Benrubi Leah M, Silcox Joseph, Hughto Jaclyn, Stopka Thomas J, Palacios Wilson R, Shrestha Shikhar, Case Patricia, Green Traci C
Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA.
Brandeis University Opioid Policy Research Collaborative, 415 South Street, Waltham, MA 02453, USA.
Drug Alcohol Depend Rep. 2023 Jun 16;8:100176. doi: 10.1016/j.dadr.2023.100176. eCollection 2023 Sep.
Injection drug use poses significant risk for skin and soft tissue infections, such as abscesses. In places with endemic fentanyl and an increasingly contaminated drug supply, injecting and injection-related harms may be increasing, yet are understudied. We aimed to explore abscess prevalence, experiences, and themes among people who inject drugs (PWID) in the context of an evolving drug supply.
Between 2019 and 2022, we surveyed and interviewed Massachusetts- based PWID about current drug use behaviors and abscess experiences. Chi-square tests explored correlates of abscess history and trends for past-year abscess percentages over time. Transcribed interview data were analyzed to identify themes related to abscess risk and opportunities for intervention.
Of the 297 PWID surveyed, 65.3% reported having an abscess at the injection site in their lifetime; 67.5% of these instances occurred within the last year. Reported past-year abscesses increased from 36.7% to 75.6% between 2019 and 2022. Correlates of past-year abscesses included frequent injection; methamphetamine, crack, or fentanyl use; and injection into the neck or calf. Methadone treatment was associated with significantly fewer recent abscesses. Interview data (n=151) confirmed the identified abscess risks, including syringe sharing and lack of hygienic supplies. Qualitative interviews provided additional data regarding healthcare provider stigma contributing to healthcare avoidance and the self-treatment of abscesses with adverse results.
Abscesses are an increasing concern among PWID residing in areas of high fentanyl prevalence and a contaminated drug supply. Community drug checking, overdose prevention sites, injection hygiene interventions, and improved access to care are indicated.
注射吸毒会带来皮肤和软组织感染（如脓肿）的重大风险。在芬太尼流行且毒品供应日益受污染的地区，注射及与注射相关的危害可能在增加，但相关研究较少。我们旨在探讨在不断变化的毒品供应背景下，注射吸毒者（PWID）中的脓肿患病率、经历及相关主题。
2019年至2022年期间，我们对马萨诸塞州的注射吸毒者进行了调查和访谈，了解他们当前的吸毒行为和脓肿经历。卡方检验探讨了脓肿病史的相关因素以及过去一年脓肿百分比随时间的变化趋势。对转录的访谈数据进行分析，以确定与脓肿风险及干预机会相关的主题。
在接受调查的297名注射吸毒者中，65.3%报告其一生中在注射部位出现过脓肿；其中67.5%的情况发生在过去一年。2019年至2022年期间，报告的过去一年脓肿发生率从36.7%增至75.6%。过去一年脓肿的相关因素包括频繁注射；使用甲基苯丙胺、快克或芬太尼；以及在颈部或小腿注射。美沙酮治疗与近期脓肿显著减少相关。访谈数据（n = 151）证实了已确定的脓肿风险，包括共用注射器和缺乏卫生用品。定性访谈提供了关于医疗服务提供者污名化导致回避医疗以及自行治疗脓肿且产生不良后果的更多数据。
在芬太尼流行率高且毒品供应受污染的地区，注射吸毒者对脓肿问题愈发担忧。建议开展社区毒品检测、过量用药预防点、注射卫生干预措施，并改善医疗服务可及性。
