An age-based analysis of nonmedical prescription opioid use among people who use illegal drugs in Vancouver, Canada.
An age-based analysis of nonmedical prescription opioid use among people who use illegal drugs in Vancouver, Canada.
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DOI：
10.1186/s13011-018-0180-3
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发表时间：
2018-11-27
期刊：
影响因子：
--
通讯作者：
DeBeck K
中科院分区：
文献类型：
--
作者：
Cheng T;Small W;Dong H;Nosova E;Hayashi K;DeBeck K
非医疗处方阿片类药物使用（NMPs）在北美是一个严重的公共卫生问题。在人群水平上，以前的研究已经确定了年轻与老年人群中NMPaR的患病率和相关性的差异;然而，对使用非法药物的人群中NMPaR与年龄相关的差异知之甚少。数据收集于2013年至2015年期间，来自加拿大温哥华的两项相关前瞻性队列研究：高危青年研究（阿里斯）和温哥华注射吸毒者研究（VIDUS）。使用双变量和多变量广义估计方程分别检查了年轻（阿里斯）和老年（VIDUS）参与者中与NMPPA独立相关的因素。共纳入1162名参与者。在405名合格的年轻参与者中（中位年龄= 25;四分位数间距[IQR]：22-28），40%（n = 160）报告在基线时参与了NMP 3;在757名老年参与者中（中位年龄= 48，IQR：40-55），35%（n = 262）报告在基线时参与了NMP 3。在对年轻和老年参与者的独立多变量分析中，NMP 3与海洛因使用呈正相关，（年轻：调整后的比值比[AOR] = 3.12，95%置信区间[CI]：2.08-4.68;老年：AOR = 2.79，95% CI：2.08-3.74），毒品交易（年轻：AOR = 2.22，95% CI：1.58-3.13;老年：AOR = 1.87，95% CI：1.40-2.49）和难以获得服务（年轻：AOR = 1.47，95% CI：1.04-2.09;老年：AOR = 1.74，95% CI：1.32-2.29）。仅在青年队列中，NMPPA与年轻年龄相关（AOR = 1.12，95% CI：1.05-1.19），裂纹使用（AOR = 1.56，95% CI：1.06-2.30），和滥用药物（AOR = 1.41，95% CI：1.00-1.97）;参与NMPPART的老年参与者更有可能报告使用晶体甲基苯丙胺（AOR = 1.97，95% CI：1.46-2.66）、非致死性药物过量（AOR = 1.76，95% CI：1.20-2.60）和性工作（AOR = 1.49，95% CI：1.00-2.22）。NMPOU的患病率在吸毒的年轻人和老年人中相似，并且与两个年龄组的易感性标志物独立相关。参与非致命性药物过量的成年人面临非致命性药物过量的风险，这突出表明需要针对青年和成年人的战略来解决非致命性药物过量问题，包括更好地获得卫生和社会服务，以及一系列阿片类药物使用的成瘾治疗选择。研究结果还强调了改善针对PWUD的疼痛治疗策略的重要性。
Nonmedical prescription opioid use (NMPOU) is a serious public health problem in North America. At a population-level, previous research has identified differences in the prevalence and correlates of NMPOU among younger versus older age groups; however, less is known about age-related differences in NMPOU among people who use illegal drugs. Data were collected between 2013 and 2015 from two linked prospective cohort studies in Vancouver, Canada: the At-Risk Youth Study (ARYS) and the Vancouver Injection Drug Users Study (VIDUS). Factors independently associated with NMPOU among younger (ARYS) and older (VIDUS) participants were examined separately using bivariate and multivariate generalized estimating equations. A total of 1162 participants were included. Among 405 eligible younger participants (Median age = 25; Inter-Quartile Range [IQR]: 22–28), 40% (n = 160) reported engaging in NMPOU at baseline; among 757 older participants (Median age = 48, IQR: 40–55), 35% (n = 262) reported engaging in NMPOU at baseline. In separate multivariate analyses of younger and older participants, NMPOU was positively and independently associated with heroin use (younger: Adjusted Odds Ratio [AOR] = 3.12, 95% Confidence Interval [CI]: 2.08–4.68; older: AOR = 2.79, 95% CI: 2.08–3.74), drug dealing (younger: AOR = 2.22, 95% CI: 1.58–3.13; older: AOR = 1.87, 95% CI: 1.40–2.49), and difficulty accessing services (younger: AOR = 1.47, 95% CI: 1.04–2.09; older: AOR = 1.74, 95% CI: 1.32–2.29). Among the youth cohort only, NMPOU was associated with younger age (AOR = 1.12, 95% CI: 1.05–1.19), crack use (AOR = 1.56, 95% CI: 1.06–2.30), and binge drug use (AOR = 1.41, 95% CI: 1.00–1.97); older participants who engaged in NMPOU were more likely to report crystal methamphetamine use (AOR = 1.97, 95% CI: 1.46–2.66), non-fatal overdose (AOR = 1.76, 95% CI: 1.20–2.60) and sex work (AOR = 1.49, 95% CI: 1.00–2.22). The prevalence of NMPOU is similar among younger and older people who use drugs, and independently associated with markers of vulnerability among both age groups. Adults who engage in NMPOU are at risk for non-fatal overdose, which highlights the need for youth and adult-specific strategies to address NMPOU that include better access to health and social services, as well as a range of addiction treatment options for opioid use. Findings also underscore the importance of improving pain treatment strategies tailored for PWUD.
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DOI：
10.1016/j.socscimed.2017.01.027
发表时间：
2017-03
期刊：
Social science & medicine (1982)
影响因子：
--
作者：
Damon W;Callon C;Wiebe L;Small W;Kerr T;McNeil R
通讯作者：
McNeil R
影响因子：
4.4
作者：
Amlani A;McKee G;Khamis N;Raghukumar G;Tsang E;Buxton JA
通讯作者：
Buxton JA
影响因子：
6
作者：
Bruneau, Julie;Roy, Elise;Jutras-Aswad, Didier
通讯作者：
Jutras-Aswad, Didier
影响因子：
9.5
作者：
Ballinger, GA
通讯作者：
Ballinger, GA
影响因子：
4.4
作者：
Boyd, Susan;Murray, Dave;MacPherson, Donald
通讯作者：
MacPherson, Donald