Community reentry challenges after release from prison among people who inject drugs in St. Petersburg, Russia
International Journal of Prisoner Health
ISSN: 1744-9200
Article publication date: 21 September 2015
Abstract
Purpose
Little is known about the context of the post-release risk environment among formerly incarcerated people who inject drugs (PWID) in Russia. The purpose of this paper is to explore these challenges as they relate to reentry, relapse to injection opioid use, and overdose.
Design/methodology/approach
The authors conducted 25 in-depth semi-structured interviews among PWID living in St Petersburg, Russia who had been incarcerated within the past two years. Participants were recruited from street outreach (n=20) and a drug treatment center (n=5).
Findings
Emergent themes related to the post-release environment included financial instability, negative interactions with police, return to a drug using community, and reuniting with drug using peers. Many respondents relapsed to opioid use immediately after release. Those whose relapse occurred weeks or months after their release expressed more motivation to resist. Alcohol or stimulant use often preceded the opioid relapse episode. Among those who overdosed, alcohol use was often reported prior to overdosing on opioids.
Practical implications
Future post-release interventions in Russia should effectively link PWID to social, medical, and harm reduction services. Particular attention should be focussed on helping former inmates find employment and overdose prevention training prior to leaving prison that should also cover the heightened risk of concomitant alcohol use.
Originality/value
In addition to describing a syndemic involving the intersection of incarceration, injection drug use, poverty, and alcohol abuse, the findings can inform future interventions to address these interrelated public health challenges within the Russian setting.
Keywords
Acknowledgements
The authors gratefully acknowledge support from the National Institutes of Health (F31DA03570901, 5R01DA02988804, 5T32MH020031 and 2P30MH06229411, 5D43TW00102814). The authors also thank Roman Skochilov, Artem Kopelev, and Natalia Posokhova for help with various aspects related to interpretation and translation. Finally, the authors thank all participants in the study. The National Institutes of Health did not have a role in the study design, conduct, or reporting of results.
Citation
Cepeda, J.A., Vetrova, M.V., Lyubimova, A.I., Levina, O.S., Heimer, R. and Niccolai, L.M. (2015), "Community reentry challenges after release from prison among people who inject drugs in St. Petersburg, Russia", International Journal of Prisoner Health, Vol. 11 No. 3, pp. 183-192. https://doi.org/10.1108/IJPH-03-2015-0007
Publisher
:Emerald Group Publishing Limited
Copyright © 2015, Emerald Group Publishing Limited