Division of Infectious Disease & Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, USA.
Community Health Research Division, RTI International, 2150 Shattuck Avenue Suite 800, Berkeley, CA 94704, USA.
Drug Alcohol Depend. 2023 Nov 1;252:110969. doi: 10.1016/j.drugalcdep.2023.110969. Epub 2023 Sep 20.
Between January and December 2022 a multi-service center incorporating an overdose prevention site (OPS) operated with city government sanction in San Francisco. One concern often expressed about OPS is that they may increase social nuisance associated with drug use in the surrounding area, despite international evidence that this is not the case.
We conducted systematic street observation of 10 indicators of drug- and homelessness-related social nuisance in a 500 m radius around the OPS and around a comparison point in the same city before and after the introduction of the OPS. We estimated the risk that any given street within sampling areas would have nuisance post-intervention relative to the control area using Poisson regression.
Ratio of relative risks of any reported nuisance in the 500 m area surrounding the OPS from pre- to post-intervention to that of the comparison area was 0.69 (95% CI: 0.54, 0.87; p=0.002). The relative risk of drug-specific nuisance was similar to the comparison area pre/post intervention (0.90; 95% CI 0.66, 1.24; p=0.53). The risk of homelessness-specific nuisance decreased around the OPS (RR 0.7., 95% CI 0.52, 0.93; p=0.02) whereas they increased around the comparison area (RR 1.33, 95% CI 1.06, 1.68; p=0.02).
We found that implementing authorized OPS services in a U.S. city did not increase the prevalence of visible signs of drug use and homelessness in the surrounding area. These findings are similar to those found at OPS outside the U.S.
2022 年 1 月至 12 月期间，旧金山市政府批准设立了一个多服务中心，其中包括一个过量预防场所 (OPS)。人们经常对 OPS 表示担忧的一点是，它们可能会增加周围地区与吸毒相关的社会滋扰，尽管国际上有证据表明并非如此。
我们在 OPS 周围 500 米半径范围内和同一城市的比较点周围进行了 10 项与毒品和无家可归相关的社会滋扰指标的系统街道观察，在引入 OPS 前后进行了观察。我们使用泊松回归估计了干预后任何给定街道在采样区域内发生滋扰的风险相对于对照区域的风险。
OPS 周围 500 米范围内报告的任何滋扰的比值比从干预前到干预后的比值与比较区域的比值为 0.69（95%CI：0.54，0.87；p=0.002）。药物特异性滋扰的相对风险与干预前后的比较区域相似（0.90；95%CI 0.66，1.24；p=0.53）。OPS 周围的无家可归特异性滋扰风险降低（RR 0.7.，95%CI 0.52，0.93；p=0.02），而比较区域的滋扰风险增加（RR 1.33，95%CI 1.06，1.68；p=0.02）。
我们发现，在美国城市实施授权的 OPS 服务并没有增加周围地区可见的吸毒和无家可归现象的流行率。这些发现与美国以外的 OPS 相似。
