Cui Zishan, Karamouzian Mohammad, Law Michael, Hayashi Kanna, Milloy M-J, Kerr Thomas
British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC Canada.
School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC Canada.
Int J Ment Health Addict. 2024;22(6):4004-4020. doi: 10.1007/s11469-023-01098-8. Epub 2023 Jun 28.
Polysubstance use is prevalent among individuals on opioid agonist treatment (OAT), yet past studies have focused primarily on distinct substances and their association with OAT retention. Data was collected from two prospective cohorts between 2005 and 2020 in Vancouver, Canada. Among 13,596 visits contributed by 1445 participants receiving OAT, we employed repeated measures latent class analysis using seven indicators and identified four longitudinal substance use classes. Using marginal structural Cox modeling, we found that compared to the primarily crack use class, the two opioid and stimulant use classes carried a higher risk of OAT discontinuation, while the primarily cannabis and crack use class had a lower OAT discontinuation risk. Our findings highlight the need for integrated treatment strategies to manage the co-use of opioids and stimulants during receipt of OAT and suggest future research should explore the potential of cannabis as a harm reduction strategy or adjunctive treatment to OAT. Word count: 150/150.
The online version contains supplementary material available at 10.1007/s11469-023-01098-8.
多物质使用在接受阿片类激动剂治疗（OAT）的个体中很普遍，但过去的研究主要集中在不同的物质及其与OAT持续治疗的关联上。数据于2005年至2020年期间从加拿大温哥华的两个前瞻性队列中收集。在接受OAT治疗的1445名参与者贡献的13596次就诊中，我们使用七个指标进行重复测量潜在类别分析，并确定了四个纵向物质使用类别。使用边际结构Cox模型，我们发现，与主要使用快克可卡因的类别相比，两种阿片类药物和兴奋剂使用类别具有更高的OAT停药风险，而主要使用大麻和快克可卡因的类别具有较低的OAT停药风险。我们的研究结果强调了在接受OAT治疗期间需要综合治疗策略来管理阿片类药物和兴奋剂的共同使用，并建议未来的研究应探索大麻作为减少伤害策略或OAT辅助治疗的潜力。字数：150/150。
在线版本包含可在10.1007/s11469-023-01098-8获取的补充材料。
