Evidence map›Paper›PMID 36996860›Full record

SynthesisThe Lancet. Global health2023

Global coverage of interventions to prevent and manage drug-related harms among people who inject drugs: a systematic review.

Samantha Colledge-Frisby, Sophie Ottaviano, Paige Webb, Jason Grebely, Alice Wheeler, Evan B Cunningham, Behzad Hajarizadeh, Janni Leung, Amy Peacock, Peter Vickerman and 4 more

Erratum issuedAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Lancet. Global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 80 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Samantha Colledge-FrisbyNational Drug Research Institute Melbourne, Curtin University, Melbourne, VIC, Australia; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia. Electronic address: s.colledge@curtin.edu.au.
Sophie OttavianoNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
Paige WebbNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
Jason GrebelyThe Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Alice WheelerThe Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Evan B CunninghamThe Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Behzad HajarizadehThe Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Janni LeungNational Centre for Youth Substance Use Research, University of Queensland, Brisbane, QLD, Australia.
Amy PeacockNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
Peter VickermanPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Michael FarrellNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
Gregory J DoreThe Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Matthew HickmanPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Louisa DegenhardtNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.

Funding

Optimizing HIV prevention portfolios targeting people who inject drugs using dynamic economic modelingR01AI147490 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MARTIN, NATASHA · 2019 to 2022
$2.3M
Modeling Structural HIV Determinants in Substance Users and related populationsR01DA037773 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MARTIN, NATASHA, STRATHDEE, STEFFANIE A. · 2015 to 2017
$1.4M
Using existing data to understand and ameliorate risk in opioid agonist therapyR01DA044170 · NIDA · UNIVERSITY OF NEW SOUTH WALES · PI DEGENHARDT, LOUISA · 2017 to 2019
$641k
Department of HealthMedical Research Council MR/N00616X/1NIAID NIH HHS R01 AI147490NIDA NIH HHS R01 DA037773NIDA NIH HHS R01 DA044170
6 · The paper itself

Abstract

backgroundHarm reduction and treatment programmes are essential for reducing harms for people who inject drugs (PWID). We aimed to update estimates from a 2017 review of global coverage of needle and syringe exchange programmes (NSPs), opioid agonist treatment (OAT), and other harm reduction services that target PWID (eg, take-home naloxone [THN] programmes, supervised consumption facilities, and drug checking services).

methodsWe did a systematic review of available evidence from peer-reviewed and grey literature databases for studies published between Jan 1, 2017, and May 31, 2022. Programmatic data were collected on the availability of services, the number of sites, people accessing services, and equipment distributed in countries where there is evidence of injecting drug use. National estimates of coverage of OAT (ie, number of people accessing OAT per 100 PWID) and NSPs (ie, number of needles and syringes distributed per PWID per year) were generated where available using the most recent data. Regional and global estimates were derived and compared with WHO indicators. The study was registered with PROSPERO (CRD42020173974).

findingsWe included 195 studies and found there were 90 countries implementing OAT (75% of the PWID population) and 94 countries implementing NSPs (88% of the global PWID population). Only five countries (2% of the global PWID population) are providing high coverage of both services. Far fewer countries were implementing THN programmes (n=43), supervised consumption facilities (n=17), and drug checking services (n=26), with nine countries implementing all five services. Globally, we estimated there were 18 (95% uncertainty interval [UI] 12-27) people accessing OAT per 100 PWID, and 35 (95% UI 24-52) needles and syringes being distributed per person who injects drugs per year. More countries reported high (OAT 24; NSPs 10), moderate (OAT 8; NSPs 15), and low (OAT 38; NSPs 47) coverage of services compared with the previous review.

interpretationGlobal coverage of OAT and NSPs has increased modestly in the past 5 years but remains low for most countries. Programmatic data on other key harm reduction interventions are scarce.

fundingAustralian National Health and Medical Research Council.

Indexed as

Drug UsersHIV InfectionsSubstance Abuse, IntravenousSubstance-Related DisordersAustraliaHarm ReductionHumans

Identifiers

PMID36996860
PMCPMC12765503

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.