Changes in the unregulated opioid drug supply during income assistance payment weeks in Vancouver, Canada: An exploratory analysis.
Changes in the unregulated opioid drug supply during income assistance payment weeks in Vancouver, Canada: An exploratory analysis.
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DOI：
10.1016/j.drugpo.2022.103707
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发表时间：
2022-07
影响因子：
4.4
通讯作者：
Ti, Lianping
中科院分区：
文献类型：
--
作者：
Beaulac, Melissa;Richardson, Lindsey;Tobias, Samuel;Lysyshyn, Mark;Grant, Cameron;Ti, Lianping
在收入援助支付前后的几天里，报告了与毒品有关的危害增加，包括过量(中毒)，但对这段时间不受管制的药品供应的变化知之甚少。在这一探索性分析中，我们调查了不受监管的阿片类药物供应的变化是否与收入援助支付周有关。使用来自不列颠哥伦比亚省温哥华药物检查服务的数据，我们采用改进的泊松和线性回归模型来检验收入援助付款周与三个关键结果之间的关系：(1)预期阿片样本中芬太尼阳性的比例，(2)芬太尼阳性预期阿片样本中的芬太尼浓度，以及(3)预期阿片样本中苯二氮卓类药物阳性的比例。2017年10月至2019年12月，4306例(90.41%)预期阿片样本芬太尼检测呈阳性，芬太尼浓度中值为7.0%(四分位数[Q]1-Q3：5.1%-9.8%)。收入补助支付周与预期阿片类药物样本中芬太尼阳性率的增加相关(患病率[PR]：1.03；95%可信区间[CI]：1.00，1.05)；然而，我们没有发现收入援助支付周与芬太尼浓度之间有统计学意义的关联(回归系数：0.70；95%CI：0.44，1.09)。此外，收入补助付款周与预期阿片类药物样本中苯二氮类药物阳性患病率的增加有关(PR：1.86；95%CI：1.07，3.24)。这些发现表明，在收入援助支付周期间，可能有更多的芬太尼和苯二氮卓类药物在不受监管的阿片类药物供应中流通。在收入援助付款周期间，芬太尼和掺有苯二氮卓的阿片类药物的增加可能是导致每月这个时候非法药物过量增加的原因之一。
Increased drug-related harms, including overdoses (poisonings), have been reported in the days around income assistance payments, yet little is known about changes in the unregulated drug supply during this time. In this exploratory analysis, we investigated whether changes in the unregulated opioid drug supply are associated with income assistance payment weeks. Using data from drug checking services in Vancouver, BC, we conducted modified Poisson and linear regression models to examine the association between income assistance payment weeks and three key outcomes: (1) proportion of fentanyl positivity among expected opioid samples, (2) fentanyl concentration among fentanyl-positive expected opioid samples, and (3) proportion of benzodiazepine positivity among expected opioid samples. Between October 2017 and December 2019, 4306 (90.41%) of expected opioid samples tested positive for fentanyl, and the median fentanyl concentration was 7.0% (quartile [Q]1 – Q3: 5.1% – 9.8%). Income assistance payment week was associated with an increased prevalence of fentanyl positivity among expected opioid samples (prevalence ratio [PR]: 1.03; 95% confidence interval [CI]: 1.00, 1.05); however, we failed to find a statistically significant association between income assistance payment week and fentanyl concentration (regression coefficient: 0.70; 95% CI: 0.44, 1.09). Additionally, income assistance payment week was associated with an increased prevalence of benzodiazepine positivity among expected opioid samples (PR: 1.86; 95% CI: 1.07, 3.24). These findings suggest that during income assistance payment weeks, there may be more fentanyl and benzodiazepines circulating in the unregulated opioid drug supply. The rise in fentanyl and benzodiazepine-adulterated opioids during income assistance payment weeks may be contributing to the increase in illicit drug overdoses seen during this time of the month.
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DOI：
10.1111/add.15182
发表时间：
2021-03
期刊：
Addiction (Abingdon, England)
影响因子：
--
作者：
Richardson L;Dong H;Kerr T;Milloy MJ;Hayashi K
通讯作者：
Hayashi K
影响因子：
3.8
作者：
McCrae, Karen;Tobias, Samuel;Ti, Lianping
通讯作者：
Ti, Lianping
影响因子：
5.4
作者：
Krebs, Emanuel;Wang, Linwei;Richardson, Lindsey
通讯作者：
Richardson, Lindsey
影响因子：
4.4
作者：
Otterstatter, Michael C.;Amlani, Ashraf;Buxton, Jane A.
通讯作者：
Buxton, Jane A.
影响因子：
2.3
作者：
Strickland, Justin C.;Smith, Mark A.
通讯作者：
Smith, Mark A.