Introduction and Aims
Substitution is operationalised as a conscious choice made by users to use one drug instead of, or in conjunction with another based on: perceived safety, level of addiction ...potential, effectiveness in relieving symptoms, access and level of acceptance. Harm reduction is a set of strategies that aim to minimise problems associated with drug use while recognising that for some users, abstinence may be neither a realistic nor a desirable goal. In this paper, we aim for deeper understandings of older adult cannabis users' beliefs and substitution practices as part of the harm reduction framework.
Design and Methods
We present selected findings from our qualitative study of Baby Boomer (born 1946–1964) marijuana users in the San Francisco Bay Area. Although the sample consisted of primary cannabis users, many had personal experience with other drugs throughout their lifetimes. Data collection consisted of an audio‐recorded, semi‐structured in‐depth life history interview followed by a questionnaire and health survey. Qualitative interviews were analysed to discover users' harm reduction beliefs and cannabis substitution practices.
Results
Study participants described using cannabis as a safer alternative for alcohol, illicit drugs and pharmaceuticals based on their perceptions of less adverse side effects, low‐risk for addiction and greater effectiveness at relieving symptoms, such as chronic pain.
Discussion and Conclusions
Cannabis substitution can be an effective harm reduction method for those who are unable or unwilling to stop using drugs completely. More research is needed on cannabis as a safer alternative. Lau N, Sales P, Averill S, Murphy F, Sato S, Murphy S. A safer alternative: Cannabis substitution as harm reduction. Drug Alcohol Rev 2015;34:654–659
This article presents selected findings from a qualitative study of Ecstasy sellers and their sales practices, knowledge of distribution networks, buyer-seller relationships, and self-reported drug ...use. In-depth interviews were conducted with 80 men and women who had sold five or more hits of Ecstasy five or more times in the six months prior to the interview. Study participants described their perceptions of the various types of Ecstasy they had distributed or used themselves. The participants had experience with a variety of Ecstasy labels, from the popular "Blue Dolphin" tablets to the powdered form called "Molly." We tracked pill brand mentions on Ecstasy-related websites to compare with interviewees' descriptions of Ecstasy brands. This study examines Ecstasy sellers' ideas about the role of brand names in Ecstasy markets and their relationship to their beliefs about different types of Ecstasy's purity and quality. We demonstrate that considering Ecstasy branding increases our understanding of buyer and seller relationships.
Highlights • Alternative cannabis derivatives and routes of administration reduced health harms. • Controlled use was moderated, setting appropriate, and respectful of non-users. • Product ...lab-testing, proper labeling, and education supported harm reduction. • Medical recommendations led to better informed decisions about use practices. • Users contributed to the normalization of cannabis use through normification.
In the US, prescription stimulants are prescribed for a variety of conditions including attention deficit hyperactivity disorder (ADHD) and narcolepsy. Over the last two decades, dramatic increases ...in stimulant prescriptions have led to greater availability and increased risk for diversion and nonmedical use. Our own and other investigators' findings indicate that many drug “suppliers” do not fit into the traditional image of drug “dealers.” These suppliers typically do not identify themselves as “dealers,” but instead understand their drug distribution as sharing with people they know. Coomber and colleagues' (2007; 2013) concept of “social supply” raises the question: When friends supply or facilitate supply of drugs to friends, is this really dealing? Further, if dealing and supplying are distinct kinds of social transactions, should different types of criminal justice approaches be applied? Social supply extends our understanding of drug dealing as a complex social activity. In this article, we examine the issue of social supply among nonmedical users of prescription stimulants. We conducted a 36-month National Institute on Drug Abuse-funded project to conduct a qualitative, mixed methods study of 150 adult nonmedical prescription stimulant users in the San Francisco Bay Area. We explore intersecting factors, including life stage and social location, that contribute to decisions to use prescription stimulants nonmedically, motivations to use, knowledge about risks and benefits of prescription stimulant use, any adverse health or social consequences experienced, availability, acquisition and diversion of prescription stimulants, and differences in attitudes and behaviours. For this analysis, we rely on participants' narratives concerning prescription stimulant acquisition practices and how they understood these interactions, purchases, and exchanges with the suppliers of prescription stimulants in their social networks. The authors argue that acknowledging the distinction between social supply and “proper” drug dealing would redress the disparity between drug sharing and profiteering particularly regarding criminal sentencing.
Studies indicate prescription stimulant use for cognitive performance enhancement is normalized, contributing to increases in non-medical prescription stimulant use (NPSU) through peer ...recommendations and drug diversion. NPSU may follow users beyond their academic years to the workforce with some initiating use later in adulthood.
Aims: Examine findings from a San Francisco Bay Area National Institute on Drug Abuse funded research project. Explore motivations to initiate and continue NPSU focusing on San Francisco Bay Area adults in the workforce. Analyze motivations for use and use practices within the American sociocultural context. We also examine consequences of use, including falling into the 'Adderall trap' - a cycle of using to perform, sleeplessness, then using again to wake up and perform.
Methods: 67 in-depth interviews analyzed using Grounded Theory methods.
Findings: Increased availability combined with pressure to perform and compete at work, facilitated decisions to initiate and continue use. Some also used recreationally to mitigate the effects of alcohol and prolong a night out.
Conclusions: Cultural factors such as the pressure to perform in a society as the US valuing hard work, competition, and success motivate NPSU. In these cases, NPSU is not necessarily considered to be deviant, but rather following conventional values.
Findings for this article are derived from our National Institute on Drug Abuse (NIDA)-funded study of older and younger Baby Boomers and marijuana use. We explore Baby Boomers’ use of a variety of ...cannabis products and the motives behind the choices they make concerning these preparations. Cannabis concentrates and edible goods have become increasingly popular over the years. With so many new ways to consume marijuana and a growing number of medical marijuana dispensaries, more and more people are using alternative cannabis products to relieve physical ailments, to improve mental health issues, and for recreational purposes. We explore Baby Boomers’ motives to use and how aging may change those motives and influence their choices in cannabis delivery systems. As they get older, Boomers’ health concerns grow and many have turned to these alternative cannabis products to improve mental and physical well-being, and even to reduce the potential risks of traditional marijuana smoking.
Everybody’s Doing It Mui, Heather Z.; Sales, Paloma; Murphy, Sheigla
Journal of drug issues,
07/2014, Letnik:
44, Številka:
3
Journal Article
Recenzirano
In this article, we present findings from a qualitative National Institute on Drug Abuse-funded study of nonmedical prescription drug users in the San Francisco Bay Area. We interviewed young adults ...between the ages of 18 and 25 years, who used prescription drugs nonmedically at least 12 times in the 6 months prior to the interview. Employing Aker’s Social Learning Theory and Zinberg’s Drug, Set, and Setting, we explore the factors that contributed to participants’ choices to begin using prescription drugs nonmedically. Social Learning Theory provides the framework for understanding how deviant behaviors are learned and imitated, while set and setting emphasizes the psychological and social contexts of initiation and the ways in which the set and setting of the initiating user were influenced by exposure, motivation, access, and setting. Together, social learning, and set and setting allow us to understand the interaction of individual and social factors contributing to nonmedical prescription drug use initiation.
We present findings from two exploratory studies of San Francisco Bay Area women involved in illicit drug sales who saw both advantages and disadvantages to being women in traditionally ...male-dominated drug economies. We interviewed 160 sellers of street drugs and 50 sellers of prescription drugs during 2006-2009. Women perceived gender as a cover and managed their vulnerabilities by performing gendered actions and at times going against traditional gender expectations to protect themselves in harsh drug markets. The intersecting factors of race and type of drug sold played a crucial role, revealing the complex nature of women's social location in their drug-selling worlds. Study limitations are noted.
How do we get drug sellers to talk with us? We approach them from the standpoint that what they know, their experiences and perceptions about drug dealing as work, is a specialized knowledge and that ...we are asking them to share it with us despite the potential for serious personal risk. In each interview, we try to overcome difference and social distance by identifying what we call nodes of affinity - commonalities or shared experiences. As meanings are negotiated and narratives constructed, power shifts back and forth between interviewer and interviewee, shaping the give-and-take process of knowledge building. We discuss the ways in which social isolation, a defining feature of the social context of drug selling, can affect the interview process. We describe some of the strategies we have derived from the symbolic interactionist and social constructionist traditions to help engender trust and rapport with interviewees. And we describe the reciprocal presentations of self by interviewer and interviewee and the social construction of meanings and narratives in the course of the interviews. We hope this will contribute to the existing literature on the micropolitics or the relations of power that are negotiated within interview processes such that knowledge gets co-constructed.
Notwithstanding a paucity of data, prescription of the opioid antagonist naloxone to patients prescribed opioids is increasingly recommended in opioid stewardship guidelines. The aim of this study ...was to evaluate chronic pain patients' attitudes toward being offered a naloxone prescription and their experience with naloxone.
We interviewed 60 patients who received naloxone prescriptions across 6 safety-net primary care clinics (10 patients per clinic) from October 2013 to October 2015. We used a standardized questionnaire to collect information on substance use, perception of personal overdose risk, history of overdose, and experiences with naloxone prescription, including initial reaction, barriers to filling the prescription, storage and use of naloxone, associated behavioral changes, and opinions about future prescribing.
Respondents were demographically similar to all clinic patients receiving opioid prescriptions. Ninety percent had never previously received a naloxone prescription, 82% successfully filled a prescription for naloxone, and 97% believed that patients prescribed opioids for pain should be offered naloxone. Most patients had a positive (57%) or neutral (22%) response to being offered naloxone, and 37% reported beneficial behavior changes after receiving the prescription; there were no harmful behavior changes reported. Although 37% had personally experienced an opioid-poisoning event (17% of which were described as bad reactions but consistent with an overdose) and 5% reported that the prescribed naloxone had been used on them, 77% estimated their risk of overdose as low.
Primary care patients on opioids reported that receiving a prescription for naloxone was acceptable, the prescription reached patients who had not had access to naloxone, and having naloxone may be associated with beneficial changes in opioid use behaviors. Patients prescribed opioids may not interpret the terminology describing overdose to imply unintentional opioid poisoning.
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