“Like Yin and Yang”: Perceptions of Methamphetamine Benefits and Consequences Among People Who Use Opioids in Rural Communities

Abstract

Objectives: The objective of this study was to investigate methamphetamine use among people who use opioids in rural Oregon communities to explore reasons for use and perceptions of methamphetamine consequences. Methods: We conducted interviews and surveys with participants who inject drugs or misuse prescription opioids in 2 rural Oregon counties with high opioid overdose rates. Survey participants were identified through participant-driven sampling initiated in syringe service programs and field outreach (n = 144). Semi-structured interviews with participants were recruited from the same locations (n = 52). Results: Of 144 surveys completed, 112 reported using opioids in the past 30 days; 96% of the 112 also report methamphetamine use. Among the 124 reporting injection drug use, 50% indicated they injected both methamphetamine and heroin in the past 30 days. Interview participants reported early exposure to methamphetamine and indicated that methamphetamine was more widely available, less expensive, and less stigmatized compared to heroin. Participants reported using methamphetamine to improve work-life functioning and because they enjoy the high produced from simultaneous use. Several participants reported a conscious effort to shift to methamphetamine from heroin as a harm reduction strategy. Some participants reported being involuntarily discharged from treatment for opioid use disorder due to methamphetamine use. Several participants perceived methamphetamine as conveying overdose prevention or reversal benefits, while fentanyl contamination in methamphetamine was reported or suspected. Conclusion: As rural communities respond to evolving drug supply and demand, there is increasing need for public health efforts to address the emerging issue of concurrent methamphetamine and opioid use.

A Descriptive Cross-Sectional Analysis Of Potential Factors, Motivations, And Barriers Influencing Research Participation And Retention Among People Who Use Drugs In The Rural United States

“…These ndings align with a community-based study in Vancouver, Canada, that found those who use methamphetamine reported greater suspiciousness and paranoia compared to those who use opioids [28]. Methamphetamine-associated paranoia may magnify the general distrust of healthcare systems where PWUD frequently experience stigma [55,56] and may exacerbate skepticism about the transparency of research which is already elevated among rural residents [57]. Research enrolling people who use methamphetamines in rural communities should tailor recruitment and retention strategies to emphasize con dentiality and privacy.…”

Tempol Reverses the Negative Effects of Morphine on Arterial Blood-Gas Chemistry and Tissue Oxygen Saturation in Freely-Moving Rats

“…The present study has several limitations that will be subject to future research studies in which we will 1) administer Tempol following the injection of fentanyl or even higher potency analogues (e.g., sufentanil) in freely-moving male and female rats, in order to determine the efficacy of Tempol as a reversal agent against the profound cardiorespiratory responses that are elicited by these high potency synthetic opioids, and 2) inject Tempol following injection of fentanyl (following bolus or infusion paradigms) in combination with diazepam and/or methamphetamine in freely-moving male and female rats to provide information as to the efficacy of Tempol against the cardiorespiratory effects of these combinations, which are ever increasing real-world scenarios ( Warner et al, 2016 ; Macleod et al, 2019 ; Baker et al, 2021 ). Another important limitation of this study was that end-tidal PO 2 and PCO 2 were not continuously monitored.…”

“…and female rats to provide information as to the efficacy of Tempol against the cardiorespiratory effects of these combinations, which are ever increasing real-world scenarios (Warner et al, 2016;Macleod et al, 2019;Baker et al, 2021). Another important limitation of this study was that end-tidal PO 2 and PCO 2 were not continuously monitored.…”

Breaching Trust: A Qualitative Study of Healthcare Experiences of People Who Use Drugs in a Rural Setting

“…Rural communities are disproportionately burdened by opioid and methamphetamine use in the United States (Ellis et al, 2018 ; Palombi et al, 2018 ; Baker et al, 2020 ). Stigma and other barriers to accessing medical care can be magnified in rural settings where there are fewer options for healthcare services and perhaps less anonymity in medical interactions (Jones et al, 2009 ; Pullen and Oser, 2014 ; Buer, 2020 ).…”