Factors associated with methadone maintenance therapy use among a cohort of polysubstance using injection drug users in Vancouver
Factors associated with methadone maintenance therapy use among a cohort of polysubstance using injection drug users in Vancouver
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DOI：
10.1016/j.drugalcdep.2005.05.002
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发表时间：
2005-12-12
影响因子：
4.2
通讯作者：
Wood, E
中科院分区：
文献类型：
--
作者：
Kerr, T;Marsh, D;Wood, E
我们在后续访谈中确定了美沙酮维持治疗 (MMT) 的使用情况，并使用广义估计方程 (GEE) 检查了 MMT 的使用与社会人口统计和药物相关变量之间的关联。在招募到该队列的 1587 名参与者中，有 170 名（11%）在基线时参加了 MMT，另有 498 名（31%）在随访期间开始了 MMT。在曾经参加 MMT 的人中，406 人 (61%) 多次停止 MMT 并重新开始 MMT。中位治疗持续时间为 14.4 个月。多变量分析中与 MMT 使用呈显着负相关的因素包括： 原住民种族（调整后优势比 [AOR] = 0.40）；最近被监禁（AOR = 0.79）；性交易参与（AOR = 0.87） 注射器借出（AOR = 0.72）；注射海洛因（AOR = 0.64），而女性（AOR = 2.47）、HIV 阳性（AOR = 1.57）和吸食强效可卡因（AOR = 1.23）与 MMT 呈正相关且显着相关。在多变量分析中，不稳定的住房、借用注射器、非致命性过量用药、注射可卡因以及居住在温哥华市中心东区与 MMT 的使用无关。我们的研究表明，当地注射吸毒者开始使用 MMT 和保留 MMT 的比例很高。虽然 MMT 的使用与海洛因使用和艾滋病毒危险行为的减少有关，但对土著注射吸毒者的障碍是明显的，并且与强效可卡因使用增加的关系值得进一步研究。 (c) 2005 Elsevier Ireland Ltd. 保留所有权利。
We identified methadone maintenance therapy (MMT) use during follow-up interviews and examined associations between MMT use and socio-demographic and drug-related variables using generalized estimating equations (GEE). Of the 1587 participants recruited into this cohort, 170 (11%) were enrolled in MMT at baseline and additional 498 (31%) initiated MMT during follow-up. Of those ever enrolled in MMT, 406 (61%) ceased MMT and re-initiated MMT on more than one occasion. The median treatment duration was 14.4 months. Factors that were negatively and significantly associated with MMT use in multivariate analyses included: Aboriginal ethnicity (adjusted odds ratio [AOR] = 0.40); recent incarceration (AOR = 0.79); sex trade involvement (AOR = 0.87) syringe lending (AOR = 0.72); heroin injection (AOR = 0.64), whereas female gender (AOR = 2.47), HIV positivity (AOR = 1.57), and crack cocaine smoking (AOR = 1.23) were positively and significantly associated with being on MMT. Unstable housing, syringe borrowing, non-fatal overdose, cocaine injection, and residence in Vancouver's Downtown Eastside were not associated with MMT use in multivariate analyses. Our Study demonstrates high rates of initiation of and retention in MMT among local IDUs. While the use of MMT was associated with reductions in heroin use and HIV risk behavior, barriers to Aboriginal IDUs were evident, and the association with increased crack cocaine use deserves further study. (c) 2005 Elsevier Ireland Ltd. All rights reserved.