1
|
Friedman SR, Rossi D, Perlman DC. Historical and theoretical roots of the big events framework. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 133:104606. [PMID: 39378779 DOI: 10.1016/j.drugpo.2024.104606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 07/25/2024] [Accepted: 09/26/2024] [Indexed: 10/10/2024]
Abstract
This article traces the evolution of the Big Events framework since it began as an attempt to understand why sociopolitical transitions in the Former Soviet Union, South Africa, and Indonesia were followed by HIV outbreaks. Big Events frameworks have evolved over time, but all versions try to concretize how macrosocial changes lead to social, personal and environmental changes that shape risk environments and drug use or other behavioral patterns in ways that may lead to epidemics. Important stages in the evolution of the Big Events framework included understanding that the sequelae of Big Events were contingent rather than deterministic, and the development of new survey measures to understand pathways through which Big Events affect social and epidemiologic outcomes. On a broader level, the Big Events framework is a useful crystallization and application of more abstract sociological, social epidemiologic and Marxist frameworks about upstream/downstream relationships and how major social changes are related to epidemics. As such, they raise issues of how to conduct research on dialectical interaction processes. On another level, this article traces the Big Events "style of thought" as Mannheim (Mannheim, 1971) termed it, within the historical context of changes in public health and social science theory, particularly during and after the 1960s.
Collapse
Affiliation(s)
- Samuel R Friedman
- NYU Grossman School of Medicine, NY, NY, USA; Center for Drug Use and HIV/HCV Research, NY USA.
| | - Diana Rossi
- Former professor and researcher of the Faculty of Social Sciences at the University of Buenos Aires, Argentina; Founding member and consultant of Intercambios Civil Association, Argentina.
| | - David C Perlman
- Center for Drug Use and HIV/HCV Research, NY USA; Icahn School of Medicine at Mount Sinai, NY USA.
| |
Collapse
|
2
|
Tomassini L, Lancia M, Gambelunghe A, Zahar A, Pini N, Gambelunghe C. Exploring the Nexus of Climate Change and Substance Abuse: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:896. [PMID: 39063473 PMCID: PMC11277026 DOI: 10.3390/ijerph21070896] [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: 05/08/2024] [Revised: 06/28/2024] [Accepted: 07/06/2024] [Indexed: 07/28/2024]
Abstract
INTRODUCTION The increase in average air temperature and multiple extreme weather events, such as heatwaves and droughts, pose significant health risks to humans. This scoping review aims to examine the current state of the existing literature concerning the potential relationship between substance abuse and climate change, along with the aspects it encompasses. MATERIAL AND METHODS The review followed PRISMA guidelines for methodological rigor, aiming to identify studies on drug abuse. Searches were conducted across the primary databases using specific search strings. Quality assessment involved evaluating the research question's clarity, search strategy transparency, consistency in applying the inclusion/exclusion criteria, and reliability of data extraction. RESULTS Most studies were conducted in the USA. They included observational and retrospective quantitative studies, as well as qualitative and prospective observational ones. Research examined the correlation between extreme weather and some substance abuse. All studies analyzed the adverse effects of climate change, especially heatwaves, on both physiological and pathological levels. CONCLUSIONS The scoping review notes the scarcity of studies about the correlation between substance abuse and climate change, and emphasizes the threats faced by individuals with substance abuse and mental health disorders due to climate change.
Collapse
Affiliation(s)
- Luca Tomassini
- School of Advanced Studies, University of Camerino, 62032 Camerino, Italy;
| | - Massimo Lancia
- Forensic Medicine, Forensic Science and Sports Medicine Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy; (A.Z.); (N.P.); (C.G.)
| | - Angela Gambelunghe
- Occupational Medicine, Respiratory Diseases and Toxicology Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy;
| | - Abdellah Zahar
- Forensic Medicine, Forensic Science and Sports Medicine Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy; (A.Z.); (N.P.); (C.G.)
| | - Niccolò Pini
- Forensic Medicine, Forensic Science and Sports Medicine Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy; (A.Z.); (N.P.); (C.G.)
| | - Cristiana Gambelunghe
- Forensic Medicine, Forensic Science and Sports Medicine Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy; (A.Z.); (N.P.); (C.G.)
| |
Collapse
|
3
|
Perrone D, Fischer R, Florek J. COVID-19-Related Shifts in Polysubstance Use. Subst Use Misuse 2023; 58:1314-1323. [PMID: 37317983 DOI: 10.1080/10826084.2023.2181034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background: Big Events, such as economic crises and natural disasters, affect drug use patterns (e.g. Friedman & Rossi, 2015). The COVID-19 pandemic is a Big Event that led to lockdowns, travel restrictions, protocols on businesses, and rules for social engagements across the globe. Studies primarily in Europe and Oceania show that the pandemic impacted the type and amount of substances used (e.g. Winstock et al., 2020). Objectives: This study examines the impact of COVID-19 on substance use using a sample of 257 individuals across 36 states, who engage in polysubstance use. Results: The sample was recruited via DanceSafe, Inc.'s social media to complete an online survey (April-October 2020) about drug use during the pandemic. The mostly White, heterosexual sample used an average of seven different substances in the past 12 months. Slightly less than half reported increasing use since the onset of the COVID-19 pandemic, with young adults and lesbian, gay, bisexual, pansexual, or queer (LGBPQ) identifying individuals significantly more likely to do so. Relative to other substances, benzodiazepine use increased, and 3,4- methylenedioxymethamphetamine (MDMA) and psychedelic use decreased, while alcohol use stayed the same. Conclusions: The COVID-19 pandemic disproportionately affected those who are young adults, LGBPQ, and use drugs. Their unique needs during the pandemic warrant attention. The swap from leisure (e.g. MDMA) to anti-anxiety (e.g. Xanax) drugs is not surprising. Yet, the rise in novel benzodiazepines (Laing et al., 2021) is a point of concern that suggests drug checking and educational efforts can best reduce potential risks.
Collapse
Affiliation(s)
- Dina Perrone
- School of Criminology, Criminal Justice, and Emergency Management, California State University, Long Beach, California, USA
| | - Ryan Fischer
- School of Criminology, Criminal Justice, and Emergency Management, California State University, Long Beach, California, USA
| | - Jianna Florek
- School of Criminology, Criminal Justice, and Emergency Management, California State University, Long Beach, California, USA
| |
Collapse
|
4
|
Cano MT, Reavis JV, Pennington DL. Perceived discrimination enhances the association between distress and impact related to the murder of George Floyd and unhealthy alcohol use in a survey sample of U.S. Veterans who report drinking. Addict Behav Rep 2023; 17:100481. [PMID: 36713472 PMCID: PMC9876779 DOI: 10.1016/j.abrep.2023.100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 12/16/2022] [Accepted: 01/14/2023] [Indexed: 01/18/2023] Open
Abstract
Introduction On May 25, 2020, George Floyd was murdered by a Minneapolis police officer leading to increased social justice and antiracism movements (SJARM) across the United States. Vicarious exposure to racism and perceived discrimination are salient sources of distress which may lead to increased alcohol use as means of coping. The primary aim of the current study was to examine how perceived discrimination and the subjective impact and personal distress related to the SJARM following the George Floyd murder interact and relate to unhealthy alcohol use among U.S. Veterans. Methods 286 Veterans were assessed for unhealthy alcohol use (AUDIT-10), perceived discrimination (EDS), and subjective impact and personal distress related to the SJARM. Two moderation analyses were performed to examine whether subjective impact and personal distress moderated relations between perceived discrimination and alcohol use. In-depth follow-up analyses were conducted to examine differences and relationships among variables. Results In two different moderation models, perceived discrimination moderated the association between both subjective impact (p <.001) and personal distress (p <.001) felt by the SJARM and unhealthy alcohol use. In planned exploratory analyses, Veterans who reported perceived discrimination reported higher levels of unhealthy alcohol use (M = 14.71, SD = 9.39) than those who did not t(2 8 4) = 5.61, p <.001. In post-hoc analyses, racial/ethnic minorities were significantly more likely to report perceived racial discrimination (p <.001) while non-Hispanic Whites were more likely to report perceived discrimination based on education or income level (p <.01). Conclusions In the context of a socially unjust event amidst a global pandemic, perceived discrimination contributes to unhealthy alcohol use and subjective impact and personal distress associated with the SJARM following the murder of George Floyd. Results highlight the importance of addressing discrimination experiences in Veterans who seek alcohol treatment, particularly as rates of unhealthy alcohol use are on the rise.
Collapse
Affiliation(s)
- Monique T. Cano
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94143, United States
- San Francisco VA Health Care System, San Francisco, CA 94121, United States
| | - Jill V. Reavis
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94143, United States
- San Francisco VA Health Care System, San Francisco, CA 94121, United States
- Palo Alto University, Palo Alto, CA 94304, United States
| | - David L. Pennington
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94143, United States
- San Francisco VA Health Care System, San Francisco, CA 94121, United States
- Northern California Institute for Research and Education (NCIRE), San Francisco, CA 94121, United States
| |
Collapse
|
5
|
Abadie R. "The Drug Sellers Were Better Organized than the Government": A Qualitative Study of Participants' Views of Drug Markets during COVID-19 and Other Big Events. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1295. [PMID: 36674050 PMCID: PMC9859057 DOI: 10.3390/ijerph20021295] [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: 10/24/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 06/17/2023]
Abstract
"Big events", such as wars, economic crises, pandemics, or natural disasters, affect the risk environment in which people use drugs. While the impact of big events on injection risk behaviors and access to drug-treatment services is well documented, less is known about the effects of big events on drug markets. Based on self-reporting data on drug availability among people who use drugs (PWUD) in the aftermath of Hurricane Maria in Puerto Rico and during the COVID-19 lockdown in a Midwestern US state, this study aims to document the effects of big events on drug markets. Qualitative data on the effects of Hurricane Maria on drug markets are based on participants' self-reporting (N = 31). Data collection started after the hurricane and ended in 2020. Data on changes to the drug supply during the COVID-19 lockdown were collected based on semi-structured interviews with PWUD (N = 40) in a Midwestern US state. Findings show that while the drug markets might have initially been affected by big events, most effects were temporary. Drug availability, pricing, and quality might have suffered some initial fluctuations but stabilized as the drug markets absorbed the initial shocks caused by the hurricane and the lockdown measures. In preparation for increasingly more frequent and virulent pandemics and natural disasters, health infrastructures should be strengthened to prevent not only overdose episodes and deaths but also drug-related harms.
Collapse
Affiliation(s)
- Roberto Abadie
- School of Global Integrative Studies, University of Nebraska-Lincoln, Lincoln, NE 68588-0368, USA
| |
Collapse
|
6
|
Bradley H, Austin C, Allen ST, Asher A, Bartholomew TS, Board A, Borquez A, Buchacz K, Carter A, Cooper HLF, Feinberg J, Furukawa N, Genberg B, Gorbach PM, Hagan H, Huriaux E, Hurley H, Luisi N, Martin NK, Rosenberg ES, Strathdee SA, Jarlais DCD. A stakeholder-driven framework for measuring potential change in the health risks of people who inject drugs (PWID) during the COVID-19 pandemic. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 110:103889. [PMID: 36343431 PMCID: PMC9574463 DOI: 10.1016/j.drugpo.2022.103889] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/28/2022] [Accepted: 10/08/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND People who inject drugs (PWID) have likely borne disproportionate health consequences of the COVID-19 pandemic. PWID experienced both interruptions and changes to drug supply and delivery modes of harm reduction, treatment, and other medical services, leading to potentially increased risks for HIV, hepatitis C virus (HCV), and overdose. Given surveillance and research disruptions, proximal, indirect indicators of infectious diseases and overdose should be developed for timely measurement of health effects of the pandemic on PWID. METHODS We used group concept mapping and a systems thinking approach to produce an expert stakeholder-generated, multi-level framework for monitoring changes in PWID health outcomes potentially attributable to COVID-19 in the U.S. This socio-ecological measurement framework elucidates proximal and distal contributors to infectious disease and overdose outcomes, many of which can be measured using existing data sources. RESULTS The framework includes multi-level components including policy considerations, drug supply/distribution systems, the service delivery landscape, network factors, and individual characteristics such as mental and general health status and service utilization. These components are generally mediated by substance use and sexual behavioral factors to cause changes in incidence of HIV, HCV, sexually transmitted infections, wound/skin infections, and overdose. CONCLUSION This measurement framework is intended to increase the quality and timeliness of research on the impacts of COVID-19 in the context of the current pandemic and future crises. Next steps include a ranking process to narrow the drivers of change in health risks to a concise set of indicators that adequately represent framework components, can be written as measurable indicators, and are quantifiable using existing data sources, as well as a publicly available web-based platform for summary data contributions.
Collapse
Affiliation(s)
- Heather Bradley
- Georgia State University School of Public Health, 140 Decatur Street SE, Atlanta, GA, 30303, USA.
| | - Chelsea Austin
- Georgia State University School of Public Health, 140 Decatur Street SE, Atlanta, GA, 30303, USA
| | - Sean T Allen
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Alice Asher
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Tyler S Bartholomew
- University of Miami Miller School of Medicine, 1600 NW 10(th) Avenue, #1140, Miami, FL, 33136, USA
| | - Amy Board
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Annick Borquez
- University of California San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Kate Buchacz
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Anastasia Carter
- Georgia State University School of Public Health, 140 Decatur Street SE, Atlanta, GA, 30303, USA
| | - Hannah L F Cooper
- Emory University Rollins School of Public Health, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Judith Feinberg
- West Virginia University Health Sciences, 1 Medical Center Drive, #1000, Morgantown, WV, 26506, USA
| | - Nathan Furukawa
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Becky Genberg
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Pamina M Gorbach
- University of California Los Angeles, Fielding School of Public Health
| | - Holly Hagan
- NYU School of Global Public Health, 708 Broadway, New York, NY, 10003, USA
| | - Emalie Huriaux
- Washington State Department of Health, 101 Israel Road SE, Tumwater, WA, 98501, USA
| | | | - Nicole Luisi
- Emory University Rollins School of Public Health, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Natasha K Martin
- University of California San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Eli S Rosenberg
- University at Albany School of Public Health, SUNY, 1 University Place, Rensselaer, NY, 12144, USA; Office of Public Health, New York State Department of Public Health, Corning Tower, State Street, Albany, NY, 12203, USA
| | - Steffanie A Strathdee
- University of California San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Don C Des Jarlais
- NYU School of Global Public Health, 708 Broadway, New York, NY, 10003, USA
| |
Collapse
|
7
|
Abadie R, Cano M, Habecker P, Gelpí-Acosta C. Substance use, injection risk behaviors, and fentanyl-related overdose risk among a sample of PWID post-Hurricane Maria. Harm Reduct J 2022; 19:129. [PMID: 36424666 PMCID: PMC9694860 DOI: 10.1186/s12954-022-00715-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/15/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND While natural disasters like hurricanes are increasingly common, their long-term effects on people who inject drugs are not well understood. Although brief in duration, natural disasters can radically transform risk environments, increasing substance use and drug-related harms. METHODS Based on a study of people who inject drugs (PWID) and injection risk behaviors in rural Puerto Rico, the present study uses data from two different phases of the parent study. Data for 110 participants were collected from December 2015 to January 2017, soon before Hurricane Maria landed in September 2017; the 2019 phase, in the aftermath of the hurricane, included a total of 103 participants. The present study's main analyses used data from 66 PWID who participated in both the pre-Maria and post-Maria interviews (66 individuals measured at two time points, for a total of 132 observations), using mixed-effects binomial logistic regression to examine recent overdose experiences pre- and post-Maria. A separate descriptive analysis included all 103 participants from the 2019 interview. RESULTS After Hurricane Maria, some declines in injection frequency were observed (the percentage of people reporting injecting monthly or less increased from 3.0% before Hurricane Maria to 22.7% after Hurricane Maria). However, fewer PWID reported using a new needle for most or all injections. In the pre-Maria interview, 10.6% of participants indicated they had experienced an overdose during the year of the interview and/or the calendar year prior, and this figure increased to 24.2% in the post-Maria interview. In the regression analysis, the odds of reporting an overdose during the interview year and/or calendar year prior were three times as high post-Maria, relative to pre-Maria (odds ratio 3.25, 95% confidence interval 1.06-9.97). CONCLUSION Substance use patterns, injection risk behaviors, and overdose episodes and deaths differed after Hurricane Maria, relative to before the hurricane, yet it is unclear to what extent these changes also reflect the simultaneous arrival of fentanyl. In preparation for future natural disasters, it is imperative to strengthen the health infrastructure by enhancing access and curbing barriers to syringe services programs and medications for opioid use disorder, particularly in rural or underserved locations.
Collapse
Affiliation(s)
- Roberto Abadie
- grid.24434.350000 0004 1937 0060University of Nebraska-Lincoln, Lincoln, NE 68588 USA
| | - Manuel Cano
- grid.215654.10000 0001 2151 2636Arizona State University, Central Avenue 800, Phoenix, AZ 85004 USA
| | - Patrick Habecker
- grid.24434.350000 0004 1937 0060University of Nebraska-Lincoln, Lincoln, NE 68588 USA
| | - Camila Gelpí-Acosta
- grid.212340.60000000122985718LaGuardia Community College, City University of New York, 31-10 Thomson Avenue, Long Island City, NY 11101 USA
| |
Collapse
|
8
|
Price O, Man N, Bruno R, Dietze P, Salom C, Lenton S, Grigg J, Gibbs D, Wilson T, Degenhardt L, Chan R, Thomas N, Peacock A. Changes in illicit drug use and markets with the COVID-19 pandemic and associated restrictions: findings from the Ecstasy and Related Drugs Reporting System, 2016-20. Addiction 2022; 117:182-194. [PMID: 34159666 PMCID: PMC8441814 DOI: 10.1111/add.15620] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/02/2021] [Accepted: 06/09/2021] [Indexed: 12/23/2022]
Abstract
AIMS To describe (i) self-reported changes in drug use and (ii) trends in price, perceived availability, and perceived purity of illicit drugs, among people who regularly use ecstasy/ 3,4-methylenedioxymethamphetamine (MDMA) and other illicit stimulants in Australia following COVID-19 and associated restrictions. DESIGN Annual interviews with cross-sectional sentinel samples conducted face-to-face in 2016-19 and via video conferencing or telephone in 2020. Data were collected via an interviewer-administered structured questionnaire. SETTING Australian capital cities. PARTICIPANTS Australians aged 16 years or older who used ecstasy/MDMA and other illicit stimulants on a monthly or more frequent basis and resided in a capital city, recruited via social media and word-of-mouth (n ~ 800 each year). MEASUREMENTS Key outcome measures were self-reported illicit drug market indicators (price, purity and availability) and, in 2020 only, perceived change in drug use (including alcohol and tobacco) since March 2020 and reasons for this change. FINDINGS For most drugs, participants reported either no change or a reduction in their use since COVID-19 restrictions were introduced. Ecstasy/MDMA was the drug most frequently cited as reduced in use (n = 552, 70% of those reporting recent use), mainly due to reduced opportunities for socialization. While market indicators were largely stable across most drugs, the odds of perceiving MDMA capsules as 'high' in purity decreased compared with 2016-19 [adjusted odds ratio (aOR) = 0.72, 95% confidence interval (CI) = 0.53-0.99], as did perceiving them as 'easy' to obtain (aOR = 0.42, CI = 0.26-0.67). The odds of perceiving cocaine and methamphetamine crystal as 'easy' to obtain also decreased (aOR = 0.67, CI = 0.46-0.96 and aOR = 0.12, CI = 0.04-0.41, respectively). CONCLUSIONS After COVID-19-related restrictions were introduced in Australia, use of ecstasy/MDMA, related stimulants and other licit and illicit drugs mainly appeared to remain stable or decrease, primarily due to impediments to socialization.
Collapse
Affiliation(s)
- Olivia Price
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia
| | - Nicola Man
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia
| | - Raimondo Bruno
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia,School of Psychological SciencesUniversity of TasmaniaHobartAustralia
| | - Paul Dietze
- Behaviours and Health RisksBurnet InstituteMelbourneAustralia
| | - Caroline Salom
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia,Institute for Social Science ResearchUniversity of QueenslandBrisbaneAustralia
| | - Simon Lenton
- National Drug Research InstituteCurtin UniversityPerthAustralia
| | - Jodie Grigg
- National Drug Research InstituteCurtin UniversityPerthAustralia
| | - Daisy Gibbs
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia
| | - Tanya Wilson
- School of Psychological SciencesUniversity of TasmaniaHobartAustralia
| | - Louisa Degenhardt
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia
| | - Roanna Chan
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia
| | - Natalie Thomas
- Institute for Social Science ResearchUniversity of QueenslandBrisbaneAustralia
| | - Amy Peacock
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia,School of Psychological SciencesUniversity of TasmaniaHobartAustralia
| |
Collapse
|
9
|
Gountas I, Nikolopoulos G, Touloumi G, Fotiou A, Souliotis K. Could the 2010 HIV outbreak in Athens, Greece have been prevented? A mathematical modeling study. PLoS One 2021; 16:e0258267. [PMID: 34618836 PMCID: PMC8496824 DOI: 10.1371/journal.pone.0258267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/22/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION In 2009 and 2010, Athens, Greece experienced a hepatitis C virus (HCV) and a Human Immunodeficiency Virus (HIV) outbreak among People Who Inject Drugs (PWID), respectively. The HCV outbreak was not detected, while that of HIV was identified in 2011. The integrated HIV-interventions, launched in early 2012, managed to reduce directly the HIV incidence and indirectly the HCV incidence. This study aims to assess what would have been the course of the HIV outbreak and its associated economic consequences if the 2009 HCV outbreak had been detected and integrated interventions had been initiated 1- or 2-years earlier. METHODS The model was calibrated to reproduce the observed HIV epidemiological and clinical parameters among PWID of Athens, Greece. We examined the effect of the 1- or 2-years earlier detection scenarios, the 1-year later detection, the non-detection scenario, and compared them to the status quo scenario. RESULTS Cumulative HIV cases, under the status-quo scenario during 2009-2019, were 1360 (90% Credible intervals: 290, 2470). If the HCV outbreak had been detected 1- or 2- years earlier, with immediate initiation of integrated interventions, 740 and 1110 HIV cases could be averted by 2019, respectively. Regarding the costs, if there was an efficient notification system to detect the HCV outbreak 1 or 2 years earlier, 35.2-53.2 million euros could be saved compared to the status quo by 2019. CONCLUSIONS If the HCV outbreak had been detected and promptly addressed, the HIV outbreak would have been prevented and 35.2-53.2 million euros could have been saved.
Collapse
Affiliation(s)
- Ilias Gountas
- Faculty of Social and Political Sciences, University of Peloponnese, Korinthos, Greece
- * E-mail:
| | | | - Giota Touloumi
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios Fotiou
- Greek Reitox Focal Point at the Athens University Mental Health, Neurosciences, & Precision Medicine Research Institute (MHRI), Athens, Greece
| | - Kyriakos Souliotis
- Faculty of Social and Political Sciences, University of Peloponnese, Korinthos, Greece
| |
Collapse
|
10
|
Henderson R, McInnes A, Mackey L, Bruised Head M, Crowshoe L, Hann J, Hayward J, Holroyd BR, Lang E, Larson B, Leonard AJ, Persaud S, Raghavji K, Sarin C, Virani H, Wadsworth IW, Whitman S, McLane P. Opioid use disorder treatment disruptions during the early COVID-19 pandemic and other emergent disasters: a scoping review addressing dual public health emergencies. BMC Public Health 2021; 21:1471. [PMID: 34320954 PMCID: PMC8318046 DOI: 10.1186/s12889-021-11495-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 07/13/2021] [Indexed: 11/10/2022] Open
Abstract
Background During public health emergencies, people with opioid use disorder (PWOUD) may be particularly impacted. Emergent disasters such as the COVID-19 pandemic disrupt already-strained harm reduction efforts and treatment availability. This study aims to answer three research questions. How do public health emergencies impact PWOUD? How can health systems respond to novel public health emergencies to serve PWOUD? How can the results of this scoping review be contextualized to the province of Alberta to inform local stakeholder responses to the pandemic? Methods We conducted a scoping review using the 6-stage Arksey and O’Malley framework to analyse early-pandemic and pre-pandemic disaster literature. The results of the scoping review were contextualized to the local pandemic response, through a Nominal Group Technique (NGT) process with frontline providers and stakeholders in Alberta, Canada. Results Sixty one scientific journal articles and 72 grey literature resources were included after full-text screening. Forty sources pertained to early COVID-19 responses, and 21 focused on OUD treatment during other disasters. PWOUD may be more impacted than the general population by common COVID-19 stressors including loss of income, isolation, lack of rewarding activities, housing instability, as well as fear and anxiety. They may also face unique challenges including threats to drug supplies, stigma, difficulty accessing clean substance use supplies, and closure of substance use treatment centres. All of these impacts put PWOUD at risk of negative outcomes including fatal overdose. Two NGT groups were held. One group (n = 7) represented voices from urban services, and the other (n = 4) Indigenous contexts. Stakeholders suggested that simultaneous attention to multiple crises, with adequate resources to allow attention to both social and health systems issues, can prepare a system to serve PWOUD during disasters. Conclusion This scoping review and NGT study uncovers how disasters impact PWOUD and offers suggestions for better serving PWOUD. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11495-0.
Collapse
Affiliation(s)
- Rita Henderson
- Department of Family Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
| | - Ashley McInnes
- Department of Family Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Leslee Mackey
- Department of Emergency Medicine, University of Alberta, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada
| | | | - Lindsay Crowshoe
- Department of Family Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Jessica Hann
- Department of Emergency Medicine, University of Alberta, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada.,Addiction Recovery and Community Health (ARCH) Team, Royal Alexandra Hospital, 10240 Kingsway NW, Edmonton, AB, T5H 3V9, Canada
| | - Jake Hayward
- Department of Emergency Medicine, University of Alberta, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada
| | - Brian R Holroyd
- Department of Emergency Medicine, University of Alberta, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada.,Emergency Strategic Clinical Network, Alberta Health Services, 10030 - 107 St NW, Edmonton, AB, T5J 3E4, Canada
| | - Eddy Lang
- Emergency Strategic Clinical Network, Alberta Health Services, 10030 - 107 St NW, Edmonton, AB, T5J 3E4, Canada.,Department of Emergency Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Bonnie Larson
- Department of Family Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Ashley Jane Leonard
- Knowledge Resource Service, Alberta Health Services, 10030 - 107 St NW, Edmonton, AB, T5J 3E4, Canada
| | - Steven Persaud
- Department of Family Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Khalil Raghavji
- Metro City Medical Clinic, 150 - 909 5 Ave SW, Calgary, AB, T2P 3G5, Canada
| | - Chris Sarin
- Indigenous Services Canada, Suite 730, 9700 Jasper Avenue, Edmonton, AB, T5J 4C3, Canada.,Department of Community Health Sciences, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Hakique Virani
- Metro City Medical Clinic, 150 - 909 5 Ave SW, Calgary, AB, T2P 3G5, Canada.,Department of Medicine, University of Alberta, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada
| | - Iskotoahka William Wadsworth
- Blood Tribe, Stand Off, Canada.,Treaty 7 Chiefs Alliance, 206 - 8408 Elbow Drive SW, Calgary, Alberta, T2V 1K7, Canada
| | - Stacey Whitman
- Addiction and Mental Health, Alberta Health Services, 10030 - 107 St NW, Edmonton, AB, T5J 3E4, Canada
| | - Patrick McLane
- Department of Emergency Medicine, University of Alberta, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada.,Emergency Strategic Clinical Network, Alberta Health Services, 10030 - 107 St NW, Edmonton, AB, T5J 3E4, Canada
| |
Collapse
|
11
|
Socially-supportive norms and mutual aid of people who use opioids: An analysis of Reddit during the initial COVID-19 pandemic. Drug Alcohol Depend 2021; 222:108672. [PMID: 33757708 PMCID: PMC8057693 DOI: 10.1016/j.drugalcdep.2021.108672] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/28/2020] [Accepted: 01/03/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Big events (i.e., unique historical disruptions) like the COVID-19 epidemic and its associated period of social distancing can transform social structures, social interactions, and social norms. Social distancing rules and the fear of infection have greatly reduced face-to-face interactions, increased loneliness, reduced ties to helping institutions, and may also have disrupted the opioid use behaviors of people who use drugs. This research used Reddit to examine the impact of COVID-19 on the social networks and social processes of people who use opioids. METHODS Data were collected from the social media forum, Reddit.com. At the beginning of the COVID-19 pandemic in the U.S. (March 5, 2020, to May 13, 2020), 2,000 Reddit posts were collected from the two most popular opioid subreddits (r/OpiatesRecovery, r/Opiates). Posts were reviewed for relevance to COVID-19 and opioid use resulting in a final sample of 300. Thematic analysis was guided by the Big Events framework. RESULTS The COVID-19 pandemic was found to create changes in the social networks and daily lives among persons who use opioids. Adaptions to these changes shifted social networks leading to robust social support and mutual aid on Reddit, including sharing and seeking advice on facing withdrawal, dealing with isolation, managing cravings, and accessing recovery resources. CONCLUSIONS Reddit provided an important source of social support and mutual aid for persons who use opioids. Findings indicate online social support networks are beneficial to persons who use opioids, particularly during big events where isolation from other social support resources may occur.
Collapse
|
12
|
Pagano A, Hosakote S, Kapiteni K, Straus ER, Wong J, Guydish JR. Impacts of COVID-19 on residential treatment programs for substance use disorder. J Subst Abuse Treat 2020; 123:108255. [PMID: 33375986 DOI: 10.1016/j.jsat.2020.108255] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/19/2020] [Accepted: 12/14/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The COVID-19 pandemic may present special challenges for residential substance use disorder (SUD) treatment facilities, which may lack infrastructure and support to implement infection control protocols while maintaining on-site treatment services. However, little is known about how residential SUD treatment programs are impacted by the COVID-19 pandemic. METHODS The research team conducted semi-structured interviews with 17 directors of 20 residential SUD treatment programs across California during the state's shelter-in-place order. The researchers then analyzed qualitative interview data thematically and coded them using ATLAS.ti software. FINDINGS Thematic analyses identified six major themes: program-level impacts, staff impacts, client impacts, use of telehealth, program needs, and positive effects. "Program-level impacts" were decreased revenue from diminished client censuses and insufficient resources to implement infection control measures. "Staff impacts" included layoffs, furloughs, and increased physical and emotional fatigue. "Client impacts" were delayed treatment initiation; receipt of fewer services while in treatment; lower retention; and economic and psychosocial barriers to community re-entry. "Use of telehealth" included technical and interpersonal challenges associated with telehealth visits. "Program needs" were personal protective equipment (PPE), stimulus funding, hazard pay, and consistent public health guidance. "Positive effects" of the pandemic response included increased attention to hygiene and health, telehealth expansion, operational improvements, and official recognition of SUD treatment as an essential health care service. CONCLUSION Study findings highlight COVID-related threats to the survival of residential SUD treatment programs; retention of the SUD treatment workforce; and clients' SUD treatment outcomes. These findings also identify opportunities to improve SUD service delivery and suggest avenues of support for residential SUD treatment facilities during and after the COVID-19 pandemic.
Collapse
Affiliation(s)
- Anna Pagano
- Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA 94118, United States of America.
| | - Sindhu Hosakote
- Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA 94118, United States of America
| | - Kwinoja Kapiteni
- Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA 94118, United States of America
| | - Elana R Straus
- Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA 94118, United States of America
| | - Jessie Wong
- Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA 94118, United States of America
| | - Joseph R Guydish
- Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA 94118, United States of America
| |
Collapse
|
13
|
Papadimos TJ, Soghoian SE, Nanayakkara P, Singh S, Miller AC, Saddikuti V, Jayatilleke AU, Dubhashi SP, Firstenberg MS, Dutta V, Chauhan V, Sharma P, Galwankar SC, Garg M, Taylor N, Stawicki SP. COVID-19 Blind Spots: A Consensus Statement on the Importance of Competent Political Leadership and the Need for Public Health Cognizance. J Glob Infect Dis 2020; 12:167-190. [PMID: 33888955 PMCID: PMC8045535 DOI: 10.4103/jgid.jgid_397_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/11/2020] [Accepted: 11/25/2020] [Indexed: 02/07/2023] Open
Abstract
As the COVID-19 pandemic continues, important discoveries and considerations emerge regarding the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pathogen; its biological and epidemiological characteristics; and the corresponding psychological, societal, and public health (PH) impacts. During the past year, the global community underwent a massive transformation, including the implementation of numerous nonpharmacological interventions; critical diversions or modifications across various spheres of our economic and public domains; and a transition from consumption-driven to conservation-based behaviors. Providing essential necessities such as food, water, health care, financial, and other services has become a formidable challenge, with significant threats to the existing supply chains and the shortage or reduction of workforce across many sectors of the global economy. Food and pharmaceutical supply chains constitute uniquely vulnerable and critically important areas that require high levels of safety and compliance. Many regional health-care systems faced at least one wave of overwhelming COVID-19 case surges, and still face the possibility of a new wave of infections on the horizon, potentially in combination with other endemic diseases such as influenza, dengue, tuberculosis, and malaria. In this context, the need for an effective and scientifically informed leadership to sustain and improve global capacity to ensure international health security is starkly apparent. Public health "blind spotting," promulgation of pseudoscience, and academic dishonesty emerged as significant threats to population health and stability during the pandemic. The goal of this consensus statement is to provide a focused summary of such "blind spots" identified during an expert group intense analysis of "missed opportunities" during the initial wave of the pandemic.
Collapse
Affiliation(s)
- Thomas J. Papadimos
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Samara E. Soghoian
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Prabath Nanayakkara
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Sarman Singh
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Andrew C. Miller
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | | | | | - Siddharth P. Dubhashi
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Michael S. Firstenberg
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Vibha Dutta
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Vivek Chauhan
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Pushpa Sharma
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Sagar C. Galwankar
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Manish Garg
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Nicholas Taylor
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Stanislaw P. Stawicki
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| |
Collapse
|
14
|
Vasylyeva TI, Smyrnov P, Strathdee S, Friedman SR. Challenges posed by COVID-19 to people who inject drugs and lessons from other outbreaks. J Int AIDS Soc 2020; 23:e25583. [PMID: 32697423 PMCID: PMC7375066 DOI: 10.1002/jia2.25583] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/19/2020] [Accepted: 06/26/2020] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION In light of the COVID-19 pandemic, considerable effort is going into identifying and protecting those at risk. Criminalization, stigmatization and the psychological, physical, behavioural and economic consequences of substance use make people who inject drugs (PWID) extremely vulnerable to many infectious diseases. While relationships between drug use and blood-borne and sexually transmitted infections are well studied, less attention has been paid to other infectious disease outbreaks among PWID. DISCUSSION COVID-19 is likely to disproportionally affect PWID due to a high prevalence of comorbidities that make the disease more severe, unsanitary and overcrowded living conditions, stigmatization, common incarceration, homelessness and difficulties in adhering to quarantine, social distancing or self-isolation mandates. The COVID-19 pandemic also jeopardizes essential for PWID services, such as needle exchange or substitution therapy programmes, which can be affected both in a short- and a long-term perspective. Importantly, there is substantial evidence of other infectious disease outbreaks in PWID that were associated with factors that enable COVID-19 transmission, such as poor hygiene, overcrowded living conditions and communal ways of using drugs. CONCLUSIONS The COVID-19 crisis might increase risks of homelessnes, overdoses and unsafe injecting and sexual practices for PWID. In order to address existing inequalities, consultations with PWID advocacy groups are vital when designing inclusive health response to the COVID-19 pandemic.
Collapse
|
15
|
Krumhansl KA, Bergman JN, Salomon AK. Assessing the ecosystem-level consequences of a small-scale artisanal kelp fishery within the context of climate-change. ECOLOGICAL APPLICATIONS : A PUBLICATION OF THE ECOLOGICAL SOCIETY OF AMERICA 2017; 27:799-813. [PMID: 27984678 DOI: 10.1002/eap.1484] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/20/2016] [Accepted: 10/25/2016] [Indexed: 06/06/2023]
Abstract
Coastal communities worldwide rely on small-scale artisanal fisheries as a means of increasing food security and alleviating poverty. Even small-scale fishing activities, however, are prone to resource depletion and environmental degradation, which can erode livelihoods in the long run. Thus, there is a pressing need to identify viable and resilient artisanal fisheries, and generate knowledge to support management within the context of a rapidly changing climate. We examined the ecosystem-level consequences of an artisanal kelp fishery (Macrocystis pyrifera), finding small-scale harvest of this highly productive species poses minimal impacts on kelp recovery rates, survival, and biomass dynamics, and abundances of associated commercial and culturally important fish species. These results suggest that small-scale harvest poses minimal trade-offs for the other economic benefits provided by these ecosystems, and their inherent, spiritual, and cultural value to humans. However, we detected a negative impact of warmer seawater temperatures on kelp recovery rates following harvest, indicating that the viability of harvest, even at small scales, may be threatened by future increases in global ocean temperature. This suggests that negative impacts of artisanal fisheries may be more likely to arise in the context of a warming climate, further highlighting the widespread effects of global climate change on coastal fisheries and livelihoods.
Collapse
Affiliation(s)
- Kira A Krumhansl
- School of Resource and Environmental Management, Simon Fraser University, Burnaby, British Columbia, V5A 1S6, Canada
- Hakai Institute, P.O. Box 309, Heriot Bay, British Columbia, V0P 1H0, Canada
| | - Jordanna N Bergman
- Florida Fish and Wildlife Research Institute, 100 8th Avenue, St. Petersburg, Florida, 33701, USA
| | - Anne K Salomon
- School of Resource and Environmental Management, Simon Fraser University, Burnaby, British Columbia, V5A 1S6, Canada
- Hakai Institute, P.O. Box 309, Heriot Bay, British Columbia, V0P 1H0, Canada
| |
Collapse
|
16
|
Alarcón RD, Parekh A, Wainberg ML, Duarte CS, Araya R, Oquendo MA. Hispanic immigrants in the USA: social and mental health perspectives. Lancet Psychiatry 2016; 3:860-70. [PMID: 27568273 DOI: 10.1016/s2215-0366(16)30101-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 05/16/2016] [Accepted: 05/17/2016] [Indexed: 11/25/2022]
Abstract
Hispanic immigration in the USA and its effect on many areas of US society are of great relevance to health care, public health, mental health, and medical and social sciences. In this report, we review and discuss pertinent literature on causes, procedures, and eventual outcomes of Hispanic migration waves throughout the last four decades. Hispanic immigrants do not constitute a monolithic group, despite the clear predominance of Mexican and Mexican-American segments. Common features of Hispanic immigrants include a younger average age, higher presence of married households, and lower educational levels than the overall US population. Differences within the Hispanic immigrant population are present in naturalisation figures, English language fluency, occupational and income status, health insurance coverage, and sense of accomplishment in the host society. We examine most of these aspects in the context of the so-called Hispanic paradox, presented as both a cause and a result of a heavily discussed acculturative process. We investigate prevalence and other data on depression, anxiety, substance abuse, and psychotic syndromes, with emphasis on the need to do further neurobiological, epigenetic, and sociocultural research in the Hispanic population.
Collapse
Affiliation(s)
- Renato D Alarcón
- Mayo Medicine School, Mayo Clinic, Rochester, MN, USA; Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Milton L Wainberg
- New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Cristiane S Duarte
- New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Ricardo Araya
- London School of Hygiene & Tropical Medicine, London, UK
| | - María A Oquendo
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.
| |
Collapse
|
17
|
Vasilev G, Milcheva S, Vassileva J. Opioid Use in the Twenty First Century: Similarities and Differences Across National Borders. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2016; 3:293-305. [PMID: 27493878 PMCID: PMC4968876 DOI: 10.1007/s40501-016-0089-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The global prevalence in the use of opiates and opioids has remained stable, though there were some unprecedented recent increases in opioid use and associated mortality and morbidity in the United States. Internationally, there is a strong tendency for consolidation of drug treatment strategies in favor of more systematic, structured and balanced approaches to regional and national drug policies. However, there are considerable differences in the scope, focus, and implementation of national drug policies and the political context is shaping drug prevention, treatment and rehabilitation efforts to an extent not typically observed in other public health domains. As a result, though in theory, there is a considerable multi-national agreement about the efficacy and effectiveness of different treatment modalities for opioid dependence, in practice, there are striking differences among different world regions and countries in the degree of implementation of these treatment modalities into clinical practice. Such discrepancies between theory and practice are observed even in high-income countries such as the United States and European Union member states, where evidence-based treatment modalities are still not well implemented into clinical practice. Despite the lack of evidence-based support for the role of detoxification as a stand-alone treatment for opioid use disorders, it appears to be the most widely used intervention for opioid use across the world.
Collapse
Affiliation(s)
- Georgi Vasilev
- Bulgarian Addictions Institute, 93 Antim I, Sofia 1303, Bulgaria, Tel: 00359 885 000 533
| | - Svetla Milcheva
- University Hospital Sveta Marina, 1 Hristo Smirnenski blvd, Varna 9100, Bulgaria, Tel: 00359 889 317 293
| | - Jasmin Vassileva
- Department of Psychiatry, Virginia Commonwealth University, 203 E. Cary Street, Richmond VA 23219, USA, Tel: 804 828 5807
| |
Collapse
|