BACKGROUND The effectiveness of drug consumption rooms (DCRs) for people who inject drugs (PWID) has been demonstrated for HIV and hepatitis C virus risk practices, and access to care for substance use disorders. However, data on other health-related complications are scarce. Using data from the French COSINUS cohort, we investigated the impact of DCR exposure on non-fatal overdoses, abscesses and emergency department (ED) visits, all in the previous 6 months. METHODS COSINUS is a 12-month prospective cohort study of 665 PWID in France studying DCR effectiveness on health. We collected data from face-to-face interviews at enrolment, and at 6 and 12 months of follow-up. After adjusting for other correlates (P-value < 0.05), the impact of DCR exposure on each outcome was assessed using a two-step Heckman mixed-effects probit model, allowing us to adjust for potential non-randomization bias due to differences between DCR-exposed and DCR-unexposed participants, while taking into account the correlation between repeated measures. RESULTS At enrolment, 21%, 6% and 38% of the 665 participants reported overdoses, abscesses and ED visits, respectively. Multivariable models found that DCR-exposed participants were less likely to report overdoses [adjusted coefficient (95% CI): -0.47 (-0.88; -0.07), P = 0.023], abscesses [-0.74 (-1.11; -0.37), P < 0.001] and ED visits [-0.74 (-1.27; -0.20), P = 0.007]. CONCLUSION This is the first study to show the positive impact of DCR exposure on abscesses and ED visits, and confirms DCR effectiveness in reducing overdoses, when adjusting for potential non-randomization bias. Our findings strengthen the argument to expand DCR implementation to improve PWID injection environment and health.

中文翻译：

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吸毒室对法国注射吸毒者非致命过量、脓肿和急诊就诊的影响：来自 COSINUS 队列的结果。

背景 药物消费室 (DCR) 对注射吸毒者 (PWID) 的有效性已在 HIV 和丙型肝炎病毒风险实践以及获得物质使用障碍护理方面得到证明。然而，关于其他健康相关并发症的数据却很少。使用来自法国 COSINUS 队列的数据，我们调查了 DCR 暴露对非致命性药物过量、脓肿和急诊科 (ED) 就诊的影响，所有这些都是在过去 6 个月内发生的。方法 COSINUS 是一项为期 12 个月的前瞻性队列研究，研究对象是法国的 665 名注射吸毒者，研究 DCR 对健康的有效性。我们从注册时的面对面访谈以及 6 个月和 12 个月的随访中收集了数据。调整其他相关因素（P 值 < 0.05）后，使用两步 Heckman 混合效应概率模型评估 DCR 暴露对每个结果的影响，允许我们调整由于 DCR 暴露和 DCR 未暴露参与者之间的差异导致的潜在非随机化偏差，同时考虑重复测量之间的相关性。结果 在登记时，665 名参与者中分别有 21%、6% 和 38% 报告用药过量、脓肿和急诊就诊。多变量模型发现，暴露于 DCR 的参与者不太可能报告用药过量 [调整后的系数 (95% CI)：-0.47 (-0.88; -0.07)，P = 0.023]，脓肿 [-0.74 (-1.11; -0.37)， P < 0.001] 和急诊就诊 [-0.74 (-1.27; -0.20)，P = 0.007]。结论 这是第一项显示 DCR 暴露对脓肿和急诊就诊的积极影响的研究，并在调整潜在的非随机偏倚时证实了 DCR 在减少过量用药方面的有效性。