Willingness to access an in-hospital supervised injection facility among hospitalized people who use illicit drugs.

Abstract

BACKGROUND: Despite the reliance on abstinence-based drug policies within hospital settings, illicit drug use is common among hospitalized patients with severe drug addiction. Hospitalized patients who use illicit drugs (PWUDs) have been known to resort to high-risk behavior to conceal their drug use from healthcare providers. Novel interventions with the potential to reduce high-risk behavior among PWUDs in hospital settings have not been well studied. OBJECTIVE: The objective of the study was to examine factors associated with willingness to access an in-hospital supervised injection facility (SIF). DESIGN: Data were derived from participants enrolled in 2 Canadian prospective cohort studies involving PWUDs between June 2013 and November 2013. A cross-sectional study surveying various sociodemographic characteristics, drug use patterns, and experiences was conducted. SETTING: Vancouver, Canada. MEASUREMENTS: Bivariable and multivariable logistic regression analyses were used to explore factors significantly associated with willingness to access an in-hospital SIF. RESULTS: Among 732 participants, 499 (68.2%) would be willing to access an in-hospital SIF. In multivariable analyses, factors positively and significantly associated with willingness to access an in-hospital SIF included: daily heroin injection (adjusted odds ratio [AOR] = 1.90; 95% confidence interval [CI]: 1.20-3.11); having used illicit drugs in hospital (AOR = 1.63; 95% CI: 1.18-2.26); and having recently used an SIF (AOR = 1.53; 95% CI: 1.10-2.15). CONCLUSIONS: Our findings highlight the potential of in-hospital SIFs to complement existing harm reduction programs that serve PWUD. Moreover, an in-hospital SIF may minimize the harms associated with high-risk illicit drug use in the hospital.