Can differences in the type, nature or amount of polysubstance use explain the increased risk of non-fatal overdose among psychologically distressed people who inject drugs?
Can differences in the type, nature or amount of polysubstance use explain the increased risk of non-fatal overdose among psychologically distressed people who inject drugs?
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DOI：
10.1016/j.drugalcdep.2015.06.020
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发表时间：
2015-09-01
影响因子：
4.2
通讯作者：
Alati, Rosa
中科院分区：
文献类型：
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作者：
Betts, Kim S.;McIlwraith, Fairlie;Alati, Rosa
背景：本研究调查多物质使用的类型、性质或数量是否可以解释患有严重心理困扰的注射吸毒者非致命性吸毒过量的风险增加。方法：数据来自非法药物报告系统 (IDRS) 的三年（2011-2013 年），该系统是澳大利亚注射吸毒者的年度哨点样本（n = 2673）。使用结构方程模型 (SEM) 对 14 种药物类型构建了 5 个潜在因素，每个潜在因素代表一种多物质使用类型。进行了测量不变性测试，以确定有和没有严重心理困扰的人之间的多物质使用情况是否存在差异。接下来，我们对多物质使用因素的非致命过量进行了回归，并在组间测试的关系中存在差异。研究结果：在那些患有严重心理困扰的人中，以海洛因、羟考酮、晶体甲基苯丙胺和可卡因使用为特征的多物质使用情况与非致命过量使用风险较高相关。在没有严重心理困扰的人中，两种多物质使用概况（主要以阿片类药物替代疗法和处方药为特征）可以防止非致命性过量用药。结论：注射吸毒者与没有严重心理困扰的人之间，多物质使用概况类型没有差异。然而，一种特定多物质特征的使用性质使前一组的非致命性用药过量风险大大增加，而涉及阿片类药物替代疗法的多物质使用性质仅在后一组中具有保护作用。研究结果确定了多物质使用情况对有心理问题的个人与毒品相关的伤害具有重要意义。 (C) 2015 Elsevier Ireland Ltd. 保留所有权利。
Background: This study investigates whether the type, nature or amount of polysubstance use can explain the increased risk of non-fatal overdose among people who inject drugs with severe psychological distress.Methods: Data came from three years (2011-2013) of the Illicit Drug Reporting System (IDRS), an annual sentinel sample of injecting drug users across Australia (n =2673). Structural Equation Modelling (SEM) was used on 14 drug types to construct five latent factors, each representing a type of polysubstance use. Tests of measurement invariance were carried out to determine if polysubstance use profiles differed between those with and without severe psychological distress. Next, we regressed non-fatal overdose on the polysubstance use factors with differences in the relationships tested between groups.Findings: Among those with severe psychological distress a polysubstance use profile characterised by heroin, oxycodone, crystal methamphetamine and cocaine use was associated with greater risk of non-fatal overdose. Among those without severe psychological distress, two polysubstance use profiles, largely characterised by opioid substitution therapies and prescription drugs, were protective against non-fatal overdose.Conclusion: The types of polysubstance use profiles did not differ between people who inject drugs with and without severe psychological distress. However, the nature of use of one particular polysubstance profile placed the former group at a strongly increased risk of non-fatal overdose, while the nature of polysubstance use involving opioid substitution therapies was protective only among the latter group. The findings identify polysubstance use profiles of importance to drug-related harms among individuals with psychological problems. (C) 2015 Elsevier Ireland Ltd. All rights reserved.