Behavioral and Health Outcome Differences by Heroin or Methamphetamine Preference Among People in Rural US Communities Who Use Both Substances.

Substance use : research and treatment Pub Date : 2024-08-21 eCollection Date: 2024-01-01 DOI:10.1177/29768357241272374
L Sarah Mixson, Bridget M Whitney, Wiley D Jenkins, Thomas J Stopka, P Todd Korthuis, Lydia N Drumright, Stephanie A Ruderman, Peter D Friedmann, Mai T Pho, April M Young, Ryan P Westergaard, David W Seal, Vivian F Go, William C Miller, William A Zule, Judith Feinberg, Hannah Lf Cooper, Judith I Tsui, Heidi M Crane, Joseph A Delaney
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Abstract

Background: The United States' (US) opioid overdose epidemic has evolved into a combined stimulant/opioid epidemic, a pattern driven in part by mitigating opioid overdose risk, variable substance availability, and personal preferences. This study aimed to investigate the association between self-reported substance preference (heroin or methamphetamine) and behavioral/health outcomes among individuals who used both heroin and methamphetamine in the rural US.

Methods: The Rural Opioid Initiative is a consortium of 8 research cohorts from 10 states and 65 rural counties that recruited individuals reporting past 30-day injection of any substance or opioid substance use by any route from 1/2018 to 3/2020. Analyses were restricted to participants ⩾18 years, who self-reported either heroin or methamphetamine as their preferred substance and past 30-day use of both heroin and methamphetamine. We examined cross-sectional associations between preferred substance (heroin versus methamphetamine) and behavioral and health outcomes using random effects meta-analysis with adjusted regression models.

Results: Among 1239 participants, 61% (n = 752) reported heroin as their preferred substance. Adjusting for age, sex, and race/ethnicity, methamphetamine preference was associated with lower prevalence ratios for current naloxone possession (adjusted prevalence ratio [aPR] = 0.68; 95% Confidence Interval [95% CI] = 0.59-0.78; P-value ⩽ .001), of ever being told they had the hepatitis C virus (HCV; aPR = 0.72; 95% CI: 0.61-0.85; P-value ⩽ .001) and a personal history of overdose (aPR = 0.81; 95% CI = 0.73-0.90; P-value ⩽ .001).

Conclusion: In our study analyzing associations between preferred substance and various behavioral and health outcomes amongst people who use both heroin and methamphetamine, a majority of participants preferred heroin. Methamphetamine preference was associated with lower prevalence of naloxone possession, ever being told they had HCV, and prior history of an overdose. This study underscores the need for targeted harm reduction services for people who prefer methamphetamine in rural areas.

美国农村社区同时使用海洛因和甲基苯丙胺的人群在行为和健康结果方面的差异。
背景:美国的阿片类药物过量疫情已演变成刺激剂/阿片类药物的综合疫情,这种模式的部分原因是阿片类药物过量风险的降低、药物供应的变化以及个人偏好。本研究旨在调查美国农村地区同时使用海洛因和甲基苯丙胺的人自我报告的药物偏好(海洛因或甲基苯丙胺)与行为/健康结果之间的关联:农村阿片类药物倡议 "是一个由来自 10 个州和 65 个农村县的 8 个研究队列组成的联盟,该联盟招募了报告在过去 30 天内注射过任何药物或在 2018 年 1 月至 2020 年 3 月期间通过任何途径使用过阿片类药物的个人。分析仅限于年龄⩾18 岁的参与者,他们自我报告说海洛因或甲基苯丙胺是他们的首选物质,并且在过去 30 天内使用过海洛因和甲基苯丙胺。我们使用随机效应荟萃分析和调整回归模型研究了首选药物(海洛因和甲基苯丙胺)与行为和健康结果之间的横截面关联:在 1239 名参与者中,61%(n = 752)称海洛因是他们的首选药物。在对年龄、性别和种族/民族进行调整后,甲基苯丙胺偏好与当前拥有纳洛酮的流行率较低有关(调整流行率 [aPR] = 0.68; 95% 置信区间 [95% CI] = 0.59-0.78;P值⩽ .001)、曾被告知感染丙型肝炎病毒(HCV;aPR = 0.72;95% CI:0.61-0.85;P值⩽ .001)和个人用药过量史(aPR = 0.81;95% CI = 0.73-0.90;P值⩽ .001):我们的研究分析了同时吸食海洛因和甲基苯丙胺的人所偏好的物质与各种行为和健康结果之间的关系。甲基苯丙胺偏好与较低的纳洛酮持有率、曾被告知感染丙型肝炎病毒以及既往用药过量史有关。这项研究强调,有必要为农村地区偏好甲基苯丙胺的人群提供有针对性的减低伤害服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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