Publications by authors named "Monica Fadanelli"
Article Synopsis
- Illicitly manufactured fentanyl is a major cause of opioid overdose deaths in the U.S., prompting this study to explore harm reduction strategies among rural drug users.
- The research included 349 qualitative interviews across 10 states, focusing on drug use behaviors and specific aspects of fentanyl exposure.
- Participants employed various strategies to minimize overdose risks, such as avoiding certain drugs, using fentanyl test strips, and having naloxone on hand, highlighting the need for improved access to harm reduction resources.
Article Synopsis
- Efforts to distribute naloxone are improving overdose reversal abilities, yet individuals using drugs in rural areas are often hesitant to call 911 due to fears of legal repercussions and stigma.
- The Rural Opioid Initiative involves eight studies in various rural US communities, analyzing how contextual factors impact drug use and health behaviors through qualitative interviews with drug users.
- Findings reveal that many respondents prefer non-evidence-based methods for reversing overdoses, emphasizing the need for better education on effective strategies and addressing concerns about law enforcement to encourage seeking emergency help.
Background: Opioid-related overdoses are a major cause of mortality in the US. Medicaid Expansion is posited to reduce opioid overdose-related mortality (OORM), and may have a particularly strong effect among people of lower socioeconomic status. This study assessed the association between state Medicaid Expansion and county-level OORM rates among individuals with low educational attainment.
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- The text emphasizes the importance of harm reduction programs, specifically syringe service programs (SSPs), in rural areas like Appalachian Kentucky amidst rising drug-related issues.
- The study involved interviews with staff from local SSPs to understand their establishment, operations, and sustainability, revealing initial opposition from community members and health officials due to stigma and misconceptions.
- Over time, positive interactions and visible health impacts transformed some staff into advocates for SSPs, leading to a stronger framework for their sustainability and the potential for expanding such programs in similar underserved regions.
Background: Expanding access to sterile syringes in rural areas is vital, as injection-related epidemics expand beyond metropolitan areas globally. While pharmacies have potential to be an easily accessible source of sterile syringes, research in cities has identified moral, legal and ethical barriers that preclude over-the-counter (OTC) sales to people who inject drugs (PWID). The current study builds on prior urban-based research by elucidating (1) pharmacy OTC policies and (2) pharmacists' rationale for, and barriers and facilitators to, OTC syringe sales in a US rural area hard hit by drug-related epidemics.
View Article and Find Full Text PDFBackground: Enrolling sufficient number of people who inject drugs (PWID) into syringe services programs (SSP) is important to curtail outbreaks of drug-related harms. Still, little is known about barriers and facilitators to SSP enrollment in rural areas with no history of such programs. This study's purpose was to develop a grounded theory of the role of the risk environment and individual characteristics of PWID in shaping SSP enrollment in rural Kentucky.
View Article and Find Full Text PDFBackground: Buprenorphine is a cornerstone to curbing opioid epidemics, but emerging data suggest that rural pharmacists in the US sometimes refuse to dispense this medication. We conducted a case study to explore buprenorphine dispensing practices in 12 rural Appalachian Kentucky counties, and analyze whether and how they were shaped by features of the rural risk environment.
Methods: In this case study, we conducted one-on-one semi-structured interviews with 14 pharmacists operating 15 pharmacies in these counties to explore buprenorphine dispensing practices and perceived influences on these practices.
Background: Though overdose rates have been increasing in US rural areas for two decades, little is known about the rural risk environment for overdoses. This qualitative study explored the risk environment for overdoses among young adults in Eastern Kentucky, a rural epicenter of the US opioid epidemic.
Methods: Participants were recruited via community-based outreach.
Drug self-administration models of addiction typically require animals to make the same response (e.g., a lever-press or nose-poke) over and over to procure and take drugs.
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