Injecting Alone. The Importance of Perceived Safety, Stigma and Pleasure for Solitary Injecting

Hanoa, Kristin; Bilgrei, Ola Røed; Buvik, Kristin

doi:10.1177/00220426231151377

Cited by 4 publications

(2 citation statements)

References 42 publications

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“…The proximity between these spaces for people who use drugs and low-threshold services enhances access to life-saving treatment during overdoses, emphasizing the importance of urban, centralized locations 13,14 . Overdose deaths often occur alone in private residences 23,24 , but our study showed how outreach workers were also approached at the Bench with concerns for individuals who were socially connected to the Bench but not present.…”

Section: Discussionmentioning

confidence: 85%

A Place of Encounter: Health and Social Care Workers' Perspectives on Public Gathering Spaces for People Using Drugs

Bjønness,

Lie,

Grønnestad

2024

Preprint

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In the context of addressing substance use issues in urban areas, public gathering places for individuals who use drugs play a multifaceted role, serving as sites of belonging, support, and potential criminal activity. As these gathering places, often referred to as open drug scenes, are associated with drug dealing, violence, and harm, numerous attempts to close or control them by law enforcement have been made, resulting in increased violence, stigma, and risk of overdoses. This qualitative study explores the experiences of health and social workers regarding a public gathering place, referred to as “the Bench,” in a medium-sized Norwegian city. Through semi-structured interviews with thirteen participants representing various support agencies, four thematic areas emerged: 1) Belonging and a gateway to support and services, 2) Balancing user autonomy at the Bench and systems support, 3) The role of a centralized location, and 4) The preventive role of support workers at the Bench. While the Bench fosters a sense of community and provides access to vital services, concerns about illicit activities persist due to its visibility. Nevertheless, its central location facilitates outreach efforts and ensures easy access to support services. The study underscores the preventive role of healthcare and social workers in stabilizing the environment and mitigating conflicts. Furthermore, it highlights the importance of central locations for public gathering places, emphasizing the proximity to low-threshold services for overdose prevention. Despite some challenges, the Bench represents a crucial venue for establishing relationships and providing assistance to individuals who use drugs, contributing to harm reduction efforts in the community.

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Section: Discussionmentioning

confidence: 85%

A Place of Encounter: Health and Social Care Workers' Perspectives on Public Gathering Spaces for People Using Drugs

Bjønness,

Lie,

Grønnestad

2024

Preprint

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“…Our study findings highlight the need for interventions that increase the possibility of a bystander witnessing an overdose, along with greater naloxone distribution, to reduce OODs. Recognizing the importance of social and environmental factors that influence settings for drug use, public health efforts may encompass destigmatizing drug use, reducing isolation, housing-focused interventions, education and overdose awareness events, public messaging, peer-to-peer witnessing, and social support to reduce solitary drug use and improve overdose response . Additionally, there are several interventions currently being piloted or launched to prevent OODs among people who use drugs alone.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Strategies to Enhance Community-Based Naloxone Distribution Supported by an Opioid Settlement

Zang,

Skinner,

Krieger

et al. 2024

JAMA Netw Open

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ImportanceMany US states are substantially increasing community-based naloxone distribution, supported in part through settlements from opioid manufacturers and distributors.ObjectivesTo evaluate the potential impact of increased naloxone availability on opioid overdose deaths (OODs) and explore strategies to enhance this impact by integrating interventions to address solitary drug use.Design, Setting, and ParticipantsThis decision analytical modeling study used PROFOUND (Prevention and Rescue of Fentanyl and Other Opioid Overdoses Using Optimized Naloxone Distribution Strategies), a previously published simulation model, to forecast annual OODs between January 2023 and December 2025. The simulated study population included individuals from Rhode Island who misused opioids and stimulants and were at risk for opioid overdose.ExposuresThe study modeled expanded naloxone distribution supported by the state’s opioid settlement (50 000 naloxone nasal spray kits each year). Two approaches to expanding naloxone distribution were evaluated: one based on historical spatial patterns of naloxone distribution (supply-based approach) and one based on the spatial distribution of individuals at risk (demand-based approach). In addition, hypothetical interventions to enhance the likelihood of witnessed overdoses in private or semiprivate settings were considered.Main Outcomes and MeasuresAnnual number of OODs and ratio of fatal to nonfatal opioid overdoses.ResultsModeling results indicated that distributing more naloxone supported by the state’s opioid settlement could reduce OODs by 6.3% (95% simulation interval [SI], 0.3%-13.7%) and 8.8% (95% SI, 1.8%-17.5%) in 2025 with the supply-based and demand-based approaches, respectively. However, increasing witnessed overdoses by 20% to 60% demonstrated greater potential for reducing OODs, ranging from 8.5% (95% SI, 0.0%-20.3%) to 24.1% (95% SI, 8.6%-39.3%). Notably, synergistic associations were observed when combining both interventions: increased naloxone distribution with the 2 approaches and a 60% increase in witnessed overdoses could reduce OODs in 2025 by 33.5% (95% SI, 17.1%-50.4%) and 37.4% (95% SI, 19.6%-56.3%), respectively.Conclusions and RelevanceThese findings suggest that interventions to address solitary drug use are needed to maximize the impact of continued efforts to increase community-based naloxone distribution, which may be particularly important for jurisdictions that have strong community-based naloxone distribution programs.

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Mortality risk and causes of death among people who use opioids in a take-home naloxone cohort

Ericson,

Eide,

Lobmaier

et al. 2024

Drug and Alcohol Dependence

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Injecting Alone. The Importance of Perceived Safety, Stigma and Pleasure for Solitary Injecting

Cited by 4 publications

References 42 publications

A Place of Encounter: Health and Social Care Workers' Perspectives on Public Gathering Spaces for People Using Drugs

A Place of Encounter: Health and Social Care Workers' Perspectives on Public Gathering Spaces for People Using Drugs

Evaluation of Strategies to Enhance Community-Based Naloxone Distribution Supported by an Opioid Settlement

Mortality risk and causes of death among people who use opioids in a take-home naloxone cohort

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