Street Users Research Articles

The Sociology of Street Use in Edo and colonial Manila

People on the streets create a unique culture just by occupying its space. A user-centered design considers first and foremost the needs and behavior of these individuals as they utilize the street space. The paper examines street user behavior in Edo and colonial Manila. The historical context of street use provides potential constructs and concepts that would lead to improving street space. The premise is that due to a similar monsoon-based climate and forest environment origins, even with a contrasting development of street urban form, there is still an underlying similarity with respect to the use of street space in both Edo and Manila. In-depth discussion centers on the sociology of street space as well as street user behavior examining in detail group attributes, individual attributes and user groupings to provide us proof of the presence of street culture brought about mainly by its users and the potential of reviving such culture to make it conducive for street use. Analysis will dwell on the significance of attributes, their level of similarity or dissimilarity as well as their frequency of occurrence and how the information may influence street space design.

Exposure to aerosol pollution and reported respiratory symptoms among segments of urban and rural populations in Sri Lanka

(The Correct PDF for this article is now available)Health effects due to exposure to air pollution have become a growing concern as an ill-effect of rapid urbanization in several regions of Sri Lanka. Evidence suggests that exposure to particulate matter and other aerosols such as SO2 and NOx have increased in urbanized areas in Sri Lanka. But presently adequate evidence to show the association between health effects and air pollution is not available. In this ecological study, we present the micro-level picture of aerosol pollution obtained by using an interviewer administered questionnaire survey and comparing the results against exposure to aerosols. Secondary data were gathered on Sri Lankan health issues from the Ministry of Health to understand the most common causes of mortality and morbidity in the city. Symptoms and the medical diagnosis information were collected from randomly selected probability proportionate samples of five categories of street users (commuters in buses, three wheelers, outdoor venders, shop keepers and residents) in an urbanized area of Colombo and in a rural area of a peripheral district. Exposure levels were measured using passive air samplers in both locations. Moreover active sampling measurements of curbside levels of Total Suspended Particulate Matters (TSP), Sulfur Dioxide (SO2) and Nitrogen Dioxide (NO2) were collected in urbanized area. Aerosol exposure of urban and rural dwellers in all five categories, have shown significant differences in levels of SO2 (p = 0.001) and NO2 (p < 0.001). Three wheeler drivers and shop keepers showed no significant difference in SO2 levels in both locations (p = 0.045 and p = 0.113) while buses at both locations showed the highest NO2 and SO2 levels at both sites while houses had the lowest levels. Further analysis showed that the exposure levels of bus drivers significantly vary (SO2, F= 13.399, p = 0.001; NO2, F =52.283, p < 0.001) on the route characteristics (urban, urban to sub urban and rural). Urban street users had higher prevalence of cough (p < 0.001, OR = 3.43, CI = 2.29 - 5.15) and phlegm (p <0.001, OR = 2.19, CI = 2.29 - 5.15). Wheezing among city dwellers was 20.5% and among rural dwellers was 13.7% (p = 0.043, OR = 1.62, CI = 0.99 - 2.67).There was no significant difference in breathlessness over the different locations. The association might be overridden by localized risk factors such as difference in lifestyles among the urban and rural populations such as the higher number of people using wood as cooking fuel being in the rural site. Short- and long-term mitigation strategies are needed to reduce people's exposure to such air pollutants. The outcome of this study has been extended for necessary policy implications and mitigation guidelines by introducing recommendations of land use development in the city limits. DOI: 10.4038/besl.v7i2.1941 Built-Environment Sri Lanka Vol.7(2) 31-39

Storied Infrastructure: Tracing Traffic, Place, and Power in Canada’s Capital City

Storied Infrastructure: Tracing Traffic, Place, and Power in Canada’s Capital City Nick Scott (bio) The street yearns for action nobler than traffic. Leonard Cohen Montreal 1964 Most canadians depend on a Car, Truck, or Bus for everyday travel and worry about congestion and the price of gas. The recent bailout of the auto sector and stimulus spending on roads, bridges, and highways reveal the commitment of Canadian governments to expanding traffic through motor vehicle use. As a shared way of flowing and idling in the world, however, traffic, in spite of mass participation and immense ecological import, remains a relatively elusive idea, and one too frequently dominated by a functionalist engineering approach. As a technoscientific attempt to eliminate congestion, this approach overlooks social understandings of traffic, its politics, and its cultural significance. I aim to extend an alternative understanding of “traffic” as irreducible to either congestion or itinerancy but marked instead by multiple relations of stasis and flow among human and nonhuman actors. To this end I draw on two different literatures, mobility studies and narrative approaches to urban planning, to explore how people imagine and practise traffic in a spatial culture of automobility. [End Page 149] This narrative approach to urban planning highlights the multiplicity of traffic and the agency of material infrastructure (see Latour). By foregrounding the different voices of streets, I aim to defamiliarize the habitual voice of automobility. In contrast to modernization cum motorization narratives which follow a teleological plot line, the stories that streets tell from different temporal and spatial perspectives have the potential to disrupt a natural, apolitical culture of car-dependence. The mobilities literature that I will rely on argues that buildings, roads, and other kinds of places gain meaning through the ways in which they carry or constrict the flows of subjects, ideas, and objects. It views streets as sociotechnical ensembles of tarmac, electricity, hydrocarbons, values, juridical systems, and habitus. Built for particular bodies and machines, streets evoke the discursive and political construction of traffic alongside hard infrastructure. After situating traffic within mobilities and narrative approaches to planning, I follow the stories of five prominent streets in Canada’s capital city. Ottawa represents a strategic case study of mobility and planning. Like Canberra, Brasilia, and New Delhi, Ottawa is a living product of muscular, modernist planning of the last century which equated national progress with mass automobility. To a greater degree than other conurbations in Canada, traffic in the National Capital Region reflects a totalizing vision of the good city in which the car is tied to modernity, national identity, and power. By engaging what some have called a relational “politics of mobility” (Cresswell, “Politics”; Simpson; Henderson), I argue that Ottawa’s streets articulate a deeply contested process by which automobility has become systematically invested with forms of material and immaterial power denied to other forms of traffic. To build my case I draw on media discourse, photographs, planning documents, developmentese, and field observations. Through these materials I show that, along with the daily lives of street users, cars, and their manifold interactions, a critical if frequently forgotten world of traffic resides in the stories of streets themselves. Assembling a Politics of Automobility Over the last decade, research on the movement of people, goods, and ideas has enjoyed increasing attention. A growing interdisciplinary literature on “mobilities” explores how movement mediates social life and the creation of meaningful spaces in which people live together. The “mobilities paradigm,” as some refer to it, includes “studies of corporeal movement, transportation and communications infrastructures, capitalist spatial restructuring, migration and immigration, citizenship and [End Page 150] transnationalism, and tourism and travel” (Hannam et al. 9–10). These studies have two things in common. First, they explore the proliferation of mobilities, exploring how interdependent institutions and novel sociotechnical networks, from currency markets and exurban commutes to mobile social networking, bring individual biographies unevenly into contact with globalized flows of people, products, and information. Second, mobility studies just as importantly form a response to dominant conceptions of movement. In particular, mobility contrasts with conceptions in transport geography and engineering geared toward maximizing the economic efficiency and productivity of movement. Cresswell usefully distinguishes mobility from movement as one might...

New insights and new possibilities for public service leadership

This paper introduces the findings of an unusual international endeavour that combines action research with leadership development for 40 senior officials from Australia, Canada, New Zealand and the UK. The four nation Leadership Across Borders programme, co‐delivered by the governments' business schools of each country, set out to explore and understand some of the most significant facets of public service ranging from citizen engagement to whole‐of‐government complexity, and from the economic downturn to crisis management. Over the 10 months of the programme, the senior group engaged with heads of the public service, leading academics, delivery experts, leaders of civic society and scores of street level service users. This paper highlights the critical importance of understanding complexity and the role of ‘systems thinking’ in dealing with modern problems. But it also points to a new order of innovation required of leaders if they are to bring value to problems such as deprivation and global financial crises, and if they are to successfully bring about citizen‐centred services in increasingly complex societies.

The Use of Enforcement to Combat ‘Street Culture’ in England: An Ethical Approach?

Within a social justice ethical framework, the use of ‘enforcement’ measures to prevent people from engaging in ‘street activities’, such as begging and street drinking, can only be morally justified if such initiatives can be shown to benefit the welfare of the vulnerable ‘street users’ affected. It may be hypothesized that this is unlikely, and such measures are bound to be regressive in their effects, but in fact evidence from an evaluation conducted in five locations across England suggests otherwise. Drawing on a normative framework which engages with both moral and political philosophy, this paper argues that the motivations and impacts associated with enforcement are more ethically complex, and less punitive, than they may at first appear. It demonstrates that the use of enforcement measures, when accompanied by appropriate support, can in fact lead to beneficial outcomes for some individuals involved in begging or street drinking in some situations. The outcomes for other members of the street population can, however, be very negative, and are highly unpredictable, such that the use of enforcement is always a high-risk strategy, even if ethically justifiable in certain circumstances.

Fighting Traffic

Fighting Traffic Peter D. Norton (bio) and Bruce Epperson (bio) To the Editor I have no wish to question Bruce Epperson’s overall assessment of Fighting Traffic: The Dawn of the Motor Age in the American City (January 2009, pp. 235–37), but I believe readers of Technology and Culture deserve corrections of three important errors in Mr. Epperson’s review. First, the reviewer alleges that the book attributes the transformation of the city street “to a powerful coalition of industry representatives and elite automobile clubs” which “hijacked a series of urban transportation-safety conferences convened by Commerce secretary Herbert Hoover.” In fact, this very small but important episode, confined in the book to six pages (187–93), describes no hijacking, just perfectly legal interest-group politics of the usual variety. This event was not important enough to merit any mention in the summary of the book’s argument in the introduction. Second, according to the reviewer, “Norton eschews systematic quantification in favor of an anecdotal approach.” The reviewer thereby dismisses substantial research in archival and published primary sources as “anecdotal,” though such research is the foundation of nearly all professional historical monographs. I should note that reviewers who have published books in the field have characterized Fighting Traffic as “exquisitely researched” (Zachary Schrag) and as founded upon “rigorous research” (Gijs Mom). I cannot judge these assessments myself, except to say that as professional historians these reviewers distinguish research from anecdote. The reviewer purports to present nineteenth-century data that refute my claim that traffic casualties in the early 1920s were unprecedented in scale. The data presented, however, do not serve this purpose. Epperson claims that in 1867, 200 New Yorkers were killed by horse traffic. The data originate from Maxwell Lay’s Ways of the World (1992, p. 132), but are in fact figures for London (as reference to Lay’s source will indicate). In fact, in 1925 automobile fatalities per 100,000 inhabitants in New York City were three times higher than the comparable 1867 London fatality rate attributable to horse traffic. Other data the reviewer presents as a refutation of my statement that fatalities rose “fast” merely confirm the data in Fighting Traffic; both show a rise in traffic fatalities that was, by any standard, fast. The reviewer notes [End Page 982] that fatalities in 1920–1930 rose only 2.57 times (in fact a steeper rise than in any decade since). In the four years following World War I, fatalities rose 64 percent, a rate never since approached in any four-year period; hence, by 1923, cars were under attack by the non-motoring majority in cities. The reviewer notes correctly that fatalities per 100,000 motor vehicles declined overall in the 1920s. I used casualty data to explain antipathy to cars among the non-motoring majority, however, for whom casualties per 100,000 inhabitants mattered, not fatalities per 100,000 vehicles. The book’s argument has much less to do with actual casualty figures (though these are provided) than with the evolving perceptions of competing street users’ rights of access to streets. The strength of these perceptions is substantiated, as it must be, not by casualty figures but by textual evidence. That there was a prevailing perception (justified or not) circa 1920 that automobiles were dangerous, and that pedestrians were presumed innocent when they were struck by them, is a claim substantiated by overwhelming evidence, and perhaps most convincingly by the well-documented anxiety these perceptions fostered among automotive interest groups. Perceptions (as opposed to accident data) are exceedingly difficult to quantify, but where possible, this has been done. For example, the views of the authors of letters to a newspaper are surveyed (p. 270), police chiefs’ opinions on the causes of accidents are measured (p. 53), and the 42,000 signatures on a speed-governor initiative in Cincinnati (which implicitly blamed automobiles for accidents) are offered as evidence (p. 96). Whether accident data would justify their opinions or not, those who blamed motorists threatened the automobile’s urban future, and this threat led some social groups to organize to extend responsibility for casualties to non-motorists, and to defend motorists’ right to the streets...

Exploring Drug Sourcing among Regular Prescription Opioid Users in Canada: Data from Toronto and Victoria

Recent North American data document increased prescription opioid (PO) misuse in general and street-drug-user populations. One aspect of this phenomenon – as distinct from illicit drug use – appears to be sourcing, since POs may be obtained through various forms of diversion from the medical system and other sources. However, the overall function of street-drug markets for POs remains unclear. Regular street users of POs in Toronto (N = 43) and Victoria (N = 39) were recruited by community-based methods and completed an interviewer-administered questionnaire exploring features of PO sourcing from street-drug markets. Respondents were PO- and non-opioid poly-drug users, with few holding their own prescription for POs. Regular sources for POs were more common in Toronto. Sizeable proportions of respondents in both sites reported exchanging and selling illicit drugs, involving both PO and non-PO drugs in Toronto, yet mainly restricted to the latter in Victoria. Respondents suggested a possible demarcation line between street market sources for POs and street market sources for illicit drugs. The availability of, demand for, and prices for PO-drugs was observed to have increased in recent years. Street-drug markets appear to be one key source feeding increasing levels of PO use among street users. Our data suggest that there may be distinct market patterns for POs, findings which are important for developing interventions and future research.

Profiling poly-substance use typologies in a multi-site cohort of illicit opioid and other drug users in Canada–a latent class analysis

‘Poly-substance use’ is increasingly prevalent among street drug user populations. The objective was to employ latent class analysis (LCA) to empirically categorize and extract potential typologies of poly-substance users within a multi-site cohort of illicit opioid and other drug users (OPICAN) in Canada, and examine potential associations with social and health indicators. Drug use patterns of 582 participants from the most recent follow-up (2005) of the cohort study–focusing on drug use prevalence indicators in the past 30 days–were empirically analyzed via LCA. These classes were further examined for associations with social and health variables using chi-square, ANOVA. Binomial logistic regression models were used to predict class membership. LCA analysis resulted in eight distinct user typologies, characterized both by the distinct relative prevalence of different substances (e.g., including: heroin, prescription opioids, benzodiazepines, cocaine, crack, alcohol, cannabis, and others) used and administration routes (e.g., injection or noninjection), the majority of which were described by the predominant use of two or more distinct substance groups (e.g., opioids and stimulants). At least two of the active poly-substance user classes were described by predominant noninjection as the primary route of administration. ‘Poor or fair’ health status was reported at the highest prevalence level by the class of intensive poly-substance injectors, while HCV-positive status was disproportionately low in the classes of current noninjectors. Analytical examination of poly-substance use patterns is a distinct challenge for meaningful drug use monitoring, also providing important evidence for targeted prevention and treatment interventions.

Fentanyl use among street drug users in Toronto, Canada: Behavioural dynamics and public health implications

Prescription opioids (POs) are playing an increasingly central role in street drug use and related harms in North America. One distinct PO substance of interest is Fentanyl (Duragesic ®), a potent opioid analgesic designed for transdermal time-release application. Studies from Europe and North America have documented the sizeable overdose and mortality burden associated with the non-medical use of this drug. This study explores practices and risk dynamics associated with Fentanyl abuse, also considering public health implications. Semi-structured interviews were conducted with 25 regular street-entrenched illicit PO users in Toronto, Canada, a sub-sample of which were recent Fentanyl users. Results showed that while relatively rare on the illicit PO market in Toronto, Fentanyl is a highly desired, sought after and relatively expensive PO drug among street users. In addition, the new ‘matrix’ patch technology implemented for Fentanyl since 2005 is a limited safeguard against abuse as simple extraction methods are utilized by street users. Finally, distinct risk behaviours relevant for public health emerge due to the high black market costs of Fentanyl and the extraction techniques applied, potentially facilitating high risks for infectious disease (e.g., HCV, HIV) transmission and/or overdose. Consequently, prevalence and practices of Fentanyl use by street users require closer monitoring, targeted interventions and further research regarding risks and outcomes.

Street space sustainability in Asia: the role of the Asian pedestrian and street culture

Discussion initiates from the present practice of street space design and management in the Asian context to establish that the current thrust of standards and mandates is geared towards promoting vehicle use and lacks consideration of other street users such as the pedestrian. The objective is to conduct a socio-cultural analysis of the Asian street user focusing on behavior, street sociology and culture. It aims to understand the Asian psyche and how this knowledge may contribute to enhancing street space sustainability. Four aspects of the Asian street user are considered: its physiological attribute and the needhierarchy, the Asian psyche compared with its Western counterpart, sociology of street use, and potential of reviving pedestrian culture. An interpretative, culture-bound approach is utilized to define the parameters to sustain people’s use of the street environment. It aims to review historical precedents on street space and use as well as utilize various anthropological methods.

Being in Public: The Threat and Promise of Stranger Contact

License to Harass provides a sociolegal study of racially and sexually abusive within common outdoor spaces. Based on interviews with street users across three Californian cities, Laura Beth Nielsen's book examines subjects' experiences with offensive public speech, their attitudes about the extent to which it poses a problem for American society, and their beliefs about whether the law should be employed to restrict it (Nielsen 2004, 2). At the heart of Nielsen's account is an interrogation of how members of the public see law's role-should law be used to regulate or ban socially insulting speech, and, if not, why not? What place, in particular, do free speech principles occupy in the case against state regulation?

The ‘Place’ of Street Children in Kampala, Uganda: Marginalisation, Resistance, and Acceptance in the Urban Environment

In this paper I examine the ‘place’ of street children in Kampala, Uganda, highlighting their ingenious and resourceful use of the urban environment. Considered ‘out of place’ in urban public space, street children create their own niches in the marginal spaces of the city. By looking at untouchable spaces, underground spaces, and rooftop spaces I show how they develop their own place identities. For survival, street children react to their exclusion by resisting this out-of-place image and encroaching into crowded spaces or by dominating the street under the cover of darkness. However, in certain city spaces, street children are also legitimised and accepted by other street users if they conform to the desired behaviours of that space. The place of street children in Kampala is one which is contested, resulting in a multiplicity of street children's niches being created which vary both spatially and temporally.

Hair morphine concentrations of fatal heroin overdose cases and living heroin users.

To compare heroin and other opiate use of heroin overdose fatalities, current street heroin users and drug-free therapeutic community clients. Hair morphine concentrations that assess heroin use and other opiate use in the 2 months preceding interview or death were compared between heroin overdose fatalities diagnosed by forensic pathologists (FOD) (n = 42), current street heroin users (CU) (n = 100) and presumably abstinent heroin users in a drug-free therapeutic community (TC) (n = 50). Sydney, Australia. The mean age and gender breakdown of the three samples were 32.3 years, 83% male (FOD), 28.7 years, 58% male (CU) and 28.6 years, 60% male (TC). The median blood morphine concentration among the FOD cases was 0.35 mg/l, and 82% also had other drugs detected. There were large differences between the three groups in hair morphine concentrations, with the CU group (2.10 ng/mg) having concentration approximately four times that of the FOD group (0.53 ng/mg), which in turn had a concentration approximately six times that of the TC group (0.09 ng/mg). There were no significant differences between males and females in hair concentrations within any of the groups. Hair morphine concentrations were correlated significantly with blood morphine concentrations among FOD cases (r = 0.54), and self-reported heroin use among living participants (r = 0.57). The results indicate that fatal cases had a lower degree of chronic opiate intake than the active street users, but they were not abstinent during this period.

Opioid drugs: a comparative survey of therapeutic and "street" use.

The prescription of strong opioid analgesics for chronic non-cancer pain (CNCP) is described as controversial and can result in misidentification of patients as drug abusers or individuals with an addiction. This study compared the effects of opioid drugs on CNCP patients and "street" users. The groups comprised 36 CNCP patients attending a pain clinic and 39 street users, recruited on London streets. CNCP patients were interviewed in a pain clinic and street users in a street setting. A questionnaire was used to assess drug craving, dose escalation, cessation of use, compulsion to use, effects on career, relationships and activities, experience of "highs," and problems due to intoxication. To assess physiological dependence, subjects answered questions on specific effects e.g. stomach pains, nausea/vomiting, cramps/aches, etc.). Efficacy was assessed in CNCP patients by determining analgesia and physical function. CNCP patients started therapy in the low dose range for oral morphine (</=60 mg/day) and most (83%) did not move into a higher dose range once adequate levels of analgesia were attained. Street users started smoking heroin intermittently, before daily use. Most escalated their dose by increasing the amount used and by switching from smoking to injecting. Unlike CNCP patients, street users demonstrated patterns of compulsive drug use, social problems and intoxication. Only 3 / 31 (9.5%) pain patients that discontinued opioid therapy reported withdrawal symptoms on abstaining from the drug compared to 35 (89.5%) of street users. Findings suggest that CNCP patients prescribed strong opioid analgesics derive more benefit than harm.

Cocaine and metabolite elimination patterns in chronic cocaine users during cessation: plasma and saliva analysis.

Several reports suggest a prolonged elimination of cocaine and metabolites after chronic use compared with single or occasional use. This study was designed to measure the half-lives of cocaine in plasma and saliva of individuals who consumed cocaine on a frequent basis. The disposition and elimination patterns of cocaine and metabolites in the body fluids of chronic high-dose cocaine users during acute cessation of use were investigated. Plasma and saliva specimens were collected over a 12-h period during cessation and analyzed by gas chromatography-mass spectrometry. Pharmacokinetic parameters were derived by noncompartmental analysis of plasma and saliva data. Results indicated a cocaine terminal T(1/2) of 3.8 h in plasma and 7.9 h in saliva. The terminal T(1/2) of benzoylecgonine was 6.6 h in plasma and 9.2 h in saliva. Compared with prior studies of acute low-dose cocaine administration, these findings suggest that cocaine's half-life is longer in active street users than in occasional users though the half-life of its main metabolite benzoylecgonine remains similar (as do cocaine saliva-to-plasma ratios). Thus, regular use of cocaine appears to alter the disposition and elimination of cocaine when compared to single or occasional use.

Book: Review/Commentary: Mothers and Illicit Drugs: Transcending the Myths

Mothers and Illicit Drugs: Transcending Myths, by Susan C. Boyd (Toronto: University of Toronto Press, 1999), 243 pp., $50 US (cloth), $20 US (paper). Susan C. Boyd's Mothers and Illicit Drugs: Transcending Myths intends to bring balance to traditional research that is by men, about men, and focused on problematic and poor users. Boyd interviews 28 Canadian women from diverse backgrounds and uses their responses as well as relevant research to demonstrate that experiences of users-- particularly women and mothers-are mediated by class, race, and gender. Her work challenges prevailing assumptions regarding women who have used narcotics and questions socially constructed label drug user, illuminating ways in which it positions women as objects of regulation and control. But Boyd's work occasionally makes claims that it cannot support. In end, methodological decisions are its Achilles' heel. Even so, fact that readers are left wanting to know more-about Boyd's assertions and about women she interviews-is in part a testament to book's worth. Boyd approaches her research from a critical feminist perspective, aiming to create social change and help transform lives (pp. 36-37). While Boyd reviews ethnographic literature, she opts for a more circumscribed methodology, choosing a semistructured interview format to facilitate the airing of opinion and revelation of (p. 37). Boyd explains that her choice of method is justified by failure of other researchers to ask users their opinions regarding use and policies. This choice-- and its coupling with brief but dense reviews of relevant literature-proves problematic. In first chapter, Boyd sets an ambitious agenda. She introduces constructs that drive her analysis (the social construction of motherhood, ideology of mothering, and maternal use, to name a few) and critically assesses literature from which they emerge. The remainder of her book is arranged by topic: drugs and mothering; neonatal abstinence syndrome (NAS) and Sunny Hill Hospital for Children; social services' assistance and regulation; treatment; and effects of criminalization of narcotics. Boyd's professional life clearly informed her research, shaping her commitment to a broad agenda. With a 15-year background in human services to women, Boyd is interested in how women from different backgrounds experience these services differently. The keystone of Boyd's expansive framework is her argument that women's experience of use is mediated by their race, class, and gender, in conjunction with legal and socio-economic environment (p. 36). More specifically, her central interest is experience of mothers who are (falsely) assumed to be bad mothers because they use-or have used-illicit drugs. Both Boyd and women she interviews have much to say about assumptions surrounding illicit use, pregnancy, childbirth, and mothering. Challenging stereotype of passive street user afflicted with a disease (addiction), women in Boyd's sample describe both positive and negative experiences that are mediated by type of drug, route of administration, duration of effect, cost of drug, race, class, gender, and legislation. Boyd contests ideas that planned, healthy pregnancies are inconsistent with illicit use and that drug-using mothers underestimate seriousness and significance of childbirth. She reports that women in her sample were initially willing to make and capable of making decisions about their pregnancies, and perceived childbirth as life-affecting and significant. Attempts to act in ways that were congruent with these perceptions, however, were often frustrated by service providers. The women were treated poorly by medical community, offered little support by human service agencies, and provided with inaccurate information about effects of illicit drugs on maternal health by health professionals. …

Utilization of community-based services among homeless persons: An application of a theoretical model

Data from a longitudinal study of 379 homeless adults were analyzed to document the pattern of use of community-based social services and to identify the correlates of service use. The analytical framework employed was the Andersen model, adapted to take into consideration the life circumstances of homeless people in a demographically diverse setting. The relevance of predisposing, enabling, and need factors in predicting service use and type of assistance received was examined using multinomial logistic regression models. The study found that a significant portion of the homeless sample did not use social services and that among service users, most reported receipt of concrete services only. Our analyses suggest that there is a need for service providers to target their programs and interventions to the underserved and hard-to-reach segments of the adult homeless population including males, non-Whites, street users, episodically homeless people, and individuals experiencing alcohol problems. © 1999 John Wiley & Sons, Inc.

The Impact of an HIV Risk-Reduction Program Among Street Drug Users in Rio de Janeiro, Brazil

This article assesses the impact of an HIV risk-reduction program on risky behaviors in a population of street cocaine users in Rio de Janeiro, Brazil. Pre- and postintervention data were collected, and changes in the frequency of drug use, sexual risk behaviors, and other life-situation variables were examined. Participation in the program was associated with a significant decrease in the average number of days of cocaine use and a significant increase in employment and income. Significant increases in condom use were also documented. The data suggest that this population of street cocaine users was capable of understanding the severity of AIDS as well as learning and applying specific risk-reduction techniques to their behavior. The results further demonstrate the feasibility of conducting street research among an at-risk population of cocaine users in Brazil and in other countries in which there is little tradition of research with out-of-treatment drug users.

Effect alteration of methamphetamine by amino acids or their salts on ambulatory activity in mice.

Effect alterations of methamphetamine by pretreatment of amino acids or their salts on ambulatory activity in mice were investigated to confirm a fact that certain amino acids, particularly monosodium L-glutamate, are added to methamphetamine by the street users, and that the amino acids augment the effect of methamphetamine. The ambulatory activity of mouse was measured by a tilting-type round activity cage of 25 cm in diameter. The amino acids or their salts tested were monosodium L-glutamate, monosodium L-aspartate, gamma-amino-butyric acid, L-alanine, L-lysine hydrochloride and L-arginine hydrochloride. A single administration of each chemical at doses of 1 and 2 g/kg i.p. did not induce a marked change in the ambulatory activity in mice. Methamphetamine 2 mg/kg s.c. induced an increase in the ambulatory activity with a peak at 40 min after the administration, and the increased ambulatory activity persisted for 3 hr. The ambulation-increasing effect of methamphetamine was augmented by the pretreatment of monosodium L-glutamate and monosodium L-aspartate at 30 min before the methamphetamine administration, while attenuated by the pretreatment of L-lysine hydrochloride and L-arginine hydrochloride in a dose-dependent manner. Gamma-aminobutyric acid and L-alanine did not affect the effect of methamphetamine. Similar augmentation and attenuation in the ambulation-increasing effect of methamphetamine were induced by the pretreatment of sodium bicarbonate 0.9 g/kg i.p. (urinary alkalizer) and ammonium chloride 0.07 g/kg i.p. (urinary acidifier), respectively. The urinary pH level was elevated by the administration of monosodium L-glutamate, monosodium L-aspartate and sodium bicarbonate, and decreased by L-lysine hydrochloride, L-arginine hydrochloride and ammonium chloride. Gamma-aminobutyric acid and L-alanine did not elicit a marked change in the urinary pH level. The present experiment confirms the fact in human that monosodium L-glutamate augments the effect of methamphetamine. Moreover, the present results suggest that monosodium salts of acidic amino acids augment, and conversely monohydrochloric salts of basic amino acids attenuate the effect of methamphetamine. The alterations of the ambulation-increasing effect of methamphetamine may be due to the urinary excretion rates of the drug through changes in the urinary pH level after the administration of amino acids or their salts.

Nonmedical Use of Pentazocine

To the Editor.— Recent reports on the nonmedical use of pentazocine (Talwin) and tripelennamine (Pyribenzamine) by Showalter and Moore (239:1610, 1978) and by Poklis (240:108, 1978) may describe only the tip of the iceberg of nonmedical use of pentazocine. The previous reports described the use of pentazocine and tripelennamine in a combination called T's and Blues as a heroin substitute by street users. Within the past six months, we have begun receiving reports of the use of pentazocine in combination with other drugs for a psychoactive effect. Four respondents to our ongoing drug use survey have reported combining pentazocine with promethazine hydrochloride (Phenergan), and two respondents have reported using pentazocine with prochlorperazine (Compazine). The respondents indicated that usually tablets were crushed and prepared for injection, but that occasionally they were able to obtain drugs in the injectable form, indicating a probable diversion of medical supplies. None of our respondents were