The 130th Annual Meeting of APHA

Abstract #40235

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, perlis@ndri.org, (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:

• At the conclusion of the session, the participant will be able to recognize that the travelling lifestyle chosen by some groups of injecting drugs users may serve to limit their drug consumption just enough to avoid addiction.

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.