"Like Yin and Yang": Perceptions of Methamphetamine Benefits and Consequences Among People Who Use Opioids in Rural Communities.

OBJECTIVES: The objective of this study was to investigate methamphetamine use among people who use opioids in rural Oregon communities to explore reasons for use and perceptions of methamphetamine consequences. METHODS: We conducted interviews and surveys with participants who inject drugs or misuse prescription opioids in 2 rural Oregon counties with high opioid overdose rates. Survey participants were identified through participant-driven sampling initiated in syringe service programs and field outreach (n = 144). Semi-structured interviews with participants were recruited from the same locations (n = 52). RESULTS: Of 144 surveys completed, 112 reported using opioids in the past 30 days; 96% of the 112 also report methamphetamine use. Among the 124 reporting injection drug use, 50% indicated they injected both methamphetamine and heroin in the past 30 days. Interview participants reported early exposure to methamphetamine and indicated that methamphetamine was more widely available, less expensive, and less stigmatized compared to heroin. Participants reported using methamphetamine to improve work-life functioning and because they enjoy the high produced from simultaneous use. Several participants reported a conscious effort to shift to methamphetamine from heroin as a harm reduction strategy.Some participants reported being involuntarily discharged from treatment for opioid use disorder due to methamphetamine use. Several participants perceived methamphetamine as conveying overdose prevention or reversal benefits, while fentanyl contamination in methamphetamine was reported or suspected. CONCLUSION: As rural communities respond to evolving drug supply and demand, there is increasing need for public health efforts to address the emerging issue of concurrent methamphetamine and opioid use.

Mindfulness and compassion training in adolescence: a developmental contemplative science perspective.

Adolescence is a developmental period of risk, as well as a window of opportunity for cultivating positive development and thriving. It is characterized by simultaneous changes in the brain, body, mind, and social domains that offer a platform for building new skills and habits. This chapter discusses the role that secular forms of mindfulness and compassion training may play in fostering positive development in adolescence. The emerging discipline of "Developmental Contemplative Science" (DCS) is introduced, the theoretical and empirical basis of mindfulness in adolescence is illustrated in depth, and secular mindfulness and compassion practices for youth are portrayed. Last, this chapter offers an agenda for future research on connecting mindfulness to key developmental domains in adolescence.