Incarceration and drug use patterns among a cohort of injection drug users
Incarceration and drug use patterns among a cohort of injection drug users
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DOI：
10.1111/j.1360-0443.2008.02387.x
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发表时间：
2009-01-01
期刊：
影响因子：
6
通讯作者：
Wood, Evan
中科院分区：
文献类型：
--
作者：
DeBeck, Kora;Kerr, Thomas;Wood, Evan
禁毒执法仍然是应对与毒品有关的危害的主要措施。然而，监禁对阻止吸毒的影响仍然没有得到充分的评价。我们试图探讨监禁和注射毒品（IDU）的人之间的毒品使用模式之间的关系，使用广义估计方程（GEE），我们检查了在温哥华注射毒品使用者研究的参与者之间的注射停止的流行和相关性，随后超过9年。在亚组分析中，我们使用McNemar检验和线性增长曲线分析来评估报告监禁和未监禁的参与者在监禁前和监禁后一段时间内药物使用模式的变化，在1603名IDU中，842名（53%）报告在随访期间的某个时间点停止注射至少6个月。在多变量GEE分析中，近期监禁与注射停止呈负相关[调整后的比值比（AOR）= 0.43，95%置信区间（CI）0.37-0.50]，而美沙酮的使用与停止呈正相关（AOR = 1.38，95% CI 1.22-1.56）。在对研究期间被监禁者和未被监禁者的药物使用纵向模式进行的亚组分析中，线性增长曲线分析表明，两组之间的药物使用模式无统计学显著差异（均P > 0.05），这些观察数据表明，监禁并没有减少IDU的药物使用。监禁可能会阻碍促进注射吸毒者停止注射的机制。相反，结果表明，美沙酮的使用与注射停止呈正相关，独立于以前的药物使用频率。
Drug law enforcement remains the dominant response to drug-related harm. However, the impact of incarceration on deterring drug use remains under-evaluated. We sought to explore the relationship between incarceration and patterns of drug use among people who inject drugs (IDU).Using generalized estimating equations (GEE), we examined the prevalence and correlates of injection cessation among participants in the Vancouver Injection Drug User Study followed over 9 years. In subanalyses, we used McNemar's tests and linear growth curve analyses to assess changes in drug use patterns before and after a period of incarceration among participants reporting incarceration and those not incarcerated.Among 1603 IDU, 842 (53%) reported injection cessation for at least 6 months at some point during follow-up. In multivariate GEE analyses, recent incarceration was associated negatively with injection cessation [adjusted odds ratio (AOR) = 0.43, 95% confidence interval (CI) 0.37-0.50], whereas the use of methadone was associated positively with cessation (AOR = 1.38, 95% CI 1.22-1.56). In subanalyses assessing longitudinal patterns of drug use among incarcerated individuals and those not incarcerated over the study period, linear growth curve analyses indicated that there were no statistically significant differences in patterns of drug use between the two groups (all P > 0.05).These observational data suggest that incarceration does not reduce drug use among IDU. Incarceration may inhibit access to mechanisms that promote injection cessation among IDU. In contrast, results indicate that methadone use is associated positively with injection cessation, independent of previous frequency of drug use.