Characterizing peer roles in an overdose crisis: Preferences for peer workers in overdose response programs in emergency shelters

Abstract

Findings indicate that participants regarded peer workers as providing a range of unique benefits. They emphasized the critical role of both social networks and informal roles in optimizing overdose responses. The scaling up of peer programming in distinct risk environments such as emergency shelters through both formal and informal roles has potential to help improve overdose prevention efforts, including in settings not well served by conventional public health programming.

Peer worker involvement in low-threshold supervised consumption facilities in the context of an overdose epidemic in Vancouver, Canada

“…The present study builds on this work in identifying the use of task shifting to peer workers as a successful novel approach for facilitating the rapid implementation and delivery of low-threshold SCF programming in the context of an overdose epidemic, thereby strengthening emergency response capacity in a timely manner. Furthermore, similar to previous studies of other peerrun harm reduction initiatives (Bardwell et al, 2018b;Greer et al, 2016;Hayashi et al, 2010;Kerr et al, 2003;McNeil et al, 2015Sherman et al, 2008;Small et al, 2012;Ti et al, 2012), our findings illustrate how this task shifting approach functioned to enhance the effectiveness of this form of harm reduction programming, including by improving service engagement, reducing potential for overdose-related harms, and promoting uptake of addiction treatment and other health services among PWUD.…”

“…While social-structural obstacles to peer engagement in SCFs persist, numerous studies have illustrated the value of peer-based harm reduction initiatives, including syringe exchange, safer assisted injecting and overdose response interventions, in engaging and reducing harms among higher risk subpopulations of people who use drugs (PWUD) (Bardwell et al, 2018b;Greer et al, 2016;Hayashi et al, 2010;Sherman et al, 2008;Small et al, 2012;Ti et al, 2012). For example, an evaluation of a peer-based overdose response training and naloxone distribution programme in Chicago found that this was an effective strategy to reduce overdose-related harms, particularly given that this training (including naloxone administration) was subsequently utilized in response to an overdose event by the majority of those trained (Sherman et al, 2008).…”

“…In response, various harm reduction strategies have been implemented or expanded in BC, particularly in Vancouver's Downtown Eastside, a neighbourhood with a large open drug scene and high levels of poverty and homelessness, but also a history of drug user-led activism (BC Ministry of Health and Addictions, 2018;Boyd et al, 2009;Kerr et al, 2017). Much of the response to the overdose epidemic in this neighbourhood has been spearheaded by peers involved in collective action initiatives and harm reduction programming delivered as part of the public health system and established peer-based drug user organizations in the Downtown Eastside (Bardwell et al, 2018b;BC Ministry of Health and Addictions, 2018;Boyd et al, 2018;Jozaghi et al, 2018;Kerr et al, 2017). For example, peers have led the development and implementation of interventions such as naloxone training, distribution and response initiatives, as well as unsanctioned SCFs, including "pop-up" SCF tents that were erected in the Downtown Eastside beginning in September 2016 (Boyd et al, 2018;.…”

“Am I gonna get in trouble for acknowledging my will to be safe?”: Identifying the experiences of young sexual minority men and substance use in the context of an opioid overdose crisis

“…For example, people who use drugs have turned to illicit prescription-based sources of substances and consistent drug dealers to procure substances of consistent quality and perceived safety [37][38][39]. Similarly, peer-based harm reduction initiatives have been identified as highly acceptable, effective, and trusted approaches to further engage people who use drugs in developing and taking up strategies to mitigate substance use-related harms, including overdose [40][41][42].…”

“An Emotional Roller-Coaster:" Stressors Faced by Peer Workers in Overdose Response Settings

“…In this context, experiential workers are those with past or present drug use experience who use that lived experience to inform their professional work [10]. Experiential workers inform and lead nimble and effective overdose response and prevention services for PWUD [11][12][13][14] within overdose response settings. These include stand alone supervised consumption sites and overdose prevention services (OPSs), as well as services in shelter and housing agencies.…”