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