scholarly journals Opioid Use Among Those Who Have Criminal Justice Experience: Harm Reduction Strategies to Lessen HIV Risk

2018 ◽  
Vol 15 (3) ◽  
pp. 255-258 ◽  
Author(s):  
Lauren Brinkley-Rubinstein ◽  
David Cloud ◽  
Ernest Drucker ◽  
Nickolas Zaller
2017 ◽  
Vol 13 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Lauren Brinkley-Rubinstein ◽  
David H. Cloud ◽  
Chelsea Davis ◽  
Nickolas Zaller ◽  
Ayesha Delany-Brumsey ◽  
...  

Purpose The purpose of this paper is to discuss overdose among those with criminal justice experience and recommend harm reduction strategies to lessen overdose risk among this vulnerable population. Design/methodology/approach Strategies are needed to reduce overdose deaths among those with recent incarceration. Jails and prisons are at the epicenter of the opioid epidemic but are a largely untapped setting for implementing overdose education, risk assessment, medication assisted treatment, and naloxone distribution programs. Federal, state, and local plans commonly lack corrections as an ingredient in combating overdose. Harm reduction strategies are vital for reducing the risk of overdose in the post-release community. Findings Therefore, the authors recommend that the following be implemented in correctional settings: expansion of overdose education and naloxone programs; establishment of comprehensive medication assisted treatment programs as standard of care; development of corrections-specific overdose risk assessment tools; and increased collaboration between corrections entities and community-based organizations. Originality/value In this policy brief the authors provide recommendations for implementing harm reduction approaches in criminal justice settings. Adoption of these strategies could reduce the number of overdoses among those with recent criminal justice involvement.


2020 ◽  
Author(s):  
Sarahmona Przybyla ◽  
Catherine Cerulli ◽  
Jacob Bleasdale ◽  
Kennethea A. Wilson ◽  
Melissa Hordes ◽  
...  

Abstract Background: Women’s rise in opioid use disorder has increased their presence in the criminal justice system and related risk behaviors for HIV infection. Although pre-exposure prophylaxis (PrEP) is an effective biomedical HIV prevention treatment, uptake among this high-risk population has been particularly low. Considerably little is known about the interplay between justice-involved women with opioid use disorder and HIV prevention. The aim of this study was to explore PrEP knowledge, attitudes, and perceptions for personal and partner use among women participants in the nation’s first ever opiate intervention court program.Methods: The authors conducted semi-structured, in-depth interviews with 31 women recruited from an Opioid Intervention Court, a recent fast-track treatment response to combat overdose deaths. We utilized a consensual qualitative research approach to explore attitudes, perceptions, and preferences about PrEP from women at risk for HIV transmission via sexual and drug-related behavior and used thematic analysis methods to code and interpret the data. Results: PrEP interest and motivation were impacted by various factors influencing the decision to consider PrEP initiation or comfort with partner use. Three primary themes emerged regarding HIV risk perceptions, barriers and facilitators to personal PrEP utilization, and perspectives on PrEP use by sexual partners. Conclusions: Findings suggest courts may provide a venue to offer women PrEP education and HIV risk assessments. Study findings inform public health, substance use, and criminal justice research and practice with justice-involved participants experiencing opioid use disorder on the development of gender-specific PrEP interventions with the ultimate goal of reducing HIV incidence.


2019 ◽  
Vol 3 (1) ◽  
pp. e8-e21 ◽  
Author(s):  
Stephanie Knaak ◽  
Romie Christie ◽  
Sue Mercer ◽  
Heather Stuart

Background & Objective: Canada is in the midst of an opioid crisis. Given the sheer magnitude of the crisis and escalating death toll, the mobilization of harm reduction interventions is an important priority. Currently, little is known about the role played by stigmatization, particularly in terms of how this may impact the endorsement and uptake of harm reduction strategies and initiatives among front-line providers. Materials & Methods: Opening Minds, the anti-stigma initiative of the Mental Health Commission of Canada, undertook a one-and-a-half-year research project to understand the qualities, characteristics, sources, consequences, and solutions to the problem of stigmatization on the front-lines of the opioid crisis. A qualitative key informant design was selected. Participants included various first responder and health provider groups, people with lived experience of opioid or other drug use, and people in key policy or programming roles. Eight focus groups were held across Canada, and 15 one-on-one key informant interviews were completed. Results: Analysis of focus group and key informant interviews revealed three main ways in which stigma shows up on the front lines of the opioid crisis among providers. These themes coalesced around a central main problem, that of low compassion satisfaction. Suggestions for how these concerns can be addressed were also identified. Conclusion: The findings from this research revealed several key ways that stigma ‘shows up’ in the experiences and perceptions of front-line providers and provide several promising avenues for combatting stigmatization related to opioid use and harm reduction. An important avenue for future research is to develop and elaborate on the theoretical connections between the concepts of stigmatization and compassion satisfaction as a way to better understanding the problem of stigmatization in helping environments.


2020 ◽  
Author(s):  
Sarahmona Przybyla ◽  
Catherine Cerulli ◽  
Jacob Bleasdale ◽  
Kennethea A. Wilson ◽  
Melissa Hordes ◽  
...  

Abstract BackgroundWomen’s rise in opioid use disorder has increased their presence in the criminal justice system and related risk behaviors for HIV infection. Although pre-exposure prophylaxis (PrEP) is an effective biomedical HIV prevention treatment, uptake among this high-risk population has been particularly low. Considerably little is known about the interplay between justice-involved women with opioid use disorder and HIV prevention. The aim of this study was to explore PrEP knowledge, attitudes, and perceptions for personal and partner use among women participants in the nation’s first ever opioid intervention court program.MethodsThe authors conducted semi-structured, in-depth interviews with 31 women recruited from an Opioid Intervention Court,a recent fast-track treatment response to combat overdose deaths. We utilized a consensual qualitative research approach to explore attitudes, perceptions, and preferences about PrEP from women at risk for HIV transmission via sexual and drug-related behavior and used thematic analysis methods to code and interpret the data. ResultsPrEP interest and motivation were impacted by various factors influencing the decision to consider PrEP initiation or comfort with partner use. Three primary themes emerged: HIV risk perceptions, barriers and facilitators to personal PrEP utilization, and perspectives on PrEP use by sexual partners. Conclusions Findings suggest courts may provide a venue to offer women PrEP education and HIV risk assessments. Study findings inform public health, substance use, and criminal justice research and practice with justice-involved participants experiencing opioid use disorder on the development of gender-specific PrEP interventions with the ultimate goal of reducing HIV incidence.


Author(s):  
Sarahmona M. Przybyla ◽  
Catherine Cerulli ◽  
Jacob Bleasdale ◽  
Kennethea Wilson ◽  
Melissa Hordes ◽  
...  

Abstract Background Women’s rise in opioid use disorder has increased their presence in the criminal justice system and related risk behaviors for HIV infection. Although pre-exposure prophylaxis (PrEP) is an effective biomedical HIV prevention treatment, uptake among this high-risk population has been particularly low. Considerably little is known about the interplay between justice-involved women with opioid use disorder and HIV prevention. The aim of this study was to explore PrEP knowledge, attitudes, and perceptions for personal and partner use among women participants in the nation’s first ever opioid intervention court program. Methods The authors conducted semi-structured, in-depth interviews with 31 women recruited from an Opioid Intervention Court, a recent fast-track treatment response to combat overdose deaths. We utilized a consensual qualitative research approach to explore attitudes, perceptions, and preferences about PrEP from women at risk for HIV transmission via sexual and drug-related behavior and used thematic analysis methods to code and interpret the data. Results PrEP interest and motivation were impacted by various factors influencing the decision to consider PrEP initiation or comfort with partner use. Three primary themes emerged: HIV risk perceptions, barriers and facilitators to personal PrEP utilization, and perspectives on PrEP use by sexual partners. Conclusions Findings suggest courts may provide a venue to offer women PrEP education and HIV risk assessments. Study findings inform public health, substance use, and criminal justice research and practice with justice-involved participants experiencing opioid use disorder on the development of gender-specific PrEP interventions with the ultimate goal of reducing HIV incidence.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Geoff Bardwell ◽  
Tamar Austin ◽  
Lisa Maher ◽  
Jade Boyd

Abstract Background Smoking or inhaling illicit drugs can lead to a variety of negative health outcomes, including overdose. However, most overdose prevention interventions, such as supervised consumption services (SCS), prohibit inhalation. In addition, women are underrepresented at SCS and are disproportionately impacted by socio-structural violence. This study examines women’s experiences smoking illicit drugs during an overdose epidemic, including their utilization of a women-only supervised inhalation site. Methods Qualitative research methods included on-site ethnographic observation and semi-structured interviews with 32 participants purposively recruited from the women-only site. Data were coded and analyzed using NVivo 12 and thematic analysis was informed by gendered and socio-structural understandings of violence. Results Participants had preferences for smoking drugs and these were shaped by their limited income, inability to inject, and perceptions of overdose risk. Participants expressed the need for services that attend to women’s specific experiences of gendered, race-based, and structural violence faced within and outside mixed-gender social service settings. Results indicate a need for sanctioned spaces that recognize polysubstance use and drug smoking, accommodated by the women-only SCS. The smoking environment further fostered a sociability where participants could engage in perceived harm reduction through sharing drugs with other women/those in need and were able to respond in the event of an overdose. Conclusions Findings demonstrate the ways in which gendered social and structural environments shape women’s daily experiences using drugs and the need for culturally appropriate interventions that recognize diverse modes of consumption while attending to overdose and violence. Women-only smoking spaces can provide temporary reprieve from some socio-structural harms and build collective capacity to practice harm reduction strategies, including overdose prevention. Women-specific SCS with attention to polysubstance use are needed as well as continued efforts to address the socio-structural harms experienced by women who smoke illicit drugs.


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