Journal of urban health : bulletin of the New York Academy of Medicine
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Drug overdose is the leading cause of unintentional death in the USA and the majority of deaths involve an opioid. Pharmacies are playing an increasingly important role in getting naloxone-the antidote to an opioid overdose-into the community. The aim of the current study was to understand, from the perspective of those who had obtained naloxone at the pharmacy, whose drug using status and pain patient status was not known until the interviews were conducted, as well as those who had not obtained naloxone at the pharmacy but were at risk for overdose, factors that impact the likelihood of obtaining pharmacy-based naloxone (PBN). ⋯ Finally, themes at the societal-level of influence were as follows: generational crisis, and frustration at lack of response to opioid crisis. Overall our findings reveal factors at multiple levels which may play a role in likelihood of obtaining naloxone at the pharmacy. These factors can be used to inform interventions seeking to increase provision of pharmacy-based naloxone.
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Implementing Targeted Sampling: Lessons Learned from Recruiting Female Sex Workers in Baltimore, MD.
Globally, HIV prevention interventions have proven efficacious among street-based female sex workers (FSWs); yet, there is a dearth of US-based HIV prevention research among this group. The lack of research among FSWs in the USA is partially driven by challenges in recruiting members of this population. The purpose of this research is to describe how targeted sampling was employed to recruit a cohort of street-based FSWs for a study that examined the role of police in shaping the HIV risk environments of street-based FSWs in Baltimore, MD. Our research demonstrates that targeted sampling can be an advantageous strategy for recruiting hidden populations that are mobile and geographically dispersed.
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Stress, drug use, and depression are interconnected, but less is understood about sources of stress among adults with co-occurring drug use and depressive symptoms. The current study aimed to identify sources of stress and correlates among these adults. Data come from a cross-sectional baseline survey, including participants (n = 336) 18 to 55 years old, who reported past 6-month heroin or cocaine use and depressive symptoms. ⋯ Past 6-month injection drug use (aPR = 1.28, 95% CI 1.04-1.58), perceived lack of control over drug use (aPR = 1.37, 95% CI 1.10-1.70), and drug use stigma was associated with an increased prevalence of high drug network stress (aPR = 1.32, 95% CI 1.05-1.65). Stress is a complex construct, including distinct sources and correlates. Further understanding of sources of stress is beneficial in recognizing potentially modifiable challenges faced by individuals who use drugs and experience depressive symptoms.
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Editorial Comment
Expanding a Comprehensive Strategy for Overdose Prevention in the USA.
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Environmental burdens such as air pollution are inequitably distributed with groups of lower socioeconomic statuses, which tend to comprise of large proportions of racial minorities, typically bearing greater exposure. Such groups have also been shown to present more severe health outcomes which can be related to adverse pollution exposure. Air pollution exposure, especially in urban areas, is usually impacted by the built environment, such as major roadways, which can be a significant source of air pollution. ⋯ When considering univariate associations between pollution and health outcomes, the only significant association existed between nitrogen oxides and COPD being negatively correlated. Greater percent tree canopy cover and green space access were associated with higher prevalence of COPD, CHD, and stroke. Overall, in considering health outcomes in connection with pollution exposure infrastructure and ethnic demographics, demographics remained the most significant explanatory variable.