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俄勒冈州城乡纳洛酮预测因素:NHBS 和 OR-HOPE 研究结果。

Predictors of having naloxone in urban and rural Oregon findings from NHBS and the OR-HOPE study.

机构信息

Regional Research Institute, Portland State University, 1600 SW 4(th)Avenue, Suite 900, Portland, OR, 97201, USA; Public Health Division, Oregon Health Authority, 800 NE Oregon Street, Portland, OR, 97232, USA.

Comagine Health, 650 NE Holladay, Suite 1700, Portland, OR, 97232, USA.

出版信息

Drug Alcohol Depend. 2021 Oct 1;227:108912. doi: 10.1016/j.drugalcdep.2021.108912. Epub 2021 Jul 21.

DOI:10.1016/j.drugalcdep.2021.108912
PMID:34315014
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8464511/
Abstract

PURPOSE

Naloxone is an opioid antagonist that can be effectively administered by bystanders to prevent overdose. We determined the proportion of people who had naloxone and identified predictors of naloxone ownership among two samples of people who inject drugs (PWID) who use opioids in Portland and rural Western Oregon.

BASIC PROCEDURES

We used data from participants in Portland's National HIV Behavioral Surveillance (NHBS, N = 477) and the Oregon HIV/Hepatitis and Opioid Prevention and Engagement Study (OR-HOPE, N = 133). For each sample, we determined the proportion of participants who had naloxone and estimated unadjusted and adjusted relative risk of having naloxone associated with participant characteristics.

MAIN FINDINGS

Sixty one percent of NHBS and 30 % of OR-HOPE participants had naloxone. In adjusted analysis, having naloxone was associated with female gender, injecting goofballs (compared to heroin alone), housing stability, and overdose training in the urban NHBS sample, and having naloxone was associated with drug of choice, frequency of injection, and race in the rural OR-HOPE sample. In both samples, having naloxone was crudely associated with SSP use, but this was attenuated after adjustment.

PRINCIPAL CONCLUSIONS

Naloxone ownership was insufficient and highly variable among two samples of PWID who use opioids in Oregon. People who use methamphetamine, males, and people experiencing homelessness may be at increased risk for not having naloxone and SSP may play a key role in improving access.

摘要

目的

纳洛酮是一种阿片类拮抗剂,可由旁观者有效给药,以预防过量用药。我们确定了使用阿片类药物的两个吸毒者(PWID)样本中具有纳洛酮的人群比例,并确定了纳洛酮拥有的预测因素,这两个样本分别来自波特兰和俄勒冈州农村地区。

基本程序

我们使用了来自波特兰国家艾滋病毒行为监测(NHBS,N=477)和俄勒冈州艾滋病毒/肝炎和阿片类药物预防和参与研究(OR-HOPE,N=133)参与者的数据。对于每个样本,我们确定了具有纳洛酮的参与者比例,并估计了参与者特征与具有纳洛酮相关的未调整和调整后的相对风险。

主要发现

NHBS 中有 61%,OR-HOPE 中有 30%的参与者有纳洛酮。在调整分析中,具有纳洛酮与女性性别、注射“ goofballs”(与单独使用海洛因相比)、住房稳定性以及城市 NHBS 样本中的过量用药培训有关,而在农村 OR-HOPE 样本中,具有纳洛酮与毒品选择、注射频率和种族有关。在两个样本中,纳洛酮的使用与 SSP 的使用都存在粗略关联,但在调整后这种关联减弱了。

主要结论

在俄勒冈州使用阿片类药物的两个 PWID 样本中,纳洛酮的拥有量不足且差异很大。使用甲基苯丙胺的人、男性和无家可归的人可能面临没有纳洛酮的风险增加,SSP 可能在改善纳洛酮的获取途径方面发挥关键作用。