Nav: Home

Safe consumption spaces would be welcomed by high-risk opioid users

June 05, 2019

A large majority of people who use heroin and fentanyl would be willing to use safe consumption spaces where they could obtain sterile syringes and have medical support in case of overdose, suggests a study led by researchers at the Johns Hopkins Bloomberg School of Public Health.

In the study, published June 5 in the Journal of Urban Health, the researchers surveyed 326 users of heroin, fentanyl and illicit opioid pills in Baltimore, Boston and Providence, cities hard-hit by America's ongoing opioid overdose epidemic. About 77 percent of participants reported a willingness to use safe consumption spaces--sanctioned locations which have been set up and evaluated in other countries such as Canada and Australia but not yet in the U.S. Willingness to use safe consumption spaces was even higher, at 84 percent, among people who relied on public spaces such as streets, parks and abandoned buildings to use drugs.

The results indicated that 84 percent of the Boston participants, 78 percent of the Baltimore participants and 68 percent of the Providence participants were willing to use a safe consumption space--the overall rate coming in at 77 percent.

"On the whole, we found a strong willingness to use safe consumption spaces. This is important because often the voices of people who use drugs are not always included in policy debates or in the implementation of public health interventions," says study lead author Ju Nyeong Park, PhD, MHS, an assistant scientist in the Department of Health, Behavior and Society at the Bloomberg School.

Safe consumption spaces, also called safe injection facilities and overdose prevention sites, represent a "harm-reduction" approach to the public health and social problems stemming from drug addiction.

They have been in use abroad since the mid-1980s and now number more than 100 facilities in 12 countries. Studies indicate that the public health benefits are many, as they greatly reduce overdose deaths, greatly reduce transmission of HIV and Hepatitis B and C viruses via needle-sharing, help keep users out of parks and other public places and offer good opportunities for steering users to treatment.

There are currently no legal safe consumption spaces in the U.S., however, due to a federal law--known as the "crack house statute"--that creates a serious criminal liability for anyone knowingly connected with a property purposed for illegal drug use. Concerns about safe consumption spaces encouraging illegal drug use and potentially blighting the neighborhoods where they are situated also have led to local opposition in some cases. But the severity of the current opioid-use epidemic in the U.S. --opioids were involved in most of the 70,000-plus drug overdose deaths in 2017--is such that safe consumption spaces are now discussed as viable options among policymakers in some state and local governments. Public health researchers also have been weighing in with studies.

"The study documents that people who use drugs are motivated to be safe and take precautions to reduce their exposure to harm," says Susan Sherman, PhD, professor in the Bloomberg School's Department of Health, Behavior and Society and the study's senior investigator. "We can use this evidence to holistically address the opioid epidemic."

Park, Sherman and their colleagues, working through street recruitment and local syringe service programs, contacted and obtained survey data from a diverse sample of 326 people in Baltimore, Boston and Providence who said they had used opioids non-medically in the previous 30 days. Most reported using injected drugs--mostly heroin. Almost 70 percent were homeless, and 60 percent reported habitually using drugs in public or semi-public places. More than a third of participants reported having experienced an overdose in the past six months. About 73 percent reported recent use of a drug they suspected had contained fentanyl, a synthetic opioid that is much more potent--and thus has higher overdose potential--than heroin.

The participants most likely to say they were willing to use a safe consumption space were those who preferred drugs containing fentanyl and those who primarily used drugs in public spaces. Among those who primarily used drugs publicly, 84 percent said they were willing to use a safe consumption space.

When participants were asked about things that could make it harder for them to use a safe consumption space, the factors they cited most frequently were fear of arrest (38 percent) and privacy concerns (36 percent).

All in all, participants' broad willingness to use safe consumption spaces suggests that such facilities, if available, would provide a viable alternative to using drugs on the streets. "It's encouraging because even though these are people engaging in very high-risk behaviors in very different contexts within these three cities, they were willing to use this harm-reduction intervention," Park says.
-end-
"Willingness to use safer consumption spaces among opioid users at high risk of fentanyl overdose in Baltimore, Providence, and Boston" was written by Ju Nyeong Park, Susan G. Sherman, Saba Rouhani, Kenneth B. Morales, Michelle McKenzie, Sean T. Allen, Brandon D.L. Marshall, and Traci C. Green.

Support for the research was provided by the Bloomberg American Health Initiative and the National Institutes of Health (P20GM125507; K01DA046234).

Johns Hopkins University Bloomberg School of Public Health

Related Public Health Articles:

Public health guidelines aim to lower health risks of cannabis use
Canada's Lower-Risk Cannabis Use Guidelines, released today with the endorsement of key medical and public health organizations, provide 10 science-based recommendations to enable cannabis users to reduce their health risks.
Study clusters health behavior groups to broaden public health interventions
A new study led by a University of Kansas researcher has used national health statistics and identified how to cluster seven health behavior groups based on smoking status, alcohol use, physical activity, physician visits and flu vaccination are associated with mortality.
Public health experts celebrate 30 years of CDC's prevention research solutions for communities with health disparities
It has been 30 years since CDC created the Prevention Research Centers (PRC) Program, currently a network of 26 academic institutions across the US dedicated to moving new discoveries into the communities that need them.
Public health experts support federally mandated smoke-free public housing
In response to a new federal rule mandating smoke-free policies in federally funded public housing authorities, three public health experts applaud the efforts of the US Department of Housing and Urban Development to protect nonsmoking residents from the harmful effects of tobacco exposure.
The Lancet Public Health: UK soft drinks industry levy estimated to have significant health benefits, especially among children
The UK soft drinks industry levy, due to be introduced in April 2018, is estimated to have significant health benefits, especially among children, according to the first study to estimate its health impact, published in The Lancet Public Health.
Social sciences & health innovations: Making health public
The international conference 'Social Sciences & Health Innovations: Making Health Public' is the third event organized as a collaborative endeavor between Maastricht University, the Netherlands, and Tomsk State University, the Russian Federation, with participation from Siberian State Medical University (the Russian Federation).
Columbia Mailman School Awards Public Health Prize to NYC Health Commissioner Dr. Mary T.
Dr. Mary T. Bassett, Commissioner of the New York City Department of Health and Mental Hygiene, was awarded the Frank A.
Poor health literacy a public health issue
America's poor record on health literacy is a public health issue, but one that can be fixed -- not by logging onto the internet but by increased interaction with your fellow human beings, a Michigan State University researcher argues.
Despite health law's bow to prevention, US public health funding is dropping: AJPH study
Although the language of the Affordable Care Act emphasizes disease prevention -- for example, mandating insurance coverage of clinical preventive services such as mammograms -- funding for public health programs to prevent disease have actually been declining in recent years.
'Chemsex' needs to become a public health priority
Chemsex -- sex under the influence of illegal drugs -- needs to become a public health priority, argue experts in The BMJ this week.

Related Public Health Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Digital Manipulation
Technology has reshaped our lives in amazing ways. But at what cost? This hour, TED speakers reveal how what we see, read, believe — even how we vote — can be manipulated by the technology we use. Guests include journalist Carole Cadwalladr, consumer advocate Finn Myrstad, writer and marketing professor Scott Galloway, behavioral designer Nir Eyal, and computer graphics researcher Doug Roble.
Now Playing: Science for the People

#530 Why Aren't We Dead Yet?
We only notice our immune systems when they aren't working properly, or when they're under attack. How does our immune system understand what bits of us are us, and what bits are invading germs and viruses? How different are human immune systems from the immune systems of other creatures? And is the immune system so often the target of sketchy medical advice? Those questions and more, this week in our conversation with author Idan Ben-Barak about his book "Why Aren't We Dead Yet?: The Survivor’s Guide to the Immune System".