Аннотация:
This article describes the drug epidemics waves theory as well as the subcultural evolution theory of drug use, which allows to explain these waves’ dynamics and describe socio-psychological mechanisms of succession in formation of new generations of drug users. According to this theory, each drug wave (epidemic) consists of four phases: incubation – genesis of a drug’s fashion in some narrow subculture; expansion – rapid growth of the drug’s popularity in a broader population; plateau – the most widespread use of the drug; decline – the drug reputation becomes so bad that the number of its new users rapidly falls. The fall of the drug’s reputation is accompanied by stigmatization of the drug, its users and consequences of its use. The data from a pilot project on young hard drug users in Saint-Petersburg are also presented to illustrate this theory. Thirty-nine structured interviews were conducted. 70% of the respondents used only stimulants in the past month (including novel psychoactive substances (NPS)) and only 18% of the respondents had an episodic experience of opioid use sometime in their life. The pilot study data are consistent with the subcultural evolution theory of drug use, which is expressed in a high level of stigmatization by young people who use drugs (PWUD) of opioid users as well as people living with HIV (PLWH) or hepatitis C virus (HCV), as these diseases are strongly associated with intravenous drug use. Thus, almost two thirds of the respondents felt some degree of aversion to opioids users, around a half of them reported aversion to PLWH and about three quarters felt aversion to HCV-positive people. A hypothesis is proposed that currently two epidemics in St-Petersburg are observed: a declining opioid epidemic and a NPS epidemic which is at a high level. New large-scale studies are needed for confirming or rejection of this hypothesis.
Ключевые слова:
people who inject drugs (PWID), people who used drugs (PWUD), opioids, HIV, HCV, Russia, mixed-methods study, young drug users.