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Abstract：
Most of the existing research on supervised consumption services (SCS) is focused on injection drug use. Less is known about the applicability of SCS for people who consume drugs orally, intranasally, or through inhalation. This is problematic because people who use drugs through modes other than injection are also at risk of overdose death and other harm, and experience barriers accessing health and social services. We aimed to describe existing SCS models that accommodate these alternate routes of drug consumption, and synthesize available information on characteristics of program participants.
We conducted a systematic scoping review of 9 peer-reviewed and 13 grey literature databases on SCS that incorporate non-injection routes of consumption. We screened 22,882 titles, and excluded 22,843 (99.8%) articles. We ultimately included 39 (0.2%) full-text articles; 28 (72%) of these articles explicitly identified SCS that permit alternate routes of consumption and 21 (54%) discussed characteristics of participants who consume drugs through non-injection routes. Data on study characteristics, terms and definitions, and site and program participant characteristics were extracted and double-coded. Extracted data were analyzed using descriptive statistics and narrative synthesis.
Included articles describe 48 SCS that permit non-injection routes of consumption, most of which were located in Germany. The majority of these SCS were legally sanctioned and had models of care that were largely comparable to supervised injection services. Notable differences included physical infrastructure such as ventilated rooms or outdoor areas to accommodate inhalation, and shorter time limits on non-injection drug consumption episodes. Program participants engaging in non-injection forms of consumption were typically men over the age of 30 and structurally vulnerable (e.g., experiencing homelessness or unstable housing).
Extant academic and grey literature indicates that site characteristics and demographics of program participants of SCS that permit non-injection routes of consumption largely reflect those of supervised injection services. Further research on the range of existing SCS that incorporate non-injection routes of consumption is needed to ensure high quality service provision, and improved health outcomes for people who consume drugs via oral, intranasal, and inhalation routes.
We conducted a systematic scoping review of 9 peer-reviewed and 13 grey literature databases on SCS that incorporate non-injection routes of consumption. We screened 22,882 titles, and excluded 22,843 (99.8%) articles. We ultimately included 39 (0.2%) full-text articles; 28 (72%) of these articles explicitly identified SCS that permit alternate routes of consumption and 21 (54%) discussed characteristics of participants who consume drugs through non-injection routes. Data on study characteristics, terms and definitions, and site and program participant characteristics were extracted and double-coded. Extracted data were analyzed using descriptive statistics and narrative synthesis.
Included articles describe 48 SCS that permit non-injection routes of consumption, most of which were located in Germany. The majority of these SCS were legally sanctioned and had models of care that were largely comparable to supervised injection services. Notable differences included physical infrastructure such as ventilated rooms or outdoor areas to accommodate inhalation, and shorter time limits on non-injection drug consumption episodes. Program participants engaging in non-injection forms of consumption were typically men over the age of 30 and structurally vulnerable (e.g., experiencing homelessness or unstable housing).
Extant academic and grey literature indicates that site characteristics and demographics of program participants of SCS that permit non-injection routes of consumption largely reflect those of supervised injection services. Further research on the range of existing SCS that incorporate non-injection routes of consumption is needed to ensure high quality service provision, and improved health outcomes for people who consume drugs via oral, intranasal, and inhalation routes.
摘要：
现有的大多数关于监督消费服务（SCS）的研究都集中在注射药物使用上。关于SCS对口服药物的适用性知之甚少，鼻内,或通过吸入。这是有问题的，因为通过注射以外的方式使用药物的人也有过量死亡和其他伤害的风险，并在获得健康和社会服务方面遇到障碍。我们旨在描述现有的SCS模型，以适应这些替代的药物消费途径，并综合有关计划参与者特征的可用信息。
我们对纳入非注射消费途径的SCS的9个同行评审数据库和13个灰色文献数据库进行了系统范围审查。我们筛选了22,882个标题，并排除了22,843（99.8％）的文章。我们最终纳入了39篇（0.2％）全文文章；这些文章中有28篇（72％）明确确定了允许替代消费途径的SCS，有21篇（54％）讨论了通过非注射途径消费药物的参与者的特征。有关研究特征的数据，术语和定义，并提取站点和计划参与者的特征并进行双重编码。提取的数据使用描述性统计和叙述性综合进行分析。
包括的文章描述了48种允许非注射消费途径的SCS，其中大部分位于德国。这些SCS中的大多数都受到法律制裁，并且具有与有监督的注射服务相当的护理模式。显著的差异包括物理基础设施，如通风房间或室外区域，以适应吸入，和更短的时间限制非注射药物消费事件。参与非注射形式消费的计划参与者通常是30岁以上且结构脆弱的男性(例如，经历无家可归或不稳定的住房)。
现有的学术和灰色文献表明，允许非注射消费途径的SCS计划参与者的站点特征和人口统计在很大程度上反映了监督注射服务的特征。需要进一步研究纳入非注射消费路线的现有SCS范围，以确保提供高质量的服务，并改善通过口服药物消费的人的健康结果，鼻内,和吸入途径。
我们对纳入非注射消费途径的SCS的9个同行评审数据库和13个灰色文献数据库进行了系统范围审查。我们筛选了22,882个标题，并排除了22,843（99.8％）的文章。我们最终纳入了39篇（0.2％）全文文章；这些文章中有28篇（72％）明确确定了允许替代消费途径的SCS，有21篇（54％）讨论了通过非注射途径消费药物的参与者的特征。有关研究特征的数据，术语和定义，并提取站点和计划参与者的特征并进行双重编码。提取的数据使用描述性统计和叙述性综合进行分析。
包括的文章描述了48种允许非注射消费途径的SCS，其中大部分位于德国。这些SCS中的大多数都受到法律制裁，并且具有与有监督的注射服务相当的护理模式。显著的差异包括物理基础设施，如通风房间或室外区域，以适应吸入，和更短的时间限制非注射药物消费事件。参与非注射形式消费的计划参与者通常是30岁以上且结构脆弱的男性(例如，经历无家可归或不稳定的住房)。
现有的学术和灰色文献表明，允许非注射消费途径的SCS计划参与者的站点特征和人口统计在很大程度上反映了监督注射服务的特征。需要进一步研究纳入非注射消费路线的现有SCS范围，以确保提供高质量的服务，并改善通过口服药物消费的人的健康结果，鼻内,和吸入途径。
