Publications (2)4.31 Total impact
Article: Injecting drug use and unstable housing: Scope for structural interventions in harm reduction[show abstract] [hide abstract]
ABSTRACT: Evidence links unstable housing, and especially homelessness, with elevated health harm among drug users, including riskier drug injecting practices. We undertook 45 qualitative interviews with injecting drug users (IDUs) in Bristol and London in 2006, the majority of whom had recently experienced homelessness. IDUs were recruited through drug user networks and drug agencies. We undertook thematic analyses of drug injector accounts concentrating on risk linked to drug injecting in a context of unstable housing. Findings show that temporary accommodation and hostels for the homeless may provide a ‘safe haven’ from street-based drug use and public injecting environments, and are characterized as a retreat from the ‘chaos’ of the street. But hostels may also constitute ‘risk environments’, facilitating drug using and risk networks and transitions to new patterns of use, including increased frequency of injecting. For some, homelessness was positioned as ‘safer’ than temporary housing with regards to managing drug use. Stable housing emerges as a key structural factor in creating enabling environments for health. We emphasize that temporary accommodation hostels have potential for harm-reduction interventions, but may also be associated with the production of risk related to drug use and injecting.09/2009; 16(5):436-450.
[show abstract] [hide abstract]
ABSTRACT: We report on an exploratory qualitative study investigating drug injectors' narratives of vein damage and groin (femoral vein) injection associated with the injection of crack-heroin speedball. We undertook 44 in-depth qualitative interviews among injectors of crack-heroin speedball in Bristol and London, England, in 2006. The data suggest an emerging culture of crack-based speedball injection. Injectors' narratives link speedball injection with shifts towards groin injection articulated as an acceptable risk, and not merely as a last resort in the face of increased vein deterioration associated with speedball. Accounts of vein damage linked to speedball emphasize 'missed hits' related to the local anaesthetic action of crack, the excess use of citric in the preparation of speedball injections and 'flushing' when making a hit. We find that groin injection persists despite an awareness of health risks and medical complications. We emphasize an urgent need for reviewing harm reduction in relation to vein care in the context of shifts to crack-based speedball injection, and the use of the femoral vein, among UK injectors. There is an additional need for interventions to promote safer groin and speedball injecting as well as to prevent transitions toward groin and crack injection.Addiction 12/2007; 102(11):1782-90. · 4.31 Impact Factor