School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
Inner City Health and Wellness Program, Edmonton, Alberta, Canada.
Can J Public Health. 2023 Oct;114(5):787-795. doi: 10.17269/s41997-023-00803-3. Epub 2023 Jul 18.
A temporary emergency shelter was established inside the Commonwealth Stadium in Edmonton, Alberta, to reduce COVID-19 transmission and mitigate health risks among people experiencing homelessness.
A non-profit organization, Boyle Street Community Services, opened an overdose prevention site (OPS) between February and March 2022 inside the temporary emergency shelter. People accessed the shelter-based OPS to consume unregulated drugs (via injection, intranasally, or orally), receive medical aid, access sterile drug use equipment, and be connected to additional health and social supports, without leaving the shelter. We conducted short interviewer-administered surveys with OPS participants to examine participant views and identify suggested improvements.
The shelter-based OPS was accessed a total of 1346 times by 174 unique people. Fentanyl was the most common self-reported drug consumed (59%) and most consumption (99% of episodes) was by injection. OPS staff responded to 66 overdoses and reported no deaths. Survey respondents reported that the shelter-based OPS was convenient, with no need to forfeit their shelter spot or find transportation to another OPS. Respondents indicated that the OPS felt safe and accessible and reported that it reduced drug use in other shelter areas. Participants identified the OPS' exclusion of inhalation as a limitation.
People who use unregulated drugs and are experiencing homelessness are at a higher risk of negative health outcomes, which COVID-19 exacerbated. Integrating temporary shelter/housing and harm reduction services may be an innovative way to lower barriers, increase accessibility, and improve well-being for this structurally vulnerable population. Future operators should consider incorporating inhalation services to further reduce service gaps.
在艾伯塔省埃德蒙顿的英联邦体育场内设立了一个临时紧急避难所，以减少 COVID-19 的传播并降低无家可归者的健康风险。
非营利组织 Boyle Street Community Services 于 2022 年 2 月至 3 月期间在临时紧急避难所内开设了一个过量预防点（OPS）。人们可以在避难所内的 OPS 点使用未经管制的药物（通过注射、鼻内或口服），接受医疗救助，使用无菌的药物使用设备，并获得更多的健康和社会支持，而无需离开避难所。我们对 OPS 参与者进行了简短的访谈式调查，以研究参与者的观点并确定改进建议。
共有 174 名独特的人总共 1346 次访问了避难所内的 OPS。芬太尼是最常被报告的自我报告药物（59%），也是最常被报告的药物（99%的事件）。OPS 工作人员应对了 66 例过量用药事件，报告无死亡。调查受访者表示，避难所内的 OPS 很方便，无需放弃他们的避难所位置或寻找前往另一个 OPS 的交通工具。受访者表示，OPS 感觉安全且易于获得，并报告说它减少了其他避难所区域的药物使用。参与者认为 OPS 排除了吸入是一个限制。
使用未经管制的药物且无家可归的人面临更高的负面健康结果风险，而 COVID-19 加剧了这种风险。将临时避难所/住房和减少伤害服务整合在一起可能是一种降低障碍、提高可及性并改善这个结构上脆弱的人群福祉的创新方法。未来的运营者应考虑纳入吸入服务，以进一步减少服务差距。
