The 130th Annual Meeting of APHA

4089.0: Tuesday, November 12, 2002 - Board 7

Abstract #40235

Modern "Geographic Cure" for excessive injection drug use (IDU)

Theresa Perlis, PhD1, Don C. Des Jarlais2, Cassandra Torrico1, and Joy Settembrino2. (1) National Development and Research Institutes, Inc, 71 West 23rd Street, 8th floor, New York, NY 10010, 212-845-4484,, (2) National Development and Research Institutes, Inc., 71 West 23rd. Street, 8th floor, New York, NY 10010

Objective: The "geographic cure," relocating as a method of reducing one's drug use, has long been part of drug user folklore in the U.S. Heroin injection is currently rife among geographically mobile U.S. youth. Anecdotal reports indicate traveling or skipping town is the main strategy they use to prevent heroin use escalating into full addiction. We assess the travel-IDU relationship among these "Urban Nomad" drug users. Methods: 93 urban nomads, with IDU history, were street-recruited in New York City. Structured interviews identified travel patterns and "injection" cities in which the subject injected most recently during the past year. Ethnographic interviews were conducted with a subset of 20. Results: Most urban nomads associate with loosely organized groups emphasizing enduring supportive relationships. While injection plays a major role in friendship ties, "junkies" are scorned since they are not "free". 88% reported prior year IDU. Injection frequencies varied; reasons included geographic variation in heroin availability and lack of dealer-access. Median number of person-trips for the previous year (a journey between two cities by one person) was 14. Only 6% of frequent travelers (>14 person-trips) had injected in each of the last 3 cities visited versus 29% of infrequent travelers. A shorter visit was associated with lower likelihood of injection in a city. Conclusions: Desire for membership in a "family" that uses heroin frequently but scorns addiction, demands of frequent travel, and lack of consistent drug-access while traveling all serve as harm-reduction mechanisms to reduce the chances of developing addiction within this heroin-using group.

Learning Objectives:

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Special Populations and Substance Abuse Poster Session II

The 130th Annual Meeting of APHA