Samantha Colledge1, Sarah Larney2, Raimondo Bruno3, Daisy Gibbs4, Louisa Degenhardt4, Wing See Yuen4, Paul Dietze5, Amy Peacock4. 1. National Drug and Alcohol Research Centre, 22-32 King st. Randwick, University of New South Wales Sydney, Sydney, Australia. Electronic address: s.colledge@student.unsw.edu.au. 2. Department of Family Medicine and Emergency Medicine, Université de Montréal and Centre de Recherche du CHUM, Canada. 3. School of Psychological Sciences, University of Tasmania, Australia. 4. National Drug and Alcohol Research Centre, 22-32 King st. Randwick, University of New South Wales Sydney, Sydney, Australia. 5. Behaviours and Health Risks Program, Burnet Institute, Australia.
Abstract
INTRODUCTION: People who inject drugs (PWID) commonly experience harms related to their injecting, many of which are consequences of modifiable drug use practices. There is currently a gap in our understanding of how certain injecting-related injuries and diseases (IRID) cluster together, and socio-demographic and drug use characteristics associated with more complex clinical profiles. METHOD: Surveys were conducted with 902 Australian PWID in 2019. Participants provided information regarding their drug use, and past month experience of the following IRID: artery injection, nerve damage, skin and soft tissue infection, thrombophlebitis, deep vein thrombosis, endocarditis, septic arthritis, osteomyelitis, and septicaemia. We performed a latent class analysis, grouping participants based on reported IRID and ran a class-weighted regression analysis to determine variables associated with class-membership. RESULTS: One-third (34 %) of the sample reported any IRID. A 3-class model identified: 1) no IRID (73 %), moderate IRID (21 %), and 3) high IRID (6%) clusters. Re-using one`s own needles was associated with belonging to the high IRID versus moderate IRID class (ARRR = 2.38; 95 % CI = 1.04-5.48). Other factors, including daily injecting and past 6-month mental health problems were associated with belonging to moderate and high IRID classes versus no IRID class. CONCLUSION: A meaningful proportion of PWID reported highly complex IRID presentations distinguished by the presence of thrombophlebitis and associated with greater re-use of needles. Increasing needle and syringe coverage remains critical in addressing the harms associated with injecting drug use and expanding the capacity of low-threshold services to address less severe presentations might aid in reducing IRID amongst PWID.
INTRODUCTION:People who inject drugs (PWID) commonly experience harms related to their injecting, many of which are consequences of modifiable drug use practices. There is currently a gap in our understanding of how certain injecting-related injuries and diseases (IRID) cluster together, and socio-demographic and drug use characteristics associated with more complex clinical profiles. METHOD: Surveys were conducted with 902 Australian PWID in 2019. Participants provided information regarding their drug use, and past month experience of the following IRID: artery injection, nerve damage, skin and soft tissue infection, thrombophlebitis, deep vein thrombosis, endocarditis, septic arthritis, osteomyelitis, and septicaemia. We performed a latent class analysis, grouping participants based on reported IRID and ran a class-weighted regression analysis to determine variables associated with class-membership. RESULTS: One-third (34 %) of the sample reported any IRID. A 3-class model identified: 1) no IRID (73 %), moderate IRID (21 %), and 3) high IRID (6%) clusters. Re-using one`s own needles was associated with belonging to the high IRID versus moderate IRID class (ARRR = 2.38; 95 % CI = 1.04-5.48). Other factors, including daily injecting and past 6-month mental health problems were associated with belonging to moderate and high IRID classes versus no IRID class. CONCLUSION: A meaningful proportion of PWID reported highly complex IRID presentations distinguished by the presence of thrombophlebitis and associated with greater re-use of needles. Increasing needle and syringe coverage remains critical in addressing the harms associated with injecting drug use and expanding the capacity of low-threshold services to address less severe presentations might aid in reducing IRID amongst PWID.
Keywords:
Abscess; Deep vein thrombosis; Injecting-related injuries and diseases; Intravenous drug use; Skin and soft tissue infections; Thrombophlebitis
Authors: Maximilian Meyer; Jean N Westenberg; Johannes Strasser; Kenneth M Dürsteler; Undine E Lang; Michael Krausz; Marc Vogel Journal: Harm Reduct J Date: 2022-06-07