Essiina Launonen1, Isla Wallace2, Elina Kotovirta3, Hannu Alho4, Kaarlo Simojoki5. 1. Clinicum, University of Helsinki and Helsinki University Hospital, P.O. Box 63, FI-00014 Helsinki University, Finland; University of Eastern Finland, School of Medicine, Faculty of Health Sciences, P.O. Box 1627, FI-70211 Kuopio, Finland. Electronic address: essiina.launonen@helsinki.fi. 2. Department of Applied Health Research, University College London, Torrington Place, London WC1E 7HB, UK. 3. Ministry of Social Affairs and Health, Department for Promotion of Welfare and Health, Unit for Harm Prevention, P.O. Box 33, FI-00023 Government, Finland. 4. Clinicum, University of Helsinki and Helsinki University Hospital, P.O. Box 63, FI-00014 Helsinki University, Finland; National Institute of Health and Welfare, Department of Mental and Substance Abuse Services, P.O. Box 30, FI-00271 Helsinki, Finland. 5. Clinicum, University of Helsinki and Helsinki University Hospital, P.O. Box 63, FI-00014 Helsinki University, Finland; A-Clinic Foundation, Maistraatinportti 2, 00240 Helsinki, Finland.
Abstract
BACKGROUND: The intravenous (IV) use of opioid maintenance treatment (OMT) medications and other intoxicating drugs among OMT patients is a challenge for many OMT units and affects treatment outcomes. The aim of this study is to examine factors associated with IV use of OMT medications and other intoxicating drugs among Finnish OMT patients. METHODS: A cross-sectional study was conducted among all Finnish OMT patients of whom 60% (n=1508) participated. The data were collected by anonymous questionnaire. Binominal regression analysis with unadjusted and adjusted ORs was conducted to evaluate predictors for IV use. FINDINGS: Factors associated with the injection of a patient's own OMT medication were: being treated with buprenorphine-naloxone (BNX) (OR 2.60, p=0.005) with a low dose (<9.0mg/day; OR 5.70, p<0.001) and being treated in a health-care centre (OR 2.03, p=0.029). Factors associated with the injection of illicit OMT medications were: being treated with BNX (OR 5.25, p<0.001) with a low dose (<9.0mg/day; OR 2.89, p=0.017), lack of psychosocial support (OR 2.62, p<0.001) and concurrent use of psychotropic medications from illicit sources (OR 4.28, p<0.001). Associated factors for the injection of other intoxicating drugs were: concurrent use of illicit drugs (OR 1.72, p=0.015), psychotropic medications from illicit sources (OR 4.78, p<0.001) and from a doctor (OR 1.93, p=0.004). CONCLUSIONS: More effort should be made to reduce concurrent injecting use during OMT. This may be done by addressing concurrent substance use orders more effectively, by ensuring that patients receive an optimal BNX dose and by providing more psychosocial support.
BACKGROUND: The intravenous (IV) use of opioid maintenance treatment (OMT) medications and other intoxicating drugs among OMTpatients is a challenge for many OMT units and affects treatment outcomes. The aim of this study is to examine factors associated with IV use of OMT medications and other intoxicating drugs among Finnish OMTpatients. METHODS: A cross-sectional study was conducted among all Finnish OMTpatients of whom 60% (n=1508) participated. The data were collected by anonymous questionnaire. Binominal regression analysis with unadjusted and adjusted ORs was conducted to evaluate predictors for IV use. FINDINGS: Factors associated with the injection of a patient's own OMT medication were: being treated with buprenorphine-naloxone (BNX) (OR 2.60, p=0.005) with a low dose (<9.0mg/day; OR 5.70, p<0.001) and being treated in a health-care centre (OR 2.03, p=0.029). Factors associated with the injection of illicit OMT medications were: being treated with BNX (OR 5.25, p<0.001) with a low dose (<9.0mg/day; OR 2.89, p=0.017), lack of psychosocial support (OR 2.62, p<0.001) and concurrent use of psychotropic medications from illicit sources (OR 4.28, p<0.001). Associated factors for the injection of other intoxicating drugs were: concurrent use of illicit drugs (OR 1.72, p=0.015), psychotropic medications from illicit sources (OR 4.78, p<0.001) and from a doctor (OR 1.93, p=0.004). CONCLUSIONS: More effort should be made to reduce concurrent injecting use during OMT. This may be done by addressing concurrent substance use orders more effectively, by ensuring that patients receive an optimal BNX dose and by providing more psychosocial support.
Authors: Tea Rosic; Leen Naji; Balpreet Panesar; Darren B Chai; Nitika Sanger; Brittany B Dennis; David C Marsh; Launette Rieb; Andrew Worster; Lehana Thabane; Zainab Samaan Journal: BMJ Open Date: 2021-01-12 Impact factor: 2.692