Engagement in drug treatment following nonfatal overdose among people who inject drugs in Appalachia.


Journal

The International journal on drug policy
ISSN: 1873-4758
Titre abrégé: Int J Drug Policy
Pays: Netherlands
ID NLM: 9014759

Informations de publication

Date de publication:
07 2021
Historique:
received: 30 09 2020
revised: 03 02 2021
accepted: 13 02 2021
pubmed: 24 2 2021
medline: 11 8 2021
entrez: 23 2 2021
Statut: ppublish

Résumé

Immediately after experiencing a non-fatal overdose, many people who inject drugs (PWID) engage in harm-minimizing behavior change, including engagement in drug treatment. To inform the implementation of tailored interventions designed to facilitate drug treatment engagement in rural communities, we sought to identify correlates of starting any form of drug treatment after their most recent overdose among PWID who reside in a rural county in West Virginia. Data are from a PWID population estimation study in Cabell County, West Virginia. We used multivariable logistic regression to identify independent sociodemographic and substance use-related correlates of any form of drug treatment engagement after an overdose among 179 PWID who had overdosed in the past 6 months. One-third of our sample (33.0%) started any form of drug treatment in the 30 days following their most recent overdose. Factors associated with engaging in drug treatment included: recent buprenorphine or Suboxone injection (aOR: 2.39, 95% CI: 1.15, 4.96), someone calling 911 after their most recent overdose (aOR: 3.29, 95% CI: 1.63, 6.65), and older age (aOR per year of age: 0.95, 95% CI: 0.91, 0.99). Our results suggest that contact with emergency personnel after an overdose may represent an important opportunity to link PWID to drug treatment. The implementation of response teams trained in linking PWID to the services they require and helping persons navigate treatment systems maybe be a valuable intervention to reduce the harms of the opioid overdose crisis.

Sections du résumé

BACKGROUND
Immediately after experiencing a non-fatal overdose, many people who inject drugs (PWID) engage in harm-minimizing behavior change, including engagement in drug treatment. To inform the implementation of tailored interventions designed to facilitate drug treatment engagement in rural communities, we sought to identify correlates of starting any form of drug treatment after their most recent overdose among PWID who reside in a rural county in West Virginia.
METHODS
Data are from a PWID population estimation study in Cabell County, West Virginia. We used multivariable logistic regression to identify independent sociodemographic and substance use-related correlates of any form of drug treatment engagement after an overdose among 179 PWID who had overdosed in the past 6 months.
RESULTS
One-third of our sample (33.0%) started any form of drug treatment in the 30 days following their most recent overdose. Factors associated with engaging in drug treatment included: recent buprenorphine or Suboxone injection (aOR: 2.39, 95% CI: 1.15, 4.96), someone calling 911 after their most recent overdose (aOR: 3.29, 95% CI: 1.63, 6.65), and older age (aOR per year of age: 0.95, 95% CI: 0.91, 0.99).
CONCLUSIONS
Our results suggest that contact with emergency personnel after an overdose may represent an important opportunity to link PWID to drug treatment. The implementation of response teams trained in linking PWID to the services they require and helping persons navigate treatment systems maybe be a valuable intervention to reduce the harms of the opioid overdose crisis.

Identifiants

pubmed: 33621731
pii: S0955-3959(21)00074-8
doi: 10.1016/j.drugpo.2021.103176
pii:
doi:

Substances chimiques

Buprenorphine, Naloxone Drug Combination 0

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Pagination

103176

Subventions

Organisme : NIDA NIH HHS
ID : K01 DA046234
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI094189
Pays : United States

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declarations of Interest Dr. Susan G. Sherman is an expert witness for plaintiffs in opioid litigation. No other authors have competing interests to disclose.

Auteurs

Sean T Allen (ST)

Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. Electronic address: sallen63@jhu.edu.

Patrick T Wedlock (PT)

Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; Public Health Informatics, Computational, and Operations Research (PHICOR), City University of New York (CUNY) School of Public Health, New York City, NY 10027, USA.

Rebecca Hamilton White (RH)

Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.

Kristin E Schneider (KE)

Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.

Allison O'Rourke (A)

DC Center for AIDS Research, Department of Psychological & Brain Sciences at the George Washington University, 2125G St. NW, Washington, DC 20052, USA.

N Jia Ahmad (NJ)

Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.

Brian W Weir (BW)

Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.

Michael E Kilkenny (ME)

Cabell-Huntington Health Department, 703 7(th) Avenue, Huntington, WV 25701, USA.

Susan G Sherman (SG)

Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.

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