The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #55080

Paul J Draus, PhD, Russel Falck, MA, Robert G. Carlson, PhD, Harvey Siegal, PhD, and Jichuan Wang, PhD. Community Health, Wright State University, 3640 Colonel Glenn Hwy., Dayton, OH 45435

The intravenous injection and sharing of illicit drugs is a practice associated with multiple risks, from addiction and potential overdose, to transmission of blood-borne pathogens, to criminal prosecution and social exclusion. These risks may be compounded by a lack of services or awareness in smaller communities, where such practices are carefully concealed. This paper explores the progression of heroin and cocaine use from inhalation to injection among separate circles of injectors based in two counties in west central Ohio. These users were located through a process of respondent-driven sampling (RDS) implemented as the beginning phase of a three-year natural history study of illicit stimulant use in rural areas. In addition to completing a lengthy structured interview dealing with drug use history and health issues, the subjects (n=20) also participated in a series of qualitative interviews and focus groups. Issues to be discussed include: family, education, and socioeconomic background of users; previous drug experience; initiation patterns; gender differences; local social relations associated with injecting; sharing of resources such as money, time and transportation; treatment availability and access; the state of local knowledge of the problems of injection drug users; and the limitations of "one-size-fits-all" approaches to addictions treatment for special populations.

Learning Objectives:

At the conclusion of this session, participants will be able to:
• describe the common characteristics of two networks of cocaine and heroin users located in two rural counties in west central Ohio
• describe and analyze self-reported accounts of pathways to injection
• discuss social issues of particular relevance for small-town injectors, including barriers to treatment, as identified by users themselves
• suggest possible strategies for prevention/intervention in small communities.

Keywords: Injection Drug Users, Access and Services

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.