The Influence of Poly-drug Use Patterns on the Association Between Opioid Agonist Treatment Engagement and Injecting Initiation Assistance

Overview

Journal Subst Abuse Treat Prev Policy

Publisher Biomed Central

Specialty Psychiatry

Date 2022 May 19

PMID 35590419

Authors

Stephanie A Meyers-Pantele

Maria Luisa Mittal

Sonia Jain

Shelly Sun

Indhu Rammohan

Nadia Fairbairn

M-J Milloy

Kora DeBeck

Kanna Hayashi

Dan Werb

Affiliations

Soon will be listed here.

Abstract

Background: Evidence suggests people who inject drugs (PWID) prescribed opioid agonist treatment (OAT) are less likely to provide injection drug use (IDU) initiation assistance. We investigated the association between OAT engagement and providing IDU initiation assistance across poly-drug use practices in Vancouver, Canada.

Methods: Preventing Injecting by Modifying Existing Responses (PRIMER) is a prospective study seeking to identify structural interventions that reduce IDU initiation. We employed data from linked cohorts of PWID in Vancouver and extended the findings of a latent profile analysis (LPA). Multivariable logistic regression models were performed separately for the six poly-drug use LPA classes. The outcome was recently assisting others in IDU initiation; the independent variable was recent OAT engagement.

Results: Among participants (n = 1218), 85 (7.0%) reported recently providing injection initiation assistance. When adjusting for age and sex, OAT engagement among those who reported a combination of high-frequency heroin and methamphetamine IDU and low-to-moderate-frequency prescription opioid IDU and methamphetamine non-injection drug use (NIDU) was associated with lower odds of IDU initiation assistance provision (Adjusted Odds Ratio [AOR]: 0.18, 95% CI: 0.05-0.63, P = 0.008). Significant associations were not detected among other LPA classes.

Conclusions: Our findings extend evidence suggesting that OAT may provide a population-level protective effect on the incidence of IDU initiation and suggest that this effect may be specific among PWID who engage in high-frequency methamphetamine and opioid use. Future research should seek to longitudinally investigate potential causal pathways explaining the association between OAT and initiation assistance provision among PWID to develop tailored intervention efforts.

Citing Articles

First-line opioid agonist treatment as prevention against assisting others in initiating injection drug use: A longitudinal cohort study of people who inject drugs in Vancouver, Canada.

Bouck Z, Tricco A, Rosella L, Banack H, Fox M, Platt R Drug Alcohol Depend Rep. 2023; 7:100168.

PMID: 37397436 PMC: 10311194. DOI: 10.1016/j.dadr.2023.100168.

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