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We propose that female methamphetamine users who live in suburbia experience risks for disease transmission stemming from their social environment that remain under the radar of public health surveillance networks. The data analyzed in this article were collected from 2007 to 2011 and were drawn from two sequential studies on methamphetamine use. The studies were conducted in the suburbs of a southeastern U.S. metropolis. We analyzed a total of 65 qualitative interviews with former and active methamphetamine-using women. Data from focus groups also were included in the analysis. The participants’ ages ranged from 18 to 51 years. We identified three major themes with regard to risk behaviors and transmission of infectious diseases: (1) setting risk behaviors such as sharing syringes and homelessness, lack of transportation, and unemployment; (2) sexual risk behaviors such as condom use and having multiple partners; and (3) service-related risks such as risk awareness and prevention behaviors as well as utilization of social services and health care. Our findings point to the pervasive nature of social influences on the risk for infectious disease transmission. We suggest that harm-reduction programs (HRPs) be implemented in suburban communities to increase access to these services. Second, our data support the concept of social recovery for drug users to better their health and social lives holistically. © 2014, © The Author(s) 2014.
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BACKGROUND: Naloxone is an opioid antagonist that can reverse an opioid overdose. Increased opioid-related mortality rates led to greater distribution of naloxone without a prescription and administration of naloxone by laypersons. This study fills a gap in knowledge of naloxone experiences among active users of opioids living in suburban communities. PURPOSE: The purpose of this article is to provide nurse practitioners with an in-depth understanding of current naloxone use practices among people who experience overdose events. The specific aims are to compare access to naloxone in diverse suburban towns, to examine administration differences across settings, and to understand perspectives on naloxone experiences from people who are actively using opioids. METHODOLOGICAL ORIENTATION: The data for this analysis were drawn from an ethnographic study in the suburban towns around Atlanta, Georgia; Boston, Massachusetts; and New Haven, Connecticut. Short surveys and in-depth interviews were collected. Inductive methods were used to compare data across settings. SAMPLE: The sample of 106 included 48% female, 62% White, 24% African American/Black, 13% more than one race, and 21% Hispanic/Latinx. The mean age was 41.35 years. CONCLUSIONS: Differences between study settings in access to naloxone, administration frequency, and delivery systems were found. Findings suggest more education and training is needed in overdose prevention and harm reduction intervention. Studies on delivery systems need to address the increase in fentanyl-related overdoses. IMPLICATIONS FOR PRACTICE: Nurse practitioners can help to target distribution of naloxone in local communities, facilitate collaboration with harm reduction services, and provide evidence-based education and training to laypersons. Copyright © 2020 American Association of Nurse Practitioners.
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