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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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Background: Mothers and pregnant women who use opioids are particularly vulnerable. Mothers often fear surveillance, stigma, and loss of custody of their children when seeking treatment. Although opioid agonist therapy (OAT) has been shown to be effective, access varies regionally, and not all mothers can cease using opioids. This study compares outcomes of mothers who use opioids in the UK with universal healthcare and OAT access, and mothers in the U.S. with restricted healthcare and OAT access, focusing on their interactions with services. Methods: This is a secondary data analysis of two studies on mothers who use opioids. Data were collected from nine mothers in Scotland (UK) and 20 mothers in New Jersey (US) through ethnographic, longitudinal studies spanning one year. The UK study used a “Learning Alliance” engagement approach, a patient/public engagement model that involves stakeholders in developing objectives and the dissemination of findings. The US study engaged “community-based consultants,” who are paid individuals with lived experience from the study field communities to assist researchers in recruitment and ethnographic fieldwork. Ethical approval was received from review boards. Data were anonymized before analysis, and people with lived experience provided feedback on findings. Grounded theory methods were used for analysis. Results: Findings reveal both convergent and divergent experiences. Mothers in Scotland had more access to healthcare and social housing but faced increased surveillance, while New Jersey mothers often experienced housing insecurity and difficulty obtaining healthcare. Shared challenges included trust issues, stigmatization, inconsistent practitioner engagement, responsibilization, and unclear expectations from child protection services. While Scottish mothers had better access to OAT, both groups faced child custody loss due to unregulated drug use. Mothers in both studies were struggling to meet reunification requirements of abstinence (with or without OAT) within the required time frame. Conclusions: Differing governance structures create persistent challenges across national boundaries. While health practitioners generally support harm reduction strategies, it does not go beyond OAT for mothers. Our findings indicate the need for radical harm reduction approaches with social justice for mothers who use drugs, including safer parental drug use strategies. © The Author(s) 2025.
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