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The effectiveness of substance use interventions for homeless and vulnerably housed persons: A systematic review of systematic reviews on supervised consumption facilities, managed alcohol programs, and pharmacological agents for opioid use disorder

Magwood, Olivia ; Salvalaggio, Ginetta ; Beder, Michaela ; Kendall, Claire ; Kpade, Victoire ; Daghmach, Wahab ; Habonimana, Gilbert ; Marshall, Zack ; Snyder, Ellen ; O'Shea, Tim ; Lennox, Robin ; Hsu, Helen ; Tugwell, Peter ; Pottie, Kevin Le Foll, Bernard

PloS one, 2020-01, Vol.15 (1), p.e0227298 [Periódico revisado por pares]

United States: Public Library of Science

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Título:
The effectiveness of substance use interventions for homeless and vulnerably housed persons: A systematic review of systematic reviews on supervised consumption facilities, managed alcohol programs, and pharmacological agents for opioid use disorder
Autor: Magwood, Olivia ; Salvalaggio, Ginetta ; Beder, Michaela ; Kendall, Claire ; Kpade, Victoire ; Daghmach, Wahab ; Habonimana, Gilbert ; Marshall, Zack ; Snyder, Ellen ; O'Shea, Tim ; Lennox, Robin ; Hsu, Helen ; Tugwell, Peter ; Pottie, Kevin
Le Foll, Bernard
Assuntos: Alcohol ; Alcohol use ; Alcohol-Related Disorders - epidemiology ; Alcohol-Related Disorders - rehabilitation ; Alcohols ; Biology and Life Sciences ; Consumption ; Drinking (Alcoholic beverages) ; Drinking behavior ; Drinking of alcoholic beverages ; Drug addiction ; Drug overdose ; Drug Overdose - epidemiology ; Drug Overdose - prevention & control ; Drug use ; Earth Sciences ; Epidemiology ; Equity method ; Grey literature ; Handbooks ; Harm Reduction ; Health aspects ; Health care access ; Health Services Accessibility - organization & administration ; Health Services Accessibility - statistics & numerical data ; Homeless people ; Homeless persons ; Homelessness ; Housing - organization & administration ; Housing - statistics & numerical data ; Humans ; Ill-Housed Persons - psychology ; Ill-Housed Persons - statistics & numerical data ; Intervention ; Literature reviews ; Medicine ; Medicine and Health Sciences ; Mental disorders ; Methadone ; Morbidity ; Mortality ; Narcotic Antagonists - therapeutic use ; Narcotics ; Observational Studies as Topic ; Opiate Substitution Treatment - methods ; Opiate Substitution Treatment - statistics & numerical data ; Opiates ; Opioid abuse ; Opioid-Related Disorders - epidemiology ; Opioid-Related Disorders - rehabilitation ; Opioids ; Overdose ; Pharmacology ; Population ; Populations ; Prevalence ; Primary care ; Program Evaluation ; Public health ; Research and Analysis Methods ; Reviews ; Risk behavior ; Risk reduction ; Risk taking ; Social Sciences ; Studies ; Substance abuse ; Substance abuse treatment ; Substance use ; Substance use disorder ; Systematic review ; Systematic Reviews as Topic ; Treatment Outcome ; Vulnerable Populations - psychology ; Vulnerable Populations - statistics & numerical data ; Well being ; Working groups
É parte de: PloS one, 2020-01, Vol.15 (1), p.e0227298
Notas: Competing Interests: Kevin Pottie, Ginetta Salvalaggio, Claire Kendall and Peter Tugwell are principal investigators in an ongoing project to develop Canadian evidence-based guidelines for providing social programs and healthcare services to people who are homeless and vulnerably housed. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
Descrição: Substance use is disproportionately high among people who are homeless or vulnerably housed. We performed a systematic overview of reviews examining the effects of selected harm reduction and pharmacological interventions on the health and social well-being of people who use substances, with a focus on homeless populations. We searched MEDLINE, EMBASE, PsycINFO, Joanna Briggs Institute EBP, Cochrane Database of Systematic Reviews and DARE for systematic reviews from inception to August 2019. We conducted a grey literature search and hand searched reference lists. We selected reviews that synthesized evidence on supervised consumption facilities, managed alcohol programs and pharmacological interventions for opioid use disorders. We abstracted data specific to homeless or vulnerably housed populations. We assessed certainty of the evidence using the GRADE approach. Our search identified 483 citations and 30 systematic reviews met all inclusion criteria, capturing the results from 442 primary studies. This included three reviews on supervised consumption facilities, 24 on pharmacological interventions, and three on managed alcohol programs. Supervised consumption facilities decreased lethal overdoses and other high risk behaviours without any significant harm, and improved access to care. Pharmaceutical interventions reduced mortality, morbidity, and substance use, but the impact on retention in treatment, mental illness and access to care was variable. Managed alcohol programs reduced or stabilized alcohol consumption. Few studies on managed alcohol programs reported deaths. Substance use is a common chronic condition impacting homeless populations. Supervised consumption facilities reduce overdose and improve access to care, while pharmacological interventions may play a role in reducing harms and addressing other morbidity. High quality evidence on managed alcohol programs is limited.
Editor: United States: Public Library of Science
Idioma: Inglês

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The effectiveness of substance use interventions for homeless and vulnerably housed persons: A systematic review of systematic reviews on supervised consumption facilities, managed alcohol programs, and pharmacological agents for opioid use disorder

Magwood, Olivia ; Salvalaggio, Ginetta ; Beder, Michaela ; Kendall, Claire ; Kpade, Victoire ; Daghmach, Wahab ; Habonimana, Gilbert ; Marshall, Zack ; Snyder, Ellen ; O'Shea, Tim ; Lennox, Robin ; Hsu, Helen ; Tugwell, Peter ; Pottie, Kevin Le Foll, Bernard

United States: Public Library of Science

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