Introduction: A few studies have shown that rave music parties (RMP) enabled long-term positive transformative experiences. However, phenomenological inquiry on the subjective meaning of RMP attendees' experience before and after such parties is scant. The present study explored the preparations for participation in RMP and the parties' consequences for attendees who consume psychedelic drugs.
Method: The study used interpretative phenomenological analysis to analyze transcriptions of semi-structured interviews with 27 Israeli rave party attendees.
Results: The study found five themes regarding attendees' preparations for RMP: physical preparations; anticipation and body sensations; cognitive preparations; social preparations; and logistic preparations. Four themes relate to the attendees' experienced consequences after RMP: physical consequences; emotional consequences; cognitive effects; and positive social consequences.
Conclusions: In light of liminality and rite of passage theories, the study highlights the importance of the pre-liminal rites of separation, including physical preparations, anticipation and body sensations, and cognitive, social and logistic preparations. The consequences after the party correspond to the post-liminal stage where the participants return to their normal life, yet with changes in physical, emotional, cognitive, and social aspects. Israeli policymakers should consider adopting European drug-checking policy as a harm reduction measure to minimize negative consequences of drug use in the pre-liminal and post-liminal stages of RMP.
Introduction: Understanding conditions in which interventions succeed or fail is critical. The PRimary care Opioid Use Disorders treatment (PROUD) trial, a cluster-randomized hybrid study, tested whether implementation of office-based addiction treatment supported by a nurse increased medication of OUD. Six health systems each provided two primary care (PC) clinics that were randomly assigned to implement the intervention or usual care. This secondary, exploratory study used an innovative mixed methods approach to understand contextual factors that consistently distinguished intervention clinics that increased OUD treatment from those that did not.
Methods: The study collected contextual information through field notes, health system debriefs, and nurse interviews. Rapid qualitative analysis using a template based on the Practical, Robust Implementation and Sustainability Model identified themes reflecting the external environment, recipients, and implementation infrastructure. The study used qualitative themes to create binary factors reflecting barriers and facilitators potentially critical to implementation success and assigned clinics a factor value of 1 if present and 0 if absent. Two clinic-level outcomes were defined: 1) significant increase in patient-years of OUD treatment from baseline to two-year follow-up; and 2) high rate of OUD treatment at two-year follow-up (≥20 per 10,000 patient-years). Coincidence analysis, a cross-case configurational method, identified difference-makers for both OUD outcomes across intervention clinics.
Results: Qualitative analysis yielded 11 themes which were dichotomized and consolidated into 9 factors. Two factor values perfectly distinguished between intervention clinics with and without increased OUD treatment (outcome #1): (a) presence of strong support from PC staff and providers and (b) lack of OUD treatment in the community. Intervention clinics increased OUD treatment when either factor value was present; when both were absent, clinics did not increase treatment. Strong support from PC staff and providers was independently sufficient to achieve high rates of OUD treatment (outcome #2) while the absence of support explained low rates of treatment. Importantly, strong support from leadership was not sufficient for either outcome.
Conclusion: Strong support from staff and providers consistently differentiated between clinics with increased OUD treatment across both outcomes in the PROUD trial from those without. OUD programs should consider increasing support across clinic roles.