School of Public Health, University of Alberta, Edmonton, Alberta, Canada; Inner City Health and Wellness Program, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
Inner City Health and Wellness Program, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
Int J Drug Policy. 2022 Apr;102:103589. doi: 10.1016/j.drugpo.2022.103589. Epub 2022 Jan 29.
Internationally, many supervised consumption services (SCS) include drug inhalation (smoking). However, most research is focused on SCS for people who inject drugs. We aimed to: (1) synthesize the literature on including inhalation or other forms of non-injection drug use (e.g., oral, intranasal) within SCS; (2) describe the state of the science on the feasibility of this practice and its outcomes; and (3) outline an agenda for future evaluation research in this area.
We searched 9 academic and 13 grey literature databases and ultimately included 40 studies. Thirty-two studies (80%) reported findings from feasibility or needs assessments. From these studies, we extracted information on willingness to use these services, perspectives of people who use drugs and other stakeholders, and recommendations for implementation. Eight studies (20%) evaluated including inhalation in SCS, from which we extracted data on associated outcomes. Data were analysed using narrative synthesis and descriptive statistics.
We found high willingness to use SCS including inhalation among people who use drugs, especially those experiencing structural vulnerability. Research emphasized a need for implementation to account for the social nature of drug inhalation, and to limit potential occupational hazards associated with passive inhalation. Positive outcomes associated with inhalation within SCS included improved health and safety of people who use drugs and decreased public drug use. However, this evidence was based primarily on a limited number of studies with designs of mixed quality.
Our review demonstrates feasibility of, and need for, implementing SCS including inhalation, and some potential positive outcomes associated with this practice. However, more comprehensive and systematic evaluations of including inhalation as well as other forms of non-injection drug use (e.g., oral, intranasal, rectal) within SCS should be conducted.
在国际上，许多监督消费服务（SCS）包括药物吸入（吸烟）。然而，大多数研究都集中在为注射毒品者提供 SCS 上。我们的目的是：（1）综合有关在 SCS 中纳入吸入或其他形式的非注射药物使用（例如，口服，鼻内）的文献；（2）描述该实践的可行性及其结果的科学现状；（3）概述该领域未来评估研究的议程。
我们搜索了 9 个学术数据库和 13 个灰色文献数据库，最终纳入了 40 项研究。其中 32 项研究（80％）报告了可行性或需求评估的结果。从这些研究中，我们提取了有关使用这些服务的意愿、吸毒者和其他利益相关者的观点以及实施建议的信息。 8 项研究（20％）评估了在 SCS 中纳入吸入，从中我们提取了与相关结果相关的数据。使用叙述性综合和描述性统计对数据进行分析。
我们发现吸毒者非常愿意使用包括吸入在内的 SCS，尤其是那些处于结构脆弱性的吸毒者。研究强调需要实施，以考虑到药物吸入的社会性质，并限制与被动吸入相关的潜在职业危害。与 SCS 中吸入相关的积极结果包括改善吸毒者的健康和安全，减少公共吸毒。然而，这一证据主要基于少数设计质量混合的研究。
我们的综述表明，实施包括吸入在内的 SCS 的可行性和必要性，以及这种做法可能带来的一些积极结果。然而，应该对包括吸入以及其他形式的非注射药物使用（例如，口服，鼻内，直肠）在内的 SCS 进行更全面和系统的评估。
