BC Centre on Substance Use, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
J Urban Health. 2018 Apr;95(2):267-277. doi: 10.1007/s11524-017-0225-3.
Although abstinence from drug use is often a key goal of youth substance use treatment, transitioning to less harmful routes and types of drug use is desirable from both a clinical and public health perspective. Despite this, little is known about the trajectories of youth who inject drugs including changes in patterns of non-injection drug use. The At-Risk Youth Study (ARYS) is a longitudinal cohort of street-involved youth who use drugs in Vancouver, Canada. We used linear growth curve modeling to compare changes in non-injection drug use among participants who ceased injecting drugs for at least one 6-month period between September 2005 and May 2015 to matched controls who continued injecting over the same period. Of 387 eligible participants, 173 (44.7%) reported ceasing drug injection at least once. Non-injection drug use occurred during 160 (79.6%) periods of injection cessation. In adjusted linear growth curve analyses, the only non-injection drug use pattern observed to decrease significantly more than controls following injection cessation was daily crack/cocaine use (p = 0.024). With the exception of frequent crack/cocaine use, transitions out of injection drug use did not appear to coincide with increased reductions in patterns of non-injection drug use. Our findings indicate that most (80%) of the observed injection cessation events occurred in the context of ongoing substance use. Given that transitioning out of drug injection represents a significant reduction in risk and harm, efforts supporting vulnerable youth to move away from injecting may benefit from approaches that allow for ongoing non-injection drug use.
尽管戒除毒品通常是青少年药物使用治疗的关键目标，但从临床和公共卫生的角度来看，转向危害较小的药物使用途径和类型是理想的。尽管如此，对于注射毒品的青少年（包括非注射药物使用模式的变化）的轨迹知之甚少。风险青年研究（ARYS）是加拿大温哥华一个涉及街头吸毒的青少年纵向队列研究。我们使用线性增长曲线模型来比较 2005 年 9 月至 2015 年 5 月期间至少有一次停止注射毒品 6 个月的参与者和同期继续注射的匹配对照组之间非注射药物使用的变化。在 387 名合格参与者中，有 173 名（44.7%）报告至少停止过一次药物注射。在 160 次（79.6%）注射停止期间发生了非注射药物使用。在调整后的线性增长曲线分析中，与继续注射相比，只有在停止注射后观察到非注射药物使用明显减少的模式是每日吸食快克可卡因（p=0.024）。除了频繁吸食快克可卡因外，注射药物使用的转变似乎并没有伴随着非注射药物使用模式的减少。我们的研究结果表明，大多数（80%）观察到的注射停止事件发生在持续药物使用的背景下。鉴于从药物注射中转变出来代表着风险和危害的显著降低，支持弱势青年远离注射的努力可能受益于允许继续非注射药物使用的方法。
