The Heroin Shortage in the UK and Europe

Hallam, Christopher

doi:10.2139/ssrn.1908881

Cited by 4 publications

(2 citation statements)

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“…Similar to the heroin shortages in Australia (Degenhardt, Conroy, Day, Gilmour, & Hall, 2005; Degenhardt, Day, et al, 2005) and England (Hallam, 2011; Simonson & Daly, 2011), we found that in the Kenya shortage, prices for heroin increased, purity decreased, and drug substitution and poly-drug use were practiced. In his review of Australia's 2001 shortage, Jaffe (2005) cautioned the effects of abrupt changes to the heroin supply in places where smoking and inhalation are the primary modes of heroin use (Jaffe, 2005).…”

Section: Discussionsupporting

confidence: 71%

“…Heroin shortages have been reported in the United States during World War II and the early 1970s (Agar, 1978; Schneider, 2008), Australia in 2001 (Degenhardt et al, 2004; Degenhardt, Gascoigne, Howard, & Webber, 2002), and England in 2010 (Hallam, 2011; Simonson & Daly, 2011). The Kenyan shortage described here may be the first to be documented in a developing country.…”

Section: Introductionmentioning

confidence: 99%

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Heroin shortage in Coastal Kenya: A rapid assessment and qualitative analysis of heroin users’ experiences

Mital

Miles

McLellan-Lemal

et al. 2016

International Journal of Drug Policy

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Introduction While relatively rare events, abrupt disruptions in heroin availability have a significant impact on morbidity and mortality risk among those who are heroin dependent. A heroin shortage occurred in Coast Province, Kenya from December 2010 to March 2011. This qualitative analysis describes the shortage events and consequences from the perspective of heroin users, along with implications for health and other public sectors. Methods As part of a rapid assessment, 66 key informant interviews and 15 focus groups among heroin users in Coast Province, Kenya were conducted. A qualitative thematic analysis was undertaken in Atlas.ti. to identify salient themes related to the shortage. Results Overall, participant accounts were rooted in a theme of desperation and uncertainty, with emphasis on six sub-themes: (1) withdrawal and strategies for alleviating withdrawal, including use of medical intervention and other detoxification attempts; (2) challenges of dealing with unpredictable drug availability, cost, and purity; (3) changes in drug use patterns, and actions taken to procure heroin and other drugs; (4) modifications in drug user relationship dynamics and networks, including introduction of risky group-level injection practices; (5) family and community response; and (6) new challenges with the heroin market resurgence. Conclusions The heroin shortage led to a series of consequences for drug users, including increased risk of morbidity, mortality and disenfranchisement at social and structural levels. Availability of evidence-based services for drug users and emergency preparedness plans could have mitigated this impact.

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