在最近被监禁的注射吸毒者中，非致命性阿片类药物过量和未满足的阿片类药物使用障碍药物需求

IF 3.9 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-02-25 DOI:10.1016/j.drugalcdep.2025.112634

Valerie Madera-Garcia , Dita Broz , Amy R. Baugher , Rebecca B. Hershow , Sharoda Dasgupta , Alice Asher , Rose Hefferon , Nancy Worthington , Susan Cha , for the NHBS Study Group

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引用次数: 0

摘要

阿片类药物使用障碍（mod）的药物治疗是预防阿片类药物过量的关键。尽管最近被监禁的吸毒者中阿片类药物过量的风险很高，但这一人群仍然错过了参与mod治疗的机会。我们研究了最近被监禁的注射吸毒者（PWID）中未满足的mod需求与非致命性阿片类药物过量之间的关系，并通过选定的特征评估了非致命性阿片类药物过量的患病率。方法我们分析了来自美国20个大城市的PWID的国家艾滋病行为监测（NHBS）系统的2022年数据。计算调整患病率比（aPR）和95%置信区间（95% CI），以检查未满足的mod需求与非致命性阿片类药物过量之间的关系。结果在最近被监禁的1648名PWID中，28%的人报告在过去12个月内对mod的需求未得到满足，39%的人报告非致命性阿片类药物过量。在过去12个月内经历无家可归（aPR=1.43, 95% CI= 1.27-1.61）和生活在美国中西部地区（aPR=1.18, 95% CI= 1.01-1.38）与报告非致命性阿片类药物过量显着相关。在过去的12个月里，最近被监禁的未满足mod需求的PWID报告非致命性阿片类药物过量的可能性是1.4倍(50%；aPR=1.42, 95% CI= 1.29-1.56)，而近期监禁的PWID未满足mod需求（35%）。结论在过去12个月内被监禁的PWID患者中，mod需求与非致死性阿片类药物过量显著相关，提示有必要研究改善最近被监禁的PWID患者mod治疗的具体策略。

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Non-fatal opioid overdose and unmet need for medications for opioid use disorder among recently incarcerated people who inject drugs

Background

Medications for opioid use disorder (MOUD) are key to preventing opioid overdose. Despite the high risk of opioid overdose among recently incarcerated people who use drugs, missed opportunities for engagement in MOUD treatment persist in this population. We examined the association between unmet need for MOUD and non-fatal opioid overdose among recently incarcerated people who inject drugs (PWID) and assessed prevalence of non-fatal opioid overdose by selected characteristics.

Methods

We analyzed 2022 data from the National HIV Behavioral Surveillance (NHBS) system among PWID from 20 large U.S. cities. Adjusted prevalence ratios (aPR) and 95 % confidence intervals (95 % CI) were calculated to examine the association between unmet need for MOUD and non-fatal opioid overdose.

Results

Among 1648 recently incarcerated PWID, 28 % reported an unmet need for MOUD and 39 % reported a non-fatal opioid-involved overdose in the past 12 months. Experiencing homelessness in the last 12 months (aPR=1.43, 95 % CI=1.27–1.61) and living in the Midwest region of the U.S. (aPR=1.18, 95 % CI=1.01–1.38) were significantly associated with reporting a non-fatal opioid overdose. Recently incarcerated PWID with an unmet need for MOUD were 1.4 times as likely to report a non-fatal opioid overdose in the past 12 months (50 %; aPR=1.42, 95 % CI=1.29–1.56) compared with recently incarcerated PWID without an unmet need for MOUD (35 %).

Conclusions

Unmet need for MOUD was significantly associated with non-fatal opioid overdose among PWID who were incarcerated in the past 12 months, suggesting the need to investigate specific strategies to improve to MOUD treatment among recently incarcerated PWID.

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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.