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The willingness of people who inject drugs in Boston to use a supervised injection facility.

The willingness of people who inject drugs in Boston to use a supervised injection facility.
Author Information (click to view)

León C, Cardoso L, Mackin S, Bock B, Gaeta JM,


León C, Cardoso L, Mackin S, Bock B, Gaeta JM, (click to view)

León C, Cardoso L, Mackin S, Bock B, Gaeta JM,

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Substance abuse 2017 08 11() 0 doi 10.1080/08897077.2017.1365804

Abstract
BACKGROUND
In Massachusetts, the number of opioid-related deaths has increased 350% since 2000. In the setting of increasing overdose deaths, one potential intervention is Supervised Injection Facilities (SIFs). This study explores willingness of people who inject drugs in Boston to use a SIF and examines factors associated with willingness.

METHODS
A cross-sectional survey of a convenience sample of 237 people who inject drugs and utilize Boston’s needle exchange program (NEP). The drop-in NEP provides myriad harm reduction services and referrals to addiction treatment. The survey was mostly self-administered (92%).

RESULTS
Results showed positive willingness to use a SIF was independently associated with: use of heroin as main substance (Odds Ratio[OR]:5.47; 95%Confidence Interval[CI]:1.9-15.4; p = 0.0004), public injection (OR:5.09; 95%CI:1.8-14.3; p = 0.002), history of seeking SUD treatment (OR:4.99; 95%CI:1.2-21.1; p = 0.05), having heard of SIF (OR:4.80; 95%CI:1.6-14.8; p = 0.004), Hispanic ethnicity (OR:4.22; 95%CI:0.9-18.8; p = 0.04), frequent NEP use (OR:4.18; 95%CI:1.2-14.7; p = 0.02), current desire for SUD treatment (OR:4.15; 95%CI:1.2-14.7; p = 0.03), hepatitis C diagnosis (OR:3.68; 95%CI:1.2-10.1; p = 0.02), PTSD diagnosis (OR:3.27; 95%CI 1.3-8.4; p = 0.01), report of at least one chronic medical diagnosis (hepatitis C, HIV, hypertension, or diabetes) (OR:3.27; 95%CI:1.2-8.9; p = 0.02), and comorbid medical and mental health diagnoses (OR:2.93; 95%CI:1.2-7.4; p = 0.02).

CONCLUSIONS
Most respondents (91.4%) reported willingness to use a SIF. Respondents with substance use behavior reflecting high risk for overdose were significantly more likely to be willing to use a SIF. Respondents with behaviors that contribute to public health burden of injection drug use were also significantly more likely to be willing to use a SIF. Results indicate that this intervention would be well utilized by individuals who could most benefit from the model. As part of a broader public health approach, SIFs should be considered to reduce opioid overdose mortality, decrease public health burden of the opioid crisis, and promote access to addiction treatment and medical care.

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