Safety becomes danger: dilemmas of drug-use in public space

Dovey, Kim; Fitzgerald, John W.; Choi, Youngju

doi:10.1016/s1353-8292(01)00024-7

Cited by 116 publications

(84 citation statements)

References 8 publications

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“…These findings corroborate observations from our earlier in-depth interviews with IDUs in Mexico [14,17], as well as a growing body of literature that suggests policing practices in many international settings-the United States, Russia, Australia, Canada and now Mexico-have an adverse effect on the ability of IDUs to practice safe injecting behaviors [1,[10][11][12]15,16,20,21,28].…”

Section: Discussionsupporting

confidence: 88%

“…Overall, 92% were male and 99% considered themselves Hispanic or Latino. Median age was 34 years [interquartile range (IQR): [28][29][30][31][32][33][34][35][36][37][38][39][40] and median time since first injection was 12.5 years (IQR: [8][9][10][11][12][13][14][15][16][17][18][19].…”

Section: Study Populationmentioning

confidence: 99%

“…Qualitative studies have shown that fear of police detection and detainment can discourage purchase and carrying of sterile syringes, even in settings where over-the-counter syringe sales and possession are legal, leading to syringe sharing [10][11][12][13][14]. Fears of police detection also lead to hurried injection, particularly in public places, resulting in sharing of syringes and other injection paraphernalia [10][11][12]14,15]. Further, there is evidence that aggressive policing practices lead to higher utilization of shooting galleries, where drugs can be used hidden from public view and previously used injection equipment is obtained readily [13,16,17].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Syringe possession arrests are associated with receptive syringe sharing in two Mexico–US border cities

Pollini

Brouwer

Lozada³

et al. 2007

Addiction

121

113

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Aims To identify factors associated with receptive syringe sharing among injection drug users (IDUs) and elucidate the association between syringe possession arrests and syringe sharing.Design Cross‐sectional study.Setting Mexican border cities of Tijuana, Baja California and Ciudad Juarez, Chihuahua.Participants IDUs in Tijuana (n = 222) and Ciudad Juarez (n = 206) were recruited using respondent‐driven sampling (RDS). IDUs were ≥ 18 years and had injected illicit drugs in the past month.Measurements An interviewer‐administered survey was used to collect quantitative data on socio‐demographic, behavioral and contextual characteristics, including self‐reported syringe sharing and arrests for syringe possession. Associations with receptive syringe sharing were investigated using logistic regression with RDS adjustment.Findings Overall, 48% of participants reported ever being arrested for carrying an unused/sterile syringe, even though syringe purchase and possession is legal in Mexico. Arrest for possessing unused/sterile syringes was associated independently with receptive syringe sharing [adjusted odds ratio (AOR) = 2.05; 95% confidence interval (CI): 1.26, 3.35], as was injecting in a shooting gallery (AOR = 3.60; 95% CI: 2.21, 5.87), injecting in the street (AOR = 2.05; 95% CI: 1.18, 3.54) and injecting methamphetamine (AOR = 2.77; 95% CI: 1.41, 5.47) or cocaine (AOR = 1.96; 95% CI: 1.15, 3.36). More than half of participants (57%) had been arrested for possessing a used syringe; in a second model, arrest for used syringe possession was also associated independently with receptive sharing (AOR = 2.87; 95% CI: 1.76, 4.69).Conclusions We documented high levels of syringe‐related arrests in two Mexican–US border cities and an independent association between these arrests and risky injection practices. Public health collaborations with law enforcement to modify the risk environment in which drug use occurs are essential to facilitate safer injection practices.

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Section: Discussionsupporting

confidence: 88%

Section: Study Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Syringe possession arrests are associated with receptive syringe sharing in two Mexico–US border cities

Pollini

Brouwer

Lozada³

et al. 2007

Addiction

121

113

View full text Add to dashboard Cite

show abstract

“…The public injecting environment in particular has been noted as a mediator of elevated health risk as a consequence of a lack of privacy, hygiene and amenity, and a fear of interruption, police attention or public exposure, which may result in hurried injections in which safety routines are sidelined 9,10,17,18,19,20 . A number of cohort studies associate higher levels of health risk behaviour with drug injection in public or street injecting locations 16,20,21,22 .…”

Section: Public Injecting and Homelessnessmentioning

confidence: 99%

“…Younger men are at higher risk than older men (the SMR for 18-24 year olds was 8.3, compared to 3.7 in 25-44 year olds and 2.3 for men aged 45-64 years) 38 . The prevalence of psychiatric morbidity among homeless males aged [16][17][18][19][20][21] in London has been estimated to be 55% 39 . Another study estimated that a third of homeless women suffered from severe mental illness with a further quarter from other mental illness 40 .…”

Section: Public Injecting and Homelessnessmentioning

confidence: 99%

Injecting drug use and unstable housing: Scope for structural interventions in harm reduction

Briggs

Rhodes

Marks

et al. 2009

Drugs: Education, Prevention and Policy

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Evidence links unstable housing, and especially homelessness, with elevated health harm among drug users, including riskier drug injecting practices. We undertook 45 in-depth qualitative interviews with injecting drug users (IDUs) in Bristol and London in 2006. IDUs were recruited through drug user networks and drug agencies. Temporary accommodation and hostels for the homeless may provide a 'safe haven' from street-based drug use and public injecting environments, and are characterised as a retreat from the 'chaos' of the street. But hostels may also constitute 'risk environments' in facilitating drug using and risk networks, transitions to new patterns of use, including increased frequency of injecting. For some, homelessness was positioned as 'safer' than temporary housing with regards to managing drug use. Stable housing emerges as a key structural factor in creating enabling environments for health. We emphasise that temporary accommodation hostels have potential for harm-reduction interventions, but may also be associated with the production of risk related to drug use and injecting.

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Intranasal Naloxone for Treatment of Opioid Overdose

Kelly

Kerr

Dietze

2009

Opiate Receptors and Antagonists

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In theory, intranasal (IN) naloxone should be effective and practical for the treatment of acute opioid overdose. To date, evaluation of its effectiveness has been limited, but what is known is promising with reports that it is effective and safe, can reduce the requirement for injected treatments and has comparable times to recovery with other routes of administration. Unfortunately, naloxone as it is currently manufactured is not ideal for IN administration, as effective doses require drug volumes in excess of recommended volumes for adequate nasal absorption. Further well-designed research is needed to confirm IN naloxone's effectiveness, adverse event profile and utility. If effectiveness and safety can be confirmed, wider distribution of naloxone treatment to community workers, family and peers may be feasible, with the potential to save lives.

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Safety becomes danger: dilemmas of drug-use in public space

Cited by 116 publications

References 8 publications

Syringe possession arrests are associated with receptive syringe sharing in two Mexico–US border cities

Syringe possession arrests are associated with receptive syringe sharing in two Mexico–US border cities

Injecting drug use and unstable housing: Scope for structural interventions in harm reduction

Intranasal Naloxone for Treatment of Opioid Overdose

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