The Willingness of People who Inject Drugs in Boston to use a Supervised Injection Facility

León, Casey; Cardoso, Lena; Mackin, Sarah; Bock, Barry; Gaeta, Jessie M.

doi:10.1080/08897077.2017.1365804

Cited by 21 publications

(18 citation statements)

References 40 publications

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“…Their representations are consistent with the objectives of this structure, which means that they understand well the potential benefit of a DCR. This is in accordance with several other studies conducted in different countries were DCR operate [ 25 – 30 ]. The only exception is their disbelief in its social objective efficacy.…”

Section: Discussionsupporting

confidence: 93%

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Opinion of health professionals and drug users before the forthcoming opening of the first drug consumption room in Paris: a quantitative cross-sectional study

et al. 2018

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BackgroundOn the brink of the opening of the first French drug consumption room in Paris, the general opinion of the local involved health care professionals and drug users was not known. The objective of this study was to determine their expectations and to search for influencing factors.MethodWe carried out a quantitative cross-sectional study. A multiple choice questionnaire was proposed to the surrounding willing general practitioners (GPs) and pharmacists, to the emergency doctors of Lariboisière hospital, and to the professionals of the harm reduction facilities and their drug users (PWUD). For each question, there was a choice between seven answers, from “− 3” (very negative impact) to “+ 3” (very positive impact). The influence of the characteristics of each group on its mean answers was explored by Mann-Whitney, Kruskal-Wallis, and Spearman’s tests.ResultsThe median expectations among the groups of responding GPs (N = 62), other health care professionals (N = 82), and PWUD (N = 57) were mainly positive. They thought that the drug consumption room (DCR) would improve the health of PWUD, reduce their at-risk behaviors, would not increase drug use or drug dealing in the neighborhood, and would reduce nuisance in the public space. Only the group of GPs expressed that the DCR could decrease the quietness of the neighborhood, and only the group of PWUD had higher expectations that the DCR would decrease the number of arrests and the number of violent behavior. GPs’ expectations were significantly better in terms of health improvement of PWUD and reducing their precariousness if they had a previous experience in addiction medicine (Mann-Whitney, p = 0.004 and p = 0.019), with a longer practice (Spearman’s rho, p = 0.021 and p = 0.009), and if they were currently prescribing opioid substitution treatments (Mann-Whitney, p = 0.030 and p = 0.002).Among non-GPs, those who were working in addiction medicine centers had significantly better expectations than pharmacists, and the professionals of the local emergency department had intermediate expectations.ConclusionsHealth care professionals and drug users had a positive opinion of the to-be-created Parisian drug consumption room. Experience in addiction medicine influenced positively health professionals’ expectations.

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Section: Discussionsupporting

confidence: 93%

“…In the international literature, the opinion of PWUD regarding DCR has been extensively investigated in several countries: surveys and qualitative studies have shown that they were predominantly in favor of DCRs in Canada, Australia, Denmark, UK, and in the USA [ 25 – 30 ].…”

Section: Introductionmentioning

confidence: 99%

Opinion of health professionals and drug users before the forthcoming opening of the first drug consumption room in Paris: a quantitative cross-sectional study

et al. 2018

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“…These data demonstrate high willingness to use SCS among PWUD indicating their potential for engaging PWUD and intervening on their risk environment to help avert the most extreme consequences of the opioid epidemic. While SCS are not legally sanctioned in the USA, a number of cities are advocating for their implementation [14,27]. Our study adds to the nascent USbased literature and could be useful in informing future efforts around SCS implementation.…”

Section: Discussionmentioning

confidence: 93%

“…Several studies have examined willingness to use SIFs among people who inject drugs (PWID) in the USA; three quantitative studies showed high willingness among PWID in San Francisco (85%), Boston (91%), and Rhode Island (87%) [12][13][14]. In all of these studies, elevated willingness to use a SIF was observed in high-risk subgroups such as PWID engaging in public injection and speedball use (concomitant heroin and cocaine use) and individuals with complex morbidities and high health service needs.…”

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confidence: 99%

Willingness to Use Safe Consumption Spaces among Opioid Users at High Risk of Fentanyl Overdose in Baltimore, Providence, and Boston

et al. 2019

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Safe consumption spaces (SCS) are evidence-based interventions that reduce drug-related morbidity and mortality operating in many countries. However, SCS are yet to be widely implemented in the USA despite the escalating overdose epidemic. The aim of this multi-city study was to identify the factors associated with willingness to use a SCS among people who use drugs (PWUD) in Baltimore, Providence, and Boston, stratified by injection drug use status. Our secondary aim was to characterize the anticipated barriers to accessing SCS if they were to be implemented in these cities. PWUD were invited to complete a cross-sectional survey in 2017. The analysis was restricted to 326 opioid users (i.e., heroin, fentanyl, and non-medical opioid pill use). The majority (77%) of participants expressed willingness to use a SCS (Baltimore, 78%; Providence, 68%; Boston. 84%). Most respondents were male (59%), older than 35 years (76%), nonwhite (64%), relied on public/semi-public settings to inject (60%), had a history of overdose (64%), and recently suspected fentanyl contamination of their drugs (73%). A quarter (26%) preferred drugs containing fen-tanyl. Among injectors, female gender, racial minority status, suspicion of drugs containing fentanyl, and drug use in public/semi-public settings were associated with higher willingness to use a SCS; prior arrest was associated with lower willingness. Among non-injectors, racial minority status, preference for fentanyl, and drug use in public/semi-public settings were associated with higher willingness, whereas recent overdose held a negative association. The most commonly anticipated barriers to accessing a SCS in the future were concerns around arrest (38%), privacy (34%), confidentiality/ trust/safety (25%), and cost/time/transportation (16%). These data provide evidence of high SCS acceptability among high-risk PWUD in the USA, including those who prefer street fentanyl. As SCS are implemented in the USA, targeted engagement efforts may be required to reach individuals exposed to the criminal justice system.

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“…Our review was limited to looking at country-level data, when we know that there can be substantial variation within a country. For example, in the USA, there were eligible studies with estimates of recent non-fatal overdose ranging from 9% in San Francisco to over 50% in Boston (Leon, Cardoso, Mackin, Bock, & Gaeta, 2018;Robinson et al, 2017). Similarly, pooling studies in Viet Nam reporting on lifetime non-fatal overdose resulted in a lower estimate than recent non-fatal overdose in our results.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of non-fatal overdose among people who inject drugs: A multi-stage systematic review and meta-analysis

Colledge

Peacock

Leung

et al. 2019

International Journal of Drug Policy

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The prevalence of non-fatal overdose among people who inject drugs: a multi-stage systematic review and meta-analysis Background: People who inject drugs (PWID) are at an elevated risk of fatal overdose in the first year after experiencing a non-fatal event. Such non-fatal events may also result in overdose-related sequelae, ranging from physical injury to paralysis. Given variation in drug markets and treatment availability across countries and regions, we may see similar variations in non-fatal overdose prevalence. Monitoring non-fatal overdose prevalence among PWID is essential for informing treatment intervention efforts, and thus our review aims to estimate the global, regional, and national prevalence of non-fatal overdose, and determine characteristics associated with experiencing such an event. Methods: We conducted a systematic review and meta-analyses to estimate country, regional, and global estimates of recent and lifetime non-fatal overdose prevalence among PWID. Using meta-regression analyses we also determined associations between sample characteristics and non-fatal overdose prevalence. Results: An estimated 3.2 (1.8-5.2) million PWID have experienced at least one overdose in the previous year. Among PWID, 20.5% (15.0-26.1%) and 41.5% (34.6-48.4%) had experienced a non-fatal event in the previous 12 months and lifetime respectively. Frequent injecting was strongly associated with PWID reporting recent and lifetime non-fatal overdose. Estimates of recent non-fatal overdose were particularly high in Asia and North America. Conclusion: Around one in five PWID are at an elevated risk of fatally overdosing every year, however there is substantial geographical variation. In countries with higher rates of non-fatal overdose there is need to introduce or mainstream overdose prevention strategies such as opioid agonist treatment and naloxone administration training programs.

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The Willingness of People who Inject Drugs in Boston to use a Supervised Injection Facility

Cited by 21 publications

References 40 publications

Opinion of health professionals and drug users before the forthcoming opening of the first drug consumption room in Paris: a quantitative cross-sectional study

Opinion of health professionals and drug users before the forthcoming opening of the first drug consumption room in Paris: a quantitative cross-sectional study

Willingness to Use Safe Consumption Spaces among Opioid Users at High Risk of Fentanyl Overdose in Baltimore, Providence, and Boston

The prevalence of non-fatal overdose among people who inject drugs: A multi-stage systematic review and meta-analysis

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