Roth Alexis M, Armenta Richard F, Wagner Karla D, Strathdee Steffanie A, Goldshear Jesse L, Cuevas-Mota Jazmine, Garfein Richard S
a Department of Community Health & Prevention , Drexel University , Philadelphia , Pennsylvania , USA.
b Family Medicine and Public Health , University of California San Diego , San Diego , California , USA.
Subst Use Misuse. 2017 Jul 29;52(9):1202-1206. doi: 10.1080/10826084.2017.1302956. Epub 2017 Jun 12.
Black tar heroin is typically prepared for injection with heat which decreases the risk of HIV transmission by inactivating the virus. We received reports that persons who inject drugs (PWID) in Tijuana, Baja California, Mexico, a black tar heroin market, were using only water to dissolve heroin.
Because Tijuana abuts San Diego County, CA, United States, we undertook the present analyses to determine the prevalence of this practice among PWID in San Diego, California.
PWID completed quarterly behavioral assessments and serological testing for blood-borne viruses. Bivariate and multivariable logistic regression models were constructed to assess for individual, social, and structural correlates of preparing heroin without heat within the preceding 6 months.
Nearly half of black tar heroin users (149/305) reported they had prepared heroin without heat within 6 months. In multivariable analysis, cold preparation was independently associated with younger age (10 year decrease; AOR = 1.25; 95% CI 1.03, 1.53), more drug injecting acquaintances (per 5 acquaintance increase; AOR = 1.05; 95% CI 1.01, 1.09) and prefilled syringe use (injecting drugs from syringes that are already filled with drugs before purchase; AOR = 1.86; 95% CI 1.14, 3.02). Conclusions/Importance: To our knowledge, this is the first paper to report that PWID living in a black tar heroin market are preparing heroin without heat. Additional research is needed to determine whether this is an endemic practice or PWID are engaging in new forms of drug preparation in response to changes in the environment.
黑色焦油海洛因通常通过加热来准备注射，这会使病毒失活，从而降低艾滋病毒传播风险。我们收到报告称，在墨西哥下加利福尼亚州蒂华纳这个黑色焦油海洛因市场，注射毒品者（PWID）仅用水来溶解海洛因。
由于蒂华纳与美国加利福尼亚州圣地亚哥县接壤，我们进行了本分析，以确定加利福尼亚州圣地亚哥注射毒品者中这种做法的流行情况。
注射毒品者完成了季度行为评估和血液传播病毒的血清学检测。构建了双变量和多变量逻辑回归模型，以评估在前6个月内不加热制备海洛因的个体、社会和结构相关因素。
近一半的黑色焦油海洛因使用者（149/305）报告称他们在6个月内未加热制备过海洛因。在多变量分析中，冷制备与年龄较小（年龄降低10岁；调整后比值比[AOR]=1.25；95%置信区间[CI]1.03，1.53）、更多注射毒品的熟人（每增加5个熟人；AOR=1.05；95%CI1.01，1.09）以及使用预填充注射器（注射购买前已装满毒品的注射器中的毒品；AOR=1.86；95%CI1.14，3.02）独立相关。结论/重要性：据我们所知，这是第一篇报告称生活在黑色焦油海洛因市场的注射毒品者不加热制备海洛因的论文。需要进一步研究以确定这是一种地方流行做法，还是注射毒品者为应对环境变化而采用的新的毒品制备形式。
