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Assessing the impact of a temporary class drug order on ethylphenidate‐related infections among people who inject drugs in Lothian, Scotland: an interrupted time–series analysis
Author(s) -
Yeung Alan,
Weir Amanda,
Austin Hannah,
Morrison Kirsty,
Inverarity Donald,
Sherval Jim,
Henderson Naomi,
Joshi Shruti,
Ure Roisin,
McAuley Andrew
Publication year - 2017
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.13898
Subject(s) - medicine , outbreak , interrupted time series analysis , relative risk , streptococcus pyogenes , confidence interval , intervention (counseling) , epidemiology , staphylococcus aureus , virology , biology , psychiatry , statistics , mathematics , bacteria , genetics
Abstract Background and Aims In April 2015, the UK government enacted a temporary class drug order (TCDO) on ethylphenidate in response to reported harms associated with its use, in particular an outbreak of infections among people who inject drugs (PWID) in Lothian, Scotland. This study assesses the effect that the TCDO had on reducing the most common infections identified during the outbreak: Streptococcus pyogenes and Staphylococcus aureus . Design The outbreak was split into a pre‐intervention period (35 weeks) and a post‐intervention period (26 weeks) based around the date of the TCDO. Segmented negative binomial regression models were used to compare trends in weekly counts of infections between the pre‐ and post‐intervention periods. Setting and participants PWID in the Lothian region of Scotland. Measurements Cases of S. pyogenes and S. aureus infections reported within the National Health Service, Lothian. Findings There were 251 S. pyogenes and/or S. aureus infections recorded among 211 PWID between February 2014 and December 2015: 171 infections in the pre‐intervention period and 51 in the post‐intervention period. Significant trend changes in weekly S. pyogenes and/or S. aureus infections following the TCDO were found [relative risk (RR) = 0.88, 95% confidence interval (CI) = 0.82–0.94]. PWID who self‐reported using novel psychoactive substances (NPS) were at higher risk of acquiring these infections (RR = 1.81, 95% CI = 1.12–2.93), particularly when comparing the risk of infection with NPS use for a specific strain, S. pyogenes emm 76.0, against the risk of infection with NPS use for S. pyogenes ( emm types other than emm 76.0) (RR = 3.49, 95% CI = 1.32–9.21). Conclusions The UK government's 2015 temporary class drug order on ethylphenidate was effective in reducing infections among people who inject drugs during an outbreak situation in Lothian, Scotland.