OBJECTIVE Opioid withdrawal symptoms are widely understood to contribute to health risk but have rarely been measured in community samples of opioid using people who inject drugs (PWID). METHODS Using targeted sampling methods, 814 PWID who reported regular opioid use (at least 12 uses in the last 30 days) were recruited and interviewed about demographics, drug use, health risk, and withdrawal symptoms, frequency, and pain. Multivariable regression models were developed to examine factors associated with any opioid withdrawal, withdrawal frequency, pain severity, and two important health risks (receptive syringe sharing and non-fatal overdose). RESULTS Opioid withdrawal symptoms were reported by 85 % of participants in the last 6 months, with 29 % reporting at least monthly withdrawal symptoms and 35 % reporting at least weekly withdrawal symptoms. Very or extremely painful symptoms were reported by 57 %. In separate models, we found any opioid withdrawal (adjusted odds ratio [AOR] = 2.75, 95 % confidence interval [CI] = 1.52, 5.00) and weekly or more opioid withdrawal frequency (AOR = 1.94; 95 % CI = 1.26, 3.00) (as compared to less than monthly) to be independently associated with receptive syringe sharing while controlling for confounders. Any opioid withdrawal (AOR = 1.71; 95 % CI = 1.04, 2.81) was independently associated with nonfatal overdose while controlling for confounders. In a separate model, weekly or more withdrawal frequency (AOR = 1.69; 95 % CI = 1.12, 2.55) and extreme or very painful withdrawal symptoms (AOR = 1.53; 95 % CI = 1.08, 2.16) were associated with nonfatal overdose as well. CONCLUSIONS Withdrawal symptoms among PWID increase health risk. Treatment of withdrawal symptoms is urgently needed and should include buprenorphine dispensing.

中文翻译：

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阿片类药物戒断症状，​​发作频率和疼痛特征与注射毒品者的健康风险相关。

目的阿片类药物戒断症状被广泛认为会导致健康风险，但很少有人使用注射药物（PWID）在阿片类药物社区样本中进行测量。方法采用有针对性的抽样方法，招募了814名PWID，他们报告了常规的阿片类药物的使用（过去30天内至少有12次使用），并就人口统计学，药物使用，健康风险以及戒断症状，​​频率和疼痛进行了访谈。开发了多变量回归模型以检查与任何阿片类药物停药，停药频率，疼痛严重程度和两个重要的健康风险（接受注射器共用和非致命过量）相关的因素。结果在过去6个月中，有85％的参与者报告了阿片类药物戒断症状，其中29％的人至少每月出现戒断症状，​​而35％的人至少每周出现戒断症状。据报告有57％的人出现非常或非常痛苦的症状。在单独的模型中，我们发现了任何阿片类药物停药（调整后的优势比[AOR] = 2.75，95％置信区间[CI] = 1.52，5.00）和每周或更多的阿片类药物停药频率（AOR = 1.94； 95％CI = 1.26，3.00 ）（与少于每月一次的费用相比）与接受性注射器共享独立关联，同时控制混杂因素。在控制混杂因素的同时，任何阿片类药物戒断（AOR = 1.71； 95％CI = 1.04，2.81）均与非致命性过量相关。在一个单独的模型中，每周或更高的戒断频率（AOR = 1.69; 95％CI = 1.12，2.55）和极端或非常痛苦的戒断症状（AOR = 1.53; 95％CI = 1.08，2。16）也与非致命性过量相关。结论PWID中的戒断症状会增加健康风险。迫切需要戒断症状的治疗，其中应包括丁丙诺啡分配。