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A qualitative study on overdose response in the era of COVID-19 and beyond: how to spot someone so they never have to use alone.
Perri, Melissa; Kaminski, Natalie; Bonn, Matthew; Kolla, Gillian; Guta, Adrian; Bayoumi, Ahmed M; Challacombe, Laurel; Gagnon, Marilou; Touesnard, Natasha; McDougall, Patrick; Strike, Carol.
  • Perri M; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
  • Kaminski N; MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
  • Bonn M; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
  • Kolla G; Canadian Association of People Who Use Drugs, Dartmouth, NS, Canada.
  • Guta A; Canadian Association of People Who Use Drugs, Dartmouth, NS, Canada.
  • Bayoumi AM; Canadian Students for Sensible Drug Policy, Toronto, Canada.
  • Challacombe L; Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada.
  • Gagnon M; School of Social Work, University of Windsor, Windsor, ON, Canada.
  • Touesnard N; MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
  • McDougall P; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
  • Strike C; Division of General Internal Medicine, Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Harm Reduct J ; 18(1): 85, 2021 08 05.
Article in English | MEDLINE | ID: covidwho-2053910
ABSTRACT

BACKGROUND:

Spotting is an informal practice among people who use drugs (PWUD) where they witness other people using drugs and respond if an overdose occurs. During COVID-19 restrictions, remote spotting (e.g., using a telephone, video call, and/or a social media app) emerged to address physical distancing requirements and reduced access to harm reduction and/or sexually transmitted blood borne infection (STBBI's) prevention services. We explored spotting implementation issues from the perspectives of spotters and spottees.

METHODS:

Research assistants with lived/living expertise of drug use used personal networks and word of mouth to recruit PWUD from Ontario and Nova Scotia who provided or used informal spotting. All participants completed a semi-structured, audio-recorded telephone interview about spotting service design, benefits, challenges, and recommendations. Recordings were transcribed and thematic analysis was used.

RESULTS:

We interviewed 20 individuals between 08/2020-11/2020 who were involved in informal spotting. Spotting was provided on various platforms (e.g., telephone, video calls, and through texts) and locations (e.g. home, car), offered connection and community support, and addressed barriers to the use of supervised consumption sites (e.g., location, stigma, confidentiality, safety, availability, COVID-19 related closures). Spotting calls often began with setting an overdose response plan (i.e., when and who to call). Many participants noted that, due to the criminalization of drug use and fear of arrest, they preferred that roommates/friends/family members be called instead of emergency services in case of an overdose. Both spotters and spottees raised concerns about the timeliness of overdose response, particularly in remote and rural settings.

CONCLUSION:

Spotting is a novel addition to, but not replacement for, existing harm reduction services. To optimize overdose/COVID-19/STBBI's prevention services, additional supports (e.g., changes to Good Samaritan Laws) are needed. The criminalization of drug use may limit uptake of formal spotting services.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Communication / Substance-Related Disorders / Pandemics / Drug Overdose / COVID-19 Type of study: Observational study / Qualitative research / Randomized controlled trials Topics: Long Covid Limits: Humans Country/Region as subject: North America Language: English Journal: Harm Reduct J Year: 2021 Document Type: Article Affiliation country: S12954-021-00530-3

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Communication / Substance-Related Disorders / Pandemics / Drug Overdose / COVID-19 Type of study: Observational study / Qualitative research / Randomized controlled trials Topics: Long Covid Limits: Humans Country/Region as subject: North America Language: English Journal: Harm Reduct J Year: 2021 Document Type: Article Affiliation country: S12954-021-00530-3