This post is part of a collaborative narrative series composed of my writing and Chris Arnade’s photos exploring issues of addiction, poverty, prostitution and urban anthropology in Hunts Point, Bronx. For more on the series, look here.
To evaluate the prevalence and correlates of non-fatal overdose among a polysubstance-using cohort of injection drug users (IDU) in Vancouver.
We evaluated factors associated with non-fatal overdose among participants enrolled in the Vancouver Injection Drug Users Study (VIDUS) using univariate statistics. Self-reports of the awareness of drugs taken and drug potency, polysubstance use, and assistance received at the time of non-fatal overdose were also recorded.
From 1 December 2003 to 1 June 2005, 551 participants who were active injectors were followed. In total, 37 (6.7%) individuals reported experiencing a non-fatal overdose in the previous 6 months. Factors positively associated with non-fatal overdose included public injecting (odds ratio (OR)=4.74, 95% confidence interval (CI) 2.35–9.37, P<0.001), crystal methamphetamine use (OR=4.11) and injection (OR=3.63), morphine injection (OR=3.55), non-injection opiate use (OR=3.30), frequent heroin injection (OR=2.28) and sex trade work (OR=2.12). Factors negatively associated with non-fatal overdose included participation in methadone maintenance therapy (OR=0.31) and injecting alone (OR=0.36). Sixty-two percent of individuals were unaware of drug potency, 64.9% of IDU were taking other drugs at the time of overdosing, with crack being the main drug (37.0%). Fifty-four percent were assisted by ambulance personnel, 56.8% were taken to accident and emergency or hospital, 38.1% left accident and emergency or hospital before being released, and 35.1% were given Naloxone.
Structural interventions are needed that seek to modify the social and contextual risks for overdose, increased access to treatment programmes, and trials of novel interventions for crystal methamphetamine users.¹
Eric and Sonya: Their New City. Courtesy of Chris Arnade.
In the place to which they ran, the place meant for getting clean and getting jobs, Eric and Sonya tried crystal meth.
It was snowball-sized and their first time. $80 worth.
It was like tripping and coke together. They were twisted on the side of the road, under the wings of the elevated highway.
A woman on the side of the road looking like a normal, dirty party girl, but acting out of her mind, just offered it. She wanted someone to do it with.
They were on a trek to the place where they buy heroin, a mile or two away from home.
Home, an abandoned warehouse discovered to have electricity. A sprawling, broken-edged structure, where at night they huddle around a space heater that Eric had begged and make plans to call the Rhode Island Secretary of State about their kids.
During the days, they pace the road’s shadow for drugs, meander the nice part of town with its cobblestoned streets and historic buildings for money. Drugs bookend the day; panhandling comes in between.
Like other places they’ve been, Xanie bars are $5. Dope, more than that.
It’s fair to say that they do less now. Money’s harder here. The other day, a man offered Sonya $5 for a fuck. $5.
And the other night, she went into a restaurant/bodega and spent $20. Fresh heroin in her system, she started nodding, drifting to sleep or some other world at the table. The manager tried to throw her out, so she threw her beer at the wall across the store and cursed. A cop came, and she hasn’t been back.
Do they know how long it took for her to get $20, to enjoy the normalcy of sitting and eating?
But there’s more than one restaurant/bodega, some with Xanie bars just outside and men who speak black compliments inside. Stores where you can buy a shot of liquor in a plastic cup and convince someone to play Justin Timberlake’s “Take Back the Night” on the $2 jukebox. Isn’t that the one on the radio?
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