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Exploration of weekly variation in naloxone possession and carriage among people who use opioids in New York City before, during, and after the COVID-19 pandemic.
Roth, Alexis M; Ward, Kathleen M; Hensel, Devon J; Elliott, Luther; Bennett, Alex S.
Afiliación
  • Roth AM; Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA, United States of America.
  • Ward KM; Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA, United States of America.
  • Hensel DJ; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States of America.
  • Elliott L; Department of Sociology, Indiana University Indianapolis, Indianapolis, IN, United States of America.
  • Bennett AS; Center for Drug Use and HIV/HCV Research, New York University School of Global Public Health, New York, NY, United States of America.
PLoS One ; 19(7): e0307151, 2024.
Article en En | MEDLINE | ID: mdl-39024257
ABSTRACT

BACKGROUND:

Naloxone is critical for reversing opioid-related overdoses. However, there is a dearth of research examining how naloxone possession and carriage are impacted by time-varying individual and social determinants, and if this differed during the height of the COVID-related mitigation measures (e.g., shutdowns).

METHODS:

We utilized weekly ecological momentary assessments (EMA) to measure factors associated with naloxone possession and carriage among 40 people who use illicit opioids in New York City, for 24 months. Descriptive statistics were used to explore the frequency of weeks with consistent naloxone possession and carriage. Mixed effects binary and multivariable logistic regression was used to test for the impact of time-varying EMA- and baseline-level factors on each outcome.

RESULTS:

Approximately 70% of weekly EMAs were associated with consistent naloxone possession or carriage. In multivariable models, compared to during the height of the COVID-related shutdowns (March 12, 2020-May 19, 2021), the time before was associated with lower odds of consistent possession (Odds Ratio (OR) = 0.05, 95% Confidence Interval (CI) = 0.01-0.15) and consistent carriage (OR = 0.06, CI = 0.01-0.25). Additionally, being female (OR = 11.15, CI = 2.85-43.42), being White versus being Black or Hispanic/Latinx (OR = 8.05, CI = 1.96-33.06), and lifetime overdose (OR = 1.96, CI = 1.16-19.80) were associated with higher odds of consistent possession. Recent opioid injection (OR = 3.66, CI = 1.34-9.94), being female (OR = 7.91, CI = 3.91-8.23), and being White (OR = 5.77, CI = 1.35-24.55) were associated with higher odds of consistent carriage. Not wanting to be perceived as a drug user was reported in nearly one third (29.0%; 190/656) of EMAs where inconsistent possession was reported.

CONCLUSIONS:

Our findings paint a relatively positive picture of possession and carriage during COVID-related shutdowns, particularly among white and female participants, and highlight the importance of capturing time-varying factors to understand naloxone-related behavior. To curb growing disparities, outreach to equip Black and Hispanic/Latinx people with naloxone is needed as well as interventions to reduce stigma as a barrier to naloxone engagement.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: COVID-19 / Naloxona Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: COVID-19 / Naloxona Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos