Scars, Harm and Pain

Epele, María E.

doi:10.1300/j233v01n01_04

Cited by 21 publications

(21 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In eight studies [54,55,59,62,65,67,68,76], investigators attributed bacterial infections to suboptimal drug preparation and injecting techniques created by unsafe spaces, including when participants lacked housing and tried to avoid being seen by police when using outdoors.…”

Section: Unsafe Spacesmentioning

confidence: 99%

See 1 more Smart Citation

Social and structural determinants of injection drug use‐associated bacterial and fungal infections: A qualitative systematic review and thematic synthesis

Brothers

Bonn²,

Lewer

et al. 2023

Addiction

View full text Add to dashboard Cite

Background and aimsInjection drug use‐associated bacterial and fungal infections are increasingly common, and social contexts shape individuals’ injecting practices and treatment experiences. We sought to synthesize qualitative studies of social–structural factors influencing incidence and treatment of injecting‐related infections.MethodsWe searched PubMed, EMBASE, Scopus, CINAHL and PsycINFO from 1 January 2000 to 18 February 2021. Informed by Rhodes’ ‘risk environment’ framework, we performed thematic synthesis in three stages: (1) line‐by‐line coding; (2) organizing codes into descriptive themes, reflecting interpretations of study authors; and (3) consolidating descriptive themes into conceptual categories to identify higher‐order analytical themes.ResultsWe screened 4841 abstracts and included 26 qualitative studies on experiences of injecting‐related bacterial and fungal infections. We identified six descriptive themes organized into two analytical themes. The first analytical theme, social production of risk, considered macro‐environmental influences. Four descriptive themes highlighted pathways through which this occurs: (1) unregulated drug supply, leading to poor drug quality and solubility; (2) unsafe spaces, influenced by policing practices and insecure housing; (3) health‐care policies and practices, leading to negative experiences that discourage access to care; and (4) restrictions on harm reduction programmes, including structural barriers to effective service provision. The second analytical theme, practices of care among people who use drugs, addressed protective strategies that people employ within infection risk environments. Associated descriptive themes were: (5) mutual care, including assisted‐injecting and sharing sterile equipment; and (6) self‐care, including vein health and self‐treatment. Within constraining risk environments, some protective strategies for bacterial infections precipitated other health risks (e.g. HIV transmission).ConclusionsInjecting‐related bacterial and fungal infections are shaped by modifiable social–structural factors, including poor quality unregulated drugs, criminalization and policing enforcement, insufficient housing, limited harm reduction services and harmful health‐care practices. People who inject drugs navigate these barriers while attempting to protect themselves and their community.

show abstract

Section: Unsafe Spacesmentioning

confidence: 99%

“…In six of these studies [54,57,62,65,67,68] hygienic surfaces to prepare drugs [54,67,68], inadequate lighting to find veins (leading to 'missed hits' and inadvertent subcutaneous injection) [54] and no clean, running water to wash hands/skin or to dissolve drugs (leading people to use unhygienic water alternatives) [62,65,67,68]:…”

Section: Unsafe Spacesmentioning

confidence: 99%

Social and structural determinants of injection drug use‐associated bacterial and fungal infections: A qualitative systematic review and thematic synthesis

Brothers

Bonn²,

Lewer

et al. 2023

Addiction

View full text Add to dashboard Cite

show abstract

“…Peer-to-peer injection arises from diverse circumstances and motivations. For injection recipients, lack of knowledge on how to inject has been reported, along with shorter length of injection career (Epele, 2001;Fairbairn et al, 2010;Lee et al, 2013;O'Connell et al, 2005). For women, poor vein availability, as well as wanting to reducing scarring and damage have been documented as reasons for needing injection assistance (Epele, 2001;.…”

Section: Introductionmentioning

confidence: 99%

“…For injection recipients, lack of knowledge on how to inject has been reported, along with shorter length of injection career (Epele, 2001;Fairbairn et al, 2010;Lee et al, 2013;O'Connell et al, 2005). For women, poor vein availability, as well as wanting to reducing scarring and damage have been documented as reasons for needing injection assistance (Epele, 2001;. PWID wanting jugular injection and those in the midst of withdrawal have also report needing assistance injecting (Hoda, Kerr, Li, Montaner, & Wood, 2008;.…”

Section: Introductionmentioning

confidence: 99%

“…PWID wanting jugular injection and those in the midst of withdrawal have also report needing assistance injecting (Hoda, Kerr, Li, Montaner, & Wood, 2008;. Providing injection assistance can be associated with exchanges of money or drugs (Epele, 2001;Fairbairn et al, 2010;Parkin & Coomber, 2009), although qualitative research has found that some providers take pride in assisting others and do so because they have had their own troubles self-injecting (Carlson, 2000;Murphy & Waldorf, 1991).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Peer-to-peer injection: Demographic, drug use, and injection-related risk factors

Lamb

Kral

Dominguez-Gonzalez

et al. 2018

International Journal of Drug Policy

View full text Add to dashboard Cite

Background: Peer-to-peer injection (either providing or receiving an injection to/from a person who injects drugs [PWID]) is common (19%-50%) among PWID. Most studies of peer-to-peer injection have focused on receiving injection assistance, with fewer examining providing injection assistance and none considering characteristics of PWID who do both. We examined characteristics of PWID by peer-to-peer injection categories (receiving, providing, both, and neither) and determined if these behaviors were associated with receptive and distributive syringe sharing.Methods: Los Angeles and San Francisco PWID (N = 777) were recruited using targeted sampling methods and interviewed during 2011-2013. Multinomial logistic regression was used to determine characteristics associated with peer-to-peer injection categories and logistic regression was used to examine if peer-to-peer categories were independently associated with distributive and receptive syringe sharing.Results: Recent peer-to-peer injection was reported by 42% of PWID (18% provider; 14% recipient; 10% both). In multinomial regression analysis, PWID reporting any peer-to-peer injection were more likely to inject with others than those who did neither. Injection providers and those who did both were associated with more frequent injection, illegal income source, and methamphetamine injection while injection recipients were associated with fewer years of injection. Injection providers were younger, had more years of injecting, and were more likely to inject heroin than PWID who did neither. In multivariate analyses, we found that providers and *

show abstract

“People Knew They Could Come Here to Get Help”: An Ethnographic Study of Assisted Injection Practices at a Peer-Run ‘Unsanctioned’ Supervised Drug Consumption Room in a Canadian Setting

McNeil

Small

Lampkin³

et al. 2013

AIDS Behav

111

113

View full text Add to dashboard Cite

People who require help injecting are disproportionately vulnerable to drug-related harm, including HIV transmission. North America’s only sanctioned SIF operates in Vancouver, Canada under an exemption to federal drug laws, which imposes operating regulations prohibiting assisted injections. In response, the Vancouver Area Network of Drug Users (VANDU) launched a peer-run unsanctioned SIF in which trained peer volunteers provide assisted injections to increase the coverage of supervised injection services and minimize drug-related harm. We undertook qualitative interviews (n=23) and ethnographic observation (50 hours) to explore how this facility shaped assisted injection practices. Findings indicated that VANDU reshaped the social, structural, and spatial contexts of assisted injection practices in a manner that minimized HIV and other health risks, while allowing people who require help injecting to escape drug scene violence. Findings underscore the need for changes to regulatory frameworks governing SIFs to ensure that they accommodate people who require help injecting.

show abstract

Scars, Harm and Pain

Cited by 21 publications

References 24 publications

Social and structural determinants of injection drug use‐associated bacterial and fungal infections: A qualitative systematic review and thematic synthesis

Social and structural determinants of injection drug use‐associated bacterial and fungal infections: A qualitative systematic review and thematic synthesis

Peer-to-peer injection: Demographic, drug use, and injection-related risk factors

“People Knew They Could Come Here to Get Help”: An Ethnographic Study of Assisted Injection Practices at a Peer-Run ‘Unsanctioned’ Supervised Drug Consumption Room in a Canadian Setting

Contact Info

Product

Resources

About