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Risk of non-fatal overdose and polysubstance use in a longitudinal study with people who inject drugs in Tijuana, Mexico.
Rivera Saldana, Carlos D; Abramovitz, Daniela; Meacham, Meredith C; Gonzalez-Zuniga, Patricia; Rafful, Claudia; Rangel, Gudelia; Strathdee, Steffanie A; Cepeda, Javier.
Afiliação
  • Rivera Saldana CD; Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, USA.
  • Abramovitz D; School of Public Health, San Diego State University, San Diego, USA.
  • Meacham MC; Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, USA.
  • Gonzalez-Zuniga P; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, USA.
  • Rafful C; Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, USA.
  • Rangel G; Faculty of Psychology, National Autonomous University of Mexico, Mexico City, Mexico.
  • Strathdee SA; Global Mental Health Research Center, National Institute of Psychiatry, Mexico City, Mexico.
  • Cepeda J; Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada.
Drug Alcohol Rev ; 40(7): 1340-1348, 2021 11.
Article em En | MEDLINE | ID: mdl-34042226
INTRODUCTION: Among people who inject drugs (PWID), polysubstance use has been associated with fatal and non-fatal overdose (NFOD). However, the risk of overdose due to the cumulative number of various recently used drug types remains unexplored. We estimated the risk of NFOD for different polysubstance use categories among PWID in Tijuana, Mexico. METHODS: Data came from 661 participants followed for 2 years in Proyecto El Cuete-IV, an ongoing prospective cohort of PWID. A multivariable Cox model was used to assess the cumulative impact of polysubstance use on the time to NFOD. We used the Cochran-Armitage test to evaluate a dose-response relationship between number of polysubstance use categories and NFOD. RESULTS: We observed 115 NFOD among 1029.2 person-years of follow-up (incidence rate: 11.2 per 100 person-years; 95% confidence interval [CI] 9.3-13.3). Relative to those who used one drug class, the adjusted hazard ratio of NFOD for individuals reporting using two drug classes was 1.11 (95% CI 0.69-1.79), three drug classes was 2.00 (95% CI 1.16-3.44) and for those reporting three compared to two was 1.79 (95% CI 1.09-2.97). A significant Cochran-Armitage trend test (P < 0.001) suggested a dose-response relationship. DISCUSSION AND CONCLUSIONS: Polysubstance use was associated with increased risk of NFOD with a dose-response relationship over 2 years. We identified a subgroup of PWID at high risk of NFOD who reported concurrent use of opioids, stimulants and benzodiazepines. Prioritising tailored harm reduction and overdose prevention interventions for PWID who use multiple substances in Tijuana is needed.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Abuso de Substâncias por Via Intravenosa / Usuários de Drogas / Overdose de Drogas Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Humans País/Região como assunto: Mexico Idioma: En Revista: Drug Alcohol Rev Assunto da revista: TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Austrália
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Abuso de Substâncias por Via Intravenosa / Usuários de Drogas / Overdose de Drogas Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Humans País/Região como assunto: Mexico Idioma: En Revista: Drug Alcohol Rev Assunto da revista: TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Austrália