Intravenous injection of oral morphine: what do users say?
Results of the online survey assessing the needs and expectations of intravenous oral morphine users regarding a possible trial of injectable opioid substitution.
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This online open survey was conducted from 23/03/2020 to 01/04/2021. The questionnaire was drafted jointly by the Medical Pharmacology Service of the University Hospital of Clermont-Ferrand, and the associative platform "PsychoACTIF". The latter offers a blog and a French-speaking forum on risk and harm reduction (RHR) in open access, which constitutes a dematerialized space of solidarity between consumers of psychoactive products. This survey was approved by the South-East VI Committee for the Protection of Persons and registered under the ethical notice number 2022/CE25. Users were free to participate anonymously, spontaneously and voluntarily in the survey. The link led to a page recalling the purpose of the survey and asking for the respondent's consent. Once this consent was obtained, the questionnaire began with three mandatory inclusion questions aimed at confirming the use of oral morphine by intravenous route in France. The survey was continued by collecting demographic data, information on the morphine used and its supply, the injection preparation methods and the existence of substance co-consumption and occurrence of health complications associated with morphine injection. The survey concluded by collecting respondents' opinions and comments on the possibility of injectable substitution. Answers to the 32 questions marked with an asterisk in the questionnaire were required to proceed to the next questions. The questionnaire was adapted to the users' answers to the previous items to target the questions that concerned them. This adaptability reduced the time required to complete the survey and promoted its completeness. Once the questions were validated, respondents did not have the technical ability to correct their previous responses. When an "Other" item was checked, respondents were offered a free text box to provide any clarification. This free text box was accompanied by an alert telling users not to enter any information that would remove their anonymity. Responses were collected using REDCap® software, allowing for electronic data acquisition and security. The REDCap web platform (https://project-redcap.org) possesses the authorization of the French personal data protection authority. In order to guarantee respondent anonymity, no IP addresses and/or tracking cookies were collected for this survey. In order to preserve the anonymity of the respondents as much as possible, it was necessary to manually check for the existence of duplicates and/or multiple respondents by comparing the dates and times of connection to the questionnaire and the proximity of the responses provided.