Drug overdose among women in intimate relationships: The role of partner violence, adversity and relationship dependencies


Autoři: Nabila El-Bassel aff001;  Phillip L. Marotta aff002;  Dawn Goddard-Eckrich aff001;  Mingway Chang aff001;  Tim Hunt aff001;  Ewin Wu aff001;  Louisa Gilbert aff001
Působiště autorů: Columbia University, School of Social Work, New York, New York, United States of America aff001;  Yale University, School of Medicine, Department of Psychiatry, New Haven, Connecticut, United States of America aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225854

Souhrn

Background

This study examines the relationship between experiencing intimate partner violence (IPV), exposure to prior childhood adversity, lifetime adverse experiences, drug-related relationship dependencies with intimate partners and overdose, hospitalization for drug use, friends and family members who overdosed and witnessing overdose.

Methodology

This paper included a sample of 201 women who use drugs in heterosexual relationships with criminal justice-involved men in New York City. We included measures of experiencing overdose, hospitalization for drug use, witnessing overdose, and having friends and family who overdosed. Intimate partner violence consisted of either 1) none/verbal only, 2) moderate and 3) severe abuse. Dichotomous indicators of drug-related relationship dependencies included financial support, drug procurement, splitting and pooling drugs. A scale measured cumulative exposure to childhood adversity and lifetime exposures to adverse events. This paper hypothesized that experiencing moderate and severe IPV, drug-related dependencies and exposure to prior childhood and lifetime adversity would be associated with a greater risk of experiencing overdose, hospitalization for drug use, witnessing overdose and having friends and family members who overdosed. Generalized linear modeling with robust variance estimated relative risk ratios that accounted for potential bias in confidence intervals and adjusted for race, ethnicity, education and marital status.

Results

We found experiencing moderate or severe IPV was associated with ever being hospitalized for drug use and having a family member who experienced overdose. Experiencing moderate IPV was associated with increased risk of witnessing overdose, Partner drug dependencies were associated with overdose, ever being hospitalized for drug use, witnessing overdose, and having a family member or friend who experienced overdose. Childhood and lifetime adversity exposures were significantly associated with increased risk of overdose, ever being hospitalized for drug use, ever witnessing overdose and having a friend and family member who overdosed.

Conclusion

Findings underscore the intersection of experiencing IPV and drug-related relationship dependencies, childhood adversity and lifetime adversity in shaping experiences of and witnessing overdose among women who use drugs. They highlight the urgent need to address IPV, adversity experiences and drug-related relationship dependencies in overdose prevention for women who use drugs.

Klíčová slova:

Drug abuse – Drug dependence – Drug research and development – Finance – Human families – Child abuse – Intimate partner violence – Recreational drug use


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2019 Číslo 12