澳大利亚注射吸毒者使用针具交换项目者中多次非致命阿片类药物过量的流行情况及其相关因素。

Prevalence and correlates of multiple non-fatal opioid overdoses among people who inject drugs who utilise needle syringe programs in Australia.

机构信息

The Kirby Institute, UNSW Sydney, Sydney, Australia.

National Drug & Alcohol Research Centre, UNSW Sydney, Sydney, Australia.

出版信息

Int J Drug Policy. 2021 Oct;96:103245. doi: 10.1016/j.drugpo.2021.103245. Epub 2021 Apr 9.

DOI:10.1016/j.drugpo.2021.103245

PMID:33840562

Abstract

BACKGROUND

Non-fatal overdose (NFOD) is a major cause of morbidity among people who inject drugs (PWID) and multiple NFOD is associated with increased risk of fatal overdose. Despite this, few studies have examined the prevalence and correlates of drug-specific multiple NFOD. The current study aimed to determine the prevalence and correlates of recent multiple non-fatal opioid overdose (NFOOD) among PWID who access needle syringe programs (NSPs) in Australia.

METHODS

The Australian Needle and Syringe Program Survey is conducted annually and was conducted at 46 sites across Australia in 2019. Participation involves completion of a self-administered questionnaire and a capillary dried blood spot for HIV and hepatitis C virus testing. In 2019, respondents who reported a minimum of one NFOOD in the previous 12 months (recent NFOOD) were asked to complete supplementary questions regarding their last NFOOD. Bivariate and multivariate logistic regression were used to determine factors independently associated with multiple recent NFOOD.

RESULTS

A total of 222 respondents reported recent NFOOD. Respondents were predominantly male (59%), one third (39%) were aged less than 39 years and 73% reported last injecting heroin at their last NFOOD. One in two respondents (48%, n = 107) reported multiple opioid overdoses (median 3, interquartile range 2-5). The odds of reporting multiple NFOOD were higher among respondents who reported injecting in a public location at their last NFOOD (adjusted odds ratio [AOR] 2.10, 95% CI 1.14-3.90, p = 0.018) and benzodiazepine use in the 12 h prior to NFOOD (AOR 2.74, 95% CI 1.50-4.99, p = 0.001).

CONCLUSIONS

Multiple NFOOD was prevalent among PWID who utilised NSPs who reported recent NFOOD. Public injecting and benzodiazepine use were associated with increased risk of multiple NFOOD, and there is a need for interventions specifically targeting PWID who report these high risk injecting practices.

摘要

背景

非致命性药物过量（NFOD）是注射吸毒者（PWID）发病率的主要原因，多次 NFOD 与致命性药物过量的风险增加有关。尽管如此，很少有研究检查过特定药物的多次 NFOD 的流行率和相关因素。本研究旨在确定澳大利亚使用针具交换项目（NSP）的 PWID 中近期多次非致命性阿片类药物过量（NFOOD）的流行率和相关因素。

方法

澳大利亚针具和注射器计划调查每年进行一次，2019 年在澳大利亚 46 个地点进行。参与包括完成自我管理的问卷和用于艾滋病毒和丙型肝炎病毒检测的毛细血管干血斑。2019 年，报告在过去 12 个月内至少有一次 NFOOD（近期 NFOOD）的受访者被要求完成有关其最后一次 NFOOD 的补充问题。使用二变量和多变量逻辑回归确定与多次近期 NFOOD 独立相关的因素。

结果

共有 222 名受访者报告了近期 NFOOD。受访者主要为男性（59%），三分之一（39%）年龄小于 39 岁，73%报告最后一次注射海洛因是在最近的 NFOOD 时。二分之一（48%，n=107）的受访者报告了多次阿片类药物过量（中位数 3，四分位距 2-5）。在最后一次 NFOOD 时在公共场所注射的受访者报告多次 NFOOD 的可能性更高（调整后的优势比[OR] 2.10，95%CI 1.14-3.90，p=0.018），在 NFOOD 前 12 小时内使用苯二氮䓬（OR 2.74，95%CI 1.50-4.99，p=0.001）。