5-21 HMT, University of Alberta, Edmonton, AB, T6G 2H4.
Athabasca University, 1 University Drive, Athabasca, AB, T9S 3A3.
Int J Drug Policy. 2021 Feb;88:102991. doi: 10.1016/j.drugpo.2020.102991. Epub 2020 Nov 7.
While previous scholarship has documented barriers to Supervised Consumption Services (SCS) access, little is known about how Non-SCS-users perceive available, sanctioned SCS, and how such perceptions may hinder their SCS use. The objectives of this study were to examine: 1) barriers to accessing SCS for SCS-users and Non-SCS-users; and 2) the extent to which these barriers are consistent between groups.
We conducted semi-structured interviews with 75 PWUD in two cities in Western Canada, Edmonton and Calgary, who may or may not have accessed available SCS. Participants were recruited on the streets near SCS via traditional fieldwork and snowball sampling. We employed a generalized prompt guide and asked a range of questions about how PWUD perceived and/or experienced SCS in the area. All interviews were digitally recorded, transcribed, thematically coded, and analysed.
Despite PWUD's generally positive perceptions of SCS, we identified several operational barriers to SCS access, including wait times and time limits, restrictions on injection assistance, and client bans from clinics. We also identified contextual barriers, including perceptions of the 'unnecessary' use of naloxone and police surveillance. Importantly, these barriers were consistent between SCS-users and Non-SCS-users, though some SCS-users actively worked to counter contextual barriers among peers.
Operational and contextual barriers to SCS use contribute to intermittent access for existing clients and preclude SCS access for others. Addressing such barriers may increase SCS uptake, thereby further extending the well-documented and critical reach of these harm reduction initiatives.
虽然之前的研究已经记录了获得监督消费服务（SCS）的障碍，但对于非 SCS 用户如何看待现有的、合法的 SCS，以及这些看法如何阻碍他们使用 SCS，知之甚少。本研究的目的是检验：1）SCS 用户和非 SCS 用户获得 SCS 的障碍；2）这些障碍在两组之间的一致性程度。
我们在加拿大西部的埃德蒙顿和卡尔加里两个城市进行了半结构式访谈，访谈对象为可能已经或尚未获得可用 SCS 的 75 名吸毒者。参与者通过传统的实地工作和滚雪球抽样在 SCS 附近的街道上招募。我们采用了通用提示指南，并询问了吸毒者对该地区 SCS 的看法和/或体验的一系列问题。所有访谈均进行了数字记录、转录、主题编码和分析。
尽管吸毒者普遍对 SCS 持积极态度，但我们发现了一些获得 SCS 的操作障碍，包括等待时间和时间限制、对注射援助的限制以及禁止吸毒者进入诊所。我们还发现了一些背景障碍，包括对纳洛酮“不必要”使用的看法和警察的监视。重要的是，这些障碍在 SCS 用户和非 SCS 用户之间是一致的，尽管一些 SCS 用户积极努力在同行中消除背景障碍。
使用 SCS 的操作和背景障碍导致现有客户间歇性地获得服务，并且使其他人无法获得 SCS。解决这些障碍可能会增加 SCS 的使用率，从而进一步扩大这些减少伤害的倡议的已记录的和至关重要的影响范围。
