ArticleThe International journal on drug policy2020
Circumstances of overdose among street-involved, opioid-injecting women: Drug, set, and setting.
Article in The International journal on drug policy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 24 citations in OpenAlex.
- The Drug Market's Impact on the Overdose Risk Environment for Women Who Use Drugs During the COVID-19 Pandemic.Journal of urban health : bulletin of the New York Academy of Medicine · 2026Article
- Article
- Mechanisms of overdose from unintentional fentanyl use when intending to use stimulants: a qualitative study of people who use stimulants and avoid opioids.Research square · 2026Article
- What are set and setting: Reducing vagueness to improve research and clinical practice.Journal of psychopharmacology (Oxford, England) · 2025Article
- "I don't know how you can overdose smoking them:" Perceptions of overdose risks among persons who use illicit fentanyl-laced counterfeit pills.The International journal on drug policy · 2025Article
- Facilitators of and obstacles to practitioners' adoption of harm reduction in cannabis use: a scoping review.Harm reduction journal · 2024Article
- Towards a New Dynamic Interaction Model of Adolescent CUD Manifestation, Prevention, and Treatment: A Narrative Review.Psychoactives · 2023Article
- Specific polysubstance use patterns predict relapse among patients entering opioid use disorder treatment.Drug and alcohol dependence reports · 2022Article
- COVID-19 economic impact payments and opioid overdose deaths.The International journal on drug policy · 2022Observational
- Trends in Mortality From Novel Psychoactive Substances as "Legal Highs": Gender Differences in Manner of Death and Implications for Risk Differences for Women.Frontiers in psychiatry · 2022Article
- Miscarriage and Abortion Among Women Attending Harm Reduction Services in Philadelphia: Correlations With Individual, Interpersonal, and Structural Factors.Substance use & misuse · 2022Article
- Characteristics and correlates of U.S. clinicians prescribing buprenorphine for opioid use disorder treatment using expanded authorities during the COVID-19 pandemic.Drug and alcohol dependence · 2021Article
- Circumstances of overdose among suburban women who use opioids: Extending an urban analysis informed by drug, set, and setting.The International journal on drug policy · 2021Article
- The Association of Drug-Use Characteristics and Active Coping Styles With Positive Affect in Patients With Heroin-Use Disorder and Methamphetamine-Use Disorder During the COVID-19 Pandemic.Frontiers in public health · 2021Article
- Layperson reversal of opioid overdose supported by smartphone alert: A prospective observational cohort study.EClinicalMedicine · 2020Article
- COVID-19, mental health, and opioid use disorder: Old and new public health crises intertwine.Psychological trauma : theory, research, practice and policy · 2020Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
introductionCurrent discourses about the causes of the overdose crisis largely focus on the harmful effects of drugs. Prior research, however, indicates that drug use experience is shaped by complex interactions of drugs with physiological and mental "sets" of people who use drugs and the wider social and physical "setting." Zinberg's "drug, set, and setting" theoretical framework was applied to identify patterns in circumstances leading up to women's overdose.
methodsIn-depth semi-structured interviews were conducted with 29 opioid-injecting street-involved women, clients of a Philadelphia harm reduction program. Qualitative analysis with deductive and inductive coding was utilized to examine transcripts for theory-driven and emerging themes.
resultsTen out of 29 women attributed their overdose to "drugs," reporting the unpredictable quality of street opioids, concurrent use of benzodiazepines, or chasing the "high." Thirteen women reported "set" as a type of circumstance where their emotional states were affected by a "good" or "bad" day, leading them to unusual drug consumption practices. Six women described "setting" type of circumstances where their overdose was preceded by a recent change in context, such as release from prison, which prompted unsafe drug use to address physiological or psychological dependence on drugs.
conclusionWhile all overdoses result from the pharmacological action of drugs, some overdoses were triggered by circumstances occurring in women's set or setting. Overdose prevention policies should embrace not only individual-level behavioral interventions, but also structural measures to address stress, social isolation, and risky drug use contexts that plague the lives of street-involved women who inject opioids.
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Registered trials
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