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- Holmén, Elin, et al.
(författare)
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Take-Home Naloxone and risk management from the perspective of people who survived an opioid overdose in Stockholm — An analysis informed by drug, set and setting
- 2023
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Ingår i: International journal of drug policy. - 0955-3959 .- 1873-4758. ; 115
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Tidskriftsartikel (refereegranskat)abstract
- Background: Take-Home Naloxone (THN) programs were introduced in Sweden in 2018 —a country with one of the highest rates of overdose mortality in the EU and a severe stigmatisation of people who inject drugs. This qualitative study builds on the international research that has expanded a previously narrow and medical focus on overdose deaths. It uses Zinberg’s framework to look beyond the role of the “drug ”to include the attitudes and personality of the person ( “set ”) and contextual factors ( “setting ”). This study explores the impacts of THN from the perspective of overdose survivors. Methods: Between November 2021 and May 2022 semi-structured interviews were conducted with 22 opioid overdose survivors, recruited among clients of the Stockholm needle and syringe program. All the participants had been treated with naloxone in an overdose situation. The interviews were processed through thematic analysis using deductive and inductive coding in accordance with the theoretical framework. Results: Interviewees included men and women who used different types of drugs. THN has impacted on “drug ”in terms of naloxone-induced withdrawal symptoms and peers having to deal with survivors’ emotions. Exploring “set ”revealed feelings of shame following naloxone revival for the person who overdosed. Despite such reactions, participants retained an overwhelmingly positive attitude towards THN. Participants integrated THN into their risk management practices ( “setting ”) and some acknowledged that THN provided a new way to treat overdoses without necessarily needing to interact with authorities, especially the police. Conclusion: The THN program has influenced “drug, set and setting ”for participants, providing increased safety at drug-intake and transferring overdose management and the burden of care to the community. The lived experi- ence of participants also exposes the limitations of THN indicating that there are additional unmet needs beyond THN programs, particularly in terms of “setting ”.
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| 3. |
- Löfroth, Hjördis, et al.
(författare)
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Challenges in slope stability assessment of contaminated fibrous sediments along the northern Baltic coast of Sweden
- 2021
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Ingår i: Engineering Geology. - : Elsevier BV. - 0013-7952 .- 1872-6917. ; 289
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Tidskriftsartikel (refereegranskat)abstract
- In several locations along Sweden's northern Baltic coast there are deposits of contaminated fibrous sediments that are known as fiberbanks. Historically, these anthropogenic fiberbanks and associated contaminants were formed outside pulp and paper factories because of unregulated waste discharges. Some of the fiberbanks are located on seafloor slopes that are unstable and may fail, which could result in large amounts of fiber and contaminant dispersion. Hydroacoustic surveys have revealed that some parts of the fiberbanks have been dispersed to a wider area by submarine landslides. However, the unusual nature of these cellulose-rich sediments makes it difficult to apply conventional techniques for assessing submarine slope stability. Therefore, a combination of investigation techniques and interpretation methods was tested to assess the stability and triggering mechanisms for submarine slope failure identified in fiberbanks from the Ångermanälven river estuary on the Baltic sea coast. The integration of bathymetric data, sediment lithology and geotechnical characteristics from in-situ and laboratory measurements, enabled the characterisation of underlying natural sediments and the fiberbanks at two sites. Despite low densities, which indicate that the fiberbank material is near the buoyancy level, the fiberbank deposits seem to be relatively stable. Our results indicate the underlying natural sediments are also stable and would require an external triggering mechanism to generate the observed slope failures. We suggest that pore water pressure, potentially related to groundwater table fluctuations, may be an important trigger for submarine landslides in the study area.Management of fiberbanks and associated fiber-rich sediments, which are numerous along Sweden's north east coast, requires that sites are risk assessed and prioritized for remediation. To do so, under water slope stability should be considered as a possible dispersion pathway and therefore needs to be investigated. The study illustrates the value of using a combination of geophysical and geotechnical field and laboratory methods, together with empirical relationships, to assess relevant input parameters for slope stability calculations for this type of sediment.
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