McCaughran-Contreras Celine, Fernando Saranee, Sikora Mike, Hawkins Jennifer, Kniseley Marinel, Snyder Daniel, Long Connie, Robson James, Slaunwhite Amanda, Salmon Amy
University of British Columbia, Vancouver, Canada.
CHEOS: Centre for Health Evaluation and Outcome Sciences, Vancouver, Canada.
Harm Reduct J. 2021 Jul 28;18(1):77. doi: 10.1186/s12954-021-00525-0.
The relationship between incarceration and risk of overdose has been well-documented in the literature, but few studies document the perspectives of persons at risk of overdose who were incarcerated. This sub-inquiry aimed to understand the experiences of persons with a history of substance use and incarceration in the Fraser East region of BC and how involvement with the criminal justice system affected their drug use and perceived risk of overdose.
The Fraser East Overdose Response project utilized a community-based participatory action approach that included peer researchers with lived experience in all parts of the research process. This qualitative pilot study aimed to better understand individuals at risk of an unwitnessed overdose in order to prevent deaths and identify effective local responses. A snowball sampling technique was used to recruit persons aged 19 and over who used illicit drugs over the past 3 years in the Fraser East since 2016. In total, 22 participants were interviewed. Of these, 13 participants identified a history of incarceration. Interviews were analyzed using a framework analysis approach.
The perspectives that participants shared revealed that impacts from incarceration are influenced by policies but also highly individualized. Our inquiry found three broader themes, within which were situated differing and sometimes conflicting interpretations and experiences of systemic environments: (1) incarceration was associated with harms and was perceived to increase risk of overdose following release, (2) incarceration was perceived to have limited impact on substance use and overdose risk, and (3) incarceration was associated with a perceived reduction of substance use and overdose risk.
Understanding the complexities of the perceptions of those with lived experience of substance use and incarceration is of importance to better inform interventions in this population. The existing knowledge base urgently requires further inquiry into the intersections between qualitative perspectives, environments and policies, and quantitative outcomes of overdose vís-a-vís correctional institution.
监禁与药物过量风险之间的关系在文献中已有充分记载，但很少有研究记录被监禁的药物过量风险人群的观点。本次子调查旨在了解不列颠哥伦比亚省弗雷泽东部地区有药物使用和监禁史的人群的经历，以及与刑事司法系统的接触如何影响他们的药物使用和感知到的药物过量风险。
弗雷泽东部药物过量应对项目采用了基于社区的参与式行动方法，在研究过程的各个环节都纳入了有实际生活经历的同伴研究者。这项定性试点研究旨在更好地了解有无人见证药物过量风险的个体，以预防死亡并确定有效的当地应对措施。采用滚雪球抽样技术招募了自2016年以来在弗雷泽东部过去3年中使用过非法药物的19岁及以上人群。总共采访了22名参与者。其中，13名参与者有监禁史。采用框架分析方法对访谈进行分析。
参与者分享的观点表明，监禁的影响受政策影响，但也高度个体化。我们的调查发现了三个更广泛的主题，其中包含了对系统环境的不同且有时相互冲突的解释和经历：（1）监禁与伤害相关，并且被认为在释放后会增加药物过量的风险，（2）监禁被认为对药物使用和药物过量风险的影响有限（3）监禁与药物使用和药物过量风险的感知降低相关。
了解有药物使用和监禁实际生活经历者认知的复杂性，对于更好地为针对这一人群的干预措施提供信息非常重要。现有的知识库迫切需要进一步探究定性观点、环境和政策之间的交叉点，以及与惩教机构相关的药物过量的定量结果。
