The emergence of the COVID-19 pandemic has presented the addiction services with an unprecedented set of challenges. Opioid users are particularly vulnerable because of their high level of pre-existing health problems and lifestyle factors. In order to minimise their risks to self and to others in the current Covid-19 crisis, the service has sought to urgently identify vulnerable individuals, and induct them into OST treatment promptly. Additionally, several guidelines have been created and regularly updated by the HSE for any healthcare staff working with opioid users. These include guidance documents, to facilitate prompt induction of patients onto the OST programme, the prescribing of naloxone to all patients at risk of overdose, eConsultation, medication management for those in self-isolation, and the delivery of injecting equipment. The guidance documents and resources will provide a template for a new way of working for the sector during these challenging times and into the future.
Background
Festival drug-related deaths are a growing public health concern.
Aim
To examine drug use and related harm-reduction practices and attitudes towards utilisation of drug safety testing services.
Methods
Data collection took place over the 2019 festival season (June–October). The questionnaire was self-reported. Data was gathered via the online survey, which was promoted through online and social media platforms and outlets. Social media communication methods were used to reach the targeted population more effectively.
Results
A total of 1193 Irish festival attendees over the age of 18 completed an anonymous online survey. Alcohol, MDMA powder/crystals, ecstasy pills and cocaine were the highest reported drugs used by Irish festival attendees. The vast majority of participants reported polysubstance use (86.8%/n = 1036). Forty percent of participants (39.98%/n = 477) reported having had sex following the use of a drug at a festival; of these, 66% (n = 316) said that the sex was unprotected. Most participants (84.0%/n = 1003) engaged in some form of harm reduction when taking drugs at festivals.
Overwhelmingly, participants reported a willingness to engage with drug-checking services. The vast majority (96.3%; n = 1149) and would use drug checking services more than three-quarters (75.1%/n = 897) reported that they would use an ‘amnesty bin’ for drugs if it were part of an alert system to notify if dangerous drugs are in circulation. A chi-square test of Independence was conducted to examine whether age and utilisation of drug safety testing service a festival were independent. Moreover, when all cases are taken together, the difference between testing modalities (onsite, offsite and amnesty bin) shows a significant difference p < 001 between those who would use onsite and offsite drug testing facilities.
Conclusion
The evidence from this survey indicates that those young people who use drugs at festivals would be prepared to utilise drug checking services and amnesty bins should help inform the public health response to this important area.
Opioid agonist treatment (OAT) is the most effective treatment for opioid dependence, although it relies heavily on regular face-to-face healthcare delivery. Following the emergence of COVID-19, policies were rapidly changed in Ireland to reduce the risk of contracting the virus for both clients and treatment providers. From March 2020, the Health Service Executive (HSE) National Social Inclusion Office introduced a series of national contingency guidelines, to ensure fast and uninterrupted access to OAT while balancing efforts to mitigate COVID-19 risks. The Programme for Government 2020 states they will retain many of the measures introduced during the COVID-19 pandemic to reduce waiting times in accessing treatment services and reduce overdose mortality. It is therefore essential to examine the impacts, benefits and unintended consequences of the special measures introduced during COVID-19 at a national level, thus informing which measures can and should be sustained throughout and beyond COVID-19 to support effective, safe and patient-centered care promoting the health and wellbeing of all people with opioid dependence. The aim of this project is to identify priorities for quality improvements which will inform clinical decision making throughout and beyond the pandemic. This will be achieved through a Delphi consensus study. Quality indicators will be identified by comparing the national contingency guidelines with the national 2016 Clinical Guidelines. The project steering group will review the proposed indicators, and the agreed quality indicators will be integrated into an on-line Delphi questionnaire. One hundred participants will be invited to form the Delphi consensus panel and will include a wide range of stakeholders, including people accessing OAT services, general practitioners, pharmacists and outreach workers. Evidence generated from this study will inform national policy decisions in relation to improving quality of care in OAT.
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