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对注射器服务项目参与者进行应急管理及减少兴奋剂使用的关注。

Interest in contingency management and reducing stimulant use among syringe service program participants.

作者信息

Erath Tyler G, LaCroix Rosalie, O'Keefe Erin, Desarno Michael, Higgins Stephen T, Rawson Richard A

机构信息

Vermont Center on Behavior and Health, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA.

Howard Center Safe Recovery, Burlington, VT, USA.

出版信息

J Subst Use Addict Treat. 2025 Jul 31:209763. doi: 10.1016/j.josat.2025.209763.

Abstract

INTRODUCTION

Expanding access to effective treatment for stimulant use disorder (StimUD) is increasingly urgent as US fatal drug poisonings involving stimulants have rapidly increased. Limited information is available regarding interest in StimUD treatment among syringe service program (SSP) participants including interest in contingency management (CM).

METHODS

We surveyed SSP participants in Burlington, Vermont regarding their interests in reducing and stopping stimulant use, participating in CM, and examined associations between sociodemographics, drug use, and health/treatment variables with interest in reducing and stopping stimulant use using multivariable logistic regression.

RESULTS

Among 139 participants, 64.6 % reported interest in reducing and 59.7 % in stopping stimulant use. Overall, 82.8 % of participants reported interest in CM to reduce or stop stimulant use. Interest in reducing use was greater (odds ratio[95 % CI]) among participants currently receiving substance use disorder (SUD) treatment (3.84[1.61-9.14], p < .01), without Hepatitis C viral (HCV) infection (2.61[1.14-5.98], p = .02), and being somewhat (19.29[2.25-165.65], p = .01) or very (19.65[2.34-164.84], p = .01) concerned about anxiety. Interest in stopping use was greater among participants currently receiving SUD treatment (4.98[1.97-12.62], p < .01), without HCV infection (2.87[1.22-6.74], p = .02), participants whose primary drug was opioids compared to both stimulants and opioids (28.13[2.95-267.93], p < .01), and participants whose primary drug was stimulants compared to both stimulants and opioids (12.81[1.45-113.43], p = .02).

CONCLUSIONS

Results demonstrate interest in stimulant use treatment among this sample of SSP participants, with strong interest in CM. As community-based programs with high social acceptability for their non-judgmental services, SSPs are a novel setting to examine providing evidence-based CM for StimUD.

摘要

引言

随着美国涉及兴奋剂的致命药物中毒事件迅速增加,扩大对兴奋剂使用障碍(StimUD)有效治疗的可及性变得愈发紧迫。关于注射器服务项目(SSP)参与者对StimUD治疗的兴趣,包括对应急管理(CM)的兴趣,现有信息有限。

方法

我们对佛蒙特州伯灵顿市的SSP参与者进行了调查,了解他们在减少和停止使用兴奋剂、参与CM方面的兴趣,并使用多变量逻辑回归分析社会人口统计学、药物使用以及健康/治疗变量与减少和停止使用兴奋剂兴趣之间的关联。

结果

在139名参与者中,64.6%的人表示有兴趣减少使用兴奋剂,59.7%的人表示有兴趣停止使用兴奋剂。总体而言,82.8%的参与者表示有兴趣通过CM来减少或停止使用兴奋剂。目前正在接受物质使用障碍(SUD)治疗的参与者(优势比[95%置信区间]为3.84[1.61 - 9.14],p <.01)、未感染丙型肝炎病毒(HCV)的参与者(2.61[1.14 - 5.98],p = 0.02)以及对焦虑有些(19.2[2.25 - 165.65],p = 0.01)或非常(19.65[2.34 - 164.84],p = 0.01)担忧的参与者,对减少使用兴奋剂的兴趣更大。目前正在接受SUD治疗的参与者(4.98[1.97 - 12.62],p <.01)、未感染HCV的参与者(2.87[1.22 - 6.74],p = 0.02)、主要药物为阿片类药物而非兴奋剂和阿片类药物的参与者(28.对于主要药物为兴奋剂而非兴奋剂和阿片类药物的参与者(12.81[1.45 - 113.43],p = 0.02),停止使用兴奋剂的兴趣更大。

结论

结果表明该样本的SSP参与者对兴奋剂使用治疗有兴趣,对CM有浓厚兴趣。作为因其无评判服务而具有高社会接受度的社区项目,SSP是一个研究为StimUD提供循证CM的新环境。

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