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Victor G, Ray B, Watson DP. Use of harm reduction strategies by individuals with a history of incarceration: A short report using baseline data collected from the STAMINA clinical trial. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 162:209376. [PMID: 38641053 DOI: 10.1016/j.josat.2024.209376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/20/2024] [Accepted: 04/14/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Due to the considerably heightened risk of overdose immediately following jail or prison release, expansion of harm reduction interventions for citizens returning to the community after an incarceration episode should be of utmost concern. However, there are no studies examining the adoption and use of harm reduction among this population. This short report examines the use of individual-level harm reduction strategies (HRS) among people who use drugs, comparing those who have lifetime histories of incarceration with those who do not. METHODS This study included baseline data (N = 274) from a larger clinical trial, which recruited participants at two syringe service programs. Fisher's exact tests examine correlations between HRS and lifetime incarceration. RESULTS Significant variation in HRS use were observed by demographic characteristics. Those with lifetime incarceration histories were less likely to report ensuring naloxone was available when using, using when others were present, using fentanyl test strips, using a trusted drug supplier, and using some other HRS compared to those without lifetime incarceration histories. Similarly, those with lifetime incarceration histories were also less likely to report using non-prescribed buprenorphine and methadone, which could potentially reduce overdose risk even if not explicitly used as an HRS. CONCLUSION The results suggest that one of the populations at highest risk of overdose is least likely to use strategies that may reduce overdose risk. Targeted efforts to increase exposure to HRS learning opportunities and access to these resources could help reduce overdose disparities for people returning to the community after incarceration.
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Affiliation(s)
- Grant Victor
- School of Social Work, Rutgers, The State University of New Jersey, 390 George Street, New Brunswick, NJ 08901, USA; Rutgers Addiction Research Center, The State University of New Jersey, 671 Hoes Lane West, Piscataway, NJ 08854, USA.
| | - Bradley Ray
- RTI International, Division for Applied Justice Research, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA
| | - Dennis P Watson
- Chestnut Health Systems, 221 West Walton Street, Chicago, IL 60610, USA.
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2
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Kopak AM, Thomas SD. Jail Characteristics and Availability of Opioid Treatment Services: Results from a Nationally Representative Survey. J Behav Health Serv Res 2024; 51:313-324. [PMID: 38519625 DOI: 10.1007/s11414-024-09881-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 03/25/2024]
Abstract
The current wave of the opioid epidemic has contributed to a record number of drug-related overdoses and a significant proportion of people who experience opioid use disorder are admitted to local jails. These correctional facilities serve as the principal entry point to the criminal justice system as nearly every person who is taken into custody is admitted to a local detention center. Although jails are recognized as primary intervention points for people who may require treatment for opioid use disorder, services in these facilities remain deficient. The absence of jail-based treatment has become a pressing concern as the number of drug-related deaths in custody continues to rise and the risk of post-release overdose also remains high. The present study draws on the opioid-related module of the 2019 Bureau of Justice Statistics' Census of Jails to assess the relationships between the characteristics of 2588 local detention centers and the availability of treatment services. These specific approaches included screening for opioid use disorder, providing medication to manage withdrawal symptoms, administering medication for opioid use disorder (MOUD), providing overdose reversal medication at the time of release, and linking people with community-based care following release from the detention center. The results demonstrate facilities located in the Northeast, larger jails, those in urban areas, and detention centers with higher turnover rates are significantly more likely to provide a wider variety of opioid treatment services. These findings have important implications for the prioritization of policies and the allocation of resources to support the adoption of opioid treatment services in local jails.
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Affiliation(s)
- Albert M Kopak
- UNC Health Sciences at the Mountain Area Health Education Center (MAHEC), 121 Hendersonville Road, Asheville, NC, 28803, USA.
| | - Sierra D Thomas
- UNC Health Sciences at the Mountain Area Health Education Center (MAHEC), 121 Hendersonville Road, Asheville, NC, 28803, USA
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Russell C, George TP, Chopra N, Le Foll B, Matheson FI, Rehm J, Lange S. Feasibility and effectiveness of extended-release buprenorphine (XR-BUP) among correctional populations: a systematic review. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024:1-20. [PMID: 38940929 DOI: 10.1080/00952990.2024.2360984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 04/29/2024] [Indexed: 06/29/2024]
Abstract
Background: Medications for opioid use disorder (MOUD) reduce risks for overdose among correctional populations. Among other barriers, daily dosing requirements hinder treatment continuity post-release. Extended-release buprenorphine (XR-BUP) may therefore be beneficial. However, limited evidence exists.Objectives: To conduct a systematic review examining the feasibility and effectiveness of XR-BUP among correctional populations.Methods: Searches were carried out in Pubmed, Embase, and PsychINFO in October 2023. Ten studies reporting on feasibility or effectiveness of XR-BUP were included, representing n = 819 total individuals (81.6% male). Data were extracted and narratively reported under the following main outcomes: 1) Feasibility; 2) Effectiveness; and 3) Barriers and Facilitators.Results: Studies were heterogeneous. Correctional populations were two times readier to try XR-BUP compared to non-correctional populations. XR-BUP was feasible and safe, with no diversion, overdoses, or deaths; several negative side effects were reported. Compared to other MOUD, XR-BUP significantly reduced drug use, resulted in similar or higher treatment retention rates, fewer re-incarcerations, and was cost-beneficial, with a lower overall monthly/yearly cost. Barriers to XR-BUP, such as side effects and a fear of needles, as well as facilitators, such as a lowered risk of opioid relapse, were also identified.Conclusion: XR-BUP appears to be a feasible and potentially effective alternative treatment option for correctional populations with OUD. XR-BUP may reduce community release-related risks, such as opioid use and overdose risk, as well as barriers to treatment retention. Efforts to expand access to and uptake of XR-BUP among correctional populations are warranted.
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Affiliation(s)
- Cayley Russell
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Ontario Node, Canadian Research Initiative in Substance Misuse (CRISM), Toronto, ON, Canada
| | - Tony P George
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Addictions Division, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Nitin Chopra
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Addictions Division, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Bernard Le Foll
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Ontario Node, Canadian Research Initiative in Substance Misuse (CRISM), Toronto, ON, Canada
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Addictions Division, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada
| | - Flora I Matheson
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, a site of Unity Health Toronto, Toronto, ON, Canada
- Centre for Criminology & Sociolegal Studies, University of Toronto, Toronto, ON, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Ontario Node, Canadian Research Initiative in Substance Misuse (CRISM), Toronto, ON, Canada
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
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Stewart RE, Cardamone NC, Altman CA, Bowen J, Mandell DS. MOUD Adoption Among Clients of Organizations That Provide MOUD or Coordinate Care With External Providers. Psychiatr Serv 2024:appips20230522. [PMID: 38532687 DOI: 10.1176/appi.ps.20230522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Affiliation(s)
- Rebecca E Stewart
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Stewart, Cardamone, Mandell); Community Behavioral Health, Philadelphia (Altman); City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia (Bowen)
| | - Nicholas C Cardamone
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Stewart, Cardamone, Mandell); Community Behavioral Health, Philadelphia (Altman); City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia (Bowen)
| | - Charles A Altman
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Stewart, Cardamone, Mandell); Community Behavioral Health, Philadelphia (Altman); City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia (Bowen)
| | - Jill Bowen
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Stewart, Cardamone, Mandell); Community Behavioral Health, Philadelphia (Altman); City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia (Bowen)
| | - David S Mandell
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Stewart, Cardamone, Mandell); Community Behavioral Health, Philadelphia (Altman); City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia (Bowen)
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Hoff E, Hansen L, Pulitzer Z, Campalans N, Salyards M, Muquith M, Shavit S, Nguyen H, Crain C, Walker R, Nijhawan AE. A randomized control trial of a combined community health worker and re-entry intervention for people with HIV recently released from jail who use substances. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 152:209118. [PMID: 37454733 DOI: 10.1016/j.josat.2023.209118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/21/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION People with human immunodeficiency virus (HIV; PWH) who use substances are disproportionately involved in the criminal justice system. While HIV viral suppression typically improves during incarceration, these gains are frequently lost after release. We evaluated the impact of a combined intervention (formerly incarcerated community health workers [CHW] plus a re-entry organization; CHW+) on postrelease HIV- and substance use-related outcomes. METHODS We conducted a pilot randomized controlled trial of a CHW+ for PWH who use substances, within 30 days of release from a large southern, urban jail. Between February 2019 and August 2021, participants were recruited, enrolled, and randomized to treatment as usual (TAU; passive referral to care) or CHW+. Follow up study visits occurred at 3, 6, and 12 months. The primary outcome was HIV VL at 6 months; secondary outcomes included 6-month urinary toxicology and high-risk substance use at 12 months. RESULTS A total of 31 participants were enrolled who were primarily male (n = 24; 77 %), Black (n = 22; 71 %), unemployed (n = 23; 74.2 %), had unstable housing (n = 18; 58 %), had food insecurity (n = 14; 45 %), and reported their drug of choice was stimulants (n = 24; 77 %). The study identified no significant difference in HIV VL suppression at 6 months (20 % v. 37 %; [CHW+ v. TAU], p = 0.61). We observed improved substance use outcomes in CHW+ v. TAU, including fewer positive urinary toxicology screens for stimulants (40 % v. 100 %; p = 0.01) and a trend toward less high-risk substance use (30 % v. 43 %). The CHW+ group met more basic needs, such as food security [+32 % v. +11 %], housing security [+52 % v. -7 %] and full-time employment [+20 % v. +5 %] compared to TAU. CONCLUSIONS PWH who use substances assigned to a combined intervention of CHW+ after jail release did not achieve higher rates of HIV VL suppression than TAU; however, they had improved substance use outcomes and met more basic subsistence needs. Results highlight the potential of culturally informed interventions to address the competing needs of PWH who use substances after release from jail and call for further development of innovative solutions to successfully bridge to HIV care in the community.
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Affiliation(s)
- Emily Hoff
- Department of Internal Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Laura Hansen
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Zoe Pulitzer
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Nicholas Campalans
- Department of Internal Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Maverick Salyards
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States; Department of Public Health, Texas Christian University, United States
| | - Maishara Muquith
- Department of Internal Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Shira Shavit
- Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Hue Nguyen
- Unlocking DOORS®, Dallas, TX, United States
| | | | - Robrina Walker
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States; The Emmes Company, Rockville, MD, United States
| | - Ank E Nijhawan
- Department of Internal Medicine, University of Texas-Southwestern, Dallas, TX, United States; Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States.
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Ray B, Christian K, Bailey T, Alton M, Proctor A, Haggerty J, Lowder E, Aalsma MC. Antecedents of fatal overdose in an adult cohort identified through administrative record linkage in Indiana, 2015-2022. Drug Alcohol Depend 2023; 247:109891. [PMID: 37120921 DOI: 10.1016/j.drugalcdep.2023.109891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND The United States continues to experience unprecedented rates of overdose mortality and need to identify effective policies or practices that can be implemented. This study aims to measure the prevalence, frequency, timing, and rate of touchpoints that occurred prior to a fatal overdose where communities might intervene. METHODS In collaboration with Indiana state government, we conducted record-linkage of statewide administrative datasets to vital records (January 1, 2015, through August 26, 2022) to identify touchpoints (jail booking, prison release, prescription medication dispensation, emergency department visits, and emergency medical services). We examined touchpoints within 12-months prior to a fatal overdose among an adult cohort and explored variation over time and by demographic characteristics. RESULTS Over the 92-month study period there were 13,882 overdose deaths (89.3% accidental poisonings, X40-X44) in our adult cohort that were record-linked to multiple administrative datasets and revealed nearly two-thirds (64.7%; n=8980) experienced an emergency department visit, the most prevalent touchpoint followed by prescription medication dispensation, emergency medical services responses, jail booking, and prison release. However, with approximately 1 out of every 100 returning citizens dying from drug overdose within 12-months of release, prison release had the highest touchpoint rate followed by emergency medical services responses, jail booking, emergency department visits, and prescription medication dispensation. CONCLUSION Record-linking administrative data from routine practice to vital records from overdose mortality is a viable means of identifying where resources should be situated to reduce fatal overdose, with potential to evaluate the effectiveness of overdose prevention efforts.
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Affiliation(s)
- Bradley Ray
- RTI International, 3040 Cornwallis Road, Research Triangle Park, NC27709, United States.
| | - Kaitlyn Christian
- Indiana Management Performance Hub, 100 North Senate Avenue, Room N855, Indianapolis, IN46204, United States
| | - Timothy Bailey
- Indiana Management Performance Hub, 100 North Senate Avenue, Room N855, Indianapolis, IN46204, United States
| | - Madison Alton
- Indiana Division of Mental Health and Addiction, 402 West Washington Street W353, Indiana, IN46204, United States
| | - Alison Proctor
- RTI International, 3040 Cornwallis Road, Research Triangle Park, NC27709, United States
| | - John Haggerty
- RTI International, 3040 Cornwallis Road, Research Triangle Park, NC27709, United States
| | - Evan Lowder
- Department of Criminology, Law and Society, George Mason University, 4400 University Drive, 4F4, Fairfax, VA22030, United States
| | - Matthew C Aalsma
- Department of Pediatrics, Indiana University School of Medicine, 340 W. 10th StreetIndianapolisIN46202, United States
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7
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Bailey K, Abramovitz D, Patterson TL, Harvey-Vera AY, Vera CF, Rangel MG, Friedman J, Davidson P, Bourgois P, Strathdee SA. Correlates of recent overdose among people who inject drugs in the San Diego/Tijuana border region. Drug Alcohol Depend 2022; 240:109644. [PMID: 36179507 PMCID: PMC9608984 DOI: 10.1016/j.drugalcdep.2022.109644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/23/2022] [Accepted: 09/18/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Along the Mexico-US border, illicitly manufactured fentanyls (fentanyl) have been detected in other illicit drugs, including street opioid formulations known as 'china white.' We studied correlates of recent overdose among people who inject drugs (PWID), focusing on the risk of knowlingly or unknowingly using fentanyl in china white. METHODS From October 2020 - September, 2021 we surveyed participants in San Diego, California and Tijuana, Mexico and employed Poisson regression to identify correlates of recent overdose. RESULTS Of 612 PWID, most were male (74.0 %), Latinx (71.9 %), US residents (67.0 %). Mean age was 43 years. In the last six months, 15.8 % experienced overdose, 31.0 % knowingly used fentanyl and 11.1 % used china white, of whom 77.9 % did not think it contained fentanyl. After controlling for sex and race, factors independently associated with risk of overdose included knowingly using fentanyl, using china white and not believing it contained fentanyl, recent drug rehabilitation, being stopped/arrested by police, and homelessness. Further, PWID who believed china white contained fentanyl were less likely to use it. CONCLUSIONS Both intentional fentanyl use and unintentional exposure to fentanyl via china white were associated with overdose risk; however, PWID who believed china white contained fentanyl were less likely to use it. These data suggest that advanced drug checking systems should be implemented to empower PWID to avoid dangerous street formulations or to plan their drug use knowing its contents. Other overdose risk factors such as decreased tolerance following drug treatment, police interactions, and homelessness also require urgent intervention.
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Affiliation(s)
- Katie Bailey
- University of California San Diego School of Medicine, 9500 Gilman Drive, mail Code 0507, La Jolla, CA 92093, United States of America.
| | - Daniela Abramovitz
- University of California San Diego School of Medicine, 9500 Gilman Drive, mail Code 0507, La Jolla, CA 92093, United States of America.
| | - Thomas L Patterson
- University of California San Diego School of Medicine, 9500 Gilman Drive, mail Code 0507, La Jolla, CA 92093, United States of America.
| | - Alicia Y Harvey-Vera
- University of California San Diego School of Medicine, 9500 Gilman Drive, mail Code 0507, La Jolla, CA 92093, United States of America; US-Mexico Border Health Commission, P.º del Centenario 10851, Zona Urbana Rio Tijuana, 22320 Tijuana, BC, Mexico
| | - Carlos F Vera
- University of California San Diego School of Medicine, 9500 Gilman Drive, mail Code 0507, La Jolla, CA 92093, United States of America.
| | - Maria Gudelia Rangel
- US-Mexico Border Health Commission, P.º del Centenario 10851, Zona Urbana Rio Tijuana, 22320 Tijuana, BC, Mexico; Universidad Xochicalco, Escuela de Medicina, Campus Tijuana, Rampa Yumalinda 4850, Chapultepec Alamar, 22110 Tijuana, BC, Mexico.
| | - Joseph Friedman
- University of California Los Angeles Center for Social Medicine, B7-435, UCLA Semel Institute, Los Angeles, CA 90095-1759, United States of America.
| | - Peter Davidson
- University of California San Diego School of Medicine, 9500 Gilman Drive, mail Code 0507, La Jolla, CA 92093, United States of America.
| | - Philippe Bourgois
- University of California Los Angeles Center for Social Medicine, B7-435, UCLA Semel Institute, Los Angeles, CA 90095-1759, United States of America.
| | - Steffanie A Strathdee
- University of California San Diego School of Medicine, 9500 Gilman Drive, mail Code 0507, La Jolla, CA 92093, United States of America.
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