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Rate of methadone use among Aboriginal opioid injection drug users.
CMAJ. 2007 Jul 03; 177(1):37-40.CMAJ

Abstract

BACKGROUND

Previous studies have shown elevated rates of health-related harms among Aboriginal people who use injection drugs such as heroin. Methadone maintenance therapy is one of the most effective interventions to address the harms of heroin injection. We assessed the rate of methadone use in a cohort of opioid injection drug users in Vancouver and investigated whether methadone use was associated with Aboriginal ethnic background.

METHODS

Using data collected as part of the Vancouver Injection Drug Users Study (May 1996-November 2005), we evaluated whether Aboriginal ethnic background was associated with methadone use using generalized estimating equations and Cox regression analysis. We compared methadone use among Aboriginal and non-Aboriginal injection drug users at the time of enrollment and during the follow-up period, and we evaluated the time to first methadone use among people not using methadone at enrollment.

RESULTS

During the study period, 1603 injection drug users (435 Aboriginal, 1168 non-Aboriginal) were recruited. At enrollment, 54 (12.4%) Aboriginal participants used methadone compared with 247 (21.2%) non-Aboriginal participants (odds ratio [OR] 0.53, 95% confidence interval [CI] 0.38-0.73, p < 0.001). Among the 1351 (84.3%) participants who used heroin, Aboriginal people were less likely to use methadone throughout the follow-up period (adjusted OR 0.60, 95% CI 0.45-0.81, p < 0.001). Among people using heroin but who were not taking methadone at enrollment, Aboriginal ethnic background was associated with increased time to first methadone use (adjusted relative hazard 0.60, 95% CI 0.49-0.74, p < 0.001).

INTERPRETATION

Methadone use was lower among Aboriginal than among non-Aboriginal injection drug users. Culturally appropriate interventions with full participation of the affected community are required to address this disparity.

Authors+Show Affiliations

British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC. ewood@cfenet.ubc.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17606937

Citation

Wood, Evan, et al. "Rate of Methadone Use Among Aboriginal Opioid Injection Drug Users." CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, vol. 177, no. 1, 2007, pp. 37-40.
Wood E, Montaner JS, Li K, et al. Rate of methadone use among Aboriginal opioid injection drug users. CMAJ. 2007;177(1):37-40.
Wood, E., Montaner, J. S., Li, K., Barney, L., Tyndall, M. W., & Kerr, T. (2007). Rate of methadone use among Aboriginal opioid injection drug users. CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, 177(1), 37-40.
Wood E, et al. Rate of Methadone Use Among Aboriginal Opioid Injection Drug Users. CMAJ. 2007 Jul 3;177(1):37-40. PubMed PMID: 17606937.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rate of methadone use among Aboriginal opioid injection drug users. AU - Wood,Evan, AU - Montaner,Julio S, AU - Li,Kathy, AU - Barney,Lucy, AU - Tyndall,Mark W, AU - Kerr,Thomas, PY - 2007/7/4/pubmed PY - 2007/7/27/medline PY - 2007/7/4/entrez SP - 37 EP - 40 JF - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne JO - CMAJ VL - 177 IS - 1 N2 - BACKGROUND: Previous studies have shown elevated rates of health-related harms among Aboriginal people who use injection drugs such as heroin. Methadone maintenance therapy is one of the most effective interventions to address the harms of heroin injection. We assessed the rate of methadone use in a cohort of opioid injection drug users in Vancouver and investigated whether methadone use was associated with Aboriginal ethnic background. METHODS: Using data collected as part of the Vancouver Injection Drug Users Study (May 1996-November 2005), we evaluated whether Aboriginal ethnic background was associated with methadone use using generalized estimating equations and Cox regression analysis. We compared methadone use among Aboriginal and non-Aboriginal injection drug users at the time of enrollment and during the follow-up period, and we evaluated the time to first methadone use among people not using methadone at enrollment. RESULTS: During the study period, 1603 injection drug users (435 Aboriginal, 1168 non-Aboriginal) were recruited. At enrollment, 54 (12.4%) Aboriginal participants used methadone compared with 247 (21.2%) non-Aboriginal participants (odds ratio [OR] 0.53, 95% confidence interval [CI] 0.38-0.73, p < 0.001). Among the 1351 (84.3%) participants who used heroin, Aboriginal people were less likely to use methadone throughout the follow-up period (adjusted OR 0.60, 95% CI 0.45-0.81, p < 0.001). Among people using heroin but who were not taking methadone at enrollment, Aboriginal ethnic background was associated with increased time to first methadone use (adjusted relative hazard 0.60, 95% CI 0.49-0.74, p < 0.001). INTERPRETATION: Methadone use was lower among Aboriginal than among non-Aboriginal injection drug users. Culturally appropriate interventions with full participation of the affected community are required to address this disparity. SN - 1488-2329 UR - https://www.unboundmedicine.com/medline/citation/17606937/Rate_of_methadone_use_among_Aboriginal_opioid_injection_drug_users_ L2 - http://www.cmaj.ca/cgi/pmidlookup?view=long&amp;pmid=17606937 DB - PRIME DP - Unbound Medicine ER -