Al-Tayyib Alia, Koester Stephen, Langegger Sig, Raville Lisa
a Denver Public Health , Denver Health and Hospital Authority , Denver , Colorado , USA.
b Anthropology and Health & Behavioral Sciences , University of Colorado Denver , Denver , Colorado , USA.
Subst Use Misuse. 2017 Jul 3;52(8):1051-1058. doi: 10.1080/10826084.2016.1271432. Epub 2017 Mar 21.
We sought to describe an emerging drug use pattern characterized by injection of both methamphetamine and heroin. We examined differences in drug injection patterns by demographics, injection behaviors, HIV and HCV status, and overdose.
Persons who inject drugs (PWID) were recruited as part of the National HIV Behavioral Surveillance (NHBS) system in Denver, Colorado. We used chi-square statistics to assess differences between those who reported only heroin injection, only methamphetamine injection, and combined heroin and methamphetamine injection. We used generalized linear models to estimate unadjusted and adjusted prevalence ratios to describe the association between drug injection pattern and reported nonfatal overdose in 2015. We also examined changes in the drug reported as most frequently injected across previous NHBS cycles from 2005, 2009, and 2012.
Of 592 participants who completed the survey in 2015, 173 (29.2%) reported only injecting heroin, 123 (20.8%) reported only injecting methamphetamine, and 296 (50.0%) reported injecting both drugs during the past 12 months. Injecting both heroin and methamphetamine was associated with a 2.8 (95% confidence interval: 1.7, 4.5) fold increase in reported overdose in the past 12 months compared with only injecting heroin. The proportion of those reporting methamphetamine as the most frequently injected drug increased from 2.1% in 2005 to 29.6% in 2015 (p < 0.001).
The rapid increase in methamphetamine injection, and the emergence of combining methamphetamine with heroin, may have serious public health implications.
我们试图描述一种以同时注射甲基苯丙胺和海洛因为特征的新兴药物使用模式。我们研究了在人口统计学、注射行为、艾滋病毒和丙型肝炎病毒感染状况以及过量用药方面药物注射模式的差异。
作为科罗拉多州丹佛市国家艾滋病毒行为监测（NHBS）系统的一部分，招募了注射吸毒者（PWID）。我们使用卡方统计量来评估仅报告注射海洛因、仅注射甲基苯丙胺以及同时注射海洛因和甲基苯丙胺者之间的差异。我们使用广义线性模型来估计未调整和调整后的患病率比，以描述2015年药物注射模式与报告的非致命过量用药之间的关联。我们还研究了在2005年、2009年和2012年之前的NHBS周期中报告注射频率最高的药物的变化情况。
在2015年完成调查的592名参与者中，173人（29.2%）报告仅注射海洛因，123人（20.8%）报告仅注射甲基苯丙胺，296人（50.0%）报告在过去12个月内同时注射这两种药物。与仅注射海洛因相比，同时注射海洛因和甲基苯丙胺与过去12个月内报告的过量用药增加2.8倍（95%置信区间：1.7，4.5）相关。报告甲基苯丙胺为注射频率最高药物的比例从2005年的2.1%增加到2015年的29.6%（p < 0.001）。
甲基苯丙胺注射的迅速增加以及甲基苯丙胺与海洛因混合使用情况的出现，可能对公共卫生产生严重影响。
