School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
British Columbia Centre on Substance Use (BCCSU), Vancouver, British Columbia, Canada.
Subst Abus. 2019;40(3):350-355. doi: 10.1080/08897077.2018.1528493. Epub 2018 Nov 20.
Despite the popularity of 3,4-methylenedioxymethamphetamine (MDMA; ecstasy) among young people across North America and Europe, MDMA is rarely explored in studies of young people at high risk of injecting drugs. We conducted a study among street-involved youth who use illicit drugs in Vancouver, Canada, to understand if use of MDMA is associated with initiation of injection drugs. We followed injection-naïve participants in the At-Risk Youth Study (ARYS), an ongoing prospective cohort of street-involved youth aged 14-26 who use illicit drugs. Bivariate and multivariate extended Cox models with time-updated variables were used to examine the association between MDMA use and initiation of injection drug use between September 2005 and May 2015. Among 483 youth, 306 (63.4%) had a history of MDMA use and 218 (45.1%) had used MDMA in the previous 6 months at baseline. A total of 105 (21.7%) youth initiated injection drug use over the 10-year period, yielding an incidence density of 8.51 (95% confidence interval [CI]: 6.96-10.30) per 100 person-years. MDMA use was not significantly associated with initiating injection drugs at the bivariate (hazard ratio: 0.93, 95% CI: 0.61-1.42) or multivariate (adjusted hazard ratio: 0.88, 95% CI: 0.57-1.35) level, after adjusting for socio-demographic and substance use confounders. Amid ongoing frequent use of MDMA among some young people in North America, we did not observe an elevated risk of injection initiation among those who used MDMA in this cohort of street-involved youth.
尽管 3,4-亚甲二氧基甲基苯丙胺（MDMA；摇头丸）在北美和欧洲的年轻人中很受欢迎，但在研究有注射毒品风险的年轻人时，很少涉及 MDMA。我们在加拿大温哥华对有街头背景的滥用非法药物的年轻人进行了一项研究，以了解 MDMA 的使用是否与开始注射毒品有关。我们对正在进行的前瞻性队列研究（ARYS）中的注射毒品初治参与者进行了随访，该研究纳入了年龄在 14-26 岁之间、有街头背景且滥用非法药物的年轻人。采用双变量和多变量扩展 Cox 模型，结合时间更新变量，检验 2005 年 9 月至 2015 年 5 月期间 MDMA 使用与开始使用注射药物之间的关联。在 483 名青年中，306 名（63.4%）有 MDMA 使用史，218 名（45.1%）在基线时有过去 6 个月内使用 MDMA。在 10 年期间，共有 105 名（21.7%）青年开始使用注射药物，100 人年的发生率密度为 8.51（95%置信区间[CI]：6.96-10.30）。在调整社会人口统计学和物质使用混杂因素后，在双变量（危险比：0.93，95%CI：0.61-1.42）或多变量（调整后的危险比：0.88，95%CI：0.57-1.35）水平上，MDMA 使用与开始注射药物均无显著相关性。在北美洲一些年轻人持续频繁使用 MDMA 的情况下，我们没有观察到在该有街头背景的年轻人队列中，使用 MDMA 的人开始注射药物的风险增加。
