Columbia University, School of Social Work, New York, New York, United States of America.
Yale University, School of Medicine, Department of Psychiatry, New Haven, Connecticut, United States of America.
PLoS One. 2019 Dec 27;14(12):e0225854. doi: 10.1371/journal.pone.0225854. eCollection 2019.
This study examines the relationship between experiencing intimate partner violence (IPV), exposure to prior childhood adversity, lifetime adverse experiences, drug-related relationship dependencies with intimate partners and overdose, hospitalization for drug use, friends and family members who overdosed and witnessing overdose.
This paper included a sample of 201 women who use drugs in heterosexual relationships with criminal justice-involved men in New York City. We included measures of experiencing overdose, hospitalization for drug use, witnessing overdose, and having friends and family who overdosed. Intimate partner violence consisted of either 1) none/verbal only, 2) moderate and 3) severe abuse. Dichotomous indicators of drug-related relationship dependencies included financial support, drug procurement, splitting and pooling drugs. A scale measured cumulative exposure to childhood adversity and lifetime exposures to adverse events. This paper hypothesized that experiencing moderate and severe IPV, drug-related dependencies and exposure to prior childhood and lifetime adversity would be associated with a greater risk of experiencing overdose, hospitalization for drug use, witnessing overdose and having friends and family members who overdosed. Generalized linear modeling with robust variance estimated relative risk ratios that accounted for potential bias in confidence intervals and adjusted for race, ethnicity, education and marital status.
We found experiencing moderate or severe IPV was associated with ever being hospitalized for drug use and having a family member who experienced overdose. Experiencing moderate IPV was associated with increased risk of witnessing overdose, Partner drug dependencies were associated with overdose, ever being hospitalized for drug use, witnessing overdose, and having a family member or friend who experienced overdose. Childhood and lifetime adversity exposures were significantly associated with increased risk of overdose, ever being hospitalized for drug use, ever witnessing overdose and having a friend and family member who overdosed.
Findings underscore the intersection of experiencing IPV and drug-related relationship dependencies, childhood adversity and lifetime adversity in shaping experiences of and witnessing overdose among women who use drugs. They highlight the urgent need to address IPV, adversity experiences and drug-related relationship dependencies in overdose prevention for women who use drugs.
本研究考察了经历亲密伴侣暴力（IPV）、暴露于先前儿童期逆境、一生中经历的不良事件、与亲密伴侣的药物相关关系依赖以及过量、因药物使用住院、朋友和家人过量以及目睹过量之间的关系。
本文包括了纽约市与有犯罪记录的男性发生异性恋关系的 201 名女性吸毒者样本。我们纳入了经历过量、因药物使用住院、目睹过量以及有朋友和家人过量的测量指标。亲密伴侣暴力包括 1）无/仅口头暴力，2）中度和 3）严重虐待。药物相关关系依赖的二分指标包括经济支持、药物采购、分割和混合药物。一个量表衡量了儿童期逆境和一生中经历的不良事件的累积暴露情况。本文假设经历中度和重度 IPV、药物相关依赖以及先前儿童期和一生中经历的逆境与经历过量、因药物使用住院、目睹过量以及有朋友和家人过量的风险增加有关。使用稳健方差估计的广义线性模型估计了相对风险比，这些比数比考虑了置信区间中的潜在偏差，并根据种族、族裔、教育程度和婚姻状况进行了调整。
我们发现经历中度或重度 IPV 与因药物使用而住院治疗和有家人经历过量有关。经历中度 IPV 与增加目睹过量的风险有关，伴侣药物依赖与过量、因药物使用住院治疗、目睹过量以及有家人或朋友经历过量有关。儿童期和一生中经历的逆境暴露与过量、因药物使用住院治疗、目睹过量以及有朋友和家人过量的风险增加显著相关。
研究结果强调了经历 IPV 和药物相关关系依赖、儿童期逆境和一生中逆境在塑造女性吸毒者经历和目睹过量方面的交集。它们突出表明，迫切需要在女性吸毒者的过量预防中解决 IPV、逆境经历和药物相关关系依赖问题。
