Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Harm Reduct J. 2021 Aug 5;18(1):85. doi: 10.1186/s12954-021-00530-3.
Spotting is an informal practice among people who use drugs (PWUD) where they witness other people using drugs and respond if an overdose occurs. During COVID-19 restrictions, remote spotting (e.g., using a telephone, video call, and/or a social media app) emerged to address physical distancing requirements and reduced access to harm reduction and/or sexually transmitted blood borne infection (STBBI's) prevention services. We explored spotting implementation issues from the perspectives of spotters and spottees.
Research assistants with lived/living expertise of drug use used personal networks and word of mouth to recruit PWUD from Ontario and Nova Scotia who provided or used informal spotting. All participants completed a semi-structured, audio-recorded telephone interview about spotting service design, benefits, challenges, and recommendations. Recordings were transcribed and thematic analysis was used.
We interviewed 20 individuals between 08/2020-11/2020 who were involved in informal spotting. Spotting was provided on various platforms (e.g., telephone, video calls, and through texts) and locations (e.g. home, car), offered connection and community support, and addressed barriers to the use of supervised consumption sites (e.g., location, stigma, confidentiality, safety, availability, COVID-19 related closures). Spotting calls often began with setting an overdose response plan (i.e., when and who to call). Many participants noted that, due to the criminalization of drug use and fear of arrest, they preferred that roommates/friends/family members be called instead of emergency services in case of an overdose. Both spotters and spottees raised concerns about the timeliness of overdose response, particularly in remote and rural settings.
Spotting is a novel addition to, but not replacement for, existing harm reduction services. To optimize overdose/COVID-19/STBBI's prevention services, additional supports (e.g., changes to Good Samaritan Laws) are needed. The criminalization of drug use may limit uptake of formal spotting services.
在吸毒者中，发现是一种非正式的做法，即他们观察其他人使用毒品，如果发生过量，就会做出反应。在 COVID-19 限制期间，出现了远程发现（例如，使用电话、视频通话和/或社交媒体应用程序），以满足保持身体距离的要求，并减少获得减少伤害和/或性传播血液传染病（STBBI）预防服务的机会。我们从发现者和被发现者的角度探讨了发现实施方面的问题。
具有吸毒生活/经验的研究助理利用个人网络和口碑从安大略省和新斯科舍省招募提供或使用非正式发现的吸毒者。所有参与者都完成了关于发现服务设计、益处、挑战和建议的半结构化、录音电话访谈。录音被转录，并使用主题分析。
我们在 2020 年 8 月至 11 月期间采访了 20 名参与非正式发现的个人。发现是在各种平台（例如电话、视频通话和通过短信）和地点（例如家庭、汽车）上提供的，提供了联系和社区支持，并解决了使用监督消费场所的障碍（例如位置、耻辱感、保密性、安全性、可用性、与 COVID-19 相关的关闭）。发现电话通常从制定过量反应计划开始（即何时何地打电话）。许多参与者指出，由于吸毒的刑事化和对被捕的恐惧，他们更喜欢在发生过量的情况下，由室友/朋友/家人而不是紧急服务来打电话。发现者和被发现者都对过量反应的及时性表示担忧，尤其是在偏远和农村地区。
发现是对现有减少伤害服务的补充，而不是替代。为了优化过量/COVID-19/STBBI 预防服务，需要额外的支持（例如，修改好撒玛利亚人法）。吸毒的刑事化可能会限制对正式发现服务的接受。
