was conducted on September 15 2020 and again in April 15 2021 to capture any new studies. Three bibliographic databases (Web of Science Core Collection, Embase, PubMed) and several preprint servers (EuropePMC, bioRxiv, medRxiv, F1000, PeerJ Preprints, PsyArXiv, Research Square) were searched. We included English language original studies only.
Results
Of 1564 articles screened in the abstract and title screening phase, we included 111 research studies (peer-reviewed: 98, grey literature: 13) that met inclusion criteria. There was limited research on substance use other than those involving tobacco or alcohol. We noted that individuals engaging in substance use had increased risk for COVID-19 severity, and Black Americans with COVID-19 and who engaged in substance use had worse outcomes than white Americans. There were issues with treatment provision earlier in the pandemic, but increased use of telehealth as the pandemic progressed. COVID-19 anxiety was associated with increased substance use.
Conclusions
Our scoping review of studies to date during COVID-19 uncovered notable research gaps namely the need for research efforts on vaccines, COVID-19 concerns such as anxiety and worry, and low- to middle-income countries (LMICs) and under-researched topics within substance use, and to explore the use of qualitative techniques and interventions where ap- propriate. We also noted that clinicians can screen and treat individuals exhibiting substance use to mitigate effects of the pandemic.
Funding
Study was funded by the Institution for Social and Policy Studies, Yale University and The Horowitz Foundation for Social Policy. DH was funded by a NIDA grant (R01DA048860). The funding body had no role in the design, analysis, or interpretation of the data in the study.
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