Changes in public order after the opening of a medically supervised safer injecting facility for illicit injection drug users
Changes in public order after the opening of a medically supervised safer injecting facility for illicit injection drug users
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DOI：
10.1503/cmaj.1040774
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发表时间：
2004-09-28
影响因子：
14.6
通讯作者：
Tyndall, MW
中科院分区：
文献类型：
--
作者：
Wood, E;Kerr, T;Tyndall, MW
背景：北美第一个医疗监督下的安全注射设施，为非法注射毒品使用者在温哥华开放，9月10日。2003年22日。虽然类似的设施存在于一些欧洲城市，在澳大利亚悉尼，没有标准化的评价，其影响已在科学literature.Methods：使用标准化的前瞻性数据收集协议，我们测量注射相关的公共秩序问题，在6周前和12周后开放的更安全的注射设施在温哥华。我们测量了在公共场所注射毒品的人数、公共场所丢弃的注射器和与注射有关的垃圾的变化。我们使用泊松对数线性回归模型来评估这些公共秩序指标的变化，同时考虑潜在的混杂变量，如警察存在和降雨量。在分层线性回归模型中，设施开放后的12周期间与公共注射吸毒者人数的减少独立相关（p < 0.001）、公共丢弃的注射器（p < 0.001）和注射相关的垃圾（p < 0.001）。在公众地方注射毒品的吸毒者的预测平均每日人数为4.3人，（95%置信区间[Cl] 3.5-5.4），（95% CI 1.9-3.0）开瓶后;公共废弃注射器的相应预测平均每日数量分别为11.5（95%CI 10.0-13.2）和5.4（95%CI 4.7-6.2）。从温哥华市外部收集的关于丢弃在室外安全处置箱中的注射器数量的统计数据与我们的发现一致。解释：开放更安全的注射设施与公共秩序的几项措施的改善独立相关，包括减少公共注射毒品使用和公共注射器处置。
Background: North America's first medically supervised safer injecting facility for illicit injection drug users was opened in Vancouver on Sept. 22, 2003. Although similar facilities exist in a number of European cities and in Sydney, Australia, no standardized evaluations of their impact have been presented in the scientific literature.Methods: Using a standardized prospective data collection protocol, we measured injection-related public order problems during the 6 weeks before and the 12 weeks after the opening of the safer injecting facility in Vancouver. We measured changes in the number of drug users injecting in public, publicly discarded syringes and injection-related litter. We used Poisson log-linear regression models to evaluate changes in these public order indicators while considering potential confounding variables such as police presence and rainfall.Results: In stratified linear regression models, the 12-week period after the facility's opening was independently associated with reductions in the number of drug users injecting in public (p < 0.001), publicly discarded syringes (p < 0.001) and injection-related litter (p < 0.001). The predicted mean daily number of drug users injecting in public was 4.3 (95% confidence interval [Cl] 3.5-5.4) during the period before the facility's opening and 2.4 (95% Cl 1.9-3.0) after the opening; the corresponding predicted mean daily numbers of publicly discarded syringes were 11.5 (95% Cl 10.0-13.2) and 5.4 (95% Cl 4.7-6.2). Externally compiled statistics from the city of Vancouver on the number of syringes discarded in outdoor safe disposal boxes were consistent with our findings.Interpretation: The opening of the safer injecting facility was independently associated with improvements in several measures of public order, including reduced public injection drug use and public syringe disposal.