Shifts in substance use patterns among a cohort of people who use opioids after delisting of OxyContin in BC, Canada: An interrupted time series study.
Shifts in substance use patterns among a cohort of people who use opioids after delisting of OxyContin in BC, Canada: An interrupted time series study.
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DOI：
10.1016/j.drugpo.2022.103852
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发表时间：
2022-11
影响因子：
4.4
通讯作者：
Kerr, Thomas
中科院分区：
文献类型：
--
作者：
Karamouzian, Mohammad;Buxton, Jane A.;Hategeka, Celestin;Nosova, Ekaterina;Hayashi, Kanna;Milloya, M. -J.;Kerr, Thomas
关键词：
奥施康定于2012年3月从加拿大省级药物处方中除名，取而代之的是一种新配方的抗篡改形式的羟考酮（即，OxyNeo）。我们评估了奥施康定的退市是否与阿片类药物使用者（PWUO）使用不受管制的阿片类药物和其他物质的变化有关。数据来源于2006年至2018年在加拿大不列颠哥伦比亚省温哥华进行的两项前瞻性队列研究。纳入了在奥施康定退市前后至少接受过一次随访访视的PWUO。感兴趣的结果是自我报告的定期（即，至少每周一次）使用海洛因、非处方处方阿片类药物、大麻、甲基苯丙胺、快克可卡因和可卡因粉末。使用准实验中断的时间序列，我们拟合广义最小二乘模型，以评估参与者的即时和长期的物质使用的做法后，政策的变化。我们分析了来自1014名参与者的数据，他们在研究期间参与了17457次访问。奥施康定退市后，海洛因使用立即增加5.17%（95%置信区间[CI]：0.68 - 9.67），随时间推移每月增加0.47%（0.35 - 0.58）。非处方阿片类药物的使用立即增加了1.80%（0.10至3.50），随着时间的推移每月增加0.16%（0.12至0.19）。大麻的使用立即增加了4.37%（0.88至7.87），随着时间的推移每月增加了0.11%（0.02至0.19）。甲基苯丙胺的使用没有立即增加，但随着时间的推移每月增加0.10%（0.01至0.18）。快克可卡因的使用立即下降了6.13%（-10.94至-1.69），但随着时间的推移并不显着。最后，可卡因粉末的使用没有立即或随着时间的推移而增加。奥施康定在BC的退市与PWUO中不受管制的阿片类药物使用减少无关。我们的研究结果指出了PWUO干预后物质使用模式的转变，并进一步强调了减少供应干预措施在解决阿片类药物流行病方面的意外后果。
OxyContin was delisted from Canadian provincial drug formularies in March 2012 and replaced with a reformulated tamper-resistant form of oxycodone (i.e., OxyNeo). We assessed if delisting of OxyContin was associated with changes in the use of unregulated opioids and other substances among people who use opioids (PWUO). Data were derived from two prospective cohort studies of people who use drugs in Vancouver, BC, Canada from 2006 to 2018. PWUO who had at least one follow-up visit before and after delisting of OxyContin were included. Outcomes of interest were self-reported regular (i.e., at least weekly) use of heroin, non-prescribed prescription opioids, cannabis, methamphetamine, crack cocaine, and powder cocaine during the previous six months. Using quasi-experimental interrupted time series, we fit generalized least squares models to assess participants’ immediate and long-term substance use practices after the policy change. We analyzed data from 1014 participants who contributed to 17457 visits during the study. Following the delisting of OxyContin, heroin use increased immediately by 5.17% (95% confidence intervals [CI]: 0.68 to 9.67) and over time by 0.47% (0.35 to 0.58) per month. Non-prescribed prescription opioid use increased immediately by 1.80% (0.10 to 3.50) and over time by 0.16% (0.12 to 0.19) per month. Cannabis use increased immediately by 4.37% (0.88 to 7.87) and over time by 0.11% (0.02 to 0.19) per month. Methamphetamine use did not increase immediately but increased over time by 0.10% (0.01 to 0.18) per month. Crack cocaine use decreased immediately by 6.13% (−10.94 to −1.69) but not significantly over time. Lastly, powder cocaine use did not increase immediately or over time. Delisting of OxyContin in BC was not associated with a reduction in unregulated opioid use among PWUO. Our findings point to a shift in substance use patterns of PWUO post-intervention and further highlight the unintended consequences of supply-reduction interventions in addressing the opioid epidemic.
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DOI：
10.1136/bmj.b1649
发表时间：
2009-04-30
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Wood E;Kerr T;Marshall BD;Li K;Zhang R;Hogg RS;Harrigan PR;Montaner JS
通讯作者：
Montaner JS
影响因子：
3.8
作者：
Bach P;Hayashi K;Milloy MJ;Nosova E;Kerr T;Wood E;Fairbairn N
通讯作者：
Fairbairn N
影响因子：
4
作者：
Severtson, Stevan Geoffrey;Bartelson, Becki Bucher;Dart, Richard C.
通讯作者：
Dart, Richard C.
影响因子：
8.1
作者：
Hategeka C;Ruton H;Karamouzian M;Lynd LD;Law MR
通讯作者：
Law MR
影响因子：
4.2
作者：
Strickland, Justin C.;Havens, Jennifer R.;Stoops, William W.
通讯作者：
Stoops, William W.