A qualitative study of how Danish drug consumption rooms influence health and well-being among people who use drugs

Kappel, Nanna; Toth, Eva Charlotte; Tegner, Jette; Lauridsen, Sigurd

doi:10.1186/s12954-016-0109-y

Cited by 39 publications

(57 citation statements)

References 25 publications

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“…Since 2006, more papers described DCR/SIF clients or service operation . Also, after 2006, papers using qualitative methods have spiked including those focused on DCR clients or staff , and on other stakeholders . Since 2013, an increasing number of papers analysed SIF‐related laws and policies .…”

Section: Resultsmentioning

confidence: 99%

Drug consumption rooms: A systematic review of evaluation methodologies

Běláčková¹,

Salmon²,

Day

et al. 2019

Drug and Alcohol Review

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Issues. Drug consumptions rooms (DCR) and supervised injecting facilities (SIF) are expanding internationally. Previous reviews have not systematically addressed evaluation methodologies. Approach. Results from systematic searches of scientific databases in English until June 2017 were coded for paper type, country and year of publication. For evaluation papers, study outcome, methodology/study design and main indicators of DCR/SIF 'exposure' were recorded. Key Findings. Two hundred and nineteen eligible peer-reviewed papers were published since 1999: the majority from Canada (n = 117 papers), Europe (n = 36) and Australia (n = 32). Fifty-six papers reported evaluation outcomes. Ecological study designs (n = 10) were used to assess the impact on overdose, public nuisance and crime; modelling techniques (n = 6) estimated impact on bloodborne diseases, overdose deaths and costs. Papers using individual-level data included four prospective cohorts (n = 28), cross-sectional surveys (n = 7) and service records (n = 5). Individual-level data were used to assess safer injecting practice, uptake into health and social services and all the other above outcomes except for impact on crime and costs. Four different indicators of DCR/SIF attendance were used to measure service 'exposure'. Implications. Research around DCRs/SIFs has used ecological, modelling, cross-sectional and cohort study designs. Further research could involve systematic inclusion of a control group of people who are eligible but do not access SIFs, validation of self-reported proportion of injections at SIFs or a stepped-wedge or a cluster trial comparing localities. Conclusions. Methodologies appropriate for DCR/SIF evaluation have been established and can be readily replicated from the existing literature. Research on operational aspects, implementation and transferability is also warranted. [

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Section: Resultsmentioning

confidence: 99%

Drug consumption rooms: A systematic review of evaluation methodologies

Běláčková¹,

Salmon²,

Day

et al. 2019

Drug and Alcohol Review

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“…Examples of this include clinical restrictions placed on women's access to harm reduction services: for example, in Denmark pregnant women are the only group explicitly excluded from accessing drug consumption rooms, because of potential foetal harm, despite the greater potential harm of unsafe injection. [65,66] In other cases, women can face criminal charges or a loss of parental rights for drug use while pregnant or parenting. These circumstances are not proven to deter drug use, but do imperil the relationship between women and health providers.…”

Section: Criminalisationmentioning

confidence: 99%

Women and Barriers to Harm Reduction Services: A Literature Review and Initial Findings From a Qualitative Study in Barcelona, Spain

Shirley-Beavan

Forteza²,

Burke-Shyne

et al. 2020

Preprint

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Background There are an estimated 3.2 million women who inject drugs worldwide, constituting 20% of all people who inject drugs. The limited data that is available suggests that women who inject drugs are at greater risk of HIV and viral hepatitis acquisition than men who inject drugs. This increased vulnerability is a product of a range of environmental, social and individual factors affecting women, which also affect their ability to engage in health promoting services such as harm reduction. Methods The researchers undertook a narrative literature review examining access to harm reduction services for women who use drugs in Europe, and conducted semi-structured focus groups with women who use drugs and harm reduction and prison health workers in Barcelona, Spain. Results Women who use drugs face multiple barriers to accessing harm reduction services. These include: stigma, both in society in general and from health and harm reduction workers in prisons and in the community; gender-based violence and a lack of services that are equipped to address the interaction between drug use and experiences of violence; criminalisation in the form of legal barriers to access, arrest and harassment from law enforcement, and incarceration; a lack of services focused on the specific needs of women, notably sexual and reproductive health services and childcare. In Barcelona, participants reported experiencing all these barriers, and that their engagement with the Metzineres harm reduction centre had to some extent mitigated them. However, women continued to experience structural barriers to harm reduction service access. Conclusions Women and gender non-conforming people who use drugs face unique barriers to accessing harm reduction services. While services such as Metzineres can be life-changing and life-affirming for its members, it is incumbent on states to act to address the structural barriers to health faced by women who use drugs.

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“…Finally, there are some outcomes, both positive and negative, that are potentially associated with SCSs but are difficult to evaluate. For example, if SCS implementation makes PWUO feel more respected and less stigmatized (as suggested in some of the qualitative literature; see, for example, Krusi et al, 2009;Small et al, 2009;Kappel et al, 2016), it would be hard to capture this in a traditional quasi-experimental analysis. This is because (1) quantification of these outcomes is subjective and can be difficult to measure and (2) the effects could spill over to PWUO who do not use SCSs, as well as those in other neighborhoods, thus "contaminating" potential control groups and making it harder to identify an effect.…”

Section: Other Studiesmentioning

confidence: 99%

Considering Heroin-Assisted Treatment and Supervised Drug Consumption Sites in the United States

Kilmer¹,

Taylor²,

Caulkins³

et al. 2018

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A qualitative study of how Danish drug consumption rooms influence health and well-being among people who use drugs

Cited by 39 publications

References 25 publications

Drug consumption rooms: A systematic review of evaluation methodologies

Drug consumption rooms: A systematic review of evaluation methodologies

Women and Barriers to Harm Reduction Services: A Literature Review and Initial Findings From a Qualitative Study in Barcelona, Spain

Considering Heroin-Assisted Treatment and Supervised Drug Consumption Sites in the United States

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