Circumstances of overdose among street-involved, opioid-injecting women: Drug, set, and setting
Circumstances of overdose among street-involved, opioid-injecting women: Drug, set, and setting
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DOI：
10.1016/j.drugpo.2020.102691
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发表时间：
2020-04-01
影响因子：
4.4
通讯作者：
Lankenau, Stephen E.
中科院分区：
文献类型：
--
作者：
Ataiants, Janna;Roth, Alexis M.;Lankenau, Stephen E.
导言：目前关于过量危机原因的论述主要集中在药物的有害影响上。然而，先前的研究表明，药物使用经历是由药物与使用药物的人的生理和心理“设置”以及更广泛的社会和物理“设置”的复杂相互作用形成的。Zinberg的“药物，设置，设置”的理论框架被应用到识别模式的情况下导致妇女的overdose.Methods：在深入的半结构化访谈进行了29阿片类药物注射街头参与妇女，费城减少伤害计划的客户。定性分析与演绎和归纳编码被用来检查成绩单的理论驱动和新兴themes.Results：10的29名妇女归因于他们的过量“毒品”，报告的不可预测的质量街头阿片类药物，同时使用苯二氮卓类药物，或追逐“高”。13名妇女报告说，“设定”是一种情况，她们的情绪状态受到“好”或“坏”的一天的影响，导致她们采取不寻常的药物消费做法。六名妇女描述了“设置”类型的情况下，他们的过量之前，最近的变化，如从监狱释放，这促使不安全的药物使用，以解决生理或心理依赖药物。结论：虽然所有的药物过量导致药物的药理作用，一些过量的情况下发生在妇女的设置或设置触发。过量预防政策不仅应该包括个人层面的行为干预，还应该包括结构性措施，以解决困扰注射阿片类药物的街头妇女生活的压力，社会孤立和危险的药物使用环境。
Introduction: Current discourses about the causes of the overdose crisis largely focus on the harmful effects of drugs. Prior research, however, indicates that drug use experience is shaped by complex interactions of drugs with physiological and mental "sets" of people who use drugs and the wider social and physical "setting." Zinberg's "drug, set, and setting" theoretical framework was applied to identify patterns in circumstances leading up to women's overdose.Methods: In-depth semi-structured interviews were conducted with 29 opioid-injecting street-involved women, clients of a Philadelphia harm reduction program. Qualitative analysis with deductive and inductive coding was utilized to examine transcripts for theory-driven and emerging themes.Results: Ten out of 29 women attributed their overdose to "drugs," reporting the unpredictable quality of street opioids, concurrent use of benzodiazepines, or chasing the "high." Thirteen women reported "set" as a type of circumstance where their emotional states were affected by a "good" or "bad" day, leading them to unusual drug consumption practices. Six women described "setting" type of circumstances where their overdose was preceded by a recent change in context, such as release from prison, which prompted unsafe drug use to address physiological or psychological dependence on drugs.Conclusion: While all overdoses result from the pharmacological action of drugs, some overdoses were triggered by circumstances occurring in women's set or setting. Overdose prevention policies should embrace not only individual-level behavioral interventions, but also structural measures to address stress, social isolation, and risky drug use contexts that plague the lives of street-involved women who inject opioids.