Use of withdrawal management services among people who use illicit drugs in Vancouver, Canada
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 d...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-07-01
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| Series: | Substance Abuse Treatment, Prevention, and Policy |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13011-018-0164-3 |
| _version_ | 1828346890215751680 |
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| author | Sharon Vipler Kanna Hayashi M.-J. Milloy Evan Wood Ekaterina Nosova Thomas Kerr Lianping Ti |
| author_facet | Sharon Vipler Kanna Hayashi M.-J. Milloy Evan Wood Ekaterina Nosova Thomas Kerr Lianping Ti |
| author_sort | Sharon Vipler |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-14T00:31:21Z |
| format | Article |
| id | doaj.art-c8561ad6efdd47ff965ebb414b173b21 |
| institution | Directory Open Access Journal |
| issn | 1747-597X |
| language | English |
| last_indexed | 2024-04-14T00:31:21Z |
| publishDate | 2018-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Substance Abuse Treatment, Prevention, and Policy |
| spelling | doaj.art-c8561ad6efdd47ff965ebb414b173b212022-12-22T02:22:31ZengBMCSubstance Abuse Treatment, Prevention, and Policy1747-597X2018-07-011311810.1186/s13011-018-0164-3Use of withdrawal management services among people who use illicit drugs in Vancouver, CanadaSharon Vipler0Kanna Hayashi1M.-J. Milloy2Evan Wood3Ekaterina Nosova4Thomas Kerr5Lianping Ti6BC Centre on Substance UseBC Centre on Substance UseBC Centre on Substance UseBC Centre on Substance UseBC Centre on Substance UseBC Centre on Substance UseBritish Columbia Centre for Excellence in HIV/AIDS, University of British Columbia, St. Paul’s HospitalAbstract 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.http://link.springer.com/article/10.1186/s13011-018-0164-3Detoxification servicesWithdrawal managementAddiction treatmentPeople who use illicit drugs |
| spellingShingle | Sharon Vipler Kanna Hayashi M.-J. Milloy Evan Wood Ekaterina Nosova Thomas Kerr Lianping Ti Use of withdrawal management services among people who use illicit drugs in Vancouver, Canada Substance Abuse Treatment, Prevention, and Policy Detoxification services Withdrawal management Addiction treatment People who use illicit drugs |
| title | Use of withdrawal management services among people who use illicit drugs in Vancouver, Canada |
| title_full | Use of withdrawal management services among people who use illicit drugs in Vancouver, Canada |
| title_fullStr | Use of withdrawal management services among people who use illicit drugs in Vancouver, Canada |
| title_full_unstemmed | Use of withdrawal management services among people who use illicit drugs in Vancouver, Canada |
| title_short | Use of withdrawal management services among people who use illicit drugs in Vancouver, Canada |
| title_sort | use of withdrawal management services among people who use illicit drugs in vancouver canada |
| topic | Detoxification services Withdrawal management Addiction treatment People who use illicit drugs |
| url | http://link.springer.com/article/10.1186/s13011-018-0164-3 |
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