scholarly journals “They’re not doing enough.”: women’s experiences with opioids and naloxone in Toronto

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Emilie R. Macleod ◽  
Iren Tajbakhsh ◽  
Sarah Hamilton-Wright ◽  
Nancy Laliberte ◽  
Jessica L. Wiese ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Thematic Analysis ◽  
Qualitative Interviews ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Community Partner ◽  
Research Knowledge ◽  
Women’S Experiences ◽  
Opioid Crisis ◽  
Women's Experiences

Abstract Background Amid increasing opioid overdose deaths in Canada since 2010 and a changing naloxone access landscape, there is a need for up-to-date research on Canadian women’s experiences with opioids. Studies on Canadian take-home naloxone programs are promising, but research beyond these programs is limited. Our study is the first to focus on women’s experiences and perspectives on the opioid crisis in Ontario, Canada’s most populous province, since the opioid crisis began in 2010. Objective Our objective was to address research knowledge gaps involving Canadian women with criminal justice involvement who use opioids, and identify flaws in current policies, responses, and practices. While the opioid overdose crisis persists, this lack of research inhibits our ability to determine whether overdose prevention efforts, especially involving naloxone, are meeting their needs. Methods We conducted semi-structured, qualitative interviews from January to April 2018 with 10 women with experience of opioid use. They were recruited through the study’s community partner in Toronto. Participants provided demographic information, experiences with opioids and naloxone, and their perceptions of the Canadian government’s responses to the opioid crisis. Interviews were transcribed verbatim and inductive thematic analysis was conducted to determine major themes within the data. Results Thematic analysis identified seven major concerns despite significant differences in participant life and opioid use experiences. Participants who had used illicit opioids since naloxone became available over-the-counter in 2016 were much more knowledgeable about naloxone than participants who had only used opioids prior to 2016. The portability, dosage form, and effects of naloxone are important considerations for women who use opioids. Social alienation, violence, and isolation affect the wellbeing of women who use opioids. The Canadian government’s response to the opioid crisis was perceived as inadequate. Participants demonstrated differing needs and views on ideal harm reduction approaches, despite facing similar structural issues surrounding stigma, addiction management, and housing. Conclusions Participants experienced with naloxone use found it to be useful in preventing fatal overdose, however many of their needs with regards to physical, mental, and social health, housing, harm reduction, and access to opioid treatment remained unmet.

scholarly journals “They’re Not Doing Enough.”: Women’s Experiences with Opioids and Naloxone in Toronto

2020 ◽  
Author(s):  
Emilie MacLeod ◽  
Iren Tajbakhsh ◽  
Sarah Hamilton-Wright ◽  
Nancy Laliberte ◽  
Jessica Wiese ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Qualitative Interviews ◽  
Opioid Overdose ◽  
Demographic Information ◽  
Opioid Use ◽  
Women’S Experiences ◽  
Opioid Crisis ◽  
Women's Experiences ◽  
Overdose Deaths ◽  
Inductive Thematic Analysis

Abstract BACKGROUND: Amid increasing opioid overdose deaths in Canada, there is currently a need for up-to-date research on Canadian women’s experiences with opioids and their recently down-scheduled antidote, naloxone. Studies on Canadian take-home naloxone programs are promising, but research on perspectives outside these programs is limited. As the first qualitative study since the inception of the 2010’s opioid crisis to focus on Canadian women’s experiences and perspectives, our objective was to address these knowledge gaps and to identify resulting flaws in current policies, responses, and practices.METHODS: We conducted semi-structured, qualitative interviews from January to April 2018 with 10 women with experience of opioid use. They were recruited through the study’s community health partner in Toronto. They provided demographic information, experiences with opioids and naloxone, and their views on the Canadian government’s responses to the opioid crisis. Interviews were transcribed verbatim and inductive thematic analysis was conducted to determine major themes within the data.RESULTS: Participants who had used illicit opioids since the Canadian government’s down-scheduling of naloxone in 2016 were much more knowledgeable about naloxone than participants who had only used opioids prior. The portability, dosage form, and effects of naloxone are important considerations for women who use opioids. Social alienation, violence, and isolation affect the wellbeing of women who use opioids. The Canadian government’s response to the opioid crisis was perceived as neglectful and inadequate. Participants demonstrated differing needs and views on ideal harm reduction approaches, despite facing similar structural issues surrounding stigma, addiction management, and housing.CONCLUSIONS: Participants experienced with naloxone use found it to be useful in preventing fatal overdose, however many of their needs with regards to physical, mental, and social health, housing, harm reduction, and access to opioid treatment remained unmet.

scholarly journals Searching for help online: An analysis of peer-to-peer posts on a male-only infertility forum

2016 ◽  
Vol 23 (7) ◽  
pp. 917-928 ◽  
Author(s):  
Esmée Hanna ◽  
Brendan Gough
Keyword(s):  
Thematic Analysis ◽  
Online Communities ◽  
Help Seeking ◽  
Peer To Peer ◽  
Research Knowledge ◽  
Women’S Experiences ◽  
Women's Experiences ◽  
Reproductive Research

Men’s experiences of infertility help seeking are under-researched and thus less widely understood than women’s experiences, with men’s needs for support often missing from reproductive research knowledge. This article presents a thematic analysis of peer-to-peer posts within the context of a UK men-only online infertility forum. The key themes demonstrate that men value male support from those with experience, and that masculinity influences help-seeking requests and men’s accounts more broadly. We highlight the value of such online communities in offering support to men in need while recognising the importance of further research across other online settings in order to inform practice around supporting men in the reproductive realm.

A sexual superpower or a shame? Women’s diverging experiences of squirting/female ejaculation in Sweden

Sexualities ◽  
2021 ◽  
pp. 136346072110410
Author(s):  
Jessica Påfs
Keyword(s):  
Thematic Analysis ◽  
Scientific Literature ◽  
Women’S Experiences ◽  
Sexual Stimulation ◽  
Women's Experiences ◽  
Female Ejaculation ◽  
Scant Attention ◽  
The Subject

Squirting, or female ejaculation, is the expulsion of fluid during sexual stimulation. The limited scientific literature has focused primarily on clarifying what this fluid contains, while women’s own voices on the experience have received scant attention. This study explores 28 women’s experiences and applies a thematic analysis. The sensation of squirting is individual and sometimes conflicting. Descriptions range from considering it amazing, a superpower and feminist statement to an unpleasant and/or shameful event. Across the board, there is a wish for nuanced information and for the current taboo and mystification surrounding the subject to be broken.

Women's experiences of outpatient induction of labour

2019 ◽  
Vol 27 (6) ◽  
pp. 373-380
Author(s):  
Dalvir Kandola
Keyword(s):  
Literature Review ◽  
Direct Effect ◽  
Thematic Analysis ◽  
Service Provision ◽  
Induction Of Labour ◽  
Inpatient Stay ◽  
Women’S Experiences ◽  
Women's Experiences ◽  
Comprehensive Literature Review ◽  
Pluralistic Approach

Background Outpatient induction of labour is offered to relieve the pressure on inpatient stay and to improve women's experiences. Aim To contribute to the knowledge of outpatient induction of labour with the focus on women's experiences to inform practice. The question was: ‘What are women's experiences of outpatient induction of labour?’ Method A comprehensive literature review using a pluralistic approach and thematic analysis. Findings The review found three themes: the home as a positive setting for outpatient induction of labour, the value of outpatient induction of labour in promoting normality and the importance of receiving reassurance during outpatient induction of labour. Conclusion Although the results were mostly positive and in favour of outpatient induction of labour, there were variations in service provision. There was a lack of understanding as to how best to offer reassurance to women once discharged home, which was found to have a direct effect on their experiences.

scholarly journals Drug Use, Homelessness and Health: Responding to the Opioid Overdose Crisis with Housing and Harm Reduction Services

2021 ◽  
Author(s):  
katrina milaney
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Housing Instability ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Chi Square ◽  
Increased Risk ◽  
Reported Data ◽  
Structural Inequities ◽  
Hospital Use

Abstract Background Canada is in the midst of an opioid overdose crisis and Alberta has one of the highest opioid use rates across the country. Populations made vulnerable through structural inequities who also use opioids, such as those who are unstably housed, are at an increased risk of experiencing harms associated with opioid use. The main purpose of this study was to explore if there was an association between unstable housing and hospital use for people who use opioids. Methods Analysis utilized self-reported data from the Alberta Health and Drug Use Survey which surveyed 813 Albertans in three cities. Hospital use was modeled using a logistic regression with our primary variable of interest being housing unstable status. Chi square tests were conducted between hospital use and variables associated with demographics, characteristics of drug use, health characteristics, and experiences of receiving services to establish model inclusion. Results Results revealed a significant association between housing instability and hospital use.with unstably housed individuals twice as likely torequire hospital care. Conclusions Results highlight the importance of concurrently addressing housing instability alongside the provision of harm reduction services such assafe supply and supervised consumption sites. These findings have significant implications for policy and policymakers during the opioid overdose epidemic, and provide a foundation for future areas of research.

scholarly journals Women’s experiences of self-administration of misoprostol at home as part of early medical abortion: a qualitative evaluation

2020 ◽  
pp. bmjsrh-2020-200661 ◽  
Author(s):  
Jeni Harden ◽  
Julie Ancian ◽  
Sharon Cameron ◽  
Nicola Boydell
Keyword(s):  
Clinical Setting ◽  
Qualitative Interviews ◽  
Qualitative Evaluation ◽  
Medical Abortion ◽  
Self Administration ◽  
Women’S Experiences ◽  
Women's Experiences ◽  
The Uk ◽  
Experiences Of Women ◽  
At Home

BackgroundBetween 2017 and 2019, legislation was introduced in the UK that approved the home as a place for self-administration of misoprostol for early medical abortion. While research has shown that early medical abortion at home is as safe as in a clinical setting, women’s experiences in the UK in the light of this change have not yet been investigated. This qualitative research explored the experiences of women in one region of Scotland, UK who accessed early medical abortion with home self-administration of misoprostol.MethodsQualitative interviews were conducted with 20 women who had recently undergone early medical abortion (≤69 days' gestation) with home self-administration of misoprostol. The data were analysed thematically using an approach informed by the Framework analytic approach.ResultsWomen appreciated the flexibility that home administration of misoprostol offered, including the opportunity to control the timing of the abortion. This was particularly important for women who sought not to disclose the abortion to others. Most women valued being in the comfort and privacy of the home when preparing for self-administration, although a small number highlighted some concerns about being at home. Most women reported that self-administration of misoprostol was straightforward; however, some expressed concerns around assessing whether their experiences were ‘normal’.ConclusionsWomen welcomed the opportunity for home self-administration of misoprostol. To further improve women’s early medical abortion experience we suggest that the legislation be amended so that women can self-administer in an appropriate non-clinical setting, not just their home.

scholarly journals Explaining the Differences in Opioid Overdose Deaths between Scotland and England/Wales: Implications for European Opioid Policies

2021 ◽  
pp. 1-14
Author(s):  
Jan van Amsterdam ◽  
Wim van den Brink ◽  
Mimi Pierce
Keyword(s):  
Statistical Data ◽  
Social Deprivation ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Polydrug Use ◽  
Treatment Coverage ◽  
Opioid Crisis ◽  
Lower Treatment ◽  
Key Drivers ◽  
Overdose Deaths

<b><i>Backgrounds:</i></b> Between 2009 and 2018, the number of opioid-related deaths (ORDs) in Scotland showed a dramatic increase, whereas in England and Wales, a much lower increase in ORD was seen. This regional difference is remarkable, and the situation in Scotland is worrisome. Therefore, it is important to identify the drivers of ORD in Scotland. <b><i>Methods:</i></b> A systematic literature review according to PRISMA guidelines was conducted to identify peer-reviewed studies about key drivers for the observed differences in ORDs between Scotland and England/Wales. In addition, non-peer-reviewed reports on nationwide statistical data were retrieved via Google and Google Scholar and analysed to quantify differences in ORD drivers between Scotland and England/Wales. <b><i>Results:</i></b> The systematic review identified some important drivers of ORD, but none of these studies provided direct or indirect comparisons of ORD drivers in Scotland and England/Wales. However, the reports with nationwide statistical data showed important differences in ORD drivers between Scotland and England/Wales, including a higher prevalence of people using opioids in a problematic way (PUOP), more polydrug use in people using drugs in a problematic way (PUDP), a higher age of PUDP, and lower treatment coverage and efficacy of PUDP in Scotland compared to England/Wales, but no regional differences in injecting drug use, incarceration/prison release without treatment, and social deprivation in PUDP. <b><i>Conclusion:</i></b> It is concluded that the opioid crisis in Scotland is best explained by a combination of drivers, consisting of a higher population involvement in (problematic) opioid use (notably methadone), relatively more polydrug use (notably benzodiazepines and gabapentinoids), a steeper ageing of the PUOP population in the past 2 decades, and lower treatment coverage and efficacy in Scotland compared to England/Wales. The findings have important consequences for strategies to handle the opioid crisis in Scotland.

“Un abrazo a la distancia”: An Exploration of Spanish-Speaking Women’s Experiences with Pregnancy and Social Isolation in an Urban U.S. Setting

2021 ◽  
pp. 154041532110410
Author(s):  
Talia Robledo-Gil ◽  
Shakkaura Kemet ◽  
Meredith Pensak ◽  
Abigail Cutler ◽  
Blair McNamara ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Social Isolation ◽  
Gestational Age ◽  
Qualitative Interviews ◽  
Language Preference ◽  
Long Distance ◽  
Women’S Experiences ◽  
Spanish Speaking ◽  
Women's Experiences ◽  
The Impact

Introduction: Research on Spanish-speaking Latina/Hispanic women's experiences during pregnancy is limited. Methods: We recruited women from urban, walk-in pregnancy testing clinics from June 2014 to June 2015. Women aged 16–44 years, at less than 24 weeks gestational age, who spoke either English or Spanish were eligible and completed an enrollment questionnaire and individual interview according to language preference. During qualitative interviews, we explored pregnancy intentions, initial reactions to a new pregnancy, and feelings about the impact of this pregnancy on relationships and daily life. Qualitative narrative content analysis was conducted using Atlas.ti software. Results: Among interviews with 31 Spanish-speaking Latina/Hispanic pregnant women, participants’ average age was 28 years old with a mean gestational age of 7 weeks. We identified social isolation as the most common theme, characterized by four interwoven and overlapping subthemes: (1) sola—the experience of feeling alone; (2) familismo cercano—the importance of close relationships; (3) familismo lejano—overcoming long distance relationships; and (4) mi patria—preserving homeland cultural connectedness. Conclusions: Spanish-speaking Latina/Hispanic pregnant women described experiencing multiple aspects of social isolation. Language preference may suggest risk of social isolation, necessitating provider awareness and support initiatives to improve social support and lessen social isolation among newly pregnant, Spanish-speaking Latina women.

scholarly journals Older Women’s Experiences in the Icelandic Workforce – Positive or Negative?

2020 ◽  
Author(s):  
Sigurveig H. Sigurðardóttir ◽  
Ásta Snorradóttir
Keyword(s):  
Labour Market ◽  
Older Women ◽  
Qualitative Interviews ◽  
Well Being ◽  
Negative Attitudes ◽  
Women’S Experiences ◽  
Women's Experiences ◽  
Job Opportunities

The purpose of the study is to gain a deeper understanding of older women’s experiences in the labour market, how they value their job opportunities and perceived attitudes towards them. Qualitative interviews were conducted with seven women aged 57–74 years who all have at least 10 years working experience after they turned 40. Experiencing discrimination in the workforce was often mentioned by the women. Their experience is that men are less discriminated against on grounds of age than women. Older women pride themselves for participating in the workforce for being reliable, unselfish and undemanding rather than being experienced, skillful and good at their jobs. The results indicate that it is important to research further the well-being of older women in the labour market and try to change the negative attitudes and discrimination that appear prevalent. Ageism against older women can affect their well-being and health and must be prevented.

scholarly journals Implementation of Buprenorphine Services in NYC Syringe Services Programs: a qualitative process evaluation

2021 ◽  
Author(s):  
Andrea Jakubowski ◽  
Caroline Rath ◽  
Alex Harocopos ◽  
Monique Wright ◽  
Alice Welch ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Technical Assistance ◽  
Opioid Overdose ◽  
Health Departments ◽  
Psychosocial Needs ◽  
Opioid Use ◽  
Treatment Access ◽  
Stage Of Development ◽  
Low Threshold ◽  
Buprenorphine Treatment

Abstract Background Syringe services programs (SSPs) hold promise for providing buprenorphine treatment access to people with opioid use disorder (OUD) who are reluctant to seek care elsewhere. In 2017, the New York City Department of Health and Mental Hygiene (DOHMH) provided funding and technical assistance to nine SSPs to develop “low-threshold” buprenorphine services as part of a multipronged initiative to lower opioid-related overdose rates. The aims of this study were to 1) Describe characteristics of SSP-based buprenorphine services; and 2) Identify barriers to and facilitators of implementing SSP-based buprenorphine services. Methods We conducted 26 semi-structured qualitative interviews from April 2019 - November 2019 at eight SSPs in NYC that received funding and technical assistance from DOHMH. Interviews were conducted with three categories of staff: leadership (8 interviews); staff (11), and providers (6). We used thematic analysis to identify themes within pre-identified domains: program characteristics and barriers and facilitators to program implementation. We make recommendations for implementation based on our findings. Results Programs differed in their stage of development, location of services provided, and provider type, availability, and practices. Barriers to providing buprenorphine services at SSPs included gaps in staff knowledge and comfort communicating with participants about buprenorphine, difficulty hiring providers, managing tension between harm reduction and traditional OUD treatment philosophies, and financial constraints. Challenges also arose from serving a population with unmet psychosocial needs. Implementation facilitators included technical assistance from DOHMH, designated buprenorphine coordinators, offering other supportive services to participants, and telehealth to bridge gaps in provider availability. Key recommendations include: 1) health departments should provide support for SSPs in training staff, building health service infrastructure and developing policies and procedures, 2) SSPs should designate a buprenorphine coordinator and ensure regular training on buprenorphine for their frontline staff, and 3) providers should be selected or supported to use a harm reduction approach to buprenorphine treatment. Conclusions Despite encountering challenges, eight SSPs implemented buprenorphine services outside of conventional OUD treatment settings. Our findings have implications for health departments, SSPs, and other community organizations implementing buprenorphine services. Expansion of low-threshold buprenorphine services is a promising strategy to address the opioid overdose epidemic.

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