Historique
Article de Périodique
Pipes as an engagement tool: qualitative findings from a crack equipment and harm reduction training intervention in England (2026)
Auteur(s) :
SHARPE, C. ;
BUSZA, J. ;
VUCKOVIC, C. ;
SCOTT, J. ;
HOPE, V. ;
SOUTHWELL, M. ;
WILKINS, L. ;
PLATT, L. ;
HARRIS, M.
Année
2026
Page(s) :
art. 105165
Langue(s) :
Anglais
Domaine :
Drogues illicites
Thésaurus géographique
ANGLETERRE
;
ROYAUME-UNI
Thésaurus mots-clés
CRACK
;
MATERIEL LIE A L'USAGE
;
REDUCTION DES RISQUES ET DES DOMMAGES
;
ETUDE QUALITATIVE
;
INTERVENTION
;
FORMATION
;
INTERVENANT
;
USAGER
;
PRISE EN CHARGE
Résumé :
Background: Crack cocaine use is increasingly prevalent in England, yet drug services are poorly equipped to support the needs of this population. Provision of stimulant inhalation equipment is prohibited, and workforce crack-related harm reduction knowledge is generally low. The Safe Inhalation Pipe Provision (SIPP) project piloted a crack inhalation equipment and training intervention in England. This paper explores how and in what way crack training and equipment provision influences engagement with drug service providers.
Methods: SIPP is a mixed-method study, comprising a before-and-after survey, service monitoring data, qualitative interviews, focus groups, and observations. Here we report qualitative data generated with people who use crack and providers at three intervention and three comparison group sites. We conducted a thematic analysis and report themes specific to contact and engagement with drug services.
Results: Prior to intervention implementation, little adequate crack-specific support was identified. SIPP equipment provision facilitated increased contact and/or disclosure of crack use with services. Workforce training enhanced communication and relationship-building opportunities, enabling disclosure of additional need and commensurate provision or linkage to health and social supports. The capacity for contact to facilitate engagement was impacted by organisational and structural constraints, and for some populations barriers to access remain entrenched.
Conclusions: Provision of crack inhalation equipment can facilitate new contacts with services among a highly marginalised population. Complementary workforce training helps to enable relationship building and engagement opportunity. Additional methods of provision, including through peer networks, are required to support people for whom barriers to service access remain.
Trial registration: ISRCTN12541454 https://doi.org/10.1186/ISRCTN12541454. [Author's abstract]
Highlights:
Crack cocaine support is structurally deprioritised in English drug services.
We report on a crack equipment and training pilot implemented with police support.
Equipment increased contact with services and disclosure among people who use crack.
Workforce training improved staff competency, enabling client engagement.
Engagement helped clients disclose unmet need, enabling service support and referral.
Methods: SIPP is a mixed-method study, comprising a before-and-after survey, service monitoring data, qualitative interviews, focus groups, and observations. Here we report qualitative data generated with people who use crack and providers at three intervention and three comparison group sites. We conducted a thematic analysis and report themes specific to contact and engagement with drug services.
Results: Prior to intervention implementation, little adequate crack-specific support was identified. SIPP equipment provision facilitated increased contact and/or disclosure of crack use with services. Workforce training enhanced communication and relationship-building opportunities, enabling disclosure of additional need and commensurate provision or linkage to health and social supports. The capacity for contact to facilitate engagement was impacted by organisational and structural constraints, and for some populations barriers to access remain entrenched.
Conclusions: Provision of crack inhalation equipment can facilitate new contacts with services among a highly marginalised population. Complementary workforce training helps to enable relationship building and engagement opportunity. Additional methods of provision, including through peer networks, are required to support people for whom barriers to service access remain.
Trial registration: ISRCTN12541454 https://doi.org/10.1186/ISRCTN12541454. [Author's abstract]
Highlights:
Crack cocaine support is structurally deprioritised in English drug services.
We report on a crack equipment and training pilot implemented with police support.
Equipment increased contact with services and disclosure among people who use crack.
Workforce training improved staff competency, enabling client engagement.
Engagement helped clients disclose unmet need, enabling service support and referral.
Affiliation :
Department for Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
Public Health Institute and School of Public and Allied Health, Liverpool John Moores University, Liverpool, UK
Coact, Bath, UK
The Health Shop, Nottingham, UK
Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
Public Health Institute and School of Public and Allied Health, Liverpool John Moores University, Liverpool, UK
Coact, Bath, UK
The Health Shop, Nottingham, UK