Examining Differences Among Opioid Agonist Treatment Clients in Regional and Metropolitan Settings of New South Wales, Australia

IF 1.9 4区医学 Q2 NURSING

Australian Journal of Rural Health Pub Date : 2025-03-19 DOI:10.1111/ajr.70029

Daniel T. Winter, Lauren A. Monds, Nicholas Lintzeris, Paul S. Haber, Carolyn A. Day

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引用次数: 0

Abstract

Objective

Whilst prior studies have examined characteristics and barriers for opioid agonist treatment (OAT) clients in regional settings, there are limited studies examining these differences in relation to metropolitan OAT clients. This study aimed to examine key characteristics, including sedating medication and substance use, transport and driving behaviours and differences between OAT clients within regional and metropolitan areas of New South Wales, Australia.

Design

Cross-sectional survey of OAT clients.

Setting

Fifteen public OAT clinics across New South Wales, Australia, between January 2020 and June 2021.

Participants

Survey was completed by 482 people currently receiving OAT.

Main Outcome Measures

Self-reported sample characteristics, self-reported sedating medication use and substance use, transportation and driving histories.

Results

Significant differences in OAT pharmacotherapies prescribed between regional and metropolitan participants were noted (aOR = 2.42, 95% CI = 1.42–4.11). Methadone was the most commonly prescribed OAT in both settings (74.1% and 54.4%, respectively). Nearly half (45.6%) of regional participants received OAT from a private dispensary compared to 4.7% in metropolitan areas. While few differences in past-month substance use were noted, reported heroin use was lower (aOR = 0.27; 95% CI = 0.09–0.78) in regional areas. Regional participants were more likely than metropolitan participants to drive a vehicle to dosing (aOR = 2.89, 95% CI = 1.12–7.46) and less likely to take public transport (aOR = 0.41, 95% CI = 0.18–0.93) or active transport (aOR = 3.75, 95% CI = 1.50–9.40). Few differences regarding driving offences, based on geography, were noted.

Conclusions

Key differences with treatment, substance use, transport and driving were noted within this study. It is evident that regional OAT clients more often rely on motor vehicles to complete daily activities. Such challenges related to OAT should be addressed by informed policy and regulatory changes that ensure access and equity of treatment and safety, regardless of location.

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检查在澳大利亚新南威尔士州地区和大都市设置阿片类激动剂治疗客户的差异

虽然先前的研究已经检查了区域设置中阿片受体激动剂治疗（OAT）客户的特征和障碍，但检查与大都市OAT客户相关的这些差异的研究有限。本研究旨在检查关键特征，包括镇静药物和物质使用，交通和驾驶行为以及澳大利亚新南威尔士州区域和大都市地区OAT客户之间的差异。设计OAT客户的横断面调查。2020年1月至2021年6月期间，在澳大利亚新南威尔士州设立15家公共OAT诊所。参与者调查由482名目前正在接受OAT的人完成。自我报告的样本特征，自我报告的镇静药物使用和物质使用，交通和驾驶历史。结果地区和城市参与者在OAT药物治疗处方上存在显著差异（aOR = 2.42, 95% CI = 1.42-4.11）。美沙酮是两种情况下最常用的OAT处方（分别为74.1%和54.4%）。近一半（45.6%）的地区参与者从私人药房接受OAT，而大都市地区的这一比例为4.7%。虽然过去一个月的物质使用差异不大，但报告的海洛因使用较低(aOR = 0.27；95% CI = 0.09-0.78)。地区参与者比大都市参与者更有可能开车去给药（aOR = 2.89, 95% CI = 1.12-7.46），而乘坐公共交通工具（aOR = 0.41, 95% CI = 0.18-0.93）或主动交通工具（aOR = 3.75, 95% CI = 1.50-9.40）的可能性更小。报告指出，不同地区的驾驶违法行为差异不大。结论：本研究注意到治疗、药物使用、交通和驾驶方面的主要差异。很明显，区域OAT客户更多地依赖机动车辆来完成日常活动。应通过明智的政策和监管改革来解决与OAT相关的这些挑战，以确保无论在何处都能获得公平的治疗和安全。

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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来源期刊

Australian Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

2.30

自引率

16.70%

发文量

122

审稿时长

12 months

期刊介绍： The Australian Journal of Rural Health publishes articles in the field of rural health. It facilitates the formation of interdisciplinary networks, so that rural health professionals can form a cohesive group and work together for the advancement of rural practice, in all health disciplines. The Journal aims to establish a national and international reputation for the quality of its scholarly discourse and its value to rural health professionals. All articles, unless otherwise identified, are peer reviewed by at least two researchers expert in the field of the submitted paper.