The social production of substance abuse and HIV/HCV risk: an exploratory study of opioid-using immigrants from the former Soviet Union living in New York City

<p>Abstract</p> <p>Background</p> <p>Several former Soviet countries have witnessed the rapid emergence of major epidemics of injection drug use (IDU) and associated HIV/HCV, suggesting that immigrants from the former Soviet Union (FSU) may be at heightened risk for similar problems. This exploratory study examines substance use patterns among the understudied population of opioid-using FSU immigrants in the U.S., as well as social contextual factors that may increase these immigrants' susceptibility to opioid abuse and HIV/HCV infection.</p> <p>Methods</p> <p>In-depth interviews were conducted with 10 FSU immigrants living in New York City who initiated opioid use in adolescence or young adulthood, and with 6 drug treatment providers working with this population. Informed by a grounded theory approach, interview transcripts were inductively coded and analyzed to identify key themes.</p> <p>Results</p> <p>The "trauma" of the immigration/acculturation experience was emphasized by participants as playing a critical role in motivating opioid use. Interview data suggest that substance use patterns formed in the high-risk environment of the FSU may persist as behavioral norms within New York City FSU immigrant communities - including a predilection for heroin use among youth, a high prevalence of injection, and a tolerance for syringe sharing within substance-using peer networks. Multiple levels of social context may reproduce FSU immigrants' vulnerability to substance abuse and disease such as: peer-based interactional contexts in which participants typically used opioids; community workplace settings in which some participants were introduced to and obtained opioids; and cultural norms, with roots in Soviet-era social policies, stigmatizing substance abuse which may contribute to immigrants' reluctance to seek disease prevention and drug treatment services.</p> <p>Conclusion</p> <p>Several behavioral and contextual factors appear to increase FSU immigrants' risk for opioid abuse, IDU and infectious disease. Further research on opioid-using FSU immigrants is warranted and may help prevent increases in HIV/HCV prevalence from occurring within these communities.</p

Religião e uso de drogas por adolescentes Religion and drug use by adolescents

INTRODUÇÃO: Estudos internacionais e nacionais mostram que a religiosidade é um modulador importante no consumo de álcool e drogas entre estudantes adolescentes. OBJETIVOS: verificar se diferentes variáveis da religiosidade influenciam o uso freqüente e/ou pesado de álcool e drogas entre estudantes de 1º e 2º graus. MÉTODOS: Estudo transversal com uma técnica de amostragem do tipo intencional. Foi utilizado um questionário anônimo de autopreenchimento. A amostra foi constituída por 2.287 estudantes de escolas públicas periféricas e centrais e escolas particulares da cidade de Campinas, SP, entrevistados no ano de 1998. As drogas estudadas foram: álcool, tabaco, solventes, medicamentos, maconha, cocaína e ecstasy. As variáveis independentes incluídas na análise de regressão logística foram: filiação religiosa, freqüência de ida ao culto/missa por mês, considerar-se pessoa religiosa e educação religiosa na infância. Para identificar como as variáveis de religiosidade influenciam o uso de álcool e drogas utilizaram-se análises bivariadas e a análise de regressão logística para resposta dicotômica. RESULTADOS: O uso pesado de pelo menos uma droga foi maior entre os estudantes que tiveram educação na infância sem religião. O uso no mês de cocaína e de "medicamentos para dar barato" foi maior nos estudantes que não tinham religião. O uso no mês de ecstasy e de "medicamentos para dar barato" foi maior nos estudantes que não tiveram educação religiosa na infância. CONCLUSÕES: Várias dimensões da religiosidade relacionam-se com o uso de drogas por adolescentes, com possível efeito inibidor. Particularmente interessante foi que uma maior educação religiosa na infância mostrou-se marcadamente importante em tal possível inibição.<br>INTRODUCTION: Many international studies show that religion is an important dimension modulating the use of alcohol and drugs by adolescents. OBJECTIVES: to determine which religious variables are associated to frequent or heavy use of alcohol, tobacco and drugs among adolescents in intermediate and high schools in Campinas, Brazil. METHODS: A cross-sectional study using a self-report anonymous questionnaire was administered to 2.287 students from a convenience sample of seven schools: five from central areas (two public and three private schools) and two public schools from the outskirts of the city, in 1998. The study analyzes data regarding the use of alcohol, tobacco, medicines, solvents, marijuana, cocaine and ecstasy. The religious variables included in the regression analysis were: religious affiliation, church attendance, self-assessed religiousness, and religious education in childhood. For the substances, nicotine, alcohol, marijuana, cocaine, ecstasy and "abuse of medicines" a logistic regression analysis for dicotomic answer was applied. RESULTS: The heavy use of at least one drug during the last month was more frequent among students that did not have a religious education during childhood. The use in the last month of cocaine, ecstasy and (abuse of) medicines was more frequent among those students that had no religion (cocaine and medicines) and that did not have a religious education during childhood (ecstasy and medicines). CONCLUSIONS: this study is consistent with previous investigations demonstrating a strong influence of religious variables over the use of drugs among adolescents. Interesting, it was found that no or weaker religious education during childhood was markedly associated with significant more use of drugs during adolescence