Smoking heroin with cannabis versus injecting heroin: unexpected impact on treatment outcomes

Autor: Nirvana Morgan, Ugasvaree Subramaney, William M. U. Daniels
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
medicine.medical_treatment
Health Status
Treatment outcome
030508 substance abuse
Medicine (miscellaneous)
Comorbidity
Heroin
0302 clinical medicine
Recurrence
Medicine
Substance Abuse
Intravenous
Rehabilitation
biology
Psychopathology
Heroin Dependence
lcsh:Public aspects of medicine
Treatment outcomes
Middle Aged
Psychiatry and Mental health
Health psychology
Treatment Outcome
Methods of heroin use
Female
Crime
0305 other medical science
Social Adjustment
medicine.drug
Adult
medicine.medical_specialty
Adolescent
Context (language use)
Marijuana Smoking
03 medical and health sciences
Young Adult
mental disorders
Humans
Psychiatry
Nyaope
Cannabis
Harm reduction
business.industry
Research
Public Health
Environmental and Occupational Health
lcsh:RA1-1270
biology.organism_classification
business
030217 neurology & neurosurgery
Follow-Up Studies
Zdroj: Harm Reduction Journal, Vol 16, Iss 1, Pp 1-9 (2019)
Harm Reduction Journal
ISSN: 1477-7517
Popis: Background In several countries, especially in Africa, the dominant method of heroin intake is smoking a joint of cannabis laced with heroin. There is no data exploring the impact of smoking heroin with cannabis on treatment outcomes. Aim To compare treatment outcomes between people who inject heroin and people who smoke heroin with cannabis. Methodology Three hundred heroin users were assessed on admission to inpatient rehabilitation and after treatment. We compared drug use, psychopathology, criminality, social functioning and general health between heroin injectors and heroin-cannabis smokers at treatment entry, and at 3 and 9 months after rehabilitation. Results The sample comprised 211 (70.3%) heroin-cannabis smokers and 89 (29.7%) heroin injectors. Eighty-four percent were followed up at 3 months and 75% at 9 months. At 9 months, heroin-cannabis smokers had a higher proportion of those who relapsed to heroin use compared with intravenous (IV) users (p = 0.036). The median number of heroin use episodes per day was lower for IV users than heroin-cannabis smokers at both follow-up points (p = 0.013 and 0.0019). A higher proportion of IV users was HIV positive (p = 0.002). There were no significant differences in psychopathology, general health, criminality and social functioning between IV users and heroin-cannabis smokers at all three time points. Conclusions Heroin users who do not inject drugs but use other routes of administration may have increased risk for relapse to heroin use after inpatient rehabilitation and should therefore have equal access to harm reduction treatment services. Advocating a transition from injecting to smoking heroin in an African context may pose unique challenges.
Databáze: OpenAIRE
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