Abstract
BackgroundOur previous research has found low and stable mean drug treatment coverage among people who inject drugs (PWID) across 90 large US metropolitan statistical areas (MSAs) during 1993–2002. This manuscript updates previous estimates of change in drug treatment coverage for PWID in 90 MSAs during 1993–2007.MethodsOur drug treatment sample for calculating treatment coverage includes clients enrolled in residential or ambulatory inpatient/outpatient care, detoxification services, and methadone maintenance therapy at publicly- and privately-funded substance abuse agencies receiving public funds. Coverage was measured as the number of PWID in drug treatment, calculated by using data from the Substance Abuse and Mental Health Service Administration, divided by numbers of PWID in each MSA. We modeled change in drug treatment coverage rates using a negative binomial mixed-effects model. Fixed-effects included an intercept and a main effect for time. Incidence rate ratios (IRR) were calculated for both average change from 1993 to 2007 and MSA-specific estimates of change in coverage rates.ResultsOn average over all MSAs, coverage was low in 1993 (6.1%) and showed no improvement from 1993 to 2007 (IRR = 0.99; 95% CI, 0.86, 1.2). There was modest variability across MSAs in coverage in 1993 (log incidence rate SD = 0.36) as well as in coverage change from 1993 to 2007 (log IRR SD = 0.32). In addition, results indicate significant variability among MSAs in coverage.ConclusionsInadequate treatment coverage for PWID may produce a high cost to society in terms of the spread of overdose mortality and injection-related infectious diseases. A greater investment in treatment will likely be needed to have a substantial and more consistent impact on injection drug use-related harms. Future research should examine MSA-level predictors associated with variability in drug treatment coverage.
Highlights
In the United States, the misuse of and addiction to opioids – including prescription opioid analgesics, heroin, and synthetic opioids – is a serious national problem that affects public health as well as social and economic welfare [1,2,3,4,5]
In 2015, over 33,000 Americans died as a result of an opioid-related overdose, another 2.5 million people suffered from substance use disorders related to prescription opioid analgesics, heroin, and synthetic opioids [4, 6,7,8,9,10]
The cost of prescription opioids, combined with their shrinking availability, has led opioid users to the cheaper and more readily available alternative of heroin [4, 11,12,13,14]. This trend has led to a wave of new young heroin injectors, escalating the risk of Human immunodeficiency virus (HIV) and Hepatitis C virus (HCV) and drug-related mortality among this cohort [12, 13, 15,16,17,18]
Summary
In the United States, the misuse of and addiction to opioids – including prescription opioid analgesics, heroin, and synthetic opioids – is a serious national problem that affects public health as well as social and economic welfare [1,2,3,4,5]. The cost of prescription opioids, combined with their shrinking availability, has led opioid users to the cheaper and more readily available alternative of heroin [4, 11,12,13,14]. This trend has led to a wave of new young heroin injectors, escalating the risk of HIV and HCV and drug-related mortality among this cohort [12, 13, 15,16,17,18]. Our previous research has found low and stable mean drug treatment coverage among people who inject drugs (PWID) across 90 large US metropolitan statistical areas (MSAs) during 1993–2002. This manuscript updates previous estimates of change in drug treatment coverage for PWID in 90 MSAs during 1993–2007
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
