RTI International, 3040 Cornwallis Rd., Research Triangle Park, NC, 27606 USA.
IBM Research, 75 Binney Street, Cambridge, MA 02142, USA.
Drug Alcohol Depend. 2018 Nov 1;192:80-87. doi: 10.1016/j.drugalcdep.2018.06.039. Epub 2018 Aug 22.
Since 2000, heroin use patterns have shifted within the United States. How this change may relate to polydrug use among local heroin users is unknown. Although polydrug use has been studied, user perceptions of drug use in terms of health risks, arrest risk, availability, cost, liking, and dependence have not been considered.
Data are presented from a brief, face-to-face survey conducted in 2016 of 200 non-in-treatment heroin users from Cleveland, OH. We assessed the use of and attitudes on alcohol, marijuana, methamphetamine, heroin, crack cocaine, powder cocaine, and prescription drugs. We estimated polydrug (concurrent past month) use with cluster analysis and latent profiles. Regression analysis estimated the strength of relationships between attitudes and frequency of use.
We identified five clusters: Cluster 1 used heroin concomitantly with alcohol and occasionally crack; Cluster 2 used heroin and crack cocaine daily; Cluster 3 used heroin daily and almost exclusively; Cluster 4 used heroin and marijuana daily; and Cluster 5 were part-time drug users. Drug use frequency was associated with liking and being anxious when drugs could not be obtained. High perceived availability of heroin and cocaine and low cost facilitated polydrug use.
Understanding polydrug use clusters among heroin users is important for addressing the larger opioid epidemic. Users' perceptions of a drug's availability and cost appeared to facilitate polydrug use and justify more detailed future research on drug access.
自 2000 年以来，美国的海洛因使用模式发生了变化。这种变化如何与当地海洛因使用者的多药使用有关尚不清楚。尽管已经对多药使用进行了研究，但用户对药物使用的看法（包括健康风险、被捕风险、可获得性、成本、喜好和依赖）尚未得到考虑。
本文呈现了 2016 年在俄亥俄州克利夫兰市对 200 名未接受治疗的海洛因使用者进行的一次简短面对面调查的数据。我们评估了酒精、大麻、冰毒、海洛因、快克可卡因、可卡因粉和处方药物的使用情况和态度。我们使用聚类分析和潜在剖面估计了多药（同期过去一个月）使用情况。回归分析估计了态度与使用频率之间关系的强度。
我们确定了五个聚类：聚类 1 同时使用海洛因、酒精和偶尔使用快克；聚类 2 每天使用海洛因和快克可卡因；聚类 3 每天使用海洛因且几乎完全使用；聚类 4 每天使用海洛因和大麻；聚类 5 是兼职吸毒者。药物使用频率与获得药物时的喜好和焦虑有关。海洛因和可卡因的高感知可获得性以及低价格促进了多药使用。
了解海洛因使用者多药使用的聚类情况对于解决更大的阿片类药物流行至关重要。用户对药物可获得性和成本的看法似乎促进了多药使用，并为进一步研究药物获取提供了依据。
