Injection Opioid and Injection Methamphetamine Use in the Rural United States: A Systematic Review and Network Analysis

• Author: Kimberly A. Tyler,Kirk Dombrowski,Luke Michael Novack,Kimberly Gocchi Carrasco,Patrick Habecker
• Date: 01 April 2020
• DOI: 10.1177/0022042619895247
• Published date: 01 April 2020
• Subject Matter: Articles

https://doi.org/10.1177/0022042619895247

Journal of Drug Issues

2020, Vol. 50(2) 127 –141

© The Author(s) 2019

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DOI: 10.1177/0022042619895247

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Article

Injection Opioid and Injection

Methamphetamine Use in the

Rural United States: A Systematic

Review and Network Analysis

Luke Michael Novack1, Kimberly Gocchi Carrasco1,

Kimberly A. Tyler1, Kirk Dombrowski1,

and Patrick Habecker1

Abstract

The abuse of opioid and methamphetamine is a public health crisis in the United States,

particularly in rural areas where injection drug use is common. This systematic review of rural

injection drug use synthesized the research on injection of opioids and methamphetamine use

and assessed the similarity of their research findings to the field of rural injection drug use in

the United States. A citation network analysis was used to support the assessment of research

similarity and provided a visualization of the field. This citation network analysis exposed a gap

in the literature revealing that the state of research may not be fully applicable to the field in its

entirety in the United States. In summary, this review provides a representative overview of the

state of research in the field of injection drug use. Future research should conduct studies on

rural drug use in areas of the country not represented in this review.

Keywords

opioids, methamphetamine, rural drug use, injection drug use, networks

Introduction

The abuse of opioids has become increasingly more problematic in the United States with signifi-

cant increases in overdoses since 1999, according to the Centers for Disease Control and

Prevention (CDC) and the Drug Enforcement Administration (DEA) (CDC, 2017a; DEA, 2016,

2017). Much of rural opioid abuse takes place in Appalachia, where poor economic opportunity

as a result of deindustrialization and a loss of blue-collar jobs encouraged the operation of pill

mills that sold prescription opioids (POs) such as OxyContin which cemented the drug’s status

as the drug of choice in the region. These pill mills and legitimate pharmacies that filled prescrip-

tions made OxyContin a drug that was readily available to individuals who wanted the drug to

deal with physical and psychological pain (Dasgupta et al., 2018; Okie, 2010, 2011). The National

Institute on Drug Abuse (NIDA, 2018) has defined opioids as a class of drugs that include “pre-

scription pain relievers, heroin, and synthetic opioids such as fentanyl.” The DEA (2017) reported

1University of Nebraska–Lincoln, NE, USA

Corresponding Author:

Luke Michael Novack, Department of Sociology, University of Colorado Boulder, Ketchum 482, Boulder, CO 80309,

USA.

Email: Luke.Novack@colorado.edu

895247JODXXX10.1177/0022042619895247Journal of Drug IssuesNovack et al.

research-article2019