“The rock always comes first”: Drug users’ accounts about using formal health care

René D. Drumm, Duane C. McBride, Lisa Metsch, Bryan J. Page, Kimberly Dickerson, Beverly Jones

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Illicit drug use remains a significant public health threat. The issues surrounding drug use are recognized by public health professionals as important for several reasons. The incidence and prevalence of drug use persists in spite of the extensive societal, interpersonal, and individual consequences. In addition, the chronic health issues and health care costs associated with drug use continue to spiral. A wide variety of quantitative studies have examined the extent of health care problems, access, cost, and health care satisfaction among illicit drug users. While these studies offer important information through survey formats, fewer studies focus on subjective constructions of health care management from the users' perspective. This article examines the elements of the decision-making process involved in accessing formal health care among chronic and injecting street drug users. Twenty-eight in-depth interviews provide the data for this analysis, which is part of a large quantitative study of 1,479 injecting and chronic drug users and nondrug users in Miami, Florida. By exploring the elements of health care access through the eyes of the drug users, researchers and treatment professionals may gain insights into new ways to improve health care access for this at-risk population.

Original languageEnglish (US)
Pages (from-to)461-469
Number of pages9
JournalJournal of psychoactive drugs
Issue number4
StatePublished - 2003


  • Addictions
  • Drug abuse
  • Health care
  • Qualitative research

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Psychology(all)
  • Clinical Psychology


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