The impacts and service responses to injecting cathinones and novel opioids amongst marginalized drug using populations – a scoping review

Background: A growing body of literature reports on the injection of synthetic cathinones (SC) and novel synthetic opioids (NSO) in marginalized drug-using (MDU) populations. This review seeks to establish what is known about the injection of SCs and NSOs impacts on MDUs. Method: A six-stage iterative scoping literature review was conducted in relation to SCs, NSOs, MDU impacts and service responses. Searches were conducted through Pubmed™ and Google Scholar™. Results: Two Thousand and Ninety-Nine search items were retrieved. After duplicates were removed (n = 880), articles were screened for injecting drug use by MDUs leading to the removal of a further 1102 articles. Three articles were identified through a hand search, yielding a total of 22 articles for appraisal. Conclusions: SC injection has largely dissipated in many regions due to service and policy responses and changes in the drug market. Responses to NSO have been less effective, with extensive use and opioid overdosing due to contamination and adulteration within the illicit drug market. These impacts have stimulated innovative responses such as fentanyl test strips and housing-based consumption sites. The evidence for their effectiveness is not established. In this context, the underlying environmental and structural factors shaping the risk of these populations should be addressed.info:eu-repo/semantics/acceptedVersio

The impacts and service responses to Injecting Synthetic Cathinones and Novel Synthetic Opioids amongst marginalised drug using populations – a scoping review

Background: A growing body of literature reports on the injection of synthetic cathinones (SC) and novel synthetic opioids (NSO) in marginalized drug-using (MDU) populations. This review seeks to establish what is known about the injection of SCs and NSOs impacts on MDUs. Method: A six-stage iterative scoping literature review was conducted in relation to SCs, NSOs, MD impacts and service responses. Searches were conducted through Pubmed™ and Google Scholar™. Results: Two Thousand and Ninety-Nine search items were retrieved. After duplicates were removed (n =880), articles were screened for injecting drug use by MDUs leading to the removal of a further 1102 articles. Three articles were identified through a hand search, yielding a total of 22 articles for appraisal. Conclusions: SC injection has largely dissipated in many regions due to service and policy responses and changes in the drug market. Responses to NSO have been less effective, with extensive use and opioid overdosing due to contamination and adulteration within the illicit drug market. These impacts have stimulated innovative responses such as fentanyl test strips and housing-based consumption sites. The evidence for their effectiveness is not established. In this context, the underlying environmental and structural factors shaping the risk of these populations should be addressed

Virtually Hidden: A Theoretical Framework for understanding and conceptualising Online Drug Related Pornography

Online drug use pornography has been freely available through websites on the open internet for at least 7 years. Surprisingly there is almost no exploration of its nature, character or impacts on both performers and those engaging with this type of content within the research literature. Nor is it an issue that has engaged health care providers and other statutory and non-statutory agencies even though it may have implications within their respective domains. A preliminary scoping of the online environment is used to propose a theoretical framework that combines Goffman’s performance theory with that of Turner and Schechner’s positioning of ritual theory within performance theory, Butler’s concept of performativity online and Luppichi’s concept of the ‘technoself’. Utilizing the proposed theoretical framework, it is postulated that the presence, performance and engagement of online drug use pornography is a social boundary testing and possibly breaking performance centred on iterative relationships between performer and consumers of this content

A qualitative study of physical activity and dietary practices of people accessing opioid agonist treatment in Ireland

Background: Active heroin use presents a time of chaotic behaviours, while opioid agonist treatment (OAT) offers an opportunity for people with opiate substance use disorder to improve health and functioning. Lifestyle behaviours of physical activity and healthy dietary practices are increasingly studied for their role in maintaining physical and mental health among people with mental disorders. Aim: This research aimed to explore service user experiences of change with respect to physical activity and dietary practices since entering OAT. This research also explored barriers and facilitators to positive lifestyle behaviours among those accessing OAT. Methods: Qualitative descriptive interviews were conducted with (n=10) service users using pre-determined themes to explore the aforementioned topic. Results: Participants largely viewed lifestyle behaviours as having improved since entering OAT. A number of barriers, such as methadone related symptomology, physical ill-health, and social circumstances were impeding lifestyle behaviours. Physical activity was also impacted by a number of psychological barriers, such as perceived stigma. Facilitators to lifestyle behaviours discussed by participants demonstrated new routines and support structures associated with the OAT service. Conclusions: Lifestyle behaviours appear to be positively modified during OAT allied to additional health care supports in place for service users and a potential for improved health and social function. A number of barriers, particularly psychological, remain with respect to behaviour change for this population. This research explores these, with learnings for services to support behaviour change

Slam sex’ - sexualised injecting drug use (‘SIDU’) - A scoping review.

Sexualised injecting drug use (‘SIDU’) is a phenomenon associated with a wide array of high-risk injecting and sex-related practices. This review establishes what is known about Men who have Sex with Men (MSM) and SIDU to assess implications for health care and policy. The Levac, Colquhoun & O’Brien, (2010) scoping review methodology was employed for the purposes of the search. Characteristics of MSM for ‘SIDU’ appear to include being on anti-retroviral treatment and urban residency with drivers being challenging social taboos; a search for intimacy; convenience of administration; relationship breakdown and increased restrictions in clubs and saunas. Attraction for use appears to be enhancement or prolongation of sexual experiences/ pleasure; intimacy and the facilitation of a range of potentially ‘unsafe’ sexual activity. Traditional services are ill-equipped to address ‘SIDU’ because of a lack of knowledge of practices, lack of associated vocabulary and a failure to integrate sexual health with drug services. For effective responses these issues need to be addressed

Stress and Maladaptive Coping of Italians Health Care Professionals during the First Wave of the Pandemic

Stress during the pandemic has had an impact on the mental health of healthcare professionals (HCPs). However, little is known about coping and “maladaptive” coping behaviours of this population. This study investigates “maladaptive” coping behaviours and their correlation with stress, anxiety and insomnia of Italian HCPs during the pandemic. It reports on a cross-sectional, descriptive and correlational study based on a survey of 1955 Italian HCPs. Overall participants reported increases in cigarette smoking, time spent online and video playing. Overall reported alcohol consumption decreased but increased in those reporting drinking more than once a week. Those reporting starting smoking during the pandemic were found to have higher SAS and PSS scores. Those reporting being online for 3 or more hours were found to have higher ISS scores. Doctors who reported playing video games were found to have higher PSS, ISS and SAS scores whilst nurses who reported playing video games were found to have higher ISS scores. Doctors who reported playing for longer than one hour had higher PSS scores. Online behaviours may be a coping behaviour of HCPs affected by the pandemic. However, this is an underexplored area for the wellbeing of HCPs. These deficits need to be addressed going forward

Responding to COVID-19: Emerging practices in addiction medicine in 17 countries

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