Abstract / Summary
An overdose prevention site (OPS) was implemented as a harm-reduction strategy to mitigate the consequences associated with the injection of substances at one Canadian hospital. This study sought to examine awareness, interest, and use of a hospital-based OPS among individuals who inject drugs and accessed addiction care in an acute care setting. Data were collected from the Outcomes for Patients Accessing Addiction Care (OPAC) study, a single-site hospital-based cohort study that enrolled individuals with a substance use disorder who accessed addiction care. Data for this study were a cross-sectional analysis of a prospective cohort between May 2018 and March 2020 in participants who had reported injection drug use. Participants were asked about sociodemographic characteristics, substance use patterns, and awareness and use of a hospital-based OPS. Factors associated with hospital-based OPS use were identified using a Multivariable Logistic Regression model. Overall, 142 study participants met criteria for inclusion, with 119 (84%) reporting awareness of the hospital-based OPS and 82 (58%) reported having accessed the OPS. A total of 118 (83%) participants reported previous history of overdose, and 87 (61%) reported a previous patient-initiated discharge (PID) event. In multivariable analyses, craving in the previous 24 h (Adjusted Odds Ratio [AOR]: 3.12; 95% Confidence Interval [CI]: 1.17–8.34), ever having experienced an overdose (AOR: 4.32; 95% CI: 1.37–13.62), and having a previous PID event (AOR: 4.35; 95% CI: 1.66–11.39) were positively associated with use of the hospital’s OPS. There was a high level of awareness of the hospital-based OPS among individuals who inject drugs and had accessed addiction care. Having previously experienced an overdose, having cravings in the preceding 24-hour period, and having a PID event were strong predictors of hospital-based OPS use. Hospital-based OPS’ offer a feasible and acceptable harm reduction strategy for individuals who inject unregulated substances. Future research should explore the impact OPS access may have on health and substance use outcomes among individuals who inject drugs.