About: Navigating environmental constraints to injection preparation: the use of saliva and other alternatives to sterile water among unstably housed PWID in London

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About: Navigating environmental constraints to injection preparation: the use of saliva and other alternatives to sterile water among unstably housed PWID in London Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Navigating environmental constraints to injection preparation: the use of saliva and other alternatives to sterile water among unstably housed PWID in London
Creator	Ciccarone, Daniel Harris, Magdalena Hope, Vivian Mcgowan, Catherine Scott, Jenny Wright, Talen
Source	Medline; PMC
abstract	BACKGROUND: The United Kingdom is experiencing an increase in drug-related deaths and serious bacterial infections among its most vulnerable citizens. Cuts to essential services, coupled with a growing homeless population, create a challenging environment to tackle this public health crisis. In this paper, we highlight an underexplored environmental constraint faced by people living and injecting drugs on the streets. Access to water for injection is restricted in the UK, due to legislative and financial barriers. Austerity measures, such as public toilet closures, further restrict the ability of people made homeless to access clean water and protect themselves from health harms. METHODS: We generated questionnaire (n = 455) and in-depth qualitative interview (n = 32) data with people who inject drugs in London for the Care and Prevent study. Participants provided detail on their life history; drug use, injecting and living environments; health conditions and care seeking practices. FINDINGS: A high proportion of the survey sample reported lifetime history of street homelessness (78%), bacterial infections (65%) and related hospitalisation (30%). Qualitative accounts highlight unsafe, potentially dangerous, injection practices in semi-public spaces. Multiple constraints to sourcing sterile water for injection preparation were reported. Alternatives to sterile water included puddle water, toilet cistern water, whisky, cola soda and saliva. Participants who injected heroin and crack cocaine together unanimously reported adding water at two stages during injection preparation: first, adding water as a vehicle for heroin (which was then heated); second, adding cold water to the heroin mixture prior to adding the crack cocaine. This new finding of a stage addition of solvent may represent an additional risk of infection. CONCLUSION: Currently, harm reduction equipment and resources for safe injecting are not meeting the needs of people who inject drugs who are street homeless or unstably housed. Preparation of injections with non-sterile water sources could precipitate bacterial and fungal infections, particularly when used without the application of heat. It is crucial that water for injection, also skin cleaning, is made available for the unstably housed and that harm reduction messaging is tailored to speak to the everyday realities of people who prepare and inject drugs in public spaces.
has issue date	2020-04-10(xsd:dateTime)
bibo:doi	10.1186/s12954-020-00369-0
bibo:pmid	32276626
has license	cc-by
sha1sum (hex)	62503f1644ab37642dbc887d28642c76c288bf09
schema:url	https://doi.org/10.1186/s12954-020-00369-0
resource representing a document's title	Navigating environmental constraints to injection preparation: the use of saliva and other alternatives to sterile water among unstably housed PWID in London
has PubMed Central identifier	PMC7145770
has PubMed identifier	32276626
schema:publication	Harm Reduct J
resource representing a document's body	covid:62503f1644ab37642dbc887d28642c76c288bf09#body_text
is schema:about of	named entity 'dangerous' named entity 'drugs' named entity 'injection' named entity 'injection' named entity 'seeking' named entity 'CONSTRAINT' named entity 'HEROIN' named entity 'LIFETIME' named entity 'ITS' named entity '455' named entity 'STERILE WATER FOR INJECTION' named entity 'SOLVENT' named entity 'RISK OF INFECTION' named entity 'STAGE' named entity 'LEGISLATIVE' named entity 'ENVIRONMENTS' named entity 'DRUG USE' named entity 'INJECT' named entity 'TOILET' named entity 'UNITED KINGDOM' named entity 'CISTERN' named entity 'CRISIS' named entity 'ACCESS' named entity 'GROWING' named entity 'PUBLIC' named entity 'REPORTED' named entity 'SAMPLE' named entity 'QUALITATIVE' named entity 'VULNERABLE' named entity 'DATA' named entity 'injection' named entity 'barriers' named entity 'puddle' named entity 'data' named entity 'bacterial infections' named entity 'crack cocaine' named entity 'streets' named entity 'water' named entity 'Prevent' named entity 'restricted' named entity 'heroin' named entity 'inject drugs' named entity 'restrict' named entity 'drug' named entity 'mixture' named entity 'heroin' named entity 'adding' named entity 'drug-related' named entity 'London' named entity 'clean water' named entity 'heroin' named entity 'cistern' named entity 'public toilet' named entity 'homeless population' named entity 'United Kingdom' named entity 'paper' named entity 'Qualitative' named entity 'short-sighted' named entity 'PWID' named entity 'homeless' named entity 'drug injecting' named entity 'Alcohol' named entity 'solvent' named entity 'rough sleeping' named entity 'infection' named entity 'venous ulcers' named entity 'crack cocaine' named entity 'crack cocaine' named entity 'chronic obstructive pulmonary disease' named entity 'treatment services' named entity 'water for injection' named entity 'European Union' named entity 'Stata' named entity 'risk factors' named entity 'baby wipes' named entity 'endotoxins'

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