Synthetic Opioid key responses
- Mapping evidence-based key responses to synthetic opioids and their implementation strategies
- Field-tested Toolkit with seven implementation guides
Le stanze del consumo. Evidenze scientifiche e prove di efficacia nella documentazione di Fuoriluogo
Le stanze del consumo. Evidenze scientifiche e prove di efficacia nella documentazione di Fuoriluogo
Il fascicolo di Fuoriluogo. It dedicato alle stanze del consumo.
ODYSSEAS: supervised use of drugs versus bureaucracy in Greece
Ulysses travelled for 10 years before returning to his home island of Ithaca to overthrow the contenders and rule with wisdom and justice. Despite evidence to the contrary, it could take Greece and its authorities 10 years to realise the need to maintain the investment in scaling up harm reduction services for injecting drug users. Previous authors have shown the increase in the number of newly diagnosed HIV infections among injecting drug users in Greece since early 2011. They have also shown the prompt response from the Greek authorities in 2011 and 2012 that led to an expansion of the capacity of the system to distribute clean needles and syringes and offer opioid substitution treatment.
Salle de consommation à moindre risque : les généralistes majoritairement favorables à l'expérimentation
Contexte : L’ouverture de la première salle de consommation à moindre risque (SCMR) en France a eu lieu en octobre 2016 à Paris dans le Xe arrondissement. Les médecins généralistes libéraux (MG) du nord de Paris sont concernés en tant qu’acteurs du territoire de soins.
Objectif : Recueillir l’opinion des MG libéraux du nord de Paris sur l’expérimentation de la SCMR.
Méthode : Tous les MG libéraux des IXe, Xe, XVIIIe et XIXe arrondissements de Paris ont été contactés par téléphone, et un questionnaire a été adressé à ceux qui l’acceptaient.
Résultats : Cent onze MG ont répondu (âge médian 57 ans, 36 % de femmes, 57,3 % en cabinet individuel), soit 33,5 %. Une majorité des avis exprimés (61,5 %) étaient favorables à l’ouverture de la SCMR (p = 0,036), avec des réserves pour 39,3 % d’entre eux. 18 % de l’échantillon était sans opinion sur la question. En analyse multivariée, les facteurs significativement associés à un avis favorable étaient l’âge inférieur à 50 ans et le fait d’être prescripteur de traitements de substitution aux opiacés. Les principales réserves exprimées concernaient la sécurité des quartiers environnants.
Conclusion : Les MG étaient donc majoritairement favorables à une expérimentation de qualité de la SCMR sur leur territoire, notamment ceux formés à la réduction des risques depuis les années 1990. Cependant, ils étaient en attente des résultats de son évaluation concrète. Ces résultats méritent d’être réévalués plusieurs mois après l’ouverture de la SCMR.
Salle de shoot. Les salles d'injection supervisée à l'heure du débat français
Le débat sur les salles d’injection exacerbe les tensions entre tenants de la « guerre à la drogue » et partisans de la « réduction des risques » (politique qui permet aux usagers de drogues de préserver leur santé même s’ils n’arrêtent pas les drogues). Il révèle la fracture entre des responsables politiques nationaux tentés par la démagogie, et des élus locaux, pragmatiques.
Refusant les expériences en Espagne, Suisse, Allemagne ou Canada, et balayant les études scientifiques, le précédent gouvernement avait dit « non » aux salles d'injection. Malgré ce refus, des villes de droite comme de gauche – Bordeaux, Nancy, Strasbourg, Marseille ou Paris – ont préparé la mise en place de ces salles en attendant des jours meilleurs.
Ce livre revient sur ces années où les usagers de drogues illicites ont été des boucs émissaires. Il est un cri d’espoir et un appel pour une politique des drogues plus humaine et plus efficace, fondée sur la régulation des usages.
A critical evaluation of the effects of safe injection facilities
Research has overwhelmingly supported the proposition that safe injection facilities (SIFs) are successful in meeting their stated objectives. However, the methodological and analytic approaches used in these studies have not been scrutinized to any significant degree. Previous studies are compromised by an array of deficiencies, including a lack of baseline data, insufficient conceptual and operational clarity, inadequate evaluation criteria, absent statistical controls, dearth of longitudinal designs, and inattention to intrasite variation. This review suggests that much of the commonly-cited evidence regarding the effects of SIFs cannot be substantiated. Disentangling complicated casual mechanisms first requires that the identified shortcomings be addressed.
A Critical Review of the effectiveness of Safe Injection Facilities as a Harm Reduction strategy
Injection drug use is associated with several public health issues, primarily the spread of serious blood-borne diseases such as human immunodeficiency virus (HIV) and hepatitis C virus (HCV). Injections drug users often participate in risky behaviors such as the sharing of drug paraphernalia. Blood-borne diseases such as HIV and HCV are very easily transmitted between injection drug users through shared drug paraphernalia. In the United States, over one million people are infected with HIV, and one third of these infections are related to injection drug use in some manner.
There are many traditional interventions and programs currently being implemented in an attempt to address the public health issues associated with injection drug use; however, a controversial intervention focused on harm reduction is the focus of this paper. Safe injection facilities are relatively new interventions aimed at reaching high-risk injection drug users. These facilities provide a safe place in which injection drug users can take their own drugs and inject them under the supervision of medical staff. The benefits of this type of intervention are many. Injection drug users are able to inject in a safe environment in which they do not feel rushed, easy access to clean drug paraphernalia to use for injections, and trained medical staff are able to respond to overdose situations in a rapid manner. Safe injection facilities have an excellent record of reducing overdose deaths, in some cases to zero. There is potential for safe injection facilities to be of great public health significance in helping to control the spread of diseases and improving the quality of life for drug users.
Safe injection facilities are common in Europe, but are viewed with great hesitation and concern in North America and some other countries. This paper is a critical review of the literature, examining studies conducted on the various issues surrounding safe injection facilities, and their potential role as an important public health intervention.
An Overview Of Drug Consumption Rooms
In response to growing concerns about the public health and public order problems related to drug use, countries use a comprehensive approach to the drug problem, which includes prevention, harm reduction, treatment, and enforcement. Harm reduction encompasses interventions, programmes and policies that seek to reduce the health, social and economic harms of drug use to individuals, communities and societies. Drug consumption rooms are an example of a harm reduction programme and are a component of some drug strategies in some countries.
Drug consumption rooms (DCRs) are legally sanctioned public health facilities that offer a hygienic environment where people can use drugs under the supervision of trained staff. The overall rationale for consumption rooms is to reach and address the problems of specific, high-risk populations of drug users, especially injectors and those who consume in public. Drug consumption rooms aim to reduce the risk of transmission of blood-borne infections, in particular HIV (Human Immunodeficiency Virus) and hepatitis; to reduce the likelihood of illness and death resulting from overdose; and to help people who use drugs avoid other harms associated with drug consumption under unhygienic or unsafe conditions.
This article looks at the experiences with drug consumption rooms describes the general features and analyzes them from a historical point of view. This article also explores the position of these rooms in international law.
Appendix B: Guidelines for the operation and use of Consumption Rooms
At the conference 'Consumption rooms as a professional service in addictions-health : International conference for the development of guidelines', 180 participants from Germany, the Netherlands, Switzerland, Austria, France, and Australia came together to discuss the low-threshold and acceptance-orientated facilities, known as 'consumption rooms. Conference participants came from agencies operating and wishing to operate these services, social and health authorities, the police and justice system, and from policy making and administrative authorities active in the area of low-threshold and acceptance-orientated drug assistance. Many professional groups were represented : social workers, psychologists, nurses, doctors, public prosecutors, lawyers and police officers. As well as a general exchange of experience, working groups developed guidelines on six specific topic areas. These covered planning, realisation, operation, documentation/data collection, and the political acceptability of these services. These Guidelines are intended to serve as a professional orientation for existing facilities as well as for those being planned. They should also inform decision making by those responsible for policy and adminstration.
