Secure consumption spaces would be welcomed by high risk opioid users

A large majority of people who consume heroin and fentanyl would be willing to use safe eating places where they could get sterile syringes and benefit from medical support in case of overdose, suggests a study conducted by researchers from the Johns Hopkins Bloomberg School of Public Health.

In the study, published on June 5 in the Journal of Urban HealthThe researchers interviewed 326 heroin users, fentanyl and illicit opioid pills in Baltimore, Boston and Providence, cities hit hard by the opioid overdose epidemic in America. About 77% of participants reported being willing to use safe consumption spaces – licensed locations that were created and evaluated in other countries such as Canada and Australia but not yet in the United States . The willingness to use safe consumption spaces was even higher (84%), among those who used public spaces such as streets, parks and abandoned buildings to use drugs.

The results showed that 84% of participants in Boston, 78% of participants in Baltimore and 68% of participants in Providence were willing to use a safe consumption space – the overall rate rising to 77%.

"Overall, we have seen a strong desire to use safe spaces for consumption, which is important because often the voices of drug users are not always taken into account in political debates or in implementation of public health interventions, "says lead author of the study, Ju Nyeong Park, Ph.D., MHS, deputy researcher in the Department of Health, Behavior and from the company to the Bloomberg School.

Safe consumption spaces, also known as secure injection sites and overdose prevention sites, represent an approach to "harm reduction" of public health and social problems arising from drug abuse.

They have been used overseas since the mid-1980s and now have more than 100 installations in 12 countries. Studies indicate that the benefits to public health are many, as they significantly reduce the number of overdose deaths, significantly reduce the transmission of HIV and hepatitis B and C viruses through needle sharing , keep users away from parks and other public places and offer good opportunities to guide them. treatment.

In the United States, there is currently no safe space for safe consumption because of a federal law – known as the "crack law" – which creates a heavy criminal liability for anyone who is knowingly connected to a crime. well intended for illicit drug use. Concerns about safe consumption spaces that encourage the use of illicit drugs and potentially annihilate the neighborhoods where they are located have also generated local opposition in some cases. But the seriousness of the current opioid consumption epidemic in the United States – opioids have been implicated in most of the 70,000 drug overdose deaths and more in 2017 – is such that consumer spaces Sure are now considered viable options by decision-makers in some states and local governments. . Public health researchers also weighed in on the studies.

"The study shows that people who use drugs are motivated to be safe and take precautions to reduce their exposure to harm," says Susan Sherman, PhD, Professor, Department of Health, Behavior and the Bloomberg School company. investigator. "We can use this evidence to comprehensively treat the epidemic of opioids."

Park, Sherman and their colleagues, working as part of street recruiting programs and local syringe services, contacted and obtained survey data from a diverse sample of 326 people in Baltimore, Boston and Providence, who reported using opioids for non-medical purposes in the last 30 days. Most reported using injected drugs, mostly heroin. Almost 70% were homeless and 60% reported having used drugs in public or semi-public places. More than a third of participants reported overdose in the last six months. About 73% of them said they recently consumed a drug that they suspected of having fentanyl content, a synthetic opioid much more potent than heroin, and therefore more likely to him. cause an overdose.

The most likely participants to say they were willing to use a safe place to eat were those who preferred drugs containing fentanyl and those who consumed them primarily in public places. Of those who primarily used drugs in public, 84% said they were willing to use safe space.

When asked about factors that could prevent them from using safe space, the most commonly cited factors were fear of arrest (38%) and privacy (36%).

Overall, participants' willingness to use safe consumption spaces suggests that such facilities, if available, would be a viable alternative to drug use on the streets. "It's encouraging, because even if it involves people who engage in very high-risk behaviors in very different contexts within these three cities, they were willing to use this intervention." harm reduction, "said Park.