1. Conducting Research in the “Real” World
Laurie A. Drapela, Ph.D.
Washington State University Vancouver
March 7th, 2002

2. The Size of the Problem

3. The Research Question
: Sharp increase in heroin deaths (Multnomah County)
RAP – Recovery Association Project
Advocacy organization: housing for persons in recovery from opiate addiction
Approaches Multnomah County Board of Commissioners (BCC)
DO SOMETHING ABOUT THIS!!!!

4. Methodology Two approaches: Quantitative data
How many heroin deaths are there?
Who is dying from heroin overdose?
Qualitative data
How do heroin overdoses occur?
Mark:
I also mentioned ADAM data (Arrestee Drug Abuse Monitoring Program) and DAWN data (Drug Abuse Warning Network).
I mentioned these in the course of discussion with students about how we could find out the prevalence of drug use in Multnomah County.

5. Fatal Overdose Profile (N=99)
Males: 74%
White: 92%
Ages 35-45: 54% long term users
Criminal Justice System Involvement: Approximately 25% of persons were on probation or parole at the time of death.

6. Ethnographic Investigation
How do heroin overdoses occur?
Subjects & Setting
Portland, Oregon
10 current heroin users
8 former users
4 narcotics officers

7. Market Factors Heroin is cheap! Potency is highly variable
Across dealers
Within a given dealer across time
Within a given batch of black tar heroin
We talked about how the fact that Portland is exclusively a black tar heroin market and how black tar heroin is processed.
“stepped on” = slang referring to the fact that batches of BTH are often remixed as they move up the coast from Mexico.

8. The Results Heroin OD’s (ME Records; Quantitative) Qualitative
Mostly older white males
Deaths: mostly at home. Only 1 in 6 occurs in a public place
Polydrug is a problem: 36% of overdoses!
Qualitative
Many users are afraid to call when witnessing an overdose
Benzos
Jail/treatment

9. Short-Term Recommendations
To the Medical Examiner:
Revise toxicology screening
Better document polydrug use in heroin overdose deaths
To the Medical Community:
Bulletin to the medical community
Be conservative when prescribing benzodiazepines! Ask about drug history!

10. Harm Reduction
Accepts, for better and for worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them. (

11. To the User Population:
Shoot straight: no chasers
Know your dope
Don’t shoot up alone
Control your kit
You can always do more, but you can never do less
ID an OD
9-1-1 is a safe call
To the Police:
Greater police discretion re: arrest for PCS