British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.
Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Subst Abuse Treat Prev Policy. 2023 Mar 10;18(1):16. doi: 10.1186/s13011-023-00521-6.
Supervised consumption sites (SCS) and overdose prevention sites (OPS) have been increasingly implemented in response to the ongoing overdose epidemic in Canada. Although there has been a dramatic increase in overdose deaths since the start of the SARS-CoV 2 (COVID-19) pandemic, little is known about how SCS access may have been affected by this pandemic. Therefore, we sought to characterize potential changes in access to SCS during the COVID-19 pandemic among people who use drugs (PWUD) in Vancouver, Canada.
Between June and December 2020, data were collected through the Vancouver Injection Drug Users Study (VIDUS) and the AIDS Care Cohort to Evaluate Exposure to Survival Services (ACCESS), two cohort studies involving people who use drugs. Multivariable logistic regression was used to examine individual, social and structural factors associated with self-reported reduced frequency of SCS/OPS use since COVID-19.
Among 428 participants, 223 (54.7%) self-identified as male. Among all individuals surveyed, 63 (14.8%) reported a decreased frequency of use of SCS/OPS since COVID-19. However, 281 (66%) reported that they "did not want to" access SCS in the last 6 months. In multivariable analyses, younger age, self-reported fentanyl contamination of drugs used and reduced ease of access to SCS/OPS since COVID-19 were positively associated with a decreased frequency of use of SCS/OPS since COVID-19 (all p < 0.05).
Approximately 15% of PWUD who accessed SCS/OPS reported reduced use of these programs during the COVID-19 pandemic, including those at heightened risk of overdose due to fentanyl exposure. Given the ongoing overdose epidemic, efforts must be made to remove barriers to SCS access throughout public health crises.
为应对加拿大持续不断的阿片类药物过量流行，已越来越多地实施监督消费场所（SCS）和过量预防场所（OPS）。尽管自 SARS-CoV 2（COVID-19）大流行开始以来，药物过量死亡人数急剧增加，但对于 SCS 的使用途径如何受到这一大流行的影响知之甚少。因此，我们试图描述加拿大温哥华的药物使用者在 COVID-19 大流行期间使用 SCS 的途径可能发生的潜在变化。
在 2020 年 6 月至 12 月期间，通过温哥华注射吸毒者研究（VIDUS）和评估生存服务接触的艾滋病护理队列（ACCESS）收集数据，这两项队列研究涉及药物使用者。多变量逻辑回归用于检查自 COVID-19 以来，与自我报告的 SCS/OPS 使用频率降低相关的个人、社会和结构因素。
在 428 名参与者中，有 223 名（54.7%）自我认定为男性。在所有接受调查的人中，有 63 人（14.8%）报告自 COVID-19 以来 SCS/OPS 的使用频率降低。但是，有 281 人（66%）报告说，他们在过去 6 个月内“不想”使用 SCS。在多变量分析中，年龄较小、自我报告的药物使用中芬太尼污染以及自 COVID-19 以来 SCS/OPS 的获取途径减少与 SCS/OPS 的使用频率降低呈正相关（均 p<0.05）。
约 15%使用过 SCS/OPS 的药物使用者报告在 COVID-19 大流行期间减少了对这些项目的使用，其中包括因接触芬太尼而面临更高药物过量风险的人群。鉴于当前的药物过量流行，必须在公共卫生危机期间努力消除获得 SCS 的障碍。
