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患有阿片类物质使用障碍的女性囚犯样本中的过量用药经历

Overdose Experiences Among a Sample of Women in Jail with Opioid Use Disorder.

作者信息

Dickson Megan F, Annett Jaxin, Walker Meghan, Leukefeld Carl, Webster J Matthew, Levi Mary M, Tillson Martha, Staton Michele

机构信息

University of Kentucky Center on Drug and Alcohol Research, Lexington, KY, USA.

Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA.

出版信息

Subst Use Misuse. 2024;59(13):1911-1920. doi: 10.1080/10826084.2024.2383982. Epub 2024 Jul 28.

Abstract

Previous non-fatal overdose may increase risk of overdose fatality for women reentering the community following incarceration, but pre-incarceration overdose experiences are understudied. This study describes the prevalence and correlates of non-fatal overdose prior to jail among women with opioid use disorder (OUD).  Women ( = 700) were randomly selected from eight Kentucky jails, screened for OUD, and interviewed as part of the NIDA-funded Kentucky Justice Community Opioid Innovation Network (JCOIN) trial. Descriptive statistics were used to examine women's prior overdose experiences, while bivariate analyses and logistic regression were used to identify correlates of overdose in the 90 days prior to jail.  Analyses found that 55.4% of women had overdosed in their lifetime, and 21.4% overdosed in the 90 days prior to jail. Of those who overdosed in the 90 days prior to jail, heroin (80.7%) was the most-commonly used drug prior to overdose, 35.2% received emergency, medically-attended services post-overdose, and 92.4% were administered naloxone - primarily by acquaintances. Overdosing in the 90 days prior to jail was positively correlated with identifying as a sexual minority, being from an urban community, childhood victimization, as well as recent heroin, fentanyl, and injection drug use. Findings indicate that prior overdose is common among jailed women with OUD, and although naloxone was often administered, few women received medically-attended services post-overdose. Results highlight the importance of distributing naloxone to community members and women reentering the community from jail, and suggest additional research is needed to understand factors inhibiting medical care following an overdose.

摘要

既往非致命性过量用药可能会增加女性在监禁后重新融入社区时过量用药致死的风险,但监禁前的过量用药经历尚未得到充分研究。本研究描述了患有阿片类物质使用障碍(OUD)的女性在入狱前非致命性过量用药的患病率及其相关因素。从肯塔基州的八所监狱中随机选取了700名女性,对她们进行了OUD筛查,并作为美国国立药物滥用研究所资助的肯塔基州司法社区阿片类创新网络(JCOIN)试验的一部分进行了访谈。描述性统计用于研究女性既往的过量用药经历,而双变量分析和逻辑回归则用于确定入狱前90天内过量用药的相关因素。分析发现,55.4%的女性一生中曾有过过量用药经历,21.4%的女性在入狱前90天内有过过量用药经历。在入狱前90天内有过过量用药经历的女性中,海洛因(80.7%)是过量用药前最常用的药物,35.2%的女性在过量用药后接受了紧急医疗服务,92.4%的女性接受了纳洛酮治疗——主要是由熟人给予的。入狱前90天内的过量用药与自我认同为性少数群体、来自城市社区、童年受侵害经历以及近期使用海洛因、芬太尼和注射毒品呈正相关。研究结果表明,既往过量用药在患有OUD的入狱女性中很常见,尽管经常使用纳洛酮,但很少有女性在过量用药后接受医疗服务。结果凸显了向社区成员和从监狱重新融入社区的女性分发纳洛酮的重要性,并表明需要进一步研究以了解抑制过量用药后医疗护理的因素。

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