City Drug Research Articles

S.F. voters back measure mandating treatment for some aid recipients

Residents of San Francisco have joined city leaders in taking a decided turn toward a more punitive approach to combating the city's drug use crisis, convincingly approving a ballot measure that will link city welfare benefits to mandated drug screening and participation in treatment.

Barriers to effective care: Specialty drug treatment in Philadelphia

IntroductionIn Philadelphia, the poorest big city in the United States, an estimated 60,000 people misuse opioids and more than 3500 have died of overdose in the past three years. In 2019, fentanyl was detected in 76% of drug-related deaths and 94% of opioid-involved deaths. While much attention has been directed at the public face of the city's drug problem, more than 75% of drug deaths in 2017 took place in a private residence. MethodBased on qualitative research to understand the vulnerabilities of this hidden population of drug users, we interviewed kin of 35 people who had died of opioid overdose in 2017 to learn whether their loved one had interacted with any social services or harm-reduction interventions. ResultsIn our demographically and geographically representative sample of decedents, we found that while most had received treatment at least once, many faced barriers to getting treatment when they needed it, including barriers related to stigma, structural racism, gender inequities, bureaucracy, insurance requirements, and cost. ConclusionWe argue that these barriers place an undue burden on people with substance use disorder and their kin during particularly fraught moments of heightened vulnerability. The failure of state and federal policies, practices, and infrastructure to address these barriers, and the failure to require that evidence-based care be provided during treatment have deleterious effects on people affected by the opioid epidemic in the United States.

Baltimore Citywide Engagement of Emergency Departments to Combat the Opioid Epidemic.

An editorial is presented which addresses a collaborative effort involving local public health and hospital emergency departments to combat an opioid epidemic in Baltimore, Maryland, and it mentions how most of the city's drug overdoses involve opioids such as heroin and fentanyl. The Baltimore City Health Department (BCHD) and the Maryland SBIRT (Screening, Brief Intervention, and Referral to Treatment) health care initiative are assessed.

Crack in Los Angeles: Crisis, Militarization, and Black Response to the Late Twentieth-Century War on Drugs

In the winter of 1985 the Los Angeles Police Department (lapd) unveiled a signature new weapon in the city's drug war. With Chief Daryl F. Gates copiloting, the Special Weapons and Tactics Team (swat) used a fourteen-foot battering ram attached to an “armored vehicle” to break into a house in Pacoima. After tearing a “gaping hole” in one of the outside walls of the house, police found two women and three children inside, eating ice cream. swat uncovered negligible quantities of illicit drugs, and the district attorney subsequently declined to prosecute. In the days following the raid, black clergy and the San Fernando Valley chapter of the National Association for the Advancement of Colored People (naacp) organized a protest rally in a local church. “We don't need new weapons to be tried out on us,” Rev. Jeffrey Joseph exclaimed. “Of all the methods that there are to arrest a person, they used a brand new toy.” Not all members of the African American community agreed, however. City councilman David Cunningham, who represented South Los Angeles, praised Gates's actions. “Go right ahead, Chief. You do whatever you can to get rid of these rock houses. They're going to destroy the black community if you don't.”1

Modelling crack cocaine use trends over 10 years in a Canadian setting

Crack cocaine use among illicit drug users is associated with a range of health and community harms. However, long-term epidemiological data documenting patterns and risk factors for crack use initiation remain limited especially among injection drug users. We investigated longitudinal patterns of crack cocaine use among polydrug users in Vancouver, Canada. We examined the rate of crack use among injection drug users enrolled in a prospective cohort study in Vancouver, Canada between 1996 and 2005. We also used a Cox proportional hazards regression analysis to identify independent predictors of crack use initiation among this population. In total, 1603 injection drug users were recruited between May 1996 and December 2005. At baseline, 7.4% of participants reported ever using crack and this rate increased to 42.6% by the end of the study period (Mantel trend test P < 0.001). Independent predictors of crack use initiation during the study period included frequent cocaine injection, crystal methamphetamine injection, residency in the city's drug using epicenter and involvement in the sex trade (all P < 0.05). These findings demonstrate a massive increase in crack use among injection drug users in a Canadian setting. Our findings also highlight the complex interactions that contribute to the initiation of crack use among injection drug users and suggest that evidence-based interventions are urgently needed to address crack use initiation and to address harms associated with its ongoing use.

Defining realities

PurposeThe purpose of this paper is to examine how organisations generate the additional value from community consultation and take advantage of the opportunities that engagement with the community can present.Design/methodology/approachThe paper derives from the author's experiences as a public relations officer. In 2000, he experienced two consultations on the same topic while working for the City of Melbourne. The first was a consultation imposed by the State Government on whether supervised injecting facilities should be introduced in Victoria to deal with the growing heroin problem. The second was the development of the City's Drug Action Plan. The contrast between these two consultations was stark and motivated the author to share his thoughts on community consultation.FindingsMore successful community consultations, and more creative results, are achieved by consulting about the problem, allowing the community and organisation to come up with solutions together. This approach was particularly successful in the development and implementation of the City of Melbourne Drug Action Plan in 2000. Community consultation can be a very effective tool when used appropriately by organisations that are prepared to utilise the knowledge and expertise of the communities they deal with.Originality/valueWhile this paper deals predominantly with community relations in the organisational operations context, the techniques described are valid and useful for all community relations projects regardless of definition, and indeed can be used in other forms of public relations and public affairs.

Conversation with Robert L. DuPont

Conversation with Robert L. DuPont

"Running" and Resistance: Nihilism and Cultural Memory in Chicano Urban Narratives

Nihilism is about the expression of an undaunted yearning, desperate (violently so, perhaps even to the extreme of self-destruction), but not hopeless, meaningful in its furious revolt against a world of bewildering violence and meaningless death. Nick de Genova When I was a student, I lived and worked in East Palo Alto, California, a Latino and African-American community twenty miles south of San Francisco. I worked as an apartment manager for a real estate company that owned several buildings in the city's drug district, a two-block neighborhood known as Whisky Gulch because of its reputation, established during Prohibition, as a center of vice. For the often futile task of collecting rents from impoverished tenants and mediating arguments between them and the buildings' owners, I was provided with a rent-free apartment. While living there, I witnessed some of the conflicts and casualties of the lower-level drug trade, a business which helped some of my tenants feed their children and pay the rent. I experienced in a way that forever changed my own cultural politics the lives of people whose daily existence was mediated by the threat of violence and meaningless death, by what Nick De Genova, in an essay on Richard Wright's Native Son, has called the constitutive violence of a social order founded upon racial subordination and effected in outright terror.(1) I once saw a man stabbed in a fight in broad daylight, another just after he had been shot in the stomach, and two dead teenage boys, members of a Latino gang, moments after they were murdered one evening by a mugger who wanted their jewelry. The police were often complicit in this violence, pushing dealers out of outlying neighborhoods into Whisky Gulch, deliberately playing one group off against another, accepting bribes from some to look the other way. Twelve young men were murdered in one year in Whisky Gulch alone. Surpassing larger cities by posting an astonishing rate of one homicide for every four hundred residents, East Palo Alto, an incorporated city with a population of 23,000, made headlines across the country as the murder capital of the United States. News film crews flooded into the neighborhood. Reporters from a television magazine program showcased the apartment buildings in Whisky Gulch in its report on the gang-ridden and drug-plagued city block in the country. This urban battlefield was located just a mile from the tranquil, manicured grounds of Stanford University, known to students as the farm, where I was enrolled in a graduate program in American literature. A part of my research involved collecting and translating a set of autobiographical writings by my grandfather, Francisco Robles Perez, a former farm laborer who emigrated to the United States from Mexico in 1921. At the same time, because of my work in Whisky Gulch, I became involved in the lives of a diverse group of Mexican immigrant and Chicano/a residents. In this essay, I wish to explore a cultural space between these two worlds, not only between the academy and East Palo Alto, but between the past and present, a space spanning Mexican (American) cultural memory as reflected in my grandfather's stories and the urban Chicano/a postmodern experience as embodied by the young Mexicanos and Chicanos of Whisky Gulch.(2) I will examine this cultural space by focusing upon the theme of nihilism in two contemporary urban narratives, Luis J. Rodriguez's autobiography, Always Running, La Vida Loca: Gang Days in L.A. (1993) and Ronald L. Ruiz's novel, Happy Birthday Jesus (1994). Written from the perspective of young people who share much in common with the residents of Whisky Gulch, these works explicate Chicano nihilism by positioning it within the context of a racialized and carceral society that relentlessly engulfs urban minority youth with the threat of violence, imprisonment, and death.(3) Underscoring the ability of even the most alienated Chicano youth to embrace ethnic identity and pride, these writings thematize nihilism not as a pathological condition, but rather as a form of resistance to the threat of social erasure and exclusion, a resonant counterdiscourse for disenfranchised Chicanos in their struggle to overcome the dauntingly oppressive forces of postmodern urban America. …

Response to Fine, Reeves and Harney's Article on Employee Drug Testing

Wish to call to your attention what I believe to be errors in the article Drug Testing: Are Cities Complying with the Courts? as the article speaks of the program in place in the city of St. Louis. At the present time we do have three random drug and alcohol testing pools: one for Airport Police Officers which has been in effect for about two years, one for those Commercial Drivers License holders required by federal law to be randomly tested, and another public safety pool that includes City marshals, security guards, correctional officers, firefighters, and emergency medical service personnel. Those are the only job classifications we presently randomly test. I do not consider this program particularly intrusive. Our rules would allow random testing in other areas ifthe program were approved by the Director of Personnel. One organization within the City is attempting to get such approval, and for two years that approval has been withheld pending agreement on the particular job classifications that would be included and the circumstances under which those employees' work duties would make them candidates for random testing. If these issues are satisfactorily resolved, then we would approve such additions to the random testing program. But we take seriously our duty to run a responsible drug and alcohol program while protecting the rights of City employees, and therefore additions to the random testing pool have come slowly. It should also be noted that, although the City's Drug and Alcohol Policy allows dismissal after a single positive result, that only occurs for the employees who must carry firearms in the routine conduct of their duties (they automatically lose their license to carry a weapon) or who serve as corrections officers. All other employees who are positive for drugs or alcohol receive a lesser punishment and are mandatorily referred to the Employee Assistance Program. If they stay clean, they stay employed . .. if not, they're dismissed.