Examining a migration-based phenomenon of heroin use in an urban drug scene in Sao Paulo, Brazil
International Journal of Migration, Health and Social Care
ISSN: 1747-9894
Article publication date: 21 June 2021
Issue publication date: 20 September 2021
Abstract
Purpose
Brazil’s street-based drug use is mostly characterized by non-injection psychostimulant (e.g. crack-cocaine) drug use in Brazil, with limited interventions and service availability. Recently, an influx of multi-ethnic migrants within an urban drug scene in Sao Paulo was associated with heroin use, a drug normatively absent from Brazil. The purpose of this paper is to characterize and compare heroin use-related characteristics and outcomes for an attending sub-sample of clients from a large community-based treatment centre (“CRATOD”) serving Sao Paulo’s local urban drug scene.
Design/methodology/approach
All non-Brazilian patients (n = 109) receiving services at CRATOD for 2013–2016 were identified from patient files, divided into heroin users (n = 40) and non-heroin users (n = 69). Based on chart reviews, select socio-demographic, drug use and health status (including blood-borne-virus and other infections per rapid test methods) were examined and bi-variately compared. Multi-variate analyses examined factors independently associated with heroin use.
Findings
Most participants were male and middle-aged, poly-drug users and socio-economically marginalized. While heroin users primarily originated from Africa, they reported significantly more criminal histories, drug (e.g. injection) and sex-risk behaviors and elevated rates of BBV (e.g. Hepatitis C Virus and HIV). A minority of heroin users attending the clinic was provided methadone treatment, mostly for detoxification.
Originality/value
This study documented information on a distinct sample of mostly migration-based heroin users in Sao Paulo, Brazil. Based on the local experience, global migration dynamics can bring changes to established drug use cultures and services, including new challenges for drug use-related related behaviors and therapeutic interventions that require effective understanding and addressing.
Keywords
Acknowledgements
The authors thank Mrs Lenka Vojtila for her skilled technical assistance in assembling this manuscript.Statement of ethics: this research project wasconducted ethically inaccordance with the World Medical Association Declaration of Helsinki. The Ethics Review Board of the Federal University of Sao Paulo (UNIFESP) approved thepresent study (#CAAE-68624617.5.0000.5505).Funding sources: Prof Fischer acknowledges funding support from the Canadian Institutes of Health Research (CIHR) grant SAF-98314 and the Hugh Green Foundation Chair in Addiction Research, Faculty of Medical and Health Sciences, University of Auckland, New Zealand. CRATOD and the services it provides are funded by the Sao Paulo state’ssecretariat of health.Declaration of intereststatement: the authors report no conflict of interest.Data availability statement: data used in this study was extracted from patient files housed at CRATOD.
Citation
Ribeiro, M., Frajzinger, R., Ogata Perrenoud, L. and Fischer, B. (2021), "Examining a migration-based phenomenon of heroin use in an urban drug scene in Sao Paulo, Brazil", International Journal of Migration, Health and Social Care, Vol. 17 No. 3, pp. 274-285. https://doi.org/10.1108/IJMHSC-06-2020-0065
Publisher
:Emerald Publishing Limited
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