Cheng Tessa, Small Will, Nosova Ekaterina, Hogg Bob, Hayashi Kanna, Kerr Thomas, DeBeck Kora
Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, B.C., V5A 1S6, Canada.
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, B.C., V6Z 1Y6, Canada.
BMC Res Notes. 2018 Jan 16;11(1):35. doi: 10.1186/s13104-018-3152-9.
We investigated the prevalence of and risk factors associated with initiating nonmedical prescription opioid use (NMPOU) before and after illegal drugs using data from two linked cohort studies of street youth and adults who use illegal drugs in Vancouver, Canada. All participants who attended a study visit between 2013 and 2016 were eligible for the primary analyses.
Among 512 youth and 833 adult participants, the prevalence of NMPOU was extremely high (88% among street youth; 90% among adults), and over one-third of those who reported engaging in NMPOU had initiated NMPOU before illegal drug use (vs. transitioning from illegal drugs to NMPOU). Participants who reported either transitioning to or from NMPOU had higher risk profiles, particularly related to substance use, when compared with those who reported never engaging in NMPOU. Sub-analyses restricted to only those who engaged in NMPOU found few statistically significant differences between those who initiated NMPOU prior to illegal drugs versus those who initiated illegal drugs prior to NMPOU. Findings suggest that among people who use illegal drugs, early NMPOU trajectories do not appear to critically shape future patterns and practices.
我们利用加拿大温哥华两项针对街头青年和使用非法药物的成年人的关联队列研究数据，调查了在使用非法药物之前和之后开始非医疗处方阿片类药物使用（NMPOU）的患病率及相关风险因素。2013年至2016年间参加研究访视的所有参与者均符合主要分析的条件。
在512名青年和833名成年参与者中，NMPOU的患病率极高（街头青年中为88%；成年人中为90%），且报告有NMPOU行为的人中超过三分之一在使用非法药物之前就开始了NMPOU（与从非法药物转向NMPOU的情况相反）。与报告从未有过NMPOU行为的参与者相比，报告从NMPOU转向或从NMPOU转变而来的参与者具有更高的风险特征，特别是与物质使用有关。仅对有NMPOU行为的人进行的亚分析发现，在非法药物之前开始NMPOU的人与在NMPOU之前开始使用非法药物的人之间几乎没有统计学上的显著差异。研究结果表明，在使用非法药物的人群中，早期的NMPOU轨迹似乎并未对未来的模式和行为产生关键影响。
