Electronic harm reduction interventions for drug overdose monitoring and prevention: A scoping review

Drug and Alcohol Dependence, Journal Year: 2023, Volume and Issue: 250, P. 110878 - 110878

Published: June 30, 2023

Novel strategies are required to address rising overdose deaths across the globe. We sought identify breadth and depth of existing evidence around electronic harm reduction (e-harm reduction) interventions that aimed reduce harms associated with substance use.We conducted a scoping review according PRISMA-ScR PRISMA for Searching guidelines. A health sciences librarian systematically searched seven databases from inception until January 20, 2023. Citation chaining reference lists included studies were additional articles. Two reviewers independently screened, extracted charted data. Additionally, we gray literature search environmental scan supplement findings.A total 51 met criteria inclusion (30 peer-reviewed articles 21 non-peer reviewed). Most in Western countries (USA = 23, Canada 3, Europe China 1) among adult samples (adult 27, youth/adults =1, unspecified 2). Study designs predominantly quantitative (n 24), minority using qualitative 4) or mixed methods e-harm 15), followed by education 6), treatment 2), combined/other approaches 7). Interventions utilized web-based/mobile applications telephone/telehealth 10), other technology 5).While is promising, further research establish efficacy effectiveness these novel interventions.

Language: Английский

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Preference for hotline versus mobile application/countdown-based mobile overdose response services: a qualitative study

Harm Reduction Journal, Journal Year: 2024, Volume and Issue: 21(1)

Published: Feb. 5, 2024

Abstract Background In response to the exacerbated rates of morbidity and mortality associated with overlapping overdose COVID-19 epidemics, novel strategies have been developed, implemented, operationalized scaled reduce harms resulting from this crisis. Since emergence mobile services (MORS), two aimed help acute including staffed hotline-based unstaffed timer-based services. article, we aim gather perspectives various key interest groups on these technologies determine which might best support service users. Methods Forty-seven participants interested people who use substances not used MORS, healthcare workers, family members, harm reduction employees MORS operators participated in semi-structured interviews. Transcripts were coded analyzed using a thematic analysis approach. Results Four major themes emerged regarding participant differences between services, namely connection, perceived safety, privacy accessibility, alongside features that are recommended for future. Conclusions Overall, noted individuals vary their desire connection during substance session offered by hotline modalities. Participants approaches be more reliable thus potentially safer than counterparts but access technology is limitation both approaches.

Language: Английский

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The Sociology of Prescribing: A Narrative Review and Agenda

Social Science & Medicine, Journal Year: 2025, Volume and Issue: 368, P. 117830 - 117830

Published: Feb. 7, 2025

Prescribing is a key symbol of the authority medical practice, and restricted to qualified clinicians who permit access many medicines. Variously framed as over- or under-prescribed, otherwise inadequately provisioned, sociologists have attended clinical logics practices underpinning prescribing. Despite being feature in there only scattered attention 'sociology prescribing' general social theory In contrast, has been flourishing sociology diagnosis recent decades that organises field. Revisiting nascent prescribing emerged 1970s, this article reviews sociological (and other scientific) contributions provides an agenda for contemporary approach perspectives on drug A conceptualises act embodied relational practice shaped through complex choreographies health encounters systems. Early literature documented variations across sites, divergent expectations prescription between doctor patient, characterised symbolically potent, enabling alleviate, validate, placate patient concerns. While industries understand technical process following mandates ethics evidence-based medicine (or 'rational prescribing'), research identified pharmaceutical detailing, workplace cultures, practice-relevant knowledge determinants practice. Recent inquiry also focused professional tensions with expansion non-medical prescribing, critiques (bio)medicalisation pharmaceuticalisation society, impacts new technologies like electronic I propose care, expertise, power, work domains future Attending these will be vital continually reimagined transformations technological political arrangements pharmaceuticals healthcare.

Language: Английский

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Engaging Stigmatised Communities in Australia with Digital Health Systems: Towards Data Justice in Public Health

Sexuality Research and Social Policy, Journal Year: 2023, Volume and Issue: 20(3), P. 1220 - 1231

Published: Feb. 6, 2023

Abstract Introduction In 2018, following government policy changes to Australia’s national electronic health record system, ‘My Health Record’, consumer advocates—including organisations representing people living with HIV, who use drugs and sex workers—raised concerns about privacy data security. Responding these controversies, this study explores the practical, ethical political complexities of engaging stigmatised communities digital systems. Methods We conducted 16 qualitative semi-structured interviews in 2020 key informants experience stigma, discrimination marginalisation Australia. These included workers, inject drugs, gay bisexual men transgender gender diverse people. a reflexive thematic analysis. Results Key were sceptical proposed benefits records for their communities, concerned risks potential discrimination. Meaningful consultation, consent mechanisms tackling structural stigma raised as solutions communities. Conclusions Although could benefit from being systems, significant cultural, legal social reforms believed be necessary build trust argue that forms justice are effective future Policy Implications Engaging communities—including relation gender, sexuality, work, drug use, HIV—requires commitment justice. The design implementation systems requires investment ongoing meaningful consultation representative organisations.

Language: Английский

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Planning and implementing community-based drug checking services in Scotland: a qualitative exploration using the consolidated framework for implementation research

Substance Abuse Treatment Prevention and Policy, Journal Year: 2024, Volume and Issue: 19(1)

Published: Jan. 17, 2024

Abstract Background Drug checking services (DCS) provide harm reduction support and advice to individuals based on chemical analysis of submitted substances concern. Whilst there are currently no DCS in Scotland, community-based being planned three cities. Methods In this paper, we report qualitative findings interviews with 43 participants, focused perceptions their implementation. Participants were relevant professionals, those experience drug use, family members use. The Consolidated Framework for Implementation Research (CFIR) was used inform data collection analysis. We under nine constructs/themes across the five CFIR domains. Results noted importance implemented low-threshold, trusted a ethos, outlined range further service design considerations such as speed testing, information provided through process. relation ‘inner setting’, key finding related potential value leveraging existing resources order expand both reach effectiveness trend communication. approach local national police DCS, attitudes public community, described important external factors which could influence success (or otherwise) Bringing together stakeholders dialogue developing tailored communication strategies seen ways build DCS. Overall, found high levels perceived need amongst all stakeholder groups. Conclusions Our present initial implementation Scotland be explored operationalised. Further, our focus contexts is research more generally, given minimal consideration issues literature.

Language: Английский

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Harm Reduction Without Supportive Policing: Experiences of Drug Users in Nepal

Journal of Social Behavioral and Health Sciences, Journal Year: 2025, Volume and Issue: 19(1)

Published: Jan. 15, 2025

This study explored the impact of drug criminalization and policing on harm reduction efforts in Nepal. In contexts marked by widespread corruption, often exacerbates mistreatment law enforcement people who use drugs (PWUD), creating substantial barriers to their accessing services. Utilizing a constructivist framework modified grounded theory approach, we conducted in-depth interviews with 20 PWUD examine experiences use, interactions police, consequent effects efforts. Three key themes emerged: exploitation as significant source income for corrupt police officers, human rights being violated behaviors frequently contradicting principles practices. The findings demonstrate how undermines initiatives Policy reforms are urgently needed equip knowledge skills, thus enabling access essential

Language: Английский

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Impacts of the COVID-19 pandemic on supervised consumption service delivery in Vancouver and Surrey, Canada from the perspective of service providers

Deleted Journal, Journal Year: 2025, Volume and Issue: 22(1)

Published: Jan. 20, 2025

Following the onset of COVID-19 pandemic, an ever-increasing number people have died from toxic drug supply in Canada. Emerging evidence suggests that reduced access to harm reduction services has been a contributing factor. However, precise impacts pandemic on supervised consumption service (SCS) delivery not well characterized. The present study sought explore SCS Vancouver and Surrey, Between October 2021 March 2022, in-depth, semi-structured interviews were conducted with staff two SCS: SafePoint Surrey (n = 12) Insite 9). Thematic analysis focused key changes after emergence focus associated challenges emergent responses. Participants described as: capacity restrictions hindering compromising care quality; exclusion frontline perspectives evolving policy practice decision-making; intensified power dynamics between users; modified overdose response procedures, combined rise complex presentations, undermining accessibility quality. Emergent responses these included: collective organizing for policy; individual non-compliance emerging policies; experiencing burnout their roles. This highlights how COVID-19-related produced users, while identifying strategies employed by address challenges. Additionally, findings point opportunities improve who use drugs during intersecting public health crises.

Language: Английский

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Locked Out, Opened Up and Locked In by Needle and Syringe Exchange Programs: Harm Reduction in the Swedish Prohibitionist Context

Contemporary Drug Problems, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 26, 2025

Intrigued by the overwhelmingly positive response to needle and syringe exchange program (NSP) people who inject drugs in Stockholm, this article sought untangle harm reduction a prohibitionist drug policy context. The drew on assemblage thinking used semistructured individual interviews with 32 drugs, three focus groups staff at Stockholm NSP. aim was dissect form of NSP how it worked move towards or away from drug-related harm. analysis identified bodies such as regulations, setting, stigma gathered ways that reduced capacity forward enroll, inclusion would decrease uphold other connections considered be more important. Regular visitors however described free injecting equipment, care, continuity, trust were important objects opening up for movement less Fiercely, these profoundly caring experiences could also block new becomings moves discouraged previous negative service providers structural stigma, refrained improve their wellbeing. They risked becoming locked similar services. A significant consequence agential cuts us researchers, staff, policymakers alike, targeting primarily those do access benefit harm-reducing interventions, is alternative solutions embracing out become unimaginable.

Language: Английский

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Reimagining subjectivities in place: Necropolitical logics of safer supply and housing in Vancouver’s Downtown Eastside

Social Science & Medicine, Journal Year: 2025, Volume and Issue: 372, P. 117930 - 117930

Published: March 5, 2025

Language: Английский

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“Sometimes I’m interested in seeing a fuller story to tell with numbers” Implementing a forecasting dashboard for harm reduction and overdose prevention: a qualitative assessment

BMC Public Health, Journal Year: 2025, Volume and Issue: 25(1)

Published: March 7, 2025

The escalating overdose crisis in the United States points to urgent need for new and novel data tools. Overdose tools are growing popularity but still face timely delays surveillance availability, lack of completeness, wide variability quality by region. As such, we innovative identify prioritize emerging high-need areas. Forecasting offers one such solution. Machine learning methods leverage numerous datasets that could be used predict future vulnerability at regional, town, even neighborhood levels. This study aimed understand multi-level factors affecting early stages implementation an forecasting dashboard. dashboard was developed with statewide harm reduction providers increase data-driven response resource distribution level. part PROVIDENT (Preventing OVerdose using Information Data from EnvironmeNT), a randomized, community trial, conducted where facilitated three focus groups organizations enrolled larger trial. Focus group participants held titles as peer outreach workers, case managers, program coordinators/managers. We employed Exploration, Preparation, Implementation, Sustainment (EPIS) Framework guide our analysis. framework multi-level, four-phase analysis unique within human services environment assess exploration preparation phases influenced launch intervention. Multiple themes centering on organizational culture resources emerged, including limited staff capacity interventions repeated exposure stress trauma, which limit intervention uptake. Community-level included burden collection funding efforts build stronger networks dashboarding allocation. Using allowed us contextual Additional investments may required create optimal setting integration

Language: Английский

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