Assessing the feasibility, acceptability and accessibility of a peer-delivered intervention to reduce harm and improve the well-being of people who experience homelessness with problem substance use: the SHARPS study

Harm Reduction Journal, Journal Year: 2022, Volume and Issue: 19(1)

Published: Feb. 4, 2022

For people experiencing homelessness and problem substance use, access to appropriate services can be challenging. There is evidence that the development of trusting relationships with non-judgemental staff facilitate service engagement. Peer-delivered approaches show particular promise, but base still developing.The study used mixed methods assess feasibility, acceptability accessibility a peer-delivered, relational intervention reduce harms improve health/well-being, quality life social functioning, for use. Four Peer Navigators were employed support individuals (n = 68 total, participants). They based in outreach hostels Scotland England. Qualitative interviews conducted participants, services, observations all settings. Quantitative outcomes relating participants' physical mental health, Navigator relationship, measured via 'holistic health check' six questionnaires completed at two time-points.The was found acceptable to, feasible accessible for, Navigators, staff. Participants reported improvements engagement, feeling more equipped independently. The lived experience highlighted as particularly helpful, enabling trusting, authentic, meaningful developed. Some challenges experienced relation 'fit' within some Among participants there reductions drug use risky injecting practices. increases number receiving opioid substitution therapy. Overall, positively received, collective recognition unique highly valuable. While most measures chosen holistic check suitable this population, they should streamlined avoid duplication participant burden.The established harm reduction not outcomes-focused, did range positive outcomes. A full randomised controlled trial now required effectiveness.Study registered ISRCTN: 15900054.

Language: Английский

---

Patterns and Predictors of Heroin Use, Remission, and Psychiatric Health Among People with Heroin Dependence: Key Findings from the 18–20-Year Follow-Up of the Australian Treatment Outcome Study (ATOS)

International Journal of Mental Health and Addiction, Journal Year: 2023, Volume and Issue: unknown

Published: Jan. 18, 2023

Abstract This study aimed to investigate the long-term patterns and predictors of heroin use, dependence, psychiatric health over 18–20 years among a cohort Australians with using prospective longitudinal conducted in Sydney, Australia. The original consisted 615 participants, who were followed up at 3 months 1, 2, 3, 11, post-baseline; 401 (65.2%) re-interviewed years. Australian Treatment Outcome Study structured interview established psychometric properties was administered participants each follow-up, addressing demographics, treatment drug use history, overdose, crime, physical mental health. Overall, 96.7% completed least one follow-up interview. At years, 109 (17.7%) deceased. Past-month decreased significantly period (from 98.7 24.4%), four Just under half receiving treatment. Reductions accompanied by reductions other substance needle sharing, injection-related health, improvements general Major depression borderline personality disorder (BPD) consistently associated poorer outcome. there is strong evidence that clinically significant levels improvement can be maintained long term. mortality rate devastating, six More sustained targeted efforts are needed relation major BPD ensure evidence-based treatments delivered people dependence.

Language: Английский

---

Best practices for community-based overdose education and naloxone distribution programs: results from using the Delphi approach

Harm Reduction Journal, Journal Year: 2022, Volume and Issue: 19(1)

Published: May 28, 2022

Abstract Background Opioid-related overdose deaths have surged in the USA over last two decades. Overdose fatalities are preventable with timely administration of naloxone. Syringe service programs (SSP) pioneered community-based naloxone distribution through prevention and (OEND) programs. There is a dearth information regards to best practices for OEND. Methods We utilized modified Delphi approach develop set OEND delivery. Starting an initial list practices, we engaged 27 experts, field programming who reviewed, made recommendations changes, assigned priority each practice. Results Two rounds input resulted final 20 organized into four categories. The mean scores ranged from 1.17 2.17 (range 1 3). top 5 ranked were ensuring that SSP participants low barrier, consistent, needs-based access there ample available within communities. While remaining fifteen deemed important, they had more do organizational culture implementation climate. Conclusions Increasing delivery essential reduce opioid deaths; however, it will be insufficient add without eye toward quality fidelity model upon which evidence based. This summarizes consensus among experts can serve as tool SSPs providing improve services.

Language: Английский

---

Willingness to use and distribute HIV self-testing kits among people who inject drugs in the San Diego–Tijuana border region

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

Published: Jan. 3, 2024

Abstract Background HIV self-testing (HIVST) could increase testing access among people who inject drugs (PWID), and secondary distribution (i.e., peer-delivery) of HIVST kits in PWID social networks further expand coverage. We assessed willingness to use distribute the San Diego–Tijuana border region. Methods From 2020 2021, HIV-negative Diego, USA, Tijuana, Mexico, completed surveys provided data on individual ( N = 539) network 366) characteristics. used modified Poisson regression examine effects characteristics kits. Results Most participants were willing (81%) At level, prior was positively associated with (adjusted prevalence ratio [aPR] 1.24, 95% confidence interval [CI] 1.10–1.40) (aPR 1.27, CI 1.12–1.43) kits, while perceiving oneself be at higher risk than others negatively 0.83, 0.74–0.93). size 1.04 per member, 1.01–1.08) greater proportions one’s encouraging them 1.29, 1.16–1.44) having a history homelessness 1.51, 1.31–1.74) or detention/arrest 1.57, 1.36–1.82), proportion including “very close” persons 0.80, 0.69–0.94). Conclusions found high potential for their face greatest barriers facility-based testing.

Language: Английский

---

Drug-Death Related Bereavement and Social Support

OMEGA - Journal of Death and Dying, Journal Year: 2024, Volume and Issue: unknown

Published: March 13, 2024

The loss of a close one to drug-related death (DRD) has been characterized as form stigmatized bereavement, and research shown that there is high risk bereavement complications. Social support can be buffer against complications, but because stigma, DRD bereaved persons access social challenged. Based on data from Norwegian sample ( N = 252) the present study examines (1) persons’ perceived different aspects support, (2) association between experiences societal own withdrawal, self-blame, their perceptions support. Results show contact with in same situation particularly low compared other aspects, stigma (4%) withdrawal (5%) predict variations perception

Language: Английский

---