The International journal on drug policy
-
Int. J. Drug Policy · Mar 2020
Perceptions and concerns of hepatitis C reinfection following prison-wide treatment scale-up: Counterpublic health amid hepatitis C treatment as prevention efforts in the prison setting.
Hepatitis C (HCV) infection is highly prevalent within the prison setting. Direct-acting antiviral (DAA) therapies have changed the HCV treatment landscape, offering simple treatment (with minimal side-effects) and high efficacy. These advances have enabled the first real-world study of HCV treatment as prevention (TasP), the Surveillance and Treatment of Prisoners with hepatitis C (SToP-C) study. This paper draws on data from qualitative interviews completed with SToP-C participants following prison-wide DAA treatment scale-up. ⋯ HCV DAA treatment is provided somewhat under the guise of 'cure is easy', but fails to address the ongoing risk factors experienced by people who inject drugs in prisons, as well as other people in prison who may be at risk of blood-to-blood exposure. Health messaging regarding HCV treatment and treatment for reinfection should be tailored to ensure patient-centred care. Health interventions in prison must address the whole person and the circumstances in which they live, not just the illness.
-
Int. J. Drug Policy · Feb 2020
Women's utilization of housing-based overdose prevention sites in Vancouver, Canada: An ethnographic study.
In response to a fentanyl-driven overdose crisis, low-threshold supervised consumption sites, termed overdose prevention sites (OPS), have been rapidly implemented in Vancouver, Canada. Since approximately 88% of fatal overdoses in the province occur indoors, OPS have been integrated into select non-profit-operated single room accommodations (SRA) housing. We examined the social-structural features of these housing-based OPS (HOPS) on women's overdose risk. ⋯ Findings highlight how the low-barrier design and operation of HOPS can undermine women's engagement with HOPS. Overdose prevention strategies in SRAs should also include gender-specific models (e.g. women-only HOPS, women peer workers) to help mitigate barriers to these services within the context of the current overdose crisis.
-
Int. J. Drug Policy · Feb 2020
Help me fix: The provision of injection assistance at an unsanctioned overdose prevention site in Toronto, Canada.
There is an acute public health crisis from opioid-related poisoning and overdose in Canada. The Moss Park Overdose Prevention Site (MP-OPS) - an unsanctioned overdose prevention site - opened in a downtown park in Toronto in August 2017, when no other supervised consumption services existed in the province. As an unsanctioned site, MP-OPS was not constrained by federal rules prohibiting assisted injection, and provided a unique opportunity to examine assisted injection within a supervised setting. Our objective was to examine the association between assisted injection and overdose, and whether any association between assisted injection and overdose differs according to gender. ⋯ Findings that women receiving assisted injecting are at higher odds of overdose within the supervised setting of the MP-OPS are consistent with previous literature on assisted injection in community settings. Rules banning assisted injection in supervised consumption services may be putting a group of people, particularly women and those injecting fentanyl, at higher risk of health harms by denying them access to a supervised space where prompt overdose response is available.
-
Int. J. Drug Policy · Feb 2020
The relationships between chronic pain and changes in health with cannabis consumption patterns.
Pain is the most common reason endorsed by patients seeking medical cannabis. Given the nature of chronic pain, it is particularly important to understand consumption patterns for patients who use cannabis for chronic health conditions to evaluate how frequency of use might impact overall health and functioning. This analysis examines whether levels of chronic pain were associated with cannabis consumption patterns, after controlling for patient-level differences in demographics. ⋯ While the efficacy of cannabis for various medical conditions continues to be evaluated, the best available evidence suggests a possible benefit for the treatment of chronic pain. The results of this study indicate that individuals with high pain are more likely to consume cannabis multiple times a day, but this use may not be related to better health. Our results point to a need for more research on the health impacts of frequency of cannabis use among medical cannabis dispensary patients.
-
Int. J. Drug Policy · Feb 2020
Critical studies of harm reduction: Overdose response in uncertain political times.
North America continues to witness escalating rates of opioid overdose deaths. Scale-up of existing and innovative life-saving services - such as overdose prevention sites (OPS) as well as sanctioned and unsanctioned supervised consumption sites - is urgently needed. ⋯ Services appear to be most innovative, dynamic, and inclusive when people with lived experience, allies, and service providers are directly responding to fast-changing drug use patterns and crises on the ground, before services become formally bureaucratised. We suggest a continuing need to both critically theorise harm reduction and to build strong community relationships in harm reduction work, in efforts to overcome political moves that impede collaboration with and inclusiveness of people who use drugs.