Innovations to the ECHO model to enhance reach and network-building among addiction clinicians in Western Canada.

Background: Building capacity for evidence-based treatment and support for people with substance use disorders (SUD) is an urgent priority in the context of the toxic drug poisoning crisis. We implemented the first substance use-focused Project Extension for Community Healthcare Outcomes (ECHO) in Western Canada for health care providers, to enhance their clinical addiction skills and knowledge, facilitate practice change, and foster a supportive community of practice. The aims of this article are to describe our innovations to the Project ECHO model in British Columbia (BC) and Yukon, and present key program outcomes.

"You might be nice, but where you take me, they're not gonna be": Preferences for field-based post-overdose interventions.

Introduction: Emergency medical services (EMS) systems are piloting interventions to respond to overdoses with additional services such as leave-behind naloxone and medication for opioid use disorder, but little is known about the perspectives of people who use drugs (PWUD) on these interventions being delivered by EMS during an overdose response.

Methods: The Consolidated Framework for Implementation Research guided the development of data collection tools, the analytic strategy and the organisation of results. A community engaged method was used which included both academically trained researchers and community trained researchers who are also PWUD.

No change in substance use disorders or overdose after implementation of state Earned Income Tax Credit (EITC).

Background: Inadequate income is associated with higher likelihood of experiencing a substance use disorder (SUD). This study tests whether the earned income tax credit (EITC), which issues supplemental income for workers with children in the U.S.

Community-Partnered Research appraisal tool for conducting, reporting and assessing community-based research.

The aim of this study was to develop an appraisal tool to support and promote clear, accurate and transparent standards and consistency when conducting, reporting and assessing community-based research. Current recommendations for developing reporting guidelines was used with three key differences: (1) an analysis of existing guides, principles and published literature about community engagement, involvement and participation in research using situational and relational maps; (2) feedback and pilot-testing by a community-based research team; and (3) testing the utility and usability of the appraisal tool. After a series of iterative revisions, the resulting Community-Partnered Research (CPR) appraisal tool emerged into three products: an elaborate prospective format, a basic retrospective format, and a supplemental checklist format.

Socioeconomic Status and CD4 Count Among People with HIV Who Inject Drugs in St. Petersburg, Russia.

Lack of access to resources is a "fundamental cause" of poor HIV outcomes across the care cascade globally and may have the greatest impact on groups with co-existing marginalized identities. In a sample of people living with HIV (PWH) who inject drugs and were not on antiretroviral therapy (ART), we explored associations between access to resources and HIV severity. Fundamental Cause Theory (FCT) sees socioeconomic status/access to resources as a root cause of disease and emphasizes that individuals with limited resources have fewer means to mitigate health risks and implement protective behaviors, which ultimately generates disparities in health outcomes.

Assessing and addressing social determinants of health in school-based health centers in King County, Washington.

Objective: School-Based Health Centers (SBHCs) can reduce barriers to accessing care for school-aged children and adolescents. However, current practices related to screening for and responding to social determinants of health (SDOH) in SBHCs are unknown. Our study sought to understand SBHC staff's knowledge related to SDOH, and their screening and referral practices for addressing SDOH.

Residential and inpatient treatment of substance use disorders in Sub-Saharan Africa: a scoping review.

Background: With substance use rates increasing in Sub-Saharan Africa (SSA), an understanding of the accessibility and effectiveness of rehabilitative services for people who use alcohol and other drugs (AOD) is critical in the global efforts to diagnose and treat substance use disorders (SUD). This scoping review seeks to address the gaps in knowledge related to the types of research that have been conducted regarding inpatient or residential SUD treatment in SSA, the settings in which the research was conducted, and the study countries.

Methods: A search of three databases, PubMED, Scopus, and African Index Medicus, was conducted for publications related to the treatment of SUD in inpatient or residential settings in SSA.

Supervised smoking facility access, harm reduction practices, and substance use changes during the COVID-19 pandemic: a community-engaged cross-sectional study.

Background: The potential public health benefits of supervised smoking facilities (SSFs) are considerable, and yet implementation of SSFs in North America has been slow. We conducted this study to respond to significant knowledge gaps surrounding SSF utilization and to characterize substance use, harm reduction practices, and service utilization following the onset of the COVID-19 pandemic.

Methods: A questionnaire was self-administered at a single site by 175 clients using an outdoor SSF in Vancouver, Canada, between October-December 2020.

Socioeconomic marginalization and risk of overdose in a community-recruited cohort of people who use drugs: A longitudinal analysis.

Background: Poverty and socioeconomic disadvantage are important contributors to drug-related harm, but their precise role in overdose risk remains poorly understood. We sought to examine linkages between socioeconomic marginalization and non-fatal overdose risk in a community deeply affected by the ongoing drug poisoning crisis.

Methods: This observational study used data derived from two community-recruited prospective cohorts of people who use drugs (PWUD) in Vancouver, British Columbia, Canada.

A Qualitative Assessment of the Treatment Needs of Women with Concurrent Eating and Substance Use Disorders in a Residential Setting.

Eating and substance use disorders (SUD) are generally treated separately, leaving eating disorders (ED) overlooked within substance use treatment. The frequent co-occurrence of SUD and ED is well documented. Despite their many similarities and frequent co-occurrence, these two disorder types continue to be largely treated separately-either sequentially, with the most severe disorder addressed first, or concurrently but in separate programs.

"That Line Just Kept Moving": Motivations and Experiences of People Who Use Methamphetamine.

Introduction: Methamphetamine use is on the rise with increasing emergency department (ED) visits, behavioral health crises, and deaths associated with use and overdose. Emergency clinicians describe methamphetamine use as a significant problem with high resource utilization and violence against staff, but little is known about the patient's perspective. In this study our objective was to identify the motivations for initiation and continued methamphetamine use among people who use methamphetamine and their experiences in the ED to guide future ED-based approaches.

"Another tool in the toolkit"-Perceptions, suggestions, and concerns of emergency service providers about the implementation of a supervised consumption site.

Background: As Supervised Consumption Sites (SCS) are implemented in the United States, it is important to consider the needs and perceptions of impacted stakeholders. Emergency service providers (ESP) have a central role in responding to the overdose epidemic. This study intended to assess the how ESP perceive the potential implementation of an SCS in their community, as well as solicit program design and implementation-related concerns and suggestions.

Pathways connecting socioeconomic marginalization and overdose: A qualitative narrative synthesis.

Purpose: This qualitative narrative synthesis sought to identify pathways connecting socioeconomic marginalization (SEM) and overdose for people who use drugs.

Methods: We included studies with qualitative examination of SEM and fatal and non-fatal overdose published in English between 2000 and 2021. Studies were systematically identified and screened by searching MEDLINE (Ovid), Embase (Ovid), PsycINFO (EBSCOhost), CINAHL (EBSCOhost), Google Scholar, Cochrane Central Registry of Controlled Trials (CENTRAL), and Cochrane Drug and Alcohol Group (CDAG) Specialized Registry, citations, and contacting experts.

Grouping Public Health Skills to Facilitate Workforce Development: A Factor Analysis of PH WINS.

Objectives: This study examined whether distinct factors exist among public health skills, measured through the Public Health Workforce Interests and Needs Survey (PH WINS). Understanding how workforce training needs group is important for developing targeted and appropriate public health workforce training sessions.

Design: Exploratory factor analysis was used to examine public health skills among tier 1 staff (nonmanagers) and a combined group of tier 2 and 3 staff (managers and executives).

The DASH model: Data for addressing social determinants of health in local health departments.

Recent frameworks, models, and reports highlight the critical need to address social determinants of health for achieving health equity in the United States and around the globe. In the United States, data play an important role in better understanding community-level and population-level disparities particularly for local health departments. However, data-driven decision-making-the use of data for public health activities such as program implementation, policy development, and resource allocation-is often presented theoretically or through case studies in the literature.

Parental and own substance use disorder: The intersection of gender and early adversity.

Background: Children who are exposed to parental substance use disorder (SUD) have a higher risk of SUD themselves. This study examines the extent to which the association between parental and own SUD is conditional upon childhood trauma, socioeconomic status, and gender.

Methods: This study uses data from the Nashville Stress and Health Study with 1234 respondents ages 25-65 collected from 2011 to 2014, weighted be representative of the general population.

Legalization of cannabis in Canada-Local media analysis.

Background And Objectives: Legalization of recreational cannabis is occurring across the United States, with some controversy. To understand the range of issues that can arise when such a policy change is enacted, we examined portrayal of legalization at the local level by studying newspaper articles in Calgary, Alberta, shortly before and after cannabis legalization in Canada.

Method: We searched the largest-circulation newspaper for cannabis-related items and analyzed for content and slant toward cannabis legalization.

Mental disorder and opioid overdose: a systematic review.

Purpose: This systematic review summarizes and presents the current state of research quantifying the relationship between mental disorder and overdose for people who use opioids.

Methods: The protocol was published in Open Science Framework. We used the PECOS framework to frame the review question.

Using passive surveillance technology for overdose prevention: Key ethical and implementation issues.

Passive surveillance technology has the potential to increase safety through monitoring spaces where people are at risk of overdose. One key opportunity for the use of passive surveillance technology to prevent overdose fatality is in bathrooms where people may be using drugs. However, uncertainty remains with regards to how to attain informed consent, implications for data storage and privacy and potential negative socio-legal ramifications for people who use drugs.

Geographic Differences in Cannabis Conversations on Twitter: Infodemiology Study.

Background: Infodemiology is an emerging field of research that utilizes user-generated health-related content, such as that found in social media, to help improve public health. Twitter has become an important venue for studying emerging patterns in health issues such as substance use because it can reflect trends in real-time and display messages generated directly by users, giving a uniquely personal voice to analyses. Over the past year, several states in the United States have passed legislation to legalize adult recreational use of cannabis and the federal government in Canada has done the same.

Socioeconomic marginalization and opioid-related overdose: A systematic review.

Background: Socioeconomic marginalization (SEM) is an important but under-explored determinant of opioid overdose with important implications for health equity and associated public policy initiatives. This systematic review synthesizes evidence on the role of SEM in both fatal and non-fatal overdose among people who use opioids.

Methods: Studies published between January 1, 2000 and March 31, 2018 were identified through searching electronic databases, citations, and by contacting experts.

Unique roles of childhood poverty and adversity in the development of lifetime co-occurring disorder.

Gender differences in stressors that affect the development of co-occurring psychiatric and substance use disorders (COD) have been given inadequate attention, despite evidence that women and men commonly develop different types of both psychiatric disorder and substance use disorders and have different experiences of illness and treatment. This paper assesses early life antecedents of COD, specifically childhood poverty and childhood adversity, and how they vary by gender. Weighted multinomial logistic regressions were conducted with the National Epidemiologic Survey of Alcohol and Related Conditions-III (NESARC-III) (n = 33,676) nationally representative data from 2014-2015 to assess whether antecedents of COD are conditional on gender.

Material security and adherence to antiretroviral therapy among HIV-positive people who use illicit drugs.

Objective: To examine the relationship between poverty, operationalized using a novel material security measure, and adherence to antiretroviral therapy (ART) among people who use illicit drugs (PWUD) in a context of universal access to HIV care.

Design: We analyzed data from a community-recruited prospective cohort in Vancouver, Canada (n = 623), from 2014 to 2017.

Methods: We used multivariable generalized mixed-effects analyses to estimate longitudinal factors associated with mean material security score.