Self‐detoxification from opioid drugs

Ison, Julie; Day, Ed; Fisher, Kaye; Pratt, Mercedes; Hull, Martyn; Copello, Alex

doi:10.1080/14659890500143697

Cited by 5 publications

(7 citation statements)

References 4 publications

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“…However, the effectiveness of detoxification can be located in providing a safe withdrawal from opiates (Mattick & Hall, 1996), relatively high completion rates (Smyth et al, 2005;Cox et al, 2007) and potential to effect reduced drug use, reduced injecting and increased health at followup (Cox et al, 2007), and accessing long-term treatment (Gowing & Ali, 2006). It is evident from epidemiological research that some opiate users can become abstinent without accessing formal treatment (Friedman et al, 2004;Ison et al, 2006;Bobrova et al, 2006;Peterson et al, 2010). Some research suggests that even if clear access pathways are available, not all opiate dependent users would enter treatment if offered (Zule & Desmond, 2000;Booth et al, 2003;Peterson et al, 2010).…”

Section: Methodsmentioning

confidence: 99%

“…In order to increase treatment access from rural areas, and minimise frequent relapse typical to opiate dependent users, it is therefore important to consult and recognise the views of those attempting to detoxify from opiates, in order to yield timely and proactive recommendations for national, regional and indeed local drug service provision. In the broader literature on treatment outcomes, the individual experiences and perspectives of self-detoxification (Ison et al, 2006) remain neglected and under-researched. Research on self-detoxification may have the potential to contribute to improvements within detoxification programmes (Noble et al, 2002;Ison et al, 2006).…”

Section: Background To the Researchmentioning

confidence: 99%

“…In the broader literature on treatment outcomes, the individual experiences and perspectives of self-detoxification (Ison et al, 2006) remain neglected and under-researched. Research on self-detoxification may have the potential to contribute to improvements within detoxification programmes (Noble et al, 2002;Ison et al, 2006). This research was initiated and funded by the South Eastern Region Drugs Task Force in 2007, following heightened anecdotal agency and opiate user reports of the impacts of lack of opiate detoxification services and, as such, increasing self-detoxification in the rural areas.…”

Section: Background To the Researchmentioning

confidence: 99%

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Maze and minefield — a grounded theory of opiate self‐detoxification in rural Ireland

McDonnell

Hout

2010

Drugs and Alcohol Today

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Opiate use is no longer confined to the greater urban context in Ireland, with scant detoxification services present in rural areas (Carew et al, 2009; National Advisory Committee on Drugs, 2008). This exploratory research aimed to yield an illustrative account of opiate users' experiences of self‐detoxification by adopting a grounded theory approach (Glaser & Strauss, 1967). Data emerging from 21 in‐depth interviews (n=12 heroin users, n=9 drug service providers: statutory, community and voluntary) were analysed using the constant comparative method. The study generated a substantive theory of self‐detoxification as a subjective process of seeking heroin abstinence. Self‐detoxification emerged as a frequent and reactive or proactive process in collaboration with others (heroin users, family and drug service providers). The study has implications for drug service delivery in rural Ireland in terms of increasing information provision and access to opiate detoxification through the development of low threshold services and community‐based detoxification.

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Section: Methodsmentioning

confidence: 99%

Section: Background To the Researchmentioning

confidence: 99%

Section: Background To the Researchmentioning

confidence: 99%

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Maze and minefield — a grounded theory of opiate self‐detoxification in rural Ireland

McDonnell

Hout

2010

Drugs and Alcohol Today

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“…Crushed buprenorphine tablets could for instance be more commonly injected than methadone syrup, which is assumed to be a more hazardous intake method. Different intake modes may in turn be related to motives for use, such as the removal of withdrawal symptoms versus getting "high" (Daniulaityte et al, 2012;Harris et al, 2013;Ison et al, 2006;Otiashvili et al, 2010). Further, that a low frequency of buprenorphine use was associated with increased overdose risk could potentially be explained by low tolerance levels in those who use buprenorphine infrequently, as tolerance levels are considered an important mechanism in relation to drug overdoses (Darke et al, 1996;Seldén et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Illicit use of opioid substitution drugs: Prevalence, user characteristics, and the association with non-fatal overdoses

Bretteville-Jensen¹,

Lillehagen²,

Gjersing³

et al. 2015

Drug and Alcohol Dependence

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Background and aims: Diversion of opioid substitution drugs (OSD) is of public concern. This study examined the prevalence, frequency, and predictors of illicit OSD use in a group of injecting drug users (IDUs) and assessed if such use was associated with non-fatal overdoses.Methods: Semi-annual cross-sectional interviews conducted in Oslo, Norway, (2006Norway, ( -2013, from 1,355 street-recruited IDUs. Hurdle, logistic, and multinomial regression models were employed.Results: Overall, 27% reported illicit OSD use in the past four weeks; 16.8% methadone, 12.5% buprenorphine, and 2.9% both drugs. Almost 1/10 reported at least one non-fatal overdose in the past four weeks, and roughly 1/3 reported such experience in the past year. Use of additional drugs tended to be equally, or more prevalent among illicit OSD users than other IDUs. In terms of illicit OSD use being a risk factor for non-lethal overdoses, our results showed significant associations only for infrequent buprenorphine use (using once or less than once per week). Other factors associated with non-fatal overdoses included age, education, homelessness, as well as the benzodiazepines, stimulants, and heroin use. Conclusions:Users of diverted OSD may represent a high-risk population, as they used more additional drugs and used them more frequently than other IDUs. However, illicit OSD use may be less harmful than previously assumed. After accounting for an extensive set of covariates, only infrequent illicit buprenorphine use, but not methadone use, was associated with non-fatal overdoses.

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“…The routines included press-ups and sit-ups and running on the spot. Physical activity and exercise are mentioned in the self-detoxification literature as common techniques used to distract the mind from withdrawal symptoms (Gossop et al, 1991;Ison et al, 2006;McDonnell and Van Hout, 2010). For the participants, these techniques were part of the strategy for removing 'heroin-as-poison' from the body.…”

Section: Maintaining a Low Profile In Prison Drug Treatmentmentioning

confidence: 99%

Self-detoxification, embodiment and masculinity: a qualitative analysis of dependent heroin users’ experiences of coming off drugs in prison

Walmsley

2021

Drugs: Education, Prevention and Policy

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Not all heroin users that enter the prison estate continue to use heroin or access opiate maintenance or detoxification treatment programmes. Some prisoners decide to self-detoxify. The literature on self-detoxification is thin and focuses on the decisions and practices of self-detoxification in community settings. Less attention has been given to the role of the body and the lived experience of selfdetoxification in prison settings. The aim of this paper therefore is to examine the process of selfdetoxification in prison, with a particular focus on the role of the body, embodiment and prisoner social relations. This paper draws on Drew Leder's (1990) absent body theoretical framework and the literature on prison masculinity to analyse qualitative interviews with recently released prisoners. It shows how the decision to self-detoxify can be understood as part of the masculine performance of keeping a low profile. Keeping a low profile helped the participants minimise the risks of victimisation. The self-detoxification techniques the participants used were underpinned by an awareness of the body as poisoned by heroin, suffering because of its presence, rather than its absence. This study has implications for prisoners' access to opiate maintenance and detoxification treatment programmes and harm reduction services upon release.

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Self‐detoxification from opioid drugs

Cited by 5 publications

References 4 publications

Maze and minefield — a grounded theory of opiate self‐detoxification in rural Ireland

Maze and minefield — a grounded theory of opiate self‐detoxification in rural Ireland

Illicit use of opioid substitution drugs: Prevalence, user characteristics, and the association with non-fatal overdoses

Self-detoxification, embodiment and masculinity: a qualitative analysis of dependent heroin users’ experiences of coming off drugs in prison

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