وبلاگ تکی

According to the CDC, overdose rates have increased roughly 5-fold since 1990 65, in line with the increasing potency of opioids, as the crisis is dominated by illicitly manufactured fentanyl and fentanyl analogues 9, 10. PWID should be made aware of OD prevention strategies such as the use of fentanyl test strips and proper administration of naloxone. Education on proper equipment and cleaning should include counseling on proper injection technique. The Harm Reduction Coalition provides a manual guiding these practices 34, though a few key points have been extracted and included below. Injecting into the same locations repeatedly can interfere with circulation and cause phlebitis, and veins can collapse or become leaky if they are not given adequate time to heal 2, 34.

• The current study analyzed and mapped the research activity on harm reduction in the context of IDU.
• Changes in the illicit drug market, such as the appearance of unfamiliar tablets and increased suspicion, desperation, and aggression, have been reported 61.
• This review determined papers to be “linked” if multiple papers investigated the same underlying cohort of individuals in an overlapping study period and measured the same or similar outcomes.

Unclear evidence for agonist treatment

The muscle tissue has a rich blood supply, allowing the drug to be absorbed into the bloodstream gradually compared to IV injections. This slower absorption rate can provide a sustained release of the medication over time, making IM injections suitable for vaccines, hormonal therapies, and long-acting medications. There are also other ways and techniques of injection (for example, subcutaneous), but we will focus on the above as the most common.

• The study also revealed that research activity is primarily concentrated in high-income, English-speaking countries, highlighting the need for more research in low- and middle-income countries.
• This inconclusiveness is caused by limited data, such as the availability of few observational studies ranging from five to nine for each outcome of interest, inconsistent comparisons (THN or SIF vs. various controls), and variations in outcomes across primary studies.
• Supervised injection facilities are harm reduction interventions that allow people who inject drugs to use previously obtained substances under the supervision of health professionals.
• The test strip can then be dipped in the water up to the first line and held for 15 seconds, and afterwards placed on a sterile surface.

Access to Addiction Treatment Programs

The third study explored harm reduction service provision across 34 cities during the pandemic, and highlighted the introduction and continuation of a prescribed benzodiazepine stabilisation protocol in Dublin 32. The literature is abundant with studies, including Reducing injection harm a dozen systematic reviews and meta-analyses that have assessed the impact of these interventions in improving drug-related harms. However, substantial variations in methods, outcome measures, and transparency of their reporting exist, which can lead to results suggesting interventions that may not be effective. Moreover, when interventions are implemented, they may not be adequately translated into practice or tailored to suit the relevant populations.

INFECTION PREVENTION

However, limited data exist regarding ID physician perceptions and practices when caring for PWID. In a previous Emerging Infections Network (EIN) survey, administered in 2017, fewer than half of respondents felt comfortable assessing patient injection practices and offering counseling on infection prevention 14. The current study sought to better understand the current harm reduction practices promoted by ID physicians in order to inform future efforts to improve longitudinal care for PWID. These findings demonstrate the necessity of tailored harm reduction advice, such as cautioning that naloxone may be ineffective for benzodiazepine overdose and exploring other strategies such as avoiding using alone, using a test dose, and keeping naloxone on hand 44. Behavioural changes were evident, consistent with research on the impact of drug checking results on behaviour modification 79. Behavioural modifications following drug checking intervention included disposal of adulterated samples, reduced benzodiazepine use, reduced injection frequency, and reduced solitary drug use 44, 51, 54.

Assessing and Summarizing the Body of Evidence on Effectiveness

The number includes only members who ever responded to an EIN survey and excluded 147 members who joined the EIN but have not yet responded to any surveys. AThis is not a comprehensive list of resources, but rather a starter guide for accessing additional training or support. The author alone is responsible for the views expressed in this publication and these do not necessarily represent the decisions or the stated policy of the World Health Organization.

This should not be considered a major drawback in a study that focus on research patterns and trends rather than on a specific research question as in the case of systematic review. Finally, the research gaps provided in the current study was based on research mapping rather than screening the articles themselves. Therefore, these research gaps remain an overall picture of the research status rather than specific detailed research gaps based on the content analysis of the articles. In April 2022, an electronic survey was distributed via e-mail to all adult ID physicians who are members of the EIN 15.

For people who inject drugs, supervised injection facilities may reduce risk of overdose morbidity and mortality and improve access to care, while not increasing crime or public nuisance to the surrounding community. Overall, the research topics in both sets of articles share a common focus on harm reduction strategies and interventions. The top 40 cited articles were thoroughly reviewed to verify their relevance to the field of harm reduction interventions for substance use.

Understanding the physiology behind intravenous (IV) and intramuscular (IM) injections is crucial for minimizing harm and ensuring the effectiveness of the substance being used. Both methods involve delivering substances directly into the body but differ in their specific targets and absorption rates. There are also other ways and techniques of injection (for example, subcutaneous), but we will mostly focus on the above as the most common. Review authors used standard systematic review methods outlined by the Community Guide.23,24 This systematic review was not registered and the protocol was not previously published. Titles, abstracts, and keywords were screened independently in duplicate by four reviewers (IN, CM, CH, RML) using Rayyan (Rayyan 2024) with blinded voting. An initial screening of 40 studies was conducted independently by all reviewers to pilot the inclusion criteria.

Primarily prescribed for anxiety, panic and sleep disorders, and substance withdrawal; these medications hold anxiolytic, hypnotic, muscle relaxant, and anticonvulsant properties 3. This section collects any data citations, data availability statements, or supplementary materials included in this article. Consisting of data provided by the authors to benefit the reader, the posted materials are not copyedited and are the sole responsibility of the authors, so questions or comments should be addressed to the corresponding author. Syringes with smaller needle gauges will result in smaller puncture wounds and therefore decrease the likelihood for infection to occur 2, 34. When the needle is too short, it may miss the vein, and if it is too long, it may go through the vein.

Skin and Soft Tissue Infections

In addition, a manual search was performed in the reference lists of included studies, and conventional search engines (i.e., Google and Google Scholar). If you use injection drugs, understanding and practicing harm reduction can help keep you safe and healthy — but many people aren’t aware of the basics. A critical component of SSPs is the promotion of safe injection practices through supply distribution and education.

Understand Overdose Prevention and Response

The US Food and Drug Administration (FDA) has approved an intranasal naloxone spray and an autoinjector naloxone formulation for community use 71. The auto-injection device is prefilled and provides verbal instructions to the naloxone user on how to deliver the medication once activated; however, it is not commonly used due to its prohibitive cost 71. The intranasal formulation is a prepackaged nasal spray that requires no assembly and is sprayed into 1 nostril 71. Additionally, a less prevalent option is an intramuscular naloxone formulation that can be administered intramuscularly or adapted for intranasal use by attaching a leur-lock mucosal atomizer device 72. In the absence of safe injection kits or sterile equipment access, patients should be counseled on proper and alternative equipment (Table 1).

A recent analysis of 14 drug cryptomarkets (1st February 2024 to 31st January 2025) revealed that benzodiazepines comprised the third-largest percentage (8.1%) of all drug listings 27. The growing presence and easy availability of novel benzodiazepines only add complexity to efforts aimed at reducing benzodiazepine-related harm. A systematic search was conducted in PubMed and Scopus without timeframe or language limits (updated December 2022).

On average, two thirds of clients of the SIFs in included studies were men; a quarter of clients were experiencing homelessness. History of incarceration was common in the study populations of included studies, as were HIV and hepatitis C virus infection and poor mental health indicators. Finally, study participants (SIF clients and non-clients) reported high levels of syringe sharing behavior and history of overdose, regardless of SIF use.

By prioritizing harm reduction strategies, we not only pave the way for meaningful recovery but also protect the health and well-being of the community at large. The primary data source for the current study was Scopus, a comprehensive bibliographic database that includes a wide range of scholarly publications across various disciplines (). An electronic survey was distributed to physician members of the Emerging Infections Network to inquire about practices used when caring for patients with IDU-related infections.

This approach provides a visual summary of the breadth and availability of information within a specific area and the gaps in the current evidence, which may ground further research, and policy development 21. In the dim light of an early morning, a young man named Alex finds himself in the quiet corner of a park, his hands trembling as he prepares for his daily ritual. Despite his efforts to be cautious, his lack of access to clean needles and a safe environment leaves him vulnerable, a reality faced by millions globally. In cities and towns around the world, countless individuals, much like Alex, engage in unsafe injection practices, a decision often made out of necessity rather than choice. The consequences are dire and far-reaching, contributing to a staggering 13% of new HIV infections worldwide being attributed to needle sharing among people who inject drugs (PWID). Beyond the risk of HIV, unsafe injections pave the way for hepatitis C outbreaks, bacterial infections, and a myriad of other health complications, casting a long shadow over communities.