People Who Use Drugs

People who inject drugs (PWID) are likely to experience wounds and infection related to their injection drug use. Common wounds and infections experienced by PWID include blood poisoning (septicemia), infection of the heart lining (endocarditis), tetanus, hepatitis, bruising, collapsed veins, abscesses and blood clots. Preventing and caring for wounds in PWID requires special consideration of the conditions surrounding drug use.

Syringe services programs (SSPs) remain highly effective, cost-saving interventions for the prevention of blood-borne infections among people who inject drugs. However, there have been restrictions regarding financial resources allocated to these programs, particularly in the US South. This study aimed to provide cost data regarding the implementation and first-year operations of an academic-based SSP utilizing fixed and mobile strategies, including the integration of onsite wound care.

With the worst opioid overdose death crisis in the United States history, urgent new approaches to assist people who use drugs onto medication for opioid use disorder are necessary. In this commentary, addiction medicine clinicians and drug user union representatives align to argue that conventional ways of buprenorphine initiation that require periods of withdrawal must be augmented with additional novel approaches to initiation. 

The National Academies of Science, Engineering, and Medicine defines stigma as a range of negative attitudes, beliefs and behaviors that are associated with certain conditions such as addiction. Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA), has been a leading voice in talking about the “chilling effect” stigma has on our ability to address substance use and addiction in our country. In an April 2020 perspective piece published in the New England Journal of Medicine and in her NIDA blog piece, Dr. Volkow explains how stigma can prevent people from seeking care and can even contribute to their continuing addiction. We encourage our visitors to read Dr. Volkow’s writings as well as to familiarize themselves with the efforts to reduce stigma led by the National Institutes of Health (NIH) including the NIH HEAL InitiativeSM, which has made addressing stigma a key element in their efforts to address opioid addiction.

The workshop presented strategies to integrate HIV, hepatitis, and sexual health concerns into services for PWID. The session will focus on communication skills, assessment techniques, and building motivation among PWID to make healthier choices. Mr. Sacco looked at programmatic and clinical-level integration strategies and offered participants an opportunity to assess current service delivery models and develop a plan to enhance care. Mrs. Bell and Ms. Chavis intrdoduce participants to resources and funding opportunities available through HRSA’s HIV/AIDS Bureau (HAB).

The UNODC Regional Program Office for Eastern Europe (Kiev, Ukraine), in collaboration with the Humanitarian Action Fund (St. Petersburg, Russia), issues recommendations on web outreach for people who use drugs (PWUD), including people who use new psychoactive substances (NPS). Web outreach is a method of establishing contact, counseling, involving and retaining PWUD in harm reduction programs through websites, social networks, instant messengers, specialized forums, including Darknet platforms.

In spring 2021, pharmaceutical manufacturers and distributors notified syringe services programs (SSPs) and partners that there would be significant interruptions in the supply of injectable/intramuscular (IM) naloxone. Currently, production and distribution delays are expected to last until fall 2021. This will specifically affect SSPs because IM naloxone is the most affordable formulation, and therefore is most commonly utilized by programs that distribute large volumes of naloxone to reduce fatal overdose rates. 

Goals: Increase knowledge of harm reduction principles, strategies, and resources, increase knowledge of managed use, abstinence, and safer use to meet people who use drugs where they are at, provide a safe environment (plenaries and breakouts) to discuss licit and illicit drug use as a multi-faceted phenomenon requiring successful interventions and policies and increase knowledge of stigma as it relates to harm reduction principles and practices.

Background: Injecting drug users (IDUs) are at increased risk of acquiring and transmitting HIV and other bloodborne pathogens through the multi-person use of syringes. Although research has shown that increased access to syringes through syringe exchange programs (SEPs) is an effective strategy to reduce risky injection practices many areas of the United States still do not have SEPs. In the absence of SEPs, legislation allowing pharmacies over-the-counter sales of syringes has also been shown to reduce syringe sharing. The success of pharmacy sales however is limited by other legal stipulations, such as drug paraphernalia laws, which in turn may contribute to fear among IDUs about being caught purchasing and carrying syringes.

This Technical Briefing provides a description of Peer-to-Peer Distribution of Naloxone (P2PN). This is based on six case studies of pioneers of P2PN; three from the UK and three international examples that inform the guidance in this Technical Briefing. This document will inform and be extended following a pilot of P2PN in four sites in England in 2019. These will be supported by small grants from EuroNPUD. The learning from this pilot will help test the model and peer education approach promoted in this briefing.