BackgroundThe main objectives of this study are to describe the smoked cocaine user's profile in socially-depressed areas and their needs from a harm-reduction perspective, to investigate their use of smoking crack and compare the acute effects between injecting and smoking consumption.MethodsThe study took place in SAPS, Barcelona, Spain. Two focus group sessions were undertaken with a total of 8 drug users. Secondly, the 8 participants answered a structured questionnaire and in the course of the sessions, as a snowball activity, were trained to survey 6 other crack smokers.ResultsWe obtained 56 questionnaires. The majority of participants were from non-European Community countries (62.69%), 70.2% of participants referred to sharing the smoking equipment. The most frequent symptoms reported during smoked cocaine were mydriasis (83.33%)), perspiration (72.92%) and compulsive object search (70.83%) During the group sessions, participants said that smoked cocaine is much more addictive than injected cocaine and causes more anxiety. Participants also reported the difficulty of changing from injected use to smoked use, due to the larger amount of cocaine needed to reach the same effects as when having injected.ConclusionsWe can conclude that the research, focused on achieving greater knowledge of the smoked cocaine user's profile, their usage of smoking crack, consumption patterns and acute effects, should be incorporated into substance misuse interventions.

Background and Objective There are currently more than 150 supervised consumption sites (SCS) worldwide. These sites offer a much-needed point of contact between the health care system and people who use drugs and, as such, have been proven to effectively reduce harms and improve health. SCS are typically staffed by mental health and harm reduction workers, social workers, workers with living or lived experience, and registered nurses. It has been established that the care provided by nurses within SCS fall within their legislated scope of practice but the actual role of nurses in SCS remains poorly defined and understood. Material and Methods To address this significant practice, policy and research gap, a consensus statement was developed based on information generated by 17 content experts from 10 countries namely, Canada, Spain, Australia, France, Denmark, Norway, Ireland, Switzerland, Germany, and Scotland. The statement was developed from “the ground up” by gathering information on three content areas: nursing practice in SCS, training, and needs. This information was summarized, and then submitted to two rounds of voting using a modified Delphi method to build consensus. Results The final content of the consensus statement is comprised of five sections: (1) Philosophy of care, (2) Framework, (3) Nursing role, (4) Training requirements, and (5) Needs of nurses. Conclusion This consensus statement is the first step toward a better understanding of the role of nurses in SCS. There is immense responsibility on nurses in this setting, as the majority of people who access SCS face many barriers in accessing other health and social services, even when their need for those services may be critical. For these reasons, it is essential to better prepare nurses for these realities. We hope that this first international consensus statement can serve as a foundation to guide practice, policy, research, and operational decisions in SCS.