Karen McElrath

MDMA and Sexual Behavior: Ecstasy Users' Perceptions About Sexuality and Sexual Risk

This study examines the relationship between MDMA (Ecstasy), sexual behavior, and sexual risk taking. The sample consisted of 98 current and former users of MDMA. Several strategies were utilized to recruit respondents and data were collected through in-depth interviews during 1997 and 1998. The majority of respondents had used MDMA during the 6-month period prior to the interview and a large percentage had consumed the drug on 100 occasions or more. Most respondents reported feelings of emotional closeness while consuming MDMA but without the desire for penetrative sex. Others, however, reported that MDMA increased sexual arousal and some respondents (in particular, gay and bisexual females) had used MDMA specifically for sexual enhancement. Sexual risk taking (e.g., having multiple partners, engaging in sex without a condom) was prevalent among respondents who did engage in sexual activity during MDMA episodes. Explanations for the findings are offered and implications for prevention/intervention are discussed.

Methadone as Social Control: Institutionalized Stigma and the Prospect of Recovery

Methadone maintenance treatment (MMT) is an intervention used to treat opioid (heroin) dependence. Several investigators have found that MMT is effective in reducing heroin use and other behaviors; however, a disproportionate number of MMT clients leave treatment prematurely. Moreover, MMT outcome variables are often limited in terms of their measurement. Utilizing an integrated theoretical framework of social control and stigma, we focused on the experiences of methadone maintenance from the perspective of clients. We pooled interview data from four qualitative studies in two jurisdictions and found linkages between social control and institutional stigma that serve to reinforce “addict” identities, expose undeserving customers to the public gaze, and encourage clients to be passive recipients of treatment. We discuss the implications for recovery and suggest recommendations for change.

Resistance, transition and exclusion: Politically motivated ex-prisoners and conflict transformation in Northern Ireland

The landscape of political imprisonment in Northern Ireland was changed due to the general release and reintegration of politically motivated prisoners as part of the Belfast Agreement. This article reflects upon the post-prison experiences of former prisoners and their families, and in particular how the move from a resistant to a transitional framework has facilitated a greater openness and willingness amongs ex-prisoners to acknowledge the personal and familial problems related to incarceration. We also explore the ways in which ex-prisoners have attempted to deal with the continued social, political and civic exclusion which arises as a result of their conflict-related ‘criminal’ convictions. In the final section of the article, the authors further develop the move from a resistant to a transitional characterization of incarceration and its consequences.

Crime victimization among injection drug users

This study uses routine activity theory to examine violent and property crime victimization among a sample of 308 injection drug users (IDUs). We estimate prevalence rates and identify factors that contribute to the victimization of IDUs. The findings suggest that victimization rates of IDUs were much higher than rates found for the general urban population. Generally, crime involvement did not contribute significantly to victimization risk. Use of crack-cocaine increased the likelihood of property crime victimization whereas heroin use decreased the probability of both violent and property crime victimization. Other drug lifestyle activities (i.e., waiting in uncomfortable situations to buy drugs) also affected victimization risk Finally, the results suggest that victimization differed by age and by gender, despite controls for drug use and drug lifestyle activities. Explanations for these results are offered.

A preference for mephedrone: drug markets, drugs of choice, and the emerging “legal high” scene.

This study focuses on individuals’ preferences for mephedrone, a new psychoactive substance that has emerged in several countries. We examine the reasons for mephedrone preferences, and describe the positive and negative effects of the drug experience, route of administration and consumers’ views about the legality of mephedrone. Data were collected through semi-structured interviews with 45 adults who had used mephedrone since January 2010. Respondents resided in one of two jurisdictions that were characterized by different legislative controls over mephedrone. The findings suggest the importance of macro-level drug market factors that shaped peoples preferences for mephedrone. Additionally, respondents’ preferences were guided by pharmacological properties that helped them conceal the effects of mephedrone in public and semi-public spaces. Respondents were not deterred by the (impending) change from legal to illicit drug. The findings have implications for the study of localized drug markets, and in particular, legislative controls over emerging legal highs.

Does Ulster still say no? Drugs, politics and propaganda in Northern Ireland

Considerable emphasis has been placed in Northern Ireland as elsewhere upon providing an estimate of the prevalence and pattern of drug misuse, yet despite the importance of this information, a less than adequate picture has emerged. In this paper, divided into three sections, we attempt to layout and explore the assemblage of factors influencing drug misuse in Northern Ireland and subsequently our knowledge of it. In the first section we endeavor to demonstrate that drug use, distribution, and policy cannot be examined in isolation from the politics and practices of the protagonists to the conflict in Northern Ireland. In the second we critically review existing data on drug misuse ranging from the various public health and law enforcement indicators through to the limited emprical research avaliable. The final section makes urgent calls for quality research in Northern Ireland that would be instrumental in influencing effective drug policy and practice.

Key concepts in drugs and society

Why do people take drugs? How do we understand moral panics? What is the relationship between drugs and violence? How do peoples social positions influence their involvement in drug use? Insightful and illuminating, this book discusses drugs in social contexts. The authors bring together their different theoretical and practical backgrounds, offering a comprehensive and interdisciplinary introduction that opens up a wide scientific understanding moving beyond cultural myths and presuppositions. This is an invaluable reference source for students on criminology, sociology and social sciences programmes, as well as drug service practitioners such as drug workers, social workers and specialist nurses.

The Trouble with Peace: The Cease-Fires and their Impact on Drug Use among Youth in Northern Ireland

The cease-fires of 1994 marked the transition of Northern Ireland toward peace. Local media, public perception, and claims by “drug authorities” suggest an increase in drug use subsequent to the cease-fires. This article suggests that social problems in Northern Ireland must be understood in the context of wider political conflict and that the conflict affects all social phenomena. Therefore, the extent and patterning of drug use in young people in Northern Ireland are explored, linked to the major cease-fires. The historical influences of the key paramilitary groups are outlined in relation to their drug ideologies. Media and professional perceptions are examined alongside available evidence constructed from multiple indicators of drug use. Our review of the evidence suggests that it is incorrect to assume that most drug use has increased since the cease-fires. One notable exception to that general conclusion is that a heroin scene may be developing in Northern Ireland.

Peer injecting: implications for injecting order and blood-borne viruses among men and women who inject heroin

A large body of research has highlighted practices and rituals that characterise injecting drug use and behavioural and environmental risks that can contribute to the transmission of blood-borne viruses. Compared with other injecting practices, considerably less is known about peer injecting, i.e. receiving or giving injections, particularly the social context in which it occurs. In this article, we explore peer injecting and injecting order at initiation into injecting drug user (IDU) and during subsequent injection episodes. Using data from semi-structured interviews, we highlight the experiences of 41 males and females who had received injections from other IDUs. Respondents were recruited through various strategies, largely chain referral. The results suggest gendered similarities as well as differences in terms of peer injecting, the order of injection and micro-risk contexts for blood-borne viruses.

Service user involvement in drug treatment programmes: Barriers to implementation and potential benefits for client recovery.

Service user forums have the potential for improving awareness of services, empowering service users and strengthening community partnerships within an inclusive treatment and rehabilitation framework. The research aimed to investigate perspectives about service user involvement in order to inform the development of effective service user forum(s) in west Ireland. A total of 30 interviews with key service providers and 12 interviews with service users were conducted, with interview questions focusing on: (1) awareness of the Service User Support Team and (2) barriers to service user involvement and the development of service user forums in the region. An integrated data collection and thematic analysis was undertaken. Current levels of service user involvement were low, restricted by one-way communication and appeared grounded in user-provider power differentials and stigma relating to drug dependency. Service providers queried the actual terms of reference, capacity and training that would be needed for service user forums to advocate and lobby for service users. The use of existing support groups, creation of internet user forums and rotation of rural meetings were recommended to promote engagement among service users. The research underscores the need for transparency, resources and a framework for good practice that reflects a participatory approach.