Recovery support services as part of the continuum of care for alcohol or drug use disorders

Addiction, Год журнала: 2025, Номер unknown

Опубликована: Янв. 28, 2025

Abstract Background The definition of ‘recovery’ has evolved beyond merely control problem substance use to include other aspects health and wellbeing (known as ‘recovery capital’) which are important prevent relapse problematic alcohol or drug (AOD) use. Developing a Recovery Oriented System Care (ROSC) requires consideration interventions services (Recovery Support Services, RSS) designed build recovery capital often delivered alongside established treatment structures. Lived experience its application the process engaging people, changing behaviour prevention is an essential part these services. Aim To map out evidence base for RSS guidance commissioners addiction in each 152 local authorities England. Methods authors updated findings 2017 systematic review through further rapid scoping review, aiming extent, range nature research under six headings: (1) Peer‐based support (P‐BRSS); (2) Employment approaches; (3) housing; (4) Continuing care check‐ups; (5) community centres (RCC); (6) educational settings. A search PubMed, Embase, CINAHL, CENTRAL PsychINFO databases was conducted. abstracts all articles published since were reviewed by two authors, full text versions relevant obtained data extracted. narrative then prepared, mapping them on ROSC continuum care. restricted adults (over 18 years), but substances available outcomes included. Results Four forms well supported evidence. RCTs increase levels employment demonstrated large effect sizes, continuing that extend intervention into early phase have shown small significant benefit. Peer‐delivered link people ongoing associated with decreased rates re‐admission, increased engagement, social change. However, variability design studies means work required clarify effective components intervention. Studies housing also positive results, including differences from standard No controlled exist RCCs settings, complexity wide potential outcome measures mean study designs may be more relevant. Conclusions This monograph provides structure help policy makers, service providers describe understand emerging field research. Services (RSS) proving clinical, public cost utility. rational fiscal response endemic challenges should therefore intensive acute clinical linked extensive community‐based RSS.

Язык: Английский

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

Harm Reduction Journal, Год журнала: 2024, Номер 21(1)

Опубликована: Фев. 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.

Язык: Английский

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The implementation of safer drug consumption facilities in Scotland: a mixed methods needs assessment and feasibility study for the city of Edinburgh

Harm Reduction Journal, Год журнала: 2025, Номер 22(1)

Опубликована: Янв. 13, 2025

Scotland currently has amongst the highest rates of drug-related deaths in Europe, leading to increased advocacy for safer drug consumption facilities (SDCFs) be piloted country. In response concerns about harms Edinburgh, elected officials have considered introducing SDCFs city. This paper presents key findings from a feasibility study commissioned by City Edinburgh Council support these deliberations. Using multi-method needs assessment approach, we carried out spatial and temporal analysis data including health, mortality, consumption, crime service provision indicators; 48 interviews 22 people with lived/living experience (PWLE) use city, five family members affected harms, 21 professional stakeholders likely involved commissioning or delivering SDCFs. Data were collected using convergent parallel design. We descriptive quantitative date thematic qualitative data. Quantitative provides an overview local context terms recorded patterns as reported prior surveys. Qualitative PWLE families captures lived experiences who drugs, loved ones, within that context, perceived trends, views on practicality SDCF provision, hopes anxieties regarding potential provision. Professional insights into how responsible strategic planning delivery view role described are dispersed across multiple locations, some areas higher concentration. Reported levels opioid use, illicit benzodiazepine cocaine injecting high. revealed strong SDCFs, preference services include peer delivery. However, also expressed safety security, remained uncertain prioritisation possible opportunity costs face restricted budgets. There is case Edinburgh. design reflect distributions harm, type, preferences both informality security among users. Models used elsewhere would therefore need adapted such considerations. These may apply more broadly UK internationally, given changing harm.

Язык: Английский

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Association of drug overdoses and user characteristics of Canada’s national mobile/virtual overdose response hotline: the National Overdose Response Service (NORS)

BMC Public Health, Год журнала: 2023, Номер 23(1)

Опубликована: Сен. 27, 2023

Abstract Background Several novel overdose response technology interventions, also known as mobile services (MORS), have emerged adjunct measures to reduce the harms associated with drug poisoning epidemic. This retrospective observational study aims identify characteristics and outcomes of individuals utilizing one such service, National Overdose Response Service (NORS). Methods A analysis was conducted using NORS call logs from December 2020 April 2023 imputed by operators. variety variables were examined including demographics, substance use route, location, outcomes. Odds ratios 95% confidence intervals calculated around interest test association between key indicators poisonings. Results Of 6528 completed calls on line, 3994 (61.2%) for supervised consumption, 1703 (26.1%) mental health support, 354 (5.42%) harm reduction education or resources, 477 (7.31%) other purposes. Overall, there 77 (1.18%) events requiring a physical/ in-person intervention. total calls, 3235 (49.5%) women, 1070 (16.3%) people who identified gender diverse. Calls mostly originated urban locations ( n = 5796, 88.7%) province Ontario 4137, 63.3%). indicate that opioids (OR 6.72, CI 3.69–13.52), in combination methamphetamine 9.70, 3.24–23.06), multiple consumption routes 6.54, 2.46–14.37), occurring British Columbia (B.C) 3.55, 1.46–7.33) had significantly higher likelihood poisoning. No deaths recorded only 3 false callouts occurred. The overall event incidence phone 1.2%. Conclusion presents complimentary opportunity access prefer alone face barriers accessing especially minorities high-risk patterns.

Язык: Английский

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Overdose prevention centres as spaces of safety, trust and inclusion: A causal pathway based on a realist review

Drug and Alcohol Review, Год журнала: 2024, Номер 43(6), С. 1573 - 1591

Опубликована: Авг. 5, 2024

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 intervene to prevent and manage any overdoses that occur. Many reviews OPCs exist but do not explain how work.

Язык: Английский

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The relationship between felt stigma and non-fatal overdose among rural people who use drugs

Harm Reduction Journal, Год журнала: 2024, Номер 21(1)

Опубликована: Апрель 6, 2024

Abstract Background Drug overdose deaths in the United States exceeded 100,000 2021 and 2022. Substance use stigma is a major barrier to treatment harm reduction utilization priority target ending epidemic. However, little known about relationship between overdose, especially rural areas. We aimed characterize association felt non-fatal multi-state sample of rural-dwelling people who drugs. Methods Between January 2018 March 2020, 2,608 reporting past 30-day opioid were recruited via modified chain-referral sampling areas across 10 states. Participants completed computer-assisted survey substance substance-related attitudes, behaviors, experiences. used multivariable logistic regression with generalized estimating equations test recent overdose. Results 6.6% participants ( n = 173) reported an 30 days. Recent was significantly associated after adjusting for demographic use-related covariates (aOR: 1.47, 95% CI: 1.20–1.81). The remained significant sensitivity analyses on component fear enacted items 1.48, 1.20–1.83) internalized item 1.51, 1.07–2.14). Conclusions Felt related higher risk Stigma interventions tailored services those experiencing high are underutilized approaches that may mitigate risk.

Язык: Английский

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Evaluation of Strategies to Enhance Community-Based Naloxone Distribution Supported by an Opioid Settlement

JAMA Network Open, Год журнала: 2024, Номер 7(5), С. e2413861 - e2413861

Опубликована: Май 30, 2024

Many US states are substantially increasing community-based naloxone distribution, supported in part through settlements from opioid manufacturers and distributors. To evaluate the potential impact of increased availability on overdose deaths (OODs) explore strategies to enhance this by integrating interventions address solitary drug use. This decision analytical modeling study used PROFOUND (Prevention Rescue Fentanyl Other Opioid Overdoses Using Optimized Naloxone Distribution Strategies), a previously published simulation model, forecast annual OODs between January 2023 December 2025. The simulated population included individuals Rhode Island who misused opioids stimulants were at risk for overdose. modeled expanded distribution state's settlement (50 000 nasal spray kits each year). Two approaches expanding evaluated: one based historical spatial patterns (supply-based approach) (demand-based approach). In addition, hypothetical likelihood witnessed overdoses private or semiprivate settings considered. Annual number ratio fatal nonfatal overdoses. Modeling results indicated that distributing more could reduce 6.3% (95% interval [SI], 0.3%-13.7%) 8.8% SI, 1.8%-17.5%) 2025 with supply-based demand-based approaches, respectively. However, 20% 60% demonstrated greater reducing OODs, ranging 8.5% 0.0%-20.3%) 24.1% 8.6%-39.3%). Notably, synergistic associations observed when combining both interventions: 2 increase 33.5% 17.1%-50.4%) 37.4% 19.6%-56.3%), These findings suggest use needed maximize continued efforts which may be particularly important jurisdictions have strong programs.

Язык: Английский

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County-level predictors of US drug overdose mortality: A systematic review

Drug and Alcohol Dependence, Год журнала: 2022, Номер 242, С. 109714 - 109714

Опубликована: Ноя. 24, 2022

Язык: Английский

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Characteristics and Risk of Adverse Mental Health Events Amongst Users of the National Overdose Response Service (NORS) Telephone Hotline

International Journal of Mental Health and Addiction, Год журнала: 2024, Номер unknown

Опубликована: Март 25, 2024

Abstract The National Overdose Response Service (NORS) is a Canadian mobile or virtual overdose response hotline intended to prevent drug deaths but has unexpectedly received mental health related calls, including adverse events. Our study aimed examine these occurrences and caller characteristics predictive of outcomes. Using the NORS call dataset, we conducted descriptive representation emergencies along with correlative statistics. We found that had 2518 28 (1.1%) being Men, rural callers, polyroute substance consumption history overdosing were have increased odds having an event, while from Quebec, using non-standard routes line between 50 99 times decrease odds. This supports utility prevention hotlines also support people experiencing situations reduce harm for individuals and/or use disorders.

Язык: Английский

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Health, harm reduction, and social service providers’ perspectives on the appropriateness and feasibility of peer distribution of HIV self-test kits among people who use drugs

Harm Reduction Journal, Год журнала: 2024, Номер 21(1)

Опубликована: Фев. 4, 2024

Abstract Background People who use drugs (PWUD) experience elevated HIV risk and numerous barriers to facility-based testing. self-testing (HIVST) could circumvent many of those is acceptable among PWUD, yet HIVST implementation for PWUD limited. Service providers’ perspectives on specific delivery strategies help increase availability PWUD. Methods From April–November 2021, we interviewed 16 health, harm reduction, social service providers working with in San Diego, CA. Interviews rapid thematic analysis explored HIVST’s utility appropriateness, as well the feasibility anticipated challenges strategies, including peer or secondary distribution. Results Participants viewed a significant threat health confirmed presence local promising potentially empowering solution. Based community familiarity distribution reduction supplies (i.e., naloxone) information, participants kits an appropriate feasible strategy increasing reach HIVST, but also described potential (e.g., engaging socially disconnected individuals, ensuring linkages services following HIVST) provided suggestions alternative kit models vending machines). Conclusions promising, appropriate, feasible, specialized efforts may be needed most marginalized individuals ensure consistent provision educational information referral supports that maximize impact this approach.

Язык: Английский

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