A qualitative study of diphenhydramine injection in Kyrgyz prisons and implications for harm reduction
Abstract Background To reduce opioid dependence and HIV transmission, Kyrgyzstan has introduced methadone maintenance therapy and needle/syringe programs into prisons. Illicit injection of diphenhydramine, an antihistamine branded as Dimedrol®, has been anecdotally reported as a potential challenge...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-10-01
|
| Series: | Harm Reduction Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12954-020-00435-7 |
| _version_ | 1818117073086185472 |
|---|---|
| author | Jaimie P. Meyer Gabriel J. Culbert Lyuba Azbel Chethan Bachireddy Ainura Kurmanalieva Tim Rhodes Frederick L. Altice |
| author_facet | Jaimie P. Meyer Gabriel J. Culbert Lyuba Azbel Chethan Bachireddy Ainura Kurmanalieva Tim Rhodes Frederick L. Altice |
| author_sort | Jaimie P. Meyer |
| collection | DOAJ |
| description | Abstract Background To reduce opioid dependence and HIV transmission, Kyrgyzstan has introduced methadone maintenance therapy and needle/syringe programs into prisons. Illicit injection of diphenhydramine, an antihistamine branded as Dimedrol®, has been anecdotally reported as a potential challenge to harm reduction efforts in prisons but has not been studied systematically. Methods We conducted qualitative interviews in Kyrgyz or Russian with prisoners (n = 49), former prisoners (n = 19), and stakeholders (n = 18), including prison administrators and prisoner advocates near Bishkek, Kyrgyzstan from October 2016 to September 2018. Interviews explored social–contextual factors influencing methadone utilization in prisons. Transcripts were coded by five researchers using content analysis. Dimedrol injection emerged as an important topic, prompting a dedicated analysis. Results After drinking methadone, some people in prison inject crushed Dimedrol tablets, a non-prescription antihistamine that is banned but obtainable in prison, to achieve a state of euphoria. From the perspectives of the study participants, Dimedrol injection was associated with devastating physical and mental health consequences, including psychosis and skin infections. Moreover, the visible wounds of Dimedrol injecting contributed to the perception of methadone as a harmful drug and supporting preference for heroin over methadone. Conclusion Dimedrol injecting is a potentially serious threat to harm reduction and HIV prevention efforts in Kyrgyzstan and elsewhere in the Eastern European and Central Asian region and requires further investigation. |
| first_indexed | 2024-12-11T04:32:36Z |
| format | Article |
| id | doaj.art-e171ce957c9b4eefb58f17e6b3670468 |
| institution | Directory Open Access Journal |
| issn | 1477-7517 |
| language | English |
| last_indexed | 2024-12-11T04:32:36Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Harm Reduction Journal |
| spelling | doaj.art-e171ce957c9b4eefb58f17e6b36704682022-12-22T01:20:49ZengBMCHarm Reduction Journal1477-75172020-10-011711910.1186/s12954-020-00435-7A qualitative study of diphenhydramine injection in Kyrgyz prisons and implications for harm reductionJaimie P. Meyer0Gabriel J. Culbert1Lyuba Azbel2Chethan Bachireddy3Ainura Kurmanalieva4Tim Rhodes5Frederick L. Altice6Yale School of Medicine, AIDS ProgramPopulation Health Nursing Science, College of Nursing, University of Illinois at ChicagoYale School of Medicine, AIDS ProgramVirginia Commonwealth University School of MedicineAIDS Foundation East-WestThe London School of Tropical Hygiene and Tropical MedicineYale School of Medicine, AIDS ProgramAbstract Background To reduce opioid dependence and HIV transmission, Kyrgyzstan has introduced methadone maintenance therapy and needle/syringe programs into prisons. Illicit injection of diphenhydramine, an antihistamine branded as Dimedrol®, has been anecdotally reported as a potential challenge to harm reduction efforts in prisons but has not been studied systematically. Methods We conducted qualitative interviews in Kyrgyz or Russian with prisoners (n = 49), former prisoners (n = 19), and stakeholders (n = 18), including prison administrators and prisoner advocates near Bishkek, Kyrgyzstan from October 2016 to September 2018. Interviews explored social–contextual factors influencing methadone utilization in prisons. Transcripts were coded by five researchers using content analysis. Dimedrol injection emerged as an important topic, prompting a dedicated analysis. Results After drinking methadone, some people in prison inject crushed Dimedrol tablets, a non-prescription antihistamine that is banned but obtainable in prison, to achieve a state of euphoria. From the perspectives of the study participants, Dimedrol injection was associated with devastating physical and mental health consequences, including psychosis and skin infections. Moreover, the visible wounds of Dimedrol injecting contributed to the perception of methadone as a harmful drug and supporting preference for heroin over methadone. Conclusion Dimedrol injecting is a potentially serious threat to harm reduction and HIV prevention efforts in Kyrgyzstan and elsewhere in the Eastern European and Central Asian region and requires further investigation.http://link.springer.com/article/10.1186/s12954-020-00435-7AntihistaminesEastern Europe and Central Asia (EECA)HIVInjection drug useMethadonePrisons |
| spellingShingle | Jaimie P. Meyer Gabriel J. Culbert Lyuba Azbel Chethan Bachireddy Ainura Kurmanalieva Tim Rhodes Frederick L. Altice A qualitative study of diphenhydramine injection in Kyrgyz prisons and implications for harm reduction Harm Reduction Journal Antihistamines Eastern Europe and Central Asia (EECA) HIV Injection drug use Methadone Prisons |
| title | A qualitative study of diphenhydramine injection in Kyrgyz prisons and implications for harm reduction |
| title_full | A qualitative study of diphenhydramine injection in Kyrgyz prisons and implications for harm reduction |
| title_fullStr | A qualitative study of diphenhydramine injection in Kyrgyz prisons and implications for harm reduction |
| title_full_unstemmed | A qualitative study of diphenhydramine injection in Kyrgyz prisons and implications for harm reduction |
| title_short | A qualitative study of diphenhydramine injection in Kyrgyz prisons and implications for harm reduction |
| title_sort | qualitative study of diphenhydramine injection in kyrgyz prisons and implications for harm reduction |
| topic | Antihistamines Eastern Europe and Central Asia (EECA) HIV Injection drug use Methadone Prisons |
| url | http://link.springer.com/article/10.1186/s12954-020-00435-7 |
| work_keys_str_mv | AT jaimiepmeyer aqualitativestudyofdiphenhydramineinjectioninkyrgyzprisonsandimplicationsforharmreduction AT gabrieljculbert aqualitativestudyofdiphenhydramineinjectioninkyrgyzprisonsandimplicationsforharmreduction AT lyubaazbel aqualitativestudyofdiphenhydramineinjectioninkyrgyzprisonsandimplicationsforharmreduction AT chethanbachireddy aqualitativestudyofdiphenhydramineinjectioninkyrgyzprisonsandimplicationsforharmreduction AT ainurakurmanalieva aqualitativestudyofdiphenhydramineinjectioninkyrgyzprisonsandimplicationsforharmreduction AT timrhodes aqualitativestudyofdiphenhydramineinjectioninkyrgyzprisonsandimplicationsforharmreduction AT fredericklaltice aqualitativestudyofdiphenhydramineinjectioninkyrgyzprisonsandimplicationsforharmreduction AT jaimiepmeyer qualitativestudyofdiphenhydramineinjectioninkyrgyzprisonsandimplicationsforharmreduction AT gabrieljculbert qualitativestudyofdiphenhydramineinjectioninkyrgyzprisonsandimplicationsforharmreduction AT lyubaazbel qualitativestudyofdiphenhydramineinjectioninkyrgyzprisonsandimplicationsforharmreduction AT chethanbachireddy qualitativestudyofdiphenhydramineinjectioninkyrgyzprisonsandimplicationsforharmreduction AT ainurakurmanalieva qualitativestudyofdiphenhydramineinjectioninkyrgyzprisonsandimplicationsforharmreduction AT timrhodes qualitativestudyofdiphenhydramineinjectioninkyrgyzprisonsandimplicationsforharmreduction AT fredericklaltice qualitativestudyofdiphenhydramineinjectioninkyrgyzprisonsandimplicationsforharmreduction |