scholarly journals Preferences and acceptability of law enforcement initiated referrals for people who inject drugs: a mixed methods analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Gabriella K. Olgin ◽  
Annick Bórquez ◽  
Pieter Baker ◽  
Erika Clairgue ◽  
Mario Morales ◽  
...  
Keyword(s):  
Substance Use ◽  
Mixed Methods ◽  
Law Enforcement ◽  
Harm Reduction ◽  
Social Services ◽  
People Who Inject Drugs ◽  
Strong Support ◽  
Substance Use Treatment ◽  
Health And Social Services ◽  
Service Referral

Abstract Background Law enforcement officers (LEOs) come into frequent contact with people who inject drugs (PWID). Through service referrals, LEOs may facilitate PWID engagement in harm reduction, substance use treatment, and other health and supportive services. Little is known about PWID and LEO attitudes and concerns about service referrals, however. The objective of this mixed-methods study was to examine the alignment of service referral preferences and acceptability among PWID and LEOs in Tijuana, Mexico. Methods We assessed service referral preferences and perceived likelihood of participation in health and social services, integrating data from structured questionnaires with 280 PWID and 306 LEOs, contextualized by semi-structured interviews and focus groups with 15 PWID and 17 LEOs enrolled in two parallel longitudinal cohorts in Tijuana, Mexico. Results Among potential service referral options, both PWID (78%) and LEOs (88%) most frequently cited assistance with drug- and alcohol-use disorders. Over half of PWID and LEOs supported including harm reduction services such as syringe service programs, overdose prevention, and HIV testing. The majority of PWID supported LEO referrals to programs that addressed basic structural needs (e.g. personal care [62%], food assistance [61%], housing assistance [58%]). However, the proportion of LEOs (30–45%) who endorsed these service referrals was significantly lower (p <  0.01). Regarding referral acceptability, 71% of PWID reported they would be very likely or somewhat likely to make use of a referral compared to 94% of LEOs reporting that they thought PWID would always or sometimes utilize them. These results were echoed in the qualitative analysis, although practical barriers to referrals emerged, whereby PWID were less optimistic that they would utilize referrals compared to LEOs. Conclusions We identified strong support for LEO service referrals among both LEO and PWID respondents, with the highest preference for substance use treatment. LEO referral programs offer opportunities to deflect PWID contact with carceral systems while facilitating access to health and social services. However, appropriate investments and political will are needed to develop an evidence-based (integrated) service infrastructure.

scholarly journals Substance use Treatment and Harm Reduction Services for Migrants and Refugees in the COVID-19 Pandemic: Findings from a Global Survey

2020 ◽  
Author(s):  
Cornelis De Jong ◽  
Ali Farhoudian ◽  
Mehrnoosh Vahidi ◽  
Mohsen Ebrahimi ◽  
Hamed Ekhtiari ◽  
...  
Keyword(s):  
Substance Use ◽  
Harm Reduction ◽  
Substance Use Disorders ◽  
Mental Health Problems ◽  
World Health ◽  
Substance Use Treatment ◽  
Second Phase ◽  
Addiction Medicine ◽  
Global Survey ◽  
The Impact

Abstract Migrants and refugees are considered vulnerable to mental health problems and substance use disorders; and may be particularly affected by service disruptions associated with the COVID-19 pandemic The International Society of Addiction Medicine (ISAM) ran a multi-phased global survey among clinicians and health professional that are actively working in the field of addiction medicine to investigate the impact of the COVID-19 pandemic on substance use and related services. In March 2020, the first month after the announcement of the pandemic by the World Health Organization, 177 informants from 77 countries took part in the global survey, and only 12.9% of them reported their countries’ substance use treatment and harm reduction services for the migrants and refugees with substance use disorders continued as usual. In May 2020, 11.7% of respondents of the second phase reported that the services for refugees and migrants improved in comparison to March 2020; 11.7% reported that these services in their country discontinued. Results suggest that refugee and migrants access to treatment and harm reduction services has been reduced as a result of COVID-19. It can be concluded that it is crucial to improve the visibility of migrants’ needs and exploit appropriate interventions for those with substance use disorders.

A national study of the availability of law enforcement agency wellness programming for officers: A latent class analysis

2021 ◽  
pp. 146135572110640
Author(s):  
Bruce G Taylor ◽  
Weiwei Liu ◽  
Elizabeth A. Mumford
Keyword(s):  
Mental Health ◽  
United States ◽  
Substance Use ◽  
Law Enforcement ◽  
Latent Class Analysis ◽  
Latent Class ◽  
Wellness Programs ◽  
The United States ◽  
Substance Use Treatment ◽  
Class Analysis

The purpose of this study is to understand the availability of employee wellness programs within law enforcement agencies (LEAs) across the United States, including physical fitness, resilience/wellness, coping skills, nutrition, mental health treatment, and substance use treatment. The research team investigated whether patterns of LEA wellness programming are identifiable and, if so, what characteristics describe these patterns. We assess using latent class analysis whether there are distinct profiles of agencies with similar patterns offering different types of wellness programs and explore what characteristics distinguish agencies with certain profiles of wellness programming. Data were from a nationally representative sample of 1135 LEAs: 80.1% municipal, 18.6% county and 1.3% other agencies (state-level and Bureau of Indian Affairs LEAs). We found that many agencies (62%) offer no wellness programming. We also found that 23% have comprehensive wellness programming, and that another group of agencies specialize in specific wellness programming. About 14% of the agencies have a high probability of providing resilience coping skill education, mental health and/or substance use treatment services programming. About 1% of the agencies in the United States limit their programming to fitness and nutrition, indicating that fitness and nutrition programs are more likely to be offered in concert with other types of wellness programs. The analyses revealed that agencies offering broad program support are more likely to be large, municipal LEAs located in either the West, Midwest or Northeast (compared with the southern United States), and not experiencing a recent budget cut that impacted wellness programming.

Barriers and Facilitators of HIV and Hepatitis C Care Among People Who Inject Drugs in Nairobi, Kenya: A Qualitative Study with Peer Educators

2021 ◽  
Author(s):  
Natasha Ludwig-Barron ◽  
Brandon L Guthrie ◽  
Loice Mbogo ◽  
David Bukusi ◽  
William Sinkele ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Law Enforcement ◽  
Harm Reduction ◽  
People Who Inject Drugs ◽  
Community Level ◽  
Barriers And Facilitators ◽  
Peer Educators ◽  
Prevention Education ◽  
Individual Level ◽  
Policy Level

Abstract Background: In Kenya, people who inject drugs (PWID) are disproportionately affected by HIV and hepatitis C (HCV) epidemics, including HIV-HCV coinfections; however, few have assessed factors affecting their access to and engagement in care through the lens of harm reduction specialists. This qualitative study leverages the personal and professional experiences of peer educators to help identify HIV and HCV barriers and facilitators to care among PWID in Nairobi, including resource recommendations to improve service uptake. Methods: We recruited peer educators from two harm reduction facilities in Nairobi, Kenya, using random and purposive sampling techniques. Semi-structured interviews explored circumstances surrounding HIV and HCV service access, prevention education and resource recommendations. A thematic analysis was conducted using the Modified Social Ecological Model (MSEM) as an underlying framework, with illustrative quotes highlighting emergent themes. Results: Twenty peer educators participated, including six women, with 2 months to 6 years of harm reduction service. Barriers to HIV and HCV care were organized by (a) individual-level themes including competing needs of addiction and misinterpreted symptoms; (b) network-level themes including social isolation and drug pusher interactions; (c) community-level themes including transportation, mental and rural healthcare services, and limited HCV resources; and (d) policy-level themes including nonintegrated services, clinical administration, and law enforcement. Stigma, an overarching barrier, was highlighted throughout the MSEM. Facilitators to HIV and HCV care were comprised of (a) individual-level themes including concurrent care, personal reflections, and religious beliefs; (b) network-level themes including community recommendations, navigation services, family commitment, and employer support; (c) community-level themes including quality services, peer support, and outreach; and (d) policy-level themes including integrated services and medicalized approaches within law enforcement. Participant resource recommendations include (i) additional medical, social and ancillary support services, (ii) national strategies to address stigma and violence and (iii) HCV prevention education. Conclusions : Peer educators provided intimate knowledge of PWID barriers and facilitators to HIV and HCV care that were described at each level of the MSEM, and should be given careful consideration when developing future initiatives. Recommendations emphasized policy and community-level interventions including educational campaigns and program suggestions to supplement existing HIV and HCV services.

scholarly journals Access to and Use of Health and Social Services among People who Inject Drugs in two urban areas of Mozambique, 2014: Qualitative Results from a Formative Assessment

2020 ◽  
Author(s):  
Liliana Candida Dengo-Baloi ◽  
Makini Aida Boothe ◽  
Cynthia Amino Semá-Baltazar ◽  
Isabel Sathane ◽  
Denise Chitsondzo Langa ◽  
...  
Keyword(s):  
Formative Assessment ◽  
Social Services ◽  
Risk Behaviors ◽  
Urban Areas ◽  
People Who Inject Drugs ◽  
Service Providers ◽  
Psychiatric Treatment ◽  
Health Workers ◽  
Hot Spot ◽  
Health And Social Services

Abstract Background: Prior to 2014, data about health seeking behaviors or service uptake for People who inject drugs (PWID) in Mozambique did not exist. We present the results from the formative assessment component of the Biological and Behavioral Survey (BBS). Methods: Standardized interview guides were used during key informant interviews (KII) and focus group discussions (FGD) in Maputo and Nampula/Nacala to discuss issues related to risk behaviors and access to and utilization of health and social services by PWID. The target sample size was not defined a priori, but instead KII and FGD were conducted until responses reached saturation. Data analysis was based on the principles of grounded theory related to qualitative research. Results: Eighty-eight respondents, ages 15 to 60, participated in KIIs and FGDs. Participants were majority male from diverse income and education levels and included current and former PWID, non-injection drug users, health and social service providers, peer educators, and community health workers. Respondents reported that PWID engage in high-risk behaviors such as needle and syringe sharing, exchange of sex for drugs or money, and low condom use. According to participants, PWID would rather rent, share or borrow injection equipment at shooting galleries than purchase them due to stigma, fear of criminalization, transportation and purchase costs, restricted pharmacy hours, personal preference for needle sharing, and immediacy of drug need. Barriers to access and utilization of health and social services include distance, requirements to represent identification documents and fear of criminalization, the limited availability of programs for PWID, lack of knowledge of the few programs that exist, concerns about the quality of care provided by health providers, lack of readiness as a result of addiction and perceived stigma related to the use of mental health services offering treatment to PWID. Conclusions: Mozambique urgently needs to establish specialized harm reduction programs for PWID and improve awareness of available resources. Services should be located in hot spot areas to address issues related to distance, transportation and the planning required for safe injection. Specific attention should go to the creation of PWID-focused health and social services outside of state-sponsored psychiatric treatment centers.

scholarly journals Access to and Use of Health and Social Services among People who Inject Drugs in two urban areas of Mozambique, 2014: Qualitative Results from a Formative Assessment

2020 ◽  
Author(s):  
Liliana Candida Dengo-Baloi ◽  
Makini Aida Boothe ◽  
Cynthia Amino Semá-Baltazar ◽  
Isabel Sathane ◽  
Denise Chitsondzo Langa ◽  
...  
Keyword(s):  
Formative Assessment ◽  
Social Services ◽  
Risk Behaviors ◽  
Urban Areas ◽  
People Who Inject Drugs ◽  
Service Providers ◽  
Psychiatric Treatment ◽  
Health Workers ◽  
Hot Spot ◽  
Health And Social Services

Abstract Background: Prior to 2014, data about health seeking behaviors or service uptake for People who inject drugs (PWID) in Mozambique did not exist. We present the results from the formative assessment component of the Biological and Behavioral Survey (BBS). Methods: Standardized interview guides were used during key informant interviews (KII) and focus group discussions (FGD) in Maputo and Nampula/Nacala to discuss issues related to risk behaviors and access to and utilization of health and social services by PWID. The target sample size was not defined a priori, but instead KII and FGD were conducted until responses reached saturation. Data analysis was based on the principles of grounded theory related to qualitative research. Results: Eighty-eight respondents, ages 15 to 60, participated in KIIs and FGDs. Participants were majority male from diverse income and education levels and included current and former PWID, non-injection drug users, health and social service providers, peer educators, and community health workers. Respondents reported that PWID engage in high-risk behaviors such as needle and syringe sharing, exchange of sex for drugs or money, and low condom use. According to participants, PWID would rather rent, share or borrow injection equipment at shooting galleries than purchase them due to stigma, fear of criminalization, transportation and purchase costs, restricted pharmacy hours, personal preference for needle sharing, and immediacy of drug need. Barriers to access and utilization of health and social services include distance, requirements to represent identification documents and fear of criminalization, the limited availability of programs for PWID, lack of knowledge of the few programs that exist, concerns about the quality of care provided by health providers, lack of readiness as a result of addiction and perceived stigma related to the use of mental health services offering treatment to PWID. Conclusions: Mozambique urgently needs to establish specialized harm reduction programs for PWID and improve awareness of available resources. Services should be located in hot spot areas to address issues related to distance, transportation and the planning required for safe injection. Specific attention should go to the creation of PWID-focused health and social services outside of state-sponsored psychiatric treatment centers.

scholarly journals Access to and use of health and social services among people who inject drugs in two urban areas of Mozambique, 2014: qualitative results from a formative assessment

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Liliana Dengo-Baloi ◽  
Makini Boothe ◽  
Cynthia Semá Baltazar ◽  
Isabel Sathane ◽  
Denise Chitsondzo Langa ◽  
...  
Keyword(s):  
Formative Assessment ◽  
Social Services ◽  
Urban Areas ◽  
People Who Inject Drugs ◽  
Health And Social Services

scholarly journals Impact of drug consumption rooms on risk practices and access to care in people who inject drugs in France: the COSINUS prospective cohort study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023683
Author(s):  
Marc Auriacombe ◽  
Perrine Roux ◽  
Laélia Briand Madrid ◽  
Sébastien Kirchherr ◽  
Charlotte Kervran ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis C ◽  
Drug Use ◽  
Harm Reduction ◽  
Access To Care ◽  
Social Services ◽  
People Who Inject Drugs ◽  
Drug Consumption ◽  
Risk Practices ◽  
The Impact

IntroductionThe high prevalence of hepatitis C and the persistence of HIV and hepatitis C virus (HCV) risk practices in people who inject drugs (PWID) in France underlines the need for innovative prevention interventions. The main objective of this article is to describe the design of the COSINUS cohort study and outline the issues it will explore to evaluate the impact of drug consumption rooms (DCR) on PWID outcomes. Secondary objectives are to assess how DCR (a) influence other drug-related practices, such as the transition from intravenous to less risky modes of use, (b) reduce drug use frequency/quantity, (c) increase access to treatment for addiction and comorbidities (infectious, psychiatric and other), (d) improve social conditions and (e) reduce levels of violence experienced and drug-related offences. COSINUS will also give us the opportunity to investigate the impact of other harm reduction tools in France and their combined effect with DCR on reducing HIV-HCV risk practices. Furthermore, we will be better able to identify PWID needs.Methods and analysisEnrollment in this prospective multi-site cohort study started in June 2016. Overall, 680 PWID in four different cities (Bordeaux, Marseilles, Paris and Strasbourg) will be enrolled and followed up for 12 months through face-to-face structured interviews administered by trained staff to all eligible participants at baseline (M0), 3 month (M3), 6 month (M6) and 12 month (M12) follow-up visits. These interviews gather data on socio-demographic characteristics, past and current drug and alcohol consumption, drug-use related practices, access to care and social services, experience of violence (as victims), offences, other psychosocial issues and perception and needs about harm reduction interventions and services. Longitudinal data analysis will use a mixed logistic model to assess the impact of individual and structural factors, including DCR attendance and exposure to other harm reduction services, on the main outcome (HIV-HCV risk practices).Ethics and disseminationThis study was reviewed and approved by the institutional review board of the French Institute of Medical Research and Health (opinion number: 14–166). The findings of this cohort study will help to assess the impact of DCR on HIV-HCV risk practices and other psycho-social outcomes and trajectories. Moreover, they will enable health authorities to shape health and harm reduction policies according to PWID needs. Finally, they will also help to improve current harm reduction and therapeutic interventions and to create novel ones.

Sign in / Sign up

Export Citation Format

Share Document