Impact des salles de consommation de drogues sur les overdoses non mortelles, les abcès et les visites aux urgences chez les personnes qui s'injectent des drogues en France

Roux et al. montrent que ces interventions de réduction des risques sont efficaces pour réduire les overdoses, les abcès et les visites aux urgences. Pour en savoir plus, en anglais, veuillez lire les informations ci-dessous.

By P Roux, M Jauffret-Roustide, C Donadille, L Briand Madrid, C Denis, I Célérier, C Chauvin, N Hamelin, G Maradan, M P Carrieri, C Protopopescu, L Lalanne, M Auriacombe, COSINUS Study Group

Abstract

Background: The effectiveness of drug consumption rooms (DCRs) for people who inject drugs (PWID) has been demonstrated for HIV and hepatitis C virus risk practices, and access to care for substance use disorders. However, data on other health-related complications are scarce. Using data from the French COSINUS cohort, we investigated the impact of DCR exposure on non-fatal overdoses, abscesses and emergency department (ED) visits, all in the previous 6 months.

Methods: COSINUS is a 12-month prospective cohort study of 665 PWID in France studying DCR effectiveness on health. We collected data from face-to-face interviews at enrolment, and at 6 and 12 months of follow-up. After adjusting for other correlates (P-value < 0.05), the impact of DCR exposure on each outcome was assessed using a two-step Heckman mixed-effects probit model, allowing us to adjust for potential non-randomization bias due to differences between DCR-exposed and DCR-unexposed participants, while taking into account the correlation between repeated measures.

Results: At enrolment, 21%, 6% and 38% of the 665 participants reported overdoses, abscesses and ED visits, respectively. Multivariable models found that DCR-exposed participants were less likely to report overdoses [adjusted coefficient (95% CI): -0.47 (-0.88; -0.07), P = 0.023], abscesses [-0.74 (-1.11; -0.37), P < 0.001] and ED visits [-0.74 (-1.27; -0.20), P = 0.007].

Conclusion: This is the first study to show the positive impact of DCR exposure on abscesses and ED visits, and confirms DCR effectiveness in reducing overdoses, when adjusting for potential non-randomization bias. Our findings strengthen the argument to expand DCR implementation to improve PWID injection environment and health.

Keywords: Safer injecting facility; abscess; emergency department; injection drug users; overdose; risk environment; skin and soft tissue infections.

© The Author(s) 2022; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.