British Columbia Centre on Substance Use, St. Paul's Hospital, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.
Division of Social Medicine, Department of Medicine, University of British Columbia, Vancouver, Canada.
Harm Reduct J. 2022 Nov 17;19(1):125. doi: 10.1186/s12954-022-00701-w.
Settings throughout Canada and the USA continue to experience crises of overdose death due to the toxic unregulated drug supply. Injecting drugs alone limits the potential for intervention and has accounted for a significant proportion of overdose deaths, yet the practice remains understudied. We sought to examine the practice of injecting alone among people who inject drugs (PWID) in Vancouver, Canada.
Data were derived from two prospective cohorts of people who use drugs between June 2016 and November 2018. This analysis was restricted to participants who, in the previous 6 months, reported any injection drug use. Rates of injecting alone were categorized as always, usually, sometimes, or occasionally. We fit a multivariable generalized linear mixed model to identify factors associated with injecting drugs alone.
Among 1070 PWID who contributed 3307 observations, 931 (87%) reported injecting alone at least once during the study period. In total, there were 729 (22%) reports of always injecting alone, 722 (21.8%) usually, 471 (14.2%) sometimes, 513 (15.5%) occasionally, and 872 (26.4%) never. In a multivariable model, factors positively associated with injecting drugs alone included male sex (adjusted odds ratio [AOR] 1.69; 95% confidence interval [CI] 1.20-2.37), residence in the Downtown Eastside neighbourhood (AOR 1.43; 95% CI 1.08-1.91), binge drug use (AOR 1.36; 95% CI 1.08-1.72), and experiencing physical or sexual violence or both (AOR 1.43; 95% CI 1.00-2.03). Protective factors included Indigenous ancestry (AOR 0.71; 95% CI 0.52-0.98) and being in a relationship (AOR 0.30; 95% CI 0.23-0.39).
We observed that injecting alone, a key risk for overdose mortality, was common among PWID in Vancouver. Our findings underline the need for additional overdose prevention measures that are gender-specific, culturally appropriate, violence- and trauma-informed, and available to those who inject alone.
加拿大和美国各地仍持续面临着因有毒不受监管的毒品供应而导致的过量死亡危机。单独注射毒品的做法限制了干预的可能性，并导致了很大一部分过量死亡，但这种做法仍研究不足。我们试图研究加拿大温哥华注射毒品者（PWID）中单独注射的做法。
数据来自于 2016 年 6 月至 2018 年 11 月期间的两个前瞻性吸毒者队列。本分析仅限于在过去 6 个月内报告过任何注射吸毒的参与者。单独注射的频率分为总是、通常、有时或偶尔。我们拟合了多变量广义线性混合模型，以确定与单独注射毒品相关的因素。
在 1070 名 PWID 中，有 3307 次观察结果，其中 931 名（87%）在研究期间至少报告过一次单独注射。总共有 729 次（22%）报告总是单独注射，722 次（21.8%）通常，471 次（14.2%）有时，513 次（15.5%）偶尔，872 次（26.4%）从不。在多变量模型中，与单独注射毒品相关的因素包括男性（调整后的优势比[OR]1.69；95%置信区间[CI]1.20-2.37）、居住在东城区（OR 1.43；95% CI 1.08-1.91）、狂欢式吸毒（OR 1.36；95% CI 1.08-1.72）和经历身体或性暴力或两者兼有（OR 1.43；95% CI 1.00-2.03）。保护因素包括原住民血统（OR 0.71；95% CI 0.52-0.98）和恋爱关系（OR 0.30；95% CI 0.23-0.39）。
我们观察到，在温哥华的 PWID 中，单独注射这种导致过量死亡率的关键风险因素很常见。我们的研究结果强调需要采取额外的针对过量的预防措施，这些措施应具有性别针对性、文化适宜性、以暴力和创伤为导向，并适用于单独注射的人群。
