Trends and psychosocial correlates of same day polysubstance use among people who inject drugs in Australia, 2012-2022.

Injecting drug use Opioids Polysubstance use Psychosocial risk factors Stimulants

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:
02 Aug 2023
Historique:
received: 19 01 2023
revised: 17 07 2023
accepted: 25 07 2023
medline: 5 8 2023
pubmed: 5 8 2023
entrez: 4 8 2023
Statut: aheadofprint

Résumé

Polysubstance use is associated with negative health and social outcomes among people who inject drugs. We aimed to describe trends in polysubstance use and identify psychosocial correlates and associated drug use risk behaviours. We defined polysubstance use as intentional same day use of more than one of three drug classes: opioids, other non-opioid depressants (hereafter 'depressants'), and stimulants. We used 10 years (2012-2022, excluding 2020) of data from annual surveys in Australian capital cities with people who inject drugs (N=5657) to construct five mutually exclusive polysubstance use profiles: opioid-depressant, opioid-stimulant, stimulant-depressant, opioid-stimulant-depressant, and single drug class use. We examined time trends using the Mann Kendall test and identified correlates using multinomial logistic regression. Same day polysubstance use was relatively common among this sample (43.6%). Opioid-depressant use was the most frequent polysubstance use profile, but this decreased over the study period (32.6% to 13.3%, p<0.001). This aligned with observed decreases in use of pharmaceutical opioids (p<0.001), opioid agonist treatment (p=0.007), and benzodiazepines (p=0.001). There was no evidence for any trend in the other polysubstance use profiles, although single drug class use increased (51.9% to 64.7%, p=0.031). The different polysubstance use profiles were variously associated with psychosocial factors, including unstable housing and very high psychological distress, and other drug use risk behaviours, including non-fatal overdose, receptive and/or distributive needle sharing, and reusing one's own needles. Same day polysubstance use has remained relatively common among this sample over time, although the typology has changed. Collectively, our findings point to diverse drug use patterns among people who inject drugs and reiterate the need for a range of harm reduction, treatment, and support options.

Sections du résumé

BACKGROUND BACKGROUND
Polysubstance use is associated with negative health and social outcomes among people who inject drugs. We aimed to describe trends in polysubstance use and identify psychosocial correlates and associated drug use risk behaviours. We defined polysubstance use as intentional same day use of more than one of three drug classes: opioids, other non-opioid depressants (hereafter 'depressants'), and stimulants.
METHODS METHODS
We used 10 years (2012-2022, excluding 2020) of data from annual surveys in Australian capital cities with people who inject drugs (N=5657) to construct five mutually exclusive polysubstance use profiles: opioid-depressant, opioid-stimulant, stimulant-depressant, opioid-stimulant-depressant, and single drug class use. We examined time trends using the Mann Kendall test and identified correlates using multinomial logistic regression.
RESULTS RESULTS
Same day polysubstance use was relatively common among this sample (43.6%). Opioid-depressant use was the most frequent polysubstance use profile, but this decreased over the study period (32.6% to 13.3%, p<0.001). This aligned with observed decreases in use of pharmaceutical opioids (p<0.001), opioid agonist treatment (p=0.007), and benzodiazepines (p=0.001). There was no evidence for any trend in the other polysubstance use profiles, although single drug class use increased (51.9% to 64.7%, p=0.031). The different polysubstance use profiles were variously associated with psychosocial factors, including unstable housing and very high psychological distress, and other drug use risk behaviours, including non-fatal overdose, receptive and/or distributive needle sharing, and reusing one's own needles.
CONCLUSION CONCLUSIONS
Same day polysubstance use has remained relatively common among this sample over time, although the typology has changed. Collectively, our findings point to diverse drug use patterns among people who inject drugs and reiterate the need for a range of harm reduction, treatment, and support options.

Identifiants

DOI: 10.1016/j.drugpo.2023.104150 PMID: 37541925
pubmed: 37541925
pii: S0955-3959(23)00197-4
doi: 10.1016/j.drugpo.2023.104150
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

104150

Informations de copyright

Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest AP has received untied educational grant from Seqirus and Mundipharma for study of opioid medications. RB has received untied educational grant from Mundipharma and Indivior for study of opioid medications. All other authors have no conflicts of interest to declare.

Auteurs

Olivia Price (O)

National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia. Electronic address: o.price@unsw.edu.au.

Rachel Sutherland (R)

National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.

Nicola Man (N)

National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.

Raimondo Bruno (R)

National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; School of Psychological Sciences, University of Tasmania, Hobart, Australia.

Paul Dietze (P)

Behaviours and Health Risks, Burnet Institute, Melbourne, Australia; National Drug Research Institute, Curtin University, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne Australia.

Caroline Salom (C)

National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; Institute for Social Science Research, The University of Queensland, Brisbane, Australia.

Jane Akhurst (J)

National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.

Amy Peacock (A)

National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; School of Psychological Sciences, University of Tasmania, Hobart, Australia.

Classifications MeSH