National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
Kirby Institute, UNSW Sydney, Sydney, Australia.
Drug Alcohol Rev. 2019 Feb;38(2):159-168. doi: 10.1111/dar.12908. Epub 2019 Feb 13.
Needle-syringe programs (NSP) are an underutilized source of data on drug injection trends; these data are essential for informing public health interventions. We examine trends in NSP service occasions from 2007-2015.
Using standardised data from 26 NSP outlets through the Queensland NSP Minimum Data Set (QNSPMDS), trends in service occasions among clients intending to inject methamphetamine, heroin, opioid substitution therapy (OST) medications and other pharmaceutical opioids were assessed using multilevel mixed-effects negative binomial regression, adjusting for month, year, age and clustering by site.
Over 1.5 million service occasions were recorded in 2007-2015. Methamphetamine was the main 'drug intended to inject' (33.7%), however cf. 2007, the incidence rate ratio decreased to 0.64 (95% CI: 0.62, 0.66) in 2009, remaining low until 2015. Among clients reporting methamphetamine injection, there was a shift in the form from base to the higher-potency crystal methamphetamine since 2012. Heroin injection (22.5% service occasions) initially increased (cf. 2007), followed by a decline to 0.77 (95% CI: 0.75, 0.79) in 2015. Significant and sustained increases in OST and other pharmaceutical opioids injection were observed throughout the study period, accounting for 7.2% and 19.8% of total visits, respectively.
The QNSPMDS provides unique, routinely collected, jurisdiction-wide and standardised data on the demographics of people who inject drugs, types of drugs injected and regional variations; these data are essential in informing policy, planning and program implementation. There remains significant opportunity to enhance engagement and linkage to care alongside needle-syringe provision.
针具交换计划（NSP）是药物注射趋势数据的一个未充分利用的来源；这些数据对于为公共卫生干预措施提供信息至关重要。我们检查了 2007-2015 年 NSP 服务次数的趋势。
使用昆士兰州 NSP 最小数据集（QNSPMDS）中的 26 个 NSP 服务点的标准化数据，使用多水平混合效应负二项回归评估了打算注射甲基苯丙胺、海洛因、阿片类药物替代疗法（OST）药物和其他药物类阿片类药物的客户的服务次数趋势，调整了月份、年份、年龄和按地点聚类。
在 2007-2015 年期间，记录了超过 150 万次服务。甲基苯丙胺是主要的“打算注射的药物”（33.7%），然而，与 2007 年相比，2009 年的发病率比下降到 0.64（95%CI：0.62，0.66），直到 2015 年一直保持低位。在报告甲基苯丙胺注射的客户中，自 2012 年以来，从基础形式转变为更高效力的晶体甲基苯丙胺。海洛因注射（22.5%的服务次数）最初增加（与 2007 年相比），然后在 2015 年下降到 0.77（95%CI：0.75，0.79）。在整个研究期间，OST 和其他药物类阿片类药物注射显著且持续增加，分别占总就诊次数的 7.2%和 19.8%。
QNSPMDS 提供了独特的、常规收集的、全司法管辖区的和标准化的关于注射毒品人群的人口统计学特征、注射药物类型和区域差异的数据；这些数据对于为政策、规划和方案实施提供信息至关重要。在提供针具交换服务的同时，仍然有很大的机会加强参与和联系护理。
