Four Competing Definitions of Morphine Equivalence Insidiously Inhibit Evidence Synthesis

Analysis of opioid milligrams of morphine equivalents (MME) per day definitions. Presented virtually at the 37th annual International Conference on Pharmacoepidemiology and Therapeutic Risk Management

Treatment experiences for skin and soft tissue infections among participants of syringe service programs in North Carolina

Introduction: Bacterial and fungal infections, such as skin and soft tissue infections (SSTIs) and infective endocarditis (IE), are increasing among people who use drugs in the United States. Traditional healthcare settings can be inaccessible and unwelcoming to people who use drugs, leading to delays in getting necessary care. The objective of this study was to examine SSTI treatment experiences among people utilizing services from syringe services programs. This study was initiated by people with lived experience of drug use to improve quality of care. Methods: We conducted a cross-sectional survey among participants of five syringe services programs in North Carolina from July through September 2020. Surveys collected information on each participant’s history of SSTIs and IE, drug use and healthcare access characteristics, and SSTI treatment experiences. We examined participant characteristics using counts and percentages. We also examined associations between participant characteristics and SSTI history using binomial linear regression models. Results: Overall, 46% of participants reported an SSTI in the previous 12 months and 10% reported having IE in the previous 12 months. Those with a doctor they trusted with drug use-related concerns had 27 fewer (95% confidence interval = − 51.8, − 2.1) SSTIs per every 100 participants compared to those without a trusted doctor. Most participants with a SSTI history reported delaying (98%) or not seeking treatment (72%) for their infections. Concerns surrounding judgment or mistreatment by medical staff and self-treating the infection were common reasons for delaying or not seeking care. 13% of participants used antibiotics obtained from sources other than a medical provider to treat their most recent SSTI. Many participants suggested increased access to free antibiotics and on-site clinical care based at syringe service programs to improve treatment for SSTIs. Conclusions: Many participants had delayed or not received care for SSTIs due to poor healthcare experiences. However, having a trusted doctor was associated with fewer people with SSTIs. Improved access to non-judgmental healthcare for people who use drugs with SSTIs is needed. Expansion of syringe services program-based SSTI prevention and treatment programs is likely a necessary approach to improve outcomes among those with SSTI and IE

Skin and Soft Tissue Infection Experiences and Treatment Needs among Syringe Service Program Participants

Skin and soft tissue infections include abscesses and cellulitis. These infections can result in serious health complications among people who use drugs, particularly if high-quality treatment is unavailable. Traditional healthcare treatment settings are often unwelcoming and inaccessible to people who use drugs, potentially leading to delays in getting necessary care. Our team conducted a health needs assessment among participants of five syringe services programs in North Carolina. Representatives from the syringe services programs administered surveys during July through September 2020. Participants were asked about their experiences with skin and soft tissue infections, healthcare experiences associated with these infections, and recommendations to improve quality of care. This project was conceptualized and led by people with lived experience of drug use. This project includes a survey tool that was designed by a multidisciplinary team with expertise in a wide range of fields. Team members include those with lived experience of drug use and those with training in public health, epidemiology, clinical care, and qualitative research. Additional survey results are forthcoming