ArticleAddiction (Abingdon, England)2023
Safety in solitude? Competing risks and drivers of solitary drug use among women who inject drugs and implications for overdose detection.
Article in Addiction (Abingdon, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed.
- Health Harms Associated With Forced Displacements Among People Who Use Drugs in San Francisco, California.Substance use & addiction journal · 2026Article
- 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
- "You've involved us knowing that we don't think about the law like you": a qualitative study on Supersavers' perspective of overdose engagement in Skåne county, South Sweden.Harm reduction journal · 2026Article
- Syringe service program utilization, behavioral, and experiential factors associated with greater naloxone protection in a longitudinal cohort of people who use illicit opioids in New York city.Harm reduction journal · 2026Article
- Dying younger, dying of overdose: gendered and age dimensions of mortality and shelter service access among individuals experiencing homelessness in Toronto, Canada.BMC public health · 2026Article
- Out of Sight: Sex Differences in Public and Semi-Public Drug Use Settings Among People Who Use Opioids in Baltimore, Maryland.International journal of environmental research and public health · 2026Article
- Feasibility and Acceptability of Restroom Motion Sensors for Detecting Overdoses.Substance use & addiction journal · 2026Article
- Perceptions and Experiences of Xylazine, Disparities in Xylazine Awareness, and Correlates of Xylazine-Attributed Wounds Among People Who Use Opioids.International journal of environmental research and public health · 2026Article
- Syringe Service Program Utilization, Behavioral, and Experiential Factors Associated with Greater Naloxone Protection in a Longitudinal Cohort of People Who Use Illicit Opioids in New York City.Research square · 2025Article
- Emergency medical system response, emergency department visits, and hospital admissions in response to non-fatal opioid overdoses reported by a cohort of overdose survivors in San Francisco and Boston, 2019 - 2022.Drug and alcohol dependence reports · 2025Article
- "I think that that really could benefit a lonely user:" perceptions of overdose response hotlines among people who use opioids.Harm reduction journal · 2025Article
- Qualitative insights into drug use safety strategies and social support among sexual minority women who inject drugs in Baltimore, Maryland.Harm reduction journal · 2025Article
- "It's something we're connected to": Acceptability and adoption of overdose detection technologies implemented in San Francisco permanent supportive housing.Journal of substance use and addiction treatment · 2025Article
- Predictors of overdose response hotline use for mental health and fatal overdose prevention.Canadian journal of public health = Revue canadienne de sante publique · 2025Article
- Decriminalization undone: Assessing the amendment to British Columbia's decriminalization of personal drug possession framework.Canadian journal of public health = Revue canadienne de sante publique · 2025Article
- The Police Opioid Seizure Temporal Risk (POSTeR) model of increased exposure to fatal overdose.The International journal on drug policy · 2025Article
- Time-space characteristics of emergency medical service attendance and layperson naloxone administration during non-fatal opioid overdoses in Rhode Island: A retrospective, event-level analysis.Annals of epidemiology · 2025Article
- Using illicit drugs alone in Vancouver, Canada: a gender-based analysis.Substance abuse treatment, prevention, and policy · 2025Article
- Binge Drug Injection in a Cohort of People Who Inject Drugs in Montreal: Characterizing the Substances and Social Contexts Involved.International journal of mental health and addiction · 2025Article
- Perspectives of key interest groups regarding supervised Consumption sites (SCS) and novel virtual harm reduction services / overdose response hotlines and applications: a qualitative Canadian study.Harm reduction journal · 2024Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
BACKGROUND AND
aimsSolitary drug use (SDU) can amplify risks of fatal overdose. We examined competing risks and drivers of SDU, as well as harm reduction strategies implemented during SDU episodes, among women who inject drugs (WWID).
designA cross-sectional qualitative study, including telephone and face-to-face in-depth interviews.
settingBaltimore City, MD, USA.
participantsTwenty-seven WWID (mean age = 39 years, 67% white, 74% injected drugs daily) recruited via outreach and street intercept (April-September 2021). MEASUREMENTS: Interviews explored the physical (i.e. indoor/private, outdoor/public) and social (i.e. alone, accompanied) risk environments in which drug use occurred. Guided by the principles of emergent design, we used thematic analysis to interrogate textual data, illuminating women's preferences/motivations for SDU and strategies for minimizing overdose risks when using alone.
findingsMany participants reported experiences with SDU, despite expressed preferences for accompanied drug use. SDU motivations clustered around three primary drivers: (1) avoiding opioid withdrawal, (2) preferences for privacy when using drugs and (3) safety concerns, including threats of violence. Participants nevertheless acknowledged the dangers of SDU and, at times, took steps to mitigate overdose risk, including naloxone possession, communicating to peers when using alone ('spotting') and using drugs in public spaces.
conclusionsWWID appear to engage frequently in SDU due to constraints of the physical and social environments in which they use drugs. They express a preference for accompanied drug use in most cases and report implementing strategies to mitigate their overdose risk, especially when using drugs alone.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.