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越南接受美沙酮维持治疗的阿片类药物使用障碍患者中与甲基苯丙胺使用严重程度相关的因素。

Correlates of methamphetamine use severity among patients receiving methadone maintenance treatment for opioid use disorder in Vietnam.

机构信息

Center for Training and Research on Substance Abuse-HIV, Hanoi Medical University, Hanoi, Viet Nam.

Center for Behavioral and Addiction Medicine, Department of Family Medicine, University of California, Los Angeles, United States of America.

出版信息

J Subst Abuse Treat. 2022 Jan;132:108461. doi: 10.1016/j.jsat.2021.108461. Epub 2021 May 7.

Abstract

OBJECTIVES

To assess the severity of methamphetamine use among methadone maintenance treatment (MMT) patients in Vietnam with opioid use disorder and concurrent methamphetamine use, and to identify risk factors associated with higher severity of methamphetamine use.

METHODS

We used survey data and medical record abstractions from 428 people with opioid use disorder who also use methamphetamine while partaking in methadone treatment in five clinics in Hanoi, Vietnam. We used multinomial logistic regression to assess other risk factors and problems associated with high methamphetamine use severity.

RESULTS

Those who reported injecting heroin in the past 3 months (AOR = 4.05, 95% CI [1.30, 12.55], p = 0.02), having a longer history of lifetime heroin use (AOR = 1.13, 95% CI [1.03, 1.24], p < 0.01), and having higher cravings (AOR = 1.97, 95% CI [1.31, 2.98], p < 0.01) and fatigue (AOR = 1.25, 95% CI [0.96, 1.61], p = 0.09) related to methamphetamine withdrawal had greater odds of high methamphetamine use severity. One of five clinics had a significantly higher percentage of methamphetamine use severity than others.

CONCLUSION

Successful MMT in patients with opioid use disorder in Vietnam may additionally require methamphetamine-focused screening and intervention.

摘要

目的

评估越南美沙酮维持治疗(MMT)门诊中阿片类物质使用障碍且合并使用甲基苯丙胺的患者的甲基苯丙胺使用严重程度,并确定与较高甲基苯丙胺使用严重程度相关的风险因素。

方法

我们使用了来自越南河内 5 家诊所的 428 名阿片类物质使用障碍且同时使用美沙酮治疗的患者的调查数据和病历摘要。我们使用多项逻辑回归来评估与高甲基苯丙胺使用严重程度相关的其他风险因素和问题。

结果

报告过去 3 个月内注射海洛因的患者(比值比 [OR] = 4.05,95%置信区间 [CI] [1.30,12.55],p = 0.02)、海洛因使用史较长的患者(OR = 1.13,95%CI [1.03,1.24],p < 0.01)、甲基苯丙胺戒断时更高的渴求(OR = 1.97,95%CI [1.31,2.98],p < 0.01)和疲劳(OR = 1.25,95%CI [0.96,1.61],p = 0.09)的患者,发生高甲基苯丙胺使用严重程度的可能性更大。5 家诊所中有 1 家的甲基苯丙胺使用严重程度百分比显著高于其他诊所。

结论

越南阿片类物质使用障碍患者的美沙酮维持治疗可能需要额外进行以甲基苯丙胺为重点的筛查和干预。

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