British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.
Department of Medicine, University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada.
J Urban Health. 2024 Apr;101(2):233-244. doi: 10.1007/s11524-024-00849-9. Epub 2024 Mar 27.
In response to an increase in overdose deaths, there was a rapid scale-up of supervised consumption services (SCS), including federally sanctioned SCS and low-barrier SCS known as overdose prevention sites (OPS), in Vancouver, Canada, beginning in December 2016. However, little is known about the use of such services among adolescents and young adults (AYA) in this context. We therefore sought to characterize factors associated with the use of federally sanctioned SCS and OPS among street-involved AYA who inject drugs in Vancouver during an overdose crisis. From December 2016 to March 2020, data were collected from a prospective cohort of street-involved AYA aged 14 to 26 at baseline. Using multivariable generalized estimating equation analyses, we identified factors associated with recent use of federally sanctioned SCS and OPS, respectively. Among 298 AYA who inject drugs, 172 (57.8%) and 149 (50.0%) reported using federally sanctioned SCS and OPS during the study period, respectively. In multivariable analyses, public injecting, negative police interactions, and residing or spending time ≥ weekly in the Downtown Eastside neighborhood were all positively associated with the use of federally sanctioned SCS and OPS, respectively. Additionally, ≥ daily unregulated opioid use and residential eviction were positively associated with federally sanctioned SCS use, while requiring help injecting was inversely associated. Self-identified female or non-binary gender was also positively associated with OPS use (all p < 0.05). Both federally sanctioned SCS and OPS successfully engaged AYA at heightened risk of adverse health outcomes. However, the lack of accommodation of AYA who require manual assistance with injecting at federally sanctioned SCS may be inhibiting service engagement.
为应对过量用药死亡人数的增加，自 2016 年 12 月以来，加拿大温哥华迅速扩大了监督使用服务（SCS），包括联邦批准的 SCS 和称为过量预防场所（OPS）的低门槛 SCS。然而，在这种情况下，青少年和年轻成年人（AYA）对这些服务的使用情况知之甚少。因此，我们试图描述在温哥华药物过量危机期间，与街头吸毒的 AYA 使用联邦批准的 SCS 和 OPS 相关的因素。从 2016 年 12 月到 2020 年 3 月，从基线时年龄在 14 至 26 岁的街头吸毒的 AYA 前瞻性队列中收集数据。使用多变量广义估计方程分析，我们分别确定了与近期使用联邦批准的 SCS 和 OPS 相关的因素。在 298 名注射吸毒的 AYA 中，分别有 172 名（57.8%）和 149 名（50.0%）报告在研究期间使用了联邦批准的 SCS 和 OPS。在多变量分析中，公共注射、与警察的负面互动以及居住或每周在东城区（Downtown Eastside neighborhood）花费时间≥1 周，均与使用联邦批准的 SCS 和 OPS 呈正相关。此外，≥每日未经管制的阿片类药物使用和住宅驱逐与联邦批准的 SCS 使用呈正相关，而需要帮助注射与联邦批准的 SCS 使用呈负相关。自我认同为女性或非二进制性别也与 OPS 的使用呈正相关（均 P <0.05）。联邦批准的 SCS 和 OPS 都成功地接触到了处于不良健康结果风险较高的 AYA。然而，联邦批准的 SCS 不提供对需要手动协助注射的 AYA 的服务，这可能会阻碍服务的参与。
