scholarly journals “We have to be uncomfortable and creative”: Reflections on the impacts of the COVID-19 pandemic on overdose prevention, harm reduction & homelessness advocacy in Philadelphia

2021 ◽  
Vol 1 ◽  
pp. 100013
Author(s):  
Shoshana V. Aronowitz ◽  
Eden Engel-Rebitzer ◽  
Margaret Lowenstein ◽  
Zachary Meisel ◽  
Evan Anderson ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Overdose Prevention

scholarly journals Hoots and harm reduction: a qualitative study identifying gaps in overdose prevention among women who smoke drugs

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Geoff Bardwell ◽  
Tamar Austin ◽  
Lisa Maher ◽  
Jade Boyd
Keyword(s):  
Harm Reduction ◽  
Illicit Drugs ◽  
Structural Violence ◽  
Structured Interviews ◽  
Overdose Prevention ◽  
Polysubstance Use ◽  
Reduction Strategies ◽  
Prevention Interventions ◽  
Negative Health Outcomes ◽  
Mixed Gender

Abstract Background Smoking or inhaling illicit drugs can lead to a variety of negative health outcomes, including overdose. However, most overdose prevention interventions, such as supervised consumption services (SCS), prohibit inhalation. In addition, women are underrepresented at SCS and are disproportionately impacted by socio-structural violence. This study examines women’s experiences smoking illicit drugs during an overdose epidemic, including their utilization of a women-only supervised inhalation site. Methods Qualitative research methods included on-site ethnographic observation and semi-structured interviews with 32 participants purposively recruited from the women-only site. Data were coded and analyzed using NVivo 12 and thematic analysis was informed by gendered and socio-structural understandings of violence. Results Participants had preferences for smoking drugs and these were shaped by their limited income, inability to inject, and perceptions of overdose risk. Participants expressed the need for services that attend to women’s specific experiences of gendered, race-based, and structural violence faced within and outside mixed-gender social service settings. Results indicate a need for sanctioned spaces that recognize polysubstance use and drug smoking, accommodated by the women-only SCS. The smoking environment further fostered a sociability where participants could engage in perceived harm reduction through sharing drugs with other women/those in need and were able to respond in the event of an overdose. Conclusions Findings demonstrate the ways in which gendered social and structural environments shape women’s daily experiences using drugs and the need for culturally appropriate interventions that recognize diverse modes of consumption while attending to overdose and violence. Women-only smoking spaces can provide temporary reprieve from some socio-structural harms and build collective capacity to practice harm reduction strategies, including overdose prevention. Women-specific SCS with attention to polysubstance use are needed as well as continued efforts to address the socio-structural harms experienced by women who smoke illicit drugs.

scholarly journals Naloxone Buyers Club: Overlooked Critical Public Health Infrastructure for Preventing Overdose Deaths

2021 ◽  
Author(s):  
Maya Doe-Simkins ◽  
Eliza Jane Wheeler ◽  
Mary C. Figgatt ◽  
T. Stephen Jones ◽  
Alice Bell ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Low Cost ◽  
People Who Use Drugs ◽  
Critical Element ◽  
Mutual Aid ◽  
Overdose Prevention ◽  
Service Programs ◽  
Compliance Officers ◽  
Critical Public Health ◽  
Overdose Deaths

Background Community-based naloxone distribution is an evidence-based pillar of overdose prevention. Since 2012, the naloxone Buyers Club facilitated purchase of low-cost naloxone by harm reduction and syringe service programs, the primary conduits for reaching people who use drugs. This innovative purchasing and mutual aid network has not been previously described. Methods We analyzed transactional records of naloxone orders (2017-2020, n=965), a survey of current Buyers Club members (2020, n=104), and mutual aid requests (2021, n=86). Results Between 2017 and 2020, annual orders for naloxone increased 2.6-fold. 114 unique harm reduction programs from 40 states placed orders for 3,714,110 vials of 0.4 mg/mL generic naloxone through the Buyers Club. States with most orders were: Arizona (600,000 vials), Illinois (576,800), Minnesota (347,450), California (317,200), North Carolina (315,040). Among programs that ordered naloxone in 2020, 52% (n=32) received no federal funding and ordered half as much as funded programs. During the 2021 shortage, mutual aid redistribution was common, with 80% participating as either a donor or recipient. Among 59 mutual aid requestors, 59% (n=35) were willing to accept expired naloxone; the clear preference was for generic injectable naloxone, 95% (n=56). Conclusions The naloxone Buyers Club is a critical element of overdose prevention infrastructure. Yet, barriers from corporate compliance officers and federal prescription-only status impede access. These barriers can be reduced by FDA removing the prescription requirement for naloxone and government funding for harm reduction programs.

scholarly journals A Critical Narrative Inquiry to Understand the Impacts of an Overdose Prevention Site on the Lives of Site Users

2020 ◽  
Author(s):  
Abe Oudshoorn ◽  
Michelle Sangster Bouck ◽  
Melissa McCann ◽  
Shamiram Zendo ◽  
Helene Berman ◽  
...  
Keyword(s):  
Substance Use ◽  
Harm Reduction ◽  
Sense Of Self ◽  
People Who Use Drugs ◽  
Transformative Change ◽  
Overdose Prevention ◽  
Caring Relationships ◽  
Starting Point ◽  
Reduction Strategies ◽  
The Impact

Abstract Background Globally, communities are struggling to gain support for harm reduction strategies being implemented to address the impacts of substance use. A key part of this discussion is understanding and engaging with people who use drugs to help shape community harm reduction strategies. This study focused on how an overdose prevention site has influenced the lives of people who use drugs.MethodsA critical narrative method was utilized, centred on photo-narratives. Twenty-seven individuals accessing an overdose prevention site were recruited to participate in preliminary interviews. 16 participants subsequently took photographs to describe the impact of the site and participated in a second round of interviews. Through independent coding and several rounds of team analysis, four themes were proposed to constitute a core narrative encompassing the diverse experiences of participants. ResultsA key message shared by participants was the sense that their lives have improved since accessing the site. The core narrative proposed is presented in a series of four themes or ‘chapters’: Enduring, Accessing Safety, Connecting and Belonging, and Transforming. The chapters follow a series of transitions, revealing a journey that participants presented through their own eyes; one of moving from utter despair to hope, opportunity, and inclusion. Where at the outset participants were simply trying to survive the challenges of chaotic substance use, through the relationships and services provided at the site they moved towards small or large life transformations.ConclusionsThis study contributes to an enhanced understanding of how caring relationships with staff at the overdose prevention site impacted site users’ sense of self. We propose that caring relationships are an intervention in and of themselves, and that these relationships contribute to transformation that extends far beyond the public health outcomes of disease reduction. The caring relationships at the site can be a starting point for significant social changes. However, the micro-environment that existed within the site needs to extend beyond its walls for true transformative change to take place. The marginalization and stigmatization that people who use drugs experience outside these sites remains a constant barrier to achieving stability in their lives.

scholarly journals Pulverizing medication as a harm reduction and intentional drug overdose prevention strategy: Two case studies

2021 ◽  
Author(s):  
Keisuke Takanobu ◽  
Daisuke Okazaki ◽  
Shinya Watanabe ◽  
Nobuyuki Mitsui ◽  
Teruaki Tanaka
Keyword(s):  
Harm Reduction ◽  
Case Studies ◽  
Drug Overdose ◽  
Prevention Strategy ◽  
Overdose Prevention

Opioid overdose prevention education for medical students: Adopting harm reduction into mandatory clerkship curricula

2019 ◽  
Vol 41 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Benjamin J. Oldfield ◽  
Jeanette M. Tetrault ◽  
Kirsten M. Wilkins ◽  
E. Jennifer Edelman ◽  
Noah A. Capurso
Keyword(s):  
Medical Students ◽  
Harm Reduction ◽  
Opioid Overdose ◽  
Overdose Prevention ◽  
Prevention Education

scholarly journals A critical narrative inquiry to understand the impacts of an overdose prevention site on the lives of site users

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Abe Oudshoorn ◽  
Michelle Sangster Bouck ◽  
Melissa McCann ◽  
Shamiram Zendo ◽  
Helene Berman ◽  
...  
Keyword(s):  
Substance Use ◽  
Harm Reduction ◽  
Sense Of Self ◽  
People Who Use Drugs ◽  
Transformative Change ◽  
Overdose Prevention ◽  
Caring Relationships ◽  
Starting Point ◽  
Reduction Strategies ◽  
The Impact

Abstract Background Globally, communities are struggling to gain support for harm reduction strategies being implemented to address the impacts of substance use. A key part of this discussion is understanding and engaging with people who use drugs to help shape community harm reduction strategies. This study focused on how an overdose prevention site has influenced the lives of people who use drugs. Methods A critical narrative method was utilized, centred on photo-narratives. Twenty-seven individuals accessing an overdose prevention site were recruited to participate in preliminary interviews. Sixteen participants subsequently took photographs to describe the impact of the site and participated in a second round of interviews. Through independent coding and several rounds of team analysis, four themes were proposed to constitute a core narrative encompassing the diverse experiences of participants. Results A key message shared by participants was the sense that their lives have improved since accessing the site. The core narrative proposed is presented in a series of four themes or “chapters”: Enduring, Accessing Safety, Connecting and Belonging, and Transforming. The chapters follow a series of transitions, revealing a journey that participants presented through their own eyes: one of moving from utter despair to hope, opportunity, and inclusion. Where at the outset participants were simply trying to survive the challenges of chaotic substance use, through the relationships and services provided at the site they moved towards small or large life transformations. Conclusions This study contributes to an enhanced understanding of how caring relationships with staff at the overdose prevention site impacted site users’ sense of self. We propose that caring relationships are an intervention in and of themselves, and that these relationships contribute to transformation that extends far beyond the public health outcomes of disease reduction. The caring relationships at the site can be a starting point for significant social changes. However, the micro-environment that existed within the site needs to extend beyond its walls for true transformative change to take place. The marginalization and stigmatization that people who use drugs experience outside these sites remains a constant barrier to achieving stability in their lives.

scholarly journals Space, place, and perceived illegality: the unsanctioned Parkdale Overdose Prevention Site

2021 ◽  
Author(s):  
Erika Dupuis
Keyword(s):  
Harm Reduction ◽  
Service Provision ◽  
Community Mobilization ◽  
Provincial Government ◽  
Community Activism ◽  
People Who Use Drugs ◽  
Front Line ◽  
Overdose Prevention

In August 2018 the Ontario provincial government ordered the halt of several overdose prevention sites across the province. This paper will focus on an unsanctioned site that opened out of response to resist said closures. This study aims to explore how front-line volunteers navigated opening, maintaining, and closing an unsanctioned overdose prevention site amidst a neoliberal government, and whether it had any impact on service provision. The writer interviewed volunteers who frequently worked at the unsanctioned site, discussing their community, activism, and the ongoing efforts to support people who use drugs. The findings of this research suggest that the perception of illegality had impacts on funding, burnout, and community mobilization. Keywords: governmentality, harm reduction, people who use drugs, unsanctioned overdose prevention sites

Enacting Fentanyl Tests Strips for Overdose Prevention: The Socio-Material Transformation of “Suspect Technologies” into “Technologies of Solidarity”

2021 ◽  
pp. 009145092110383
Author(s):  
Nancy D. Campbell
Keyword(s):  
Harm Reduction ◽  
Drug Users ◽  
Evidence Base ◽  
Drug Control ◽  
Policy And Practice ◽  
Overdose Prevention ◽  
Test Strips ◽  
Political Work ◽  
Hybrid Concept ◽  
Drug Checking

Fentanyl Test Strips (FTS) make possible rapid visual determinations of whether or not fentanyl is present in a given drug supply. This article places FTS within the historical contexts of drug-checking for drug control, overdose prevention, and harm reduction in North America. Following Fentanyl Test Strips (FTS) as artifacts made to signify and enact possibilities other than those for which they were developed and licensed, this article contributes to socio-material theorization of drug control, overdose prevention, and harm reduction in relation to the agency, empowerment, and liveliness of drug users through enactment of the policy and practice of off-label use. The socio-materialities of FTS co-constitute their semiotics and their interpretive flexibility within prevailing forms of evidence-based reasoning that have transformed clinical practice over past decades. They offer new renderings of facticity and artifactuality, which I connect to Ludwik Fleck’s work on the Wasserman test in Genesis and Structure of a Scientific Fact. Reading both the materiality and the semiotics of FTS as artifacts provides a hybrid concept of socio-materiality attentive to the social and material relations embedded in and embodied by FTS, and those who use them in both intended and unintended ways. Such uses differ from individualized expertise and evaluation taken as contributory to the evidence base of the global North. The political work of articulating between different grounds of struggle is underway among those seeking to distribute FTS more widely. But it is their sociomaterial flexibility that makes these artifacts move into new relations that sustains the more affective and artisanal forms of political and cultural recognition characterized in this article as “artifactual” use for an alterbiopolitics.

scholarly journals Space, place, and perceived illegality: the unsanctioned Parkdale Overdose Prevention Site

2021 ◽  
Author(s):  
Erika Dupuis
Keyword(s):  
Harm Reduction ◽  
Service Provision ◽  
Community Mobilization ◽  
Provincial Government ◽  
Community Activism ◽  
People Who Use Drugs ◽  
Front Line ◽  
Overdose Prevention

In August 2018 the Ontario provincial government ordered the halt of several overdose prevention sites across the province. This paper will focus on an unsanctioned site that opened out of response to resist said closures. This study aims to explore how front-line volunteers navigated opening, maintaining, and closing an unsanctioned overdose prevention site amidst a neoliberal government, and whether it had any impact on service provision. The writer interviewed volunteers who frequently worked at the unsanctioned site, discussing their community, activism, and the ongoing efforts to support people who use drugs. The findings of this research suggest that the perception of illegality had impacts on funding, burnout, and community mobilization. Keywords: governmentality, harm reduction, people who use drugs, unsanctioned overdose prevention sites

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