The motives and methods of methamphetamine and 'heroin' co-use in West Virginia - PubMed (original) (raw)

The motives and methods of methamphetamine and 'heroin' co-use in West Virginia

Jeff Ondocsin et al. Harm Reduct J. 2023.

Abstract

Background: Opioid and methamphetamine co-use is increasing across the USA with overdoses involving these drugs also rising. West Virginia (WV) has led the US in opioid overdose death rates since at least 2013 and rising co-use of methamphetamine with opioids has played a greater role in deaths over the last 5 years.

Methods: This study used rapid ethnography to examine methods and motivations behind opioids and methamphetamine co-use from the viewpoint of their consumers. Participants (n = 30) were people who injected heroin/fentanyl also using methamphetamine who participated in semi-structured interviews.

Results: We found multiple methods of co-using opioids and methamphetamine, whether alternately or simultaneously and in varying order. Most prioritized opioids, with motives for using methamphetamine forming three thematic categories: 'intrinsic use', encompassing both inherent pleasure of combined use greater than using both drugs separately or for self-medication of particular conditions; 'opioid assisting use' in which methamphetamine helped people manage their existing heroin/fentanyl use; and 'reluctant or indifferent use' for social participation, reflecting methamphetamine's low cost and easy availability.

Conclusions: Methamphetamine serves multiple functions among people using opioids in WV. Beliefs persist that methamphetamine can play a role in preventing and reversing opioid overdose, including some arguments for sequential use being protective of overdose. 'Reluctant' uptake attests to methamphetamine's social use and the influence of supply. The impact on overdose risk of the many varied co-use patterns needs further investigation.

Keywords: Ethnography; Injection; Methamphetamine; Opioid; Polysubstance use; Substance-related disorders.

© 2023. The Author(s).

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Conflict of interest statement

Dr. Daniel Ciccarone reports the following relevant financial relationships during the past 12 months: 1, he is a scientific advisor to Celero Systems and 2, he has been retained as an expert witness in ongoing prescription opioid litigation by Motley Rice, LLP. The remaining authors have no relevant financial or non-financial interests to disclose.

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References

    1. Substance abuse and mental health services administration. Key substance use and mental health indicators in the United States: results from the 2018 national survey on drug use and health. Rockville, MD: center for behavioral health statistics and quality; 2018. Report No.: HHS Publication No. PEP19–5068, NSDUH Series H-54.
    1. Substance abuse and mental health services administration. Key substance use and mental health indicators in the United States: Results from the 2019 National survey on drug use and health. Rockville, MD: Center for behavioral health statistics and quality; 2020. Report No.: HHS Publication No. PEP20-07-01-001, NSDUH Series H-55.
    1. Substance abuse and mental health services administration. Key substance use and mental health indicators in the United States: Results from the 2020 national survey on drug use and health. Rockville, MD: Center for behavioral health statistics and quality; 2021. Report No.: HHS Publication No. PEP21-07-01-003, NSDUH Series H-56.
    1. Gonzales R, Mooney L, Rawson RA. The methamphetamine problem in the United States. Annu Rev Public Health. 2010;31:385–398. doi: 10.1146/annurev.publhealth.012809.103600. - DOI - PMC - PubMed
    1. Ellis MS, Kasper ZA, Cicero TJ. Twin epidemics: the surging rise of methamphetamine use in chronic opioid users. Drug Alcohol Depend. 2018;193:14–20. doi: 10.1016/j.drugalcdep.2018.08.029. - DOI - PubMed

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