Groin injecting in the context of crack cocaine and homelessness: From ‘risk boundary’ to ‘acceptable risk’?

Rhodes, Tim; Stoneman, April; Hope, Vivian; Hunt, Neil; Martin, Anthea; Judd, Ali

doi:10.1016/j.drugpo.2006.02.011

Cited by 44 publications

(51 citation statements)

References 30 publications

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“…Most participants (72 %) disagreed with this rule, the main reason being that for some users these were the only places left to inject. This result may reflect the fact that whilst some users are forced to inject in the neck and groin as a result of long-term injecting, it has become increasingly normal in some English cities (Rhodes et al, 2006). Maliphant and Scott (2005) reported that 51% of their UK sample of IDUs was injecting in the groin because no other convenient sites were considered to be accessible and the likelihood of heroin users injecting into sites other than the arm increases with the duration of injecting (Karimi et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Attitudes of intravenous drug users in London towards the provision of drug consumption rooms

Butler

Chapman

Terry

2016

Drugs: Education, Prevention and Policy

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Aims: The study investigated the attitudes of intravenous drug users (IDUs) towards the provision of drug consumption rooms (DCRs) in the UK and their willingness to use DCRs. Methods:Participants were 90 methadone-maintained outpatients recruited from a London clinic. A questionnaire asked about their willingness to use a DCR, their views on various rules commonly-implemented by DCRs, and how they believed DCRs might impact on the drug-taking behaviours of drug users and their peers. Findings: A large majority (89%) expressed willingness to use a DCR and accepted the need for rules such as no drug sharing (84.3%), no assistance with injecting (81.8%), compulsory supervision (76.7%) and compulsory hand washing (92.1%). However, the IDUs were split over whether injection in the neck or groin should be disallowed and whether certain categories of IDUs (e.g. juveniles, pregnant women) should be excluded from DCRs. Majorities thought it unlikely that DCRs would encourage users to try risker drug preparations (76.6%), or encourage non injectors to inject for the first time (74.5%). Conclusions: In a country where DCRs are not available, the study highlights the willingness of IDUs to use a DCR and accept its rules, even for a sample most of whom were not homeless.

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Section: Discussionmentioning

confidence: 99%

Attitudes of intravenous drug users in London towards the provision of drug consumption rooms

Butler

Chapman

Terry

2016

Drugs: Education, Prevention and Policy

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“…In a longitudinal study in South Wales, the incidence of HCV infection was almost four times greater among injectors who had been homeless or living in temporary accommodation compared to those who had not in the previous year 43 . Drug injectors with recent experience of homelessness or unstable housing are more likely to share needles and syringes and other injecting paraphernalia 29,41,46,47,48,49,76 , as well as use crack and exchange sex 3,41,45 . Individuals who are homeless for extended periods in combination with a diagnosis of substance misuse or dependence may be especially vulnerable to engaging in risky sexual behaviours and HIV transmission 50,51 .…”

Section: Public Injecting and Homelessnessmentioning

confidence: 99%

“…There is increased recognition in the UK of the challenges posed by the management of drug use within the hostel environment 60 , alongside interest in the potential role of structural and environmental interventions in harm reduction 4,61,62 , including specifically in relation to public injecting 25,26,45,63,64,65 . Yet there remains an absence of evidence on how hostel environments may shape injecting drug use and related harm 59 .…”

Section: Housing Interventionsmentioning

confidence: 99%

“…For example, in a multi-site study among over 1,000 injectors in England, those with recent experience of homelessness or temporary accommodation had almost twice the odds of HCV positivity 42,45 . In a longitudinal study in South Wales, the incidence of HCV infection was almost four times greater among injectors who had been homeless or living in temporary accommodation compared to those who had not in the previous year 43 .…”

Section: Public Injecting and Homelessnessmentioning

confidence: 99%

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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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“…In the United Kingdom, up to 40% of IDUs recruited in several regions of England and Wales reported having injected crack in the few weeks before interview (Hunter et al, 1995, Rhodes et al, 2006Hope et al, 2008). In the United States, lifetime prevalence of crack injection in a multisite study of young IDUs was estimated to be 15% and it was 9.4% for the 6-month period preceding interview (Santibanez et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and temporal trends of crack injection among injection drug users in eastern central Canada

Roy¹,

Leclerc²,

Morissette³

et al. 2013

Drug and Alcohol Dependence

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Groin injecting in the context of crack cocaine and homelessness: From ‘risk boundary’ to ‘acceptable risk’?

Cited by 44 publications

References 30 publications

Attitudes of intravenous drug users in London towards the provision of drug consumption rooms

Attitudes of intravenous drug users in London towards the provision of drug consumption rooms

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

Prevalence and temporal trends of crack injection among injection drug users in eastern central Canada

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