"Like Yin and Yang": Perceptions of Methamphetamine Benefits and Consequences Among People Who Use Opioids in Rural Communities.
"Like Yin and Yang": Perceptions of Methamphetamine Benefits and Consequences Among People Who Use Opioids in Rural Communities.
复制标题
DOI：
10.1097/adm.0000000000000669
复制
发表时间：
2021-01-01
影响因子：
5.5
通讯作者：
Korthuis PT
中科院分区：
文献类型：
--
作者：
Baker R;Leichtling G;Hildebran C;Pinela C;Waddell EN;Sidlow C;Leahy JM;Korthuis PT
本研究的目的是调查俄勒冈州农村社区使用阿片类药物的人使用甲基苯丙胺的情况，以探索使用甲基苯丙胺的原因和对甲基苯丙胺后果的看法。我们对2个阿片类药物过量率高的俄勒冈州农村县的注射药物或滥用处方阿片类药物的参与者进行了访谈和调查。调查参与者通过参与者驱动的抽样注射器服务计划和现场推广（n = 144）。半结构化的采访参与者从相同的地点（n = 52）。在完成的144项调查中，112项报告在过去30天内使用阿片类药物; 112项调查中有96%还报告使用甲基苯丙胺。在124名报告注射毒品的人中，50%的人表示他们在过去30天内同时注射了甲基苯丙胺和海洛因。访谈参与者报告了早期接触甲基苯丙胺的情况，并表示与海洛因相比，甲基苯丙胺更容易获得，更便宜，更少被污名化。参与者报告说，使用甲基苯丙胺是为了改善工作-生活功能，因为他们享受同时使用所产生的快感。一些与会者报告说，他们有意识地努力从海洛因转向甲基苯丙胺，以此作为减少危害的战略。一些参与者报告由于使用甲基苯丙胺而非自愿地从阿片类药物使用障碍治疗中出院。一些参与者认为甲基苯丙胺传递过量预防或逆转的好处，而甲基苯丙胺芬太尼污染的报告或怀疑。随着农村社区对不断变化的毒品供求作出反应，越来越需要在公共卫生方面作出努力，解决新出现的同时使用甲基苯丙胺和类阿片的问题。
The objective of this study was to investigate methamphetamine use among people who use opioids in rural Oregon communities to explore reasons for use and perceptions of methamphetamine consequences. We conducted interviews and surveys with participants who inject drugs or misuse prescription opioids in 2 rural Oregon counties with high opioid overdose rates. Survey participants were identified through participant-driven sampling initiated in syringe service programs and field outreach (n = 144). Semi-structured interviews with participants were recruited from the same locations (n = 52). Of 144 surveys completed, 112 reported using opioids in the past 30 days; 96% of the 112 also report methamphetamine use. Among the 124 reporting injection drug use, 50% indicated they injected both methamphetamine and heroin in the past 30 days. Interview participants reported early exposure to methamphetamine and indicated that methamphetamine was more widely available, less expensive, and less stigmatized compared to heroin. Participants reported using methamphetamine to improve work-life functioning and because they enjoy the high produced from simultaneous use. Several participants reported a conscious effort to shift to methamphetamine from heroin as a harm reduction strategy. Some participants reported being involuntarily discharged from treatment for opioid use disorder due to methamphetamine use. Several participants perceived methamphetamine as conveying overdose prevention or reversal benefits, while fentanyl contamination in methamphetamine was reported or suspected. As rural communities respond to evolving drug supply and demand, there is increasing need for public health efforts to address the emerging issue of concurrent methamphetamine and opioid use.