Prevalence and correlates of using opioids alone among individuals in a residential treatment program in Michigan: implications for overdose mortality prevention

Harm Reduction Journal

Research

Amy S. B. Bohnert¹  Jessica L. Maksut²  Becky L. Genberg²  Anne C. Fernandez³  Rachel E. Gicquelais⁴ 

[1] Department of Anesthesiology, University of Michigan, 2800 Plymouth Rd, 48109, Ann Arbor, MI, USA;Veterans Affairs Center for Clinical Management Research, 2215 Fuller Rd., 48105, Ann Arbor, MI, USA;Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, 21205, Baltimore, MD, USA;Department of Psychiatry, University of Michigan, 2800 Plymouth Rd, 48109, Ann Arbor, MI, USA;School of Nursing, University of Wisconsin–Madison, 4257 Signe Skott Cooper Hall, 701 Highland Avenue, 53705, Madison, WI, USA;

关键词: Opioids;    Overdose;    Harm reduction;    Stigma;    Using alone;    Polysubstance use;   

DOI  :  10.1186/s12954-022-00723-4

 received in 2022-07-31, accepted in 2022-11-23,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundAvoiding use of opioids while alone reduces overdose fatality risk; however, drug use-related stigma may be a barrier to consistently using opioids in the presence of others.MethodsWe described the frequency of using opioids while alone among 241 people reporting daily heroin use or non-prescribed use of opioid analgesic medications (OAMs) in the month before attending a substance use disorder treatment program in the Midwestern USA. We investigated drug use-related stigma as a correlate of using opioids while alone frequently (very often vs. less frequently or never) and examined overdose risk behaviors associated with using opioids while alone frequently, adjusted for sociodemographic and clinical characteristics.ResultsThe sample was a median age of 30 years, 34% female, 79% white, and nearly all (91%) had experienced an overdose. Approximately 63% had used OAMs and 70% used heroin while alone very often in the month before treatment. High levels of anticipated stigma were associated with using either opioid while alone very often (adjusted PR: 1.20, 95% CI: 1.04–1.38). Drinking alcohol and taking sedatives within two hours of OAMs very often (vs. less often or never) and using OAMs in a new setting very often (vs. less often or never) were associated with using OAMs while alone very often. Taking sedatives within two hours of using heroin and using heroin in a new setting very often (vs. less often or never) were associated with using heroin while alone very often.ConclusionAnticipated stigma, polysubstance use, and use in a new setting were associated with using opioids while alone. These findings highlight a need for enhanced overdose harm reduction options, such as overdose detection services that can initiate an overdose response if needed. Addressing stigmatizing behaviors in communities may reduce anticipated stigma and support engagement and trust in these services.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

Fig. 4