{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:33:36Z","timestamp":1788780816498,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,3,28]],"date-time":"2013-03-28T00:00:00Z","timestamp":1364428800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess heroin injectors' perceptions of and responses to a warning issued by public health officials regarding high\u2010potency heroin and increases in fatal overdoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Semi\u2010structured qualitative interviews.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Vancouver, Canada.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Eighteen active heroin injectors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Semi\u2010structured interview guide focussing on heroin injectors' perceptions of and responses to the overdose warning, including reasons for failing to adhere to risk reduction recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Although nearly all participants were aware of the warning, their recollections of the message and the timing of its release were obscured by on\u2010going social interactions within the drug scene focussed on heroin quality. Many injection drug users reported seeking the high potency heroin and nearly all reported no change in overdose risk behaviours. Responses to the warning were shaped by various social, economic and structural forces that interacted with individual behaviour and undermined efforts to promote behavioural change, including sales tactics employed by dealers, poverty, the high cost and shifting quality of available heroin, and risks associated with income\u2010generating activities. Individual\u2010level factors, including emotional suffering, withdrawal, entrenched injecting routines, perceived invincibility and the desire for intense intoxication also undermined risk reduction messages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among heroin injectors in British Columbia, a 2011 overdose warning campaign appeared to be of limited effectiveness and also produced unintended negative consequences that exacerbated overdose risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.12151","type":"journal-article","created":{"date-parts":[[2013,3,28]],"date-time":"2013-03-28T17:57:16Z","timestamp":1364493436000},"page":"1270-1276","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["\u2018It's more about the heroin\u2019: injection drug users' response to an overdose warning campaign in a Canadian setting"],"prefix":"10.1111","volume":"108","author":[{"given":"Thomas","family":"Kerr","sequence":"first","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS  Vancouver BC Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Will","family":"Small","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS  Vancouver BC Canada"},{"name":"Faculty of Health Sciences Simon Fraser University  Burnaby BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Hyshka","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS  Vancouver BC Canada"},{"name":"Addiction and Mental Health Research Lab School of Public Health University of Alberta  Edmonton AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Maher","sequence":"additional","affiliation":[{"name":"The Kirby Institute (formerly the National Centre in HIV Epidemiology and Clinical Research) University of New South Wales  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Shannon","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS  Vancouver BC Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,3,28]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/jurban\/jtg022"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2006.02.005"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(02)00521-X"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2004.12.024"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.82.9.1294"},{"key":"e_1_2_5_7_1","first-page":"621","article-title":"What is the addicts' grapevine when there's \u2018bad dope'? An investigation in New Jersey","volume":"110","author":"Freeman R. C.","year":"1995","journal-title":"Public Health Rep"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7517-4-10"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/09581590601045220"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2005.12.007"},{"key":"e_1_2_5_11_1","unstructured":"CBC.Killer heroin doubles B.C. overdose fatalities.2011. Available at:http:\/\/www.cbc.ca\/news\/health\/story\/2011\/05\/05\/bc\u2010killer\u2010heroin.html(accessed 8 January 2012) (Archived athttp:\/\/www.webcitation.org\/6EvFAbWblon 6 March 2013)."},{"key":"e_1_2_5_12_1","unstructured":"BC Coroners Service.BC Coroners Service warns of rise in heroin\u2010related deaths.2011. Available at:http:\/\/www2.news.gov.bc.ca\/news_releases_2009\u20102013\/2011PSSG0059\u2010000493.pdf(accessed 8 January 2012) (Archived athttp:\/\/www.webcitation.org\/6EvF7WwfKon 6 March 2013)."},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2006.12.008"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0955-3959(02)00007-5"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2008.10.003"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2004.01.029"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7517-7-20"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.3109\/10826089809056260"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2007.05.003"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/0959523021000002778"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2006.01385.x"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(95)00193-X"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2006.01.029"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2008.10.002"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2008.10400624"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2006.02.005"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(98)00159-8"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62353-7"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732311400919"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/09595230701373818"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2011.05.012"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2011.08.004"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/10826080701801261"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2006.05.025"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60958-0"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2011.03369.x"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fadd.12151","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fadd.12151","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.12151","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/add.12151","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.12151","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T22:24:29Z","timestamp":1698704669000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.12151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,3,28]]},"references-count":35,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2013,7]]}},"alternative-id":["10.1111\/add.12151"],"URL":"https:\/\/doi.org\/10.1111\/add.12151","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,3,28]]},"assertion":[{"value":"2012-09-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-02-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-03-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}