Safe injection sites and availability of new needles are among measures that may be adopted by London's hospitals under a new harm reduction strategy for patients who use methamphetamine.
London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London are set to become only the second hospital systems in North America to implement such a program, details of which were announced Friday by Lawson Health Research Institute.
According to the London-based researchers, the methamphetamine harm reduction project is needed as their data shows nearly half of all patients admitted for treatment of infections related to substance use continue to self medicate with the illicit substance while in hospital.
"There is an assumption that people in hospital aren’t using, but in fact we’ve found that almost 50 per cent of patients [being treated for infections related to substance use]are injecting drugs during their stay," said study co-principal investigator Dr. Michael Silverman. "That is clearly an underestimate because many patients are worried about being stigmatized or other consequences of using in hospital and so may not be willing to report it to researchers or tell their health care providers."
Research has shown patients using in hospitals are more likely to contract an infection and tend to leave the facility against medical advice, putting their health and safety at risk.
"People aren’t able to access safe ways to use substances and they are doing it in secret, so it’s not the best way to do it to prevent infection. There are also gaps in support for withdrawal and other addiction services,” added Silverman, who is also a Lawson associate scientist and chair of infectious diseases for LHSC and St. Joseph’s Health Care London.
Canadian hospitals rarely put harm reduction strategies in place because the current standard of care does not allow for illicit drug use without an exemption under Health Canada's Controlled Drugs and Substances Act.
Currently, there are only five supervised consumption services based in acute care hospitals, said Dr. Cheryl Forchuk, Assistant Scientific Director at Lawson and study co-principal investigator.
"We are leading the way towards a groundbreaking shift to greatly improve health care for Canadians who use substances,” Forchuk said.
The harm reduction project will last four years, with researchers planning to recruit up to 360 people between the ages of 16-35 with past experience or who currently use of methamphetamine, including inpatients, outpatients and those in community outreach programs. Approximately 180 health care and service providers will also be asked to share their perspectives on harm reduction strategies.
Following the one-year consultation phase and with approval from Health Canada, recommended strategies will be implemented within LHSC and St. Joseph’s hospital sites.
Among the potential harm reduction strategies being considered are safe injection sites, new needles and syringes, available Sharp boxes, support for detox and withdrawal, medication, resources at discharge, and enhanced addiction services and counseling.