Abstract
BackgroundThe United States and Canada are amidst an opioid overdose crisis, with the Canadian province of British Columbia (BC) among the hardest hit. In response, drug checking services (DCS) have been introduced in this setting as a novel pilot harm reduction intervention though little is known about usage rates. Therefore, we sought to identify factors associated with drug checking uptake among people who use drugs (PWUD) in Vancouver, BC.MethodsData were derived from three ongoing prospective cohort studies of PWUD in Vancouver between June and November 2018. Multivariable logistic regression was used to determine factors associated with self-reported DCS utilization in the past 6 months among participants at high risk of fentanyl exposure (i.e., those self-reporting illicit opioid use or testing positive for fentanyl via urine drug screen).ResultsAmong 828 eligible participants, including 451 (55%) males, 176 (21%) reported recent use of DCS. In multivariable analyses, factors significantly associated with DCS utilization included: homelessness (Adjusted Odds Ratio [AOR] 1.47; 95% Confidence Interval [CI] 1.01–2.13) and involvement in drug dealing (AOR 1.59; 95% CI 1.05–2.39).ConclusionsIn our sample of PWUD, uptake of DCS was low, although those who were homeless, a sub-population known to be at a heightened risk of overdose, were more likely to use the services. Those involved in drug dealing were also more likely to use the services, which may imply potential for improving drug market safety. Further evaluation of drug checking is warranted.
Highlights
An opioid overdose crisis continues to impact communities across the United States and Canada
Study variables We considered a range of explanatory variables, including demographic, behavioral, and other socio-structural characteristics, that might be associated with drug checking services (DCS) utilization, based on known correlates of accessing other harm reduction services among this population [2, 24,25,26,27]
Factors independently associated with DCS use included: homelessness (Adjusted Odds Ratio [Adjusted odds ratio (AOR)] 1.47; 95% confidence interval [Confidence interval (CI)] 1.01– 2.13), living in the Downtown Eastside neighborhood (DTES) (AOR 1.68; 95% CI 1.14–2.47), recent involvement in drug dealing (AOR 1.59; 95% CI 1.05–2.39) and at least daily crack use (AOR 0.40; 95% CI 0.19–0.83)
Summary
An opioid overdose crisis continues to impact communities across the United States and Canada. This is attributed in large part to the introduction of potent and illegally manufactured synthetic opioids into the illicit drug supply [1,2,3,4]. In the Canadian province of British Columbia (BC), one of the hardest hit regions, a public health emergency was declared in 2016 in response to the increase in illegal drug overdose deaths [7, 8]. The United States and Canada are amidst an opioid overdose crisis, with the Canadian province of British Columbia (BC) among the hardest hit. We sought to identify factors associated with drug checking uptake among people who use drugs (PWUD) in Vancouver, BC
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