Yale School of Medicine, AIDS Program, 135 College Street, Suite 323, New Haven, CT, 06510, USA.
Population Health Nursing Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
Harm Reduct J. 2020 Oct 31;17(1):86. doi: 10.1186/s12954-020-00435-7.
To reduce opioid dependence and HIV transmission, Kyrgyzstan has introduced methadone maintenance therapy and needle/syringe programs into prisons. Illicit injection of diphenhydramine, an antihistamine branded as Dimedrol, has been anecdotally reported as a potential challenge to harm reduction efforts in prisons but has not been studied systematically.
We conducted qualitative interviews in Kyrgyz or Russian with prisoners (n = 49), former prisoners (n = 19), and stakeholders (n = 18), including prison administrators and prisoner advocates near Bishkek, Kyrgyzstan from October 2016 to September 2018. Interviews explored social-contextual factors influencing methadone utilization in prisons. Transcripts were coded by five researchers using content analysis. Dimedrol injection emerged as an important topic, prompting a dedicated analysis.
After drinking methadone, some people in prison inject crushed Dimedrol tablets, a non-prescription antihistamine that is banned but obtainable in prison, to achieve a state of euphoria. From the perspectives of the study participants, Dimedrol injection was associated with devastating physical and mental health consequences, including psychosis and skin infections. Moreover, the visible wounds of Dimedrol injecting contributed to the perception of methadone as a harmful drug and supporting preference for heroin over methadone.
Dimedrol injecting is a potentially serious threat to harm reduction and HIV prevention efforts in Kyrgyzstan and elsewhere in the Eastern European and Central Asian region and requires further investigation.
为了减少阿片类药物依赖和艾滋病毒传播，吉尔吉斯斯坦在监狱中引入了美沙酮维持治疗和针/注射器方案。非法注射苯海拉明（一种名为苯海拉明的抗组胺药）已被传闻为监狱内减少伤害工作的潜在挑战，但尚未进行系统研究。
我们于 2016 年 10 月至 2018 年 9 月期间在吉尔吉斯斯坦比什凯克附近，使用吉尔吉斯语或俄语对囚犯（n=49）、前囚犯（n=19）和利益攸关方（n=18）进行了定性访谈，包括监狱管理人员和囚犯维权人士。访谈探讨了影响监狱中美沙酮利用的社会背景因素。研究人员使用内容分析法对转录本进行了编码。苯海拉明注射成为一个重要的话题，促使我们进行了专门的分析。
一些囚犯在喝完美沙酮后会注射碾碎的苯海拉明片剂，这种非处方抗组胺药虽然在监狱中被禁止但仍可获得，以达到欣快的状态。从研究参与者的角度来看，苯海拉明注射会导致严重的身心健康后果，包括精神病和皮肤感染。此外，苯海拉明注射的可见伤口导致人们认为美沙酮是一种有害药物，并支持对海洛因的偏好而不是美沙酮。
苯海拉明注射可能对吉尔吉斯斯坦及东欧和中亚地区其他地方的减少伤害和艾滋病毒预防工作构成严重威胁，需要进一步调查。
