Prospective client survey and participatory process ahead of opening a mobile drug consumption room in Lisbon

Abstract

Background Ahead of opening Portugal’s first mobile drug consumption room (MDCR) in Lisbon, information from People Who Use Drugs (PWUD) and local community members was necessary to determine current needs and shape the intervention. A participatory and peer-led process was ensured at all stages of data gathering and planning of the intervention. Methods Prospective clients were surveyed to determine their willingness to use the service and preferences for use and to gain sociodemographic information. Persons over the age of 18 who reported injection drug use (PWID) were recruited using convenience sampling in the main open drug use scenes in Lisbon. In-person interviews were conducted by trained peer workers between November and December of 2017. The results ( n = 72) of the questionnaires were analyzed, providing descriptive statistics. Results There is a high level of willingness to use the MDCR, primarily for reasons of hygiene, privacy, and security. Most participants expressed a desire to use the MDCR daily. Potential clients are socially marginalized, and many suffer from unstable housing. Most are daily users and engage in unsafe injecting practices, such as public injecting and material sharing. High levels of hepatitis C, HIV, and hepatitis B were observed among the target population with low levels of healthcare access and utilization. Preferences were gauged regarding the scheduling of the MDCR’s hours and amount of time willing to travel to reach the MDCR and will be taken into account for implementation. The combination of high levels of willingness to utilize the service and high levels of need among the target population support the implementation of Lisbon’s first MDCR. Conclusions Continual participation of PWUD and other community members will be necessary to maximize the public health and social impacts of this intervention, relative to this baseline. The plan to continue the participatory and peer-led development of the MDCR includes integrating peer workers, clients, and local community members within the operation, management, and evaluation of the service. This research adds to a growing literature about drug consumption rooms (DCRs) in Europe, which is especially limited concerning MDCRs.

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“…While nurses and clinicians play a role, it is essential to recognize that they are not always the central figures in these environments. The literature emphasizes the importance of involving PWUSs and peer workers in the operation of SCSs (Taylor et al, 2019;Yoon et al, 2022;Ali et al, 2023). For example, in a qualitative systematic review, Yoon et al (2022) note that the active engagement of PWUSs and those with lived experience significantly bolstered the implementation and sustainability of SCSs.…”

“…For example, in a qualitative systematic review, Yoon et al (2022) note that the active engagement of PWUSs and those with lived experience significantly bolstered the implementation and sustainability of SCSs. Similarly, a study on Portugal's first mobile drug consumption room in Lisbon highlights the importance of a participatory and peer-led approach in shaping interventions (Taylor et al, 2019). Furthermore, Ali et al (2023) note the necessity of integrating the insights and experiences of PWUSs in the development and operation of supervised drug consumption sites.…”

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“…Peer support workers are also often employed at harm reduction sites and for community outreach (Greer et al, 2019), (Kennedy et al, 2019). It is less common however, to include PWLE as advisors or decision makers in the design and planning of harm reduction services (Taylor et al, 2019), (Altman et al, 2021). PWLE advocates have been calling for greater PWLE inclusion in decision making and service provision for many years.…”