Network of Infectious Diseases and Harm Reduction, Trimbos Institute, P,O, Box 725, Utrecht 3500, AS, The Netherlands.
Harm Reduct J. 2014 Feb 13;11:6. doi: 10.1186/1477-7517-11-6.
Injecting drug users are at increased risk for harmful effects compared to non-injecting drug users. Some studies have focused on differences in characteristics between these two groups (e.g., housing, overall health). However, no study has investigated the specific Dutch situation which in the last years has seen a decrease in homelessness among problematic hard-drug users and an increasing focus on physical health in low-threshold addiction care. The purpose of this study was to determine differences in sociodemographic, drug use and health characteristics between never-injecting (NIDUs), former-injecting (FIDUs) and current-injecting drug users (IDUs) and describe injecting practices.
A total of 202 problematic hard-drug users (NIDU = 64; FIDU = 76; IDU = 62) were recruited from 22 low-threshold care facilities, including drug consumption rooms, methadone maintenance treatment, heroin-assisted therapy, day shelter and/or night shelter, supported housing and day activity centres. Data were collected on-site through structured face-to-face interviews.
Results indicate that IDUs represented a separate group of problematic hard-drug users, with distinct sociodemographic and drug use characteristics. Overall, IDUs appeared to be the group with least favourable characteristics (unstable housing/homelessness, illegal activities, polydrug use) and NIDUs appeared to have the most favourable characteristics (stable housing, help with debts, less polydrug use). The FIDU group lies somewhere in between. The three groups did not differ significantly in terms of health. Regarding injecting practices, results showed that majority of IDUs had injected drugs for over 10 years and IDUs injected heroin, cocaine, amphetamine and/or methadone in the past 6 months. Sharing syringes was not common. A quarter reported public injecting.
Unstable housing and homelessness are related to (former) injecting drug use, and stable housing is related to never-injecting drug use. Our study suggests that the number of 'new' IDUs is low. However, public injecting among IDUs is not uncommon and is associated with unstable housing. This emphasizes the potential of housing projects as a component of harm reduction measures. Therefore, prevention of (risks associated with) injecting drug use and supported housing programmes for problematic hard-drug users deserve the continuous attention of policymakers and professionals in low-threshold addiction care.
与非注射吸毒者相比，注射吸毒者面临更大的有害影响风险。一些研究集中在这两组人群之间的特征差异上（例如，住房、整体健康状况）。然而，尚无研究调查特定的荷兰情况，近年来，问题性硬毒品使用者的无家可归现象有所减少，并且在低门槛成瘾护理中越来越重视身体健康。本研究旨在确定从未注射过（NIDU）、曾经注射过（FIDU）和当前注射过（IDU）药物的药物使用者在社会人口统计学、药物使用和健康特征方面的差异，并描述注射实践。
从 22 个低门槛护理机构（包括药物使用室、美沙酮维持治疗、海洛因辅助治疗、日间庇护所和/或夜间庇护所、支持性住房和日间活动中心）共招募了 202 名有问题的硬毒品使用者（NIDU = 64；FIDU = 76；IDU = 62）。通过现场结构化面对面访谈收集数据。
结果表明，IDU 代表了一组独特的有问题的硬毒品使用者，具有不同的社会人口统计学和药物使用特征。总体而言，IDU 似乎是特征最不利的群体（不稳定的住房/无家可归、非法活动、多药使用），而 NIDU 似乎具有最有利的特征（稳定的住房、债务帮助、少用多药）。FIDU 组则处于两者之间。这三组在健康方面没有显著差异。关于注射实践，结果表明，大多数 IDU 已经注射毒品超过 10 年，并且 IDU 在过去 6 个月内注射过海洛因、可卡因、苯丙胺和/或美沙酮。共用注射器并不常见。四分之一的人报告在公共场所注射。
不稳定的住房和无家可归与（以前）注射吸毒有关，而稳定的住房与从未注射吸毒有关。我们的研究表明，新 IDU 的数量很少。然而，IDU 中的公共注射并不罕见，并且与不稳定的住房有关。这强调了住房项目作为减少伤害措施的一个组成部分的潜力。因此，预防（与注射吸毒相关的）风险和为有问题的硬毒品使用者提供支持性住房计划应继续引起政策制定者和低门槛成瘾护理专业人员的关注。
