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Tytuł pozycji:

People, places, and stigma: A qualitative study exploring the overdose risk environment in rural Kentucky.

Tytuł :
People, places, and stigma: A qualitative study exploring the overdose risk environment in rural Kentucky.
Autorzy :
Fadanelli M; Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA. Electronic address: .
Cloud DH; Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA.
Ibragimov U; Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA.
Ballard AM; Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA.
Prood N; Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA.
Young AM; College of Public Health, University of Kentucky, 111 Washington Ave, Lexington, KY 40536, USA; Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, USA.
Cooper HLF; Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA.
Pokaż więcej
Źródło :
The International journal on drug policy [Int J Drug Policy] 2020 Nov; Vol. 85, pp. 102588. Date of Electronic Publication: 2019 Nov 18.
Typ publikacji :
Journal Article; Research Support, N.I.H., Extramural
Język :
English
Imprint Name(s) :
Publication: 1998- : Amsterdam ; New York : Elsevier
Original Publication: Liverpool, England : International Journal on Drug Policy,
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Grant Information :
R21 DA042727 United States DA NIDA NIH HHS; UG3 DA044798 United States DA NIDA NIH HHS; UH3 DA044798 United States DA NIDA NIH HHS
Contributed Indexing :
Keywords: Appalachia*; Opioids*; Overdose*; Risk environment framework*; Rural*; Stigma*
Entry Date(s) :
Date Created: 20191123 Latest Revision: 20210409
Update Code :
20210409
PubMed Central ID :
PMC7231629
DOI :
10.1016/j.drugpo.2019.11.001
PMID :
31753603
Czasopismo naukowe
Background: Though overdose rates have been increasing in US rural areas for two decades, little is known about the rural risk environment for overdoses. This qualitative study explored the risk environment for overdoses among young adults in Eastern Kentucky, a rural epicenter of the US opioid epidemic.
Methods: Participants were recruited via community-based outreach. Eligibility criteria included living in one of five rural Eastern Kentucky counties; being aged 18-35; and using opioids to get high in the past 30 days. Semi-structured interviews explored the rural risk environment, and strategies to prevent overdose and dying from an overdose. Interviews were transcribed verbatim and analyzed using constructivist grounded-theory methods.
Results: In this sample (N = 19), participants reported using in a range of locations, including homes and outdoor settings; concerns about community stigma and law enforcement shaped the settings where participants used opioids and the strategies they deployed in these settings to prevent an overdose, and to survive an overdose. Almost half of participants reported using opioids in a "trap house" or other dealing locations, often to evade police after buying drugs, and reported that others present pressed them to use more than usual. If an overdose occurred in this setting, however, these same people might refuse to call EMS to protect themselves from arrest. Outdoor settings presented particular vulnerabilities to overdose and dying from an overdose. Most participants reported using opioids outdoors, where they skipped overdose prevention steps to reduce their risk of arrest; they worried that no one would find them if they overdosed, and that cell phone coverage would be too weak to summon EMS.
Conclusion: Findings suggest that initiatives to reduce overdoses in Eastern Kentucky would be strengthened by de-escalating the War on Drugs and engaging law enforcement in initiatives to protect the health of people who use opioids.
(Copyright © 2019 Elsevier B.V. All rights reserved.)

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