scholarly journals The potential impacts of community drug checking within the overdose crisis: qualitative study exploring the perspective of prospective service users

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bruce Wallace ◽  
Thea van Roode ◽  
Flora Pagan ◽  
Dennis Hore ◽  
Bernadette Pauly

Abstract Background As drug checking becomes more integrated within public health responses to the overdose crisis, and potentially more institutionalized, there is value in critically questioning the impacts of drug checking as a harm reduction response. Methods As part of a pilot project to implement community drug checking in Victoria, BC, Canada, in-depth interviews (N = 27) were held with people who use or have used substances, family or friends of people who use substances, and/or people who make or distribute substances. Critical harm reduction and social justice perspectives and a socioecological model guided our analysis to understand the potential role of drug checking within the overdose crisis, from the perspective of prospective service users. Results Participants provided insight into who might benefit from community drug checking and potential benefits. They indicated drug checking addresses a “shared need” that could benefit people who use substances, people who care for people who use substances, and people who sell substances. Using a socioecological model, we identified four overarching themes corresponding to benefits at each level: “drug checking to improve health and wellbeing of people who use substances”, “drug checking to increase quality control in an unregulated market”, “drug checking to create healthier environments”, and “drug checking to mediate policies around substance use”. Conclusions Drug checking requires a universal approach to meet the needs of diverse populations who use substances, and must not be focused on abstinence based outcomes. As a harm reduction response, community drug checking has potential impacts beyond the individual level. These include increasing power and accountability within the illicit drug market, improving the health of communities, supporting safer supply initiatives and regulation of substances, and mitigating harms of criminalization. Evaluation of drug checking should consider potential impacts that extend beyond individual behaviour change and recognize lived realities and structural conditions.

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ashley Larnder ◽  
Piotr Burek ◽  
Bruce Wallace ◽  
Dennis K. Hore

Abstract Background Drug checking uses chemical analytical technologies to analyze drugs from the unregulated market to reduce substance use-related risks. We aim to examine the frequency of third party use of a community drug checking service to explore the potential for harm reduction to extend beyond the individual into the community, increase service accessibility, and to contribute to upstream interventions in the supply. Methods Over 31 months, data were collected from a point-of-care drug checking service operated in Victoria, Canada. Through the implementation of survey questions at the intake of the service, data were collected about whether the drug check was for the individual, to sell, and/or for others. Results Just over half (52%) of service users were checking for reasons that extended beyond individual use. When checking for others, friends were the most common response, representing 52% of responses, and outreach/support workers checking for others was the second most at 32%. Twelve percent of service users reported checking to sell or for a supplier. Conclusions Third party checking is a frequent, and important aspect of drug checking services, which through facilitating community engagement and increasing accessibility, has expanded the reach of interventions beyond individuals to reduce risks within the unregulated market. Therefore, drug checking as an overdose response should be responsive and accessible for those using the service on the behalf of others.


BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e037318
Author(s):  
Jennifer Boyd ◽  
Brian McMillan ◽  
Katherine Easton ◽  
Brigitte Delaney ◽  
Caroline Mitchell

ObjectivesPrevious qualitative research investigating the experiences of women diagnosed with gestational diabetes (GD) has provided important insights into the development of behaviour change interventions. However, these studies often lack a theoretical underpinning. This study explored the use of the capability, opportunity, motivation and behaviour (COM-B) framework (which proposes that individuals need the capability, opportunity and motivation to perform a particular behaviour) to code and the socioecological model to contextualise participant responses to better inform intervention development.DesignQualitative semistructured interviews are using purposive sampling. Interviews were audio-recorded, transcribed and coded using the COM-B framework. A socioecological approach was adopted to understand the context of intervention facets.SettingInterviews were conducted in a secondary care setting in South Yorkshire.ParticipantsTwenty-seven postnatal women with a previous diagnosis of GD were interviewed.ResultsApplying the COM-B framework to code participant, responses identified 16 key subthemes which reflected either: capability, opportunity or motivation components of the model. Four domains adapted from the socioecological model: individual, family life, community and healthcare provision; contextualised factors are important for these women in terms of behaviour change. Emotional response at the individual level was highly motivating or demotivating. Factors related to family life and community were particularly dominant and had the potential to either facilitate or impede change. We found many participants relied on healthcare provision during the prenatal and postnatal periods with timing and positive relationships being key to good care.ConclusionsOur study provides further insight into the factors crucial for behaviour change in women diagnosed with GD. By innovatively applying the COM-B framework in a socioecological context, it is clear intervention facets need to target microlevel through the macrolevel to engage this population in behaviour change. Future work should consider family-level intervention as this could allow for sustained behaviour change and consequently prevent the development of type 2 diabetes mellitus.


2020 ◽  
Vol 34 (5) ◽  
pp. 697-715
Author(s):  
Justine Virlée ◽  
Allard C.R. van Riel ◽  
Wafa Hammedi

Purpose This study aims to develop a better understanding of how online health community (OHC) members with different health literacy (HL) levels benefit from their participation, through the analysis and comparison of their resource integration (RI) processes. It investigates through a RI lens how the vulnerability of community members – captured as their level of HL – affects the benefits they derive from participation. Design/methodology/approach Quantitative and qualitative methods were used to investigate the effects of healthcare service users’ vulnerability. Data were collected about their profiles and levels of HL. Furthermore, 15 in-depth interviews were conducted. Findings The study demonstrates how low levels of HL act as a barrier to the integration of available online health resources. Participation in OHCs appears less beneficial for vulnerable users. Three types of benefits were identified at the individual level, namely, psychological quality-of-life, physical quality-of-life and learning. Benefits identified at the community level were: content generation and participation in the development of the community. Originality/value This study has implications for the understanding of how service users’ activities affect their own outcomes and how the vulnerability of users could be anticipated and considered in the design of the community.


2016 ◽  
Vol 33 (S1) ◽  
pp. S313-S313
Author(s):  
P. Quintana-Mathé ◽  
M. Grifell-Guàrdia ◽  
Á. Palma ◽  
I. Fornís-Espinosa ◽  
C. Gil-Lladanosa ◽  
...  

IntroductionMethylphenidate is a CNS stimulant approved for treatment of ADHD. It is generally considered well tolerated and exhibiting low dependence potential, although diversion for recreational use has been described. Provided that its effects are comparable to those of more popular drugs of abuse, such as cocaine and amphetamines, we hypothesized that it could be sold as such.ObjectiveThe aim of this study was:– to describe the presence of methylphenidate from the samples handled to, and analyzed by, Spanish harm-reduction service energy control between August 2009 and August 2015;– to determine whether it is being sold as other drugs.Materials and methodsAll samples presented to energy control (EC) were analyzed. EC is a Spanish harm-reduction non-governmental organization that offers to users the possibility of analyzing the substances they intend to consume.Samples in which methylphenidate was detected using Gas Chromatography–Mass Spectrometry were selected for this study.ResultsFrom a total of 20062 samples, 17 contained methylphenidate (0,09%), with no clear variations among the years studied. The samples were mostly sold as amphetamine (29%), methylphenidate (23%) and ethylphenidate (18%).ConclusionPresence of Methylphenidate in the Spanish illegal drug market seems anecdotic and stable over the studied timeframe. Moreover, it was sold as substances with similar dosages, lowering potential for life-threatening intoxications. Therefore, our results suggest that diversion of methylphenidate into the drug market as adulterant is not a concerning phenomenon.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2005 ◽  
Vol 35 (4) ◽  
pp. 665-693 ◽  
Author(s):  
Nancy Rodriguez ◽  
Charles Katz ◽  
Vincent J. Webb ◽  
David R. Schaefer

Although prior studies have monitored the trends in methamphetamine use and reported its increase over the years, few studies have considered how community-level characteristics affect the use of methamphetamine. In this study, we utilize data from the Arrestee Drug Abuse Monitoring (ADAM) program from two cities to examine how individual-level, community-level, and drug market factors influence methamphetamine use. Results indicate that both individual and community-level data significantly influence methamphetamine use. Also, findings show that predictors of methamphetamine use (at the individual and community-level) differ significantly from marijuana, cocaine, and opiate use. Policy implications regarding law enforcement suppression and the treatment of methamphetamine users are discussed.


Author(s):  
Sarah Lowe ◽  
Laura McGuinn ◽  
Marcos Quintela ◽  
Luke Player

IntroductionFlying Start (FS) is the Welsh Government’s (WG) flagship Early Years programme for families with children aged less than 4 years of age. Running since 2006, the four entitlements are: Free part-time childcare for 2-3 year olds Enhanced Health Visiting Parenting support Speech, language, and communication support Objectives and ApproachCurrently, while we know which areas in Wales are receiving FS support, individual-level data on which child received what entitlements is not available. This means that area-level outcomes can be used as proxy indicators but the individual impact of receiving FS support cannot be examined. This project describes the issues around collecting individual-level data in deprived Welsh regions, a pilot project to facilitate this collection and will report some emerging findings from the analysis of pilot data. ResultsFollowing from previous studies funded by the ESRC and WG (e.g. Supporting People Data Linking Feasibility Study), a Dataflow Development Project (DDP) has been launched to install Secure Anonymised Information Linkage (SAIL) appliances into 6 pilot Local Authorities in Wales. The SAIL appliance technology will provide Local Authorities with the ability to link individual-level data within a Local Authority or between Local Authorities and to securely anonymise data into the SAIL Databank or ADRC-W. The DDP will test acquiring the individual level FS data from pilot Local Authorities into SAIL. The project aims to evaluate FS by linking the FS cohort to a range of outcomes including health, education and social care. We will report emerging findings from the analysis of pilot data. Conclusion/ImplicationsThere is grow interest in using linked administrative data to evaluate government initiatives, and mounting enthusiasm in Local Government. If successful, this model is likely to be adopted by related WG programmes; improving the evidence base, facilitating effective evaluation, and adding to the data available for re-use in Wales.


2020 ◽  
Author(s):  
Buse Eylul Oruc ◽  
Arden Baxter ◽  
Pinar Keskinocak ◽  
John Asplund ◽  
Nicoleta Serban

Abstract Background. Recent research has been conducted by various countries and regions on the impact of non-pharmaceutical interventions (NPIs) on reducing the spread of COVID19. This study evaluates the tradeoffs between potential benefits (e.g., reduction in infection spread and deaths) of NPIs for COVID19 and being homebound (i.e., refraining from interactions outside of the household).Methods. An agent-based simulation model, which captures the natural history of the disease at the individual level, and the infection spread via a contact network assuming heterogeneous population mixing in households, peer groups (workplaces, schools), and communities, is adapted to project the disease spread and estimate the number of homebound people and person-days under multiple scenarios, including combinations of shelter-in-place, voluntary quarantine, and school closure in Georgia from March 1 to September 1, 2020.Results. Compared to no intervention, under voluntary quarantine, voluntary quarantine with school closure, and shelter-in-place with school closure scenarios 4.5, 23.1, and 200+ homebound adult-days were required to prevent one infection, with the maximum number of adults homebound on a given day in the range of 119K-248K, 465K-499K, 5,388K-5,389K, respectively. Compared to no intervention, school closure only reduced the percentage of the population infected by less than 16% while more than doubling the peak number of adults homebound.Conclusions. Voluntary quarantine combined with school closure significantly reduced the number of infections and deaths with a considerably smaller number of homebound person-days compared to shelter-in-place.


2022 ◽  
Vol 19 (1) ◽  
Author(s):  
Kristy M. Scarfone ◽  
Nazlee Maghsoudi ◽  
Karen McDonald ◽  
Cristiana Stefan ◽  
Daniel R. Beriault ◽  
...  

Abstract Background The overdose crisis has generated innovative harm reduction and drug market monitoring strategies. In Toronto, Ontario, Canada, a multi-site drug checking service (DCS) pilot project was launched in October 2019. The project provides people who use drugs with information on the chemical composition of their substances, thereby increasing their capacity to make more informed decisions about their drug use and avoid overdose. DCS also provides real-time market monitoring to identify trends in the unregulated drug supply. Methods Sample data were obtained through analyses of drug and used drug administration equipment samples submitted anonymously and free of charge to DCS in downtown Toronto from October 10, 2019, to April 9, 2020, representing the first six months of DCS implementation. Analyses were conducted in clinical laboratories using liquid chromatography- and/or gas chromatography-mass spectrometry (LC–MS, GC–MS) techniques. Results Overall, 555 samples were submitted, with 49% (271) of samples that were found to contain high-potency opioids, of which 87% (235) also contained stimulants. Benzodiazepine-type drugs were found in 21% (116) of all samples, and synthetic cannabinoids in 1% (7) of all samples. Negative effects (including overdose, adverse health events, and extreme sedation) were reported for 11% (59) of samples submitted for analysis. Conclusions Toronto’s DCS identified a range of high-potency opioids with stimulants, benzodiazepine-type drugs, and a synthetic cannabinoid, AMB-FUBINACA. This information can inform a range of evidence-informed overdose prevention efforts.


1994 ◽  
Vol 8 (4) ◽  
pp. 376-392 ◽  
Author(s):  
John G.H. Dunn

Traditionally, nomothetic and idiographic methodologies have been viewed as antithetical. This dichotomous perspective has caused many researchers to advocate the benefits associated with only one of the two approaches. Such a biased view hinders the acquisition of knowledge in the sport psychology field because the potential benefits that the nonfavored approach can offer are frequently overlooked. The present study demonstrates how research in sport psychology can be enhanced by combining nomothetic and idiographic procedures. This combined approach provides the researcher with the opportunity to validate nomothetic principles at the individual level, while simultaneously generating nomothetic hypotheses from idiographic analyses. To illustrate these points, a nomothetic profile of situational threat perceptions based upon the responses of 46 ice hockey players (reported by Dunn & Nielsen, 1993) is compared with the perceptual profiles of three individual ice hockey players. The comparisons show many unique perceptual differences between the group and individual solutions.


2021 ◽  
Author(s):  
Nicolas Michael Mattis ◽  
Philipp K. Masur ◽  
Judith Moeller ◽  
Wouter van Atteveldt

Growing concern about the democratic impact of automatically curated news platforms urges us to reconsider how such platforms should be designed. We propose a theoretical framework for personalised diversity nudges that can stimulate diverse news consumption on the individual level. To examine potential benefits and limitations of existing diversity nudges, we conduct an interdisciplinary literature review that synthesizes theoretical work on news selection mechanisms with hands-on tools and implementations from the fields of computer science and recommender systems. Based thereupon, we propose five diversity nudges that researchers and practitioners can build on. We provide a theoretical motivation of why, when, and for whom such nudges could be effective, critically reflect on their potential backfire effects and the need for algorithmic transparency, and sketch out a research agenda for diversity-aware news recommender design. Thereby, we develop concrete, theoretically grounded avenues toward facilitating diverse news consumption on algorithmically curated platforms.


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