Harm Reduction Services to Prevent and Treat Infectious Diseases in People Who Use Drugs

Thakarar, Kinna; Nenninger, Katherine; Agmas, Wollelaw

doi:10.1016/j.idc.2020.06.013

Cited by 15 publications

(6 citation statements)

References 78 publications

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“…Screening for substance use disorders and providing harm reduction and treatment services within programs for PEH are necessary given the high rates of substance use disorders and drug use in this population. 30,31 Care coordination is critical, and evaluation of transitions to and from COVID-19 isolation sites for PEH will inform our understanding of short- and long-term substance use and other health-related outcomes to guide future public health responses.…”

Section: Calls To Action To Support Public Health Responses For Pehmentioning

confidence: 99%

A Descriptive Comparison of Substance Use Services in Recovery and Isolation Sites for People Experiencing Homelessness During the COVID-19 Pandemic, Boston and Toronto

et al. 2021

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Section: Calls To Action To Support Public Health Responses For Pehmentioning

confidence: 99%

A Descriptive Comparison of Substance Use Services in Recovery and Isolation Sites for People Experiencing Homelessness During the COVID-19 Pandemic, Boston and Toronto

et al. 2021

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“…Our results suggest that the one-for-one needle exchange policy, which reduced availability to and affordability of safer use equipment in this study, is a policy that should be permanently eliminated. Increased access to safer use equipment can improve injection practices and minimize adverse outcomes, such as injection druguse associated infections [42,43]. Notably, in urban areas where one-for-one exchange was more strictly enforced, PWID participants of on-site SSPs reported reduced availability of unused equipment.…”

Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on people who inject drugs accessing harm reduction services in a rural American state

et al. 2022

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Background The impact of public health policies during the COVID-19 pandemic on people who inject drugs (PWID) has varied across regions. In other countries, recent research has shown that PWID access to harm reduction services, despite rapid adaptations, has been negatively impacted. Our study describes these impacts in a rural state. Methods We conducted semi-structured interviews with PWID, community partners, and healthcare providers in the rural state of Maine (USA). We explored how changes made during the pandemic impacted access to harm reduction services, including basic services (i.e., shelter), syringe service programs, safe drug supply, low barrier treatment, and peer support. Interviews were analyzed using the framework method to apply Penchansky’s model of access, with Saurman’s modification, which includes six dimensions of access—accessibility, availability, acceptability, affordability, accommodation, awareness. Results We interviewed thirty-six stakeholders (N = 9 community partners, N = 9 healthcare providers, N = 18 PWID). Policies such as mobile outreach expansion, mail delivery of equipment, and relaxed telemedicine regulations facilitated accessibility to syringe service programs and low barrier buprenorphine treatment. Public health policies, such as social distancing and screening policies, reduced contact, which subsequently reduced acceptability and awareness of many services. Elimination of the one-for-one needle exchange in some areas increased, acceptability (i.e., perception of service), and affordability for PWID. However, some areas actually began enforcing a one-for-one needle exchange policy, which reduced affordability, acceptability, and awareness of services. Conclusions Changes resulting from the COVID-19 pandemic have impacted all dimensions of access to harm reduction services among PWID. While some barriers to harm reduction services were unavoidable during the pandemic, we found that specific policy decisions mitigated service barriers, while other policies exacerbated them. Relaxing needle exchange policies were particularly helpful in facilitating access to harm reduction services by giving community organizations flexibility to adapt to the evolving needs of PWID. These results can inform policies and service delivery to optimally mitigate the negative impacts on PWID during, and beyond, the pandemic.

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“…Numerous studies have demonstrated that OPCs are associated with safer use practices largely because OPCs can provide PWUD access to harm reduction supplies (ie, sterile syringes, alcohol wipes, sterile water, sharps containers for used syringes, etc) in a safe and hygienic environment (ie, sanitized surfaces, protected settings without fear of violence or arrest, etc) where individuals can take their time to use in a sterile fashion. 47 The provision of safer use supplies to PWUD reduces the risk of acquiring drug useassociated infections, such as HIV and hepatitis C, as well as skin and soft tissue infections and endocarditis. [48][49][50][51] As such, multiple studies have shown improved infectious disease-related outcomes among those with access to an OPC.…”

Section: Reduced Transmission Of Infectious Diseasesmentioning

confidence: 99%

“…44,[52][53][54] In addition, OPCs facilitate opportunities for (a) education from trained staff on safer use practices and vein care, (b) connections to testing and treatment for infectious diseases such as HIV and hepatitis C, and (c) screening for other infections such as sexually transmitted infections. 47…”

Section: Reduced Transmission Of Infectious Diseasesmentioning

confidence: 99%

In Support of Overdose Prevention Centers: Position Statement of AMERSA, Inc (Association for Multidisciplinary Education and Research in Substance Use and Addiction)

Dunham,

Hill,

Kazal

et al. 2024

Substance Use & Addiction Journal

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Given increasing rates of fatal overdoses in the United States and the rapidly changing drug supply, overdose prevention centers (OPCs; also known as safe consumption sites) have been identified as a vital, evidence-based strategy that provide people who use drugs (PWUD) the opportunity to use drugs safely and receive immediate, life-saving overdose support from trained personnel. In addition to providing a safe, supervised space to use drugs, OPCs can house further essential harm reduction drop-in services such as sterile supplies, social services, and medical care. There are established national and international data demonstrating the lifesaving services provided by OPCs, inspiring a groundswell of advocacy efforts to expand these programs in the United States. Thus, the Association for Multidisciplinary Education and Research in Substance Use and Addiction (AMERSA) endorses OPCs, in addition to other harm reduction strategies that protect PWUD. Ultimately, it is imperative to increase access to OPCs across the United States and support key policy changes at the local, state, and federal levels that would facilitate urgent expansion.

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Harm Reduction Services to Prevent and Treat Infectious Diseases in People Who Use Drugs

Cited by 15 publications

References 78 publications

A Descriptive Comparison of Substance Use Services in Recovery and Isolation Sites for People Experiencing Homelessness During the COVID-19 Pandemic, Boston and Toronto

A Descriptive Comparison of Substance Use Services in Recovery and Isolation Sites for People Experiencing Homelessness During the COVID-19 Pandemic, Boston and Toronto

The impact of the COVID-19 pandemic on people who inject drugs accessing harm reduction services in a rural American state

In Support of Overdose Prevention Centers: Position Statement of AMERSA, Inc (Association for Multidisciplinary Education and Research in Substance Use and Addiction)

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