Stigma of a drug use prevention strategy and feasibility of implementation in Baltimore City: a qualitative study

Abstract

Executive Summary The stigma of an Australian drug use prevention strategy and feasibility of implementation in Baltimore City. Problem In 2016, 20.1 million Americans 12 or older had a substance use disorder, while 948,000 had a substance use disorder that involved heroin. In Maryland, the number of heroin-related deaths jumped from 534 in 2015 people to 918 people in 2016 alone. By 2017, there were a reported 2,009 opioid related deaths in Maryland. In Baltimore City, the number of heroin-related deaths rose from 260 in 2015 to 454 in 2016. Baltimore City had by far the most opioid related deaths of any jurisdiction with 761 in 2017. This increase is due to several factors. One of these factors is the rising issue with prescription opioids. These medications are widely prescribed to treat conditions such as chronic pain. Opioid addiction often leads to heroin use which is cheaper for the same effects. Goal The goal of this research was to understand the stigma surrounding the use of a safe injection facility (SIF) and the feasibility of implementing the drug prevention strategy in Baltimore City. Objectives The first objective of the study was to understand the effectiveness of SIFs through observations of a SIF and current literature from studies on SIFs. The second objective of the study was to study the beliefs and attitudes about SIFs to understand the stigma surrounding the use of a SIF through an interview with a staff member of the SIF in Sydney, Australia, and interviews with community stakeholders in Baltimore City. Plan The study design was a case study. This case study used literature, observations, an interview with a health professional at one SIF in Kings Cross, Sydney, Australia, and interviews with stakeholders in Baltimore City. Outcomes The expected outcome was to have a better understanding of the use of a SIF in the community and the feasibility of implementation as a heroin use prevention strategy in Baltimore City. This research will be used to promote interest in SIFs and inform future research that will one day be used in establishing these centers in the US.