Mocanu Victor, Viste Dylan, Rioux William, Ghosh S Monty
Department of Medicine, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada.
Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, 2J2.00 Walter C. MacKenzie Health Sciences Centre, Edmonton, Alberta T6G 2R7, Canada.
Lancet Reg Health Am. 2024 May 17;34:100770. doi: 10.1016/j.lana.2024.100770. eCollection 2024 Jun.
Overdose response technology or virtual overdose response services are an evolving complementary harm reduction intervention which may overcome certain accessibility barriers of physical supervised consumption sites (SCS) and overdose prevention sites (OPS). We sought to characterize SCS/OPS accessibility barriers among clients accessing a nationwide overdose response phone-based hotline in Canada.
We performed a retrospective cohort analysis using anonymized call logs of the National Overdose Response Service (NORS) between December 2020 to July 2023. De-identified caller locations were cross-referenced with the locations, policies and operational hours of existing physical SCS/OPS. The primary outcome was accessibility of physical SCS/OPS defined hierarchically according to alignment with caller postal code, substance use routes reported, and calling times.
Our cohort comprised 4501 calls from 331 unique clients. Despite always having nearby SCS/OPS open and supporting substance use routes of choice, 100 clients (30.2%) preferentially utilized NORS. Among 191 clients (57.7%) who never had access to physical SCS/OPS at time of calling, 92 (27.8%) lacked a nearby site, 58 (17.5%) called outside of operational hours, and 41 (12.4%) would not be permitted to smoke on premises. Secondary analyses identified correlations between accessibility and the urbanicity and geographical region of callers within Canada.
Overdose response technology or virtual overdose response services are a novel complementary harm reduction strategy both for clients with access barriers to physical SCS/OPS and those who prefer virtual services. System-level correlates of client location urbanicity and inter-provincial variation indicate actionable targets for expanding harm reduction services both physical and virtual to better engage with people who use drugs.
Health Canada Substance Use and Addictions Program, Canadian Institutes of Health Research, and Grenfell Ministries.
过量用药应对技术或虚拟过量用药应对服务是一种不断发展的补充性减少伤害干预措施，可能会克服实体监督消费场所（SCS）和过量用药预防场所（OPS）的某些可及性障碍。我们试图描述在加拿大拨打全国过量用药应对热线电话的客户中SCS/OPS的可及性障碍。
我们使用2020年12月至2023年7月期间国家过量用药应对服务（NORS）的匿名通话记录进行了一项回顾性队列分析。将去识别化的来电者位置与现有实体SCS/OPS的位置、政策和运营时间进行交叉参考。主要结局是根据与来电者邮政编码的匹配度、报告的物质使用途径和通话时间分层定义的实体SCS/OPS的可及性。
我们的队列包括来自331名独特客户的4501个电话。尽管附近始终有开放的SCS/OPS并支持选择的物质使用途径，但仍有100名客户（30.2%）优先使用NORS。在191名（57.7%）打电话时从未使用过实体SCS/OPS的客户中，92名（27.8%）附近没有场所，58名（17.5%）在运营时间之外打电话，41名（12.4%）不被允许在场所内吸烟。二次分析确定了可及性与加拿大来电者的城市化程度和地理区域之间的相关性。
过量用药应对技术或虚拟过量用药应对服务对于在使用实体SCS/OPS方面存在可及性障碍的客户以及那些更喜欢虚拟服务的客户来说，是一种新的补充性减少伤害策略。客户位置城市化程度和省际差异的系统层面相关性表明，在扩大实体和虚拟减少伤害服务以更好地接触吸毒者方面存在可采取行动的目标。
加拿大卫生部物质使用和成瘾项目、加拿大卫生研究院和格伦费尔部。
