Perceived vulnerability to overdose-related arrests among people who use drugs in Maryland

Abstract Background North America is amidst an opioid overdose epidemic. In many settings, particularly Canada, the majority of overdose deaths occur indoors and impact structurally vulnerable people who use drugs alone, making targeted housing-based interventions a priority. Mobile applications have been developed that allow individuals to solicit help to prevent overdose death. We examine the experiences of women residents utilizing an overdose response button technology within a supportive housing environment. Methods In October 2019, we conducted semi-structured qualitative interviews with 14 residents of a women-only supportive housing building in an urban setting where the overdose response button technology was installed. Data was analyzed thematically and framed by theories of structural vulnerability. Results While participants described the utility and disadvantages of the technology for overdose response, most participants, unexpectedly described alternate adoptions of the technology. Participants used the technology for other emergency situations (e.g., gender-based violence), rather than its intended purpose of overdose response. Conclusions Our findings highlight the limitations of current technologies while also demonstrating the clear need for housing-based emergency response interventions that address not just overdose risk but also gender-based violence. These need to be implemented alongside larger strategies to address structural vulnerabilities and provide greater agency to marginalized women who use drugs.

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Quality of life among people who use drugs living in poor urban communities in the Philippines

International Journal of Drug Policy ◽

10.1016/j.drugpo.2021.103160 ◽

2021 ◽

Vol 93 ◽

pp. 103160

Author(s):

Chika Yamada ◽

Atsuro Tsutsumi ◽

Takashi Izutsu ◽

Maria T.R. Tuliao ◽

Hiroya Matsuo ◽

...

Keyword(s):

Quality Of Life ◽

Urban Communities ◽

The Philippines ◽

People Who Use Drugs

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“We're actually more of a likely ally than an unlikely ally”: relationships between syringe services programs and law enforcement

Harm Reduction Journal ◽

10.1186/s12954-021-00515-2 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Carol Y. Franco ◽

Angela E. Lee-Winn ◽

Sara Brandspigel ◽

Musheng L. Alishahi ◽

Ashley Brooks-Russell

Keyword(s):

Law Enforcement ◽

Police Officers ◽

Wound Care ◽

Phenomenological Approach ◽

Treatment Programs ◽

People Who Use Drugs ◽

Positive Relationships ◽

Structured Interviews ◽

Program Staff ◽

Compliance With The Law

Abstract Background Syringe services programs provide sterile injection supplies and a range of health services (e.g., HIV and HEP-C testing, overdose prevention education, provision of naloxone) to a hard-to-reach population, including people who use drugs, aiming to prevent the transmission of infectious diseases. Methods We performed a qualitative needs assessment of existing syringe services programs in the state of Colorado in 2018–2019 to describe—their activities, needs, and barriers. Using a phenomenological approach, we performed semi-structured interviews with key program staff of syringe services programs (n = 11). All interviews were digitally recorded, transcribed, and validated. A data-driven iterative approach was used by researchers to develop a coding scheme to organize the data into major themes found across interviews. Memos were written to synthesize main themes. Results Nearly all the syringe program staff discussed their relationships with law enforcement at length. All syringe program staff viewed having a positive relationship with law enforcement as critical to the success of their program. Main factors that influence the quality of relationships between syringe services programs and law enforcement included: (1) alignment in agency culture, (2) support from law enforcement leadership, (3) police officers’ participation and compliance with the Law Enforcement Assisted Diversion (LEAD) program, which provides intensive case management for low-level drug offenders, and (4) implementation of the “Needle-Stick Prevention Law” and Drug Paraphernalia Law Exemption. All syringe program staff expressed a strong desire to have positive relationships with law enforcement and described how a collaborative working relationship was critical to the success of their programs. Conclusions Our findings reveal effective strategies to foster relationships between syringe services programs and law enforcement as well as key barriers to address. The need exists for both syringe services programs and law enforcement to devote time and resources to build a strong, positive partnership. Having such positive relationships with law enforcement has positive implications for syringe services program clients, including law enforcement being less likely to ticket persons for having used syringes, and encourage people who use drugs to seek services from syringe services programs, which can then lead them to other resources, such as housing, wound care, and substance use treatment programs.

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The Complexity of Drug Consumption Room Policy and Progress in Finland

Contemporary Drug Problems ◽

10.1177/00914509211002542 ◽

2021 ◽

pp. 009145092110025

Author(s):

Ali Unlu ◽

Fatih Demiroz ◽

Tuukka Tammi ◽

Pekka Hakkarainen

Keyword(s):

Complexity Theory ◽

Government Policy ◽

Policy Process ◽

Central Government ◽

Drug Consumption ◽

People Who Use Drugs ◽

Local Response ◽

Local Actors ◽

Moral Frameworks ◽

Drug Consumption Room

Drug consumption rooms (DCRs) have been established to reach high-risk people who use drugs (PWUDs) and reduce drug-associated harm. Despite effectiveness, their establishment requires strong advocacy and efforts since moral perspectives tend to prevail over health outcomes in many countries. DCRs have generally emerged as a local response to inadequate central government policy. Likewise, the initiative of the Municipality of Helsinki in 2018 opened up a discussion between central government, society, and local actors in Finland. This would be the first DCR in Finland, which makes the policy process and the progress of the initiative interesting for analysis. In this article, the identification of agents, structures of interactions, environmental challenges, and policy opportunities are analyzed within the framework of complexity theory. Our results show that the initiative faces policy barriers that have mainly arisen from the conceptualization of DCRs in moral frameworks that result in the prolongation of political and professional actors to take a position on DCRs.

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