"Bottoming out?" Among rural African American women who use cocaine.

CONTEXT: Studies have explored the spiraling-down effect of losing individual, familial, and social resources among African Americans who use drugs, but there is a gap in knowledge about this "bottoming-out" phenomenon among rural African American women. PURPOSE: The study was conducted to better understand the phenomenon of bottoming out among rural African American women who use cocaine. METHODS: Using an ethnographic approach, researchers drew on multiple qualitative and quantitative data collection methods. Data derived from qualitative interviews, field notes, and demographic profiles describe the phenomenon or lack thereof of bottoming out among 25 southeastern rural African American women who use cocaine. Data collection took place in a rural county of north Florida with a population between 11,000 and 15,000. Twenty-five African American females 18 years or older who used either powder or crack cocaine at the time of enrollment and resided in the rural county participated in the study. FINDINGS: Respondents used 6 major strategies that delayed or prevented them from bottoming out: (1) taking advantage of their social environment and community ties, (2) utilizing various sources of income, (3) accessing family resources, (4) maintaining some degree of discipline over spending for drugs, (5) maintaining routine drug use locations, and (6) renting cheap housing and/or house pooling. CONCLUSION: Unlike studies of similar populations in urban settings, most respondents continued to work after numerous years of drug use, tended not to lose legal custody of their children, maintained a support system of nonusers as well as users over time, and securred food, clothing, and shelter for themselves and in many instances their children using legal or illegal means.