Naloxone protection, social support, network characteristics, and overdose experiences among a cohort of people who use illicit opioids in New York City.
Naloxone protection, social support, network characteristics, and overdose experiences among a cohort of people who use illicit opioids in New York City.
复制标题
DOI：
10.1186/s12954-022-00604-w
复制
发表时间：
2022-03-04
影响因子：
4.4
通讯作者：
Elliott L
中科院分区：
文献类型：
--
作者：
Bennett AS;Scheidell J;Bowles JM;Khan M;Roth A;Hoff L;Marini C;Elliott L
尽管越来越多的人可以带回家纳洛酮，但许多使用阿片类药物的人是在无保护的情况下使用的，没有其他人可能会使用纳洛酮，这增加了过量使用导致死亡的可能性。因此，受到“保护”免于过量死亡具有社会性质，这突出表明必须查明促进类阿片使用者利用保护性社交网络的背景因素。我们采用应答者驱动抽样招募居住在纽约市的成年人，他们报告最近（过去3天）使用非医疗阿片类药物（n = 575）。参与者完成了一项基线评估，其中包括过去30天的物质使用措施，过量使用经验和“受保护”阿片类药物使用事件的数量，定义为涉及纳洛酮和另一个可以管理它的人的存在，以及网络特征和社会支持的措施。我们使用具有稳健方差的改良泊松回归来估计未调整和调整的患病率（PR）和95%置信区间（CI）。66%的参与者曾接受过纳洛酮管理培训，18%在过去三个月内使用过纳洛酮，32%最近（过去30天）过量使用。在最近的阿片类药物使用事件中，64%的人报告从未有纳洛酮和管理人员在场。这在年龄≥ 50岁的患者中更常见：（PR：1.18（CI 1.03，1.34）;确定为非西班牙裔黑人（PR：1.27（CI 1.05，1.53）;经历了更高水平的污名意识（PR：1.13（CI 1.00，1.28）;小社交网络（< 5人）（APR：1.14（CI 0.98，1.31）。近期药物过量经历与重度阿片类药物使用障碍（PR：2.45（CI 1.49，4.04））、自杀倾向（PR：1.72（CI 1.19，2.49））、抑郁（PR：1.54（CI 1.20，1.98））和苯二氮卓类药物尿分析结果阳性（PR：1.56（CI 1.23，1.96）相关，但与网络大小无关。结果显示，使用阿片类药物的人在纳洛酮保护方面存在相当大的差距，更脆弱和历史上处于不利地位的亚群不太可能受到保护。使用阿片类药物的人的更大的社交网络可能是减少过量死亡率的重要资源，但需要做出更多努力来利用社交网络的保护方面。
Despite increased availability of take-home naloxone, many people who use opioids do so in unprotected contexts, with no other person who might administer naloxone present, increasing the likelihood that an overdose will result in death. Thus, there is a social nature to being “protected” from overdose mortality, which highlights the importance of identifying background factors that promote access to protective social networks among people who use opioids. We used respondent-driven sampling to recruit adults residing in New York City who reported recent (past 3-day) nonmedical opioid use (n = 575). Participants completed a baseline assessment that included past 30-day measures of substance use, overdose experiences, and number of “protected” opioid use events, defined as involving naloxone and the presence of another person who could administer it, as well as measures of network characteristics and social support. We used modified Poisson regression with robust variance to estimate unadjusted and adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs). 66% of participants had ever been trained to administer naloxone, 18% had used it in the past three months, and 32% had experienced a recent overdose (past 30 days). During recent opioid use events, 64% reported never having naloxone and a person to administer present. This was more common among those: aged ≥ 50 years (PR: 1.18 (CI 1.03, 1.34); who identified as non-Hispanic Black (PR: 1.27 (CI 1.05, 1.53); experienced higher levels of stigma consciousness (PR: 1.13 (CI 1.00, 1.28); and with small social networks (< 5 persons) (APR: 1.14 (CI 0.98, 1.31). Having a recent overdose experience was associated with severe opioid use disorder (PR: 2.45 (CI 1.49, 4.04), suicidality (PR: 1.72 (CI 1.19, 2.49), depression (PR: 1.54 (CI 1.20, 1.98) and positive urinalysis result for benzodiazepines (PR: 1.56 (CI 1.23, 1.96), but not with network size. Results show considerable gaps in naloxone protection among people who use opioids, with more vulnerable and historically disadvantaged subpopulations less likely to be protected. Larger social networks of people who use opioids may be an important resource to curtail overdose mortality, but more effort is needed to harness the protective aspects of social networks.
登录
查看更多内容
影响因子：
12.3
作者：
Buels R;Yao E;Diesh CM;Hayes RD;Munoz-Torres M;Helt G;Goodstein DM;Elsik CG;Lewis SE;Stein L;Holmes IH
通讯作者：
Holmes IH
影响因子：
4
作者：
Bonevski B;Randell M;Paul C;Chapman K;Twyman L;Bryant J;Brozek I;Hughes C
通讯作者：
Hughes C
影响因子：
3.7
作者：
Dayton, Lauren;Gicquelais, Rachel E.;Latkin, Carl
通讯作者：
Latkin, Carl
影响因子：
4.4
作者：
Ivsins, Andrew;Boyd, Jade;McNeil, Ryan
通讯作者：
McNeil, Ryan
DOI：
10.1146/annurev-soc-060116-053556
发表时间：
2017-01-01
期刊：
ANNUAL REVIEW OF SOCIOLOGY, VOL 43
影响因子：
--
作者：
Heckathorn, Douglas D.;Cameron, Christopher J.
通讯作者：
Cameron, Christopher J.