Abstract

Background

Knowledge about the motivations for crack cocaine use and the long-term effects among people who inject heroin is limited. This study aims to understand motivations associated with this co-use drug pattern among aging men entrenched in established intergenerational heroin subcultures.

Methods

A sample of 60 men with diverse injecting heroin use histories was recruited from low-income Mexican American urban communities for semi-structured ethnographic interviews using respondent-driven sampling. Qualitative analysis was then employed to provide an in-depth understanding of patterns and motivations of polydrug use among this older population.

Results

The men discussed motivations including tolerance, curiosity and experimentation, a paradox of affordability, alternatives to the health hassles and stigma, and the cross-fertilization of drug markets. Concurrent and switching use patterns were primarily reported among those seeking a new or different high, while replacement patterns were reported by men in methadone treatment or by those who had tired of injection.

Discussion

Findings translate to the on-going opioid crisis and the emerging trend in polysubstance use involving crack cocaine, methamphetamine and other psychostimulants among people who use heroin. More research is needed to investigate the full range of social and health consequences associated with these co-use patterns. Targeted and tailored prevention and treatment services are essential to improve outcomes among aging Mexican American men who use heroin and other persons with similar polydrug use patterns.

中文翻译：

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有海洛因使用史的墨西哥裔美国老年男性使用可卡因破解可卡因：动机和多种药物使用模式

摘要

背景

关于可卡因吸毒动机和海洛因注射者长期影响的知识有限。本研究旨在了解在已确立的代际海洛因亚文化中根深蒂固的老年男性与这种共同使用药物模式相关的动机。

方法

从低收入的墨西哥裔美国城市社区招募了 60 名具有不同注射海洛因使用历史的男性样本，使用受访者驱动的抽样进行半结构化的人种学访谈。然后采用定性分析来深入了解这些老年人群中使用多种药物的模式和动机。

结果

这些人讨论了动机，包括宽容、好奇心和实验、负担能力的悖论、健康问题和耻辱的替代方案，以及药物市场的交叉施肥。并发和转换使用模式主要在那些寻求新的或不同的高点的人中报告，而替代模式则由接受美沙酮治疗的男性或那些厌倦了注射的人报告。

讨论

调查结果转化为持续的阿片类药物危机和使用海洛因的人中涉及可卡因、甲基苯丙胺和其他精神兴奋剂的多种物质使用的新趋势。需要更多的研究来调查与这些共同使用模式相关的全部社会和健康后果。有针对性和量身定制的预防和​​治疗服务对于改善使用海洛因的老年墨西哥裔美国男性和其他具有类似多种药物使用模式的人的结果至关重要。