Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S-121-4, Providence, RI 02912, USA.
Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S-121-4, Providence, RI 02912, USA; Boston University School of Medicine and Boston Medical Center, Department of Emergency Medicine, 771 Albany Street, Room 1208, Boston, MA 02118, USA; The Warren Alpert School of Medicine of Brown University, Rhode Island Hospital, 55 Claverick Street, Providence, RI 02903, USA.
Addict Behav. 2018 Jan;76:20-26. doi: 10.1016/j.addbeh.2017.07.017. Epub 2017 Jul 18.
Non-medical prescription opioid (NMPO) use is a critical public health problem in the United States, with 2.1 million new initiates annually. Young adult NMPO users are at high risk for initiating injection drug use. We assessed correlates of injection drug use among young adult NMPO users in Rhode Island, a state heavily impacted by opioid overdose.
We used data from the Rhode Island Young Adult Prescription Drug Study (RAPiDS), which recruited 199 residents aged 18-29 who reported past-30-day NMPO use (65.3% male). We compared individuals who reported ever having injected with individuals who reported never injecting, using logistic regression to identify independent correlates of injection.
Among eligible participants, the mean age was 24.6years and 61.3% were white. Over one-quarter (n=59, 29.6%) of the sample had ever injected drugs. The majority (n=46, 78.0%) of participants who had ever injected drugs reported injecting heroin as her/his first drug; the majority also reported previously snorting her/his first drug that was injected (n=46, 78.0%). In multivariable analyses, white race, older age, lifetime homelessness, and ever having overdosed or seen someone overdose were independently associated with an increased likelihood of ever injecting drugs.
These findings demonstrate a high prevalence of lifetime injection drug use among young adults who use prescription opioids non-medically. Given the observed associations between injection drug use and witnessing as well as experiencing overdose, interventions are urgently needed to improve overdose education and naloxone distribution to young adult NMPO users who inject drugs.
在美国，非医疗处方类阿片（NMPO）的使用是一个严重的公共卫生问题，每年有 210 万人新开始使用。年轻的 NMPO 使用者开始使用注射类药物的风险很高。我们评估了罗得岛年轻成年人 NMPO 使用者中注射类药物使用的相关因素，罗得岛是一个深受阿片类药物过量影响的州。
我们使用了来自罗得岛年轻成年人处方药物研究（RAPiDS）的数据，该研究招募了 199 名年龄在 18-29 岁之间的居民，他们报告了过去 30 天内 NMPO 的使用情况（65.3%为男性）。我们比较了报告有过注射行为的个体和报告从未注射过的个体，使用逻辑回归来确定注射行为的独立相关因素。
在符合条件的参与者中，平均年龄为 24.6 岁，61.3%为白人。超过四分之一（n=59，29.6%）的样本曾经注射过药物。样本中注射过药物的大多数（n=46，78.0%）报告说他们的第一支注射药物是海洛因；大多数人还报告说他们之前曾经吸食过他们注射的第一支药物（n=46，78.0%）。在多变量分析中，白人种族、年龄较大、终身无家可归、曾经过量用药或见过他人过量用药与注射药物的可能性增加独立相关。
这些发现表明，在非医疗使用处方类阿片的年轻成年人中，终生注射药物的使用非常普遍。鉴于观察到的注射类药物使用与目睹和经历过量用药之间的关联，迫切需要干预措施，以提高对注射类药物使用的 NMPO 年轻成年人的过量用药教育和纳洛酮的分发。
