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Erinoso O, Daugherty R, Kirk MR, Harding RW, Etchart H, Reyes A, Page K, Fiuty P, Wagner KD. Safety strategies and harm reduction for methamphetamine users in the era of fentanyl contamination: A qualitative analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 128:104456. [PMID: 38761461 DOI: 10.1016/j.drugpo.2024.104456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 05/09/2024] [Accepted: 05/09/2024] [Indexed: 05/20/2024]
Abstract
INTRODUCTION In the United States, methamphetamine use is increasing and the context of its use has changed, with reports of illicitly manufactured fentanyl being mixed with methamphetamine (either deliberately or inadvertently). We explore risk-mitigating actions taken by people who use drugs to protect their health when using methamphetamine in that context. METHODS We conducted qualitative interviews with 48 adults (18+) who used methamphetamine in the past three months at two sites in Nevada, USA and two sites in New Mexico, USA. Interviews were recorded, transcribed, and analyzed using thematic analysis. RESULTS Respondents described two rationales for employing harm reduction strategies. First, to prevent harm from methamphetamine containing illicit fentanyl, and second, to maintain their general wellbeing while using methamphetamine. Regarding methamphetamine containing illicit fentanyl, our findings highlight how respondents employ primary strategies like buying from trusted sources and secondary strategies such as spotting and selective use of harm reduction tools (i.e., fentanyl test strips) to reduce risks. To maintain their general wellbeing, participants reduced their use of methamphetamine as reasonably as possible, and used other substances like marijuana and alcohol alongside methamphetamine to counter the unwanted side effects of methamphetamine (i.e., hallucinations and paranoia). Use of these harm reduction strategies varied within situational and social contexts, and respondents usually developed these strategies based on their lived experiences. CONCLUSION Our findings uniquely demonstrate that people who use methamphetamine prioritize community driven, trust-based strategies within their social networks to mitigate risks in a fentanyl-contaminated drug environment. Additionally, our results indicate that harm reduction behaviors are influenced by multilevel risk environments, which include social, physical, economic, and political factors. Overall, these results highlight the potential for targeted interventions at the network level, which are responsive to complexities and shifts in drug market dynamics- such as illicit fentanyl in methamphetamine.
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Affiliation(s)
- Olufemi Erinoso
- Department of Health Behavior, Policy and Administration Sciences, School of Public Health, University of Nevada, Reno, United States
| | - Robbie Daugherty
- Department of Health Behavior, Policy and Administration Sciences, School of Public Health, University of Nevada, Reno, United States
| | - Mia R Kirk
- Department of Health Behavior, Policy and Administration Sciences, School of Public Health, University of Nevada, Reno, United States
| | - Robert W Harding
- Department of Health Behavior, Policy and Administration Sciences, School of Public Health, University of Nevada, Reno, United States
| | - Haley Etchart
- Department of Health Behavior, Policy and Administration Sciences, School of Public Health, University of Nevada, Reno, United States
| | - Andres Reyes
- Department of Internal Medicine, University of New Mexico Health Sciences, Albuquerque, NM, United States
| | - Kimberly Page
- Department of Internal Medicine, University of New Mexico Health Sciences, Albuquerque, NM, United States
| | - Phillip Fiuty
- New Mexico Health, Albuquerque, New Mexico, United States
| | - Karla D Wagner
- Department of Health Behavior, Policy and Administration Sciences, School of Public Health, University of Nevada, Reno, United States.
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Crossin R, Cleland L, Wilkins C, Rychert M, Adamson S, Potiki T, Pomerleau AC, MacDonald B, Faletanoai D, Hutton F, Noller G, Lambie I, Sheridan JL, George J, Mercier K, Maynard K, Leonard L, Walsh P, Ponton R, Bagshaw S, Muthukumaraswamy S, McIntosh T, Poot E, Gordon P, Sharry P, Nutt D, Boden J. The New Zealand drug harms ranking study: A multi-criteria decision analysis. J Psychopharmacol 2023; 37:891-903. [PMID: 37353972 PMCID: PMC10481626 DOI: 10.1177/02698811231182012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
AIMS The harms arising from psychoactive drug use are complex, and harm reduction strategies should be informed by a detailed understanding of the extent and nature of that harm. Drug harm is also context specific, and so any comprehensive assessment of drug harm should be relevant to the characteristics of the population in question. This study aimed to evaluate and rank drug harms within Aotearoa New Zealand using a multi-criteria decision analysis (MCDA) framework, and to separately consider harm within the total population, and among youth. METHODS Two facilitated workshops involved the separate ranking of harm for the total population, and then for youth aged 12-17, by two expert panels. In the total population workshop, 23 drugs were scored against 17 harm criteria, and those criteria were then evaluated using a swing weighting process. Scoring and weighting were subsequently updated during the youth-specific workshop. All results were recorded and analysed using specialised MCDA software. RESULTS When considering overall harm, the MCDA modelling results indicated that alcohol, methamphetamine and synthetic cannabinoids were the most harmful to both the overall population and the youth, followed by tobacco in the total population. Alcohol remained the most harmful drug for the total population when separately considering harm to those who use it, and harm to others. CONCLUSIONS The results provide detailed and context-specific insight into the harm associated with psychoactive drugs use within Aotearoa New Zealand. The findings also demonstrate the value of separately considering harm for different countries, and for different population subgroups.
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Affiliation(s)
- Rose Crossin
- Department of Population Health, University of Otago, Christchurch, New Zealand
| | - Lana Cleland
- Department of Population Health, University of Otago, Christchurch, New Zealand
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Chris Wilkins
- SHORE & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Marta Rychert
- SHORE & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Simon Adamson
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Tuari Potiki
- Office of Māori Development, University of Otago, Dunedin, New Zealand
| | - Adam C Pomerleau
- National Poisons Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Blair MacDonald
- National Drug Intelligence Bureau, New Zealand Police, Wellington, New Zealand
| | - Dwaine Faletanoai
- Pacific Mental Health and Addictions Services (Takanga a Fohe), Waitemata District Health Board, Takapuna, New Zealand
| | - Fiona Hutton
- Institute of Criminology, Victoria University of Wellington, Wellington, New Zealand
| | - Geoff Noller
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
- New Zealand Needle Exchange Programme, National Office, Christchurch, New Zealand
| | - Ian Lambie
- Department of Psychology, University of Auckland, Auckland, New Zealand
| | - Jane L Sheridan
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jason George
- New Zealand Needle Exchange Programme, National Office, Christchurch, New Zealand
| | - Kali Mercier
- New Zealand Drug Foundation, Wellington, New Zealand
| | | | - Louise Leonard
- Community and Other Drug Service, Waikato District Health Board, Waikato, New Zealand
| | | | - Rhys Ponton
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sue Bagshaw
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - Suresh Muthukumaraswamy
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tracey McIntosh
- School of Māori Studies and Pacific Studies, Faculty of Arts, University of Auckland, Auckland, New Zealand
- Ministry of Social Development, Wellington, New Zealand
| | | | | | - Patrick Sharry
- People and Decisions, Sydney, Australia
- Australian Graduate School of Management, University of New South Wales, Sydney, Australia
| | - David Nutt
- Centre for Neuropsychopharmacology, Imperial College, London, UK
| | - Joseph Boden
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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3
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Schumann JL, Sarkar R, Grbic M, Drummer OH, Gerostamoulos D, Iles L, Bassed R. Changing trends and characteristics of one punch deaths in Australia (2012-2018). Forensic Sci Int 2023; 345:111621. [PMID: 36878145 DOI: 10.1016/j.forsciint.2023.111621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 12/22/2022] [Accepted: 02/25/2023] [Indexed: 03/02/2023]
Abstract
One-punch assaults also known as 'coward punches', are characterised by a single severe blow to the head causing the victim to lose consciousness, resulting in a secondary impact between the head and surrounding environment. Such impacts may result in brain injury leading to fatality or permanent neurological impairment. In a previous publication, there were 90 one punch deaths around Australia between 2000 and 2012, mostly involving young men drinking alcohol at a licensed venue at the weekend. This prompted a surge of public education and awareness campaigns around Australia, in addition to regulatory and legislative changes aimed at curbing social violence. This retrospective descriptive study aimed to examine one punch deaths since 2012 in Australia to determine if there has been a decrease in deaths, and whether the demographics and circumstances of these deaths have changed. A search of the National Coronial Information System was undertaken for all closed coronial cases between 1 January 2012 and 31 December 2018. Additional information was collected from medicolegal reports including toxicology, pathology and coronial findings. There were 80 one punch fatalities in Australia, almost exclusively involving males. The median age was 43.5 (range 18-71) years and there was a decreasing trend in the number of deaths annually. Most fatal assaults occurred in the state of New South Wales (28.8%) followed by Queensland (23.8%), and in metropolitan locations (64.6%) rather than regional areas (35.4%). Alcohol was the most commonly detected drug, found in 47 cases of the 71 cases where toxicology results were available (66%), with a median concentration of 0.14 and 0.19 g/100 mL in antemortem and postmortem samples, respectively (range 0.005-0.32 g/100 mL). Five deaths reported methylamphetamine, with THC detected in 21.1% of cases. Assaults more commonly occurred on a footpath or roadside (41.3%), followed by a home or dwelling (32.5%). 8.8% of assaults occurred inside hotels, bars or other licenced venues. Most transpired on a weekday, which differed from the pre-2012 period when these assaults occurred mainly on the weekend. While some trends are positive, there has been a shift in the victim demographic as well as the typical environment for fatal one punch assaults, highlighting the importance of public health surveillance in providing a current evidence base to inform policy and practice.
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Affiliation(s)
- Jennifer L Schumann
- Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Monash University, Victoria, Australia; Monash Addiction Research Centre, Victoria, Australia.
| | - Reena Sarkar
- Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Monash University, Victoria, Australia
| | - Marko Grbic
- Victorian Institute of Forensic Medicine, Victoria, Australia
| | - Olaf H Drummer
- Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Monash University, Victoria, Australia
| | - Dimitri Gerostamoulos
- Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Monash University, Victoria, Australia
| | - Linda Iles
- Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Monash University, Victoria, Australia
| | - Richard Bassed
- Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Monash University, Victoria, Australia
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4
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Sunderland M, Kershaw S, Ward C, Bryant Z, Teesson L, Whittle R, Paton E, Charnley JL, Skehan J. Media reporting on alcohol and other drugs in Australia and the Mindframe guidelines: Baseline data. Drug Alcohol Rev 2023. [PMID: 36798029 DOI: 10.1111/dar.13622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/24/2022] [Accepted: 01/23/2023] [Indexed: 02/18/2023]
Abstract
INTRODUCTION The aim of this study was to generate a baseline database of print media reporting on alcohol and other drug (AOD) issues prior to the release of the Mindframe guidelines in March 2019. Specifically, to: (i) describe the content associated with media entries that focus on AOD use in Australian news media; (ii) determine how the media entries compare to several domains associated with recently developed Mindframe guidelines for publicly reporting on AOD; and (iii) identify content factors associated with different scores. METHODS Media entries between July 2016 and June 2017 were searched for key AOD-related terms using the Australian and New Zealand Newsstream database. Two coding schemes were developed to rate a stratified sample of 50% of the media entries against the Mindframe guidelines. Associations between content and total comparison scores were determined using linear regression models. RESULTS Detailed coding of the 2007 articles identified as relevant for the current study indicated that a majority (67%) were focused on one of three substances: alcohol, cannabis or methamphetamine. Most of the entries were either law enforcement (22%) or criminal justice related (19%). Entries that focused on methamphetamine scored significantly lower than entries on alcohol when compared to the Mindframe guidelines, similarly entries focused on crime/justice-related topics scored significantly lower than entries focused on positive outcomes. DISCUSSION AND CONCLUSIONS A disproportionate number of print media entries, particularly those related methamphetamine use, focused on crime or justice-related topics, potentially further contributing to stigma, and emphasising the legal consequences of AOD use.
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Affiliation(s)
- Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Stephanie Kershaw
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Caitlin Ward
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Zachary Bryant
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Lily Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Rebecca Whittle
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Elizabeth Paton
- Everymind, Hunter New England Health, Newcastle, Australia.,College of Human and Social Futures, University of Newcastle, Newcastle, Australia
| | - Janine L Charnley
- Everymind, Hunter New England Health, Newcastle, Australia.,College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Jaelea Skehan
- Everymind, Hunter New England Health, Newcastle, Australia.,College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
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Elison-Davies S, Newsome J, Jones A, Davies G, Ward J. Associations between psychosocial risk factors, and changes in substance dependence and psychosocial functioning, during engagement with digital cognitive behavioral therapy for methamphetamine use: use of 'Breaking Free from Substance Abuse' by incarcerated people during the COVID-19 pandemic. HEALTH & JUSTICE 2022; 10:28. [PMID: 36070026 PMCID: PMC9449936 DOI: 10.1186/s40352-022-00190-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/30/2022] [Indexed: 06/04/2023]
Abstract
BACKGROUND Methamphetamine use can be associated with involvement with correctional services and incarceration. Traditionally, treatments for methamphetamine use have been delivered in-person - however, lockdowns initiated during the COVID-19 pandemic significantly reduced access to such in-person support in prisons. Therefore, in May 2020 a digital cognitive-behavioral therapy (CBT) program for substance use disorders - 'Breaking Free from Substance Abuse' - was made available across prisons in Ohio in order to meet this treatment gap. This represents the first time this digital CBT intervention has been made widely available to incarcerated people residing in prisons or jails in the United States (US). This was a within-subjects study using data from 2187 Ohio prison residents who engaged with this digital CBT program to address their methamphetamine use. RESULTS Participants reported multiple psychosocial risk factors, including moderate to severe substance dependence, depression and anxiety; interpersonal conflict; aggressive behavior; paranoia; and difficulties with work, education and accommodation. Significant reductions in substance dependence, depression/anxiety and biopsychosocial impairment, and improvements in quality of life, were identified in the sample. Risk factors were associated with less positive outcomes, specifically interpersonal conflict and poor mental health. Completion of specific components of the program were associated with more positive outcomes - a dose response was also identified. CONCLUSIONS Digital CBT can be delivered in secure US correctional settings and may help to fill unmet needs for in-person treatment. Specifically, this digital CBT program may support incarcerated individuals to address methamphetamine use, with outcomes being associated with psychosocial risk factors and program engagement.
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Affiliation(s)
| | | | - Andrew Jones
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Glyn Davies
- LifeWorks, Manchester Science Park, Manchester, UK
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Yamamoto T, Kimura T, Tamakoshi A, Matsumoto T. Biennial Changes in the Characteristics of Patients with Methamphetamine Use Disorder in Japan from 2000 to 2020. J Psychoactive Drugs 2022:1-9. [PMID: 35894295 DOI: 10.1080/02791072.2022.2105181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Methamphetamine is an illegal drug with the greatest burdens in Japan. Social and medical measures to combat methamphetamine dependence have been implemented, but no reports on changes in the characteristics of methamphetamine use disorder patients have been conducted. We aimed to describe these changes, and provide information on the results of social and medical measures. We concatenated cross-sectional surveys from 2000 to 2020 and analyzed biennial changes. Twenty-year data from 2000 to 2018 were age-weighted according to the age structure in 2020. We performed Cochran-Armitage trend tests for crude and age-weighted changes in patient variables. There was an increase in the number of patients with methamphetamine use disorder undergoing treatment and those with a history of drug-related arrests. Patients who achieved 1-year abstinence increased, and those diagnosed with psychotic disorders decreased. Patients with a history of non-drug-related arrests and without revealing their source of methamphetamine decreased. The ages of the patient population increased, and patients with a history of benzodiazepine misuse increased. Social measures linking methamphetamine users to psychiatric care may increase the number of patients who undergo treatment.
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Affiliation(s)
- Taisuke Yamamoto
- Department of Public Health, Hokkaido University Graduate School of Medicine, Kita-ku, Japan.,Department of Drug Dependence Research, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Takashi Kimura
- Department of Public Health, Hokkaido University Graduate School of Medicine, Kita-ku, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Graduate School of Medicine, Kita-ku, Japan
| | - Toshihiko Matsumoto
- Department of Drug Dependence Research, National Center of Neurology and Psychiatry, Kodaira, Japan
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Hubená P, Horký P, Grabic R, Grabicová K, Douda K, Slavík O, Randák T. Prescribed aggression of fishes: Pharmaceuticals modify aggression in environmentally relevant concentrations. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 227:112944. [PMID: 34715502 DOI: 10.1016/j.ecoenv.2021.112944] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 06/13/2023]
Abstract
Traces of psychoactive substances have been found in freshwaters globally. Fish are chronically exposed to pollution at low concentrations. The changes of aggressive behaviour of chub (Squalius cephalus) were determined under the exposure to four psychoactive compounds (sertraline, citalopram, tramadol, methamphetamine) at environmentally relevant concentrations of 1 μg/L for 42 days. We tested whether (A) the behavioural effect of compounds varies within a single species; (B) there is a correlation between the individual brain concentration of the tested pollutants and fish aggression using the novel analysis of pollutants in brain; and (C) there is detectable threshold to effective pollutant concentration in brain. Behaviour and pollutant concentrations in brain were determined repeatedly (1st, 7th, 21st, 42nd and 56th days), including a two-week-long depuration period. The effect of particular compounds varied. Citalopram and methamphetamine generally increased the fish aggression, while no such effect was found after exposure to tramadol or sertraline. The longitudinal analysis showed an aggression increase after depuration, indicating the presence of withdrawal effects in methamphetamine- and tramadol-exposed fish. The analysis of pollutant concentration in brain revealed a positive linear relationship of citalopram concentration and aggression, while no such effect was detected for other compounds and/or their metabolites. Structural break analyses detected concentration thresholds of citalopram (1 and 3 ng/g) and sertraline (1000 ng/g) in brain tissue, from which a significant effect on behaviour was manifested. While the effect of sertraline was not detected using traditional approaches, there was a reduction in aggression after considering its threshold concentration in the brain. Our results suggest that pursuing the concentration threshold of psychoactive compounds can help to reduce false negative results and provide more realistic predictions on behavioural outcomes in freshwater environments, especially in the case of compounds with bioaccumulation potential such as sertraline.
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Affiliation(s)
- Pavla Hubená
- Czech University of Life Sciences Prague, Department of Zoology and Fisheries, Kamýcká 129, 165 00 Praha 6 - Suchdol, Czech Republic.
| | - Pavel Horký
- Czech University of Life Sciences Prague, Department of Zoology and Fisheries, Kamýcká 129, 165 00 Praha 6 - Suchdol, Czech Republic
| | - Roman Grabic
- University of South Bohemia in České Budějovice, Faculty of Fisheries and Protection of Waters, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, Zátiší 728/II, 398 25 Vodňany, Czech Republic
| | - Kateřina Grabicová
- University of South Bohemia in České Budějovice, Faculty of Fisheries and Protection of Waters, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, Zátiší 728/II, 398 25 Vodňany, Czech Republic
| | - Karel Douda
- Czech University of Life Sciences Prague, Department of Zoology and Fisheries, Kamýcká 129, 165 00 Praha 6 - Suchdol, Czech Republic
| | - Ondřej Slavík
- Czech University of Life Sciences Prague, Department of Zoology and Fisheries, Kamýcká 129, 165 00 Praha 6 - Suchdol, Czech Republic
| | - Tomáš Randák
- University of South Bohemia in České Budějovice, Faculty of Fisheries and Protection of Waters, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, Zátiší 728/II, 398 25 Vodňany, Czech Republic
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McKetin R, Sutherland R, Peacock A, Farrell M, Degenhardt L. Patterns of smoking and injecting methamphetamine and their association with health and social outcomes. Drug Alcohol Rev 2021; 40:1256-1265. [PMID: 34365687 PMCID: PMC9292494 DOI: 10.1111/dar.13364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/02/2021] [Accepted: 07/08/2021] [Indexed: 11/28/2022]
Abstract
Introduction We examine how smoking and injecting methamphetamine change over time and correlate with specific health and social outcomes. Methods Panel data from a longitudinal cohort dependent on methamphetamine (N = 444; 891 months). Random effects regression models examined the relationship between smoking and/or injecting methamphetamine and past month outcomes (substance use, ≥daily injection, needle/syringe sharing, psychological distress, poor mental and physical health, sexual behaviour, psychotic symptoms, violent behaviour and crime). Effects were adjusted for between‐group differences at baseline. Results At baseline, 56% of participants only injected methamphetamine in the past month, 18% only smoked and 26% both injected and smoked (concurrent injecting and smoking). Compared to injecting only, concurrent injecting and smoking was associated with more days of methamphetamine use (b = 1.3, P < 0.001; adjusted [A] b = 1.2, P < 0.001), more frequent injection [odds ratio (OR) 1.8, P = 0.013; adjusted OR (AOR) 1.6, P = 0.042], violent behaviour (OR 2.1, P = 0.001; AOR 1.8, P = 0.013] and crime (OR 3.1, P < 0.001; AOR 2.5, P < 0.001). Non‐injecting related outcomes did not differ significantly for only smoking versus only injecting. There was no significant transition from injecting methamphetamine at baseline to non‐injecting methamphetamine use at follow up, or from exclusively smoking methamphetamine at baseline to any methamphetamine injection at follow up. Discussion and Conclusion Efforts are needed to address heavier methamphetamine use, more frequent drug injection and elevated violent behaviour and crime among people who concurrently smoke and inject methamphetamine.
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Affiliation(s)
- Rebecca McKetin
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Rachel Sutherland
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
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9
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Kaye S, Lewandowski A, Bowman J, Doyle MF. Crystal methamphetamine use among young people entering custody: Prevalence, correlates and comorbidity. Drug Alcohol Rev 2020; 40:1266-1274. [PMID: 33155354 DOI: 10.1111/dar.13210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 09/28/2020] [Accepted: 10/07/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION AND AIMS Crystal methamphetamine (CM) is associated with a range of physical and mental health harms and may be of particular concern among young people at risk of early, problematic substance use, such as those in contact with the criminal justice system. This study aimed to investigate the prevalence and correlates of regular (i.e. at least weekly) CM use among young people preceding entry into custody. DESIGN AND METHODS Data were collected from 207 participants aged 14-18 years as part of the 2015 Young People in Custody Health Survey, a cross-sectional survey of youth in custody in New South Wales, Australia. Participants were administered face-to-face structured interviews assessing sociodemographic, childhood and family characteristics, offending history, substance use and psychopathology. Multivariable logistic regression analyses were conducted to identify factors independently associated with regular CM use. RESULTS Regular CM use was reported by 31% of participants and was independently associated with higher levels of antisocial traits/behaviour [adjusted odds ratio (AOR) 1.13, 95% confidence interval (CI) 1.02, 1.25], increased polydrug use (AOR 1.34, 95% CI 1.14, 1.58), injecting drug use (AOR 4.06, 95% CI 1.02, 16.16) and meeting symptom thresholds for two or more current psychological disorders (AOR 3.20, 95% CI 1.15, 8.94). DISCUSSION AND CONCLUSIONS Regular CM users present with more complex comorbidity than other young people in custody, increasing the health-care burden in custodial and community settings. Early identification and appropriate treatment of this comorbidity is crucial to improving the health, psychosocial and behavioural outcomes of this vulnerable group.
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Affiliation(s)
- Sharlene Kaye
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia.,National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Amy Lewandowski
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
| | - Julia Bowman
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia.,Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Michael F Doyle
- Centre of Research Excellence Indigenous Health and Alcohol, Sydney Medical School, University of Sydney, Sydney, Australia
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