Brener L, Caruana T, Broady T, Cama E, Ezard N, Madden A, Treloar C
Centre for Social Research in Health, University of New South Wales, Sydney, Australia.
St Vincent's Hospital Sydney, Alcohol and Drug Service and the National Centre for Clinical Research in Emerging Drugs Drug and Alcohol Clinical Research and Improvement Network, National Drug and Alcohol Centre, University of New South Wales, Sydney, Australia.
Addict Behav Rep. 2021 Dec 11;15:100398. doi: 10.1016/j.abrep.2021.100398. eCollection 2022 Jun.
Opioids and stimulants are the most commonly injected illicit drugs worldwide and in Australia. While some people who inject drugs (PWID) prefer either opioids or stimulants, others regularly use both opioids and stimulants. Limited available research indicates that those who use opioids and stimulants together, either in combination or alternating between the two, may engage in injection-related practices which potentially place them at greater health risk and could lead to poorer health outcomes.
Participants were recruited nationally through member organizations of the Australian Injecting and Illicit Drug Users League (AIVL); these organizations represent PWID in each Australian state and territory. This study compared a sample of PWID (N = 535) who reported past-month injection of opioids only (N = 173), stimulants only (N = 208), or both (N = 154) on a range of health and wellbeing outcomes. PWID completed a survey assessing drugs injected, frequency of injecting, receptive equipment sharing, psychological distress, self-reported hepatitis C (HCV) status, experienced and internalized stigma, drug use salience, and community attachment.
People who injected both opioids and stimulants reported more frequent injecting, more experiences of stigma, and greater reported HCV diagnosis than people who injected stimulants or opioids alone. They also showed greater attachment to a community of PWID and greater salience of drug use to their identity.
The findings of increased injecting and broader harms associated with injecting both stimulants and opioids are important for tailoring harm reduction and intervention designs for people who use both opioid and stimulant drugs, including prioritizing peer-based approaches.
阿片类药物和兴奋剂是全球及澳大利亚最常被注射使用的非法药物。虽然一些注射毒品者（PWID）更喜欢使用阿片类药物或兴奋剂中的一种，但另一些人则经常同时使用阿片类药物和兴奋剂。现有有限的研究表明，那些同时使用阿片类药物和兴奋剂，无论是联合使用还是交替使用这两种药物的人，可能会采取与注射相关的行为，这可能会使他们面临更大的健康风险，并可能导致更差的健康结果。
通过澳大利亚注射和非法药物使用者联盟（AIVL）的成员组织在全国范围内招募参与者；这些组织代表了澳大利亚每个州和领地的注射毒品者。本研究比较了一组注射毒品者（N = 535）的样本，这些人报告在过去一个月仅注射阿片类药物（N = 173）、仅注射兴奋剂（N = 208）或两者都注射（N = 154），比较了他们在一系列健康和幸福状况方面的情况。注射毒品者完成了一项调查，评估所注射的毒品、注射频率、共用接受设备、心理困扰、自我报告的丙型肝炎（HCV）状况、经历的和内化的耻辱感、毒品使用的显著性以及社区归属感。
与仅注射兴奋剂或阿片类药物的人相比，同时注射阿片类药物和兴奋剂的人报告的注射频率更高、耻辱经历更多，且报告的HCV诊断率更高。他们还表现出对注射毒品者社区更强的归属感，以及毒品使用对其身份认同的更显著影响。
与同时注射兴奋剂和阿片类药物相关的注射频率增加及更广泛危害的研究结果，对于为同时使用阿片类药物和兴奋剂的人量身定制减少伤害和干预设计很重要，包括优先采用基于同伴的方法。
