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This includes my neighborhood where I live & work treating opioid use disorder.
NY has good Medicaid program. We have methadone & buprenorphine. There are inpatient & outpatient programs. There is overdose education & naloxone distribution.
Yet overdoses continue to ⬆️
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NY has good Medicaid program. We have methadone & buprenorphine. There are inpatient & outpatient programs. There is overdose education & naloxone distribution.
Yet overdoses continue to ⬆️
1/7
This is an abandoned building where ppl hang out. There is evidence of public injection. No one wants this.
Ppl inject opioids & other drugs in alleys, parks, bathrooms & other secluded places b/c there is no place safe to go.
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Ppl inject opioids & other drugs in alleys, parks, bathrooms & other secluded places b/c there is no place safe to go.
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This is a supervised consumption site.
The "crack house" statute of controlled substances act prevents SCS in US
But they're healthcare facilities. Clean tables & sterile supplies ⬇️ HIV, HCV & other infections.
Staff respond to overdoses & refer for treatment.
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The "crack house" statute of controlled substances act prevents SCS in US
But they're healthcare facilities. Clean tables & sterile supplies ⬇️ HIV, HCV & other infections.
Staff respond to overdoses & refer for treatment.
3/7
Overdoses ⬇️by 35% within 500 m of first SCS that opened in Vancouver in 2003 (vs. ⬇️ by 9% in the rest of the city)
Ppl using the SCS ⬆️use of detox services by 30% (vs. prior year) & detox strongly associated w/ starting methadone treatment
ncbi.nlm.nih.gov/pubmed/17523986
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Ppl using the SCS ⬆️use of detox services by 30% (vs. prior year) & detox strongly associated w/ starting methadone treatment
ncbi.nlm.nih.gov/pubmed/17523986
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Safe consumption sites are one evidence-based component of a comprehensive continuum of care
As a doctor, I think about what will bring ppl into care - readiness for medication treatment.
SCS's provide treatment, but also may be first step toward engaging in medical care.
5/7
As a doctor, I think about what will bring ppl into care - readiness for medication treatment.
SCS's provide treatment, but also may be first step toward engaging in medical care.
5/7
Supervised consumption sites may seem controversial, but so was methadone treatment in 1960’s & syringe exchange in 1990’s.
Implementing sites will require engagement of all community stakeholders & actually listening to everyone's concerns.
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Implementing sites will require engagement of all community stakeholders & actually listening to everyone's concerns.
6/7
But, first & foremost, we need to recognize that ppl who use drugs deserve respect, dignity & compassion.
Sometimes this can come in the care we provide during treatment
but first we need to meet people where they are.
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Sometimes this can come in the care we provide during treatment
but first we need to meet people where they are.
7/7
