Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Ann Med. 2023 Dec;55(1):2196435. doi: 10.1080/07853890.2023.2196435.
Treatment for opioid use disorder (OUD) with diacetylmorphine is an evidence-based form of drug treatment, but it is not available in the United States (US). Better understanding acceptability of treatment with injectable diacetylmorphine among people who use opioids (PWUO) in the US may expedite future initiatives designed to engage persons in this form of treatment should it become available. The purpose of this research is to examine factors associated with interest in treatment with injectable diacetylmorphine among a sample of PWUO in the US.
Data are from a cross-sectional study of PWUO in Baltimore City, Maryland. Participants were given a brief description of treatment with injectable diacetylmorphine and then asked to rate their level of interest. We used Poisson regression with robust variance to assess factors associated with interest in treatment with injectable diacetylmorphine.
The average age of participants was 48 years, 41% were women, and most (76%) identified as non-Hispanic, Black. The most commonly used substances were non-injection heroin (76%), opioid pain relievers (73%), and non-injection crack/cocaine (73%). Two-thirds of participants (68%) indicated interest in treatment with injectable diacetylmorphine. Factors significantly associated with interest in injectable diacetylmorphine treatment included: having at least a high school education (adjusted prevalence ratio [aPR]: 1.23; 95% confidence interval [CI]: 1.04-1.45), not having health insurance (aPR: 1.23; 95% CI: 1.06-1.44), having ever overdosed (aPR: 1.20; 95% CI: 1.01-1.42), and past utilization of medications for opioid use disorder (aPR: 1.22; 95% CI: 1.01-1.47). Recent non-injection cocaine use was inversely associated with interest in treatment with injectable diacetylmorphine (aPR 0.80; 95% CI: 0.68-0.94).
The majority of participants reported interest in treatment with injectable diacetylmorphine. Given worsening trends in the addiction and overdose crisis in the US, treatment with injectable diacetylmorphine should be considered as another evidence-based option for treating OUD.KEY MESSAGESInterest in treatment with injectable diacetylmorphine was high among a sample of people who use opioids in the United States.Factors associated with increased interest in treatment with injectable diacetylmorphine included having at least a high school education, having ever overdosed, and not having health insurance.Past utilization of medications for opioid use disorder was associated with interest in treatment with injectable diacetylmorphine.
使用二乙酰吗啡治疗阿片类药物使用障碍（OUD）是一种基于证据的药物治疗形式，但它在美国（US）并不适用。更好地了解美国阿片类药物使用者（PWUO）对注射用二乙酰吗啡治疗的可接受性，可能会加速未来旨在使更多人接受这种治疗形式的举措，一旦该药物在美国可用。本研究的目的是研究与美国 PWUO 样本中对注射用二乙酰吗啡治疗的兴趣相关的因素。
数据来自马里兰州巴尔的摩市 PWUO 的一项横断面研究。参与者获得了关于注射用二乙酰吗啡治疗的简要说明，然后被要求对他们的兴趣程度进行评分。我们使用具有稳健方差的泊松回归来评估与注射用二乙酰吗啡治疗兴趣相关的因素。
参与者的平均年龄为 48 岁，41%为女性，大多数（76%）是非西班牙裔、黑人。最常使用的物质是非注射类海洛因（76%）、阿片类止痛药（73%）和非注射类可卡因（73%）。三分之二的参与者（68%）表示有兴趣接受注射用二乙酰吗啡治疗。与对注射用二乙酰吗啡治疗感兴趣显著相关的因素包括：至少受过高中教育（调整后患病率比 [aPR]：1.23；95%置信区间 [CI]：1.04-1.45）、没有医疗保险（aPR：1.23；95%CI：1.06-1.44）、曾经过量（aPR：1.20；95%CI：1.01-1.42）和过去使用过治疗阿片类药物使用障碍的药物（aPR：1.22；95%CI：1.01-1.47）。最近非注射可卡因的使用与对注射用二乙酰吗啡治疗的兴趣呈负相关（aPR 0.80；95%CI：0.68-0.94）。
大多数参与者报告有兴趣接受注射用二乙酰吗啡治疗。鉴于美国成瘾和过量危机的恶化趋势，应考虑将注射用二乙酰吗啡作为治疗阿片类药物使用障碍的另一种基于证据的选择。
在美国，阿片类药物使用者样本中对注射用二乙酰吗啡治疗的兴趣很高。与对注射用二乙酰吗啡治疗的兴趣增加相关的因素包括至少受过高中教育、曾经过量以及没有医疗保险。过去使用过治疗阿片类药物使用障碍的药物与对注射用二乙酰吗啡治疗的兴趣相关。
