Sydney M Silverstein1, Raminta Daniulaityte2, Silvia S Martins3, Shannon C Miller4, Robert G Carlson5. 1. Center for Interventions, Treatment, and Addictions Research, Department of Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, 3171 Research Blvd, Kettering, OH, United States. Electronic address: sydney.silverstein@wright.edu. 2. Center for Interventions, Treatment, and Addictions Research, Department of Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, 3171 Research Blvd, Kettering, OH, United States. Electronic address: raminta.daniulaityte@wright.edu. 3. Columbia University Mailman School of Public Health, 722 West 168th Street 5th Floor Room 509, New York, NY, United States. Electronic address: ssm2183@columbia.edu. 4. Dayton VA Medical Center/Middletown CBOC, Mental Health Service, 4337 Union Road, Middletown, OH 45005, United States; Departments of Psychiatry & Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, 3171 Research Blvd, Kettering, OH, United States. Electronic address: shannon.miller@va.gov. 5. Center for Interventions, Treatment, and Addictions Research, Department of Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, 3171 Research Blvd, Kettering, OH, United States. Electronic address: robert.carlson@wright.edu.
Abstract
BACKGROUND: Conducted in the Dayton Metropolitan area of Southwestern Ohio, this qualitative study explores the self-treatment practices of people who use illicit opioids (PWUIO) amidst the new risk environment produced by illicit, non-pharmaceutical fentanyl (NPF). We explore local perceptions of the presence of NPF in the Dayton area, and how this has both positively and negatively impacted practices of non-prescribed buprenorphine use among PWUIO. METHODS: This study analyzes qualitative data from 63 interviews conducted between October 2018 and June 2019. Participants were selected from a larger longitudinal study on non-prescribed buprenorphine use among individuals with opioid use disorder. Qualitative interviews were transcribed in their entirety, and their transcriptions were analyzed using NVivo software, drawing on a mix of thematic and inductive coding. RESULTS: Interview respondents ranged from 19 to 70 years old, with a mean age of 38.9 years. 54% of them were male, and 85.7% identified as non-Hispanic White. 98.4% of the sample had used heroin, and 93.7% of the sample reported use of NPF. Participants agreed NPF dominated the illicit opioids market in the area, and was perceived as both dangerous and desirable. The domination of NPF and associated overdose experiences prompted some to seek positive change and initiate self-treatment with non-prescribed buprenorphine. For others, NPF sabotaged established practices of harm reduction, as unanticipated experiences of precipitated withdrawals prompted some participants to give up non-prescribed buprenorphine use as a tactic of self-treatment. DISCUSSION: The changing nature of heroin/NPF necessarily gives rise to new beliefs surrounding self-treatment attempts, treatment seeking behaviors, and harm reduction practices. While buprenorphine treatment continues to offer promising results for treating opioid use disorders, it is urgent to reconsider how the unpredictable biochemical mixture of NPFs circulating on the streets today may impact the initiation and success of treatment.
BACKGROUND: Conducted in the Dayton Metropolitan area of Southwestern Ohio, this qualitative study explores the self-treatment practices of people who use illicit opioids (PWUIO) amidst the new risk environment produced by illicit, non-pharmaceutical fentanyl (NPF). We explore local perceptions of the presence of NPF in the Dayton area, and how this has both positively and negatively impacted practices of non-prescribed buprenorphine use among PWUIO. METHODS: This study analyzes qualitative data from 63 interviews conducted between October 2018 and June 2019. Participants were selected from a larger longitudinal study on non-prescribed buprenorphine use among individuals with opioid use disorder. Qualitative interviews were transcribed in their entirety, and their transcriptions were analyzed using NVivo software, drawing on a mix of thematic and inductive coding. RESULTS: Interview respondents ranged from 19 to 70 years old, with a mean age of 38.9 years. 54% of them were male, and 85.7% identified as non-Hispanic White. 98.4% of the sample had used heroin, and 93.7% of the sample reported use of NPF. Participants agreed NPF dominated the illicit opioids market in the area, and was perceived as both dangerous and desirable. The domination of NPF and associated overdose experiences prompted some to seek positive change and initiate self-treatment with non-prescribed buprenorphine. For others, NPF sabotaged established practices of harm reduction, as unanticipated experiences of precipitated withdrawals prompted some participants to give up non-prescribed buprenorphine use as a tactic of self-treatment. DISCUSSION: The changing nature of heroin/NPF necessarily gives rise to new beliefs surrounding self-treatment attempts, treatment seeking behaviors, and harm reduction practices. While buprenorphine treatment continues to offer promising results for treating opioid use disorders, it is urgent to reconsider how the unpredictable biochemical mixture of NPFs circulating on the streets today may impact the initiation and success of treatment.
Authors: Raminta Daniulaityte; Sydney M Silverstein; Timothy N Crawford; Silvia S Martins; William Zule; Angela J Zaragoza; Robert G Carlson Journal: Subst Use Misuse Date: 2020-05-22 Impact factor: 2.164
Authors: Sydney M Silverstein; Raminta Daniulaityte; Shannon C Miller; Silvia S Martins; Robert G Carlson Journal: Drug Alcohol Depend Date: 2020-03-16 Impact factor: 4.492
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Authors: Benjamin T Hayes; Andrea Jakubowski; Christine Fitzsimmons; Billy Garcia; Franklin Ramirez; Aaron D Fox Journal: Subst Use Misuse Date: 2021-05-03 Impact factor: 2.164
Authors: Ryan R Cook; Randy Torralva; Caroline King; Paula J Lum; Hansel Tookes; Canyon Foot; Pamela Vergara-Rodriguez; Allan Rodriguez; Laura Fanucchi; Gregory M Lucas; Elizabeth N Waddell; P Todd Korthuis Journal: Drug Alcohol Depend Date: 2021-09-20 Impact factor: 4.492