Abstract
Overdose prevention for people who use illicit drugs is essential during the current overdose crisis. Peer support is a process whereby individuals with lived or living experience of a particular phenomenon provide support to others by explicitly drawing on these experiences. This review provides a systematic search and evidence synthesis of peer support within overdose prevention interventions for people who use illicit drugs. A systematic search of six databases (CINAHL, SocINDEX, PsycINFO, MEDLINE, Scopus, and Web of Knowledge) was conducted in November 2020 for papers published in English between 2000 and 2020. Following screening and full-text review, 46 papers met criteria and were included in this review. A thematic analysis approach was used to synthesize themes. Important findings include: the value of peers in creating trusted services; the diversity of peers’ roles; the implications of barriers on peer-involved overdose prevention interventions; and the stress and trauma experienced by peers. Peers play a pivotal role in overdose prevention interventions for people who use illicit drugs and are essential to the acceptability and feasibility of such services. However, peers face considerable challenges within their roles, including trauma and burnout. Future interventions must consider how to support and strengthen peer roles in overdose settings.
Highlights
Drug-related overdose is a public health crisis in many European countries [1] andNorth America [2]
Given that the literature identified and reviewed for this systematic search exceeded what was feasible to synthesize in a single manuscript, in this paper we will focus on illicit drug overdose prevention
The findings outlined below capture overdose prevention interventions, inclusive of peer support, peer-led, and peer-involved services
Summary
Drug-related overdose is a public health crisis in many European countries [1] andNorth America [2]. The high number of preventable DRDs are related to many factors, including, but not limited to: polysubstance use and an increasing use of stimulants in addition to opioids; new psychoactive substances such as illicit benzodiazepines; and the introduction of synthetic opioids into the illicit opioid supply [6,7]. Those at high risk of overdoses are individuals who are structurally vulnerable and face numerous additional health and social problems, including unstable housing [8], poverty or financial instability [9], poor physical and/or mental ill health [10], and criminalization [11]. Harm reduction strategies to reduce overdoses include: safer use education; supervised consumption sites (SCS); overdose prevention sites (OPS); naloxone
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