British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, V6Z 2A9 BC, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 553B-1081 Burrard Street, Vancouver, V6Z 1Y6 BC, Canada.
British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, V6Z 2A9 BC, Canada.
Drug Alcohol Depend. 2022 Oct 1;239:109608. doi: 10.1016/j.drugalcdep.2022.109608. Epub 2022 Aug 25.
Substance use management in hospitals can be challenging. In response, a Canadian hospital opened an overdose prevention site (OPS) where community members and hospital inpatients can inject pre-obtained illicit drugs under supervision. This study aims to: (1) describe program utilization patterns; (2) characterize OPS visits; and (3) evaluate overdose events and related outcomes.
A retrospective chart review was completed at one hospital in Vancouver, Canada. All community members and hospital inpatients who visited the OPS between May 2018 and July 2019 were included. Client measures included: hospital inpatient status, use of intravenous access line for drug injection, and substances used. Program measures included: number of visits (daily/monthly), overdose (fatal/non-fatal) events and overdose-related outcomes.
Overall, 11,673 OPS visits were recorded. Monthly visits increased from 306 to 1198 between May 2018 and July 2019 respectively. On average, 26 visits occurred daily. Among all visits, 20% reported being a hospital inpatient, and 5% reported using a hospital intravenous access line for drug injection. Opioids (56%) and stimulants (24%) were the most common substances used. Overall 39 overdose events occurred - 82% required naloxone reversal, 28% required transfer to the hospital's emergency department and none were fatal. Overdose events were more common among hospital inpatients compared to community clients (6.6 vs 2.2 per 1000 visits respectively; p value = 0.046).
This unique OPS is an example of a hospital-based harm reduction initiative. Use of the site increased over time among both groups with no fatal overdose events occurring.
医院的物质使用管理可能具有挑战性。有鉴于此，一家加拿大医院开设了一个过量预防场所（OPS），社区成员和医院住院患者可以在监督下注射事先获得的非法药物。本研究旨在：（1）描述计划利用模式；（2）描述 OPS 访问；（3）评估过量事件和相关结果。
在加拿大温哥华的一家医院进行了回顾性图表审查。所有在 2018 年 5 月至 2019 年 7 月期间访问 OPS 的社区成员和医院住院患者均包括在内。客户措施包括：医院住院患者状态、静脉内接入线用于药物注射以及使用的物质。计划措施包括：访问次数（每日/每月）、过量（致命/非致命）事件和与过量相关的结果。
总体而言，共记录了 11673 次 OPS 访问。2018 年 5 月至 2019 年 7 月，每月访问量从 306 次增加到 1198 次。平均每天有 26 次访问。在所有访问中，20%报告是医院住院患者，5%报告使用医院静脉内接入线进行药物注射。阿片类药物（56%）和兴奋剂（24%）是最常用的物质。总体而言，发生了 39 起过量事件 - 82%需要纳洛酮逆转，28%需要转移到医院急诊室，没有致命事件。与社区客户相比，住院患者发生过量事件更为常见（分别为每 1000 次访问 6.6 次和 2.2 次；p 值=0.046）。
这个独特的 OPS 是医院为减少伤害而采取的一项倡议。在两组人群中，随着时间的推移，该场所的使用率均有所增加，且没有发生致命的过量事件。
