Southern Connecticut State University, 501 Crescent Street, New Haven, CT 06515, United States.
Bentley University, 175 Forest Street, Waltham, MA 02452, United States.
Int J Drug Policy. 2021 Apr;90:103082. doi: 10.1016/j.drugpo.2020.103082. Epub 2020 Dec 26.
Opioid overdoses are primarily discussed by the pharmacological properties of the drugs used. Research shows that other factors such as the social/physical environment and the mental/emotional states can have an impact on overdose events. Ataiants and colleagues (2020) used Zinberg's "drug, set, and setting" framework to identify circumstances surrounding overdose experiences of street-involved women in Philadelphia. The aim of this paper is to extend their analysis to a diverse sample of suburban women who experienced overdoses.
The mixed-methods design consisted of ethnographic fieldwork, in-depth interviews, and brief surveys with 32 suburban women who use opioids. Inductive theoretical reasoning and constant comparative analysis facilitated themes emerging within the "drug, set, and setting" framework.
Eighteen out of 32 women identified "drug" as the primary factor involved in their overdose events. Major themes were an inability to identify the synthetic opioid fentanyl, lack of knowledge or control over how much to use, poly-substance use, and an insufficient understanding of risks. Eleven out of 32 women linked "set" to their overdose experiences. Themes included emotional trauma, such as death of a child, child custody issues, and mental health conditions, such as depression. Six out of 32 women associated "setting" with one of their overdose experiences. Themes were related to being with friends or partners that used, and having recently been released from treatment or incarceration.
Findings show similar themes found among an urban sample, adding insight on the need for effective overdose interventions targeted for suburban populations. The opioid crisis is not confined to the cities, and neither should services aimed at addressing opioid overdose. The knowledge provided here can help policy makers support female-centered harm reduction services not only in urban areas but also in the suburbs.
阿片类药物过量主要是通过所使用药物的药理学特性来讨论的。研究表明，其他因素，如社会/物理环境和心理/情绪状态，也会对过量事件产生影响。Ataiants 及其同事（2020 年）使用 Zinberg 的“药物、情境和环境”框架来确定费城街头女性过量体验的周围环境。本文的目的是将他们的分析扩展到一个不同的、有过过量经历的郊区女性样本。
混合方法设计包括民族志实地工作、深入访谈和对 32 名使用阿片类药物的郊区女性的简短调查。归纳理论推理和恒比分析促进了“药物、情境和环境”框架内出现的主题。
32 名女性中有 18 名女性认为“药物”是她们过量事件的主要因素。主要主题包括无法识别合成阿片类药物芬太尼、缺乏对使用量的了解或控制、多物质使用以及对风险的认识不足。32 名女性中有 11 名女性将“情境”与她们的过量经历联系起来。主题包括情绪创伤，如孩子死亡、子女监护问题和心理健康状况，如抑郁。32 名女性中有 6 名女性将“环境”与她们的一次过量经历联系起来。主题与与使用药物的朋友或伴侣在一起，以及最近从治疗或监禁中释放有关。
研究结果显示，在城市样本中发现了类似的主题，这增加了对针对郊区人群的有效过量干预措施的必要性的认识。阿片类药物危机不仅局限于城市，针对阿片类药物过量的服务也不应如此。这里提供的知识可以帮助政策制定者支持以女性为中心的减少伤害服务，不仅在城市地区，而且在郊区。
