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Am J Drug Alcohol Abuse. 2020 Jan 26:1-6. doi: 10.1080/00952990.2019.1708087. [Epub ahead of print]

Effect of witnessing an overdose on the use of drug checking services among people who use illicit drugs in Vancouver, Canada.

Author information

1
, British Columbia Centre on Substance Use, Vancouver, BC, Canada.
2
Graduate Programs in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
3
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
4
Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
5
School of Public Policy, Simon Fraser University, Vancouver, BC, Canada.

Abstract

Background: Since 2013, fentanyl-contaminated drugs have been driving North America's opioid-overdose epidemic. Drug checking, which enables people who use illicit drugs (PWUD) to test and receive feedback regarding the contents of their drugs, is being considered as a potential tool to address the toxic drug supply. While some PWUD witness overdoses, little is known about the impact of these experiences on subsequent risk reduction practices.Objective: The purpose of this study was to examine the effect of witnessing an overdose on drug checking service use.Methods: Data were derived from prospective cohorts of PWUD in Vancouver, Canada, a setting with a community-wide fentanyl overdose crisis, between June 1, 2018 and December 1, 2018. Multivariable logistic regression was used to estimate the effect of witnessing an overdose on drug checking service use.Results: 1,426 participants were eligible for the study, including 530 females; 767 (53.8%) participants reported witnessing an overdose and 196 (13.7%) reported using drug checking services in the last 6 months. In multivariable analyses, after adjusting for a range of confounders including the use of fentanyl, witnessing an overdose was positively associated with drug checking service use (adjusted odds ratio = 2.32; 95% confidence interval: 1.57-3.49).Conclusion: Our findings suggest that witnessing an overdose may motivate PWUD to use drug checking services. Given that only a small proportion of PWUD in the study reported using drug checking services, our findings highlight the need to continue to scale-up a range of overdose prevention interventions.

KEYWORDS:

Overdose; Vancouver; drug checking; fentanyl; illicit drugs; opioids

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