"Beyond Safer Injecting"-Health and Social Needs and Acceptance of Support among Clients of a Supervised Injecting Facility.

Vendula Belackova,Marianne Jauncey,Edmund Silins,Allison M Salmon,Carolyn A Day

doi:10.3390/ijerph16112032

Abstract

Health and social issues in aging populations of people who inject drugs (PWID) tend to aggregate, despite risky injecting practices decreasing with age. Identifying needs and avenues of support is becoming increasingly important. We described the health and social situation among clients of a long-running supervised injecting facility (SIF) in Sydney, Australia. An interviewer-administered survey (n = 182) assessed current housing status, employment, physical and mental health, incarceration history, drug use, engagement in drug treatment, health service utilization, and willingness to accept support. Results were compared to the information provided at initial visit. Up to half of the participants transitioned between lower- and higher-risk health and social indicators over time. Willingness to accept support was greatest amongst those with higher self-perceived need. Support for mental health was a low priority, despite the high self-reporting of mental health issues. SIF clients are open to support for health and social issues, despite ongoing active drug use. Lower-threshold services such as SIFs are well-positioned to recognize and respond to deteriorating health and social issues for PWID. Facilitating care and treatment remains a challenge when the services to which people are being referred are higher-threshold with a more rigid approach.

Highlights

Harm reduction programs are evidence-based interventions which reduce both individual and societal harms of drug use and change risk environments [1,2,3]
Seventeen percent of participants self-identified as Aboriginal and/or Torres Strait Islander
supervised injecting facility (SIF) clients connect with health and social services over time, and the referrals they receive onsite likely contribute to this

Summary

Introduction

Harm reduction programs are evidence-based interventions which reduce both individual and societal harms of drug use and change risk environments [1,2,3]. Supervised injecting facilities (SIFs) and Drug Consumption Rooms (DCRs) are harm reduction programs which provide space for safer drug administration in hygienic settings under the supervision of qualified staff [4], and are increasing in number worldwide [5]. In 2016, 92 SIFs/DCRs operated across 11 countries, with the majority in Germany, the Netherlands and Switzerland, several in Spain, Denmark, Norway and France, and, until recently, one each in Australia, Canada and Luxembourg [5]. A ‘trial’ SIF/DCR opened in Melbourne, Australia in July 2018 [5], and the Canadian Ministry of Health has far approved. Public Health 2019, 16, 2032; doi:10.3390/ijerph16112032 www.mdpi.com/journal/ijerph

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