Factors associated with drug checking service utilization among people who use drugs in a Canadian setting
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RESEARCH
Factors associated with drug checking service utilization among people who use drugs in a Canadian setting Viseth Long1,2, Jaime Arredondo1, Lianping Ti1,3, Cameron Grant1, Kora DeBeck1,4, M‑J Milloy1,3, Mark Lysyshyn5,6, Evan Wood1,3, Thomas Kerr1,3 and Kanna Hayashi1,2*
Abstract Background: The United States and Canada are amidst an opioid overdose crisis, with the Canadian province of British Columbia (BC) among the hardest hit. In response, drug checking services (DCS) have been introduced in this setting as a novel pilot harm reduction intervention though little is known about usage rates. Therefore, we sought to identify factors associated with drug checking uptake among people who use drugs (PWUD) in Vancouver, BC. Methods: Data were derived from three ongoing prospective cohort studies of PWUD in Vancouver between June and November 2018. Multivariable logistic regression was used to determine factors associated with self-reported DCS utilization in the past 6 months among participants at high risk of fentanyl exposure (i.e., those self-reporting illicit opioid use or testing positive for fentanyl via urine drug screen). Results: Among 828 eligible participants, including 451 (55%) males, 176 (21%) reported recent use of DCS. In mul‑ tivariable analyses, factors significantly associated with DCS utilization included: homelessness (Adjusted Odds Ratio [AOR] 1.47; 95% Confidence Interval [CI] 1.01–2.13) and involvement in drug dealing (AOR 1.59; 95% CI 1.05–2.39). Conclusions: In our sample of PWUD, uptake of DCS was low, although those who were homeless, a sub-population known to be at a heightened risk of overdose, were more likely to use the services. Those involved in drug dealing were also more likely to use the services, which may imply potential for improving drug market safety. Further evalua‑ tion of drug checking is warranted. Keywords: Fentanyl, Drug checking, Drug dealing, Opioids, Overdose, Vancouver Introduction An opioid overdose crisis continues to impact communities across the United States and Canada. This is attributed in large part to the introduction of potent and illegally manufactured synthetic opioids into the illicit drug supply [1–4]. In 2018, there were 21.7 opioid overdose deaths per 100,000 population in the United States (US) and 12.4 deaths per 100,000 population in Canada *Correspondence: bccsu‑[email protected] 1 British Columbia Centre on Substance Use, 400‑1045 Howe Street, Vancouver, BC, Canada Full list of author information is available at the end of the article
[5, 6]. In the Canadian province of British Columbia (BC), one of the hardest hit regions, a public health emergency was declared in 2016 in response to the increase in illegal drug overdose deaths [7, 8]. As part of the response, various interventions were implemented and scaled up, including widespread availability of naloxone and supervised consumption services. In 2019, the number of overdose deaths has finally declined compared to previous years; however, the rate of death from over
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