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Daniulaityte R, Carlson RG, Kenne DR. Initiation to Pharmaceutical Opioids and Patterns of Misuse: Preliminary Qualitative Findings Obtained by the Ohio Substance Abuse Monitoring Network. JOURNAL OF DRUG ISSUES 2016. [DOI: 10.1177/002204260603600402] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pharmaceutical opioid misuse has been recognized as a growing public health problem across the nation. To develop appropriate treatment and prevention programs, the population of pharmaceutical opioid abusers has to be well understood. This exploratory study is based on qualitative interviews with 24 people in the Dayton/Columbus, Ohio, area. Interviews were conducted for the Ohio Substance Abuse Monitoring Network, a statewide epidemiological surveillance system. Participants ranged in age from 18 to 48 years; the majority was White and male. To explain initiation and continued use of pharmaceutical opioids, participants discussed a number of different reasons, including self-medication of emotional and physical pain, legitimate medical prescriptions related to chronic pain management, social influences, recreation, and easy access to pharmaceutical opioids. On the basis of participant age and lifetime experiences with pharmaceutical opioid and other drug misuse, six user groups were identified that faced unique risks and prevention/treatment challenges. Research implications are discussed.
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Lee JP, Antin TM. How do researchers categorize drugs, and how do drug users categorize them? CONTEMPORARY DRUG PROBLEMS 2012; 38:387-428. [PMID: 24431475 PMCID: PMC3888963 DOI: 10.1177/009145091103800304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper considers drug classifications and terms widely used in US survey research, and compares these to classifications and terms used by drug users. We begin with a critical review of drug classification systems, including those oriented to public policy and health services as well as survey research. We then consider the results of a pile sort exercise we conducted with 76 respondents within a mixed method study of Southeast Asian American adolescent and young adult drug users in urban Northern California, USA. We included the pile sort to clarify how respondents handled specific terms which we understood to be related to Ecstasy and methamphetamines. Results of the pile sort were analyzed using graphic layout algorithms as well as content analysis of pile labels. Similar to the national surveys, our respondents consistently differentiated Ecstasy terms from methamphetamine terms. We found high agreement between some specific local terms (thizz, crystal) and popular drug terms, while other terms thought to be mainstream (crank, speed) were reported as unknown by many respondents. In labeling piles, respondents created taxonomies based on consumption method (in particular, pill) as well as the social contexts of use. We conclude by proposing that divergences between drug terms utilized in survey research and those used by drug users may reflect two opposing tendencies: the tendency of survey researchers to utilize standardized language that constructs persons and experiences as relatively homogeneous, varying only within measurable degrees, and the tendency of drug users to utilize specialized language (argot) that reflects their understandings of their experiences as hybrid and diverse. The findings problematize the validity of drug terms and categories used in survey research.
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Affiliation(s)
- Juliet P. Lee
- Prevention Research Center, Pacific Institute for Research and Evaluation
| | - Tamar M.J. Antin
- Prevention Research Center, Pacific Institute for Research and Evaluation
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Bourey C, Stephenson R, Bartel D, Rubardt M. Pile sorting innovations: exploring gender norms, power and equity in sub-Saharan Africa. Glob Public Health 2012; 7:995-1008. [PMID: 22866910 DOI: 10.1080/17441692.2012.709259] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Understanding gender norms, power and equity is important for developing successful sexual and reproductive health interventions. However, little attention has been given to how to capture the gender ideals and imbalances that inform these relationships in low resource settings. Pile sorting exercises were conducted in four gender-segregated focus groups in Ethiopia and Kenya. Each group received cards illustrated with a man, woman and man and woman together and cards labelled with duties and decisions. Participants discussed and decided together whether men, women or both performed each duty and decision and assigned the cards accordingly. Participants then reflected on and physically manipulated the piles to challenge gender norms, investigate role flexibility and identify agents of social change. Data collected included photographs of the pile sorts and recordings of the discussions. Conducting pile sorting within focus group discussions enabled comparative analyses of gender norms, while enriching data by focusing discussions and encouraging consensus building. Innovative applications facilitated participants' abilities to engage abstract concepts, reflecting on issues of gender norms, power and equity.
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Affiliation(s)
- Christine Bourey
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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"I'm not afraid of those ones just 'cause they've been prescribed": perceptions of risk among illicit users of pharmaceutical opioids. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2012; 23:374-84. [PMID: 22417823 DOI: 10.1016/j.drugpo.2012.01.012] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2011] [Revised: 01/23/2012] [Accepted: 01/24/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND There has been a rise in the illicit use of pharmaceutical opioids ("pain pills") in the United States. Conducted with young adult non-medical users of pharmaceutical opioids, this study uses qualitative methods and cultural consensus analysis to describe risk perceptions associated with pharmaceutical opioids and to determine patterns of cultural sharing and intra-cultural variation of these views. METHODS The qualitative sub-sample (n=47) was selected from a larger sample of 396 young adults (18-23 years old), who were participating in a natural history study of illicit pharmaceutical opioid use. Qualitative life history interviews, drug ranking task, and cultural consensus analysis were used to elicit participant views about risks and harms associated with pain pills and other drugs, as well as alcohol and tobacco. RESULTS Cultural consensus analysis revealed that the participants shared a single cultural model of drug risks, but the level of agreement decreased with the increasing range of drugs ever used. Further, those with more extensive drug use histories differed from less "experienced" users in their views about OxyContin and some other drugs. Overall, pain pills were viewed as addicting and potentially deadly substances, but these properties were linked to the patterns and methods of use, as well as characteristics of an individual user. Further, risks associated with pharmaceutical opioids were further curtailed because they "came from the doctor," and thus had a legitimate aspect to their use. CONCLUSIONS This study highlights potential problems with universal approaches to substance use prevention and intervention among young people since such approaches ignore the fact that substance use education messages may be experienced differently depending on an individual's drug use history and his/her perceptions of drug risks. Findings reported here may be useful in the development of prevention and intervention programs aimed at reducing the harm associated with illicit use of pain pills.
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Martins SS, Carlson RG, Alexandre PK, Falck RS. Perceived risk associated with ecstasy use: a latent class analysis approach. Addict Behav 2011; 36:551-4. [PMID: 21296504 PMCID: PMC3049947 DOI: 10.1016/j.addbeh.2011.01.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 12/09/2010] [Accepted: 01/12/2011] [Indexed: 10/18/2022]
Abstract
This study aims to define categories of perceived health problems among ecstasy users based on observed clustering of their perceptions of ecstasy-related health problems. Data from a community sample of ecstasy users (n=402) aged 18 to 30, in Ohio, was used in this study. Data was analyzed via Latent Class Analysis (LCA) and Regression. This study identified five different subgroups of ecstasy users based on their perceptions of health problems they associated with their ecstasy use. Almost one third of the sample (28.9%) belonged to a class with "low level of perceived problems" (Class 4). About one fourth (25.6%) of the sample (Class 2), had high probabilities of "perceiving problems on sexual-related items", but generally low or moderate probabilities of perceiving problems in other areas. Roughly one-fifth of the sample (21.1%, Class 1) had moderate probabilities of perceiving ecstasy health-related problems in all areas. A small proportion of respondents (11.9%, Class 5) had high probabilities of reporting "perceived memory and cognitive problems", and of perceiving "ecstasy-related problems in all areas" (12.4%, Class 3). A large proportion of ecstasy users perceive either low or moderate risk associated with their ecstasy use. It is important to further investigate whether lower levels of risk perception are associated with persistence of ecstasy use.
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Affiliation(s)
- S S Martins
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205-1900, USA.
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Singer EO, Schensul JJ. Negotiating ecstasy risk, reward, and control: a qualitative analysis of drug management patterns among ecstasy-using urban young adults. Subst Use Misuse 2011; 46:1675-89. [PMID: 21955066 DOI: 10.3109/10826084.2011.610398] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This paper is based on qualitative in-depth interviews conducted from 2008 to 2009 with 118 ethnically diverse Ecstasy users from the greater Hartford area, CT, USA. Participants were urban, primarily Black and Hispanic, aged 18 to 36, and had limited higher education compared with samples in previous Ecstasy research. Interviews focused on personal background, history of Ecstasy and other drug use, and recent sexual events. In this paper, we examine: participants' negotiation of perceived risks and benefits of Ecstasy use, behavioral strategies employed to minimize risks, and the relationship of risk-benefit analysis, motivation for use, frequency of use, and polydrug use to participants' sense of control over their Ecstasy use. We conclude with recommendations for intervention approaches and suggestions for future research.
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Affiliation(s)
- Elyse Ona Singer
- Institute for Community Research, Two Hartford Square West, 146 Wyllys Street, Hartford, CT 06106-5128, USA.
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Boeri MW, Gibson D, Harbry L. Cold cook methods: an ethnographic exploration on the myths of methamphetamine production and policy implications. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2009; 20:438-43. [PMID: 19195870 DOI: 10.1016/j.drugpo.2008.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2008] [Revised: 12/04/2008] [Accepted: 12/29/2008] [Indexed: 11/30/2022]
Abstract
BACKGROUND Urban legends and myths are prevalent in drug-use environments. However, the distinction between myth and fact is not always clear. We found contradictory claims regarding the emergence of cold cook methods for producing methamphetamine when contrasting user-generated reports with official reports repudiating such methods as myths. Our aim is to open the topic for more academic discussion. METHODS We examine cold cook methods of methamphetamine production revealed in our ethnographic study and interviews with former (n=50) and current (n=48) methamphetamine users. Data were collected in the suburbs of a large southeastern city in the United States. We compare the data with reports from law enforcement professionals and public health officials. RESULTS Official reports claim the cold cook method described by users in our study is a myth and does not produce methamphetamine. Small-scale producers sell it as methamphetamine and users claim it has the same effect as methamphetamine. They are charged for possession and distribution of methamphetamine when caught with this drug. It appears the unintended consequences of recent policy aimed to reduce production and use of methamphetamine may be a user-friendly production method. We do not know the health implications at this time. CONCLUSION We do not make any definitive conclusions on the legitimacy of the stories or myths discussed here but instead suggest that labelling drug stories as myths might lead to dismissing facts that hold partial truth. The subsequent dismissal of cold cook methods among policy and public health officials risks a range of unintended consequences among vulnerable populations. We present our case for more research attention on the myths of methamphetamine production.
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Affiliation(s)
- Miriam W Boeri
- Department of Sociology and Criminal Justice,, Kennesaw State University, GA 30144-5591, United States.
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Carlson RG, Singer M, Stephens RC, Sterk CE. Reflections on 40 Years of Ethnographic Drug Abuse Research: Implications for the Future. JOURNAL OF DRUG ISSUES 2009. [DOI: 10.1177/002204260903900106] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper focuses on past, present, and potential future contributions of ethnographic research to describing and understanding “street cultures” of drug use and the implications these have for informing various interventions. The first section provides an overview of ethnography and drug abuse research. This is followed by a historical perspective on the ethnography of street cultures. Next, the significance of ethnographic drug abuse research is highlighted, with a focus on its methodology. Ethnographic contributions to the development, implementation, and evaluation of interventions are discussed, including ethical issues. Subsequently, the interdisciplinary nature of ethnographic drug abuse research is described. Methodological challenges emerged over time as the definition of street cultures and drug trends shifted. These are illustrated with examples, including the use of prescription drugs, new heroin users, and rural drug and methamphetamine use. The final sections focus on career opportunities for ethnographers and opportunities and barriers for the future. We address training needs for interdisciplinary inquiry, the potential role of ethnographers in prevention and treatment research, and the link to studies on the brain and genetics. The future of ethnographic research on drug use will be influenced by the funding structure. We conclude with a summary of reflections on the past and aspirations for the future.
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Leung KS, Li JH, Tsay WI, Callahan C, Liu SF, Hsu J, Hoffer L, Cottler LB. Dinosaur girls, candy girls, and Trinity: voices of Taiwanese club drug users. J Ethn Subst Abuse 2008; 7:237-57. [PMID: 19042808 DOI: 10.1080/15332640802313205] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Research among Asian users of methylenedioxy methamphetamine (MDMA), also known as Ecstasy, is rare. To evaluate the feasibility of a study on the abuse of and dependence on Ecstasy, two focus groups of users (n= 12) and health professionals (n=7) were conducted in Taiwan. Major results included blatant human testing with "candy and dinosaur girls" and a specific sequence of drugs called a "Trinity" (Ecstasy, ketamine, and marijuana). "Head-shaked bars" and "KTVs" were public places where illegal behaviors were implicitly allowed. Depression after Ecstasy use was not reported. For future studies, participants suggested that magnetic resonance imaging could be a strong incentive for young users to enhance willingness to participate. Cultural issues of Ecstasy use are also discussed.
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Affiliation(s)
- Kit-Sang Leung
- Department of Psychiatry, Washington University School of Medicine, 40N Kingshighway, St. Louis, MO 63108, USA.
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Understanding recreational ecstasy use in the United States: a qualitative inquiry. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2008; 20:62-9. [PMID: 18068967 DOI: 10.1016/j.drugpo.2007.10.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2007] [Revised: 10/05/2007] [Accepted: 10/22/2007] [Indexed: 11/22/2022]
Abstract
BACKGROUND Ecstasy use has increasingly become popular among young adults, many of whom view it as a safe drug with no or limited negative social and health consequences. In this paper, we explore the perceptions of ecstasy users about its recreational use as well as regarding the normalisation of use. METHODS The study participants were recruited using targeted and theoretical sampling. To be eligible, they had to be between 18 and 25 years and have used ecstasy at least four times within the past 90 days. In-depth interviews were conducted with 112 individuals. Data analysis included the constant comparison method commonly used in modified grounded theory. RESULTS The study participants associated their recreational ecstasy use with control, shaping both the timing and setting of their use. In addition, they supported that easy access/availability and social accommodations of use contributed to their acceptance of ecstasy use as a normal part of life. Moreover, low risk perceptions of the social and health consequences of ecstasy used were identified as resulting in normalisation. CONCLUSION The study findings reveal the importance of considering recreational ecstasy use from the perspective of the users themselves for prevention efforts and when providing social and health services, including intervention strategies. In addition, the potential normalisation of ecstasy use must be considered.
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Wang J, Falck RS, Li L, Rahman A, Carlson RG. Respondent-driven sampling in the recruitment of illicit stimulant drug users in a rural setting: findings and technical issues. Addict Behav 2007; 32:924-37. [PMID: 16901654 DOI: 10.1016/j.addbeh.2006.06.031] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2006] [Revised: 06/15/2006] [Accepted: 06/21/2006] [Indexed: 10/24/2022]
Abstract
Increasingly, respondent-driven sampling (RDS) is being applied to study not-in-treatment users of illicit drugs. Although RDS has been successfully applied in recruiting active users in densely-populated, metropolitan areas, its utility with hidden populations in rural areas has yet to be determined. This study critically evaluates the sample of not-in-treatment, illicit stimulant drug users (n=249) recruited from the application of RDS in three rural counties in west-central Ohio. The findings of this study largely support the results of earlier studies in urban areas and suggest that RDS is a useful method of sampling hidden drug using populations in less densely populated rural areas. Some limitations of RDS are also discussed.
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Affiliation(s)
- Jichuan Wang
- Center for Interventions, Treatment and Addictions Research Wright State University, Boonshoft School of Medicine, 3640 Colonel Glenn Highway, 110 Med Sci, Dayton, OH 45435, USA.
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Abstract
Ketamine is a dissociative anesthetic that has emerged as an increasingly popular choice among young drug users. Recent research indicates the presence of hidden populations of young people who inject ketamine in New York and other U.S. cities. Applying an ethno-epidemiological approach, the authors recruited 40 young injection drug users (IDUs) (< 25 years old) in New York City to explore health risks associated with ketamine use. This analysis looks at the varying patterns and frequencies of ketamine injection by examining personal, social, and cultural aspects of these young people's lives. We learned that drug-using histories, experiential dimensions, sociocultural characteristics, and associations with other young people help account for the different patterns of injecting ketamine within the sample. In particular, these findings indicate that young people who were more frequent ketamine injectors had the following characteristics: initiated injection drug use with ketamine; enjoyed the effects of ketamine, were stably housed; lived in the vicinity of New York City; and associated with others who also injected ketamine.
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Affiliation(s)
- Stephen E Lankenau
- University of Southern California, Keck School of Medicine, Department of Pediatrics, 6430 Sunset Boulevard, Suite 1500, Los Angeles, CA 90028, USA.
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Murphy PN, Wareing M, Fisk J. Users' perceptions of the risks and effects of taking ecstasy (MDMA): a questionnaire study. J Psychopharmacol 2006; 20:447-55. [PMID: 16574719 DOI: 10.1177/0269881106063270] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This self-report questionnaire study examined ecstasy users' perceptions of the risks associated with their use of ecstasy, their precautions against such risks, and its perceived effects on their lives. Gender differences in these areas were also explored. The sample comprised 328 ecstasy users (139 female, 187 male, one transsexual) with a mean age of 22.5 years (SD = 4.9 years). Questionnaires were completed either in hard copy or through a website concerned with ecstasy use. The results showed that friends were the most common source of information about ecstasy for the sample overall, although females were more likely to utilize this source than males. None of the five categories of perceived risk (e.g. psychiatric, physical) showed a significant gender difference. Males were more likely to take rest breaks whilst females were more likely to limit consumption as a precaution against harm. Three factors emerged from a principal components analysis concerning perceived personal change since initiation of ecstasy use. Factor 1 (23.8% of the variance) concerned negative experiences (e.g. depression). Factor 2 (22.0% of the variance) concerned positive personal qualities (e.g. caring). Factor 3 (10.5% of the variance) concerned selective aspects of functioning (e.g. alertness). The pattern of Factor 1 and Factor 2 scores over time suggested that 6 years since initiation of ecstasy use might be a time when some long-term users may be open to reassess their use of the drug. Broader implications of the findings for health education initiatives aimed at ecstasy users are discussed.
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Affiliation(s)
- Philip N Murphy
- Department of Social and Psychological Sciences, Edge Hill College of Higher Education, St Helens Road, Ormskirk, Lancashire L39 4QP, UK.
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Carlson RG, Wang J, Falck RS, Siegal HA. Drug use practices among MDMA/ecstasy users in Ohio: a latent class analysis. Drug Alcohol Depend 2005; 79:167-79. [PMID: 16002026 DOI: 10.1016/j.drugalcdep.2005.01.011] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2004] [Revised: 01/06/2005] [Accepted: 01/26/2005] [Indexed: 11/27/2022]
Abstract
This study describes the drug use practices among 402 recent MDMA (3,4-methelyenedioxymethamphetamine) users recruited in Ohio using respondent-driven sampling. About 64% of the participants were men, 81.6% were white, and the mean age was 20.9 years. Latent class analysis was used to identify subgroups of MDMA users. Use of cocaine, opioids, amphetamines, tranquilizers, inhalants, marijuana, and hallucinogens during the previous 6 months, and days of "drunkenness" in the past 30, were used for classification. A three-class model was preferable and reflected "Limited range," "Moderate range," and "Wide range" drug use patterns. For example, the conditional probability of using opioids during the previous 6 months was .07 in Class 1, .59 in Class 2, and .88 in Class 3. Other substances followed similar patterns. Predictors of class membership were examined in a multinomial logit model in which the "Limited range" Class was treated as the reference group. Participants who were white, younger, and who reported more than 10 occasions of MDMA use were more likely to be in the "Wide range" drug use Class. Latent class analysis is a useful method to help describe and understand variability in polydrug use patterns.
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Affiliation(s)
- Robert G Carlson
- Center for Interventions, Treatment and Addictions Research, Wright State University School of Medicine, 143 Biological Sciences Building, 3640 Colonel Glenn Highway, Dayton, OH 45435, USA.
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Eiserman JM, Diamond S, Schensul JJ. "Rollin' on E": a qualitative analysis of ecstasy use among inner city adolescents and young adults. J Ethn Subst Abuse 2005; 4:9-38. [PMID: 16275633 DOI: 10.1300/j233v04n02_02] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Ecstasy use has spread beyond the rave and club scenes into other arenas of party culture, and from middle-class America to working-class and low-income neighborhoods of large cities. In order to explore ecstasy use among inner city adolescents and young adults, we conducted in-depth interviews with 23 poly-drug users who had used ecstasy, in Hartford, CT. Most users reported positive experiences while on the drug. Negative experiences were most often related to poly-drug mixing. However, heavy users (40+ times ever used) experienced negative aftereffects, which led them to decide to decrease or halt their use. Some participants discussed using ecstasy during sex, and irregular use of condoms. These findings point to the need for more in-depth research on MDMA use within inner city settings, with a particular focus on ethnic and cultural context, self-controlled drug use, poly-drug mixing, and sex risk behaviors.
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