کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5120675 1486259 2017 10 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Heroin uncertainties: Exploring users' perceptions of fentanyl-adulterated and -substituted 'heroin'
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی روانپزشکی و بهداشت روانی
پیش نمایش صفحه اول مقاله
Heroin uncertainties: Exploring users' perceptions of fentanyl-adulterated and -substituted 'heroin'
چکیده انگلیسی

BackgroundThe US is experiencing an unprecedented opioid overdose epidemic fostered in recent years by regional contamination of the heroin supply with the fentanyl family of synthetic opioids. Since 2011 opioid-related overdose deaths in the East Coast state of Massachusetts have more than tripled, with 75% of the 1374 deaths with an available toxicology positive for fentanyl. Fentanyl is 30-50X more potent than heroin and its presence makes heroin use more unpredictable. A rapid ethnographic assessment was undertaken to understand the perceptions and experiences of people who inject drugs sold as 'heroin' and to observe the drugs and their use.MethodsA team of ethnographers conducted research in northeast Massachusetts and Nashua, New Hampshire in June 2016, performing (n = 38) qualitative interviews with persons who use heroin.Results(1) The composition and appearance of heroin changed in the last four years; (2) heroin is cheaper and more widely available than before; and (3) heroin 'types' have proliferated with several products being sold as 'heroin'. These consisted of two types of heroin (alone), fentanyl (alone), and heroin-fentanyl combinations. In the absence of available toxicological information on retail-level heroin, our research noted a hierarchy of fentanyl discernment methods, with embodied effects considered most reliable in determining fentanyl's presence, followed by taste, solution appearance and powder color. This paper presents a new 'heroin' typology based on users' reports.ConclusionMassachusetts' heroin has new appearances and is widely adulterated by fentanyl. Persons who use heroin are trying to discern the substances sold as heroin and their preferences for each form vary. The heroin typology presented is inexact but can be validated by correlating users' discernment with drug toxicological testing. If validated, this typology would be a valuable harm reduction tool. Further research on adaptations to heroin adulteration could reduce risks of using heroin and synthetic opioid combinations.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Drug Policy - Volume 46, August 2017, Pages 146-155
نویسندگان
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