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IF 3.9 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-02-12 DOI:10.1016/j.drugalcdep.2025.112591

William H. Eger , Dafna Paltin , Jacob D. Ross , Katie Bailey , Amanda V. Nguyen , Eli M. Solomon , Tyler S. Bartholomew , Benjamin H. Han , Angela R. Bazzi

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引用次数: 0

摘要

目标在全国范围内吸食阿片类药物和兴奋剂过量死亡人数不断上升的背景下，我们旨在评估南加州基于需求的注射器服务计划中纳洛酮的分配情况。方法利用 2024 年 1 月至 6 月的服务提供数据，我们检查了用于更安全吸烟的烟斗、无菌注射器和纳洛酮的分配情况。修正泊松回归估算了仅涉及烟斗、仅涉及注射器、同时涉及烟斗和注射器、既不涉及烟斗也不涉及注射器的情况下的流行率 (PR)，以及这些情况下是否包括纳洛酮。负二项回归研究了参与者获得的用品与他们在过去 14 天内使用纳洛酮应对的吸毒过量次数之间的关系。结果在 1260 次服务提供中，50% 只涉及管道，33% 涉及管道/注射器一起分发，11% 只涉及注射器，7% 既不涉及管道也不涉及注射器。总体而言，近一半（44%）的服务提供包括纳洛酮。与仅涉及管道分发的情况相比，仅涉及注射器分发（PR=1.41；95 % 置信区间 [CI]：1.12, 1.78）、管道/注射器合并分发（PR=1.90；95 % 置信区间：1.64, 2.20）和两者均不涉及（PR=2.39；95 % 置信区间：1.92, 2.99）的情况更有可能包含纳洛酮。供应类型与 14 天内涉及纳洛酮的用药过量反应率之间没有明显关系。结论在这种情况下，与其他类型的接触相比，涉及仅分发管道的减低伤害服务接触涉及纳洛酮的可能性较低。在从注射转向吸食不受管制物质的社区中，要遏制用药过量死亡，可能需要采取特定策略来促进纳洛酮的吸收。

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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Naloxone distribution amidst shifting drug use patterns: Insights from a needs-based syringe services program

Objective

In the context of rising overdose deaths among people smoking opioids and stimulants nationally, we aimed to evaluate naloxone distribution within a needs-based syringe services program in Southern California.

Methods

Using service delivery data spanning January–June 2024, we examined the distribution of pipes for safer smoking, sterile syringes, and naloxone. Modified Poisson regression estimated prevalence ratios (PRs) of encounters involving pipes only, syringes only, pipes and syringes together, and neither pipes nor syringes, and whether these encounters included naloxone. Negative binomial regression examined relationships between supplies acquired by participants and the number of overdoses to which they responded with naloxone in the past 14 days.

Results

Among 1260 service delivery encounters, 50 % involved pipes only, 33 % involved pipes/syringes distributed together, 11 % involved syringes only and 7 % involved neither pipes nor syringes. Overall, nearly half (44 %) of encounters included naloxone. Compared to encounters involving pipe-only distribution, encounters involving syringe-only distribution (PR=1.41; 95 % confidence interval [CI]: 1.12, 1.78), combined pipe/syringe distribution (PR=1.90; 95 % CI: 1.64, 2.20), and neither (PR=2.39; 95 % CI: 1.92, 2.99) were more likely to include naloxone. There was no significant relationship between supply type and the 14-day rate of overdose responses involving naloxone.

Conclusion

Harm reduction service delivery encounters involving pipe-only distribution were less likely to involve naloxone than other types of encounters in this setting. To curb overdose deaths in communities shifting from injecting to smoking unregulated substances, specific strategies may be needed to promote naloxone uptake.

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.