British Columbia Centre on Substance Use, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
British Columbia Centre on Substance Use, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Drug Alcohol Depend. 2018 Sep 1;190:6-8. doi: 10.1016/j.drugalcdep.2018.05.023. Epub 2018 Jun 26.
A growing body of research points to increasing peer involvement in programs for people who use drugs, although this work has focused primarily on naloxone education and distribution. This study extends this work by examining the roles of peers in leading a novel overdose response program within emergency shelters.
Semi-structured qualitative interviews were conducted with 24 people who use drugs, recruited from two emergency shelters, as well as ethnographic observation in these settings. Interviews were transcribed and analyzed thematically with attention to peer roles.
Four themes emerged from the data. First, participants discussed the development of peer support through relationship building and trust. Second, participants described a level of safety using drugs in front of peer workers due to their shared lived experience. Third, peer workers were described as favorable compared to non-peer staff because of nominal power dynamics and past negative experiences with non-peer staff. Last, given the context of the overdose crisis, peer worker roles were often routinized informally across the social networks of residents, which fostered a collective obligation to respond to overdoses.
Findings indicate that participants regarded peer workers as providing a range of unique benefits. They emphasized the critical role of both social networks and informal roles in optimizing overdose responses. The scaling up of peer programming in distinct risk environments such as emergency shelters through both formal and informal roles has potential to help improve overdose prevention efforts, including in settings not well served by conventional public health programming.
越来越多的研究表明，同伴在吸毒者项目中发挥着越来越大的作用，尽管这些工作主要集中在纳洛酮教育和分发方面。本研究通过考察同伴在紧急避难所内领导一项新的过量反应方案中的作用，扩展了这方面的工作。
从两个紧急避难所招募了 24 名吸毒者，对他们进行了半结构式定性访谈，并在这些环境中进行了民族志观察。对访谈进行了转录，并从同伴角色的角度进行了主题分析。
数据中出现了四个主题。首先，参与者讨论了通过建立关系和信任来发展同伴支持。其次，参与者描述了在同伴工作人员面前使用毒品的安全性，因为他们有共同的生活经验。第三，与非同伴工作人员相比，同伴工作人员更受欢迎，因为他们的权力关系不那么正式，而且与非同伴工作人员有过负面的过去经历。最后，鉴于过量危机的背景，同伴工作人员的角色在居民的社交网络中经常非正式地例行化，这促进了对过量反应的集体义务。
研究结果表明，参与者认为同伴工作人员提供了一系列独特的好处。他们强调了社交网络和非正式角色在优化过量反应方面的关键作用。通过正式和非正式角色，在紧急避难所等不同风险环境中扩大同伴方案，有可能有助于加强过量预防工作，包括在常规公共卫生方案服务不足的环境中。
