Chelsea L. Shover-Darling, PhD is an Associate Professor at the David Geffen School of Medicine at UCLA, where she directs the Epidemiology, Policy, and Implementation Lab (EPI Lab) and founded Drug Checking Los Angeles. She is a Visiting Senior Lecturer at University of Bristol and a Community-Embedded Researcher at Bristol Drugs Project. She has served as a co-opted member of the UK Advisory Council on the Misuse of Drugs working groups on alpha-2 agonists. As an educator, Dr Shover-Darling is committed to mentoring trainees from underrepresented in science, including people with personal experience of substance use disorders and mental illness.

Abstract

Participant and client perspectives on a hypothetical overdose prevention centre in Bristol: Results from qualitative interviews during a local spice overdose crisis

Aims: (1) Explore the views and potential design of an overdose prevention centre in Bristol. (2) Capture stories of how people who inject drugs believe an overdose prevention centre would impact their lives and health. (3) Investigate how an overdose prevention centre may impact drugs services workers. (4) Characterise desired attributes of an overdose prevention centre, including design, co-located services, and how to meet differing needs of men and women.

Methods: Face-to-face semi-structured interviews were conducted with potential overdose prevention centre participants (n=11) and drugs service staff members (n=5). Participants were eligible to be interviewed if they had any history of public injecting. Staff were eligible if they had responded to a non-fatal overdose. Interviewees were paid £25. Audio recordings were professionally transcribed and thematically coded by the study team.

Results: Participant and staff interviewees universally endorsed an overdose prevention centre in Bristol, with broad support for a fixed city-centre site and some support for mobile units (e.g. vans to reach sex workers). Life-saving medical intervention was cited as the chief benefit; other benefits included service linkage and reduced litter. Participants believed that space to inject heroin was most important, and several suggested a space to smoke spice.

Conclusions: During the month that interviews were conducted, most staff interviewees responded to one or more spice overdoses immediately outside their workplace. Though it was not a formal question, most participant interviewees disclosed they had experienced an overdose themselves; several shared that they lost a romantic partner to overdose. These contexts, along with themes that emerged in interviews, highlight how an overdose prevention centre could positively impact Bristol.