Melissa Perri1,2, Natalie Kaminski1,3, Matthew Bonn3,4, Gillian Kolla5, Adrian Guta6, Ahmed M Bayoumi2,7,8,9, Laurel Challacombe10, Marilou Gagnon5, Natasha Touesnard3, Patrick McDougall11, Carol Strike12,13. 1. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 2. MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada. 3. Canadian Association of People Who Use Drugs, Dartmouth, NS, Canada. 4. Canadian Students for Sensible Drug Policy, Toronto, Canada. 5. Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada. 6. School of Social Work, University of Windsor, Windsor, ON, Canada. 7. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. 8. Division of General Internal Medicine, Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada. 9. Department of Medicine, University of Toronto, Toronto, ON, Canada. 10. CATIE, Toronto, ON, Canada. 11. Dr. Peter AIDS Foundation, Vancouver, BC, Canada. 12. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. carol.strike@utoronto.ca. 13. MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada. carol.strike@utoronto.ca.
Abstract
BACKGROUND: Spotting is an informal practice among people who use drugs (PWUD) where they witness other people using drugs and respond if an overdose occurs. During COVID-19 restrictions, remote spotting (e.g., using a telephone, video call, and/or a social media app) emerged to address physical distancing requirements and reduced access to harm reduction and/or sexually transmitted blood borne infection (STBBI's) prevention services. We explored spotting implementation issues from the perspectives of spotters and spottees. METHODS: Research assistants with lived/living expertise of drug use used personal networks and word of mouth to recruit PWUD from Ontario and Nova Scotia who provided or used informal spotting. All participants completed a semi-structured, audio-recorded telephone interview about spotting service design, benefits, challenges, and recommendations. Recordings were transcribed and thematic analysis was used. RESULTS: We interviewed 20 individuals between 08/2020-11/2020 who were involved in informal spotting. Spotting was provided on various platforms (e.g., telephone, video calls, and through texts) and locations (e.g. home, car), offered connection and community support, and addressed barriers to the use of supervised consumption sites (e.g., location, stigma, confidentiality, safety, availability, COVID-19 related closures). Spotting calls often began with setting an overdose response plan (i.e., when and who to call). Many participants noted that, due to the criminalization of drug use and fear of arrest, they preferred that roommates/friends/family members be called instead of emergency services in case of an overdose. Both spotters and spottees raised concerns about the timeliness of overdose response, particularly in remote and rural settings. CONCLUSION: Spotting is a novel addition to, but not replacement for, existing harm reduction services. To optimize overdose/COVID-19/STBBI's prevention services, additional supports (e.g., changes to Good Samaritan Laws) are needed. The criminalization of drug use may limit uptake of formal spotting services.
BACKGROUND: Spotting is an informal practice among people who use drugs (PWUD) where they witness other people using drugs and respond if an overdose occurs. During COVID-19 restrictions, remote spotting (e.g., using a telephone, video call, and/or a social media app) emerged to address physical distancing requirements and reduced access to harm reduction and/or sexually transmitted blood borne infection (STBBI's) prevention services. We explored spotting implementation issues from the perspectives of spotters and spottees. METHODS: Research assistants with lived/living expertise of drug use used personal networks and word of mouth to recruit PWUD from Ontario and Nova Scotia who provided or used informal spotting. All participants completed a semi-structured, audio-recorded telephone interview about spotting service design, benefits, challenges, and recommendations. Recordings were transcribed and thematic analysis was used. RESULTS: We interviewed 20 individuals between 08/2020-11/2020 who were involved in informal spotting. Spotting was provided on various platforms (e.g., telephone, video calls, and through texts) and locations (e.g. home, car), offered connection and community support, and addressed barriers to the use of supervised consumption sites (e.g., location, stigma, confidentiality, safety, availability, COVID-19 related closures). Spotting calls often began with setting an overdose response plan (i.e., when and who to call). Many participants noted that, due to the criminalization of drug use and fear of arrest, they preferred that roommates/friends/family members be called instead of emergency services in case of an overdose. Both spotters and spottees raised concerns about the timeliness of overdose response, particularly in remote and rural settings. CONCLUSION: Spotting is a novel addition to, but not replacement for, existing harm reduction services. To optimize overdose/COVID-19/STBBI's prevention services, additional supports (e.g., changes to Good Samaritan Laws) are needed. The criminalization of drug use may limit uptake of formal spotting services.
Authors: Alexis M Roth; Nguyen K Tran; Ben Cocchiaro; Allison K Mitchell; David G Schwartz; Devon J Hensel; Janna Ataiants; Jacob Brenner; Inbal Yahav; Stephen E Lankenau Journal: Drug Alcohol Depend Date: 2021-10-28 Impact factor: 4.492
Authors: Thomas D Brothers; Malcolm Leaman; Matthew Bonn; Dan Lewer; Jacqueline Atkinson; John Fraser; Amy Gillis; Michael Gniewek; Leisha Hawker; Heather Hayman; Peter Jorna; David Martell; Tiffany O'Donnell; Helen Rivers-Bowerman; Leah Genge Journal: Drug Alcohol Depend Date: 2022-04-07 Impact factor: 4.852
Authors: Alexandria Macmadu; Annajane Yolken; Lisa Frueh; Jai'el R Toussaint; Roxxanne Newman; Brendan P Jacka; Alexandra B Collins; Brandon D L Marshall Journal: Harm Reduct J Date: 2022-10-18