Daily heroin injection and psychiatric disorders: A cross-sectional survey among People Who Inject Drugs (PWID) in Haiphong, Vietnam.

Adult Cross-Sectional Studies Female Heroin Heroin Dependence / diagnosis Humans Male Mental Disorders / diagnosis Middle Aged Substance Abuse, Intravenous / diagnosis Surveys and Questionnaires Vietnam / epidemiology

Depression Dual disorder Heroin Methamphetamine Psychosis

Journal

Drug and alcohol dependence

ISSN: 1879-0046

Titre abrégé: Drug Alcohol Depend

Pays: Ireland

ID NLM: 7513587

Informations de publication

Date de publication:
01 11 2020

Historique:

received: 04 07 2020

revised: 17 09 2020

accepted: 22 09 2020

pubmed: 11 10 2020

medline: 7 4 2021

entrez: 10 10 2020

Statut: ppublish

Résumé

Psychiatric comorbidities are frequent among people who inject drugs, they are associated with a poorer prognosis and need to be addressed. Their interaction with daily heroin injection requires clarification. A cross-sectional survey was conducted among PWID recruited in the city of Haiphong, Vietnam, by respondent-driven sampling. The inclusion criteria were age 18 or older and current injection drug use, verified by skin marks and positive urine tests for heroin or methamphetamine. Data on socio-demographic characteristics, drug use, sexual behaviour and access to treatment were collected using face-to-face questionnaires by trained interviewers. PWID were screened by trained psychiatrists for depression, psychotic disorder and suicidality, using the MINI questionnaire. 418 participants were included in the analyses. All were injected heroin users, 21 % were diagnosed with a current major depressive disorder, 15 % with a current psychotic disorder and 12 % presented a suicide risk. In the bivariate analyses, regular meth use, cannabis use and ketamine use were positively associated with presenting at least one psychiatric condition while daily heroin injection and being currently treated with methadone were negatively associated. In the multivariate model, poly-substance use was positively associated with depression (methamphetamine and drinking in addition to heroin) and psychotic disorder (methamphetamine and/or hazardous drinking in addition to heroin) while daily heroin injection and current methadone treatment were negatively and independently associated with depression and psychotic syndrome. Our survey confirms the burden of methamphetamine use and the protective effect of methadone but also a possible protective effect of daily heroin injection.

Sections du résumé

BACKGROUND

METHODS

A cross-sectional survey was conducted among PWID recruited in the city of Haiphong, Vietnam, by respondent-driven sampling. The inclusion criteria were age 18 or older and current injection drug use, verified by skin marks and positive urine tests for heroin or methamphetamine. Data on socio-demographic characteristics, drug use, sexual behaviour and access to treatment were collected using face-to-face questionnaires by trained interviewers. PWID were screened by trained psychiatrists for depression, psychotic disorder and suicidality, using the MINI questionnaire.

RESULTS

418 participants were included in the analyses. All were injected heroin users, 21 % were diagnosed with a current major depressive disorder, 15 % with a current psychotic disorder and 12 % presented a suicide risk. In the bivariate analyses, regular meth use, cannabis use and ketamine use were positively associated with presenting at least one psychiatric condition while daily heroin injection and being currently treated with methadone were negatively associated. In the multivariate model, poly-substance use was positively associated with depression (methamphetamine and drinking in addition to heroin) and psychotic disorder (methamphetamine and/or hazardous drinking in addition to heroin) while daily heroin injection and current methadone treatment were negatively and independently associated with depression and psychotic syndrome.

CONCLUSIONS

Our survey confirms the burden of methamphetamine use and the protective effect of methadone but also a possible protective effect of daily heroin injection.

Identifiants

DOI: 10.1016/j.drugalcdep.2020.108334 PMID: 33038638 PMC: PMC10290903

pubmed: 33038638

pii: S0376-8716(20)30499-3

doi: 10.1016/j.drugalcdep.2020.108334

pmc: PMC10290903

mid: NIHMS1634767

pii:

doi:

Substances chimiques

Heroin 70D95007SX

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Pagination

108334

Subventions

Organisme : NIDA NIH HHS

ID : R01 DA041978

Pays : United States

Informations de copyright

Références

J Addict Dis. 2008;27(3):49-65

pubmed: 18956529

Addiction. 2006 Sep;101 Suppl 1:76-88

pubmed: 16930163

Epidemiology. 2012 Jan;23(1):138-47

pubmed: 22157309

Aust N Z J Psychiatry. 2018 Jun;52(6):514-529

pubmed: 29338289

Ann Gen Psychiatry. 2011 May 15;10:17

pubmed: 21569624

Drug Alcohol Depend. 2020 Jul 1;212:108041

pubmed: 32470753

BMC Psychiatry. 2019 Mar 28;19(1):101

pubmed: 30922325

Eur Psychiatry. 1999 Nov;14(7):366-71

pubmed: 10683620

Biol Psychiatry. 2004 Nov 15;56(10):730-7

pubmed: 15556117

J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57

pubmed: 9881538

Int J Drug Policy. 2013 Nov;24(6):545-9

pubmed: 23910167

Psychol Med. 2003 Nov;33(8):1407-14

pubmed: 14672249

Harm Reduct J. 2019 Dec 26;16(1):74

pubmed: 31878934

Arch Intern Med. 1998 Sep 14;158(16):1789-95

pubmed: 9738608

Int J Drug Policy. 2016 Jun;32:50-6

pubmed: 27006257

J Psychoactive Drugs. 2018 Jul-Aug;50(3):214-223

pubmed: 29377788

Cochrane Database Syst Rev. 2011 Dec 07;(12):CD003410

pubmed: 22161378

Int J Methods Psychiatr Res. 2013 Mar;22(1):71-81

pubmed: 23494758

J Psychoactive Drugs. 2018 Nov-Dec;50(5):382-389

pubmed: 30183558

J Nerv Ment Dis. 2006 Nov;194(11):826-32

pubmed: 17102706

Am J Psychiatry. 2018 Oct 1;175(10):970-978

pubmed: 30068260

Int J Drug Policy. 2010 Sep;21(5):347-58

pubmed: 20117923

J Acquir Immune Defic Syndr. 2010 Feb;53 Suppl 1:S116-20

pubmed: 20104102

Am J Addict. 2012 Nov-Dec;21(6):531-5

pubmed: 23082831

Drug Alcohol Rev. 2008 May;27(3):253-62

pubmed: 18368606

Drug Alcohol Depend. 2010 Dec 1;112(3):209-15

pubmed: 20728288

Biol Psychiatry. 1985 Nov;20(11):1211-31

pubmed: 2996642

Arch Gen Psychiatry. 2007 May;64(5):566-76

pubmed: 17485608

Addiction. 2006 Oct;101(10):1473-8

pubmed: 16968349

J Clin Psychiatry. 2006 Jul;67(7):e01

pubmed: 17107226

Cochrane Database Syst Rev. 2002;(4):CD002209

pubmed: 12519570

Cochrane Database Syst Rev. 2008 Apr 16;(2):CD004145

pubmed: 18425898

Acta Neuropsychiatr. 2006 Feb;18(1):50-1

pubmed: 26991984

Lancet. 2012 Jan 21;379(9812):201-2

pubmed: 22008424

Drug Alcohol Depend. 2018 Apr 01;185:106-111

pubmed: 29432973

Int J Drug Policy. 2018 Dec;62:37-42

pubmed: 30359871

Drug Alcohol Depend. 2010 Sep 1;111(1-2):50-7

pubmed: 20510551

JAMA. 1990 Nov 21;264(19):2511-8

pubmed: 2232018

Biomed Res Int. 2018 Oct 4;2018:8346195

pubmed: 30402495

AIDS Behav. 2019 Mar;23(3):609-616

pubmed: 30357641

Drug Alcohol Rev. 2017 Jul;36(4):527-539

pubmed: 27786426

Drug Alcohol Depend. 2012 Dec 1;126(3):384-8

pubmed: 22728044

Lancet. 2007 Sep 15;370(9591):991-1005

pubmed: 17804058

AIDS Care. 2016 Oct;28(10):1312-5

pubmed: 27178119

Br J Psychiatry. 2007 Jul;191:55-62

pubmed: 17602126

J Nerv Ment Dis. 1988 May;176(5):257-63

pubmed: 3367140

New Dir Ment Health Serv. 1996 Summer;(70):93-105

pubmed: 8754233

Health Technol Assess. 2007 Mar;11(9):1-171, iii-iv

pubmed: 17313907

Drug Alcohol Depend. 2013 Jan 1;127(1-3):101-7

pubmed: 22789630

Addiction. 2010 Jun;105(6):991-1002

pubmed: 20659059

EClinicalMedicine. 2019 Oct 17;16:81-97

pubmed: 31832623

Am J Orthopsychiatry. 1996 Jan;66(1):17-31

pubmed: 8720638

Harm Reduct J. 2020 Feb 24;17(1):13

pubmed: 32093700

Eur Rev Med Pharmacol Sci. 2014;18(3):287-302

pubmed: 24563427

J Food Drug Anal. 2013 Dec;21(4):S42-S45

pubmed: 25278736

Curr Opin Psychiatry. 2012 May;25(3):213-8

pubmed: 22449767

Curr Opin Psychiatry. 2014 Jul;27(4):269-75

pubmed: 24852056

Drug Alcohol Depend. 2006 Jun 28;83(2):174-80

pubmed: 16343809

Lancet. 1999 Jan 16;353(9148):221-6

pubmed: 9923893

Cochrane Database Syst Rev. 2004;(3):CD002207

pubmed: 15266465

PLoS Med. 2019 Nov 26;16(11):e1002973

pubmed: 31770373

Drug Alcohol Depend. 2010 Aug 1;110(3):183-92

pubmed: 20430536

Drug Alcohol Depend. 2020 Feb 1;207:107793

pubmed: 31874449

Lancet Psychiatry. 2019 Dec;6(12):1068-1080

pubmed: 31630984

Curr Drug Abuse Rev. 2011 Dec;4(4):228-40

pubmed: 21999698

Int J Drug Policy. 2014 Jan;25(1):34-52

pubmed: 23973009

BMC Med Res Methodol. 2008 Feb 28;8:9

pubmed: 18307814

Arch Gen Psychiatry. 2007 Jul;64(7):830-42

pubmed: 17606817

BMJ. 2003 Aug 9;327(7410):310

pubmed: 12907482

Int J Drug Policy. 2014 Sep;25(5):897-904

pubmed: 24857185

Addiction. 2011 Sep;106(9):1647-55

pubmed: 21489005

Cochrane Database Syst Rev. 2010 Sep 08;(9):CD008373

pubmed: 20824876

Int J Drug Policy. 2016 Apr;30:99-106

pubmed: 26614737

Am J Psychiatry. 2002 Apr;159(4):620-9

pubmed: 11925301

Psychiatry Res. 2011 Apr 30;186(2-3):356-61

pubmed: 21055832

Psychopathology. 2010;43(2):88-95

pubmed: 20068379