Economic Challenges and Behavioral and Mental Health Risks for Overdose during the COVID-19 Pandemic among People Who Inject Drugs.
Economic Challenges and Behavioral and Mental Health Risks for Overdose during the COVID-19 Pandemic among People Who Inject Drugs.
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DOI：
10.3390/ijerph19095351
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发表时间：
2022-04-28
影响因子：
--
通讯作者：
Boodram, Basmattee
中科院分区：
文献类型：
--
作者：
Williams, Leslie D.;Lee, Eunhye;Latkin, Carl;Mackesy-Amiti, Mary Ellen;Kaufmann, Maggie;Copulsky, Elizabeth;Kaplan, Charlie;Boodram, Basmattee
注射吸毒者（PWID）是一个不成比例地与经济和精神健康挑战作斗争的人群。然而，尽管有许多报告称，在2019冠状病毒病大流行期间，全球人们面临新的或加剧的经济和/或精神健康挑战，但关于大流行对PWID的影响及其危害风险（例如过量用药）的文献仍然很少。本研究将描述大流行期间芝加哥PWID中药物过量风险因素（包括精神健康症状和护理机会的变化）的报告变化，并将研究这些风险因素变化与大流行期间经济挑战经历之间的关联。对来自芝加哥郊区的年轻PWID及其注射风险网络成员（N = 138；平均年龄= 28.7岁）的正在进行的纵向研究的参与者进行了采访，了解自COVID-19大流行开始以来他们的经历、物质使用行为和心理健康的变化。对具有大流行期间经济挑战经验的每个“过量风险因素”计算了二元交叉表。使用Fisher精确检验来评估统计显著性。还进行了调整后的逻辑回归模型，控制了社会人口特征、大流行开始以来经过的时间、大流行前的收入、无家可归者和注射频率。超过一半的样本报告在大流行期间比平时更多地单独使用，超过40%的样本报告使用比平时更多和/或购买纯度或质量降低的药物。此外，我们的很大一部分样本（52.5%的受访者）报告说，获得精神卫生保健比平时更困难。在大流行期间失去收入来源与使用更多药物、单独使用更多药物、单独使用时使用更多药物、希望停止使用但无法停止使用以及难以获得精神卫生保健有关。本研究发现的初步关联表明，大流行期间经历的经济挑战或中断可能会通过上述与过量风险相关的行为和/或条件的变化，增加经历此类挑战的PWID患者过量用药的风险。因此，干预工作的重点不仅应直接放在预防过量用药上，还应放在协助吸毒成瘾者应对其经济挑战，帮助他们恢复经济稳定和获得可能因财政困难而受到阻碍的服务上。
People who inject drugs (PWID) are a population that disproportionately struggles with economic and mental health challenges. However, despite numerous reports of people globally experiencing new or exacerbated economic and/or mental health challenges during the COVID-19 pandemic, the literature on the effect of the pandemic on PWID and their risk for harm (e.g., overdose) remains sparse. The present study will describe reported changes during the pandemic in risk factors for drug overdose (including changes in mental health symptoms and care access) among PWID in Chicago, and it will examine associations between such risk factor changes and the experience of economic challenges during the pandemic. Participants from an ongoing longitudinal study of young PWID from the Chicago suburbs and their injection risk network members (N = 138; mean age = 28.7 years) were interviewed about changes in their experiences, substance use behavior, and mental health since the start of the COVID-19 pandemic. Bivariate cross tabulations were computed of each “overdose risk factor” with experiences of economic challenges during the pandemic. Fisher’s Exact Tests were used to assess statistical significance. Adjusted logistic regression models were also conducted that controlled for sociodemographic characteristics, for time elapsed since the start of the pandemic, and for pre-pandemic income, homelessness, and injection frequency. Over half of our sample reported using alone more than usual during the pandemic, and over 40% reported using more than usual and/or buying drugs that were of a decreased purity or quality. Additionally, a large proportion of our sample (52.5% of those asked) reported more difficulty than usual accessing mental health care. Experiencing loss of a source of income during the pandemic was associated with using more drugs, using alone more, using a larger amount of drugs while using alone, wanting to stop using but being unable, and difficulty accessing mental health care. The preliminary associations found by the present study suggest that economic challenges or disruptions experienced during the pandemic are likely to increase risk for overdose among PWID experiencing such challenges, via changes in the above behaviors and/or conditions that are associated with risk for overdose. Intervention efforts should therefore be focused not only directly on overdose prevention, but also on assisting PWID with their economic challenges and helping them regain economic stability and access to services that may have been impeded by financial difficulty.
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DOI：
10.1016/j.glohj.2021.02.004
发表时间：
2021-03
期刊：
Global health journal (Amsterdam, Netherlands)
影响因子：
--
作者：
Zhang Y;Lange KW
通讯作者：
Lange KW
DOI：
10.1097/00001648-199001000-00010
发表时间：
1990-01-01
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Rothman, K J
通讯作者：
Rothman, K J
影响因子：
64.3
作者：
Kola, Lola;Kohrt, Brandon A.;Hanlon, Charlotte;Naslund, John A.;Sikander, Siham;Balaji, Madhumitha;Benjet, Corina;Cheung, Eliza Yee Lai;Eaton, Julian;Gonsalves, Pattie;Hailemariam, Maji;Luitel, Nagendra P.;Machado, Daiane B.;Misganaw, Eleni;Omigbodun, Olayinka;Roberts, Tessa;Salisbury, Tatiana Taylor;Shidhaye, Rahul;Sunkel, Charlene;Ugo, Victor;van Rensburg, Andre Janse;Gureje, Oye;Pathare, Soumitra;Saxena, Shekhar;Thornicroft, Graham;Patel, Vikram
通讯作者：
Patel, Vikram
影响因子：
5.2
作者：
Croxford S;Emanuel E;Ibitoye A;Njoroge J;Edmundson C;Bardsley M;Heinsbroek E;Hope V;Phipps E
通讯作者：
Phipps E
影响因子：
4.2
作者：
Mackesy-Amiti, Mary E.;Donenberg, Geri R.;Ouellet, Lawrence J.
通讯作者：
Ouellet, Lawrence J.