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如何通过过量用药后应对工作来解决吸毒人群的健康社会决定因素问题:来自纽约州卫生部(NYSDOH)过量用药后应对团队(PORT)的观点。

How post overdose response efforts can address social determinants of health among people who use drugs: perspectives from the New York State Department of Health (NYSDOH) Post Overdose Response Team (PORT).

机构信息

Office of Drug User Health, AIDS Institute, New York State Department of Health, 90 Church Street, 13th Floor, New York, NY, 10007, USA.

, Vermont, USA.

出版信息

Harm Reduct J. 2024 Oct 3;21(1):180. doi: 10.1186/s12954-024-01081-z.

Abstract

Individuals who have survived an overdose often have myriad needs that extend far beyond their drug use. The social determinants of health (SDOH) framework has been underutilized throughout the opioid overdose crisis, despite widespread acknowledgment that SDOH are contributors to the majority of health outcomes. Post Overdose Response Teams (PORTs) engage with individuals who have experienced 1 or more nonfatal overdoses and bear witness to the many ways in which overdose survivors experience instability with healthcare, housing, employment, and family structure. Employing a harm reduction model, PORTs are well-positioned to reach people who use drugs (PWUD) and to address gaps in basic needs on an individualized basis, including providing social support and a sense of personal connection during a period of heightened vulnerability. The New York State Department of Health (NYSDOH) PORT program is a harm reduction initiative that utilizes law enforcement data and several public databases to obtain accurate referral information and has been active since 2019 in NYC. This PORT program offers various services from overdose prevention education and resources, referrals to health and treatment services, and support services to overdose survivors and individuals within their social network. This perspective paper provides an in-depth overview of the program and shares quantitative and qualitative findings from the pilot phase and Year 1 of the program collected via client referral data, interviews, and case note reviews. It also examines the barriers and successes the program encountered during the pilot phase and Year 1. The team's approach to addressing complex needs is centered around human connection and working toward addressing SDOH one individualized solution at a time. Application of the NYSDOH PORT model as outlined has the potential to create significant positive impacts on the lives of PWUD, while potentially becoming a new avenue to reduce SDOH-related issues among PWUD.

摘要

经历过药物过量的个人通常有许多需求,这些需求远远超出了他们的药物使用范围。尽管人们普遍认识到社会决定因素(SDOH)是大多数健康结果的促成因素,但在阿片类药物过量危机中,健康的社会决定因素(SDOH)框架一直未得到充分利用。药物过量后反应团队(PORT)与经历过 1 次或多次非致命药物过量的个人接触,并见证了过量幸存者在医疗保健、住房、就业和家庭结构方面不稳定的多种方式。采用减少伤害模式,PORT 非常适合接触使用毒品的人(PWUD),并在个人基础上解决基本需求方面的差距,包括在脆弱时期提供社会支持和个人联系感。纽约州卫生部(NYSDOH)PORT 计划是一项减少伤害的倡议,它利用执法数据和几个公共数据库来获取准确的转介信息,并自 2019 年以来一直在纽约市开展活动。该 PORT 计划为过量幸存者及其社交网络中的个人提供各种服务,包括预防药物过量教育和资源、转介至健康和治疗服务以及支持服务。本文深入概述了该计划,并分享了通过客户转介数据、访谈和案例记录审查收集的试点阶段和计划第一年的定量和定性发现。它还研究了该计划在试点阶段和第一年遇到的障碍和成功。该团队解决复杂需求的方法围绕着人际联系,并致力于一次解决一个 SDOH 个体化解决方案。如前所述,应用 NYSDOH PORT 模型有可能对 PWUD 的生活产生重大积极影响,同时也有可能成为减少 PWUD 中与 SDOH 相关问题的新途径。

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