Dr. Stephen Lankenau recently joined the School of Public Health as an associate professor in the Department of Community Health and Prevention. He brings with him major grants to research prescription drug use by high-risk youth and prevention programs for injection drug users. The research will help fill important gaps in the epidemiological literature in these areas.
The first study, which is called “Non-Medical Prescription Drug Use Among High-Risk Youth,” is funded by the National Institute on Drug Abuse and will compare high-risk youth in New York and Los Angeles who are currently engaged in non-medical prescription drug use. According to Dr. Lankenau, substantial evidence suggests that the diversion of prescription drugs for non-medical use accounts for a rapidly increasing share of substances of abuse, particularly among high-risk youth and young adult populations. Yet, there is a scarcity of information about the use of these drugs, including what the substances are, how they are administered, and why they are initiated. Much of the available data on non-medical prescription drugs, which includes opioids, CNS depressants and stimulants, is limited to survey data and older populations of users. Descriptive data is lacking about the non-medical use of prescription drugs among high-risk youth populations.
The study is designed to help inform the development of a curriculum for community-based organizations aimed at reducing such drug use. The results of the study will also help to fill a critical gap in the epidemiological literature on non-medical prescription drug use among high-risk youth who are at risk for negative health outcomes, including drug dependence, drug overdose, violence, victimization, and exposure to bloodborne pathogens.
The second study, entitled “Evaluation of Overdose Prevention Programs for Injection Drug Users,” will investigate changes in overdose response and other drug-related health behaviors among injection drug users (IDU) participating in two overdose prevention programs in Los Angeles.
Drug overdose is the single greatest cause of mortality among injection drug users in the United States. Fatal heroin overdoses cause more than half of all deaths among IDUs, which far exceeds the proportion of deaths due to AIDS or other causes. Administration of heroin or other opioids via intravenous route increases the risk for HIV and other blood-borne pathogens, and also significantly increases the risk of a potentially fatal overdose.
A heroin overdose can be safely reversed with the administration of naloxone (brand name Narcan) – a legal, nonscheduled opioid antagonist. Naloxone is currently prescribed and distributed by overdose prevention programs (OPP) in 15 states. Despite the common-sense notion that these programs “work,” scientifically designed evaluations of OPPs are almost non-existent, and outcomes are still poorly defined.
Data from the study will be collected as part of an existing protocol started in January 2009, to document behaviors in response to witnessed overdoses and circumstances precipitating requests for refills of naloxone. In addition, in-depth interviews will explore rationales for and barriers to enrolling in overdose prevention training, the effects of training participation, differences between training programs, and the effects of participating in an overdose rescue.
The studies are funded by federal grants that total more approximately $1 million.
Dr. Lankenau is a sociologist who combines public health concerns and ethnographic methods to the study of high-risk youth, out-of-treatment drug users, homelessness and HIV/AIDS. He teaches graduate and undergraduate courses that apply qualitative methods to the study of public health issues. Dr. Lankenau received a Ph.D. from the University of Maryland and a postdoctoral fellowship funded by NIDA. He has held faculty appointments at Columbia University’s Mailman School of Public Health and the University of Southern California’s Keck School of Medicine.