Soboka Matiwos, Tibbo Philip G, Stewart Sherry H, Simon Patryk, Wang JianLi
Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
Front Psychiatry. 2024 Dec 13;15:1476982. doi: 10.3389/fpsyt.2024.1476982. eCollection 2024.
Despite the increasing substance use in Canada, our understanding of how substance use varies based on the intersections of gender, ethnicity/race, and income sources among preclinical populations remains limited. Thus, this study aimed to investigate, among clients of mental health and addiction (MHA) intake in Nova Scotia: 1) the prevalence of substance use by gender, ethnicity, and income source; 2) the routes of substance administration; 3) factors associated with substance use. Understanding how gender, ethnicity, and income sources intersect to influence substance use patterns is essential for designing prevention and treatment strategies tailored to an individual's unique needs. Additionally, exploring the various routes of substance administration can provide insight into potential health risks, helping to inform harm reduction strategies.
This cross-sectional study included 22,500 adults who contacted MHA central intake in Nova Scotia in 2020 and 2021. Clients were assessed for substance use, substance use frequency, route of substance administration, and mental and physical health problems. The prevalence of substance use was examined as a function of gender, ethnicity, and income source. Multinomial logistic regression was used to investigate factors associated with substance use.
Among the included MHA Intake clients, 36.1% reported daily substance use. The highest prevalence of daily substance use was identified among homeless (69.7%) and non-White men on social assistance/disability (60.9%). Also, non-White individuals on social assistance/disability were more likely to engage in frequent (aOR = 2.66, 95% =1.64, 4.30) and daily (aOR = 2.82, 95% CI: 2.08, 3.82) substance use compared to White individuals. Being young (aged 19-29), lack of access to private insurance, current/past mental illness, moderate/high suicide risk, and presence of two or more psychosocial stressors, were associated with occasional, frequent, and daily substance use alike.
The high prevalence of daily substance use among MHA Intake service users in Nova Scotia highlights the need for prevention and treatment strategies to address individual and structural level factors contributing to daily substance use.
尽管加拿大物质使用情况日益增多，但我们对临床前人群中物质使用如何因性别、种族/民族和收入来源的交叉影响而有所不同的了解仍然有限。因此，本研究旨在调查新斯科舍省心理健康与成瘾（MHA）门诊的来访者：1）按性别、种族和收入来源划分的物质使用患病率；2）物质使用途径；3）与物质使用相关的因素。了解性别、种族和收入来源如何相互作用以影响物质使用模式，对于设计针对个人独特需求的预防和治疗策略至关重要。此外，探索物质使用的各种途径可以深入了解潜在的健康风险，有助于制定减少伤害的策略。
这项横断面研究纳入了2020年和2021年联系新斯科舍省MHA中心门诊的22500名成年人。对来访者进行物质使用、物质使用频率、物质使用途径以及心理和身体健康问题的评估。将物质使用患病率作为性别、种族和收入来源的函数进行检查。采用多项逻辑回归来调查与物质使用相关的因素。
在纳入的MHA门诊来访者中，36.1%报告每日使用物质。每日物质使用患病率最高的是无家可归者（69.7%）以及领取社会救助/残疾津贴的非白人男性（60.9%）。此外，领取社会救助/残疾津贴的非白人个体比白人个体更有可能频繁（调整后比值比[aOR]=2.66，95%置信区间[CI]=1.64，4.30）和每日（aOR=2.82，95%CI：2.08，3.82）使用物质。年轻（19 - 29岁）、无法获得私人保险、当前/过去患有精神疾病、中度/高自杀风险以及存在两个或更多社会心理压力源，均与偶尔、频繁和每日使用物质有关。
新斯科舍省MHA门诊服务使用者中每日物质使用的高患病率凸显了制定预防和治疗策略以解决导致每日物质使用的个体和结构层面因素的必要性。
