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Journal article
Frequency of supervised consumption service use and acute care utilization in people who inject drugs
Drug and alcohol dependence, v 265, 112490
15 Nov 2024
Featured in Collection : Research Supported by Drexel Libraries' OA Programs
Abstract
Supervised consumption service (SCS) use among people who inject drugs may reduce acute care utilization; however, prior studies have been limited by self-reported outcomes and dichotomous exposures.
We conducted a prospective cohort study using linked questionnaire and health administrative data among people who inject drugs in Toronto, Canada (2018–2020). Baseline SCS use frequency was defined by a participant’s self-reported proportion of injections performed at an SCS over the past six months: “all/most” (≥75%), “some” (26–74%), “few” (1–25%), or “none” (0%). Outcomes measured over the following six months included: emergency department (ED) visits; hospitalizations; ED visits or hospitalizations for opioid-related overdose; and hospitalizations for injection-related infections. The relative effects of varying SCS use levels on study outcomes were estimated using inverse-probability-weighted negative binomial regression models.
Of 467 participants, 25.5%, 30.4%, 28.7%, and 15.4% respectively reported “all/most”, “some”, “few”, and “none” levels of SCS use at baseline. SCS use frequency was not significantly associated with ED visits, hospitalizations, or hospitalizations for injection-related infections. Participants reporting “some” SCS use had a higher rate of ED visits or hospitalizations for opioid-related overdose (versus “few”; rate ratio=2.30, 95% confidence interval=1.15–4.61).
SCS use had little impact on objectively measured acute care utilization, which was high overall. Although preventing overdose mortality is the primary goal of SCS in Canada, resourcing sites to support their clients’ acute healthcare needs may help build a continuum of care for people experiencing marginalization who inject drugs.
•Supervised consumption service (SCS) use may reduce acute healthcare use.•Previous research has relied on self-reported outcomes and dichotomous exposures.•We linked survey and healthcare administrative data from people who inject drugs in Toronto.•Overall, frequency of SCS use was not associated with rates of acute care utilization.
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Details
- Title
- Frequency of supervised consumption service use and acute care utilization in people who inject drugs
- Creators
- Ayden I. Scheim (Corresponding Author) - Drexel University, Urban Health CollaborativeZachary Bouck - University of TorontoZoë R. Greenwald - University of TorontoVicki Ling - ICES, Toronto, Ontario, CanadaShaun Hopkins - Toronto Public HealthMatt Johnson - Parkdale Queen West Community Health Centre, Toronto, Ontario, CanadaAhmed Bayoumi - Unity Health TorontoTara Gomes - University of TorontoDan Werb - Unity Health Toronto
- Publication Details
- Drug and alcohol dependence, v 265, 112490
- Publisher
- Elsevier
- Number of pages
- 9
- Grants
- PJT-153152, Canadian Institutes of Health Research (Canada, Ottawa) - CIHR
- Grant note
- Canadian Institutes of Health Research: PJT-153152 St. Michael's Hospital Foundation
The study was funded by the Canadian Institutes of Health Research (PJT-153152) and the St. Michael's Hospital Foundation. The funders had no role in study design or implementation, data analysis or interpretation, manuscript writing, or the decision to submit for publication.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:001358737100001
- Scopus ID
- 2-s2.0-85208769801
- Other Identifier
- 991021957115704721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Psychiatry
- Substance Abuse