Hadland Scott E, Kerr Thomas, Li Kathy, Montaner Julio S, Wood Evan
Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
Drug Alcohol Depend. 2009 Apr 1;101(1-2):1-7. doi: 10.1016/j.drugalcdep.2008.10.012. Epub 2008 Dec 9.
A number of options for treatment are available to young drug users, but little is known about the youth who actually attempt to access such services. Here we identify characteristics of a cohort of street-involved youth and highlight commonly encountered barriers.
From September 2005 to July 2007, data were collected from the At-Risk Youth Study (ARYS), a prospective cohort of 529 drug users aged 14-26 living in Vancouver, Canada. Participants who attempted to access any addiction services in the 6 months prior to enrollment were compared in univariate analyses and multiple logistic regression modeling of socio-demographic and drug-related factors.
Factors positively associated with attempting to access services included Aboriginal ethnicity (adjusted odds ratio [AOR]=1.66 [1.05-2.62]), high school education (AOR=1.66 [1.09-2.55]), mental illness (AOR=2.25 [1.50-3.38]), non-injection crack use (AOR=2.93 [1.76-4.89]), and spending >$50 on drugs per day (AOR=2.13 [1.41-3.22]). Among those who experienced difficulty-accessing services, the most commonly identified barrier was excessively long waiting lists. In a subgroup analysis comparing those who tried to access services but were unsuccessful to those who were successful, risk factors positively associated with failure included drug bingeing (odds ratio [OR]=2.86 [1.22-6.76]) and homelessness (OR=3.86 [1.11-13.4]).
In light of accumulating evidence that drug use among street youth is associated with risky health-related behaviors, improving access to treatment and other addiction services should remain an important public health priority.
年轻吸毒者有多种治疗选择，但对于实际尝试获取此类服务的年轻人了解甚少。在此，我们确定了一群街头青少年的特征，并突出了常见的障碍。
2005年9月至2007年7月，从高危青少年研究（ARYS）收集数据，这是一项对居住在加拿大温哥华的529名14 - 26岁吸毒者的前瞻性队列研究。在单因素分析以及社会人口学和药物相关因素的多因素逻辑回归模型中，对入组前6个月内尝试获取任何成瘾服务的参与者进行了比较。
与尝试获取服务呈正相关的因素包括原住民种族（调整后的优势比[AOR]=1.66 [1.05 - 2.62]）、高中教育程度（AOR=1.66 [1.09 - 2.55]）、精神疾病（AOR=2.25 [1.50 - 3.38]）、非注射式快克使用（AOR=2.93 [1.76 - 4.89]）以及每天在毒品上花费超过50美元（AOR=2.13 [1.41 - 3.22]）。在那些获取服务有困难的人中，最常提到的障碍是等候名单过长。在一项亚组分析中，将那些尝试获取服务但未成功的人与成功的人进行比较，与失败呈正相关的危险因素包括药物滥用（优势比[OR]=2.86 [1.22 - 6.76]）和无家可归（OR=3.86 [1.11 - 13.4]）。
鉴于越来越多的证据表明街头青少年吸毒与危险的健康相关行为有关，改善治疗和其他成瘾服务的可及性应仍然是一项重要的公共卫生优先事项。
