Pietrantoni Dylan, Barroca Crystal, Lynch Sarah, Byrne Jonathan, Ortner Miranda, Kotwani Roshni, Limbrick Kolin, Kaldas Paul, Moussa Michael, Fredrickson Tatem, Schaefer Jeffrey, Jacobs Robin J
Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA.
Cureus. 2023 May 15;15(5):e39023. doi: 10.7759/cureus.39023. eCollection 2023 May.
The COVID-19 pandemic has had worldwide impacts, including disrupting community services. One interrupted service was syringe service programs (SSPs), community-established initiatives that provide sterile supplies and aid in overcoming addiction in drug-using participants. In the United States (U.S.), SSPs have been key in combating the recent opioid use crisis and associated infections such as the human immunodeficiency virus (HIV) and hepatitis C. While some published reports on the pandemic's overall impacts on SSPs exist, certain aspects such as operational changes and repercussions on staff and participants may still be lacking. Information about the impact of interrupted SSP services due to the pandemic may provide insight into how to prepare to mitigate similar outcomes during possible future health outbreaks. The aim of this scoping review was thus to explore the effects of the COVID-19 pandemic on the operations, staff, and participants of SSPs in the U.S. The initial search of the databases PubMed, Embase, and Web of Science with selected keywords yielded 117 articles published in English between January 1, 2020, and August 31, 2022. After screening each article for study eligibility, 11 articles were included in the final review. Of the seven articles exploring SSP operational impacts from the pandemic, five acknowledged that mitigation strategies influenced functions, seven highlighted supply changes, and four emphasized the resulting staffing changes. Four studies inspected the pandemic's impacts on SSP participants, which included two articles highlighting participants' struggles with isolation and loneliness, one referencing the fear of exposure to the SARS-CoV-2 virus, and two examining the overall negative psychological effects experienced during this time. SSPs in various settings and regions across the U.S. experienced changes due to the COVID-19 pandemic. Many of these modifications negatively impacted operations, staffing, and participant relationships. Examining the issues that individual SSPs encountered highlights opportunities for structured solutions for the present and in the case of future infectious disease outbreaks. With the severity of the opioid use crisis in the U.S. and the dependence on SSPs for its mitigation, future work in this space should be prioritized.
新冠疫情已产生全球性影响，包括扰乱社区服务。一项受到影响的服务是注射器服务项目（SSP），这是社区发起的倡议，为吸毒参与者提供无菌用品并帮助他们克服成瘾问题。在美国，注射器服务项目对于应对近期的阿片类药物使用危机以及诸如人类免疫缺陷病毒（HIV）和丙型肝炎等相关感染起到了关键作用。虽然已有一些关于疫情对注射器服务项目总体影响的公开报告，但在诸如运营变化以及对工作人员和参与者的影响等某些方面可能仍存在欠缺。有关因疫情导致注射器服务项目中断所产生影响的信息，或许能为如何在未来可能出现的健康疫情期间做好准备以减轻类似后果提供见解。因此，本范围综述的目的是探究新冠疫情对美国注射器服务项目的运营、工作人员和参与者所产生的影响。最初使用选定关键词在PubMed、Embase和Web of Science数据库中进行检索，共得到2020年1月1日至2022年8月31日期间以英文发表的117篇文章。在对每篇文章进行研究资格筛选后，11篇文章被纳入最终综述。在7篇探讨疫情对注射器服务项目运营影响的文章中，5篇承认缓解策略影响了其功能，7篇强调了供应变化，4篇强调了由此导致的人员配置变化。4项研究考察了疫情对注射器服务项目参与者的影响，其中包括2篇强调参与者在隔离和孤独方面挣扎的文章，1篇提及对感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒的恐惧，以及2篇考察在此期间所经历的总体负面心理影响的文章。美国不同地区和环境中的注射器服务项目因新冠疫情而发生了变化。其中许多变化对运营、人员配置和参与者关系产生了负面影响。审视各个注射器服务项目所遇到的问题，凸显了为当前以及未来传染病爆发情况制定结构化解决方案的机会。鉴于美国阿片类药物使用危机的严重性以及对注射器服务项目缓解危机的依赖，该领域未来的工作应予以优先考虑。
