Suchergebnisse

We investigate the relationships between violence, drug use and methadone maintenance treatment (MMT) for women injection drug users (IDUs). The data presented here come from a longitudinal study of 233 IDUs both in and out of MMT in the San Francisco Bay Area. Each was interviewed five times over a period of three years, both qualitatively and quantitatively. Using grounded theory principals, we analyze 55 women's accounts of violence. We find that violence acts both as a barrier to entry to treatment and to successful treatment outcomes. Violence is related to drug use and treatment in several ways, primarily in that violence is a traumatic experience to which some women respond by using drugs. Violence may include forced drug use or methadone diversion. Violence may cause women to interrupt or postpone treatment. Finally, two women experienced violence from their treatment providers, which forced them to leave their programs. We suggest that in order to maximize successful treatment outcomes and reduce drug‐related harm for women, violence must be addressed in the treatment process.

Qualitative data from women defunded from a subsidized methadone maintenance treatment (MMT) program were analyzed to determine the impact of defunding on the women and their dependents. Women attested to the efficacy of MMT in creating a stable environment in which their illicit drug use was eliminated or controlled; they were able to decrease their participation in illicit activities and pursue further employment and educational goals. When defunding occurred women employed a variety of strategies including family borrowing, welfare funds, and illicit activities to remain on private MMT programs. The result of these payment strategies was often a premature detoxification from MMT due to unpaid clinic bills. Many women returned to heroin use to alleviate withdrawal symptoms from methadone detoxification. This return to heroin use was also accompanied by increased illicit activities. Defunded women reported severe emotional and financial destabilization as a result of lost access to subsidized methadone maintenance treatment.