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Differences in polysubstance use patterns and drug‐related outcomes between people who inject drugs receiving and not receiving opioid substitution therapies
Author(s) -
Betts Kim S.,
Chan Gary,
McIlwraith Fairlie,
Dietze Paul,
Whittaker Elizabeth,
Burns Lucy,
Alati Rosa
Publication year - 2016
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.13339
Subject(s) - polysubstance dependence , medicine , drug , odds ratio , confidence interval , drug class , substance abuse detection , substance abuse , psychiatry
Abstract Aims To test if polysubstance use profiles and drug‐related outcomes differ between those receiving and not receiving opioid substitution therapies (OST) among people who inject drugs (PWID). Design An annual cross‐sectional, sentinel sample of PWID across Australia. Setting Data came from 3 years (2011–13) of the Illicit Drug Reporting System (IDRS). Participants A total of 2673 participants who injected drugs from the combined national IDRS samples of 2011 ( n = 868), 2012 ( n = 922) and 2013 ( n = 883). Measurements Latent class analysis (LCA) was used to summarize participants' self‐reported use of 18 types of substances, with the resulting polysubstance use profiles then associated with participant experience of a number of drug‐related outcomes. Findings Polysubstance use profiles exhibiting a broad range of substance use were generally at increased risk of negative drug‐related outcomes, whether or not participants were receiving OST, including thrombosis among OST receivers [odds ratio (OR) = 2.13, 95% confidence intervals (CI) = 1.09–4.17], injecting with used needles among OST receivers and non‐receivers, respectively (OR = 2.78, 95% CI = 1.50–5.13; OR = 2.15, 95% CI = 1.34–3.45) and violent criminal offences among OST receivers and non‐receivers, respectively (OR =2.30, 95% CI = 1.16–4.58; OR = 1.87, 95% CI = 1.14–3.07). An important exception was non‐fatal overdose which was related specifically to a class of PWID who were not receiving OST and used morphine frequently (OR = 1.83, 95% CI = 1.06–3.17) Conclusion Regardless of opioid substitution therapies usage, people who inject drugs who use a broad‐range of substances experience greater levels of injecting‐related injuries and poorer health outcomes and are more likely to engage in criminal activity than other groups of people who inject drugs.