The Process of Injection Drug Use Among Homeless Women:A Qualitative Study

Mapping Intimacies ◽

10.21203/rs.3.rs-20519/v1 ◽

2020 ◽

Author(s):

Cynthia Kitson ◽

Patrick O'Byrne

Keyword(s):

Drug Use ◽

Qualitative Study ◽

Injection Drug Use ◽

Thematic Analysis ◽

Injection Drug ◽

Morbidity And Mortality ◽

Structured Interviews ◽

Injection Drugs

Abstract Background: The literature on women who use injection drugs (WUID) is antiquated and diluted by data from men. Due to the higher rates of morbidity and mortality among WUID, we undertook a qualitative study to better understand their drug use practices. Methods: We adopted a Deleuzo-Guattarian lens and engaged in semi-structured interviews with 35 women. Data were analyzed applied thematic analysis. Results: We divided these themes into (1) how WUID obtain resources to acquire drug, and (2) the steps involved in preparing, using, and discarding drugs. From our Deleuzo-Guattarian perspective, these findings highlighted that participants stratified their worlds according to rules of cleanliness to create hierarchies of appropriateness and acceptability. Conclusions: These findings, overall, highlight the importance of understanding the constructed world of women who use injection drugs, particularly regarding the ways by which nurses interact with these women to provide care.

Download Full-text

The Process of Injection Drug Use Among Homeless Women in Ottawa, Canada: A Qualitative Study

Research and Theory for Nursing Practice ◽

10.1891/rtnp-d-20-00068 ◽

2021 ◽

pp. RTNP-D-20-00068

Author(s):

Cynthia Kitson ◽

Patrick O’Byrne

Keyword(s):

Drug Use ◽

Qualitative Study ◽

Injection Drug Use ◽

Thematic Analysis ◽

Injection Drug ◽

Homeless Women ◽

Morbidity And Mortality ◽

Structured Interviews ◽

Injection Drugs ◽

Canada Data

BackgroundThe literature on women who use injection drugs (WUIDs) is antiquated and diluted by data from men. Due to the higher rates of morbidity and mortality among WUID, we undertook a qualitative study to better understand their drug use practices.MethodsWe adopted a Deleuze–Guattarian lens and engaged in semi-structured interviews with 35 women in Ottawa, Canada. Data from 31 of these women were analyzed using applied thematic analysis.ResultsWe divided these themes into (a) how WUID obtain resources to acquire drug,and (b) the steps involved in preparing, using, and discarding drugs. From our Deleuzo–Guattarian perspective, these findings highlighted that participants stratified their worlds according to rules of cleanliness to create hierarchies of appropriateness and acceptability.ConclusionsThese findings, overall, highlight the importance of understanding the constructed world of WUIDs, particularly regarding the ways in which nurses interact with these women to provide care.

Download Full-text

Harm reduction via online platforms for people who use drugs in Russia: a qualitative analysis of web outreach work

Harm Reduction Journal ◽

10.1186/s12954-020-00452-6 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Arsen Davitadze ◽

Peter Meylakhs ◽

Aleksey Lakhov ◽

Elizabeth J. King

Keyword(s):

Drug Use ◽

Harm Reduction ◽

Injection Drug Use ◽

Injection Drug ◽

People Who Use Drugs ◽

Structured Interviews ◽

Advantages And Disadvantages ◽

Online Platforms ◽

Outreach Work ◽

Outreach Workers

Abstract Background Harm reduction services to people who use drugs (PWUD) in Russia are insufficient in terms of quantity, government endorsement, and accessibility. The situation has recently deteriorated even further because of social distancing measures of the COVID-19 pandemic. Several organizations have started to provide some harm reduction services via online platforms by web outreach. However, little is known on how online outreach services are organized and implemented. Drawing on the example of St. Petersburg-based NGO “Humanitarian Action,” we explored web outreach work in Telegram instant messenger. Methods Our data were comprised of 4 semi-structured interviews with the NGO staff and 301 cases of web outreach work with PWUD. We used thematic analysis to study the process of web outreach, harm reduction service provision, and needs of PWUD. Results Three stages of the process of web outreach work were identified: clients initiating communication, NGO workers addressing clients’ needs, and NGO workers receiving clients’ feedback. Communication proceeded in group chat or direct messages. Challenges in addressing clients’ needs happened when clients turned for help after hours, sent recorded voice messages, sent unclear messages, and/or were unwilling to transition to telephone communication. All web outreach workers reported receiving only positive feedback on their work. The needs of PWUD were categorized into two major themes, depending on whether they can be addressed fully or partially online. In cases of online only provision of services, web outreach workers helped PWUD treat minor injection drug use complications, obtain verified harm reduction information and receive general psychological support. In instances of partial online services provision, PWUD were assisted in getting treatment of severe injection drug use complications, overdoses, and in accessing offline medical, psychological, social, legal and harm reduction services. Conclusions Our research demonstrated that web outreach work is a convenient tool for delivering some harm reduction services to PWUD either partially or completely online and for recruiting new clients (including hard-to-reach PWUD that avoid attending brick-and-mortar facilities). Harm reduction organizations should consider incorporating online harm reduction services into their activities. However, further research is needed to explore relative advantages and disadvantages of online harm reduction services.

Download Full-text

A qualitative study on the initiation into injection drug use: Necessary and background processes

Addiction Research & Theory ◽

10.1080/16066350802011664 ◽

2009 ◽

Vol 17 (5) ◽

pp. 546-559 ◽

Cited By ~ 17

Author(s):

Nooshin Khobzi ◽

Carol Strike ◽

Walter Cavalieri ◽

Robert Bright ◽

Ted Myers ◽

...

Keyword(s):

Drug Use ◽

Qualitative Study ◽

Injection Drug Use ◽

Injection Drug

Download Full-text

1215. A Mixed Methods Study on Severe Bacterial Infections in People Who Inject Drugs

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.1407 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S697-S697

Author(s):

Alexander Hrycko ◽

Benjamin Eckhardt ◽

Pedro Mateu-Gelabert ◽

Courtney Ciervo

Keyword(s):

Mixed Methods ◽

Drug Use ◽

Injection Drug Use ◽

Bacterial Infections ◽

Mixed Methods Study ◽

Injection Drug ◽

Daily Injection ◽

Drug Injection ◽

Structured Interviews ◽

Causative Microorganism

Abstract Background Severe bacterial infections (SBI) associated with intravenous drug use have been increasing in frequency in the U.S. over the last decade. This mixed methods study aims to identify the risk factors associated with SBI in hospitalized individuals with recent injection drug use. Methods We conducted 34 quantitative and 15 qualitative interviews between August 2020 and June 2021 at Bellevue Hospital in New York City. Eligible participants were (1) >/= 18 year of age, (2) admitted with a SBI, and (3) reported injection drug use within the 90 days prior to admission. Quantitative and qualitative data was obtained using a quantitative survey and in-depth, semi structured interviews of participants respectively. Analysis was performed to examine trends and explore common themes potentially contributing factors to SBI. Results Of the 34 participants included, the median age was 37.5, 85% were male, 53% white, and 65% reported being homeless within the past 3 months. Endocarditis was the most common primary diagnosis (65%). Median length of hospital stay was 24 days and 35% required ICU level care during admission. A causative microorganism was identified in 85% of participants and 50% had Staphylococcus aureus as the sole organism. Discharges against medical advice occurred in 35%. Daily injection drug use in prior 30 days was 95% with a median of 10 injections per day. In the 30 days prior to admission, 50% reported an increase in injection frequency, 80% reported reusing needles and/or syringes, 75% reused cookers, 65% reused cottons. Analysis of qualitative interview data revealed high risk injection behaviors. Participants were not practicing and unaware of strategies to reduce their risk of drug injection-related SBI. Prior hospitalizations for SBI did not impact on this knowledge deficit on what constitutes bacterial infection risk and how to prevent it. Conclusion Study findings highlight the complexity of the injection drug use process and the potential social and physiological pathways leading to SBI. Multiple domains at the structural, network, and individual level that impact drug injection practices and provide context by which these factors predispose and lead to physiological tissue damage and the development of SBI among PWID. Disclosures Benjamin Eckhardt, MD, MS, Gilead Sciences (Grant/Research Support)

Download Full-text

When and how do individuals transition from regular drug use to injection drug use in Uganda? Findings from a rapid assessment

Harm Reduction Journal ◽

10.1186/s12954-019-0350-2 ◽

2019 ◽

Vol 16 (1) ◽

Author(s):

Matayo Baluku ◽

Twaibu Wamala

Keyword(s):

Drug Use ◽

Injection Drug Use ◽

Drug Users ◽

Time Lag ◽

Rapid Assessment ◽

Injecting Drug Users ◽

Hcv Infection ◽

Injection Drug ◽

Structured Interviews ◽

Increased Risk

Abstract Background In Uganda, injection drug use is a growing but less studied problem. Preventing the transition to injection drug use may help prevent blood-borne viral transmission, but little is known about when and how people transition to injection drug use. A greater understanding of this transition process may aid in the country’s efforts to prevent the continued growth of injection drug use, HIV, and hepatitis C Virus (HCV) infection among people who inject drugs (PWID). Methods Using a rapid situation assessment framework, we conducted semi-structured interviews among 125 PWID (102 males and 23 females)—recruited through outreach and snow-ball sampling. Participants were interviewed about their experiences on when and how they transitioned into injection drug use and these issues were also discussed in 12 focus groups held with the participants. Results All the study participants started their drug use career with non-injecting forms including chewing, smoking, and sniffing before transitioning to injecting. Transitioning was generally described as a peer-driven and socially learnt behavior. The participants’ social networks and accessibility to injectable drugs on the market and among close friends influenced the time lag between first regular drug use and first injecting—which took an average of 4.5 years. By the age of 24, at least 81.6% (95.7% for females and 78.4% for males) had transitioned into injecting. Over 84.8% shared injecting equipment during their first injection, 47.2% started injecting because a close friend was already injecting, 26.4% desired to achieve a greater “high” (26.4%) which could reflect drug-tolerance, and 12% out of curiosity. Conclusions Over 81% non-injecting drug users in Kampala and Mbale districts transitioned into injecting by the age of 24; a process that reproduces a population of PWID but also puts them at increased risk of HIV and HCV infection. As Uganda makes efforts to introduce and/or strengthen harm reduction services, interventions targeting non-injecting drug users before they transition into injecting should be considered as a key component for HIV/HCV epidemic control efforts, and their evaluation considered in future researches.

Download Full-text

The Emerging Intersection Between Injection Drug Use and Early Syphilis in Nonurban Areas of Missouri, 2012–2018

The Journal of Infectious Diseases ◽

10.1093/infdis/jiaa056 ◽

2020 ◽

Vol 222 (Supplement_5) ◽

pp. S465-S470

Author(s):

Hilary Reno ◽

Branson Fox ◽

Craig Highfill ◽

Angela McKee ◽

Anne Trolard ◽

...

Keyword(s):

Drug Use ◽

Injection Drug Use ◽

Rural Areas ◽

Congenital Syphilis ◽

Injection Drug ◽

Childbearing Age ◽

Persons Who Inject Drugs ◽

Early Syphilis ◽

Injection Drugs ◽

Disease Intervention Specialist

Abstract Background The national rate of syphilis has increased among persons who inject drugs (PWID). Missouri is no exception, with increases in early syphilis (ES), congenital syphilis, and PWID, especially in nonurban counties. Methods Disease intervention specialist records for ES cases in Missouri (2012–2018) were examined. Drug use was classified as injection drug use (IDU) (opioid or methamphetamine) or non-IDU (opioid, methamphetamine, or cocaine). Rates were compared based on residence, sex of sex partner, and drug use. Results Rates of ES in Missouri increased 365%, particularly in small metropolitan and rural areas (1170%). Nonurban areas reported a higher percentage of persons with ES who used injection drugs (12%–15%) compared with urban regions (2%–5%). From 2012 to 2018, women comprised an increasing number of ES cases (8.3%–21%); 93% of women were of childbearing age. Increasingly more women in rural areas with ES also reported IDU during this time (8.4%–21.1%). Conclusions As syphilis increases in small metropolitan and rural regions, access to high-quality and outreach-based sexual health services is imperative. Healthcare policy to equip health departments with harm reduction services and drug treatment resources offers an opportunity to impact both syphilis increases as well as health outcomes associated with IDU.

Download Full-text