Papers by Wilson Palacios
Substance Abuse Treatment, Prevention, and Policy
Background Medications for opioid use disorder (MOUD; methadone, buprenorphine, naltrexone) are t... more Background Medications for opioid use disorder (MOUD; methadone, buprenorphine, naltrexone) are the most effective treatments for OUD, and MOUD is protective against fatal overdoses. However, continued illegal drug use can increase the risk of treatment discontinuation. Given the widespread presence of fentanyl in the drug supply, research is needed to understand who is at greatest risk for concurrent MOUD and drug use and the contexts shaping use and treatment discontinuation. Methods From 2017 to 2020, Massachusetts residents with past-30-day illegal drug use completed surveys (N = 284) and interviews (N = 99) about MOUD and drug use. An age-adjusted multinomial logistic regression model tested associations between past-30-day drug use and MOUD use (current/past/never). Among those on methadone or buprenorphine (N = 108), multivariable logistic regression models examined the association between socio-demographics, MOUD type; and past-30-day use of heroin/fentanyl; crack; benzodiaz...
Harm Reduction Journal
Background People who experience non-fatal overdose (NFOD) are at high risk of subsequent overdos... more Background People who experience non-fatal overdose (NFOD) are at high risk of subsequent overdose. With unprecedented increases in fentanyl in the US drug supply, many Massachusetts (MA) communities have seen a surge in opioid-related overdoses. The objective of this study was to determine factors associated with lifetime and past year NFOD in at-risk MA communities. Methods We conducted multiple rapid assessments among people who use drugs (PWUD) in eight MA communities using non-probability sampling (purposive, chain referral, respondent-driven) methods. We collected sociodemographic, substance use, overdose history, substance use treatment, and harm reduction services utilization data. We examined the prevalence of NFOD (lifetime and past year) and identified factors associated with NFOD through multivariable logistic regression analyses in a subset of 469 study participants between 2017 and 2019. Results The prevalence of lifetime and last year non-fatal opioid overdose was 62....
Criminology & Public Policy
Research Summary: Using a national survey experiment, we examined Americans’ national and local‐l... more Research Summary: Using a national survey experiment, we examined Americans’ national and local‐level support for facilities that provide a safer space for individuals to consume illicit drugs under the supervision of medical professionals. We determined whether support levels differed based on (1) the label used to refer to such facilities (“safe injection facilities” vs. “overdose prevention sites”), (2) whether beneficial information is provided about these facilities regarding either a crime control framework or a public health framework, or not. We also considered how national support differed from local‐level support, and how national or local‐level perceptions of the opioid epidemic influenced support.Policy Implications: We found that the label used to refer to these facilities was the most important factor influencing support levels. The public was also much more supportive of these facilities at the national level than at the local level, which suggests that support for th...
Drug and Alcohol Dependence, 2013
Background-Law enforcement is often the first to respond to medical emergencies in the community,... more Background-Law enforcement is often the first to respond to medical emergencies in the community, including overdose. Due to the nature of their job, officers have also witnessed firsthand the changing demographic of drug users and devastating effects on their community associated with the epidemic of nonmedical prescription opioid use in the United States. Despite this seminal role, little data exist on law enforcement attitudes toward overdose prevention and response. Methods-We conducted key informant interviews as part of a 12-week Rapid Assessment and Response (RAR) process that aimed to better understand and prevent nonmedical prescription opioid use and overdose deaths in locations in Connecticut and Rhode Island experiencing
AIDS and Behavior, 2013
Increases in drug abuse, injection, and opioid overdoses in suburban communities led us to study ... more Increases in drug abuse, injection, and opioid overdoses in suburban communities led us to study injectors residing in suburban communities in southwestern Connecticut, US. We sought to understand the influence of residence on risk and injection-associated diseases. Injectors were recruited by respondent-driven sampling and interviewed about sociodemographics, somatic and mental health, injection risk, and interactions with healthcare, harm reduction, substance abuse treatment, and criminal justice systems. HIV, hepatitis B and C (HBV and HCV) serological testing was also conducted. Our sample was consistent in geographic distribution and age to the general population and to the patterns of heroin-associated overdose deaths in the suburban towns. High rates of interaction with drug abuse treatment and criminal justice systems contrasted with scant use of harm reduction services. The only factors associated with both dependent variablesresidence in less disadvantaged census tracts and more injection risk-were younger age and injecting in one's own residence. This contrasts with the common association among urban injectors of injection-associated risk behaviors and residence in disadvantaged communities. Poor social support and moderate/severe depression were associated with risky injection practices (but not residence in specific classes of census tracts), suggesting that a region-wide dual diagnosis approach to the expansion of harm reduction services could be effective at reducing the negative consequences of injection drug use.
Journal of Qualitative Criminal Justice & Criminology, 2013
Background: Law enforcement is often the first to respond to medical emergencies in the community... more Background: Law enforcement is often the first to respond to medical emergencies in the community, including overdose. Due to the nature of their job, officers have also witnessed first-hand the changing demographic of drug users and devastating effects on their community associated with the epidemic of nonmedical prescription opioid use in the United States. Despite this seminal role, little data exist on law enforcement attitudes toward overdose prevention and response. Methods: We conducted key informant interviews as part of a 12-week Rapid Assessment and Response (RAR) process that aimed to better understand and prevent nonmedical prescription opioid use and overdose deaths in locations in Connecticut and Rhode Island experiencing overdose "outbreaks." Interviews with 13 law enforcement officials across three study sites were analyzed to uncover themes on overdose prevention and naloxone. Results: Findings indicated support for law enforcement involvement in overdose prevention. Hesitancy around naloxone administration by laypersons was evident. Interview themes highlighted officers' feelings of futility and frustration with their current overdose response options, the lack of accessible local drug treatment, the cycle of addiction, and the pervasiveness of easily accessible prescription opioid medications in their communities. Overdose prevention and response, which for some officers included law enforcement-administered naloxone, were viewed as components of community policing and good police-community relations. Conclusion: Emerging trends, such as existing law enforcement medical interventions and Good Samaritan Laws, suggest the need for broader law enforcement engagement around this pressing public health crisis, even in suburban and small town locations, to promote public safety.
Increases in drug abuse, injection, and opioid overdoses in suburban communities led us to study ... more Increases in drug abuse, injection, and opioid overdoses in suburban communities led us to study injectors residing in suburban communities in southwestern Connecticut, US. We sought to understand the influence of residence on risk and injection-associated diseases. Injectors were recruited by respondent-driven sampling and interviewed about sociodemographics, somatic and mental health, injection risk, and interactions with healthcare, harm reduction, substance abuse treatment, and criminal justice systems. HIV, hepatitis B and C (HBV and HCV) serological testing was also conducted. Our sample was consistent in geographic distribution and age to the general population and to the patterns of heroin-associated overdose deaths in the suburban towns. High rates of interaction with drug abuse treatment and criminal justice systems contrasted with scant use of harm reduction services. The only factors associated with both dependent variables-residence in less disadvantaged census tracts and more injection risk-were younger age and injecting in one's own residence. This contrasts with the common association among urban injectors of injection-associated risk behaviors and residence in disadvantaged communities. Poor social support and moderate/severe depression were associated with risky injection practices (but not residence in specific classes of census tracts), suggesting that a region-wide dual diagnosis approach to the expansion of harm reduction services could be effective at reducing the negative consequences of injection drug use.
This article explores police use of force and its aftermath by focusing on the immediacy of polic... more This article explores police use of force and its aftermath by focusing on the immediacy of police-citizen interactions via an autoethnographic account that invokes the concept of criminological verstehen. Specifically, the article explores issues of constructed meaning via Yuen's interpretive constructs of 'safe spaces' and 'creative analytic practice' as a way of coming to terms with the first author's lived experience of police brutality and its consequent legal process. Based on document analysis of official records such as police citations, medical files, and court transcripts, along with media accounts and the first author's personal notes, the process of memoing provides an immersion into and an exploration of the data, and a tool for ascertaining meaning from it. Resultant themes of presentation of self, identity accomplishment, and silence are discussed in relation to the sorts of experiences and emotions necessary to a verstehen-oriented victimology. The article concludes with a discussion of the implications of this exercise in criminological verstehen.
Analyses of the impact on sentencing when alcohol and drug-related mitigation is used in the sent... more Analyses of the impact on sentencing when alcohol and drug-related mitigation is used in the sentencing phases of capital murder trials is virtually absent from the existing literature. The present study addresses this by exploring the effect of having mitigation with alcohol and drug themes accepted in a large sample (n = 804) of capital murder trials in North Carolina. Logistic regression analyses that include a number of relevant control variables reveal no substantive impacts of having alcohol mitigation accepted by capital murder juries, but drug mitigators that were either accepted or rejected by juries were associated with an increased risk of receiving a death sentence. Possible reasons for the results and their implications are discussed and suggestions are made for further study of the effects of alcohol/drug mitigation in capital trials.
Journal of Substance Abuse Treatment, 1999
This exploratory study was conducted with the purpose of enumerating both particular social stres... more This exploratory study was conducted with the purpose of enumerating both particular social stressors (e.g., the presence of trauma) and the incidence of a comorbid diagnosis (i.e., personality disorder[s] and substance abuse) on a sample of women in a residential therapeutic community. The women in the study were assessed within the first 3 weeks following admission into drug treatment, and then again 6 months after leaving the program.
The research literature on intimate partner violence (IPV) has documented a number of poignant fa... more The research literature on intimate partner violence (IPV) has documented a number of poignant facts that serve as the foundation for this study. First, IPV is prevalent, frequent, and often repetitive. Moreover, repetitive violence within an intimate relationship tends to escalate over time, both in its frequency of occurrence and in its severity. We also know that decisions to leave the relationship do not guarantee that the violence will end. In addition, the phenomenon of ''mutual combatancy,'' prevalent in many intimate partner relationships, suggests that both parties in this
A growing body of recent research has identified that "rave" attendees are at high risk for the u... more A growing body of recent research has identified that "rave" attendees are at high risk for the use of "club drugs," such as 3,4-methylenedioxymethamphetamine (MDMA or "ecstasy"). Rave attendees, however, comprise only one of several club-going populations. In the current study, we explore the prevalence of ecstasy and other club drug (EOCD) use among a sample of club attendees in Washington, DC. Data were collected from adult, primarily homosexual, club attendees during the summer of 2003. Data collection was scheduled between 11 p.m. and 3 a.m. Participation rates were high. Of 41 Ó 2004, Baywood Publishing Co., Inc.
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Papers by Wilson Palacios