Back to the core: A network approach to bolster harm reduction among persons who inject drugs

Bouchard, Martin; Hashimi, Sadaf; Tsai, Kristen; Lampkin, Hugh; Jozaghi, Ehsan

doi:10.1016/j.drugpo.2017.10.006

Cited by 28 publications

(29 citation statements)

References 48 publications

(71 reference statements)

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“…Regardless, harm reduction services are critical to ensure that older PWUD, as well as younger PWUD, who engage in NMPOU have access to overdose prevention and reversal services such as supervised drug consumption spaces/services and the widespread distribution of Naloxone/Narcan in the community and among PWUD. The reach of harm reduction services may also be increased by strategically mobilizing key peers within PWUDs’ social networks, which are an untapped resource and could become important facilitators of harm reduction supplies and information [ 68 , 69 ].…”

Section: Discussionmentioning

confidence: 99%

An age-based analysis of nonmedical prescription opioid use among people who use illegal drugs in Vancouver, Canada

Cheng

Small

Dong

et al. 2018

Subst Abuse Treat Prev Policy

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BackgroundNonmedical prescription opioid use (NMPOU) is a serious public health problem in North America. At a population-level, previous research has identified differences in the prevalence and correlates of NMPOU among younger versus older age groups; however, less is known about age-related differences in NMPOU among people who use illegal drugs.MethodsData were collected between 2013 and 2015 from two linked prospective cohort studies in Vancouver, Canada: the At-Risk Youth Study (ARYS) and the Vancouver Injection Drug Users Study (VIDUS). Factors independently associated with NMPOU among younger (ARYS) and older (VIDUS) participants were examined separately using bivariate and multivariate generalized estimating equations.ResultsA total of 1162 participants were included. Among 405 eligible younger participants (Median age = 25; Inter-Quartile Range [IQR]: 22–28), 40% (n = 160) reported engaging in NMPOU at baseline; among 757 older participants (Median age = 48, IQR: 40–55), 35% (n = 262) reported engaging in NMPOU at baseline. In separate multivariate analyses of younger and older participants, NMPOU was positively and independently associated with heroin use (younger: Adjusted Odds Ratio [AOR] = 3.12, 95% Confidence Interval [CI]: 2.08–4.68; older: AOR = 2.79, 95% CI: 2.08–3.74), drug dealing (younger: AOR = 2.22, 95% CI: 1.58–3.13; older: AOR = 1.87, 95% CI: 1.40–2.49), and difficulty accessing services (younger: AOR = 1.47, 95% CI: 1.04–2.09; older: AOR = 1.74, 95% CI: 1.32–2.29). Among the youth cohort only, NMPOU was associated with younger age (AOR = 1.12, 95% CI: 1.05–1.19), crack use (AOR = 1.56, 95% CI: 1.06–2.30), and binge drug use (AOR = 1.41, 95% CI: 1.00–1.97); older participants who engaged in NMPOU were more likely to report crystal methamphetamine use (AOR = 1.97, 95% CI: 1.46–2.66), non-fatal overdose (AOR = 1.76, 95% CI: 1.20–2.60) and sex work (AOR = 1.49, 95% CI: 1.00–2.22).DiscussionThe prevalence of NMPOU is similar among younger and older people who use drugs, and independently associated with markers of vulnerability among both age groups. Adults who engage in NMPOU are at risk for non-fatal overdose, which highlights the need for youth and adult-specific strategies to address NMPOU that include better access to health and social services, as well as a range of addiction treatment options for opioid use. Findings also underscore the importance of improving pain treatment strategies tailored for PWUD.

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Section: Discussionmentioning

confidence: 99%

An age-based analysis of nonmedical prescription opioid use among people who use illegal drugs in Vancouver, Canada

Cheng

Small

Dong

et al. 2018

Subst Abuse Treat Prev Policy

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“…Then, the location and gender of suspected matches were compared. Successful matches were considered a match if they had ages within ten-year range; drug(s) of choice; current drug use status; and within a 5 year range of previous drug use (Bouchard, Hashimi, Tsai, Lampkin, & Jozaghi, 2018). Subjects that matched in at least three of the abovementioned variables were judged to be the same individual.…”

Section: Methodsmentioning

confidence: 99%

Socia networkl support and harm reduction activities in a peer led pilot study, British Columbia, Canada

Elkhalifa¹,

Jozaghi²,

Marsh³

et al. 2020

Preprint

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Abstract Background: People who smoke drugs (PWSD) are at high risk of both infectious disease and overdose. Harm reduction activities organised by their peers in the community can reduce risk by providing education; safer smoking supplies, and facilitate access to other services. Peers also provide a network of people who provide social support to PWSD which may reinforce harm reducing behaviours. We evaluated the numbers of supportive network members and the relationships between received support and participants’ harm reducing activities.Methods: Initial peer-researchers with past or current lived drug use experience were employed from communities in Abbotsford and Vancouver to interview ten friends from their social networks who use illegal drugs mainly through smoking. Contacts completed a questionnaire about people in their own harm reduction networks, and their relationships with each other. We categorised social support into informational, emotional and tangible aspects, and harm reduction into being trained in the use of, or carrying naloxone; assisting peers with overdoses, using brass screens to smoke, obtaining pipes from service organisations and being trained in CPR.Results: Fifteen initial peer-researchers interviewed 149 participants who provided information on up to 10 people who were friends or contacts and the relationships between them. People who smoked drugs in public were 1.46 (95% CI;1.13-1.78) more likely to assist others with possible overdoses if they received tangible support; women who received tangible support were 1.24(95% CI;1.02-1.45) more likely to carry, and be trained in the use of naloxone. There was no relationship between number of supportive network members and harm reduction behaviours.Conclusions: In this pilot study, PWSD who received tangible support were more likely to assist peers in possible overdoses and be trained in the use of and/or carry naloxone, than those who did not receive tangible support. Future work on the social relationships of PWSD may prove valuable in the search for credible and effective interventions.

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“…The social networks of peer research participants were joined together using a hierarchical cross-network matching mechanism. Successful matches were then matched on at least three of the following variables: age (within ten-year range), drug(s) of choice, current drug use status, and years of drug use (within a five-year range) (Bouchard, Hashimi, Tsai, Lampkin, & Jozaghi, 2018) and were considered to be the same individual. Physical and mental health status, and routes of drug administration were used to verify matches and to resolve discrepancies.…”

Section: Methodsmentioning

confidence: 99%

Combining chain link sampling with a community-based participatory action study of people who smoke drugs in two cities in British Columbia, Canada

Elhalifa

Jozaghi

Marsh³

et al. 2020

Preprint

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Background: The smoking of illicit drugs presents a serious social and economic burden in Canada. People who smoke drugs (PWSD) are at an increased risk of contracting multiple infections through risky drug practices. Peer-led harm reduction activities, and the resulting social networks that form around them, can potentially minimize the dangers associated with the smoking illicit drugs.Goal: The goal of this study is to examine the influence of peer-led harm reduction initiatives on drug behaviour by comparing the attributes and social networks of PWSD in two British Columbia cities with different harm reduction programs.Methods: Using community-based participatory action research (CBPAR) and respondent- driven sampling (RDS), individuals with lived drug experiences were employed from communities in Abbotsford and Vancouver as ‘peer researchers’ to interview ten contacts from their social networks. Contacts completed a questionnaire about their harm reduction networks.Results: We found that PWSD residing in Abbotsford were more likely to report engaging in harm-promoting behaviours, such as sharing, reusing, or borrowing crack pipes. However, PWSD in the Downtown Eastside Community (DTES) of Vancouver were more likely to report engaging in harm-reducing activities, such as being trained in naloxone use and CPR. These differences are likely linked to the greater availability of harm reduction programs in DTES compared to Abbotsford.

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Back to the core: A network approach to bolster harm reduction among persons who inject drugs

Cited by 28 publications

References 48 publications

An age-based analysis of nonmedical prescription opioid use among people who use illegal drugs in Vancouver, Canada

An age-based analysis of nonmedical prescription opioid use among people who use illegal drugs in Vancouver, Canada

Socia networkl support and harm reduction activities in a peer led pilot study, British Columbia, Canada

Combining chain link sampling with a community-based participatory action study of people who smoke drugs in two cities in British Columbia, Canada

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