Characteristics Associated with Nonmedical Methadone Use among People Who Inject Drugs in California.
Characteristics Associated with Nonmedical Methadone Use among People Who Inject Drugs in California.
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加州注射毒品者非医疗美沙酮使用的相关特征。
DOI：
10.1080/10826084.2019.1673420
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发表时间：
2020
影响因子：
2
通讯作者：
Bluthenthal,RickyN
中科院分区：
文献类型：
--
作者：
Zhao,JohnathanK;Kral,AlexH;Wenger,LynnD;Bluthenthal,RickyN
非法、非医疗使用阿片类激动剂药物如美沙酮是一个持续关注的问题。然而，很少有研究调查了注射毒品（PWID）的人对美沙酮的非医学使用。目的：本研究描述了PWID社区样本中非药物美沙酮使用的流行程度，并检查了与近期使用非药物美沙酮相关的因素。方法2011-2013年在美国加利福尼亚州，采用针对性抽样和访谈的方法，收集PWID患者的横断面样本（N= 777）。使用描述性、双变量和多变量逻辑回归分析来确定与过去30天内非药物美沙酮使用相关的特征。为了确定在过去6个月内非药物美沙酮使用是否与用药过量有关，进行了一项单独的多变量分析。结果在抽样的PWID中，21%的人报告在过去30天内使用过非药物美沙酮。在多因素logistic回归分析中，非药物美沙酮使用与近期美沙酮维持治疗相关（调整优势比[AOR] = 2.86； 95%可信区间[CI] = 1.90, 4.30）、近期非药物丁丙诺啡使用相关（AOR = 3.12; 95% CI = 1.31, 7.47）、较高的注射频率（参考<30次注射；30 - 89次注射AOR = 1.89; 95% CI = 1.19, 3.02； 90次以上注射AOR = 2.43; 95% CI = 1.53, 3.87）、精神分裂症诊断相关(AOR = 2.36；95% CI = 1.36, 4.10)，最近使用非注射类阿片处方（AOR = 2.97; 95% CI = 1.99, 4.43），以及最近滥用注射类阿片处方（AOR = 2.13; 95% CI = 1.27, 3.59）。发现非药物美沙酮使用与非致命性用药过量无关（AOR = 0.77; 95% CI = 0.38, 1.56）。结论非药物使用美沙酮是PWID中的一个易感亚群，与非致命性用药过量风险升高无关，需要扩大美沙酮治疗的可用性。
BackgroundIllicit, nonmedical use of opioid agonist medications such as methadone is an ongoing concern. Yet, few studies have examined nonmedical use of methadone by people who inject drugs (PWID).Objectives: This study describes the prevalence of nonmedical methadone use in a community sample of PWID and examines factors associated with recent use of nonmedical methadone.MethodsA cross-sectional sample of PWID (N= 777) was recruited using targeted sampling and interviewed in California (2011–2013). Descriptive, bivariate, and multivariate logistic regression analyses were used to determine characteristics associated with nonmedical methadone use in the last 30 days. To determine if nonmedical methadone use was associated with overdose in the last 6 months, a separate multivariate analysis was conducted.ResultsAmong PWID sampled, 21% reported nonmedical methadone use in the last 30 days. In multivariate logistic regression analysis, nonmedical methadone use was associated with recent methadone maintenance treatment (adjusted odds ratio [AOR] = 2.86; 95% confidence interval [CI] = 1.90, 4.30), recent nonmedical buprenorphine use (AOR = 3.12; 95% CI = 1.31, 7.47), higher injection frequency (referent <30 injections; 30–89 injections AOR = 1.89; 95% CI = 1.19, 3.02; 90-plus injections AOR = 2.43; 95% CI = 1.53, 3.87), schizophrenia diagnosis (AOR = 2.36; 95% CI = 1.36, 4.10), recent non-injection opioid prescription use (AOR = 2.97; 95% CI = 1.99, 4.43), and recent injection opioid prescription misuse (AOR = 2.13; 95% CI = 1.27, 3.59). Nonmedical methadone use was found not to be associated with nonfatal overdose (AOR = 0.77; 95% CI = 0.38, 1.56).ConclusionNonmedical methadone use identifies a vulnerable subpopulation among PWID, is not associated with elevated nonfatal overdose risk, and evidences a need to expand methadone treatment availability.