Social Policy, Sociology and Social Research, University of Kent, Medway, UK.
Centre for Health Services Studies, University of Kent, Canterbury, UK.
Drug Alcohol Rev. 2024 Sep;43(6):1573-1591. doi: 10.1111/dar.13908. Epub 2024 Aug 5.
Overdose prevention centres (OPC) are non-residential spaces where people can use illicit drugs (that they have obtained elsewhere) in the presence of staff who can intervene to prevent and manage any overdoses that occur. Many reviews of OPCs exist but they do not explain how OPCs work.
We carried out a realist review, using the RAMESES reporting standards. We systematically searched for and then thematically analysed 391 documents that provide information on the contexts, mechanisms and outcomes of OPCs.
Our retroductive analysis identified a causal pathway that highlights the feeling of safety - and the immediate outcome of not dying - as conditions of possibility for the people who use OPCs to build trust and experience social inclusion. The combination of safety, trust and social inclusion that is triggered by OPCs can - depending on the contexts in which they operate - generate other positive outcomes, which may include less risky drug use practices, reductions in blood borne viruses and injection-related infections and wounds, and access to housing. These outcomes are contingent on relevant contexts, including political and legal environments, which differ for women and people from racialised minorities.
OPCs can enable people who live with structural violence and vulnerability to develop feelings of safety and trust that help them stay alive and to build longer term trajectories of social inclusion, with potential to improve other aspects of their health and living conditions.
过量预防中心（OPC）是非住宿场所，人们可以在工作人员在场的情况下使用他们从其他地方获得的非法药物，工作人员可以进行干预，以预防和管理任何发生的药物过量情况。已经有许多关于 OPC 的评论，但它们并没有解释 OPC 是如何运作的。
我们使用 RAMESES 报告标准进行了一项现实主义审查。我们系统地搜索并对 391 份提供 OPC 背景、机制和结果信息的文件进行了主题分析。
我们的回溯分析确定了一个因果途径，该途径强调了安全感——以及不死的直接结果——作为 OPC 用户建立信任和体验社会包容的可能性条件。OPC 引发的安全感、信任和社会包容的结合，可能会根据其运作的背景，产生其他积极的结果，其中可能包括风险较低的药物使用行为、减少血液传播病毒和与注射相关的感染和伤口，以及获得住房。这些结果取决于相关的背景，包括政治和法律环境，这些环境对女性和少数族裔人群有所不同。
OPC 可以使那些生活在结构性暴力和脆弱环境中的人们产生安全感和信任感，帮助他们生存下去，并建立更长期的社会包容轨迹，有可能改善他们健康和生活条件的其他方面。
