Initiation of opioid agonist treatment and subsequent substance use and other patterns among adolescents and young adults in Vancouver, Canada.
Initiation of opioid agonist treatment and subsequent substance use and other patterns among adolescents and young adults in Vancouver, Canada.
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DOI：
10.1016/j.drugalcdep.2022.109441
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发表时间：
2022-06-01
影响因子：
4.2
通讯作者：
DeBeck, Kora
中科院分区：
文献类型：
--
作者：
Pilarinos, Andreas;Fast, Danya;Nosova, Ekaterina;Kwa, Yandi;Joe, Ronald;Buxton, Jane A.;DeBeck, Kora
关键词：
阿片类药物激动剂治疗（OAT）是减少阿片类药物非法使用的有效干预措施；然而，人们对青少年和年轻人 (AYA) 中的 OAT 知之甚少。本研究旨在调查 AYA 中 OAT 的保留和停用情况。数据来自“高危青年研究”，这是 2005 年 9 月至 2018 年 12 月期间在加拿大温哥华进行的一项涉及街头 AYA 的前瞻性队列。采用多变量 Cox 回归分析来确定社会人口统计学、物质使用以及与首次 OAT 时间相关的其他因素。在分析之前和之后，对启动和未启动 OAT 的 AYA 的药物使用、无家可归、服务利用和刑事司法模式进行了检查。在 676 名每周报告非法阿片类药物使用的 AYA 中，有 454 名 (67.2%) 报告在研究期间的某个时间点没有服用 OAT，217 名 (32.1%) 在随访期间开始了 OAT。在非线性增长曲线分析中，与“无 OAT”对照组相比，只有保留 OAT 的参与者表现出每日非法阿片类药物使用量显着减少（p < 0.05）。尽管如此，在保留 OAT 与“无 OAT”对照的参与者之间观察到无家可归的减少（p = 0.070）和获得服务的难度增加（p = 0.078），而在“OAT 停用者”与“无 OAT”对照之间观察到无家可归的减少（p = 0.085）和每周非医疗处方阿片类药物使用（NMPOU）（p = 0.061）。尽管发现 OAT 保留与每日非法阿片类药物使用的显着减少有关，但没有观察到其他关键指标的显着改善。这强调了与 OAT 一起提供支持以改善 AYA 治疗结果的重要性。
Opioid agonist treatments (OAT) are effective interventions for reducing illicit opioid use; however, less is known about OAT among adolescents and young adults (AYA). This study sought to examine OAT retention and discontinuation among AYA. Data were derived from the At-Risk Youth Study, a prospective cohort of street-involved AYA in Vancouver, Canada, between September 2005 and December 2018. Multivariable Cox regression analysis was employed to identify sociodemographic, substance use, and other factors associated with time to first OAT. Substance use, homelessness, service utilization, and criminal justice patterns among AYA who did and did not initiate OAT were examined using before and after analysis. Of 676 AYA who reported weekly illicit opioid use, 454 (67.2%) reported not being on OAT at some point over the study period and 217 (32.1%) initiated OAT over follow-up. In non-linear growth curve analysis, only participants retained in OAT demonstrated significant reductions in daily illicit opioid use when compared to ‘no OAT’ controls (p < 0.05). Nevertheless, reductions in homelessness (p = 0.070) and increases in difficulty accessing services (p = 0.078) were observed between participants retained in OAT vs. ‘no OAT’ controls, while reductions in homelessness (p = 0.085) and weekly non-medical prescription opioid use (NMPOU) (p = 0.061) were observed between ‘OAT discontinuers’ vs. ‘no OAT’ controls. Despite finding that OAT retention was associated with significant reductions in daily illicit opioid use, no significant improvements in other key indicators were observed. This underscores the importance of providing supports alongside OAT to improve treatment outcomes among AYA.
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影响因子：
7.6
作者：
Chavez, Laura J.;Bonny, Andrea E.;Chisolm, Deena J.
通讯作者：
Chisolm, Deena J.
影响因子：
4.2
作者：
Gonzalez-Saiz, Francisco;Lozano Rojas, Oscar;Perez de los Cobos, Jose
通讯作者：
Perez de los Cobos, Jose
影响因子：
6
作者：
DeBeck, Kora;Kerr, Thomas;Wood, Evan
通讯作者：
Wood, Evan
影响因子：
14.6
作者：
Artenie, Andreea A.;Minoyan, Nanor;Bruneau, Julie
通讯作者：
Bruneau, Julie
DOI：
10.1080/00952990.2017.1399403
发表时间：
2018
期刊：
The American journal of drug and alcohol abuse
影响因子：
--
作者：
Chang DC;Klimas J;Wood E;Fairbairn N
通讯作者：
Fairbairn N