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Barboza-Salerno GE, Thurston H, Freisthler B. The Spatial Scale and Spread of Child Victimization. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241245388. [PMID: 38769859 DOI: 10.1177/08862605241245388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Previous research shows that large, densely populated urban areas have higher rates of child victimization that have persisted over time. However, few investigations have inquired about the processes that produce and sustain hot and cold spots of child victimization. As a result, the mechanisms that produce the observed spatial clustering of child victimization, and hence "why" harms against children tend to cluster in space, remains unknown. Does the likelihood of being a victim of violence in one location depend on a similar event happening in a nearby location within a specified timeframe? Rather, are child victims of violence more likely to reside in suboptimal neighborhood conditions? This paper aims to present an analytical and theoretical framework for distinguishing between these locational (point) processes to determine whether the empirical spatial patterns undergirding child victimization are more reflective of the "spread" via contagion (i.e., dependency) or whether they are produced by neighborhood structural inequality resulting from spatial heterogeneity. To detect spatial dependence, we applied the inhomogeneous K-function to Los Angeles Medical Examiner data on child homicide victim locations while controlling for regional differences in victimization events (i.e., heterogeneity). Our analysis found strong evidence of spatial clustering in child victimization at small spatial scales but inhibition at larger scales. We further found limited support for the spatiotemporal clustering of child victimization indicative of a contagion effect. Overall, our results support the role of neighborhood structural vulnerability in the underlying mechanisms producing patterns of child victimization across Los Angeles County. We conclude by discussing the policy implications for understanding this spatial patterning in geographical context and for developing effective and targeted preventive interventions.
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Affiliation(s)
| | - Holly Thurston
- College of Social Work, The Ohio State University, Columbus, USA
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Schneider KE, Martin EM, Allen ST, Morris M, Haney K, Saloner B, Sherman SG. Volatile drug use and overdose during the first year of the COVID-19 pandemic in the United States. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 126:104371. [PMID: 38447262 PMCID: PMC11056297 DOI: 10.1016/j.drugpo.2024.104371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/16/2024] [Accepted: 02/22/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Overdose deaths in the United States rose substantially during the COVID-19 pandemic. Disruptions to the drug supply and service provision introduced significant instability into the lives of people who use drugs (PWUD), including volatility in their drug use behaviors. METHODS Using data from a multistate survey of PWUD, we examined sociodemographic and drug use correlates of volatile drug use during COVID-19 using multivariable linear regression. In a multivariable logistic regression model, we assessed the association between volatile drug use and past month overdose adjusting for sociodemographic and other drug use characteristics. RESULTS Among participants, 52% were male, 50% were white, 29% had less than a high school education, and 25% were experiencing homelessness. Indicators of volatile drug use were prevalent: 53% wanted to use more drugs; 45% used more drugs; 43% reported different triggers for drug use, and 23% used drugs that they did not typically use. 14% experienced a past-month overdose. In adjusted models, hunger (β=0.47, 95% CI: 0.21-0.72), transactional sex (β=0.50, 95% CI: 0.06-0.94), and the number of drugs used (β=0.16, 95% CI: 0.07-0.26) were associated with increased volatile drug use. Volatile drug use was associated with increased overdose risk (aOR=1.42, 95% CI: 1.17-1.71) in the adjusted model. CONCLUSIONS Volatile drug use during the COVID-19 pandemic was common, appeared to be driven by structural vulnerability, and was associated with increased overdose risk. Addressing volatile drug use through interventions that ensure structural stability for PWUD and a safer drug supply is essential for mitigating the ongoing overdose crisis.
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Affiliation(s)
- Kristin E Schneider
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA.
| | - Emily M Martin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA
| | - Sean T Allen
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA
| | - Miles Morris
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA
| | - Katherine Haney
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA
| | - Brendan Saloner
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA
| | - Susan G Sherman
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA
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Bodnar RJ. Endogenous opiates and behavior: 2022. Peptides 2023; 169:171095. [PMID: 37704079 DOI: 10.1016/j.peptides.2023.171095] [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] [Received: 08/22/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 09/15/2023]
Abstract
This paper is the forty-fifth consecutive installment of the annual anthological review of research concerning the endogenous opioid system, summarizing articles published during 2022 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides and receptors as well as effects of opioid/opiate agonists and antagonists. The review is subdivided into the following specific topics: molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors (1), the roles of these opioid peptides and receptors in pain and analgesia in animals (2) and humans (3), opioid-sensitive and opioid-insensitive effects of nonopioid analgesics (4), opioid peptide and receptor involvement in tolerance and dependence (5), stress and social status (6), learning and memory (7), eating and drinking (8), drug abuse and alcohol (9), sexual activity and hormones, pregnancy, development and endocrinology (10), mental illness and mood (11), seizures and neurologic disorders (12), electrical-related activity and neurophysiology (13), general activity and locomotion (14), gastrointestinal, renal and hepatic functions (15), cardiovascular responses (16), respiration and thermoregulation (17), and immunological responses (18).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, USA.
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Ballard AM, Falk D, Greenwood H, Gugerty P, Feinberg J, Friedmann PD, Go VF, Jenkins WD, Korthuis PT, Miller WC, Pho MT, Seal DW, Smith GS, Stopka TJ, Westergaard RP, Zule WA, Young AM, Cooper HLF. Houselessness and syringe service program utilization among people who inject drugs in eight rural areas across the USA: a cross-sectional analysis. Harm Reduct J 2023; 20:157. [PMID: 37880724 PMCID: PMC10601138 DOI: 10.1186/s12954-023-00892-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Research conducted in urban areas has highlighted the impact of housing instability on people who inject drugs (PWID), revealing that it exacerbates vulnerability to drug-related harms and impedes syringe service program (SSP) use. However, few studies have explored the effects of houselessness on SSP use among rural PWID. This study examines the relationship between houselessness and SSP utilization among PWID in eight rural areas across 10 states. METHODS PWID were recruited using respondent-driven sampling for a cross-sectional survey that queried self-reported drug use and SSP utilization in the prior 30 days, houselessness in the prior 6 months and sociodemographic characteristics. Using binomial logistic regression, we examined the relationship between experiencing houselessness and any SSP use. To assess the relationship between houselessness and the frequency of SSP use, we conducted multinomial logistic regression analyses among participants reporting any past 30-day SSP use. RESULTS Among 2394 rural PWID, 56.5% had experienced houselessness in the prior 6 months, and 43.5% reported past 30-day SSP use. PWID who had experienced houselessness were more likely to report using an SSP compared to their housed counterparts (adjusted odds ratio [aOR] = 1.24 [95% confidence intervals [CI] 1.01, 1.52]). Among those who had used an SSP at least once (n = 972), those who experienced houselessness were just as likely to report SSP use two (aOR = 0.90 [95% CI 0.60, 1.36]) and three times (aOR = 1.18 [95% CI 0.77, 1.98]) compared to once. However, they were less likely to visit an SSP four or more times compared to once in the prior 30 days (aOR = 0.59 [95% CI 0.40, 0.85]). CONCLUSION This study provides evidence that rural PWID who experience houselessness utilize SSPs at similar or higher rates as their housed counterparts. However, housing instability may pose barriers to more frequent SSP use. These findings are significant as people who experience houselessness are at increased risk for drug-related harms and encounter additional challenges when attempting to access SSPs.
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Affiliation(s)
- April M Ballard
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA.
- School of Public Health, Georgia State University, 140 Decatur Street SE, Atlanta, GA, 30303, USA.
| | - Dylan Falk
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Harris Greenwood
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Paige Gugerty
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Judith Feinberg
- School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Peter D Friedmann
- Office of Research, University of Massachusetts Chan Medical School-Baystate, Springfield, MA, USA
| | - Vivian F Go
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Wiley D Jenkins
- School of Medicine, Southern Illinois University, Carbondale, IL, USA
| | - P Todd Korthuis
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - William C Miller
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Mai T Pho
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - David W Seal
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Gordon S Smith
- School of Medicine, West Virginia University, Morgantown, WV, USA
| | | | - Ryan P Westergaard
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | | | - April M Young
- College of Public Health, University of Kentucky, 111 Washington Avenue, Lexington, KY, 40536, USA
| | - Hannah L F Cooper
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
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Jones M, Guirguis A, Watkins A, Bradshaw C, Mohamed L, Schifano F. Obstacles to treatment retention in opioid use disorder: An international substance use disorder treatment worker survey. Hum Psychopharmacol 2023; 38:e2882. [PMID: 37776029 DOI: 10.1002/hup.2882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 10/01/2023]
Abstract
INTRODUCTION Treatment retention is associated with better outcomes and reduced risk amongst people experiencing opioid use disorder (OUD). Despite this, treatment retention remains low amongst this population. METHODS We carried out an international cross-sectional survey of substance use disorder (SUD) treatment service workers. We aimed to understand the barriers to treatment retention in the context of OUD from the provider perspective, identify differences in response preference between professional groups, and describe regional differences in treatment provision. RESULTS We report data from 497 respondents based in the USA and the UK. Personality disorders, low motivation to change and social problems were the most often reported obstacles to retention. Comorbid SUD, hepatitis and HIV were not reported as often as expected. We identified associations between professional groups and response preferences related to comorbid SUD, low motivation, living arrangements and communication difficulties. UK respondents used behavioural treatments more than their US counterparts. US respondents more often reported using objective methods of measuring retention such as urine analysis, compared to their UK counterparts. DISCUSSION The findings from this survey suggest that regional differences exist between US and UK based SUD treatment service workers. Personality disorders represented the most often experienced obstacles to treatment retention amongst patients with OUD, with mental health and social problems more often reported than comorbid drug problems or physical health problems. Statistically significant relationships exist between professional group and obstacles reported. These data may be used to identify additional training needs amongst SUD treatment service staff.
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Affiliation(s)
| | | | | | | | - Lily Mohamed
- Cwm Taf Morgannwg University Health Board, Abercynon, UK
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Forati A, Ghose R, Mohebbi F, Mantsch JR. The journey to overdose: Using spatial social network analysis as a novel framework to study geographic discordance in overdose deaths. Drug Alcohol Depend 2023; 245:109827. [PMID: 36868092 DOI: 10.1016/j.drugalcdep.2023.109827] [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] [Received: 11/23/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 03/05/2023]
Abstract
INTRODUCTION Drug overdose deaths are often geographically discordant (the community in which the overdose death occurs is different from the community of residence). Thus, in many cases there is a journey to overdose. METHODS We applied geospatial analysis to examine characteristics that define journeys to overdoses using Milwaukee, Wisconsin, a diverse and segregated metropolitan area in which 26.72 % of overdose deaths are geographically discordant, as a case study. First, we deployed spatial social network analysis to identify hubs (census tracts that are focal points of geographically discordant overdoses) and authorities (the communities of residence from which journeys to overdose commonly begin) for overdose deaths and characterized them according to key demographics. Second, we used temporal trend analysis to identify communities that were consistent, sporadic, and emergent hotspots for overdose deaths. Third, we identified characteristics that differentiated discordant versus non-discordant overdose deaths. RESULTS Authority communities had lower housing stability and were younger, more impoverished, and less educated relative to hubs and county-wide numbers. White communities were more likely to be hubs, while Hispanic communities were more likely to be authorities. Geographically discordant deaths more commonly involved fentanyl, cocaine, and amphetamines and were more likely to be accidental. Non-discordant deaths more commonly involved opioids other than fentanyl or heroin and were more likely to be the result of suicide. CONCLUSION This study is the first to examine the journey to overdose and demonstrates that such analysis can be applied in metropolitan areas to better understand and guide community responses.
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Affiliation(s)
- Amir Forati
- Department of Geography, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - Rina Ghose
- Department of Geography, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - Fahimeh Mohebbi
- Department of Computer Science, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - John R Mantsch
- Department of Pharmacology & Toxicology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
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