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Circumstances of overdose among street-involved, opioid-injecting women: Drug, set, and setting
Journal article   Open access   Peer reviewed

Circumstances of overdose among street-involved, opioid-injecting women: Drug, set, and setting

Janna Ataiants, Alexis M. Roth, Silvana Mazzella and Stephen E. Lankenau
The International journal of drug policy, v 78, 102691
Apr 2020
DOI: https://doi.org/10.1016/j.drugpo.2020.102691
PMID: 32086154
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302961View
Accepted (AM)Open Access (License Unspecified),  Open

Abstract

Circumstances Drug Injection Opioids Overdose Set Setting Women
Current discourses about the causes of the overdose crisis largely focus on the harmful effects of drugs. Prior research, however, indicates that drug use experience is shaped by complex interactions of drugs with physiological and mental “sets” of people who use drugs and the wider social and physical “setting.” Zinberg's “drug, set, and setting” theoretical framework was applied to identify patterns in circumstances leading up to women's overdose. In-depth semi-structured interviews were conducted with 29 opioid-injecting street-involved women, clients of a Philadelphia harm reduction program. Qualitative analysis with deductive and inductive coding was utilized to examine transcripts for theory-driven and emerging themes. Ten out of 29 women attributed their overdose to “drugs,” reporting the unpredictable quality of street opioids, concurrent use of benzodiazepines, or chasing the “high.” Thirteen women reported “set” as a type of circumstance where their emotional states were affected by a “good” or “bad” day, leading them to unusual drug consumption practices. Six women described “setting” type of circumstances where their overdose was preceded by a recent change in context, such as release from prison, which prompted unsafe drug use to address physiological or psychological dependence on drugs. While all overdoses result from the pharmacological action of drugs, some overdoses were triggered by circumstances occurring in women's set or setting. Overdose prevention policies should embrace not only individual-level behavioral interventions, but also structural measures to address stress, social isolation, and risky drug use contexts that plague the lives of street-involved women who inject opioids.

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20 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Web of Science research areas
Substance Abuse
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