Miriam W. Boeri

Rolling Beyond Raves: Ecstasy Use Outside the Rave Setting

In this paper, we explore settings of ecstasy use other than those that are part of the rave scene. Little is known about its use in other settings. Data from young adult (18–25 years old) active ecstasy users were collected using surveys (N = 158) and qualitative in-depth interviews (N = 66). Recruitment involved targeted and theoretical sampling. Data analysis was guided by the constant comparison method, common in grounded theory. Our findings indicate that ecstasy use has extended to social settings beyond raves, including dance/music venues, bars in inner-city neighborhoods, neighborhood cruising sites, and private residences. Users may attend multiple settings, and it is common for use practices to be transmitted across settings. An understanding of emerging social settings of ecstasy use and the associated use patterns provides baseline information for the development of effective and appropriate prevention and intervention programs, including drug treatment, as well as for policy makers.

Poly-Drug Use among Ecstasy Users: Separate, Synergistic, and Indiscriminate Patterns

The main objective of this paper is to explore poly-drug use among young adult ecstasy users. This phenomenon of using multiple substances within a specific time period is multi-faceted. In this paper, we focus on the various patterns of poly-drug use and the reasons for combining multiple drugs among ecstasy users. Using a mixed-methods design, we conducted interviews with young adults who used ecstasy and other licit and illicit drugs in the past 90 days. Based on the qualitative analyses, we define three distinct types of poly-drug experiences: separate, synergistic, and indiscriminate use. While separate and synergistic poly-drug use tended to be intentional, indiscriminate poly-drug use often was unintentional. These findings show the importance of recognizing poly-drug use as a common phenomenon. The findings presented here suggest areas for further research aimed at identifying risk and protective behaviors and risk reduction strategies.

Addiction and sociality: Perspectives from methamphetamine users in suburban USA

This article contributes to a growing body of literature that emphasizes the social nature of drug use, abuse and addiction. Current discourses of addiction tend to focus on the individual while limiting attention on the social environment and the role of sociality. We seek to contribute a more intuitive, insiders’ perspective of the drug trajectory and a broader conceptualization of addiction. Drawing from our qualitative study on 100 current and former methamphetamine users in the suburbs of Atlanta, Georgia (USA), we examined the trajectories of methamphetamine use to provide greater insight on what influences drug initiation, progression, cessation and relapse from the users’ perspective. Findings show that the entire drug trajectory is intertwined with, and impacted by, sociality for the majority of drug users in our sample. Moreover, the findings of our study increase our understanding of multiple routes to recovery. We join the call for greater attention to drug use and addiction as a social behavior and future research that focuses more on the role of sociality among drug users.

Women After the Utopia: The Gendered Lives of Former Cult Members

Research on former members of cults, also known as new religious movements, often focuses on psychological issues. Little has been written about the everyday lives of former members, and rarely has gender been placed at the center of analyses. Based on participant observation at ex-cult reunions and in-depth interviews, this analytical ethnography examines the everyday lives of women who are former members of a religious cult. Their experiences and concerns are analyzed with a focus on four qualitative themes: identity, roles, interactions, and contexts. The salient issues that emerge are alienation, depression, spiritual confusion, changing wife and mother roles, limited friendships, sexual abuse, lack of education and work history, and health concerns. The minority status of cult survivor is proposed as a core concept, and the implications of this study for intervention and future research are discussed.

A Contextual Comparison of Risk Behaviors Among Older Adult Drug Users and Harm Reduction in Suburban Versus Inner-City Social Environments

Recent epidemiological data show that older adults comprise a growing age group of drug users and new AIDS cases in the United States. Prevention and intervention studies show that risk behaviors leading to HIV infection are increasing among older users, particularly among the socially vulnerable. Yet older adults remain an underresearched population of drug users and little is known about their risk behaviors. Our aim is to address this gap in knowledge on older users by comparing contextual factors that influence risk behaviors and harm reduction strategies practiced by older drug users living in different communities. This study is based on ethnographic fieldwork in suburban and inner-city neighborhoods in a large metropolitan area in the southeastern United States. Interviewers conducted face-to-face, in-depth, life history interviews with 69 older adults (ages 45 and older) who used heroin, cocaine, and/or methamphetamine. Findings show that while risk behaviors were similar among older adult drug users living in suburban and inner-city environments, the provision of harm reduction education and paraphernalia varied widely. The results show the need for the expansion of harm reduction services focused on older adult drug users who are homeless, uninsured, or socially isolated. This application-oriented research will inform health care and treatment providers and generate new directions for future collaborative harm reduction services aimed to decrease the spread of HIV and other infectious diseases associated with drug use.

Drug use trajectory patterns among older drug users

To better understand patterns of drug use trajectories over time, it is essential to have standard measures of change. Our goal here is to introduce measures we developed to quantify change in drug use behaviors. A secondary goal is to provide effective visualizations of these trajectories for applied use. We analyzed data from a sample of 92 older drug users (ages 45 to 65) to identify transition patterns in drug use trajectories across the life course. Data were collected for every year since birth using a mixed methods design. The community-drawn sample of active and former users were 40% female, 50% African American, and 60% reporting some college or greater. Their life histories provided retrospective longitudinal data on the diversity of paths taken throughout the life course and changes in drug use patterns that occurred over time. Bayesian analysis was used to model drug trajectories displayed by innovative computer graphics. The mathematical techniques and visualizations presented here provide the foundation for future models using Bayesian analysis. In this paper we introduce the concepts of transition counts, transition rates and relapse/remission rates, and we describe how these measures can help us better understand drug use trajectories. Depicted through these visual tools, measurements of discontinuous patterns provide a succinct view of individual drug use trajectories. The measures we use on drug use data will be further developed to incorporate contextual influences on the drug trajectory and build predictive models that inform rehabilitation efforts for drug users. Although the measures developed here were conceived to better examine drug use trajectories, the applications of these measures can be used with other longitudinal datasets.

A Third Model of Triangulation: Continuing the Dialogue with Rhineberger, Hartmann and Van Valey

In an article in this journal, Rhineberger, Hartmann, and Van Valey (2005), discussed the mixed methods approach known as triangulation, arguing that the meaning and uses of triangulation need to be consistently applied and more adequately described in published articles. The authors presented two models of triangulation found in their extensive literature review. In this paper, I review triangulation designs used in applied research and propose a third and distinct model called the “iterative model.” This model employs triangulation to gain increasing clarity and understanding of the complex issues involved in applied social research. Clearly defined and collectively understood models of triangulation help applied researchers better integrate triangulated sources and convey their methods across disciplinary boundaries.

Methamphetamine Use Among Suburban Women: Implications for Nurse Practitioners

Purpose: The purpose of this article is to provide nurse practitioners (NPs) with more effective strategies to diagnose methamphetamine (MA) use and assess healthcare needs of MA‐using women. Data sources: The researchers collected data from 65 suburban women who were MA users living in the suburbs of a large southeastern city in the United States. We conducted in‐depth interviews and focus groups examining their life history, drug history, risk behaviors, and access to health care. The qualitative findings are examined here. Conclusions: Three main themes emerged from the data: (a) gendered stigmatization of MA use; (b) MA‐related health risk behaviors; and (c) barriers to health and social services, which resulted in a domino effect that led to further life and health complications. When these factors are not effectively addressed, the result is more serious health problems for the women and their children. Implications for practice: This article offers awareness and assessment tools to provide NPs adequate knowledge about the factors associated with MA use in order to treat patients holistically. NPs are strategically positioned to effectively assess, diagnose, treat, and provide linkage to health and social services, especially for suburban females who are a hidden population of drug users.

Cold cook methods: an ethnographic exploration on the myths of methamphetamine production and policy implications.

BACKGROUND Urban legends and myths are prevalent in drug-use environments. However, the distinction between myth and fact is not always clear. We found contradictory claims regarding the emergence of cold cook methods for producing methamphetamine when contrasting user-generated reports with official reports repudiating such methods as myths. Our aim is to open the topic for more academic discussion. METHODS We examine cold cook methods of methamphetamine production revealed in our ethnographic study and interviews with former (n=50) and current (n=48) methamphetamine users. Data were collected in the suburbs of a large southeastern city in the United States. We compare the data with reports from law enforcement professionals and public health officials. RESULTS Official reports claim the cold cook method described by users in our study is a myth and does not produce methamphetamine. Small-scale producers sell it as methamphetamine and users claim it has the same effect as methamphetamine. They are charged for possession and distribution of methamphetamine when caught with this drug. It appears the unintended consequences of recent policy aimed to reduce production and use of methamphetamine may be a user-friendly production method. We do not know the health implications at this time. CONCLUSION We do not make any definitive conclusions on the legitimacy of the stories or myths discussed here but instead suggest that labelling drug stories as myths might lead to dismissing facts that hold partial truth. The subsequent dismissal of cold cook methods among policy and public health officials risks a range of unintended consequences among vulnerable populations. We present our case for more research attention on the myths of methamphetamine production.

Gaps in medical marijuana policy implementation: Real-time perspectives from marijuana dispensary entrepreneurs, health care professionals and medical marijuana patients

Abstract Aims: There is a need for greater understanding of the recursive processes involved in drug policy development and its impact on stakeholders. The aim of this study was to examine the challenges of implementing marijuana policy in Massachusetts, where recent policy shifts have occurred. Methods: Qualitative data were generated from ethnographic field notes, media reports, public records and in-depth interviews with 25 stakeholders, including six medical marijuana dispensary entrepreneurs, eight health care professionals and 11 medical marijuana patients. Data were triangulated using a grounded theory approach. Findings: Stakeholders expressed confusion and misunderstanding, and demonstrated that they held conflicting interpretations of the policy and regulations. Analyses revealed gaps in policy development and implementation that are organised by three specific core implementation processes and the themes of transparency, communication and education. Conclusions: Findings show a need for more transparency in implementation processes, a more effective mode of communicating regulations, and a comprehensive plan for medical marijuana education. Based on our findings, we provide recommendations to help policymakers in the US and other countries considering legalisation of marijuana or other drugs.