A syndemic examination of injecting drug use, incarceration and multiple drug-related harms in French opioid users
International Journal of Prisoner Health
ISSN: 1744-9200
Article publication date: 22 December 2021
Issue publication date: 24 November 2022
Abstract
Purpose
People who inject drugs (PWID) face multiple health problems, including infectious diseases and drug overdoses. Applying syndemic and risk environment frameworks, this paper aims to examine the co-occurrence and clustering of drug-related harms and their association with incarceration experience with or without in-prison drug injection.
Design/methodology/approach
The authors used data from a cross-sectional survey conducted in 2015 among 557 active opioid injectors. Self-reported data were collected through face-to-face or online questionnaires. They distinguished three harm categories, namely, viral infections, bacterial infections and overdoses, and built an index variable by summing the number of harm categories experienced, yielding a score from 0 to 3. Association between incarceration experience and co-occurrence of harms was modelled using a multinomial logistic regression.
Findings
Of the 557 participants, 30% reported lifetime experience of drug-related viral infection, 46% bacterial infection and 22% drug overdose. Multinomial logistic models showed that those who injected drugs during incarceration were more likely to report two (aOR = 2.35, 95% CI: 1.03–5.36) and three (aOR = 9.72, 95% CI: 3.23–29.22) harm categories than those who had never been incarcerated. They were also more likely to report three harm categories than formerly incarcerated respondents who did not inject drugs in prison (aOR = 5.14, 95% CI: 1.71–15.48).
Originality/value
This study provides insights of the syndemic nature of drug-related harms and highlights that drug injection during incarceration is associated with co-occurring harms. Public health interventions and policy changes are needed to limit the deleterious impact of prison on PWID.
Keywords
Acknowledgements
The authors thank all members of the PrebupIV Study Group and all the stakeholders involved, especially participating centers, their staff and, in particular, the study participants. They also thank Jude Sweeney for the English revision and editing of the manuscript. This study received external funding from the Inter-ministerial Mission for Combating Drugs and Addictive Behaviors (MILDECA). The funder had no role in study design, analysis, preparation of manuscript and decision to publish.
Citation
Mezaache, S., Briand-Madrid, L., Laporte, V., Rojas Castro, D., Carrieri, P. and Roux, P. (2022), "A syndemic examination of injecting drug use, incarceration and multiple drug-related harms in French opioid users", International Journal of Prisoner Health, Vol. 18 No. 4, pp. 417-428. https://doi.org/10.1108/IJPH-06-2021-0056
Publisher
:Emerald Publishing Limited
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