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  1. Article ; Online: "I don't go to funerals anymore": how people who use opioids grieve drug-related death in the US overdose epidemic.

    Schlosser, Allison V / Hoffer, Lee D

    Harm reduction journal

    2022  Volume 19, Issue 1, Page(s) 110

    Abstract: Background: Opioid-related overdose death is a public health epidemic in much of the USA, yet little is known about how people who use opioids (PWUO) experience overdose deaths in their social networks. We explore these experiences through a qualitative ...

    Abstract Background: Opioid-related overdose death is a public health epidemic in much of the USA, yet little is known about how people who use opioids (PWUO) experience overdose deaths in their social networks. We explore these experiences through a qualitative study of opioid-related overdose death bereavement among PWUO.
    Methods: We recruited 30 adults who inject opioids from a syringe service program in the Midwestern USA and interviewed them using a semi-structured guide that addressed experiences of opioid use, opioid-related overdose, and overdose reversal via the medication naloxone. Interviews were transcribed verbatim and analyzed thematically.
    Findings: Participants described overdose death as ever-present in their social worlds. Most (approximately 75%) reported at least one overdose death in their social network, and many came to consider death an inevitable end of opioid use. Participants described grief shaped by complex social relations and mourning that was interrupted due to involvement with social services and criminal legal systems. They also reported several ways that overdose deaths influenced their drug use, with some increasing their use and others adopting safer drug use practices. Despite the high prevalence of overdose deaths in their social networks, only one participant reported receiving grief support services.
    Discussion: Findings underscore the need for interventions that not only maintain life, such as naloxone distribution, but also improve quality of life by attending to grief related to overdose death bereavement. We discuss policies and practices with the potential to address the unique psychological, social, and structural challenges of grief for this population.
    MeSH term(s) Adult ; Analgesics, Opioid/therapeutic use ; Drug Overdose/drug therapy ; Humans ; Naloxone/therapeutic use ; Narcotic Antagonists/therapeutic use ; Opiate Overdose ; Opioid-Related Disorders/drug therapy ; Quality of Life
    Chemical Substances Analgesics, Opioid ; Narcotic Antagonists ; Naloxone (36B82AMQ7N)
    Language English
    Publishing date 2022-10-01
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2146691-9
    ISSN 1477-7517 ; 1477-7517
    ISSN (online) 1477-7517
    ISSN 1477-7517
    DOI 10.1186/s12954-022-00693-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Transitioning illicit drug preferences and emerging user identities in Ohio: The proliferation of methamphetamine use among African Americans.

    Flynn, Karen Coen / Hoffer, Lee D

    Journal of ethnicity in substance abuse

    2017  Volume 18, Issue 1, Page(s) 67–88

    Abstract: Understanding the social dynamics of local methamphetamine markets is critical to improving community health and reducing social costs associated with illicit drug use. We examine a local drug market in Summit County, Ohio, wherein methamphetamine users ... ...

    Abstract Understanding the social dynamics of local methamphetamine markets is critical to improving community health and reducing social costs associated with illicit drug use. We examine a local drug market in Summit County, Ohio, wherein methamphetamine users ascribe themselves different ethnic identities from those long associated with the drug elsewhere in the United States. Qualitative interviews with 52 study participants demonstrate that very poor and homeless White males and females are now using methamphetamine; however, even more surprising is that 31 of the participants identified themselves as poor or homeless, male or female African, Native, biracial, or multiracial Americans. The drug use trajectory of these 31 participants in particular involved a transition from a historical preference for crack to a present one for methamphetamine and, in some cases, a preference for concurrent use of methamphetamine and heroin. Many of these methamphetamine users also emphasized their ethnic identity to distinguish themselves as nonproducers of methamphetamine in comparison to Whites, who are commonly associated with methamphetamine production. Findings appear to suggest an emergent means of identity management resulting from the ethnic diversity of users in this methamphetamine market. These findings may have relevance in other communities with similar demographics and drug markets and may hold important implications for drug treatment, policy-making, and law enforcement professionals' work associated with methamphetamine users, producers, and distributors.
    MeSH term(s) Adult ; African Americans/statistics & numerical data ; Aged ; Amphetamine-Related Disorders/epidemiology ; Amphetamine-Related Disorders/ethnology ; Drug Users/statistics & numerical data ; European Continental Ancestry Group/statistics & numerical data ; Female ; Heroin Dependence/epidemiology ; Heroin Dependence/ethnology ; Homeless Persons/statistics & numerical data ; Humans ; Illicit Drugs ; Interviews as Topic ; Male ; Methamphetamine/administration & dosage ; Middle Aged ; Ohio ; Poverty/statistics & numerical data ; Substance-Related Disorders/epidemiology ; Substance-Related Disorders/ethnology
    Chemical Substances Illicit Drugs ; Methamphetamine (44RAL3456C)
    Language English
    Publishing date 2017-07-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 2052900-4
    ISSN 1533-2659 ; 1533-2640
    ISSN (online) 1533-2659
    ISSN 1533-2640
    DOI 10.1080/15332640.2017.1325809
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5465: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: The psychotropic self/imaginary: subjectivity and psychopharmaceutical use among heroin users with co-occurring mental illness.

    Schlosser, Allison V / Hoffer, Lee D

    Culture, medicine and psychiatry

    2012  Volume 36, Issue 1, Page(s) 26–50

    Abstract: Many people diagnosed with mental illnesses struggle with illicit drug addiction. These individuals are often treated with psychiatric medications, yet little is known about how they experience this treatment. Research on the subjective experience of ... ...

    Abstract Many people diagnosed with mental illnesses struggle with illicit drug addiction. These individuals are often treated with psychiatric medications, yet little is known about how they experience this treatment. Research on the subjective experience of psychiatric medication use highlights the complex, contradictory, and ambiguous feelings often associated with this treatment. However, for those with mental illness and addiction, this experience is complicated by the need to manage both psychiatric medication and illicit drug use. Using ethnographic data from a study of heroin use in Northeast Ohio, we explore this experience by expanding the pharmaceutical self/imaginary (Jenkins, Pharmaceutical Self: The Global Shaping of Experience in an Age of Psychopharmacology, School for Advanced Research Press, Santa Fe, NM, 2010b) to include psychopharmaceuticals and illicit drugs, what we call the psychotropic self/imaginary. Through this lens we explore the ways participants interpret and manage their psychotropic drug use in relation to sociocultural, institutional, and political-economic contexts. This analysis reveals how participants seek desired effects of legally prescribed and illicit drugs to treat mental illness, manage heroin addiction, and maintain a perceived "normal" self. Participants manage their drug use using active strategies, such as selective use of psychiatric medications, in the context of structural constraints, such as restricted access to mental health care, and cultural contexts that blur distinctions between "good" medicines and "bad" drugs.
    MeSH term(s) Antidepressive Agents/therapeutic use ; Attitude to Health ; Bipolar Disorder/drug therapy ; Bipolar Disorder/epidemiology ; Community Mental Health Services ; Comorbidity ; Female ; Heroin Dependence/drug therapy ; Heroin Dependence/epidemiology ; Humans ; Male ; Ohio ; Psychotropic Drugs/therapeutic use ; Self Efficacy ; Social Stigma ; Stress Disorders, Post-Traumatic/drug therapy ; Stress Disorders, Post-Traumatic/epidemiology ; Surveys and Questionnaires
    Chemical Substances Antidepressive Agents ; Psychotropic Drugs
    Language English
    Publishing date 2012-01-15
    Publishing country Netherlands
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 752957-0
    ISSN 1573-076X ; 0165-005X
    ISSN (online) 1573-076X
    ISSN 0165-005X
    DOI 10.1007/s11013-011-9244-9
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1355: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: The dynamics of de-adoption: a case study of policy change, de-adoption, and replacement of an evidence-based HIV intervention.

    McKay, Virginia R / Margaret Dolcini, M / Hoffer, Lee D

    Translational behavioral medicine

    2017  Volume 7, Issue 4, Page(s) 821–831

    Abstract: Evidence-based intervention (EBI) de-adoption and its influence on public health organizations are largely unexplored within public health implementation research. However, a recent shift in support for HIV prevention EBIs by the Centers for Disease ... ...

    Abstract Evidence-based intervention (EBI) de-adoption and its influence on public health organizations are largely unexplored within public health implementation research. However, a recent shift in support for HIV prevention EBIs by the Centers for Disease Control and Prevention provides an opportunity to explore EBI de-adoption. The current mixed-method study examines EBI de-adoption and the subsequent impact on a community-based organization (CBO) dedicated to HIV prevention. We conducted a case study with a CBO implementing RESPECT, an HIV prevention EBI, over 5 years (2010-2014), but then de-adopted the intervention. We collected archival data documenting RESPECT implementation and conducted two semi-structured interviews with RESPECT staff (N = 5). Using Fixsen and colleagues' implementation framework, we developed a narrative of RESPECT implementation, delivery, and de-adoption and a thematic analysis to understand additional consequences of RESPECT de-adoption. Discontinuation of RESPECT activities unfolded in a process over time, requiring effort by RESPECT staff. RESPECT de-adoption had wide-reaching influences on individual staff, interactions between the staff and the community, the agency overall, and for implementation of future EBIs. We propose a revision of the implementation framework, incorporating EBI de-adoption as a phase of the implementation cycle. Furthermore, EBI de-adoption may have important, unintended consequences and can inform future HIV prevention strategies and guide research focusing on EBI de-adoption.
    MeSH term(s) Adolescent ; Adult ; Centers for Disease Control and Prevention (U.S.) ; Evidence-Based Medicine ; Female ; HIV Infections/prevention & control ; Health Plan Implementation ; Health Policy ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Program Development ; United States ; Young Adult
    Language English
    Publishing date 2017-04-10
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2586893-7
    ISSN 1613-9860 ; 1869-6716
    ISSN (online) 1613-9860
    ISSN 1869-6716
    DOI 10.1007/s13142-017-0493-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: The dynamic influence of human resources on evidence-based intervention sustainability and population outcomes: an agent-based modeling approach.

    McKay, Virginia R / Hoffer, Lee D / Combs, Todd B / Margaret Dolcini, M

    Implementation science : IS

    2018  Volume 13, Issue 1, Page(s) 77

    Abstract: Background: Sustaining evidence-based interventions (EBIs) is an ongoing challenge for dissemination and implementation science in public health and social services. Characterizing the relationship among human resource capacity within an agency and ... ...

    Abstract Background: Sustaining evidence-based interventions (EBIs) is an ongoing challenge for dissemination and implementation science in public health and social services. Characterizing the relationship among human resource capacity within an agency and subsequent population outcomes is an important step to improving our understanding of how EBIs are sustained. Although human resource capacity and population outcomes are theoretically related, examining them over time within real-world experiments is difficult. Simulation approaches, especially agent-based models, offer advantages that complement existing methods.
    Methods: We used an agent-based model to examine the relationships among human resources, EBI delivery, and population outcomes by simulating provision of an EBI through a hypothetical agency and its staff. We used data from existing studies examining a widely implemented HIV prevention intervention to inform simulation design, calibration, and validity. Once we developed a baseline model, we used the model as a simulated laboratory by systematically varying three human resource variables: the number of staff positions, the staff turnover rate, and timing in training. We tracked the subsequent influence on EBI delivery and the level of population risk over time to describe the overall and dynamic relationships among these variables.
    Results: Higher overall levels of human resource capacity at an agency (more positions) led to more extensive EBI delivery over time and lowered population risk earlier in time. In simulations representing the typical human resource investments, substantial influences on population risk were visible after approximately 2 years and peaked around 4 years.
    Conclusions: Human resources, especially staff positions, have an important impact on EBI sustainability and ultimately population health. A minimum level of human resources based on the context (e.g., size of the initial population and characteristics of the EBI) is likely needed for an EBI to have a meaningful impact on population outcomes. Furthermore, this model demonstrates how ABMs may be leveraged to inform research design and assess the impact of EBI sustainability in practice.
    MeSH term(s) Capacity Building/organization & administration ; Evidence-Based Medicine/organization & administration ; Humans ; Systems Analysis
    Language English
    Publishing date 2018-06-05
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ISSN 1748-5908
    ISSN (online) 1748-5908
    DOI 10.1186/s13012-018-0767-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Researching a local heroin market as a complex adaptive system.

    Hoffer, Lee D / Bobashev, Georgiy / Morris, Robert J

    American journal of community psychology

    2009  Volume 44, Issue 3-4, Page(s) 273–286

    Abstract: This project applies agent-based modeling (ABM) techniques to better understand the operation, organization, and structure of a local heroin market. The simulation detailed was developed using data from an 18-month ethnographic case study. The original ... ...

    Abstract This project applies agent-based modeling (ABM) techniques to better understand the operation, organization, and structure of a local heroin market. The simulation detailed was developed using data from an 18-month ethnographic case study. The original research, collected in Denver, CO during the 1990s, represents the historic account of users and dealers who operated in the Larimer area heroin market. Working together, the authors studied the behaviors of customers, private dealers, street-sellers, brokers, and the police, reflecting the core elements pertaining to how the market operated. After evaluating the logical consistency between the data and agent behaviors, simulations scaled-up interactions to observe their aggregated outcomes. While the concept and findings from this study remain experimental, these methods represent a novel way in which to understand illicit drug markets and the dynamic adaptations and outcomes they generate. Extensions of this research perspective, as well as its strengths and limitations, are discussed.
    MeSH term(s) Anthropology, Cultural/methods ; Commerce/economics ; Commerce/statistics & numerical data ; Community Mental Health Services/organization & administration ; Community-Institutional Relations ; Heroin/economics ; Heroin Dependence/economics ; Heroin Dependence/epidemiology ; Heroin Dependence/prevention & control ; Humans ; Needle-Exchange Programs/economics ; Needle-Exchange Programs/statistics & numerical data ; Street Drugs
    Chemical Substances Street Drugs ; Heroin (70D95007SX)
    Language English
    Publishing date 2009-12
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 222658-3
    ISSN 1573-2770 ; 0091-0562
    ISSN (online) 1573-2770
    ISSN 0091-0562
    DOI 10.1007/s10464-009-9268-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1176: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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