Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA.
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA; School of Public Health, National University of Kyiv-Mohyla Academy, Voloska St, 10, Kyiv, 02000, Ukraine.
Drug Alcohol Depend. 2021 Apr 1;221:108650. doi: 10.1016/j.drugalcdep.2021.108650. Epub 2021 Feb 22.
Little is known about trends in overdose behaviors. This study explored non-fatal overdose and engagement in overdose prevention behaviors and compared these trends to city-wide overdose fatality rates from 2017 to 2019 in Baltimore, MD.
The analysis included people who used opioids (PWUO; N = 502) recruited through a community-based study. Enrollment date was used to categorize participants into annual quarters. Logistic regression models examined change in overdose experiences and prevention behaviors with time. Baltimore's fatal overdoses were also mapped over the study period to assess overlaps in trends.
The majority of the sample were male(68 %), Black(61 %), reported past 6 months homelessness(56 %), and were on average 45 years old. Most had witnessed(61 %), and 28 % had personally experienced an overdose in the past 6 months. Witnessing overdose marginally increased(aβ = 0.182;p = 0.058) while experiencing overdose did not significantly change by enrollment quarter. Most participants had or had been prescribed naloxone(72 %), and one fifth(22 %) regularly carried naloxone, with both access to(aβ = 0,408;p = 0.002) and carrying naloxone(aβ = 0.302;p = 0.006) increasing over time. Overdose communication remained stable, with 63 % of participants reporting discussing overdose sometimes/often. Among participants who injected (n = 376), regularly injecting alone decreased(aβ=-0.207;p = 0.055), and reporting others often/always having naloxone with them when injecting increased over time(aβ = 0.573;p < 0.001).
Witnessed overdose marginally increased from 2017 to 2019, aligning with city trends of fatal overdose. Overdose prevention behaviors significantly increased over time. Despite reporting having naloxone or a naloxone prescription, most PWUO did not regularly carry naloxone, and many used alone. Social network diffusion interventions may be a strategy to promote normative overdose prevention behaviors.
对于过量用药行为的趋势，我们知之甚少。本研究探讨了非致命性过量用药行为，并参与了过量预防行为，并将这些趋势与马里兰州巴尔的摩市 2017 年至 2019 年的全市过量用药死亡率进行了比较。
该分析包括通过社区研究招募的阿片类药物使用者（PWUO；N=502）。入组日期用于将参与者分为年度季度。逻辑回归模型考察了随着时间的推移，过量用药经历和预防行为的变化。巴尔的摩的致命过量用药也在研究期间进行了映射，以评估趋势的重叠。
样本的大多数人是男性（68%）、黑人（61%）、过去 6 个月无家可归（56%），平均年龄为 45 岁。大多数人曾目睹（61%），28%的人在过去 6 个月中曾经历过过量用药。目睹过量用药略有增加（β=0.182，p=0.058），而过去 6 个月内经历过量用药的情况并未随着入组季度的变化而显著改变。大多数参与者已经或已经开过纳洛酮（72%），五分之一（22%）定期携带纳洛酮，获得纳洛酮（β=0.408，p=0.002）和携带纳洛酮（β=0.302，p=0.006）随着时间的推移而增加。过量用药沟通保持稳定，63%的参与者报告有时/经常讨论过量用药。在注射药物的参与者中（n=376），经常单独注射的人数减少（β=-0.207，p=0.055），同时报告注射时经常/总是有人带着纳洛酮的人数增加（β=0.573，p<0.001）。
从 2017 年到 2019 年，目睹的过量用药略有增加，与城市致命过量用药趋势一致。随着时间的推移，过量用药预防行为显著增加。尽管报告有纳洛酮或纳洛酮处方，但大多数 PWUO 并不定期携带纳洛酮，而且许多人单独使用。社会网络扩散干预可能是促进规范过量用药预防行为的一种策略。
