Nurse-delivered safer injection education among a cohort of injection drug users: Evidence from the evaluation of Vancouver's supervised injection facility

Wood, R. Alan; Wood, Evan; Lai, Calvin; Tyndall, Mark W.; Montaner, Julio S.G.; Kerr, Thomas

doi:10.1016/j.drugpo.2008.01.003

« Previous Next »International Journal of Drug Policy
Volume 19, Issue 3 , Pages 183-188, June 2008

Nurse-delivered safer injection education among a cohort of injection drug users: Evidence from the evaluation of Vancouver's supervised injection facility

R. Alan Wood
- University of British Columbia School of Nursing, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5 Canada
- IMPART Program, British Columbia Centre of Excellence for Women's Health, E311 - 4500 Oak Street, Vancouver, BC, V6H 3N1 Canada
Evan Wood
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, BC, V6Z 1Y6 Canada
- Department of Medicine, University of British Columbia, 3300 - 950 West 10th Avenue, Vancouver, BC, V5Z 4E3 Canada
Calvin Lai
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, BC, V6Z 1Y6 Canada
Mark W. Tyndall
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, BC, V6Z 1Y6 Canada
- Department of Medicine, University of British Columbia, 3300 - 950 West 10th Avenue, Vancouver, BC, V5Z 4E3 Canada
Julio S.G. Montaner
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, BC, V6Z 1Y6 Canada
- Department of Medicine, University of British Columbia, 3300 - 950 West 10th Avenue, Vancouver, BC, V5Z 4E3 Canada
Thomas Kerr
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, BC, V6Z 1Y6 Canada
- Department of Medicine, University of British Columbia, 3300 - 950 West 10th Avenue, Vancouver, BC, V5Z 4E3 Canada
- Corresponding author at: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, BC, V6Z 1Y6 Canada. Tel.: +1 604 806 9116; fax: +1 604 806 9044.

Received 16 July 2007; received in revised form 21 November 2007; accepted 2 January 2008. published online 27 March 2008.

Abstract

Background

Despite growing implementation of harm reduction programs internationally, unsafe injecting practices remain common among injection drug users (IDU). In response, nursing interventions such as safer injection education (SIE) have been called for. In Vancouver, a supervised injection facility (SIF), where IDU inject pre-obtained illicit drugs under nursing supervision, opened in 2003 in an effort to reduce the impacts of unsafe injecting. We sought to characterize the state of nursing SIE practice in Vancouver and prospectively examine SIE among SIF users.

Methods

We examined correlates of receiving SIE among participants in the Scientific Evaluation of Supervised Injecting (SEOSI) cohort. The SEOSI cohort was derived through random recruitment of SIF users. Characteristics of participants who reported receiving SIE from SIF nurses were examined using bivariate and multivariate generalized estimating equations.

Results

1087 SEOSI participants were surveyed between March 2004 and March 2005 and included in this analysis. Approximately one third of participants reported receiving SIE at baseline and an additional 13.3% reported receiving SIE during follow-up. Those receiving SIE from SIF nurses were more likely to be females (AOR=1.55; 95% CI: 1.18–2.04), persons requiring injecting assistance (AOR=1.52; 95% CI: 1.26–1.84), binge users (AOR=1.37; 95% CI: 1.14–1.64), and those using the SIF for most of their injections (AOR=1.47; 95% CI: 1.22–1.77).

Conclusions

These findings provide evidence to support the need for nurse-delivered SIE in reaching IDU most at risk for injection-related harm. SIFs may afford unique opportunities to deliver SIE to high-risk populations. Individuals receiving SIE from Vancouver's SIF nurses were likely to possess characteristics associated with adverse health outcomes, including HIV infection.

Keywords: Patient education, Illicit drug use, Safer injection facilities, Nursing interventions, Vein care