From oxycodone to heroin: Two cases of transitioning opioid use in young <scp>A</scp>ustralians

Dertadian, George C.; Maher, Lisa

doi:10.1111/dar.12093

Cited by 15 publications

(12 citation statements)

References 12 publications

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“…Among opioid users, transition narratives predominantly linked recreational prescription opioid use to heroin use, consistent with a growing number of recent studies (Dertadian & Maher, 2014; Lankenau et al, 2012; Mars et al, 2014). Young heroin injectors, particularly from suburban areas of the Valley, came of age in an era of prescription drug misuse.…”

Section: Discussionsupporting

confidence: 72%

Down in the valley: Trajectories of injection initiation among young injectors in California’s Central Valley

Syvertsen

Paquette

Pollini

2017

International Journal of Drug Policy

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Background Injection drug use initiation represents a critical point of public health intervention, as injection increases risk forblood borne infections including Hepatitis C and HIV. In this paper, weexplore pathways to injection initiation among youth (<=30) in the ruralcontext of California’s Central Valley, where rates of injection drug useare among the highest in the nation. Methods We draw on semi-structured qualitative interviews with 20 younginjectors to examine drug use histories, including the factors that participants associated with their transition to injection drug use. Results The average age was 24.7 years (range: 20–30), 45% were female(n=9), and 30% were Latino (n=6). Participants described a variety ofpathways to injection, culminating in a first injection that involvedeither opioids (n=12) or methamphetamine (n=8). Among the opioid group, the majority used prescription opioids before transitioning to injection, while a smaller number transitioned to opioid injection from non-opioid recreational drug use. Injectors who first used prescription opioidsoften described growing up in affluent suburban areas and transitioned toinjection with peers, owing to a combination of factors related toindividual tolerance, cost, and shifting drug markets. In contrast, methamphetamine initiates grew up in less affluent families withhistories of substance use that exposed them to drugs at an early age. Methamphetamine users transitioned from smoking and snorting toinjection, often with family members or intimate partners, within broadercontexts of social disadvantage and stress. Conclusions While much of the focus on young injectors has centered onthe current opioid epidemic, our data suggest a need to consider multiple pathways toward injection initiation of different drugs. Targetedinterventions addressing the unique injection transition contexts of bothopioids and methamphetamine are urgently needed in the Central Valley ofCalifornia.

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Section: Discussionsupporting

confidence: 72%

Down in the valley: Trajectories of injection initiation among young injectors in California’s Central Valley

Syvertsen

Paquette

Pollini

2017

International Journal of Drug Policy

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“…Accounts referenced increasing tolerance to a drug (37, 40, 41, 47, 48, 52, 55, 58, 60, 68, 70, 71, 76), withdrawals (47, 48, 56, 58, 61, 70) and economic pressures or recognition of the economic efficiency of injecting (37, 41, 46–48, 51, 52, 55, 58, 60–63, 65, 68, 70–73, 76, 77) as linked to injection initiation. The economic efficiency of injecting was potentially framed around desperation and regret: injecting drugs was then about ‘getting straight rather than getting high’ (48).…”

Section: Resultsmentioning

confidence: 99%

“…Injection initiation was identified as a response to grief, misery and stress (37, 52); as an aid in coping with mental illness (including depression) (46, 50, 55), or to manage physical pain (55). For example, injection initiation was described as a result of dependence on prescription opioids following ill health and accidents (40, 44, 52): “I was in a car accident. I went through the windshield.…”

Section: Resultsmentioning

confidence: 99%

The experience of initiating injection drug use and its social context: a qualitative systematic review and thematic synthesis

et al. 2017

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Background and aim Understanding the experience of initiating injection drug use and its social contexts is crucial to inform efforts to prevent transitions into this mode of drug consumption and support harm reduction. We systematically reviewed and synthesized existing qualitative scientific literature to identify the socio-structural contexts for, and experiences of, the initiation of injection drug use. Methods We systematically searched six databases (Medline, Embase, PsychINFO, CINAHL, IBSS, and SSCI), along with a manual search, including of key journals and subject experts. Peer-reviewed studies were included if they qualitatively explored experiences of or socio-structural contexts for injection drug use initiation. A thematic synthesis approach was used to identify descriptive and analytical themes across studies. Results From 1731 initial results, 41 studies reporting data from 1996 participants were included. We developed eight descriptive themes and two analytical (higher order) themes. The first analytical theme focused on injecting initiation resulting from a social process enabled and constrained by socio-structural factors: social networks and individual interactions, socialization into drug-using identities, and choices enabled and constrained by social context all combine to produce processes of injection initiation. The second analytical theme addressed pathways that explore varying meanings attached to injection initiation and how they link to social context: seeking pleasure, responses to increasing tolerance to drugs, securing belonging and identity, and coping with pain and trauma. Conclusions Qualitative research shows that injection drug use initiation has varying and distinct meanings for individuals involved and is a dynamic process shaped by social and structural factors. Interventions should therefore respond to the socio-structural influences on injecting drug use initiation by seeking to modify the contexts for initiation, rather than solely prioritizing the reduction of individual harms through behavior change.

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“…Further, the efficiency afforded by injection vs. non-injection of drugs has been identified as a key motivator for transitions into initiation, particularly among individuals experiencing endemic poverty and during periods when the price of illegal drugs increases [26][27][28][29][30][31].…”

Section: Risk Factors For Injection Initiatesmentioning

confidence: 99%

Preventing Injection Drug use Initiation: State of the Evidence and Opportunities for the Future

et al. 2017

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From oxycodone to heroin: Two cases of transitioning opioid use in young Australians

Cited by 15 publications

References 12 publications

Down in the valley: Trajectories of injection initiation among young injectors in California’s Central Valley

Down in the valley: Trajectories of injection initiation among young injectors in California’s Central Valley

The experience of initiating injection drug use and its social context: a qualitative systematic review and thematic synthesis

Preventing Injection Drug use Initiation: State of the Evidence and Opportunities for the Future

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