Attendance at Supervised Injecting Facilities and Use of Detoxification Services

Wood, Evan; Tyndall, Mark W.; Zhang, Ruth; Stoltz, Jo-Anne; Lai, Ching‐chong; Montaner, Julio S. G.; Kerr, Thomas

doi:10.1056/nejmc052939

Cited by 149 publications

(102 citation statements)

References 4 publications

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“…21 Because an addiction counsellor is on site at the facility and other facility staff refer IDUs to addiction services, an evaluation was undertaken to examine factors associated with more rapid entry into a detoxification program among facility users. 33 Definition of this end point was based on linkage to a database maintained by Vancouver's 3 detoxification facilities, which offer medically monitored residential withdrawal services with on-site nursing and medical care. The study period considered each participant's recruitment date up until Mar.…”

Section: Referral For Addiction Treatment and Other Carementioning

confidence: 99%

Summary of findings from the evaluation of a pilot medically supervised safer injecting facility

Wood¹,

Tyndall²,

Montaner³

et al. 2006

Canadian Medical Association Journal

148

124

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CMAJ 2006;175(11):1399-404 methods has been published. 17 The evaluators were entirely external to facility operations, which are overseen by Vancouver Coastal Health, and the evaluation was supervised by a provincial steering committee and funded by Health Canada. Summary of findingsCharacteristics of people using the safer injecting facilityBefore the safer injecting facility opened, a key concern was its ability to attract its target population.18 The facility's public health and community benefit would clearly be limited if it did not attract the IDUs who were at highest risk of healthrelated harms and those responsible for public order problems (e.g., public injection drug use). Identification of the characteristics of IDUs initiating use of the facility was helped by the existence of an ongoing prospective cohort study of IDUs operating in the community before the facility opened. This cohort has been described in detail. 17,19 Thus, it was possible to examine drug use patterns in the community during the year before the opening of the facility and identify patterns that predicted subsequent initiation of use of the facility during the year after it opened.Characteristics and behaviours were defined based on questionnaire data obtained immediately before the safer injecting facility opened, whereas the prevalence of use of the facility was ascertained based on the first questionnaire after the facility opened. In a community-recruited cohort of IDUs, 45% reported using the facility and, as shown in Fig. 2, the characteristics and drug-use behaviours that predicted initiation of use of the facility included lower age, public injection drug use, homelessness or unstable housing, daily heroin injection, daily cocaine injection and a recent nonfatal overdose. 20Subsequent analysis of IDUs using the facility between Mar. 10, 2004, and Apr. 30, 2005, revealed that about 5000 unique IDUs used the facility during the first year of operation. Heroin was used in about 40% of injections, cocaine in 30% of injections, and other illicit drugs, drug combinations or diverted pharmaceuticals in the remaining injections. 21 In a survey of perceptions regarding their use of the facility, about 95% of IDUs using the facility reported high levels of satisfaction with the site and the staff. 22Examination of a random sample of 670 IDUs recruited from within the safer injecting facility between Dec. 1, 2003, and July 30, 2004, demonstrated that the following factors were independently associated with daily use of the facility: daily heroin injection (odds ratio [OR] 3.44, 95% confidence interval [CI] 2.50-4.73), homelessness (OR 2.4, 95% CI 1.6-3.6), not receiving methadone maintenance treatment (OR 2.1, 95% CI 1.44-3.1) and daily cocaine injection (OR 2.0, 95% CI 1.4-2.8). 23Requiring help with injections was negatively associated with daily use of the facility (OR 0.61, 95% CI 0.43-0.86), a finding of concern, because this factor has been identified as an independent predictor of HIV incidence in the community.2...

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Section: Referral For Addiction Treatment and Other Carementioning

confidence: 99%

Summary of findings from the evaluation of a pilot medically supervised safer injecting facility

Wood¹,

Tyndall²,

Montaner³

et al. 2006

Canadian Medical Association Journal

148

124

View full text Add to dashboard Cite

show abstract

“…Indeed, research has found that supervised injection services can play a role in facilitating uptake of addiction treatment services and promoting cessation from drug use. 12 Other studies have shown injection facilities have no adverse effects on drug use in the broader community, such as increasing rates of initiation into injecting among vulnerable populations. 13 Ultimately, these facilities appear to help advance the very goals that their opponents espouse.…”

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confidence: 99%

Supervised injection sites: Prejudice should not trump evidence of benefit

Zlotorzynska

Wood

Montaner

2013

CMAJ

Self Cite

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“…Theoretical possibilities of SIF expansion needs to be decided on by the local health authorities on the basis of scientific evidence supporting such expansion (17). Public awareness by the local health policy-makers and doctors regarding SIF will allow the community to be better educated about the benefits of these harm reduction programs and the role they play in reducing crime, drug dealing, public injection, and a host of other social maladies (9,(12)(13)(14)34,(46)(47)(48)(49)(50)(51). Community support is a fundamental part of sustaining the program and it will ultimately help in conceptualizing injection drug use as a health issue, rather than a moral one (11,16,53).…”

Section: Discussionmentioning

confidence: 99%

Examining the potential role of a supervised injection facility in Saskatoon, Saskatchewan, to avert HIV among people who inject drugs

Jozaghi

Jackson

2015

Int J Health Policy Manag

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Background: Research predicting the public health and fiscal impact of Supervised Injection Facilities (SIFs), across different cities in Canada, has reported positive results on the reduction of HIV cases among People Who Inject Drugs (PWID). Most of the existing studies have focused on the outcomes of Insite, located in the Vancouver Downtown Eastside (DTES). Previous attention has not been afforded to other affected areas of Canada. The current study seeks to address this deficiency by assessing the cost-effectiveness of opening a SIF in Saskatoon, Saskatchewan. Methods: We used two different mathematical models commonly used in the literature, including sensitivity analyses, to estimate the number of HIV infections averted due to the establishment of a SIF in the city of Saskatoon, Saskatchewan. Results: Based on cumulative cost-effectiveness results, SIF establishment is cost-effective. The benefit to cost ratio was conservatively estimated to be 1.35 for the first two potential facilities. The study relied on 34% and 14% needle sharing rates for sensitivity analyses. The result for both sensitivity analyses and the base line estimates indicated positive prospects for the establishment of a SIF in Saskatoon. Conclusion:The opening of a SIF in Saskatoon, Saskatchewan is financially prudent in the reduction of tax payers' expenses and averting HIV infection rates among PWID. Keywords: People Who Inject Drugs (PWID), HIV, Cost-Benefit Analysis, Canada Copyright: © 2015 by Kerman University of Medical Sciences Citation: Jozaghi E, Jackson A. Examining the potential role of a supervised injection facility in Saskatoon, Saskatchewan, to avert HIV among people who inject drugs.

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Attendance at Supervised Injecting Facilities and Use of Detoxification Services

Cited by 149 publications

References 4 publications

Summary of findings from the evaluation of a pilot medically supervised safer injecting facility

Summary of findings from the evaluation of a pilot medically supervised safer injecting facility

Supervised injection sites: Prejudice should not trump evidence of benefit

Examining the potential role of a supervised injection facility in Saskatoon, Saskatchewan, to avert HIV among people who inject drugs

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