Spotting as a risk mitigation method: A qualitative study comparing organization-based and informal methods

Melissa Perri; Adrian Guta; Nat Kaminski; Matthew Bonn; Gillian Kolla; Ahmed Bayoumi; Laurel Challacombe; Natasha Touesnard; Marilou Gagnon; Patrick McDougall; Carol Strike

doi:10.1016/j.drugpo.2022.103905

Spotting as a risk mitigation method: A qualitative study comparing organization-based and informal methods

Int J Drug Policy. 2023 Jan:111:103905. doi: 10.1016/j.drugpo.2022.103905. Epub 2022 Nov 12.

Authors

Affiliations

¹ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
² School of Social Work, University of Windsor, Windsor, ON, Canada.
³ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Canadian Association of People Who Use Drugs, Dartmouth, Nova Scotia, Canada.
⁴ Canadian Association of People Who Use Drugs, Dartmouth, Nova Scotia, Canada; Canadian Students for Sensible Drug Policy, Canada.
⁵ Canadian Institute for Substance Use Research, Victoria, British Columbia, Canada.
⁶ MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of General Internal Medicine, Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁷ CATIE, Toronto, Ontario, Canada.
⁸ Canadian Association of People Who Use Drugs, Dartmouth, Nova Scotia, Canada.
⁹ Dr. Peter AIDS Foundation, Vancouver, British Columbia, Canada.
¹⁰ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, ON, Canada. Electronic address: carol.strike@utoronto.ca.

PMID: 36379109
DOI: 10.1016/j.drugpo.2022.103905

Abstract

Objectives: To explore the similarities and differences of organization-based and informal spotting (remote supervision of substance use) from the perspectives of spotters and spottees across Canada.

Methods: Spotters and spottees who spot informally and for organizations were recruited across Ontario and Nova Scotia. We interviewed 20 informal and 10 organization-based participants by phone using semi-structured interviews between 08/2020 and 11/2020. Participants were asked about each methods benefits and limitations. Interviews were audio-recorded, transcribed, and analyzed thematically.

Results: Benefits of informal spotting included its ability to strengthen social connections and foster autonomy in overdose response planning. The lack of support for informal spotters created stress and burnout. Organization-based spotters enjoyed the spotting training and support provided. However, regulations surrounding having to call ambulance in overdose events deterred many people from wanting to work for or call these services.

Conclusions: Both organization-based and informal spotting have a role in mitigating harms associated with the overdose crisis. Moving forward, further research is needed on how to optimize these services for all people who use drugs in varying jurisdictions internationally.

Keywords: COVID-19; Harm reduction; Overdose response; Spotting.

MeSH terms

Drug Overdose* / prevention & control
Harm Reduction
Humans
Ontario
Organizations
Qualitative Research
Substance-Related Disorders*