Motivations for crystal methamphetamine-opioid co-injection/co-use amongst community-recruited people who inject drugs: a qualitative study

Palmer, Anna; Scott, Nick; Dietze, Paul; Higgs, Peter

doi:10.1186/s12954-020-00360-9

Cited by 60 publications

(44 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As a result of qualitative research with the SuperMIX cohort [29], in June 2017 questions related to co‐injection were added to the annual SuperMIX questionnaire, including the baseline assessment questionnaire for newly recruited participants and the follow‐up questionnaire for previously recruited participants. A cross‐sectional data sample from SuperMIX was extracted, including 537 baseline interviews from participants recruited after June 2017, and 316 most recent follow‐up interviews from previously recruited participants (total = 853 interviews, interview dates ranging from August 2017 to May 2019).…”

Section: Methodsmentioning

confidence: 99%

Prevalence and correlates of simultaneous, multiple substance injection (co‐injection) among people who inject drugs in Melbourne, Australia

et al. 2020

Self Cite

View full text Add to dashboard Cite

Aims To estimate the prevalence of and risk factors associated with concurrent injection of multiple substances (co‐injection) among a community‐recruited cohort of people who inject drugs. Design Cross‐sectional study. Setting Melbourne, Australia. Participants A sample of 720 actively injecting participants from the Melbourne Injecting Drug User Cohort Study (33% female) was extracted. Measurements We constructed two statistical models: a logistic regression model analysing correlates of co‐injection of any substance combination in the past month and a multinomial logistic regression model analysing correlates of three mutually exclusive groups: heroin–diphenhydramine co‐injection only, co‐injection of other substances and no co‐injection. Risk factors examined included drug use characteristics, demographic characteristics, health service use, hepatitis C status, injection risk behaviours and previous experience of non‐fatal overdose. Findings One‐third [n = 226, 31%; 95% confidence interval (CI): 28–34%] of participants reported co‐injecting substances within the past month, with equal numbers of participants reporting injecting combinations of heroin–diphenhydramine (n = 121, 54%; 95% CI = 48–60%) and heroin–methamphetamine (n = 121, 54%; 95% CI = 48–60%). In logistic regression analyses, reporting co‐injection of any substance combination was associated with male sex [adjusted odds ratio (aOR) = 1.80, 95% CI = 1.18–2.74, P = 0.006] and injecting daily or more frequently (aOR = 2.04, 95% CI = 1.31–3.18, P = 0.002). In multinomial logistic regression analyses, participants reporting heroin–diphenhydramine co‐injection only were significantly more likely to report groin injecting [adjusted relative risk ratio (aRRR) = 6.16, 95% CI = 2.80–13.56, P < 0.001] and overdose (requiring an ambulance) in the past 12 months (aRRR = 2.81, 95% CI = 1.17–6.72, P = 0.021) compared with participants reporting no co‐injection or co‐injection of other substances. Conclusions A substantial proportion of people who inject drugs report co‐injection of multiple substances, which is associated with a range of socio‐demographic, drug use and health service use risk factors.

show abstract

Section: Methodsmentioning

confidence: 99%

Prevalence and correlates of simultaneous, multiple substance injection (co‐injection) among people who inject drugs in Melbourne, Australia

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Importantly, many individuals who report current heroin use ‘also’ report concurrent methamphetamine use; there has been an increase in polysubstance use of opioids and amphetamines over the last few years, across the USA and globally ( Jones et al. , 2020 ; Palmer et al. , 2020 ).…”

Section: Part Ii: the Opioid Crisis Is Temporally (And Possibly Neurobiologically) Linked To Social Isolationmentioning

confidence: 99%

The role of social isolation in opioid addiction

Christie

2021

Social Cognitive and Affective Neuroscience

View full text Add to dashboard Cite

Humans are social animals: social isolation hurts people both psychologically and physically. Strong, positive social bonds help people to live longer and healthier lives compared with their more isolated peers. Opioid use disorder is associated with feelings of social isolation, an increased risk of suicide, and, at the community level, lower social capital. I propose a psychobiological mechanistic explanation that contributes to the association between opioid use and social isolation. The endogenous opioid system plays a central role in in the formation and maintenance of social bonds across the lifespan, and has been investigated primarily through the framework of the brain opioid theory of social attachment (BOTSA). In primates, maternal-infant bonding and social play are both impaired by administration of naltrexone (an opioid antagonist), and in humans the chronic use of opioids appears to be particularly (relative to other drugs) corrosive to close relationships. Social isolation may play a role in the development and exacerbation of opioid use disorder. Taken together, work on the brain’s opioid system suggests a possible mechanistic basis for bidirectional causal links between social isolation and opioid use disorder. Evaluation of this hypothesis would benefit from longitudinal psychosocial and neuropsychopharmacological investigations.

show abstract

“…A growing body of qualitative literature has described key reasons for methamphetamine use among people with OUD. These include a desire to attain a synergistic high, balance the two substances’ relative effects, or mitigate the risk of withdrawal or overdose [ 10 , 30 , 31 ]. Moreover, methamphetamine use has been described amongst people receiving MOUD in order to provide an alternative high to opioids and/or to mitigate sedating effects of MOUD [ 31 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

Use of methamphetamine and alcohol among people with opioid use disorder and HIV in Vietnam: a qualitative study

et al. 2021

View full text Add to dashboard Cite

Background Heroin use continues to drive HIV transmission in Vietnam, but methamphetamine and alcohol use are growing rapidly and, as in other countries, polysubstance use is widespread. The objective of this study was to understand the interplay between heroin, methamphetamine, and alcohol use among people with opioid use disorder (OUD) and HIV in Vietnam. Methods We conducted 44 in-depth, face-to-face qualitative interviews with people with OUD and HIV who participated in the BRAVO trial of buprenorphine versus methadone in five Vietnam HIV clinics. Interviews probed participants’ experiences of heroin, methamphetamine, and alcohol use and their interplay with HIV/OUD treatment. Interviews were professionally transcribed and analyzed using a thematic analysis approach. Results Of 44 participants interviewed 42 were male, on average 38.8 years of age, with 30 reporting a history of methamphetamine use and 33 reporting a history of alcohol use. Several themes emerged: 1) Methamphetamine and alcohol were perceived to have lower addiction potential than heroin 2) Social settings were key facilitators of alcohol and methamphetamine use 3) Some participants, but not all, used methamphetamine to help quit heroin 4) Consuming alcohol blunted the effects of heroin, while paradoxically serving as a catalyst for heroin use 5) Use of methamphetamine was perceived by many participants to be incompatible with treatment for HIV. Conclusions Participant experiences reflected a significant impact of polysubstance use on treatment of HIV and OUD. Patterns of polysubstance use are subject to common preconceptions of alcohol and methamphetamine as having a low addictive potential, and these substances are deeply enmeshed in the social life of many people with OUD in Vietnam. Interventions to address complex social norms and potential harms of polysubstance use are urgently needed as the population of people receiving medication for OUD (MOUD) increases in Vietnam and globally. Trial registration BRAVO - NCT01936857, September 2013.

show abstract

Motivations for crystal methamphetamine-opioid co-injection/co-use amongst community-recruited people who inject drugs: a qualitative study

Cited by 60 publications

References 23 publications

Prevalence and correlates of simultaneous, multiple substance injection (co‐injection) among people who inject drugs in Melbourne, Australia

Prevalence and correlates of simultaneous, multiple substance injection (co‐injection) among people who inject drugs in Melbourne, Australia

The role of social isolation in opioid addiction

Use of methamphetamine and alcohol among people with opioid use disorder and HIV in Vietnam: a qualitative study

Contact Info

Product

Resources

About