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. 2017 Oct 3;12(1):42.
doi: 10.1186/s13011-017-0126-1.

History of medication-assisted treatment and its association with initiating others into injection drug use in San Diego, CA

Maria Luisa Mittal  1 , Devesh Vashishtha  1 , Shelly Sun  2 , Sonia Jain  2 , Jazmine Cuevas-Mota  1 , Richard Garfein  1 , Steffanie A Strathdee  1 , Dan Werb  3
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History of medication-assisted treatment and its association with initiating others into injection drug use in San Diego, CA

Maria Luisa Mittal et al. Subst Abuse Treat Prev Policy. .

Abstract

Background: Medication-assisted treatment (MAT) remains the gold standard for the treatment of opioid use disorder. MAT also reduces the frequency of injecting among people who inject drugs (PWID). Relatedly, data suggest that PWID play a key role in the initiation of others into drug injecting by exposing injecting practices to injection-naïve drug users. Our primary objective was to test whether a history of MAT enrollment is associated with a reduced odds of PWID providing injection initiation assistance.

Methods: Preventing Injecting by Modifying Existing Responses (PRIMER; NIDA DP2-DA040256-01), is a multi-site cohort study assessing the impact of socio-structural factors on the risk that PWID provide injection initiation assistance. Data were drawn from a participating cohort of PWID in San Diego, CA. The primary outcome was reporting ever providing injection initiation assistance; the primary predictor was reporting ever being enrolled in MAT. Logistic regression was used to model associations between MAT enrollment and ever initiating others into injecting while adjusting for potential confounders.

Results: Participants (n = 354) were predominantly male (n = 249, 70%). Thirty-eight percent (n = 135) of participants reported ever initiating others into injection drug use. In multivariate analysis, participants who reported a history of MAT enrollment had significantly decreased odds of ever providing injection initiation assistance (Adjusted Odds Ratio [AOR]: 0.62, 95% Confidence Interval [CI]: 0.39-0.99).

Conclusions: These preliminary findings suggest an association between MAT enrollment and a lower odds that male PWID report providing injection initiation assistance to injection-naïve drug users. Further research is needed to identify the pathways by which MAT enrollment may impact the risk that PWID initiate others into drug injecting.

Keywords: HCV prevention; HIV prevention; Injection initiation assistance; Methadone; Opioid agonist treatment; Opioid substitution therapy; People who inject drugs.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the research ethics board at the University of California San Diego Human Research Protection Program. All participants provided written informed consent for study participation.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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