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

Park, Ju Nyeong; Sherman, Susan G.; Rouhani, Saba; Morales, Kenneth B.; McKenzie, Michelle; Allen, Sean T.; Marshall, Brandon D. L.; Green, Traci C.

doi:10.1007/s11524-019-00365-1

Cited by 55 publications

(35 citation statements)

References 39 publications

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“…134 Solitary drug use, which is practiced by an estimated 58% of PWUD, lowers the chances of EMS being called or naloxone being administered. [135][136][137] State-level income inequality has been shown to be highly correlated with drug overdose deaths in the early 2000s. 127,131,138 The roles of race, sex, drug, time, geography, and urbanicity in relation to overdose risk require further attention.…”

Section: Fatal Drug Overdosementioning

confidence: 99%

Situating the Continuum of Overdose Risk in the Social Determinants of Health: A New Conceptual Framework

Park

Rouhani

Beletsky³

et al. 2020

Milbank Quarterly

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117

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This article reconceptualizes our understanding of the opioid epidemic and proposes six strategies that address the epidemic's social roots. In order to successfully reduce drug‐related mortality over the long term, policymakers and public health leaders should develop partnerships with people who use drugs, incorporate harm reduction interventions, and reverse decades of drug criminalization policies. Context Drug overdose is the leading cause of injury‐related death in the United States. Synthetic opioids, predominantly illicit fentanyl and its analogs, surpassed prescription opioids and heroin in associated mortality rates in 2016. Unfortunately, interventions fail to fully address the current wave of the opioid epidemic and often omit the voices of people with lived experiences regarding drug use. Every overdose death is a culmination of a long series of policy failures and lost opportunities for harm reduction. Methods In this article, we conducted a scoping review of the opioid literature to propose a novel framework designed to foreground social determinants more directly into our understanding of this national emergency. The “continuum of overdose risk” framework is our synthesis of the global evidence base and is grounded in contemporary theories, models, and policies that have been successfully applied both domestically and internationally. Findings De‐escalating overdose risk in the long term will require scaling up innovative and comprehensive solutions that have been designed through partnerships with people who use drugs and are rooted in harm reduction. Conclusions Without recognizing the full drug‐use continuum and the role of social determinants, the current responses to drug overdose will continue to aggravate the problem they are trying to solve.

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Section: Fatal Drug Overdosementioning

confidence: 99%

Situating the Continuum of Overdose Risk in the Social Determinants of Health: A New Conceptual Framework

Park

Rouhani

Beletsky³

et al. 2020

Milbank Quarterly

Self Cite

117

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“…A small number of research studies have examined hypothetical acceptability of SCS among PWID in the US [31–34]. These studies report between 63 and 92% of PWID indicated likely use of a SCS if one existed in their community.…”

Section: Introductionmentioning

confidence: 99%

Acceptability of safe drug consumption spaces among people who inject drugs in rural West Virginia

et al. 2019

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Aim Safe consumption spaces (SCS) are indoor environments in which people can use drugs with trained personnel on site to provide overdose reversal and risk reduction services. SCS have been shown to reduce fatal overdoses, decrease public syringe disposal, and reduce public drug consumption. Existing SCS research in the USA has explored acceptability for the hypothetical use of SCS, but primarily among urban populations of people who inject drugs (PWID). Given the disproportionate impact of the opioid crisis in rural communities, this research examines hypothetical SCS acceptability among a rural sample of PWID in West Virginia. Methods Data were drawn from a 2018 cross-sectional survey of PWID ( n = 373) who reported injection drug use in the previous 6 months and residence in Cabell County, West Virginia. Participants were asked about their hypothetical use of a SCS with responses dichotomized into two groups, likely and unlikely SCS users. Chi-square and t tests were conducted to identify differences between likely and unlikely SCS users across demographic, substance use, and health measures. Results Survey participants were 59.5% male, 83.4% non-Hispanic White, and 79.1% reported likely hypothetical SCS use. Hypothetical SCS users were significantly ( p < .05) more likely to have recently (past 6 months) injected cocaine (38.3% vs. 25.7%), speedball (41.0% vs. 24.3%), and to report preferring drugs containing fentanyl (32.5% vs. 20.3%). Additionally, likely SCS users were significantly more likely to have recently experienced an overdose (46.8% vs. 32.4%), witnessed an overdose (78.3% vs. 60.8%), and received naloxone (51.2% vs. 37.8%). Likely SCS users were less likely to have borrowed a syringe from a friend (34.6% vs. 48.7%). Conclusions Rural PWID engaging in high-risk behaviors perceive SCS as an acceptable harm reduction strategy. SCS may be a viable option to reduce overdose fatalities in rural communities.

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“…If a program aims to strategically reduce its visibility it may limit community awareness and support of the program and constrain the reach of the program to potential clients who are unaware of the program's existence. Several studies in the U.S. have examined the acceptability of SUSs among PWID and found widespread endorsement that they would use those services if they existed in the community, among both urban (Park et al, 2019) and rural populations (O'Rourke et al, 2019). While our survey shows the general public is not aware of programs in their community, further research is needed on the extent to which PWID in these communities know about the programs.…”

Section: Discussionmentioning

confidence: 70%

Perceptions of syringe services programs and supervised use sites among a sample of registered voters in a U.S. state

Brooks‐Russell

Brandspigel

Franco

et al. 2020

Preprint

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Abstract BackgroundThe decision to initiate a syringe service program or expand to a supervised use site is often influenced by local public support or opposition. The purpose of this study was to better understand public attitudes to local syringe service programs to inform the possibility of expanding services.Methods.We surveyed a sample of registered voters (n = 690) in the eight counties in the state of Colorado, United States, with existing syringe service programs about their awareness of and attitudes towards syringe service programs and supervised use sites.Results.Over three-quarters of respondents reported they were familiar with syringe service programs but only quarter knew they were legal, despite all survey respondents living near an operating program. Nearly 1 in 3 respondents thought a syringe service program or a supervised use site makes a community better and a majority (57%) thought supervised use sites should be legal in their state. There were significant differences in attitudes towards the benefits and risks of syringe service programs by political party affiliation.ConclusionUnderstanding the level of community knowledge and support for syringe service programs, as well as the reasons for opposition, can be helpful in addressing community concerns when seeking to initiate or expand services.

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

Cited by 55 publications

References 39 publications

Situating the Continuum of Overdose Risk in the Social Determinants of Health: A New Conceptual Framework

Situating the Continuum of Overdose Risk in the Social Determinants of Health: A New Conceptual Framework

Acceptability of safe drug consumption spaces among people who inject drugs in rural West Virginia

Perceptions of syringe services programs and supervised use sites among a sample of registered voters in a U.S. state

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