Milloy M-J S, Kerr Thomas, Mathias Richard, Zhang Ruth, Montaner Julio S, Tyndall Mark, Wood Evan
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Am J Drug Alcohol Abuse. 2008;34(4):499-509. doi: 10.1080/00952990802122457.
Non-fatal overdose among injection drug users (IDU) is a source of significant morbidity. Since it has been suggested that supervised injecting facilities (SIF) may increase risk for overdose, we sought to evaluate patterns of non-fatal overdose among a cohort of SIF users. We examined recent non-fatal overdose experiences among participants enrolled in a prospective study of IDU recruited from within North America's first medically supervised safer injecting facility. Correlates of recent non-fatal overdoses were identified using generalized estimating equations (GEE). There were 1,090 individuals recruited during the study period of which 317 (29.08%) were female. At baseline, 638 (58.53%) reported a history of non-fatal overdose and 97 (8.90%) reported at least one non-fatal overdose in the last six months. This proportion remained approximately constant throughout the study period. In the multivariate GEE analysis, factors associated with recent non-fatal overdose included: sex-trade involvement (Adjusted Odds Ratio [AOR]: 1.45 [95% Confidence Interval [CI] 1.07-1.99], p = 0.02) and public drug use (AOR: 1.50 [95% CI 1.09-2.06]; p = 0.01). Using the SIF for >or= 75% of injections was not associated with recent non-fatal overdose in univariate (Odds Ratio: 1.05, p = 0.73) or multivariate analyses (AOR: 1.01, p = 0.96). The proportion of individuals reporting recent non-fatal overdose did not change over the study period. Our findings indicate that a sub-population of IDU might benefit from overdose prevention interventions. Our findings refute the suggestion that the SIF may increase the likelihood of overdose.
注射吸毒者（IDU）中的非致命性药物过量是导致严重发病的一个原因。由于有人认为监督注射设施（SIF）可能会增加药物过量的风险，我们试图评估一组SIF使用者中非致命性药物过量的模式。我们研究了参与北美首个医学监督下更安全注射设施招募的IDU前瞻性研究的参与者近期非致命性药物过量经历。使用广义估计方程（GEE）确定近期非致命性药物过量的相关因素。在研究期间共招募了1090人，其中317人（29.08%）为女性。基线时，638人（58.53%）报告有非致命性药物过量史，97人（8.90%）报告在过去六个月内至少有一次非致命性药物过量。在整个研究期间，这一比例大致保持不变。在多变量GEE分析中，与近期非致命性药物过量相关的因素包括：参与性交易（调整后的优势比[AOR]：1.45[95%置信区间[CI]1.07 - 1.99]，p = 0.02）和公开吸毒（AOR：1.50[95%CI 1.09 - 2.06]；p = 0.01）。在单变量分析（优势比：1.05，p = 0.73）或多变量分析（AOR：1.01，p = 0.96）中，75%或更多注射使用SIF与近期非致命性药物过量无关。报告近期非致命性药物过量的个体比例在研究期间没有变化。我们的研究结果表明，一部分IDU可能会从药物过量预防干预措施中受益。我们的研究结果反驳了SIF可能增加药物过量可能性的观点。
