Impact of a high-volume overdose prevention site on social and drug disorder in surrounding areas in San Francisco.


Journal

Drug and alcohol dependence
ISSN: 1879-0046
Titre abrégé: Drug Alcohol Depend
Pays: Ireland
ID NLM: 7513587

Informations de publication

Date de publication:
01 11 2023
Historique:
received: 20 03 2023
revised: 12 09 2023
accepted: 17 09 2023
medline: 30 10 2023
pubmed: 26 9 2023
entrez: 25 9 2023
Statut: ppublish

Résumé

Between January and December 2022 a multi-service center incorporating an overdose prevention site (OPS) operated with city government sanction in San Francisco. One concern often expressed about OPS is that they may increase social nuisance associated with drug use in the surrounding area, despite international evidence that this is not the case. We conducted systematic street observation of 10 indicators of drug- and homelessness-related social nuisance in a 500 m radius around the OPS and around a comparison point in the same city before and after the introduction of the OPS. We estimated the risk that any given street within sampling areas would have nuisance post-intervention relative to the control area using Poisson regression. Ratio of relative risks of any reported nuisance in the 500 m area surrounding the OPS from pre- to post-intervention to that of the comparison area was 0.69 (95% CI: 0.54, 0.87; p=0.002). The relative risk of drug-specific nuisance was similar to the comparison area pre/post intervention (0.90; 95% CI 0.66, 1.24; p=0.53). The risk of homelessness-specific nuisance decreased around the OPS (RR 0.7., 95% CI 0.52, 0.93; p=0.02) whereas they increased around the comparison area (RR 1.33, 95% CI 1.06, 1.68; p=0.02). We found that implementing authorized OPS services in a U.S. city did not increase the prevalence of visible signs of drug use and homelessness in the surrounding area. These findings are similar to those found at OPS outside the U.S.

Sections du résumé

BACKGROUND
Between January and December 2022 a multi-service center incorporating an overdose prevention site (OPS) operated with city government sanction in San Francisco. One concern often expressed about OPS is that they may increase social nuisance associated with drug use in the surrounding area, despite international evidence that this is not the case.
METHODS
We conducted systematic street observation of 10 indicators of drug- and homelessness-related social nuisance in a 500 m radius around the OPS and around a comparison point in the same city before and after the introduction of the OPS. We estimated the risk that any given street within sampling areas would have nuisance post-intervention relative to the control area using Poisson regression.
RESULTS
Ratio of relative risks of any reported nuisance in the 500 m area surrounding the OPS from pre- to post-intervention to that of the comparison area was 0.69 (95% CI: 0.54, 0.87; p=0.002). The relative risk of drug-specific nuisance was similar to the comparison area pre/post intervention (0.90; 95% CI 0.66, 1.24; p=0.53). The risk of homelessness-specific nuisance decreased around the OPS (RR 0.7., 95% CI 0.52, 0.93; p=0.02) whereas they increased around the comparison area (RR 1.33, 95% CI 1.06, 1.68; p=0.02).
CONCLUSION
We found that implementing authorized OPS services in a U.S. city did not increase the prevalence of visible signs of drug use and homelessness in the surrounding area. These findings are similar to those found at OPS outside the U.S.

Identifiants

pubmed: 37748424
pii: S0376-8716(23)01207-3
doi: 10.1016/j.drugalcdep.2023.110969
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

110969

Informations de copyright

Copyright © 2023 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest No conflict declared.

Auteurs

Peter J Davidson (PJ)

Division of Infectious Disease & Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, USA. Electronic address: pdavidson@ucsd.edu.

Lynn D Wenger (LD)

Community Health Research Division, RTI International, 2150 Shattuck Avenue Suite 800, Berkeley, CA 94704, USA.

Terry Morris (T)

Community Health Research Division, RTI International, 2150 Shattuck Avenue Suite 800, Berkeley, CA 94704, USA.

Veronika Majano (V)

Community Health Research Division, RTI International, 2150 Shattuck Avenue Suite 800, Berkeley, CA 94704, USA.

Erica N Browne (EN)

Community Health Research Division, RTI International, 2150 Shattuck Avenue Suite 800, Berkeley, CA 94704, USA.

Barrot H Lambdin (BH)

Community Health Research Division, RTI International, 2150 Shattuck Avenue Suite 800, Berkeley, CA 94704, USA.

Leslie W Suen (LW)

Division of General Internal Medicine at San Francisco General Hospital, Department of Medicine, University of California San Francisco, 1001 Potrero Ave, San Francisco, CA 94143, USA.

Alex H Kral (AH)

Community Health Research Division, RTI International, 2150 Shattuck Avenue Suite 800, Berkeley, CA 94704, USA.

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