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Resilience, Distress, and Dependence Influence Injection Related Risk among People Who Inject Drugs

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Abstract

Substance use behavior, particularly injecting illicit substances, can lead to a variety of negative health outcomes. Psychological distress and substance dependence can contribute to injection-related risk behaviors, behaviors that can lead to transmission of bloodborne pathogens. This study examines how resilience (measured by the Conner Davidson Resilience Scale) might contribute to reducing risk, specifically in relation to psychological distress (measured by the Kessler 6 scale) and substance dependence (measured by the severity of dependence scale). The aim of this study was to examine the intersection between resilience, psychological distress, and severity of dependence, and how these psychosocial mechanisms might influence injection-related risk behaviors including sharing syringes and other injection equipment. A total of 622 people who inject drugs who live in New Orleans were recruited using respondent-driven sampling as part of the National HIV Behavioral Surveillance. In multiple binary logistic regression analyses, psychological distress was a significant predictor of syringe sharing behavior after controlling for resilience and dependence. Resilience and dependence are independent significant predictors of syringe sharing behavior, which warrants further investigation of how resilience, psychological distress, dependence, and injection-related risk are interrelated. These findings provide a foundation for further research that may inform prevention programs focused on reducing negative health outcomes associated with high-risk injection behaviors.

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References

  • Abdul-Quader, A. S., Heckathorn, D. D., McKnight, C., Bramson, H., Nemeth, C., Sabin, K., Gallagher, K., & Des Jarlais, D. C. (2006). Effectiveness of respondent-driven sampling for recruiting drug users in New York City: findings from a pilot study. Journal of Urban Health, 83(3), 459–476.

    Article  Google Scholar 

  • Aceijas, C., Stimson, G. V., Hickman, M., & Rhodes, T. (2004). Global overview of injecting drug use and HIV infection among injecting drug users. Aids, 18(17), 2295–2303.

    Article  Google Scholar 

  • Agaibi, C. E., & Wilson, J. P. (2005). Trauma, PTSD, and resilience: a review of the literature. Trauma, Violence & Abuse, 6(3), 195–216.

    Article  Google Scholar 

  • Ahrnsbrak, R., Bose, J., Hedden, S., Lipari, R., & Park-Lee, E. (2017). Behavioral health trends in the United States: Results from the 2016 National Survey on Drug Use and Health Retrieved from https://www.samhsa.gov/data/

  • Andreas, J. B., Lauritzen, G., & Nordfjaern, T. (2015). Co-occurrence between mental distress and poly-drug use: a ten year prospective study of patients from substance abuse treatment. Addictive Behaviors, 48, 71–78.

    Article  Google Scholar 

  • Armstrong, G., Jorm, A. F., Samson, L., Joubert, L., Nuken, A., Singh, S., & Kermode, M. (2013). Association of depression, anxiety, and suicidal ideation with high-risk behaviors among men who inject drugs in Delhi, India. Journal of Acquired Immune Deficiency Syndromes (1999), 64(5), 502–510. https://doi.org/10.1097/QAI.0b013e3182a7ef21.

    Article  Google Scholar 

  • Ballantyne, J. C., Sullivan, M. D., & Kolodny, A. (2012). Opioid dependence vs. addiction: a distinction without a difference? Archives of Internal Medicine, 172(17), 1342–1343.

    Article  Google Scholar 

  • Bonanno, G. A., Westphal, M., & Mancini, A. D. (2011). Resilience to loss and potential trauma. Annual Review of Clinical Psychology, 7, 511–535.

    Article  Google Scholar 

  • Centers for Disease Control and Prevention. (2016). HIV and injection drug use. Atlanta, GA: Retrieved from https://www.cdc.gov/hiv/risk/idu.html

  • Centers for Disease Control and Prevention (CDC). (2012). HIV infection and HIV-associated behaviors among injecting drug users—20 cities, United States, 2009. MMWR. Morbidity and Mortality Weekly Report, 61(8), 133–138.

    Google Scholar 

  • Centers for Disease Control and Prevention (CDC). (2015). HIV and injection drug use fact sheet. Atlanta, GA: Retrieved from http://www.cdc.gov/hiv/pdf/risk/cdc-hiv-idu-fact-sheet.pdf

  • Connor, K. M., & Davidson, J. R. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18(2), 76–82.

    Article  Google Scholar 

  • Degenhardt, L., & Hall, W. (2012). Extent of illicit drug use and dependence, and their contribution to the global burden of disease. The Lancet, 379(9810), 55–70.

    Article  Google Scholar 

  • Dowrick, C., Kokanovic, R., Hegarty, K., Griffiths, F., & Gunn, J. (2008). Resilience and depression: perspectives from primary care. Health (London, England: 1997), 12(4), 439–452. https://doi.org/10.1177/1363459308094419.

    Article  Google Scholar 

  • Fletcher, D., & Sarkar, M. (2013). Psychological resilience: a review and critique of definitions, concepts, and theory. European Psychologist, 18(1), 12–23. https://doi.org/10.1027/1016-9040/a000124.

    Article  Google Scholar 

  • Friedman, S. R., Mateu-Gelabert, P., Sandoval, M., Hagan, H., & Des Jarlais, D. C. (2008). Positive deviance control-case life history: a method to develop grounded hypotheses about successful long-term avoidance of infection. BMC Public Health, 8(1), 94.

    Article  Google Scholar 

  • Gallagher, K. M., Sullivan, P. S., Lansky, A., & Onorato, I. M. (2007). Behavioral surveillance among people at risk for HIV infection in the U.S.: the national HIV behavioral surveillance system. Public Health Reports (Washington, D.C.: 1974), 122 Suppl, 1, 32–38.

    Article  Google Scholar 

  • Gold, S. R. (1980). The CAP control theory of drug abuse. NIDA Research Monograph, 30, 8–11.

    CAS  PubMed  Google Scholar 

  • Gossop, M., Darke, S., Griffiths, P., Hando, J., Powis, B., Hall, W., & Strang, J. (1995). The severity of dependence scale (SDS): psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. Addiction, 90(5), 607–614.

    Article  CAS  Google Scholar 

  • Harris, M., & Rhodes, T. (2013). Hepatitis C treatment access and uptake for people who inject drugs: a review mapping the role of social factors. Harm Reduction Journal, 10(1), 1.

    Article  Google Scholar 

  • Heckathorn, D. D. (1997). Respondent-driven sampling: a new approach to the study of hidden populations. Social Problems, 44(2), 174–199.

    Article  Google Scholar 

  • Heckathorn, D. D. (2002). Respondent-driven sampling II: deriving valid population estimates from chain-referral samples of hidden populations. Social Problems, 49(1), 11–34.

    Article  Google Scholar 

  • Kessler, R. C., Green, J. G., Gruber, M. J., Sampson, N. A., Bromet, E., Cuitan, M., et al. (2010). Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO world mental health (WMH) survey initiative. International Journal of Methods in Psychiatric Research, 19(S1), 4–22.

    Article  Google Scholar 

  • Krüger, S., Alda, M., Young, L. T., Goldapple, K., Parikh, S., & Mayberg, H. S. (2006). Risk and resilience markers in bipolar disorder: brain responses to emotional challenge in bipolar patients and their healthy siblings. American Journal of Psychiatry, 163(2), 257–264.

    Article  Google Scholar 

  • Lansky, A., Finlayson, T., Johnson, C., Holtzman, D., Wejnert, C., Mitsch, A., Gust, D., Chen, R., Mizuno, Y., & Crepaz, N. (2014). Estimating the number of persons who inject drugs in the United States by meta-analysis to calculate national rates of HIV and hepatitis C virus infections. PLoS One, 9(5), e97596.

    Article  Google Scholar 

  • Lévesque, A., Roy, É., Jutras-Aswad, D., Zang, G., Artenie, A. A., & Bruneau, J. (2016). Examining the link between psychological distress, mental health disorders and sharing behaviors among cocaine users. Addictive Behaviors, 62, 54–59.

    Article  Google Scholar 

  • Lundgren, L. M., Amodeo, M., & Chassler, D. (2005). Mental health status, drug treatment use, and needle sharing among injection drug users. AIDS Education & Prevention, 17(6), 525–539.

    Article  Google Scholar 

  • Martin, N. K., Vickerman, P., Grebely, J., Hellard, M., Hutchinson, S. J., Lima, V. D., et al. (2013). Hepatitis C virus treatment for prevention among people who inject drugs: modeling treatment scale-up in the age of direct-acting antivirals. Hepatology, 58(5), 1598–1609.

    Article  CAS  Google Scholar 

  • McCreesh, N., Frost, S. D., Seeley, J., Katongole, J., Tarsh, M. N., Ndunguse, R., et al. (2012). Evaluation of respondent-driven sampling. Epidemiology (Cambridge, Mass.), 23(1), 138–147. https://doi.org/10.1097/EDE.0b013e31823ac17c.

    Article  Google Scholar 

  • Mooney, J. L., Minor, K. I., Wells, J. B., Leukefeld, C., Oser, C. B., & Staton Tindall, M. (2008). The relationship of stress, impulsivity, and beliefs to drug use severity in a sample of women prison inmates. International Journal of Offender Therapy and Comparative Criminology, 52(6), 686–697.

    Article  Google Scholar 

  • National Drug Intelligence Center. (2011). National drug threat assessment 2011. Retrieved from http://www.justice.gov/archive/ndic/pubs44/44849/44849p.pdf

  • Nelson, P. K., Mathers, B. M., Cowie, B., Hagan, H., Des Jarlais, D., Horyniak, D., & Degenhardt, L. (2011). Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews. The Lancet, 378(9791), 571–583.

    Article  Google Scholar 

  • Ries, R. K., Miller, S. C., & Fiellin, D. A. (2009). Principles of addiction medicine. Philadelphia, PA: Lippincott Williams & Wilkins.

    Google Scholar 

  • Robinson, W. T., Risser, J. M., McGoy, S., Becker, A. B., Rehman, H., Jefferson, M., et al. (2006). Recruiting injection drug users: a three-site comparison of results and experiences with respondent-driven and targeted sampling procedures. Journal of Urban Health, 83(1), 29–38.

    Article  Google Scholar 

  • Salganik, M. J., & Heckathorn, D. D. (2004). Sampling and estimation in hidden populations using respondent-driven sampling. Sociological Methodology, 34(1), 193–240.

    Article  Google Scholar 

  • SAS Institute. (2014). Base SAS 9.4 procedures guide. Cary, NC: SAS Institute Inc.

  • Scott, N., McBryde, E. S., Thompson, A., Doyle, J. S., & Hellard, M. E. (2017). Treatment scale-up to achieve global HCV incidence and mortality elimination targets: A cost-effectiveness model. Gut, 66(8), 1507–1515. https://doi.org/10.1136/gutjnl-2016-311504.

    Article  PubMed  Google Scholar 

  • Sirikantraporn, S., Mateu-Gelabert, P., Friedman, S. R., Sandoval, M., & Torruella, R. A. (2012). Resilience among IDUs: planning strategies to help injection drug users to protect themselves and others from HIV/HCV infections. Substance Use & Misuse, 47(10), 1125–1133.

    Article  Google Scholar 

  • Spiller, M. W., Broz, D., Wejnert, C., Nerlander, L., Paz-Bailey, G., & Centers for Disease Control and Prevention (CDC), & National HIV Behavioral Surveillance System Study Group. (2015). HIV infection and HIV-associated behaviors among persons who inject drugs—20 cities, United States, 2012. MMWR. Morbidity and Mortality Weekly Report, 64(10), 270–275.

    PubMed  PubMed Central  Google Scholar 

  • Stajduhar, K. I., Funk, L., Shaw, A. L., Bottorff, J. L., & Johnson, J. (2009). Resilience from the perspective of the illicit injection drug user: an exploratory descriptive study. International Journal of Drug Policy, 20(4), 309–316.

    Article  Google Scholar 

  • Theall, K. P., Elifson, K. W., Sterk, C. E., & Stewart, E. A. (2007). Criminality among female drug users following an HIV risk-reduction intervention. Journal of Interpersonal Violence, 22(1), 85–107.

    Article  Google Scholar 

  • Volz, E., Wejnert, C., Cameron, C., Spiller, M., Barash, V., Degani, I., & Heckathorn, D. D. (2012). Respondent-driven sampling analysis tool (RDSAT). Ithaca, NY: Cornell University.

    Google Scholar 

  • Warner, M., Chen, L. H., Makuc, D. M., Anderson, R. N., & Minino, A. M. (2011). Drug poisoning deaths in the United States, 1980–2008. NCHS Data Brief (81), 1–8.

  • Wingo, A. P., Ressler, K. J., & Bradley, B. (2014). Resilience characteristics mitigate tendency for harmful alcohol and illicit drug use in adults with a history of childhood abuse: a cross-sectional study of 2024 inner-city men and women. Journal of Psychiatric Research, 51, 93–99.

    Article  Google Scholar 

  • Zeremski, M., Zibbell, J. E., Martinez, A. D., Kritz, S., Smith, B. D., & Talal, A. H. (2013). Hepatitis C virus control among persons who inject drugs requires overcoming barriers to care. World Journal of Gastroenterology, 19(44), 7846–7851. https://doi.org/10.3748/wjg.v19.i44.7846.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors would like to acknowledge support through the Centers for Disease Control and Prevention (CDC) for National HIV Behavioral Surveillance cooperative agreement number 5U1B/PS003252. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC. The authors would also like to thank the New Orleans based NHBS staff for their efforts in data collection.

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Authors and Affiliations

  1. Department of Behavioral and Community Health Sciences, Louisiana State University Health Sciences Center, 2020 Gravier Street, 3rd Floor, New Orleans, LA, 70112, USA

    Kiva A. Fisher, Stephen Phillippi & William T. Robinson

  2. Louisiana Department of Health - Office of Public Health, STD/HIV Program, 1450 Poydras Street, Suite 2136, New Orleans, LA, 70112, USA

    William T. Robinson

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  1. Kiva A. Fisher
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  2. Stephen Phillippi
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  3. William T. Robinson
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Correspondence to Kiva A. Fisher.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

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The authors declare that they have no conflict of interest.

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Fisher, K.A., Phillippi, S. & Robinson, W.T. Resilience, Distress, and Dependence Influence Injection Related Risk among People Who Inject Drugs. Int J Ment Health Addiction 18, 587–598 (2020). https://doi.org/10.1007/s11469-018-9955-z

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