Maxwell Jane Carlisle, Bohman Thomas M, Spence Richard T
School of Social Work, The University of Texas at Austin, Austin, Texas 78703, USA.
Subst Use Misuse. 2004 May;39(6):993-1012. doi: 10.1081/ja-120030896.
To compare the characteristics of heroin injectors vs. inhalers at their first admission to publicly funded treatment in Texas.
The sample consisted of 9732 unique clients who entered publicly funded treatment programs in Texas between 1997 and 2001 and who had a primary problem with either injected or inhaled heroin, which they had used in the past 30 days. The records were analyzed using a generalized linear model of logistic regression with the outcomes modeled as binomial and multinomial distribution and a hierarchical linear model for continuous outcomes to compare heroin inhalers and injectors.
There were large statistically significant differences between injectors and inhalers. Inhalers were more likely to be older at first use of heroin, to have entered treatment sooner, to have minor children at home, to have higher annual incomes, to be first admissions to treatment, and to have a secondary drug problem with crack cocaine. They were also more likely to be Hispanic [odds ratio (OR) = 1.74] or African-American (OR = 12.32).
Even though the race/ethnic differences in the Texas population and the type of heroin available for use in Texas differs from that studied elsewhere, many of the characteristics of heroin users are similar. Inhalers have more strengths in many areas, and these findings raise the possibility that there are factors, particularly among African-American participants in Texas, that lessen the risk of injecting heroin. Efforts should be directed to providing therapeutic interventions to discourage the transition to injecting and to encourage inhalers to enter treatment earlier rather than progressing on to injecting. This analysis is the first part of a larger study of heroin users in public and private treatment.
比较德州首次接受公共资助治疗的海洛因注射者与吸入者的特征。
样本包括9732名独特的客户，他们在1997年至2001年间进入德州的公共资助治疗项目，且在过去30天内主要存在注射或吸入海洛因的问题。使用逻辑回归的广义线性模型分析记录，将结果建模为二项式和多项分布，并使用分层线性模型分析连续结果，以比较海洛因吸入者和注射者。
注射者和吸入者之间存在统计学上的显著差异。吸入者首次使用海洛因时年龄更大，更早进入治疗，家中有未成年子女，年收入更高，首次接受治疗，且存在可卡因的二级药物问题。他们也更有可能是西班牙裔[优势比（OR）=1.74]或非裔美国人（OR = 12.32）。
尽管德州人口中的种族/民族差异以及德州可获得的海洛因类型与其他地方研究的不同，但海洛因使用者的许多特征是相似的。吸入者在许多方面有更多优势，这些发现增加了存在某些因素的可能性，特别是在德州的非裔美国参与者中，这些因素降低了注射海洛因的风险。应致力于提供治疗干预措施，以阻止向注射的转变，并鼓励吸入者更早进入治疗，而不是发展到注射。该分析是对公共和私人治疗中的海洛因使用者进行的一项更大规模研究的第一部分。
