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Subst Abuse Treat Prev Policy. 2018 Jul 5;13(1):27. doi: 10.1186/s13011-018-0164-3.

Use of withdrawal management services among people who use illicit drugs in Vancouver, Canada.

Author information

1
BC Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.
2
Department of Family Practice, University of British Columbia, 320 - 5950 University Boulevard, Vancouver, BC, V6T 1Z6, Canada.
3
Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
4
Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
5
British Columbia Centre for Excellence in HIV/AIDS, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. mintti@cfenet.ubc.ca.
6
Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. mintti@cfenet.ubc.ca.

Abstract

BACKGROUND:

For many individuals with substance use disorders, the entry point for addiction treatment can be through withdrawal management (e.g. detoxification) services. However, little is known about the factors that predict withdrawal management service use among people who use illicit drugs (PWUD). Using data derived from two prospective cohorts of PWUD, we conducted a longitudinal data analysis of factors associated with use of withdrawal management services.

METHODS:

Individuals participating in two cohorts of PWUD were prospectively followed between December 2005 and May 2016 in Vancouver, Canada. Bivariate and multivariate generalized estimating equations were used to examine factors associated with use of withdrawal management services.

RESULTS:

Out of a total of 2001 participants, 339 (16.9%) individuals reported having been to a withdrawal management centre in the previous 6 months at some point during the study period. In multivariate analyses, male sex (adjusted odds ratio [AOR]: 1.62, 95% Confidence Interval [CI]: 1.17-2.24), homelessness (AOR: 1.86, 95% CI: 1.45-2.38), binge use of any substance (AOR: 1.34, 95% CI: 1.08-1.67), having attended a supervised injection facility (AOR: 1.66, 95% CI: 1.3-2.11), and having accessed other addiction medicine treatment or supports (other than withdrawal management services or opioid agonist therapy; AOR: 3.34, 95% CI: 2.64-4.22) were positively associated with having accessed withdrawal management services, whereas older age (AOR: 0.81, 95% CI: 0.7-0.94) was negatively associated with the outcome.

CONCLUSIONS:

This study identified specific factors associated with accessing withdrawal management services. Current evidence suggests a need to re-examine the provision of withdrawal management services. Consideration needs to be given to redesigning access to care and bridging to evidence-based addiction treatment, particularly for highly vulnerable subpopulations, identified in this study as females and older people.

KEYWORDS:

Addiction treatment; Detoxification services; People who use illicit drugs; Withdrawal management

PMID:
29976225
PMCID:
PMC6034285
DOI:
10.1186/s13011-018-0164-3
[Indexed for MEDLINE]
Free PMC Article

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