Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Hút thuốc được xác định là phương thức ưa thích trong việc sử dụng nguồn cung cấp an toàn opioid; nghiên cứu mối tương quan của sở thích hút thuốc thông qua một nghiên cứu cắt ngang năm 2021 tại British Columbia
Tóm tắt
Số lượng tử vong do độc tố thuốc phiện gia tăng ở British Columbia (BC) đã dẫn đến những kêu gọi về một nguồn cung cấp được kiểm soát (chất lượng dược phẩm) cho các chất ("nguồn cung an toàn"). Để cung cấp thông tin cho các khuyến nghị về nguồn cung an toàn, chúng tôi đã hướng đến xác định lý do tại sao mọi người hiện nay lại hút thuốc opioid và đánh giá chế độ tiêu thụ ưa thích nếu những người sử dụng opioid được cung cấp nguồn cung an toàn opioid. Khảo sát Khách hàng Giảm thiểu Tác hại BC (HRCS) là một cuộc khảo sát hàng năm thu thập thông tin về đặc điểm sử dụng chất của những người sử dụng ma túy (PWUD) với mục tiêu đóng góp vào chính sách dựa trên bằng chứng. Nghiên cứu này đã sử dụng dữ liệu từ HRCS năm 2021. Biến kết quả là "ưa thích hút thuốc nguồn cung an toàn opioid" (‘có/không’). Các biến giải thích bao gồm nhân khẩu học của người tham gia, sử dụng thuốc và đặc điểm quá liều. Các phân tích hồi quy logistic đa biến bivariate và phân cấp đã được thực hiện để xác định các yếu tố liên quan đến kết quả. Trong số 282 người tham gia tổng cộng đã cho thấy sự ưa thích về phương thức tiêu thụ cho nguồn cung an toàn opioid, 62.4% ưa thích lựa chọn hút và 19.9% ưa thích tiêm nếu được cung cấp nguồn cung an toàn opioid. Các biến có liên quan đáng kể đến kết quả (ưa thích hút thuốc) bao gồm: độ tuổi từ 19-29 (AOR=5.95, CI =1.93 – 18.31) so với >50 tuổi, đã chứng kiến một vụ quá liều trong 6 tháng qua (AOR=2.26, CI=1.20 – 4.28), đã hút thuốc opioid trong 3 ngày qua (AOR=6.35, CI=2.98 – 13.53) và ưa thích hút nguồn cung an toàn chất kích thích (AOR=5.04, CI=2.53 – 10.07). Chúng tôi nhận thấy hơn một nửa số người tham gia ưa thích các lựa chọn hút thuốc khi tiếp cận nguồn cung an toàn opioid. Hiện tại ở BC, có rất ít lựa chọn nguồn cung an toàn opioid dạng hút như là một sự thay thế cho nguồn cung chất độc hại trên đường phố. Để giảm thiểu các ca tử vong do quá liều, các lựa chọn nguồn cung an toàn nên được mở rộng để đáp ứng nhu cầu của PWUD ưa thích hút thuốc opioid.
Từ khóa
#British Columbia #opioid #nguồn cung an toàn #hút thuốc #sử dụng chất #giảm thiểu tác hạiTài liệu tham khảo
Drug Overdose Deaths in the US Top 100,000 Annually [Internet]. National Centre for Health Statistics; 2021 [cited 2022 Mar 20]. Available from: https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm.
Mattson CL, Tanz LJ, Quinn K, Kariisa M, Patel P, Davis NL. Trends and Geographic Patterns in Drug and Synthetic Opioid Overdose Deaths — United States, 2013–2019. MMWR. Morbidity and Mortality Weekly Report [Internet]. 2021 [cited 2022 Jul 11];70. Available from: https://www.cdc.gov/mmwr/volumes/70/wr/mm7006a4.htm.
Opioid- and Stimulant-related Harms in Canada Published: (June 2022) [Internet]. Public Health Agency of Canada: Special Advisory Committee on the Epidemic of Opioid Overdoses; 2022. Available from: https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants.
Health. Provincial health officer declares public health emergency | BC Gov News [Internet]. Government of British Columbia; 2016 [cited 2022 Jul 11]. Available from: https://news.gov.bc.ca/releases/2016HLTH0026-000568.
BC Coroners Service Death Review Panel: A Review of Illicit Drug Toxicity Deaths [Internet]. BC Coroners Service; 2022 [cited 2022 Mar 30]. Available from: https://www2.gov.bc.ca/assets/gov/birth-adoption-death-marriage-and-divorce/deaths/coroners-service/death-review-panel/review_of_illicit_drug_toxicity_deaths_2022.pdf.
Illicit Drug Toxicity Deaths in BC [Internet]. Ministry of Public Safety & Solicitor General; 2022 Jun [cited 2022 Jul 11]. Available from: https://www2.gov.bc.ca/assets/gov/birth-adoption-death-marriage-and-divorce/deaths/coroners-service/statistical/illicit-drug.pdf.
Kuo M. The BC Public Health Opioid Overdose Emergency [Internet]. BC Centre for Disease Control; 2017 Mar. Available from: http://www.bccdc.ca/resource-gallery/Documents/Educational%20Materials/Epid/Other/Public%20Surveillance%20Report_2017_03_17.pdf.
Illicit Drug Toxicity Type of Drug Data to April 30, 2022 [Internet]. British Columbia: Ministry of Public Safety and Solicitor General; 2022 Apr [cited 2022 Jul 20]. Available from: https://www2.gov.bc.ca/assets/gov/birth-adoption-death-marriage-and-divorce/deaths/coroners-service/statistical/illicit-drug-type.pdf.
Henry B. Provincial health officer notice [Internet]. Office of the Provincial Health Officer, Ministry of Health; 2020. Available from: https://www2.gov.bc.ca/assets/gov/health/about-bc-s-health-care-system/office-of-the-provincial-health-officer/reports-publications/pho-regional-event-notice.pdf.
Ahamad K, Bach P, Brar R, Chow N, Coll N, Compton M, et al. Risk Mitigation in the Context of Dual Public Health Emergencies [Internet]. BC Centre on Substance Use; 2022 Mar [cited 2022 Mar 30]. Available from: https://www.bccsu.ca/wp-content/uploads/2020/04/Risk-Mitigation-in-the-Context-of-Dual-Public-Health-Emergencies-v1.5.pdf.
Safe Supply Concept Document [Internet]. Canadian Association of People who Use Drugs; 2019 [cited 2022 Mar 20]. Available from: https://vancouver.ca/files/cov/capud-safe-supply-concept-document.pdf.
Access to Prescribed Safer Supply in British Columbia: Policy Direction [Internet]. Ministry of Mental Health and Addictions Ministry of Health; 2021 [cited 2022 Mar 20]. Available from: https://www2.gov.bc.ca/assets/gov/overdose-awareness/prescribed_safer_supply_in_bc.pdf.
Opioid Agonist Therapy [Internet]. Centre for Addiction and Mental Health; 2016 [cited 2022 Jul 11]. Available from: https://www.camh.ca/-/media/files/oat-info-for-clients.pdf.
B.C. Introduces New Prescribed Safer Supply Policy, a Canadian First | BC Gov News [Internet]. Ministry of Mental Health and Addictions; 2021 [cited 2022 Jul 11]. Available from: https://news.gov.bc.ca/releases/2021MMHA0035-001375.
PHS Community Services Society. PHS to Deliver Multi-Year Safe Supply Program | PHS Community Services Society [Internet]. PHS. 2021 [cited 2022 Jul 11]. Available from: https://www.phs.ca/phs-to-deliver-multi-year-safe-supply-program/.
Ranger C, Hobbs H, Cameron F, Stuart H, McCall J Sullivan G, et al. Co/Lab Practice Brief: Implementing the Victoria SAFER Initiative. [Internet] Canadian Institute for Substance Use Research; 2021 [cited 2022 Nov 12]. Available from: https://www.uvic.ca/research/centres/cisur/assets/docs/colab/practice-brief-safer.pdf.
Illicit Drug Toxicity Deaths in BC Knowledge Update: Mode of Consumption [Internet]. British Columbia: Ministry of Public Safety & Solicitor General; 2022 Feb. Available from: https://www2.gov.bc.ca/assets/gov/birth-adoption-death-marriage-and-divorce/deaths/coroners-service/statistical/mode-of-consumption.pdf.
S Parent K Papamihali B Graham BJA Examining Prevalence and Correlates of Smoking Opioids in British Columbia: Opioids Are More Often Smoked than Injected. Substance Abuse Treatment, Prevention, and Policy [Internet]. 2021 Oct 18 [cited 2022 Jul 11];16(1):79 Available from: https://doi.org/10.1186/s13011-021-00414-6.
STROBE Checklist: Cohort, Case-Control, and Cross-Sectional Studies (Combined) [Internet]. STROBE - Strengthening the Reporting of Observational Studies in Epidemiology. STROBE; [cited 2022 Jul 11]. Available from: https://www.strobe-statement.org/.
Harm reduction client survey [Internet]. BC Centre for Disease Control; [cited 2022 Jul 11]. Available from: http://www.bccdc.ca/health-professionals/data-reports/harm-reduction-client-survey.
Moustaqim-Barrette A, Papamihali K, Crabtree A, Graham B, Karamouzian M, Buxton JA. Correlates of Take-Home Naloxone Kit Possession among People Who Use Drugs in British Columbia: A Cross-Sectional Analysis. Drug and Alcohol Dependence [Internet]. 2019 Dec 1 [cited 2022 Jul 11];205:107609. Available from: https://www.sciencedirect.com/science/article/pii/S0376871619303862.
M Kuo A Shamsian D Tzemis BJAA Drug U Survey among Clients of Harm Reduction Sites across British Columbia, Canada, 2012. Harm Reduction Journal [Internet]. 2014 Apr 27 [cited 2022 Jul 11];11(1):13 Available from: https://doi.org/10.1186/1477-7517-11-13.
Papamihali K, Yoon M, Graham B, Karamouzian M, Slaunwhite AK, Tsang V, et al. Convenience and Comfort: Reasons Reported for Using Drugs Alone among Clients of Harm Reduction Sites in British Columbia, Canada [Internet]. 2020 [cited 2022 Jul 11]. Available from: https://open.library.ubc.ca/soa/cIRcle/collections/facultyresearchandpublications/52383/items/1.0395074.
Karamouzian M, Papamihali K, Graham B, Crabtree A, Mill C, Kuo M, et al. Known Fentanyl Use among Clients of Harm Reduction Sites in British Columbia, Canada. International Journal of Drug Policy [Internet]. 2020 Mar 1 [cited 2022 Jul 11];77:102665. Available from: https://www.sciencedirect.com/science/article/pii/S0955395920300062.
Population Centre and Rural Area Classification 2016 [Internet]. [cited 2022 Jul 11]. Available from: https://www.statcan.gc.ca/en/subjects/standard/pcrac/2016/introduction.
Government of Canada. Geosuite [Internet]. Statistics Canada; 2016 [cited 2022 Jul 11]. Available from: https://geosuite.statcan.gc.ca/geosuite/en/index.
Pruden H, Salway T. Meet the Methods series: “What and who is Two-Spirit?” in Health Research [Internet]. Two-Spirit Dry Lab. 2020 [cited 2022 Sep 17]. Available from: https://twospiritdrylab.ca/what-and-who-is-two-spirit/.
Payer DE, Young, MM, Maloney-Hall B, Mill C, Leclerc P, Buxton J, the Canadian Community Epidemiology Network on Drug Use, & the National Drug Checking Working Group. Adulterants, contaminants and co-occurring substances in drugs on the illegal market in Canada: An analysis of data from drug seizures, drug checking and urine toxicology [Internet]. Canadian Centre on Substance Use and Addiction. 2020 [cited 2022 Sep 17]. Available from: https://www.ccsa.ca/sites/default/files/2020-04/CCSA-CCENDU-Adulterants-Contaminants-Co-occurring-Substances-in-Drugs-Canada-Report-2020-en.pdf.
Zhang Z. Model Building Strategy for Logistic Regression: Purposeful Selection. Ann Transl Med [Internet]. 2016 Mar [cited 2022 Jul 11];4(6):111. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4828741/.
Kim HY. Statistical notes for clinical researchers: Chi-squared test and Fisher’s exact test. Restor Dent Endod [Internet]. 2017 May [cited 2022 Dec 31];42(2):152–5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5426219/.
Hirji KF, Tang ML. A Comparison of Tests for Trend. Communications in Statistics - Theory and Methods [Internet]. 1998 Jan 1 [cited 2022 Jul 11];27(4):943–63. Available from: https://doi.org/10.1080/03610929808832137.
Kim B. Hierarchical Linear Regression | University of Virginia Library Research Data Services + Sciences [Internet]. [cited 2022 Jul 11]. Available from: https://data.library.virginia.edu/hierarchical-linear-regression/.
Akaike H. Akaike’s Information Criterion. In: Lovric M, editor. International Encyclopedia of Statistical Science [Internet]. Berlin, Heidelberg: Springer; 2011 [cited 2022 Jul 11]. p. 25–25. Available from: https://doi.org/10.1007/978-3-642-04898-2_110.
Cohen J, Cohen P, West S, Aiken L. Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences [Internet]. 2003 [cited 2022 Jul 11]. Available from: https://www.routledge.com/Applied-Multiple-RegressionCorrelation-Analysis-for-the-Behavioral-Sciences/Cohen-Cohen-West-Aiken/p/book/9780805822236.
Hosmer DW, Lemeshow S, Sturdivant RX. Model-Building Strategies and Methods for Logistic Regression [Internet]. 1st ed. Wiley; 2013 [cited 2022 Jul 11]. (Applied Logistic Regression, Third Edition). Available from: https://doi.org/10.1002/9781118548387.
Collinearity diagnostics [Internet]. [cited 2022 Jul 11]. Available from: https://cran.r-project.org/web/packages/olsrr/vignettes/regression_diagnostics.html.
The R Project for Statistical Computing [Internet]. R. [cited 2022 Jul 11]. Available from: https://www.r-project.org/.
Harris J, Shorter GW, Davidson G, Best P. Risk Perception, Changing Social Context, and Norms Prevent Transition to Regular Injection among People Who Smoke Heroin. Drug and Alcohol Dependence [Internet]. 2020 Mar 1 [cited 2022 Jul 11];208:107878. Available from: https://www.sciencedirect.com/science/article/pii/S0376871620300430.
Kurz M, Min JE, Dale LM, Nosyk B. Assessing the Determinants of Completing OAT Induction and Long-Term Retention: A Population-Based Study in British Columbia, Canada. Journal of Substance Abuse Treatment [Internet]. 2022 Feb 1 [cited 2022 Jul 11];133:108647. Available from: https://www.sciencedirect.com/science/article/pii/S0740547221003731.
Nosyk B, Slaunwhite A, Urbanoski K, Hongdilokkul N, Palis H, Lock K, et al. Evaluation of Risk Mitigation Measures for People with Substance Use Disorders to Address the Dual Public Health Crises of COVID-19 and Overdose in British Columbia: A Mixed-Method Study Protocol. BMJ Open [Internet]. 2021 Jun 1 [cited 2022 Jul 11];11(6):e048353. Available from: https://bmjopen.bmj.com/content/11/6/e048353.
McMurchy D, Palmer H. Assessment of the Implementation of Safer Supply Pilot Projects. [Internet]. Health Canada; March 2022 [cited 2022 Nov 12]. Available from: https://www.nss-aps.ca/sites/default/files/resources/2022-03-safer_supply_preliminary_assessment_report_en_0.pdf.
Klaire S, Sutherland C, Kerr T, Kennedy MC. A low-barrier, flexible safe supply program to prevent deaths from overdose. CMAJ. 2022 May 16;194(19):E674–6. Available from: https://www.cmaj.ca/content/194/19/E674.
Ahamad K, Compton M, Dolman C, Fairbairn N, Foreman J, Gustafon R, et al. Guidance for Injectable Opioid Agonist Treatment for Opioid Use Disorder [Internet]. BC Centre on Substance Use; [cited 2022 Jul 11]. Available from: https://www.bccsu.ca/wp-content/uploads/2021/07/BC_iOAT_Guideline.pdf.
Weng J, Fairbairn N, Sutherland C, Johnson C, Nolan S. Supervised Tablet Injectable Opioid Agonist Therapy (TiOAT): A Strategy to Address Safer Supply for Individuals With an Opioid Use Disorder? J Addict Med. 2022 Jun 1;16(3):258–60. Available from: https://pubmed.ncbi.nlm.nih.gov/34145188/.
Top 15 Causes of Death [Internet]. BCCDC Mortality Context App. [cited 2022 Jul 11]. Available from: https://bccdc.shinyapps.io/Mortality_Context_ShinyApp/.
Unregulated Drug Poisoning Emergency Dashboard [Internet]. Tableau Software. [cited 2022 Sep 17]. Available from: https://public.tableau.com/views/UnregulatedDrugPoisoningEmergencyDashboard/Introduction?%3Adisplay_static_image=y&%3AbootstrapWhenNotified=true&%3Aembed=true&%3Alanguage=en-US&:embed=y&:showVizHome=n&:apiID=host0#navType=0&navSrc=Parse.
Bourque S, Pijl EM, Mason E, Manning J, Motz T. Supervised Inhalation Is an Important Part of Supervised Consumption Services. Can J Public Health [Internet]. 2019 Apr 1 [cited 2022 Jul 11];110(2):210–5. Available from: https://doi.org/10.17269/s41997-019-00180-w.