Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA.
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA.
Int J Drug Policy. 2024 Apr;126:104371. doi: 10.1016/j.drugpo.2024.104371. Epub 2024 Mar 5.
Overdose deaths in the United States rose substantially during the COVID-19 pandemic. Disruptions to the drug supply and service provision introduced significant instability into the lives of people who use drugs (PWUD), including volatility in their drug use behaviors.
Using data from a multistate survey of PWUD, we examined sociodemographic and drug use correlates of volatile drug use during COVID-19 using multivariable linear regression. In a multivariable logistic regression model, we assessed the association between volatile drug use and past month overdose adjusting for sociodemographic and other drug use characteristics.
Among participants, 52% were male, 50% were white, 29% had less than a high school education, and 25% were experiencing homelessness. Indicators of volatile drug use were prevalent: 53% wanted to use more drugs; 45% used more drugs; 43% reported different triggers for drug use, and 23% used drugs that they did not typically use. 14% experienced a past-month overdose. In adjusted models, hunger (β=0.47, 95% CI: 0.21-0.72), transactional sex (β=0.50, 95% CI: 0.06-0.94), and the number of drugs used (β=0.16, 95% CI: 0.07-0.26) were associated with increased volatile drug use. Volatile drug use was associated with increased overdose risk (aOR=1.42, 95% CI: 1.17-1.71) in the adjusted model.
Volatile drug use during the COVID-19 pandemic was common, appeared to be driven by structural vulnerability, and was associated with increased overdose risk. Addressing volatile drug use through interventions that ensure structural stability for PWUD and a safer drug supply is essential for mitigating the ongoing overdose crisis.
在美国，COVID-19 大流行期间，过量死亡人数大幅上升。药物供应和服务提供的中断给吸毒者（PWUD）的生活带来了巨大的不稳定，包括他们的药物使用行为的波动性。
使用多州吸毒者调查数据，我们使用多变量线性回归分析了 COVID-19 期间药物使用波动的社会人口学和药物使用相关因素。在多变量逻辑回归模型中，我们调整了社会人口学和其他药物使用特征后，评估了药物使用波动与过去一个月过量用药之间的关联。
在参与者中，52%为男性，50%为白人，29%受教育程度低于高中，25%无家可归。药物使用波动的指标很普遍：53%的人希望使用更多的药物；45%的人使用了更多的药物；43%的人报告了不同的药物使用触发因素，23%的人使用了他们通常不使用的药物。14%的人经历了过去一个月的过量用药。在调整后的模型中，饥饿（β=0.47，95%CI：0.21-0.72）、交易性性行为（β=0.50，95%CI：0.06-0.94）和使用的药物数量（β=0.16，95%CI：0.07-0.26）与增加药物使用波动有关。在调整后的模型中，药物使用波动与增加过量用药风险（aOR=1.42，95%CI：1.17-1.71）有关。
COVID-19 大流行期间，药物使用波动很常见，似乎是由结构性脆弱性驱动的，并与增加的过量用药风险有关。通过确保吸毒者的结构性稳定和更安全的药物供应来解决药物使用波动问题，对于缓解当前的过量用药危机至关重要。
