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J Subst Abuse Treat. 2018 Apr;87:1-8. doi: 10.1016/j.jsat.2018.01.007. Epub 2018 Jan 11.

Concurrent drug injection during opioid agonist treatment among people who inject drugs in Ukraine.

Author information

1
ICF Alliance for Public Health, Kyiv, Ukraine; Yale University School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, CT, USA. Electronic address: makarenko.j@gmail.com.
2
ICF Alliance for Public Health, Kyiv, Ukraine; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
3
Yale University School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, CT, USA.
4
Ukrainian Institute on Public Health Policy, Kyiv, Ukraine.
5
Yale University School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, CT, USA; APT Foundation, New Haven, CT, USA.
6
ICF Alliance for Public Health, Kyiv, Ukraine.
7
Ukrainian Institute on Public Health Policy, Kyiv, Ukraine; Academy of Labor, Social Relations and Tourism, Kyiv, Ukraine.
8
Yale University School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, CT, USA; Yale University School of Public Health, Division of Epidemiology of Microbial Diseases, New Haven, CT, USA.

Abstract

Ongoing drug use during opioid agonist treatment (OAT) negatively affects treatment and health outcomes, and increases treatment dropout. This study aimed to examine correlates of concurrent illicit drug use among OAT patients in Ukraine. A random sample of 434 patients currently on OAT receiving buprenorphine (BMT) or methadone maintenance treatment (MMT) from five cities in Ukraine were assessed for factors associated with self-reported concurrent illicit drug use during OAT using a multivariable logistic regression. Among 434 OAT patients, 100 (23%) reported concurrent drug injecting in the previous 30 days; 28% of these were injecting ≥20 days. While 100 (100%) of these injected opioids, 24 (24%) injected stimulants; 40 (40%) met criteria for polysubstance use disorder that included opioids, stimulants and alcohol. Independent correlates of concurrent drug injection included: being on MMT vs. BMT (aOR = 2.8, 95%CI = 1.4-5.8), lower OAT dosage (aOR = 1.7, 95%CI = 1.1-2.7), more severe addiction severity (aOR = 2.3, 95%CI = 1.4-3.8), younger age of injection initiation (aOR = 2.3, 95%CI = 1.3-3.9), and presence of alcohol use disorder (aOR = 2.1, 95%CI = 1.3-3.5); participants living with parents were negatively associated with concurrent drug injection. Concurrent drug use was prevalent among OAT patients in Ukraine indicating the urgent needs for tailored interventions and changes in OAT program design and implementation. Results highlight the importance of prescribing an adequate OAT dosage, and discrepancies between MMT and BMT programs in Ukraine addressing needs of OAT patients with specific characteristics such as severe opioid and alcohol dependence.

KEYWORDS:

Concurrent drug injecting; Opioid agonist therapy; Ukraine

PMID:
29471921
PMCID:
PMC5826566
DOI:
10.1016/j.jsat.2018.01.007
[Indexed for MEDLINE]
Free PMC Article

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