Department of Family Practice, University of British Columbia, 5950 University Boulevard, Vancouver, British Columbia, Canada.
School of Public Policy, Simon Fraser University, 515 West Hastings Street, Office 3269, Vancouver, British Columbia, Canada; British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, British Columbia, Canada.
Drug Alcohol Depend. 2020 Nov 1;216:108242. doi: 10.1016/j.drugalcdep.2020.108242. Epub 2020 Aug 18.
Pain can return temporarily to old injury sites during opioid withdrawal. The prevalence and impact of opioid withdrawal-associated injury site pain (WISP) in various groups is unknown.
Using data from observational cohorts, we estimated the prevalence and correlates of WISP among opioid-using people who inject drugs (PWID). Between June and December 2015, data on WISP and opioid use behaviours were elicited from participants in three ongoing prospective cohort studies in Vancouver, Canada, who were aged 18 years and older and who self-reported at least daily injection of heroin or non-medical presciption opioids.
Among 631 individuals, 276 (43.7 %) had a healed injury (usually pain-free), among whom 112 (40.6 %) experienced WISP, representing 17.7 % of opioid-using PWID interviewed. In a multivariable logistic regression model, WISP was positively associated with having a high school diploma or above (Adjusted Odds Ratio [AOR] = 2.23, 95 % Confidence Interval [CI]: 1.31-3.84), any heroin use in the last six months (AOR = 2.00, 95 % CI: 1.14-3.57), feeling daily pain that required medication (AOR = 2.06, CI: 1.18-3.63), and negatively associated with older age at first drug use (AOR = 0.96, 95 % CI: 0.93-0.99). Among 112 individuals with WISP, 79 (70.5 %) said that having this pain affected their opioid use behaviour, of whom 57 (72.2 %) used more opioids, 19 (24.1 %) avoided opioid withdrawal, while 3 (3.8 %) no longer used opioids to avoid WISP.
WISP is prevalent among PWID with a previous injury, and may alter opioid use patterns. Improved care strategies for WISP are warrented.
阿片类药物戒断期间，旧伤部位的疼痛可能会暂时复发。目前尚不清楚在不同人群中，阿片类药物戒断相关伤处疼痛（WISP）的发生率和影响。
我们利用来自观察性队列的数据，估计了阿片类药物使用的注射吸毒者（PWID）中 WISP 的发生率和相关因素。2015 年 6 月至 12 月期间，我们从加拿大温哥华的三项正在进行的前瞻性队列研究中招募了年龄在 18 岁及以上、自我报告至少每日注射海洛因或非医疗处方类阿片类药物的参与者，收集了 WISP 和阿片类药物使用行为的数据。
在 631 名参与者中，有 276 人（43.7%）的伤处已经愈合（通常无疼痛），其中 112 人（40.6%）经历了 WISP，占接受访谈的阿片类药物使用的 PWID 的 17.7%。在多变量逻辑回归模型中，WISP 与具有高中或以上学历（调整后的优势比 [AOR] = 2.23，95%置信区间 [CI]：1.31-3.84）、过去六个月内有任何海洛因使用史（AOR = 2.00，95%CI：1.14-3.57）、每天感到需要药物治疗的疼痛（AOR = 2.06，CI：1.18-3.63）呈正相关，与首次吸毒年龄较大（AOR = 0.96，95%CI：0.93-0.99）呈负相关。在 112 名有 WISP 的个体中，有 79 名（70.5%）表示这种疼痛影响了他们的阿片类药物使用行为，其中 57 名（72.2%）使用了更多的阿片类药物，19 名（24.1%）避免了阿片类药物戒断，而 3 名（3.8%）不再使用阿片类药物来避免 WISP。
WISP 在有既往损伤的 PWID 中较为常见，可能会改变阿片类药物的使用模式。有必要制定改善 WISP 护理策略。
