Weill Cornell Medical College, New York, NY, 10065, USA.
Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, 10065, USA.
Harm Reduct J. 2023 Feb 2;20(1):12. doi: 10.1186/s12954-023-00742-9.
Syringe service programs (SSPs) deliver critical harm reduction services to people who inject drugs (PWID). Some SSPs in New York State received enhanced funding to provide additional services to combat opioid overdose fatalities. These SSPs, known as Drug User Health Hubs, provide buprenorphine for the treatment of opioid use disorder and other health-related services in addition to their syringe services. While the COVID-19 pandemic posed widespread challenges to the delivery of health services nationwide, the effect of the pandemic on SSPs uniquely impacts PWID. This study examines the impact of COVID-19 on service delivery of Drug User Health Hubs and stand-alone SSPs in New York State.
Between July 2020 and September 2020, we performed eleven semi-structured virtual interviews with staff from three Health Hub SSPs and three stand-alone SSPs. The interviews explored the effect of the COVID-19 pandemic on SSPs and their clients as well as the changes implemented in response. Interviews were recorded and transcribed. We performed content analysis to identify emerging themes from the data.
Due to the COVID-19 pandemic, some SSPs temporarily shut down while others limited their hours of operation. SSPs modified their service delivery to maintain syringe services and naloxone distribution over other services such as STI and HCV testing. They virtualized components of their services, including telemedicine for the provision of buprenorphine. While SSPs found virtualization to be important for maintaining their services, it negatively impacted the intimate nature of client interactions. Participants also described the impact of the pandemic on the well-being of PWID, including isolation, worsened mental health challenges, and increased drug overdoses.
In response to the COVID-19 pandemic, SSPs demonstrated innovation, adaptability, and togetherness. Despite the challenges posed by the pandemic, SSPs continued to be key players in maintaining access to sterile supplies, buprenorphine, and other services for PWID. In addition to adapting to COVID-19 restrictions, they also responded to the dynamic needs of their clients. Sustainable funding and recognition of the critical role of SSPs in supporting PWID can help to improve outcomes for PWID.
注射器服务项目 (SSP) 为注射毒品者 (PWID) 提供关键的减少伤害服务。纽约州的一些 SSP 获得了额外的资金，以提供额外的服务来对抗阿片类药物过量死亡。这些 SSP 被称为吸毒者健康中心，除了提供注射器服务外，还提供丁丙诺啡治疗阿片类药物使用障碍和其他与健康相关的服务。虽然 COVID-19 大流行给全国的医疗服务提供带来了广泛的挑战，但大流行对 SSP 的影响对 PWID 来说是独特的。本研究检查了 COVID-19 对纽约州吸毒者健康中心和独立 SSP 服务提供的影响。
在 2020 年 7 月至 2020 年 9 月期间，我们对三个健康中心 SSP 和三个独立 SSP 的工作人员进行了 11 次半结构化虚拟访谈。访谈探讨了 COVID-19 大流行对 SSP 及其客户的影响，以及为应对大流行而实施的变化。采访进行了记录和转录。我们进行了内容分析，以从数据中识别出新兴主题。
由于 COVID-19 大流行，一些 SSP 暂时关闭，而其他 SSP 则限制了营业时间。SSP 调整了服务提供方式，以维持注射器服务和纳洛酮的分发，而不是其他服务，如性传播感染和丙型肝炎检测。他们使服务的某些部分实现了虚拟化，包括提供丁丙诺啡的远程医疗。虽然 SSP 认为虚拟化对于维持服务很重要，但它对客户互动的亲密性质产生了负面影响。参与者还描述了大流行对 PWID 福祉的影响，包括隔离、心理健康挑战恶化和药物过量增加。
为应对 COVID-19 大流行，SSP 表现出创新、适应性和团结性。尽管大流行带来了挑战，但 SSP 继续成为为 PWID 提供无菌用品、丁丙诺啡和其他服务的关键参与者。除了适应 COVID-19 限制外，他们还应对客户的动态需求。可持续的资金和对 SSP 在支持 PWID 方面的关键作用的认可，可以帮助改善 PWID 的结果。
