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Evaluation of an emergency safe supply drugs and managed alcohol program in COVID-19 isolation hotel shelters for people experiencing homelessness
BACKGROUND: During a COVID-19 outbreak in the congregate shelter system in Halifax, Nova Scotia, Canada, a healthcare team provided an emergency “safe supply” of medications and alcohol to facilitate isolation in COVID-19 hotel shelters for residents who use drugs and/or alcohol. We aimed to evaluat...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Authors. Published by Elsevier B.V.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988445/ https://www.ncbi.nlm.nih.gov/pubmed/35461084 http://dx.doi.org/10.1016/j.drugalcdep.2022.109440 |
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author | Brothers, Thomas D. Leaman, Malcolm Bonn, Matthew Lewer, Dan Atkinson, Jacqueline Fraser, John Gillis, Amy Gniewek, Michael Hawker, Leisha Hayman, Heather Jorna, Peter Martell, David O’Donnell, Tiffany Rivers-Bowerman, Helen Genge, Leah |
author_facet | Brothers, Thomas D. Leaman, Malcolm Bonn, Matthew Lewer, Dan Atkinson, Jacqueline Fraser, John Gillis, Amy Gniewek, Michael Hawker, Leisha Hayman, Heather Jorna, Peter Martell, David O’Donnell, Tiffany Rivers-Bowerman, Helen Genge, Leah |
author_sort | Brothers, Thomas D. |
collection | PubMed |
description | BACKGROUND: During a COVID-19 outbreak in the congregate shelter system in Halifax, Nova Scotia, Canada, a healthcare team provided an emergency “safe supply” of medications and alcohol to facilitate isolation in COVID-19 hotel shelters for residents who use drugs and/or alcohol. We aimed to evaluate (a) substances and dosages provided, and (b) outcomes of the program. METHODS: We reviewed medical records of all COVID-19 isolation hotel shelter residents during May 2021. The primary outcome was successful completion of 14 days isolation, as directed by public health orders. Adverse events included (a) overdose; (b) intoxication; and (c) diversion, selling, or sharing of medications or alcohol. RESULTS: Seventy-seven isolation hotel residents were assessed (mean age 42 ± 14 years; 24% women). Sixty-two (81%) residents were provided medications, alcohol, or cigarettes. Seventeen residents (22%) received opioid agonist treatment (methadone, buprenorphine, or slow-release oral morphine) and 27 (35%) received hydromorphone. Thirty-one (40%) residents received prescriptions stimulants. Six (8%) residents received benzodiazepines and forty-two (55%) received alcohol. Over 14 days, mean daily dosages increased of hydromorphone (45 ± 32 – 57 ± 42 mg), methylphenidate (51 ± 28 – 77 ± 37 mg), and alcohol (12.3 ± 7.6 – 13.0 ± 6.9 standard drinks). Six residents (8%) left isolation prematurely, but four returned. During 1059 person-days, there were zero overdoses. Documented concerns regarding intoxication occurred six times (0.005 events/person-day) and medication diversion/sharing three times (0.003 events/person-day). CONCLUSIONS: COVID-19 isolation hotel residents participating in an emergency safe supply and managed alcohol program experienced high rates of successful completion of 14 days isolation and low rates of adverse events. |
format | Online Article Text |
id | pubmed-8988445 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | The Authors. Published by Elsevier B.V. |
record_format | MEDLINE/PubMed |
spelling | pubmed-89884452022-04-07 Evaluation of an emergency safe supply drugs and managed alcohol program in COVID-19 isolation hotel shelters for people experiencing homelessness Brothers, Thomas D. Leaman, Malcolm Bonn, Matthew Lewer, Dan Atkinson, Jacqueline Fraser, John Gillis, Amy Gniewek, Michael Hawker, Leisha Hayman, Heather Jorna, Peter Martell, David O’Donnell, Tiffany Rivers-Bowerman, Helen Genge, Leah Drug Alcohol Depend Article BACKGROUND: During a COVID-19 outbreak in the congregate shelter system in Halifax, Nova Scotia, Canada, a healthcare team provided an emergency “safe supply” of medications and alcohol to facilitate isolation in COVID-19 hotel shelters for residents who use drugs and/or alcohol. We aimed to evaluate (a) substances and dosages provided, and (b) outcomes of the program. METHODS: We reviewed medical records of all COVID-19 isolation hotel shelter residents during May 2021. The primary outcome was successful completion of 14 days isolation, as directed by public health orders. Adverse events included (a) overdose; (b) intoxication; and (c) diversion, selling, or sharing of medications or alcohol. RESULTS: Seventy-seven isolation hotel residents were assessed (mean age 42 ± 14 years; 24% women). Sixty-two (81%) residents were provided medications, alcohol, or cigarettes. Seventeen residents (22%) received opioid agonist treatment (methadone, buprenorphine, or slow-release oral morphine) and 27 (35%) received hydromorphone. Thirty-one (40%) residents received prescriptions stimulants. Six (8%) residents received benzodiazepines and forty-two (55%) received alcohol. Over 14 days, mean daily dosages increased of hydromorphone (45 ± 32 – 57 ± 42 mg), methylphenidate (51 ± 28 – 77 ± 37 mg), and alcohol (12.3 ± 7.6 – 13.0 ± 6.9 standard drinks). Six residents (8%) left isolation prematurely, but four returned. During 1059 person-days, there were zero overdoses. Documented concerns regarding intoxication occurred six times (0.005 events/person-day) and medication diversion/sharing three times (0.003 events/person-day). CONCLUSIONS: COVID-19 isolation hotel residents participating in an emergency safe supply and managed alcohol program experienced high rates of successful completion of 14 days isolation and low rates of adverse events. The Authors. Published by Elsevier B.V. 2022-06-01 2022-04-07 /pmc/articles/PMC8988445/ /pubmed/35461084 http://dx.doi.org/10.1016/j.drugalcdep.2022.109440 Text en © 2022 The Authors Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Brothers, Thomas D. Leaman, Malcolm Bonn, Matthew Lewer, Dan Atkinson, Jacqueline Fraser, John Gillis, Amy Gniewek, Michael Hawker, Leisha Hayman, Heather Jorna, Peter Martell, David O’Donnell, Tiffany Rivers-Bowerman, Helen Genge, Leah Evaluation of an emergency safe supply drugs and managed alcohol program in COVID-19 isolation hotel shelters for people experiencing homelessness |
title | Evaluation of an emergency safe supply drugs and managed alcohol program in COVID-19 isolation hotel shelters for people experiencing homelessness |
title_full | Evaluation of an emergency safe supply drugs and managed alcohol program in COVID-19 isolation hotel shelters for people experiencing homelessness |
title_fullStr | Evaluation of an emergency safe supply drugs and managed alcohol program in COVID-19 isolation hotel shelters for people experiencing homelessness |
title_full_unstemmed | Evaluation of an emergency safe supply drugs and managed alcohol program in COVID-19 isolation hotel shelters for people experiencing homelessness |
title_short | Evaluation of an emergency safe supply drugs and managed alcohol program in COVID-19 isolation hotel shelters for people experiencing homelessness |
title_sort | evaluation of an emergency safe supply drugs and managed alcohol program in covid-19 isolation hotel shelters for people experiencing homelessness |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988445/ https://www.ncbi.nlm.nih.gov/pubmed/35461084 http://dx.doi.org/10.1016/j.drugalcdep.2022.109440 |
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