Characterizing stimulant overdose: A qualitative study on perceptions and experiences of “overamping”

Mansoor, Manal; McNeil, Ryan; Fleming, Taylor; Baker, Allison S.; Vakharia, Sheila P.; Sue, Kimberly; Ivsins, Andrew

doi:10.1016/j.drugpo.2022.103592

Cited by 16 publications

(7 citation statements)

References 50 publications

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“…Such systems may benefit from tracking methamphetamine-related overdoses, as well as opioid-related overdoses. 28 Harm reduction programs that distribute naloxone and fentanyl test strips to people who use methamphetamine in rural areas are needed, as most methamphetamine-related deaths also involve opioids and few people using methamphetamine reported having naloxone. 9 The magnitude of methamphetamine use among people who use drugs has profound implications for US treatment programs.…”

Section: Jama Network Open | Substance Use and Addictionmentioning

confidence: 99%

Association of Methamphetamine and Opioid Use With Nonfatal Overdose in Rural Communities

et al. 2022

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Section: Jama Network Open | Substance Use and Addictionmentioning

confidence: 99%

Association of Methamphetamine and Opioid Use With Nonfatal Overdose in Rural Communities

et al. 2022

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“…The findings of this study demonstrate the critical need to evaluate and expand access to safer supply medications within housing environments for people at high risk of overdose. Furthermore, rising stimulant and polysubstance use, increasing adulteration of the drug supply with benzodiazepines such as etizolam, and resultant complex overdose presentations support the expansion of safer supply medication beyond opioids [18,49,50]. Existing qualitative evidence suggests such programs have significant potential to reduce overdose events and mortality [51].…”

Section: Discussionmentioning

confidence: 99%

Overdose Prevention and Housing: a Qualitative Study Examining Drug Use, Overdose Risk, and Access to Safer Supply in Permanent Supportive Housing in Vancouver, Canada

et al. 2022

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The majority of overdose deaths in British Columbia (BC) occur among people using illicit substances alone in private residences. Some supportive housing in BC includes on-site access to a variety of health and substance use–related services. More recently, a number of supportive housing locations have started offering prescribed safer supply medications to people at high overdose risk, though these remain limited and under-evaluated. In this study, we describe the drug use practices — including access to and use of on-site supervised consumption, OAT, and prescribed safer supply medications — of study participants living in permanent supportive housing with integrated primary care, substance use treatment services, and supervised consumption spaces. Qualitative interviews were conducted with 30 residents of a permanent supportive housing site in Vancouver, Canada. Data were analyzed using a sequential process to identify both a priori (e.g., low-barrier substance use treatment, pandemic effects on service access) and emerging themes (e.g., using alone). Most ( N = 27) study participants reported using alone in their rooms, despite having access to an on-site supervised consumption area. Reasons for using alone include the following: preference for being alone, discretion/stigma, and restrictive housing policies. Less than half ( N = 12) of the study participants accessed on-site prescribed safer supply medications. Participants receiving on-site prescribed safer supply described positive benefits including reduced use of illicit opioids, and less reliance on illicit income generation activities. On-site prescribed safer supply programs within supportive housing environments are an important tool in addressing overdose risk.

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“…The POST initiative has served to help identify several areas for improvement and enhancement, some of which have already been initiated. These include consideration of broadening post–overdose initiatives to include stimulant-related overdose (overamping), 21 establishing a more formal system of training and technical assistance, better engaging Black and Latinx individuals who use drugs to reduce disparities in overdose demographic trends, developing an advisory group of overdose survivors and family members, 22 and pursuing enhanced supports for family members since they are so frequently encountered during outreach.…”

Section: Discussionmentioning

confidence: 99%

The Massachusetts Department of Public Health Post Overdose Support Team Initiative: A Public Health–Centered Co-Response Model for Post–Overdose Outreach

Formica

Reilly

Duska

et al. 2022

Journal of Public Health Management and Practice

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Context: Post-overdose outreach programs have emerged in response to surging overdose deaths amid fentanyl contamination of the illicit opioid supply. Predominantly centered in police departments in collaboration with public health providers, these programs conduct home-based outreach with survivors and their social networks following an overdose. Approach: We describe implementation of the Post Overdose Support Team (POST) initiative, an ongoing public health funded and centered approach. Post Overdose Support Team is a person-centered model led by harm reductionists in health and human services agencies in collaboration with municipal first responders. The goal of POST is to engage overdose survivors and their social network to improve general health, connect people to services (including access to treatment, if desired), and reduce risk of subsequent overdose. Implementation: Nine agencies in Massachusetts that are part of the state's overdose education and naloxone distribution network implemented POST programs, covering 28 municipalities. The POST teams conduct home-based outreach with individuals who experienced an opioid-related overdose to provide a menu of services, including naloxone rescue kits, overdose response and risk reduction planning, referral to treatment for substance use disorders, including medication for opioid use disorder, and referral to recovery and family supports. Evaluation: From October 2017 to October 2021, the POST teams attempted to reach 5634 overdose survivors via 10 536 outreach visits. Teams successfully engaged 3014 survivors, either directly or through contact with their social network (53.5% success rate). Using data from a real-time encounter-level database, monthly peer-sharing calls with program sites, and annual site visits, we describe the implementation of the POST initiative and provide practice-based recommendations and lessons learned. Discussion: Early evidence suggests that the POST initiative is meeting its goal to engage overdose survivors, improve general health, and reduce subsequent overdose risk. Future evaluations should examine long-term outcomes among participants, including service linkages and incremental behavior change.

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Characterizing stimulant overdose: A qualitative study on perceptions and experiences of “overamping”

Cited by 16 publications

References 50 publications

Association of Methamphetamine and Opioid Use With Nonfatal Overdose in Rural Communities

Association of Methamphetamine and Opioid Use With Nonfatal Overdose in Rural Communities

Overdose Prevention and Housing: a Qualitative Study Examining Drug Use, Overdose Risk, and Access to Safer Supply in Permanent Supportive Housing in Vancouver, Canada

The Massachusetts Department of Public Health Post Overdose Support Team Initiative: A Public Health–Centered Co-Response Model for Post–Overdose Outreach

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