Patrick H. Hughes

Adolescent drug using groups in Chicago parks

In a northern Chicago neighborhood, observational and interview data were collected at parks, school lots, and beaches where adolescents congregate to buy, sell, and use nonopiate drugs. These sites were geographically distinct from areas where heroin is regularly distributed. Users at each area generally resided in the immediate neighborhood, were well known to one another, were predominantly male, displayed similar socioeconomic, religious and ethnic backgrounds, and had attended the same grade schools and high schools. These sites were relatively stable during the summer months, although visitors occasionally changed locations in response to police harassment. Attendance fluctuated with weather and time of day. Drug use was generally confined to the daily use of marihuana and weekend use of alcohol and sedative-hypnotics, but availability seemed to determine the type and frequency of drug use to a greater extent than drug perference. This study suggests the potential of a fieldwork model for prevention and intervention activities prior to the onset of more intense and diversified drug use.

Epidemiological field experiments to prevent heroin spread.

Abstract Field research into heroin abuse in Chicago suggests that heroin addiction follows epidemic rather than endemic patterns. During the appearance of a large (macro) or small (micro) epidemic in any given community, spread is primarily from user to user. As the epidemic spreads, it becomes necessary for users to associate with other users to maintain their drug supplies. Because of this association, case-finding is relatively easy. A special epidemiological field team has been developed consisting both of methadone-maintained ex-heroin users from the community and professional researchers. The field team was found to be able to detect rapidly a large percentage of involved persons in a given epidemic; one helpful technique was concentrating on the so-called heroin copping areas within the community. It was found possible to intervene successfully in epidemics by involving a large percentage of identified active heroin users in treatment; to do so, treatment facilities must be attractive and conveniently located. The major contention of these investigations is that the spread of heroin can be investigated and aborted by the utilization of standard epidemiologic principles ordinarily applied to contagious infectious diseases.

Worth a Try? Describing the Experiences of Families during the Course of Care in the Neonatal Intensive Care Unit When the Prognosis is Poor

Objective To determine how parents of infants in the neonatal intensive care unit with a poor or uncertain prognosis view their experience, and whether they view their choices as “worth it,” regardless of outcome. Study design Parents of eligible neonates at 2 institutions underwent audiotaped, semistructured interviews while their infants were still in the hospital and then again 6 months to 1 year after discharge or death. Interviews were transcribed and data were analyzed using thematic analysis. Two authors independently reviewed and coded each interview and discrepancies were resolved by consensus. Results Twenty‐six families were interviewed in the initial group and 17 families were interviewed in the follow‐up group. The most common themes identified included realism about death (24 families), appreciation for the infants care team (23 families), and optimism and hope (22 families). Overall themes were very similar across both centers, and among parents of infants who died and those who survived. Themes of regret, futility, distrust of care team, and infant pain were brought up infrequently or not at all. Conclusions No family believed that the care being provided to their infant was futile; rather, parents were grateful for the care provided to their infant, regardless of outcome. Even in the case of a poor prognosis or the death of an infant, families in our study viewed their infants stay in the neonatal intensive care unit favorably.